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The large intestine
| Main Anatomy Index | Gallbladder and biliary ducts
Last updated 30 March 2006
- The liver is a huge glandular organ belonging to the GI
- It is the largest gland in the body (about 2% of the body mass in adults).
- It is also the largest abdominal organ.
- The liver lies in the right hypochondrium, epigastrium, and left hypochondrium.
- In normal individuals, it should not be palpable below
the right costal margin.
- Its surfaces are in contact with the diaphragm and the anterior abdominal wall.
- The falciform ligament attaches the liver to both of
- In most living persons the liver is a soft reddish brown organ.
- Glisson's capsule surrounds the liver as a strong collective tissue.
- The liver receives venous blood returning from the GI tract through the portal vein.
- This venous blood is laden with the products of digestion, especially fats.
- In addition to its many metabolic activities, the liver is a storehouse for glycogen and
it secretes bile.
- Bile passes via the hepatic and cystic duct to the gall-bladder, where it is
concentrated by absorption of water.
Surfaces of the Liver
Surface of the Liver
- This is smooth and convex as it conforms to the cavity
of the inferior surface of the diaphragm.
- Although this surface fits into the dome of the diaphragm,
it is largely separated from the diaphragm by part of the peritoneal cavity called the subphrenic recess.
- The bare area is not separated from the diaphragm by
the peritoneal cavity.
- Here there is a thin layer of loose connective tissue.
- The diaphragm separates the superior part of the liver from the thoracic organs.
- The superior part of the liver is covered with peritoneum,
except posteriorly at the edge of the bare area.
- The IVC occupies a fossa in the left part of the bare area,
just to the right of the median plane.
The Visceral Surface of the
- This surface is directed inferiorly, posteriorly, and to the left.
- It is separated from the diaphragmatic surface
of the liver by the inferior border.
- Under cover of the visceral surface are:
- The superior right portion of the anterior
surface of the stomach;
- The superior part of the duodenum;
- The lesser omentum;
- The gall-bladder;
- The right colic flexure;
- Many associated vessels and nerves.
- The visceral surface of the liver has an H-shaped group of deep fissures and fossae.
- The crossbar of the H is the porta hepatis, a deep transverse fissure, about 5 cm long.
- It contains the portal vein, hepatic
artery proper, hepatic nerve plexus, hepatic ducts, and lymphatic
- The left sagittal limbs of the H are deep
fissures containing the ligamentum teres and
the ligamentum venosum.
- The right sagittal limbs of the H are fossae for the gallbladder and
Lobes of the Liver
- Functionally, the liver is divided into two lobes, the left and right lobes.
- This is by a plane that passes through the gallbladder fossa and fossa
for the IVC.
The Right Lobe of the Liver
- The functional right lobe is demarcated by: on the
visceral surface, the gallbladder fossa and the fossa for the IVC; on the diaphragmatic surface, by an
imaginary line that runs from the fundus of the gallbladder
to the IVC.
The Caudate Lobe of the Liver
- This lobe lies between the fissure for the ligamentum venosum
and the fossa for the IVC.
- It is functionally part of the left lobe.
- It is bounded inferiorly by the porta
- On the right, the caudate lobe has a small, tail-like caudate process (L. cauda,
- This process separates the portal vein from the IVC and forms a bridge to the right
The Quadrate Lobe of the Liver
- This lobe is four-sided (L. quadri, four).
- It lies between the fissure for ligamentum teres and the gallbladder
- It is bounded posteriorly by the porta
- Most of it is functionally part of the left lobe.
- The part of the inferior border of the liver between the notch for
the ligamentum teres and the gallbladder
is formed by the quadrate lobe.
The Left Lobe of the Liver
Attachments of the Liver (Ashwell, Lecture Notes, 1998)
- This is the obliterated left umbilical vein, connecting
the left branch of the portal vein to the umbilicus.
- This ligament runs in the free
edge of the falciform ligament and in a
groove named after it in the visceral surface of the
- The left umbilical vein is of great importance as it carried all the blood from the
placenta to the foetus.
- This is a fold of peritoneum, which connects the liver to
the diaphragm and supraumbilical part of the anterior abdominal wall.
- It is attached to the anterior and superior surface of
the liver and to the notch for the ligamentum teres.
- It contains the small paraumbilical veins and the ligamentum teres in its free edge.
- Its left layer continues as the anterior
layer of the left triangular ligament.
- Its right layer continues as the upper layer of the coronary ligament.
- The line of attachment of the falciform ligament
(together with the grooves for the ligamentum venosum and teres) is said to the divide the left and right lobes.
- This is a reflection of peritoneum
form the diaphragm to the liver's superior and posterior surfaces.
- It has upper and lower layers,
which are continuous at the right as the right triangular ligament and enclose
the bare area of the liver.
- To the left, the upper layer becomes the right layer of the falciform,
while the lower layer becomes the posterior layer of the left triangular ligament.
- The lower layer of the coronary ligament may reflect
onto the upper pole of the right kidney (as the hepatorenal ligament) instead of the diaphragm.
Left triangular ligament
- This is formed from the left layer of the falciform and lower layer of the coronary as they meet at the left.
Right triangular ligament
- This lesser omentum connects the liver to
the stomach and the 1st part of the duodenum.
- It inserts along the groove for the ligamentum venosum
and encircles the porta hepatis.
- The groove for the ligamentum venosum contains the
obliterated remnant of the ductus venosus, which in
foetal life connected the left branch of the portal vein
to the IVC, or the left hepatic vein, just before it
enters the IVC.
Arterial Supply to the Liver
- The liver has a double blood supply from the hepatic artery (30%) and the portal
- The right and left hepatic arteries carry oxygenated blood while the portal
vein carry products of digestion absorbed from the GI
- The arterial blood is conducted to the central vein of
each liver lobule.
Common Hepatic Artery
- This arises from the coeliac trunk and passes anteriorly to the right in the posterior
wall of the omental bursa.
- It runs inferior to the omental foramen to reach the superior part of the duodenum.
- After giving off the gastroduodenal artery, it passes
between the layers of the lesser omentum as
the hepatic artery proper.
- This artery ascends anterior in the free edge of the lesser omentum, anterior to
the portal vein and to the left
of the bile duct.
- Near the portal hepatis, the hepatic artery proper
divides into the left and right hepatic arteries.
The Portal Vein
- This is formed posterior to the neck of the pancreas by
the union of the superior mesenteric vein and the splenic vein.
- It runs in the free right edge of the lesser omentum, posterior
to the bile duct and hepatic artery, and anterior to the omental foramen.
- At the right end of the porta hepatis, the portal vein
divides into left and right branches, each supplying about 1/2 of the liver.
Venous Drainage of
- The hepatic veins draining the blood from the liver are
formed by the union of the central veins of the liver
- The hepatic veins empty into the IVC just inferior to the diaphragm.
- There are superior and inferior
groups of veins.
- The superior group may consist only of right and left veins, though there is usually a middle vein from the caudate lobe.
- The inferior group consists of 6
to 18 small veins, which drain the blood from the right lobe, including part of the caudate lobe.
of the Liver
- Most of the deep lymph vessels from the liver converge
at the porta hepatis and end in the hepatic
- These are scattered along the hepatic vessels and ducts in the lesser omentum.
- Efferent vessels from the hepatic lymph nodes drain
into the coeliac lymph nodes and from then to the thoracic duct.
- Some of the deep lymph vessels follow the hepatic veins to the vena caval foramen of the diaphragm.
- These end in the middle group of phrenic lymph nodes
and from there to the parasternal lymph nodes.
- Most superficial lymph vessels from the liver join the
lymph vessels at the porta hepatis and to the hepatic lymph nodes.
- Lymph vessels from the bare area pass through the diaphragm and enter the phrenic
and mediastinal lymph nodes.
Innervation of the Liver
- The nerves to the liver contain both sympathetic and parasympathetic fibres.
- These nerves reach the liver via the hepatic plexus,
the largest derivation of the coeliac plexus, which also
receives filaments from the left and right vagus and right phrenic nerves.
- The hepatic plexus of nerves accompanies the hepatic artery
and portal vein and their branches and enter the liver at
the porta hepatis.