LIVER

DR LEONG SOOK SAM

CONTENT
 General Anatomy
 Ligaments
 Circulation

 Couinaud Classification of hepatic segments

 Ultrasound image evaluation
GENERAL ANATOMY

 Biggest organ in the abdomen

 Location: Right upper quadrant,
rarely the left lobe extends
beyond midline to the left
LIGAMENT

 Glisson’s capsule  Round ligament (ligamentum

 surrounds entire liver teres)
 Hepatoduodenal ligament  obliterated umbilical veins

 Falciform ligament  Coronary ligament

 conducts umbilical vein  Left triangular ligament

 Ligamentum venosum  Right triangular ligament

 obliterated ductus venosis

Lig Venosum
HEPATIC CIRCULATION

 Portal vein (PV)

 Main PV enters the liver at the portal hepatiis
 Divided into right PV and left PV
 Becomes intersegmental veins:
 medial and lateral portion of the left lobe,
 anterior and posterior portion of the right lobe
 Carries deoxygenated venous blood (nutrients and toxins from
digested contents) from gastrointestinal (GI) tract, gallbladder (GB),
pancreas and spleen to the liver
PORTAL VEIN

Phasic
Hepatopetal flow
HEPATIC CIRCULATION (CONT)

 Common hepatic artery (HA) - Arterial circulation

 supplies oxygenated blood to the liver, pylorus of the stomach,
duodenum, pancreas, and gallbladder.

 Hepatic veins (HV) – venous system

 drain de-oxygenated blood from the liver into the inferior vena cava.
 three upper hepatic veins draining from the left, middle, and right
parts of the liver.
 hepatic veins drain into the inferior vena cava.
HEPATIC ARTERY
HEPATIC VEINS
PV VS HV VS HA
COUINAUD CLASSIFICATION OF HEPATIC SEGMENTS
THANK YOU