LIVER

Dr Saravanan Jagadeesan MBBS, MS, PhD

Associate Professor in Anatomy
School of Medicine, Taylors University
Liver-Introduction

• Also called ‘hepar’.

• Largest gland in the

body.

• Weight
• 1600 gm in males
• 1300 gm in females.
Liver-Introduction

• Occupies the right

hypochondrium,
epigastrium & left
hypochondrium.

• Most part of the liver is

covered by ribs & costal
cartilages.
Liver-Introduction

• The bile secreted

by liver carried to
the gall-bladder by
the cystic duct or
poured directly
into the
duodenum by the
common bile duct
to aid digestion.
• Wedge shaped,
resembles four-
sided pyramid.
• Surfaces -
• Superior
• Anterior
• Right lateral
• Posterior
• Inferior.
• Surfaces -
• Superior
• Anterior
• Right lateral
• Posterior
• Inferior.
• Superior surface
is attached to the
diaphragm and
anterior
abdominal wall
by falciform
ligament
• This ligament
divides the liver
into larger right
lobe & smaller
left lobe
• Inferior surface is
well defined -also
called visceral
surface.
• Irregular surface
due to impressions
caused by other
organs
• Has porta hepatis
and 2 fissures
• Fossa for gall
bladder
• Posterior surface
its continuous with
the superior
surface
• Presence of Bare
area of liver (area
not covered by
peritoneum)
• Groove for IVC
• Diaphragmatic
surface includes
parts related to
diaphragm which
includes
• Anterior surface
• Superior surface
• Posterior surface
• Right lateral surface
• Inferior border is
well defined &
the other borders
are rounded.
Ligaments of Liver – 2 Layered peritoneal folds

• Falciform ligament
• Its sickle shaped
• Connects the antero-
superior surface of
liver to diaphragm and
anterior abdominal
wall upto the
umbilicus
• Inferior margin is
thickened forming
ligamentum teres
(contains obliterated
left umbilical vein)
Ligaments of Liver – 2 Layered peritoneal folds
• Falciform ligament….
• The ligamentum teres
goes along the fissure
on inferior surface of
liver
• Reaches up to the left
branch of portal vein
• Contents of falciform
ligament
1. Ligamentum teres
2. Paraumbilical vein
3. Small veins –
connecting
paraumbilical vein to
diaphragmatic veins
 Ligaments of Liver
• Left triangular
ligament
connecting the
superior surface of
left lobe of liver to
the diaphragm.

• Right triangular
ligament
connecting the
lateral part of
posterior surface of
right lobe of liver
to the diaphragm.
 Ligaments of Liver

• Coronary ligament
having anterior &
posterior layers, to
enclose the bare area
of liver.
Ligaments of Liver

• Lesser omentum
connecting the
stomach & first
part of duodenum
to the fissure for
the ligamentum
venosum &
margins of porta
hepatis.
 Bare Area of Liver
• Area of liver not covered
by peritoneum, directly
comes in contact with
diaphragm.
• Triangular area
bounded by the anterior
and posterior layers of
coronary ligament and
the inferior vena cava.
• Site of porto caval
anastomosis.
Liver is divided into
right & left lobes by
falciform ligament,
fissure for ligamentum
teres & fissure for
ligamentum venosum.
Right lobe is
larger than left
and has 2 areas
which are
caudate &
quadrate lobes.
• Porta hepatis - the
hilum of the liver
• Structure passing
through arranged from
front to back
• Hepatic ducts
• Hepatic artery
• portal vein
• Lymphatics &
nerves
• Lesser omentum
extends between porta
hepatis and the lesser
curvature of stomach.
 Liver-Relations

• All the
surfaces
except
visceral
surface are
related to the
diaphragm.
Liver-Relations
• Visceral surface
is related
• Oesophagus
• Stomach
• 1st part of
duodenum
• Gall bladder
• Right kidney
• Right suprarenal
gland.
Liver-Relations
• Caudate lobe –
boundaries
Liver-Relations
• Quadrate lobe –
boundaries
• Arterial supply
• Hepatic A
(oxygenated
blood) –
branch from
coeliac trunk
• Portal vein.
• Venous
drainage is
by hepatic
veins which
drain into
inferior vena
cava.
Lymphatics from
upper surface drain
into nodes in the
posterior
mediastinum.

Lymphatics from
lower surface drain
into hepatic nodes
and celiac nodes.
• Parasympathetic supply is
by the preganglionic fibers
of the vagus nerve
(anterior vagal trunk).
• Sympathetic innervation is
by the postganglionic
fibers from the coeliac
plexus.
• Pain fibers pass through
sympathetic system
Histology of liver
• Liver covered by
capsule – Glissons
capsule
• They give fibrous septa
which form small
hepatic lobule
• Hepatic lobule
• It’s the functional unit
• Hexagonal in shape
• It has a central vein
• Corners have portal
triad
29
Histology of liver
• Sinusoids extend from
portal triad to central vein
• Hepatocytes are arranged
on sides of sinusoids
• Space between the
endothelial cells of
sinusoids and hepatocytes
is called Space of Disse
• Kupffer cells present
between the sinusoids and
hepatocytes 30
Histology of liver

31
Histology of liver

Space
of Mall

32
Development of liver

• Hepatic bud arises in at the

junction between foregut and
midgut
• It arises in the ventral
mesogastrium
• This duct will form the
following structures
• Liver cells (parencyma) & Hepatic
ducts
• Gall bladder & cystic duct
• Bile duct
33
Development of liver

• It enlarges and enters into the

septum transversum – which is
a mesodermal plate between
pericardial cavity and yolk sac
• Another 2 more outpouching
occurs
• Pars cystica
• Ventral pancreatic bud
• The liver bud now grows very
fast forming cord like structures
34
Development of liver

• These liver buds join

with vitelline veins and
umbilical veins which are
present in the septum
transversum.
• These vessels form the
sinusoids of the liver

35
Development of liver

• Hematopoietic cells,
Kupffer cells, and
connective tissue cells
are derived from
mesoderm of the
septum transversum.
• The pars cystica
enlarges and forms the
gall bladder and cystic
duct
36
 Hepatic Segments

Medial segment
Lateral segment
Posterior medial
segment

Left anterior
Posterior
lateral segment
lateral segment

Right anterior Medial segment

lateral segment Anterior medial
segment
Portosystemic anastamosis
• It’s the venous
anastomosis between
veins draining into IVC
(systemic circulation)
and portal Vein (portal
circulation)
• These are potential sites
of anastomosis
• Active only when the
liver is affected
• They act as pathway to
bypass the blood from
the affected liver 38
• Inflammation of liver – hepatitis.
• Fatty liver – more amount of fat deposited
• Cirrhosis- the liver is replaced by fibrous tissue & shrinks in
size.
Thank you