the anatomy of the liver & the biliary system
TRANSCRIPT
![Page 1: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/1.jpg)
The Liver & biliary systemBy
Dr.Faris MuhammedM.B.Ch.B, Ph.D Anatomy
College Of Medicine,Hawler Medical [email protected]
![Page 2: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/2.jpg)
The Liver• What is it ? It’s the largest gland of the body• Completely surrounded by a capsule• Partially surrounded by peritoneum• Functions: 1. Bile secretion2. CHO, fat, and protein metabolism3. Heparin formation4. Remove waste 5. Detoxifying toxins
![Page 3: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/3.jpg)
Location :• Rt upper abdomen• Beneath diaphragm• Under cover of Rt. Costal margin • Under cover of Rt. Hemi diaphragm,
which separates it from :1. Pleura2. Lungs3. Pericardium4. Heart• Extends to under cover of Lt. hemi
diaphragm
![Page 4: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/4.jpg)
SURFACES :
1. Antero-superior Surface 2. Postero-inferior Surface
SE C
Q
KDU
RCF
Rt. Lt.
G
RSRB
![Page 5: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/5.jpg)
LOBES OF LIVER • By falciform ligament * its divided to :1. Right Lobe further subdivided to :• Caudate Lobe (C)• Quadrate Lobe (Q)
2. Left Lobe
*
Lt Rt.
C
Q
![Page 6: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/6.jpg)
PORTA HEPATIS( HILUM OF LIVER )• At the visceral surface • Between C and Q• Upper L. Omentum at margins• Contents :1. Rt. & Lt. Hepatic ducts2. Rt. & Lt. branches of Hepatic
artery3. Rt. & Lt. branches of Portal vein4. Sympathetic & Parasympathetics5. Hepatic LNs.
![Page 7: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/7.jpg)
RELATIONS:• ANTERIORLY:1. Diaphragm2. Rt. & Lt costal margins3. Rt. & Lt. pleura4. Lower margins of both lungs5. Xiphoid process6. Ant. Abdominal wall in subcostal
angle
![Page 8: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/8.jpg)
• POSTERIORLY:1. Diaphragm & pleura2. Rt. & Lt. lungs3. Rt. Kidney 4. Hepatic flexure of colon5. Duodenum6. Gallbladder7. IVC8. Esophagus9. Fundus of stomach
![Page 9: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/9.jpg)
PERITONEAL LIGAMENTS OF LIVER:1. Falciform ligament2. Coronary ligament
(upper & lower layers)3. Triangular ligament (Right & Left)4. Lesser omentum
1
2 3
4
![Page 10: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/10.jpg)
UC
LCRT
LT
LO
FF
![Page 11: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/11.jpg)
5. Ligamentum teres (Oblit. Lt. paraumb. v.)6. Ligamentum venosum (Ductus venosus )
5
5
6
![Page 12: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/12.jpg)
• what's Bare area?
BARE
![Page 13: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/13.jpg)
1. ARTERIAL : • Hepatic arteries, 30%2. VENOUS :• Portal vein, 70%• Hepatic veins 3. LYMPHAICS :• ½ of body lymph is formed by liver • to LN in porta hepatis celiac nodes• from bare area through diaphragm post. Mediastinal LNs.
![Page 14: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/14.jpg)
Hepatic segments
![Page 15: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/15.jpg)
![Page 16: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/16.jpg)
Left lobe
![Page 17: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/17.jpg)
4. NERVE SUPPLY :• Symp. & Parasymp. from coeliac plexus• Anterior vagal trunk gives a hepatic branch to liver.
![Page 18: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/18.jpg)
Clinical points:•Liver support •Liver trauma•Liver biopsy•Sub-phrenic spaces
![Page 19: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/19.jpg)
BILIARY SYSTEM:Bile canaliculi
SINUSOID
H
Interlobular ductules
Branch of portal vein
Bile ducts
Periportal bile ductule
• INTRAHEPATIC BILIARY SYSTEM
NOT OUR BUISNESS
!!!!
![Page 20: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/20.jpg)
• EXTRAHEPATIC BILIARY SYSTEMConsists of :1. Rt. hepatic duct2. Lt. hepatic duct3. Com. hepatic duct4. Cystic duct5. Com. Bile duct6. Gallbladder
1 2
34
56
![Page 21: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/21.jpg)
1 2
34
56
HEPATIC DUCTS : • Emerge from porta hepatis• Rt. & Lt. HDs unite to form CHD• CHD =4 cm• CHD descend in lesser omentum • Joined by cystic duct to form CBD
![Page 22: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/22.jpg)
1 2
34
56
COMMON BILIARY DUCT:• 8cm long• 1st course (Lesser Omentum)• 2nd course (behind 2nd Duo.)• 3rd course ( post. To head of pancreas )
![Page 23: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/23.jpg)
1 2
34
56
• Hepatopancreatic ampulla of vater• Major duodenal papilla• Sphincter of Oddi
![Page 24: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/24.jpg)
GALLBLADDER:• Under the liver• Stores 30-50 ml of bile• Function• Divided into :1. Fundus2. Body 3. Neck
1
2
3
![Page 25: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/25.jpg)
RELATIONS OF GALLBLADDER:
ANTERIORLY:• Ant. Abdominal wall• Inferior surface of liver
POSTERIORLY:• Transverse colon• 1st & 2nd duodenum
![Page 26: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/26.jpg)
BLOOD SUPPLY:ARTERIAL :• Cystic artery
• VENOUS :• Cystic vein
• LYMPHATICS :• A cystic LN at the neck of GB
• NERVES :• Autonomic from coeliac plexus• Cholecystokinin
![Page 27: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/27.jpg)
CYSTIC DUCT• 3.8 cm• Somewhat S shaped• Its mucous membrane is forming a spiral fold ( the spiral valve )
![Page 28: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/28.jpg)
![Page 29: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/29.jpg)
Clinical points:• Gallstones• Biliary colic (epigastric pain, jaundice & pancreatitis)• Acute cholecystitis & referred pain to shoulder• Cholecystectomy ( variations )• Gangrenous ( single arterial supply )• Biliary atresia
![Page 30: The Anatomy Of The Liver & The biliary system](https://reader035.vdocuments.us/reader035/viewer/2022081502/58a3cb4a1a28ab98588b56e7/html5/thumbnails/30.jpg)
THANKS
Trust only on science….