The falciform ligament, or ligamentum falciforme hepatis in latin, is a double-layered fold of peritoneum that is associated with the liver, and is a remnant of the fetal ventral mesentery. The superior, convex surface of the liver relates to the diaphragm, and is therefore called the diaphragmatic surface. Between the diaphragm and the diaphragmatic surface of the liver are two spaces called the left subphrenic recess and the right subphrenic recess. These recesses are extensions of the peritoneal cavity and are separated from each other by the falciform ligament. The term ‘falciform’ is a reference to the ligament’s sickle-shaped appearance. It lies between the left and right lobe of the liver, and extends from the diaphragmatic surface of the liver to the anterior abdominal wall, thus making the function of the falciform ligament to maintain the position of the liver within the abdominal cavity. The right portion of the falciform ligament is the continuation of the coronary ligament, which connects the liver to the diaphragm. The left portion of the falciform ligament meets with the lesser omentum to form the left triangular ligament, which connects the left lobe of the liver to the diaphragm. Inferiorly, the falciform ligament has a so-called free edge, which contains the paraumbilical veins, and the round ligament of the liver, also called the ligamentum teres, or ligamentum teres hepatis. The paraumbilical veins, which anastomose with the superficial epigastric veins, are often referenced in relation to portal hypertension, because they form one of the portosystemic anastomoses which connect the portal venous system with the systemic venous system. The round ligament is the remnant of the fetal umbilical vein. The falciform ligament is relatively avascular, but receives parasympathetic innervation via the tenth cranial nerve, the vagus nerve.
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