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Liver

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The liver is a large essential organ found in the upper right quadrant of the abdomen. It is a multifunctional accessory to the gastrointestinal tract and performs such duties as detoxification, protein synthesis, biochemical production and nutrient storage to name but a few. It is the largest gland in the human body, weighing in at approximately 1.5 kilograms.

Recommended video: Liver in situ
Liver in situ seen from an anterior view of the abdomen with liver retracted.

It is completely covered by visceral peritoneum, with the exception of the bare area, which is where the liver is in contact with the diaphragm. This article will highlight the main anatomical knowledge that is generally required plus a few notes about the clinical pathology of the liver.

Lobes

There are four anatomical lobes to the liver, which are further divided into even smaller segments in accordance with the blood supply. The right lobe is the largest of the four lobes and the left lobe is a flattened smaller one.

Right lobe of the liver - ventral view

The caudate lobe sits between the fissure for the ligamentum venosum and the inferior vena cava, while the quadrate lobe is located between the gallbladder and the fissure for the ligamentum teres hepatis. The left part of the liver which is known as the functional liver, contains all the lobes but the right.

Quadrate lobe - caudal view

Surfaces

The two major aspects or surfaces of the liver are the diaphragmatic surface and the visceral surface. The latter is shrouded by the peritoneum except at the porta hepatis and the bed of the gallbladder. It is directly related to several anatomical structures which include the: 

The diaphragmatic surface is also covered by the peritoneum except in the bare area.

Visceral surface of right lobe of the liver - dorsal view

Ligaments

There are five ligaments that are directly related to the liver and they are called:

  • Coronary ligament - 

    formed by the peritoneal reflection from the diaphragm to the liver which has two layers that meet on the right.

  • Left triangular ligament - is a mix of the falciform ligament and the lesser omentum.
  • Falciform ligament - is not of embryological origin, but a peritoneal reflection of the upper abdominal wall from the umbilicus to the liver and has the round ligament of the liver on its free edge.
Recommended video: Anterior view of the liver
Structures seen on the anterior view of the isolated liver.
  • Ligamentum teres hepatis - is also known as the round ligament of the liver. It is a fibrous remnant of the umbilical vein which still extends from the internal aspect of the umbilicus up to the liver.
  • Ligamentum venosum  - is also an embryonic remnant of the ductus venosus. In utero it extended between the umbilical vein and the inferior vena cava.
Recommended video: Posterior view of the liver
Structures seen on the posterior view of the isolated liver.

Porta Hepatis and Recesses of the Liver

The porta hepatis is the central intraperitoneal fissure of the liver that separates the caudate and the quadrate lobes. It is the entrance and the exit for several important vessels including the portal vein, the hepatic artery, the hepatic nervous plexus, the hepatic ducts and the lymphatic vessels.

Porta hepatis - caudal view

The subphrenic recess which is split by the falciform ligament of the liver, is the division between the liver and the diaphragm.

The hepatorenal recess is on the inferior right aspect of the liver and separates it from the kidney anterior inferiorly and the suprarenal gland posterior inferiorly.

Subphrenic recess

Lymphatic Drainage

The lymphatic drainage is governed mainly by the hepatic nodes which can be found around the porta hepatis. From there they continue to the celiac nodes and eventually drain into the cisterna chyli.

Celiac lymph nodes - ventral view

Blood Supply

The liver is a special organ in the sense that it receives more venous blood than arterial blood and this is due to the fact that the liver helps clean the blood via detoxification. The majority of the vascular supply is brought into the organ by the portal vein and the rest from the hepatic artery. The hepatic veins drain the blood supply to the liver and they are formed by the union of the central veins which drain directly into the inferior vena cava just before it passes through the diaphragm.

Hepatic portal vein - ventral view

Innervation

The nervous supply of the liver comes from the hepatic plexus which travels along with the hepatic artery and the portal vein. The liver also receives sympathetic fibers from the celiac plexus and parasympathetic fibers from the anterior and posterior vagal trunks.

Hepatic plexus - ventral view

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Show references

References:

  • Neil S. Norton, Ph.D. and Frank H. Netter, MD, Netter’s Head and Neck Anatomy for Dentistry, 2nd Edition, Elsevier Saunders, Chapter 22 Introduction to the Upper Limb, Back, Thorax and Abdomen, Page 593 to 594.
  • Frank H. Netter, MD, Atlas of Human Anatomy, Fifth Edition, Saunders - Elsevier, Chapter 4 Abdomen, Subchapter 28 Viscera (Accessory Organs), Guide  Abdomen: Viscera (Accessory Organs) - Liver Page 148 to 149.
  • Kumar, Abbas and Aster, Robbins Basic Pathology, 9th Edition, Elsevier - Saunders, Chapter 15 Liver, Gallbladder and Biliary Tract, The Liver, Clinical Syndromes, Table 15.1 and 15.2, Page 604.

Author:

  • Dr. Alexandra Sieroslawska

Illustrators:

  • Right lobe of the liver - ventral view - Irina Münstermann
  • Quadrate lobe - caudal view -  Irina Münstermann
  • Visceral surface of right lobe of the liver - dorsal view - Irina Münstermann
  • Porta hepatis - caudal view - Irina Münstermann
  • Subphrenic recess - Paul Kim
  • Celiac lymph nodes - ventral view - Esther Gollan
  • Hepatic portal vein - ventral view - Begoña Rodriguez
  • Hepatic plexus - ventral view - Irina Münstermann
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