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Liver

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. It works synchronously with many other organs and contributes to the maintenance of the basic homeostatic mechanisms.

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.

Key Facts
Function Over 500; Main: xenobiotic biotransformation, protein synthesis, nutrient storage, bile production 
Anatomy Lobes: right, left, caudate, quadrate 
Surfaces: diaphragmatic, visceral
Ligaments: coronary, left triangular, falciform, round ligament, venous
Fissures and recesses: porta hepatis (central fissure - contains portal vein, hepatic artery, hepatic nervous plexus, hepatic ducts, lymphatic vessels), subphrenic recess (division between the liver and the diaphragm), hepatorenal recess (separates the liver and the right kidney and suprarenal gland)
Lymphatic drainage Hepatic lymph nodes (mostly around the porta hepatis) -> celiac nodes -> cisterna chyli
Vascularization Functional: portal vein (metabolic processing of the matters absorbed in intestines)
Nutritive: hepatic artery (supplying the tissue of the liver with oxygen and nutrients)
Drainage: hepatic vein -> inferior vena cava -> right atrium
Innervation Hepatic plexus, cervical plexus
Clinical relations Hepatic failure, cirrhosis, portal hypertension, cholestasis, hepatocellular carcinoma

This article will highlight the main anatomical knowledge that is generally required plus a few notes about the clinical pathology of the liver.

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

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.

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.

Recommended video: Posterior view of the liver
Structures seen on the posterior view of the isolated liver.

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.

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.
  • 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: Anterior view of the liver
Structures seen on the anterior 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.

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.

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.

Recommended video: Lymphatics of stomach and liver
Lymph nodes and vessels of the stomach and liver.

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 which carries the blood filled with metabolytes absorbed in the intestines, whereas the rest of the blood comes from the hepatic artery which originates from the abdominal aorta and carries the oxygenated blood to the liver.

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.

Recommended video: Arteries of stomach, liver and spleen
Arteries which supply the stomach, liver and spleen.

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

Clinical Aspects

The characteristic clinical signs of severe hepatic dysfunction include:

  • jaundice and cholestasis
  • hypoalbuminemia
  • hyperammonemia
  • hypoglycemia
  • palmar erythema
  • spider angiomas
  • hypogonadism
  • gynecomastia
  • weight loss
  • muscle wasting

If one or more of the previously mentioned symptoms is present, a blood test is performed to test the liver’s hepatocyte integrity, biliary excretory function and hepatocyte function. The most common hepatic disorders include hepatic failure, cirrhosis, portal hypertension and cholestasis.

Liver - want to learn more about it?

Our engaging videos, interactive quizzes, in-depth articles and HD atlas are here to get you top results faster.

Sign up for your free Kenhub account today and join over 852,397 successful anatomy students.

“I would honestly say that Kenhub cut my study time in half.” – Read more. Kim Bengochea Kim Bengochea, Regis University, Denver

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:

  • First Illustration Gallery - Begoña Rodriguez, Paul Kim, Samantha Zimmerman
  • Second Illustration Gallery - Irina Münstermann
  • Third Illustration Gallery - Irina Münstermann
  • Fourth Illustration Gallery - Irina Münstermann
  • Fifth Illustration Gallery - Irina Münstermann, Paul Kim
  • Sixth Illustration Gallery - Esther Gollan, Irina Münstermann
  • Seventh Illustration Gallery - Begoña Rodriguez, Irina Münstermann
  • Hepatic plexus - ventral view - Irina Münstermann
© Unless stated otherwise, all content, including illustrations are exclusive property of Kenhub GmbH, and are protected by German and international copyright laws. All rights reserved.

Related Atlas Images

Liver in situ

Anterior view of the liver

Inferior view of the liver

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