The Liver and Biliary System pptx - D. Muayad

• The Liver & biliary system

• The Liver

• What is it ? It’s the largest gland of the body

• Completely surrounded by a capsule
• Partially surrounded by peritoneum
• Functions:
• Bile secretion
• CHO, fat, and protein metabolism
• Heparin formation
• Remove waste
• Detoxifying toxins

• Location :
• Rt upper abdomen
• Beneath diaphragm
• Under cover of Rt. Costal margin
• Under cover of Rt. Hemi diaphragm, which separates it from :
• Pleura
• Lungs
• Pericardium
• Heart
• Extends to under cover of Lt. hemi diaphragm

• SURFACES :

• 1. Antero-superior Surface
• 2. Postero-inferior Surface

• S

• E
• C
• Q
• K
• DU
• RCF
• Rt.
• Lt.
• G
• RSR
• B

• 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

• PORTA HEPATIS( HILUM OF LIVER )

• At the visceral surface
• Between C and Q
• Upper L. Omentum at margins
• Contents :
• Rt. & Lt. Hepatic ducts
• Rt. & Lt. branches of Hepatic artery
• Rt. & Lt. branches of Portal vein
• Sympathetic & Parasympathetics
• Hepatic LNs.

• RELATIONS:

• ANTERIORLY:
• Diaphragm
• Rt. & Lt costal margins
• Rt. & Lt. pleura
• Lower margins of both lungs
• Xiphoid process
• Ant. Abdominal wall in subcostal angle

• POSTERIORLY:

• Diaphragm & pleura
• Rt. & Lt. lungs
• Rt. Kidney
• Hepatic flexure of colon
• Duodenum
• Gallbladder
• IVC
• Esophagus
• Fundus of stomach

• PERITONEAL LIGAMENTS OF LIVER:

• Falciform ligament
• Coronary ligament (upper & lower layers)
• Triangular ligament (Right & Left)
• Lesser omentum

• 1

• 2
• 3
• 4

• 5. Ligamentum teres (Oblit. Lt. paraumb. v.)

• 6. Ligamentum venosum (Ductus venosus )

• 5

• 5
• 6

• what's Bare area?

• BARE

is a large triangular area on the diaphragmatic surface of the liver, devoid of peritoneal covering. It is attached directly to the diaphragm by loose connective tissue.

• 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.

• Hepatic segments

• Left lobe

• 4. NERVE SUPPLY :
• Symp. & Parasymp. from coeliac plexus
• Anterior vagal trunk gives a hepatic branch to liver.

• BILIARY SYSTEM:

• Bile canaliculi

• H

• Interlobular ductules

• Branch of portal vein

• Bile ducts

• Periportal bile ductule

• INTRAHEPATIC BILIARY SYSTEM

• EXTRAHEPATIC BILIARY SYSTEM Consists of :

• Rt. hepatic duct
• Lt. hepatic duct
• Com. hepatic duct
• Cystic duct
• Com. Bile duct
• Gallbladder

• 3
• 4
• 5
• 6

• 3

• 4
• 5
• 6
• 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

• 3

• 4
• 5
• 6
• COMMON BILIARY DUCT:
• 8cm long
• 1st course (Lesser Omentum)
• 2nd course (behind 2nd Duo.)
• 3rd course ( post. To head of
• pancreas )