Anatomy of Liver pancreas & spleen
Liver:
- The largest visceral organ in the body
- Besides its metabolic activities, it stores glycogen and secretes bile.
- 2 functional lobes = R and L
- 2 accessory lobes = caudate and quadrate (seen on posterior surface).
- Anatomical lobes are separated by falciform ligament, but functional lobes are separated slightly to the right of the falciform ligament.
- Coronary ligaments are continuous with falciform, and help to secure liver to the diaphragm. They are also continuous at lateral ends to the triangular ligaments.
- Quadrate lobe: Inferiorly on posterior side, between R and L.
- Caudate lobe: superiorly on posterior side, between L lobe and inferior vena cava.
- Bare area of liver = an uncovered portion of the liver on the R lobe, lacks visceral peritoneum. This was once in contact with diaphragm. Boundaries are the anterior and posterior coronary ligaments, which form the triangular ligaments (R and L) at their junction.
- Porta Hepatis: bile duct, hepatic artery, portal vein travel to and from the liver.
Blood supply:
- Majority is deoxy blood from GI tract coming in through portal vein (brings in 70% of blood).
- Hepatic artery = brings in oxygenated blood → have L and R hepatic arteries (30% of blood).
Gall Bladder: Located in fossa on R lobe of liver.
- Divided into
- Fundus: projects out beyond the free edge of the liver.
- Body: main part.
- Neck: narrowing part that goes into the duct. Contains ridges which make up the spiral valve. Ridges close off to keep bile in. When fundus contracts, fluid is pushed out of the cystic duct into main biliary passageway.
- Bile comes from liver via hepatic ducts (R and L merge to form common). When there is no food present, bile produced by liver will be shunted from the liver to the gall bladder where it is concentrated and stored.
- Bile duct is formed when cystic duct merges with common hepatic duct.
- The accessory pancreatic duct empties into the minor duodenal papilla.
- Main pancreatic duct joins with bile duct→ forms hepatopancreatic ampulla→ empties into major duodenal papilla, flow is controlled by the sphincter of Oddi.
Cholecystitis: Inflammation of the gall bladder
- Due to blockage, usually from gall stone. The solution may form solid stone. If it is large enough, it stays in the gall bladder. Problem is with small ones that enter duct.
Pancreas:
- Exocrine function – pancreatic enzymes
- Endocrine function – insulin, glucagons
Is located posteriorly in abdominal cavity. The tail of the pancreas is up against the spleen. Body is behind the stomach. 4 parts:
- Head region that sits in the C of the duodenum. Includes a part that extends behind the superior mesenteric artery and vein = Uncinate process. Head region ends when it becomes the:
- Neck region
- Body
- Tail, furthest to the left.
Spleen: Closely related to tail of pancrease
- Filters blood, removes old RBCs
- Screens for foreign materials, stimulates an immune response
- Is very delicate, has thin capsule. Most frequently injured organ in the abdomen.
- If the internal structure is damaged, blood will pool in the spleen and cause expansion during hemorrhaging. May have rupture and massive bleeding into peritoneal cavity. → blood flows into greater sac supracolic compartmentà through R paracolic gutter.
- Hilum of spleen = Attachment of ligaments and point where vessels come and go. Splenic artery and vein. Splenic artery also supplies pancreas.
- Greater curvature of the spleen is right up against diaphragm. Stab wound at 9th intercostal space will injure spleen and cause pneumothorax.
