LIVER SITE - under the diaphragm - in the right hypochondrium + epigastrium + left hypochondrium SHAPES & LOBES - wedge

shaped - 5 surfaces : Superior Inferior/visceral Anterior Posterior Right/lateral - formed of 2 lobes : right large & left small lobes, by 1. attachment on anterior & of falciform superior surfaces ligament 2. fissure for on posterior surface ligamentum venosum 3. fissure for on inferior/ visceral ligamentum surface teres - also contains caudate & quadrate lobes

PANCREAS - lies transversely across posterior abdominal wall - extends from the concavity of duodenum (right side) to spleen (left side) PARTS - head - neck - body - tail - lower parts of the head forms a projection = uncinate process

DUCTS OF PANCREAS - 2 ducts: drains opens into Main pancreatic duct - upper part of the head - all the body - tail from the tail to the head then it unite with common bile duct to form ampulla of Vater, which opens in the 2nd part of duodenum Accessory pancreatic duct - uncinate process - lower part of head - 2nd part of duodenum - above the ampulla of Vater

arterial supply - Hepatic arteries - Portal vein

both divides into right & left branches

BLOOD SUPPLY - Superior & inferior pancreatico-duodenal arteries head - Pancreatic branches of splenic artery the rest of pancreas - Splenic vein - Portal vein LYMPHATICS DRAINAGE - Upper part of head coeliac lymph nodes - Lower part of head superior mesenteric lymph nodes - Rest of pancreas pancreatico-splenic lymph nodes

- 3 hepatic veins which terminate in the IVC ( right, left, middle)

RELATIONS LIVER The diaphragm and base of right lung and pleura are related to the superior, anterior & right surfaces Anterior anterior surface abdominal wall Superior - heart surface - pericardium Right 7th to 11th ribs surface Posterior - bare area - oesophageal notch surface - groove for IVC - caudate lobe - fissure for ligamentum venosum Inferior - gastric impression surface - fissure for ligamentum teres - quadrate lobe - fossa for gall bladder - duodenal impression - renal impression - supra renal impression - colic impression Bare area - triangular area - related directely to the diaphragm base groove for IVC apex right triangular ligament sides 2 layers of coronary ligament PANCREAS HEAD * lies in the concavity of the duodenum superior 1st part of duodenum right 2nd part of duodenum ( separated from it by superior & inferior pancreatico -duodenal arteries) inferior 3rd part of duodenum UNCINATE anterior superior mesenteric vessels posterior abdominal aorta NECK anterior gastroduodenal junction posterior formation of portal vein from splenic & superior mesenteric veins BODY * 3 surfaces & borders (anterior, posterior & inferior) TAIL - related to the visceral surface of spleen near its hilum - reaches the hilum via the lieno-renal ligament Anterior surface stomach( separated by the lesser sac) Inferior surface - duodeno-jejunal flexure - loops of ileum - end of transverse colon (right to left) Posterior surface (posterior abd wall) - aorta & origin of sup/ mesenteric art. - splenic and left renal vein - left psoas major - left crus of diaphragm - left kidney - left supra renal gland - left sympathetic chain Superior border - splenic artery Anterior border - gives attachment to transverse mesocolon and greater omentum Inferior border: - separates inferior from posterior surfaces

anterior transverse colon posterior - IVC - renal veins - common bile duct

LIVER

- rectangular part of the inferior surface of liver - boundaries inferior inferior border of liver posterior porta hepatis right gall bladder fossa left fissure for ligam.teres - relation anterior transverse colon middle pylorus& 1st part of duodenum posterior lesser omentum

- forms the hilum of the liver - gives attachment to lesser omentum - boundaries ant quadrate lobe post caudate lobe & process - structures passing through it structure position Hepatic ducts anterior Hepatic artery intermediate Portal vein posterior Lymphatics

1. falciform ligament 2. upper layer of coronary ligament 3. lower layer of coronary ligament 4. right triangular ligament 5. left triangular ligament 6. lesser omentum

Ligamentum teres Ligamentum venosum

connects the umblicus with the left branch of portal vein the left branch of portal vein with the IVC

represents obliterated umblical vein obliterated ductus venosus

1- Bare area 2- Groove for IVC 3- Porta hepatic 4- Fossa of gall bladder 5- Fissures for ligamentum teres and for ligamentum venosum Superior surface from the 5th left intercostal space in the mid clavicular line to the upper border of right 5th costal cartilages in right lateral plane to the 7th rib in mid axillary line from right 7th -11th ribs(mid axill. line) tip of 9th costal cartilage

Right border Fundus of gall bladder