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5.2.16 Liver: principal features

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(2.42)

Now we'll move on to look at three major organs in the upper part of the abdominal cavity, the liver, the pancreas and the spleen.

The liver occupies the highest part of the abdominal cavity. It's just beneath the diaphragm, which is here. Much the greater part of the liver lies to the right of the midline. Since the liver doesn't usually come below the costal margin, which is here, we can't get a view of it from in front by just removing the anterior abdominal wall. To see it, we need also to remove this much of the rib cage.

In removing the lower part of the rib cage we've made a big opening into the chest. We've left the diaphragm in place. Here's the diaphragm, hanging loose along its former line of attachment.

To make a tidy picture we'll displace the diaphragm upward like this, and attach it with stitches to the rib cage all along here, closing off the pleural cavity. Here's the underside of the diaphragm, artificially flattened out, and here's the liver.

We're looking at a large part of its outward-facing surface. Most of the liver is covered by peritoneum. There's an area behind that isn't, as we'll see. The liver is attached to its surroundings by peritoneal folds which we'll look at in a minute. First, let's look at the overall shape of the liver.

Here's the liver by itself, seen from in front. This small dark area is an abnormality: it's a benign tumor. The liver has two main surfaces, a highly irregular posterior surface that's approximately flat, and this much larger outward facing surface that's smooth and highly convex. The outward-facing surface conforms to the shape of the diaphragm, with which it's in close contact. Here in front, the two surfaces ...

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(2.42)

Now we'll move on to look at three major organs in the upper part of the abdominal cavity, the liver, the pancreas and the spleen.

The liver occupies the highest part of the abdominal cavity. It's just beneath the diaphragm, which is here. Much the greater part of the liver lies to the right of the midline. Since the liver doesn't usually come below the costal margin, which is here, we can't get a view of it from in front by just removing the anterior abdominal wall. To see it, we need also to remove this much of the rib cage.

In removing the lower part of the rib cage we've made a big opening into the chest. We've left the diaphragm in place. Here's the diaphragm, hanging loose along its former line of attachment.

To make a tidy picture we'll displace the diaphragm upward like this, and attach it with stitches to the rib cage all along here, closing off the pleural cavity. Here's the underside of the diaphragm, artificially flattened out, and here's the liver.

We're looking at a large part of its outward-facing surface. Most of the liver is covered by peritoneum. There's an area behind that isn't, as we'll see. The liver is attached to its surroundings by peritoneal folds which we'll look at in a minute. First, let's look at the overall shape of the liver.

Here's the liver by itself, seen from in front. This small dark area is an abnormality: it's a benign tumor. The liver has two main surfaces, a highly irregular posterior surface that's approximately flat, and this much larger outward facing surface that's smooth and highly convex. The outward-facing surface conforms to the shape of the diaphragm, with which it's in close contact. Here in front, the two surfaces meet at this quite sharply defined anterior border.

This is the gall bladder. It hangs down below the anterior border. Here's the liver seen from behind. Here's the anterior border. There is no distinct posterior border. Here's the gall bladder again; this is the inferior vena cava. There's a lot to see in the posterior aspect of the liver. We'll look at the details in a minute.

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