Liver

THE LIVER

The liver is wedge shaped organ its is the largest gland in the body situated in the upper most part of abdominal cavity on the right side the diaphragm its largely protected by the ribs

The is divided into two main lobes right and left the upper surface is convex and lies breath the diaphragm .The under surface is irregular and present the transverse fissure the surface being broken by the passage of the vessels which enter and leave the liver
The longitudinal fissure separates the caudate and left lobe of the under surface and the calceiform ligaments occupies a similar position on the upper surface of the liver .The liver is further sub divided into Four lobes (right, left, caudate & quadrate)
These are made up of lobules the lobules which are hexagonal in shave and 1 mm diameter in size are composed of cubical liver cell and the ramification of the vessels of the liver all connected by liver tissue the liver has a triple blood supply by means of the hepatic arterial, venous, and portal blood circulation
The weigh close to 3 pound and is the largest internal organ the size measure in 133 mm at med, clavicle line, and diameter of portal vein less then 13 mm



Diseases Of the liver

• OBSTRUCTIVE JAUNDICE

In obstructive jaundice the intra hepatic duct become dilated and below the portal vein another false image of the portal system will be seen in cross section view In longitudinal visualization.
It is seen as double layer sign. In this disease the boil duct ramming all around portal veins become dilated and seen just like the portal system son graphically

CIRRHOSES OF LIVER

The granularly of the liver parenchyma becomes course .The regenerated nodes of the liver cell can been on liver surface .The ages of the liver also become irregular .The enlargement of the liver is also present at the beginning .In the latest stage of the liver become cirrhoses in very advance stage hepatoma may be appear on he liver usually a hepatoma will

appear when cirrhoses of liver remain as for fifteen 

to twenty year in this stage liver will cirrhoses in size

and saner or later the patient will die. In cirrhoses 

granularly we see the white and black dot on liver

circle .The white called fibroses and black dot are

on liver lesion

CONGESTIVE LIVER OR CARDIAL LIVER

On the visualization of hepatic vein .We see that the hepatic vein are dilated and fully blood .In the mean time we say the patient to take a deep breath and hold it

 What he do it?
All the blood from the hepatic veins flows towards lungs and right heart .The hepatic veins becomes shrunk and narrow due to the out flow of blood
But when the cardiac failure is present and we say
the patient for taking deep breath they will no change
in hepatic veins these remain dilated because the heart is failure to pump or shrunk the blood.Which is running in the hepatic vein. In the source we are able to diagnose the cardiac failure
In the athletes the hepatic vein diameter is more than the non-athletic person.

HYDERATED CYST
Any cyst mass with the bright wall is hydrated which may appear on any side of the liver parenchyma sono graphically the wall of a cyst gives hyper echoic made filled with an echoic fluid. A bright wall cavity with hypo echoic fluid is a hydrated cyst of the liver

FATTY LIVER
Liver becomes enlarged which can be measured bellow the costal margin on the right side of the patient. Hyper echoic dot can be seen on the liver parenchyma which are the fats deposition in the liver .The fatty liver generally develop to diabetes

LIVER ABSCESS
Liver abscess is a very common disease in Pakistan liver abscess can be seen sono graphically a rounded invasion mark on the liver surface with pussy filled equisetic shadow. Which the indications of liver abscess.

BENIGN HAEMAN GIOMA
A coin mark with out a hollow around on the liver surface is a benign haeman gioma of the liver
Hyper echoic

LIVER METASTASIS
A coin mark on the liver surface with hollow around is metastasis of the liver

Liver Ascites
When we visualized the left lobe of the liver but placing our probe on sternum we see an echoic fluid collection around the edge of liver this is liver ascites

BLOOD CIRCULATION IN LIVER
• Three types of Blood circulation present in a liver
• 1. Arterial Blood circulation
• 2. Venous Blood Circulation
• 3. Portal Blood Circulation

Arterial Blood Circulation

Arterial start from aorta reach in liver from capillaries. The blood in a arterial system is fresh oxygenated coming from lungs and heart in this way arterial blood supplies oxygen and other nutrients to liver

VENOUS BLOOD CIRCULATION
The venous system start from I.V.C (Inferior vena cava) reach in the liver from capillaries. The venous system carries impure blood from the liver and falls it in the I.V.C

PORTAL BLOOD CIRCULATION
Portal system carries the blood from spleen pancreas and from the mesentery (i.e.) from intestine, stomach and supplies to liver. This Portal blood carries nutrient in crud from and supplied to liver where the metabolism of the nutrients takes place.

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