Leber (Hepar)/en: Unterschied zwischen den Versionen

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     <td><b>Sicht von dorsal auf die Pars superior der Facies diaphragmatica</b>
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     <td><b>Sicht von ventral auf die Facies diaphragmatica</b>
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     <td><b>Sicht von kaudal auf die Facies visceralis</b>
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Der größte Teil der Leberoberfläche ist umgeben mit viszeralem Peritoneum. Jedoch bleibt die Area nuda als einzige peritonealfrei, ihre Oberfläche bildet die bindegewebige Kapsel. Außerhalb der Peritonealabdeckung verlassen die meist drei Vv. hepatica die Leber. Eine Besonderheit ist, dass bei der Leber nur die zuführende Arterie und zuführende V. portae hepatis als auch Ductus choledochus im Mesohepaticum verlaufen, die abführenden Venen hingegen nicht. An den Umschlagsorten des viszeralen in das parietale Peritoneum an der Unterseite des Zwerchfells, erscheint das bindegewebige Peritonealepithel als „Strang“ (Lig. coronarium). Aus dieser bindegewebigen Struktur entsteht am linken Leberlappen ein kleiner Zipfel (Appendix fibrosa hepatis).
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Most of the liver surface is surrounded with visceral peritoneum. However, the area nuda remains the only one free of peritoneum, its surface forming the connective tissue capsule. Outside the peritoneal covering, the usually three Vv. hepatica leave the liver. A peculiarity is that in the liver only the afferent artery and afferent V. portae hepatis as well as Ductus choledochus run in the mesohepaticum, while the efferent veins do not. At the points of transition from the visceral to the parietal peritoneum on the underside of the diaphragm, the connective tissue peritoneal epithelium appears as a "cord" (lig. coronarium). From this connective tissue structure, a small cusp (appendix fibrosa hepatis) develops on the left lobe of the liver.
 
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Aus der ventralen Ansicht sind die zwei Leberlappen, der große Lobus hepatis dexter und der kleinere Lobus hepatis sinister, gut zu erkennen. Das Lig. falciforme hepatis verläuft zwischen den beiden Lappen. Das Ligamentum falciforme hepatis bildet das Mesohepaticum ventrale und somit die Verbindung zwischen Leber und Bauchwand.  
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From the ventral view, the two lobes of the liver, the large lobus hepatis dexter and the smaller lobus hepatis sinister, are clearly visible. The lig. falciforme hepatis runs between the two lobes. The ligamentum falciforme hepatis forms the mesohepaticum ventrale and thus the connection between the liver and the abdominal wall.  
 
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Die kaudale Sicht ermöglicht einen Blick auf zwei weitere der insgesamt vier Leberlappen: den Lobus caudatus und den Lobus quadratus hepatis. Das Lig. hepatoduodenale dient der Leber zusammen mit dem Lig. hepatogastricum als Mesohepaticum dorsale und gehört topografisch zum Omentum minus.  
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The caudal view provides a view of two more of the total four lobes of the liver: the lobus caudatus and the lobus quadratus hepatis. The hepatoduodenal ligament, together with the hepatogastric ligament, serves the liver as the mesohepaticum dorsale and is topographically part of the omentum minus.  
Die Gallenblase überragt den unteren Leberrand mit dem Fundus und liegt der Facies visceralis eng an. Der Hals der Gallenblase zeigt zur Leberpforte, wo sie in Kontakt mit den extrahepatischen Gallenwegen gelangt.  
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The gallbladder overhangs the inferior border of the liver with the fundus and lies close to the facies visceralis. The neck of the gallbladder points toward the hepatic orifice, where it comes into contact with the extrahepatic bile ducts.  
 
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Version vom 13. Dezember 2021, 13:58 Uhr

The liver is the largest digestive gland in the human body. Due to its function and tasks it is the central organ of metabolism. It forms important proteins and detoxifies the body. Almost all nutrients that are absorbed through the intestines are first passed through the liver.


Anatomy

Projection

Anatomy of the liver

The liver is located in the right upper abdomen, but extends beyond the epigastrium into the left upper abdomen. It thereby pushes far in front of the stomach, which leaves an impression (impressio gastrica) at the back of the left liver lobe. The right lobe of the liver comes into close contact with the colon (right flexure), the small intestine (pars superior), the upper part of the right kidney and the right adrenal gland. Its impression sites are also named accordingly: Impressio colica, duodenalis, renalis and suprarenalis. The position of the liver is strongly dependent on respiration, as its underside is fused to the diaphragm. Age and posture are equally crucial in determining the position of the liver. The gallbladder is located dorsally between the left and right lobes of the liver.

Liver in situ

Anatomie der Leber

The thin area of tissue between the liver and the curvature of the stomach is called the omentum minus. This serous skin lines the peritoneal cavity and is the ventral border of the bursa omentalis. This is bordered on the right by the liver.
The downward-facing liver margin is sharp-edged and easily palpable in an enlarged liver. The liver extends from the right regio hypochondriaca, through the regio epigastrica, and into the left upper abdomen. The stomach can be seen at the left inferior border of the liver. The gallbladder lies on the underside of the liver and overhangs the inferior border of the liver.

Liver segments

The liver segments are formed by a total of 8 functional subunits of the liver. Each of these units has a branch of the portal vein, the bile duct and a segment branch of the arteria hepatica propria.


Assignment to Partes and Divisiones

Pars hepatis sinistra
Segment I Pars posterior hepatis, Lobus caudatus
  • Segmentum posterius laterale sinistrum
    (= Segmentum II)
  • Segmentum anterius laterale sinistrum
    (= Segmentum III)
Divisio lateralis sinistra
Segmentum mediale sinistrum
(= Segmentum IV)

subdivided into segment IVa and IVb

Divisio medialis sinistra
Pars hepatis dextra
Segmentum anterius mediale dextrum
(= Segmentum V)

Segmentum posterius mediale dextrum
(= Segmentum VIII)

Divisio medialis dextra
Segmentum anterius laterale dextrum
(= Segmentum VI)

Segmentum posterius laterale dextrum
(= Segmentum VII)

Divisio lateralis dextra

Since each subunit has its own supply route, the liver segments can be removed individually by surgery. The liver is still functional after the removal of a subunit, as are the removed subunits themselves. This makes a partial implantation of a liver possible.

Different views

View from dorsal on the pars superior of the facies diaphragmatica View from ventral to facies diaphragmatica View from caudal to facies visceralis

Most of the liver surface is surrounded with visceral peritoneum. However, the area nuda remains the only one free of peritoneum, its surface forming the connective tissue capsule. Outside the peritoneal covering, the usually three Vv. hepatica leave the liver. A peculiarity is that in the liver only the afferent artery and afferent V. portae hepatis as well as Ductus choledochus run in the mesohepaticum, while the efferent veins do not. At the points of transition from the visceral to the parietal peritoneum on the underside of the diaphragm, the connective tissue peritoneal epithelium appears as a "cord" (lig. coronarium). From this connective tissue structure, a small cusp (appendix fibrosa hepatis) develops on the left lobe of the liver.

From the ventral view, the two lobes of the liver, the large lobus hepatis dexter and the smaller lobus hepatis sinister, are clearly visible. The lig. falciforme hepatis runs between the two lobes. The ligamentum falciforme hepatis forms the mesohepaticum ventrale and thus the connection between the liver and the abdominal wall.

The caudal view provides a view of two more of the total four lobes of the liver: the lobus caudatus and the lobus quadratus hepatis. The hepatoduodenal ligament, together with the hepatogastric ligament, serves the liver as the mesohepaticum dorsale and is topographically part of the omentum minus. The gallbladder overhangs the inferior border of the liver with the fundus and lies close to the facies visceralis. The neck of the gallbladder points toward the hepatic orifice, where it comes into contact with the extrahepatic bile ducts.

Funktion

Die Leber hat als größtes und wichtigstes Stoffwechselorgan verschiedene Aufgaben im menschlichen Körper. Sie produziert lebenswichtige Proteine und ist maßgeblich an der Verwertung von Nahrungsbestandteilen sowie dem Abbau und der Ausscheidung von Stoffen beteiligt.

Erkrankungen

Freie Exploration

  • Standard
  • Fall: 1
Schauen Sie sich die Struktur der Leber in 3D an und explorieren Sie sie frei. Danach können Sie sich andere Fälle ansehen oder Ihr erlerntes Wissen durch die Übungsaufgaben überprüfen.
Zu sehen sind hier, die Leber sowie ihre einzelnen Segmente.




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