1. Portal hepatic vein. Foetal circulation

6. Vascular Structures in Liver
Detailed Anatomy, continued …
Vascular Structures in Liver
1. Largest vessels are portal vein and IVC
a. Portal Vein:
1. appears on T.S. as tubular, echolucent structure
2. courses horizontally from porta hepatis

7. 3. walls echogenic due to structures in portal triad
Detailed Anatomy, continued …
3. walls echogenic due to structures in portal triad
b. Left Portal Vein:
1. has more variable course
2. May be difficult to trace on transverse scans

8. Hepatic Vessels IVC Right Portal Vein Left Portal Vein
Main Portal Vein

9. 2. extends into right lobe 3. branches after porta hepatis
Vascular Structures, continued …
c. Right Portal Vein:
1. anatomical landmark
2. extends into right lobe
3. branches after porta hepatis
4. L.S. shows “dumbbell” or circular structure with echogenic “collar”

10. Computer-enhanced image of RPV, L.S.

11. Computer-enhanced 3-D image of RPV, L.S.

12. 2. Appears to pass through liver
Vascular Structures, continued …
d. IVC:
1. To right of aorta
2. Appears to pass through liver
3. Diameter enlarges after renal veins join (~L-1)

13. Computer-enhanced 3-D image of Hepatic Vessels

14. c. In superior half of liver
Vascular structures, continued …
2. Hepatic Veins:
a. Tubular structures
b. Enlarge cephalad
c. In superior half of liver
d. Angles of hepatic vein branches oriented toward IVC
e. Walls not echogenic

15. Hepatic Veins
R. Hepatic Vein
Middle Hepatic Vein
L. Hepatic Vein

20. Fetal Circulation Embryonic lungs and digestive tract nonfunctional
Respiratory functions and nutrition provided by placenta

21. Placental Blood Supply
Figure 21-33a

22. Placental Blood Supply
Blood flows to the placenta:
through a pair of umbilical arteries
which arise from internal iliac arteries
and enter umbilical cord

23. Placental Blood Return
Blood returns from placenta:
in a single umbilical vein
which drains into ductus venosus
Ductus venosus:
empties into inferior vena cava

24. The Neonatal Heart
Figure 21-33b

25. Before Birth Fetal lungs are collapsed
O2 provided by placental circulation

26. At Birth Newborn breathes air Lungs expand
Pulmonary circulation provides O2

27. 2 Fetal Pulmonary Circulation Bypasses
Foramen ovale:
interatrial opening
covered by valve-like flap
directs blood from right to left atrium
Ductus arteriosus:
short vessel
connects pulmonary and aortic trunks

28. Cardiovascular Changes at Birth
Pulmonary vessels expand
Reduced resistance allows blood flow
Rising O2 causes ductus arteriosus constriction
Rising left atrium pressure closes foramen ovale

29. Congenital Cardiovascular Problems
Figure 21-34

30. Congenital Cardiovascular Problems
Develop if proper circulatory changes do not occur at birth

31. Thank you for attention !