Anatomical position of liver

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Anatomical Position of the Liver

Location

The liver is the largest gland in the body, weighing approximately 1.2–1.5 kg in adults. It lies beneath the diaphragm in the right upper quadrant of the abdomen, primarily in the right hypochondriac region, extending across the epigastric region, and reaching the left hypochondriac region with its left lobe. It is protected superiorly and laterally by the lower rib cage.

Surfaces

The liver has two main surfaces:

Surface	Description
Diaphragmatic (superior)	Convex; moulded to the undersurface of the diaphragm; covered by peritoneum except at the bare area
Visceral (inferior/posterior)	Bears impressions of adjacent organs; faces downward and backward

Lobes

Traditionally, four lobes are recognised based on external appearance:

Lobe	Location
Right lobe	Largest; accounts for 60–70% of liver mass
Left lobe	Separated from the right by the falciform ligament anteriorly
Caudate lobe	Posterior-superior surface of the right lobe; drains directly into the IVC
Quadrate lobe	Inferior surface, between gallbladder fossa, porta hepatis, and ligamentum teres

Functionally (Couinaud), the liver is divided into 8 segments (I–VIII), with Cantlie's line (gallbladder fossa to IVC) marking the true anatomical right/left division.

Relations (Visceral Surface Impressions)

The visceral surface shows impressions of neighbouring structures:

Right lobe: renal impression (right kidney), colic impression (hepatic flexure of colon), duodenal impression
Left lobe: gastric impression (stomach), pyloric impression
Caudate lobe: adjacent to the inferior vena cava posteriorly
Gallbladder: lies in its fossa on the inferior surface

Peritoneal Attachments & Ligaments

The liver is held in position by peritoneal reflections and ligaments:

Ligament	Attachment
Falciform ligament	Connects liver to anterior abdominal wall and diaphragm; contains the ligamentum teres (obliterated umbilical vein)
Coronary ligament (superior & inferior)	Attaches liver to the diaphragm; surrounds the bare area
Right & left triangular ligaments	Lateral extensions of the coronary ligament to the diaphragm
Lesser omentum	Connects the visceral surface/porta hepatis to the stomach and duodenum
Ligamentum venosum	Remnant of the ductus venosus, in the fissure on the visceral surface

The bare area is a region on the posterior diaphragmatic surface devoid of peritoneum where the liver directly contacts the diaphragm — the site of potential spread of subphrenic infection.

Blood Supply

Portal vein — ~70% of hepatic blood flow (nutrient-rich from GI tract)
Hepatic artery (branch of celiac axis) — oxygen-rich arterial supply
Hepatic veins (right and left) — drain into the inferior vena cava posteriorly, near the right atrium

Nerve Supply

From the vagus (X), phrenic nerves, and sympathetic ganglia (T7–T10 spinal levels), accompanying the hepatic arteries and bile ducts.

Diagrams

Liver structure — diaphragmatic and visceral surfaces with lobule detail

Liver structure: diaphragmatic surface (top left), visceral surface with organ impressions (top right), and hepatic lobule microanatomy — Tietz Textbook of Laboratory Medicine, p. 1964

Sources: Tietz Textbook of Laboratory Medicine (7th ed.), p. 1963–1964 | Sleisenger & Fordtran's Gastrointestinal and Liver Disease, Anatomy chapter | Schwartz's Principles of Surgery (11th ed.)

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