• Which organs, vessels, and anatomical landmarks are in direct contact with the liver in these regions?

• How do these relationships differ when viewed in axial vs. coronal vs. sagittal planes?

• What structures are positioned within or passing through the porta hepatis?

• How does the liver's relationship to the IVC and diaphragm affect its movement with respiration?

Create a visually engaging and interactive response using one or more of the following formats:

Video – Record a short explanation, demo, or screen recording using Visible Body or another 3D anatomy tool.
Photos/Drawings – Upload labeled images, annotated diagrams, or hand-drawn concept maps.
Audio Clip – Explain a complex spatial relationship in your own words—help your peers "hear" the anatomy.
Text & Links – Write a clear, concise post with key takeaways and links to useful resources.

Be creative! The goal is to make anatomy come alive. Consider real-world examples, analogies, or even storytelling to explain your concept.

Engage with Your Peers – Comment & Expand

Learning happens through discussion and collaboration! After posting, engage with at least two peers by:

Commenting on their post – Ask a thought-provoking question, share a related clinical example, or build on their explanation.
Adding to their content – If a peer posts a diagram, could you enhance it with a video or extra context?
Clarifying misconceptions – If you see something that could be refined or explained differently, offer a respectful and constructive response.

• How does the pancreas' retroperitoneal position affect its relationship with the stomach, duodenum, and spleen?

• Which regions of the pancreas (head, neck, body, tail) are in direct contact with these structures?

• How does the curvature of the duodenum influence the positioning of the pancreatic head?

• How does the vascular supply (e.g., splenic artery, superior mesenteric vessels) relate to these structures?

• If a mass or inflammation affected the pancreas, which neighboring organ would be most impacted first?

Create a visually engaging and interactive response using one or more of the following formats:

Video – Record a short explanation, demo, or screen recording using Visible Body or another 3D anatomy tool.
Photos/Drawings – Upload labeled images, annotated diagrams, or hand-drawn concept maps.
Audio Clip – Explain a complex spatial relationship in your own words—help your peers "hear" the anatomy.
Text & Links – Write a clear, concise post with key takeaways and links to useful resources.

Be creative! The goal is to make anatomy come alive. Consider real-world examples, analogies, or even storytelling to explain your concept.

Engage with Your Peers – Comment & Expand

Learning happens through discussion and collaboration! After posting, engage with at least two peers by:

Commenting on their post – Ask a thought-provoking question, share a related clinical example, or build on their explanation.
Adding to their content – If a peer posts a diagram, could you enhance it with a video or extra context?
Clarifying misconceptions – If you see something that could be refined or explained differently, offer a respectful and constructive response.

Guiding Questions:

• What anatomical relationship was initially challenging to understand?

• What helped clarify it for you (e.g., 3D models, cross-sectional imaging, diagrams, or discussions)?

• How does this relationship change in different imaging planes (axial, coronal, sagittal)?

• Why is this relationship clinically important or relevant in medical imaging?

• If you had to explain it to a peer, how would you describe it in the simplest way?

• 
  

Create a visually engaging and interactive response using one or more of the following formats:

Video – Record a short explanation, demo, or screen recording using Visible Body or another 3D anatomy tool.
Photos/Drawings – Upload labeled images, annotated diagrams, or hand-drawn concept maps.
Audio Clip – Explain a complex spatial relationship in your own words—help your peers "hear" the anatomy.
Text & Links – Write a clear, concise post with key takeaways and links to useful resources.

Be creative! The goal is to make anatomy come alive. Consider real-world examples, analogies, or even storytelling to explain your concept.

Engage with Your Peers – Comment & Expand

Learning happens through discussion and collaboration! After posting, engage with at least two peers by:

Commenting on their post – Ask a thought-provoking question, share a related clinical example, or build on their explanation.
Adding to their content – If a peer posts a diagram, could you enhance it with a video or extra context?
Clarifying misconceptions – If you see something that could be refined or explained differently, offer a respectful and constructive response.

The 'head' of the pancreas sits in the 'C' shape curve of the dudenum. The 'neck' sits anteriorly to the hepatic portal vein (blue) and the superior mesenteric artery (red artery adacent to the hepatic portal vein). The 'tail' of the pancreas extends to near the spleen and touches the spleen's blood vessels.

The duodenum curve pushes the head of the pancreas more anterior.

The splenic artery runs along the superior side of the pancreas.

If there is inflammation affecting the pancreas, the duodenum will be affected since the pancreatic duct combines with the common bile duct and they empty into the duodenum.

Superior: diaphragm

Inferior: Stomach, duodenum, gallbladder

Posterior: Inferior Vena Cava (IVC), Right Kidney

The diaphragm and IVC are directly connected to the liver.

In the frontal view, you can see the right and left lobes more clearly divided by the Falciform Ligament.

In the sagittal view, you can also see the diaphragm which is superior, and the right kidney, which is inferior, but also posterior.

In the axial view, you can see the branches of blood vessels.

The Porta Hepatis is the opening on the inferior side of the liver. This is where the portal vein, hepatic artery and common bile duct pass through.

Since the diaphragm is connected to the liver, when the diaphragm moves inferiorly, the liver and attached structures also move inferiorly. Therefore during respirations, the liver and IVC will also move inferiorly. Breathing causes pressure on the IVC which helps in blood return back to the heart.

The diagram helped demonstrate that intraperitoneal organs are fully surrounded by the paritoneum (See the small intestine). It also helped to show that retroperitoneal organs are behind the paritoneum (see the kidneys).

The relationships are clinically important. When imaging we can see if there is abnormal inflammation to these linings.

If I had to describe a intraparitoneal organ to a peer, I would use a glove analogy. If you put your hand into a glove, it is surrounded by a lining. If it is completely surrounded by a lining, it is intraperitoneal.

Differentiating these parts of the intestines is important when locating an obstruction, and describing that location to another person.

Simply, the ileum is on the right side and slightly above the jejunum, while the jejunum is on the left and mostly below. The large intestines wrap around the left top and right of the small intestines, starting with the ascending colon on the right, transverse colon traveling horizontally and connecting to the descending colon on the left.

These positions are being described in the anatomical position, but it is important to note that their positions change in different planes. For example in the coronal plane it would be easy see how the ileum is on the right side, but in a sagittal view you would not be able to tell right from left. This View may be more helpful in understanding how the different parts of the intestines overlap.

The liver is close to the portal vein and IVC. It is attached to the superior and interior phrenic artery, and the inferior phrenic vein, connecting the liver to the aorta and IVC. 

The gallbladder is attached under the right lobe of liver, the close proximity to one another influences their relationship as it allows the liver to produce bile and the gallbladder stores and concentrates it. 

The bottom view of the axial plane of the liver allows you to see the different veins and arteries within the liver which I think is quite interesting! The liver and pancreas are within the porta hepatitis. The liver is attached to the diaphragm and IVC so it would move with respiration.

The pancreas’ retroperitoneal position affects the surrounding structures, it is located deep in the body and has many structures surrounding it like, the liver, stomach, duodenum spleen and vertebral column. Since the pancreas is “tucked away” and has restricted to no movement, if any abnormalities were to occur in the pancreas, they could be harder to detect. As the abnormalities progress, they could affect the surrounding structures. The image above shows the pancreas and the pancreatic duct where pancreatic enzymes can leak out of, if there is an abnormality (ex. pancreatitis) and affect surrounding structures.

The head of the pancreatic body is nestled within the duodenum, the body is posterior to the stomach, aorta, IVC and lumbar spine, and the tail extends towards the spleen hilum. Additionally, the pancreatic head is anterior to that of it's tail.  The splenic artery provides oxygen to the pancreas, spleen, stomach and greater omentum.

Inferior relationships:

Gallbladder-Lies in a fossa on the inferior surfaces of the right lobe

Stomach-The left lobe of the liver rests anterior to the lesser curvature of the stomach

Duedenum-The first part (superior portion) of the duedenum lies inferior and posterior to the liver

Right kidney & Hepatic fixture of colon-these lie inferior to the right lobe

Posterior relationships:

Diaphragm-the bare area of the liver. Direct contact to the diaphragm and the postier abdominal wall

Inferior vena cava (IVC)-runs in a groove on the posterior surface of the liver. The hepatic veins drain directly into the IVC from the liver

Vertebral column and right adrenal gland-these are posterior to the liver

Esophagus-the abdominal esophagus runs posterior to the livers left lobe

Medial relationships:

The lesser sac, the stomach, the duodenum

The porta hepatic-central area where the hepatic artery, portal vein and common hepatic duct enter or exit the liver

Shape and positioning:

The livers doomed shape allows it to fit snuggly beneath the diaphragm, which influences;

-Superior displacement during inspiration

-close contact with the diaphragm and lungs

- the concave interior surface accommodates the contours of abdominal organs

-it is located mostly RUQ but crosses midline, this makes the liver positioned to interact with both left and right sided organs.

-peritoneal reflections: help stabilize its position and define its compartments and relational spaces

Anatomical planes:

1. Transverse Plane-

View direction: slices body top to bottom.

Liver appearance:

-Seen as a large organ occupying the RUQ, extending partially across the midline.

-Appears anterior and right-sided, wrapping around the inferior vena cava (IVC).

-You can appreciate the segmentation of the liver more clearly (especially with contrast in CT/MRI).

2. Coronal plane (Frontal)

View direction: Looking from front to back (like facing the person); slices body from front to back.

Liver appearance:

-Large, triangular shape on the right, tapering toward the left lobe.

-Sits below the diaphragm, above most abdominal organs.

3.Sagittal Plane (Lateral)

View direction: From the side (left or right); slices body into left and right halves.

Liver appearance:

-Appears as a thick vertical mass along the right side.

-You’ll mostly see the right lobe in a right sagittal slice and left lobe in a left sagittal slice.

Diaphragm Relationship and Respiratory Motion

-The liver's fits snugly beneath the diaphragm: as the diaphragm moves during breathing, the liver follows its motion. In addition to this tight anatomical coupling, ligamentous attachments (such as the falciform, coronary, and triangular ligaments) anchor the liver to the diaphragm and restrict excessive movement. Consequently, with each inhalation (diaphragm contracts and moves downward), the liver shifts inferiorly (downward), and with exhalation, it moves superiorly (upward) along with the diaphragm.

Posteriorly, the liver is in direct contact with the inferior vena cava (IVC), which actually runs in a groove along the right lobe, and it also touches the esophagus and stomach at the posterior aspect of the left lobe. The bare area of the liver, which is not covered by peritoneum, attaches directly to the diaphragm here.

On the medial surface, we see the porta hepatis. This is where the portal triad structures (the portal vein, hepatic artery, and common hepatic duct), along with lymphatics, enter and exit.

Because of its wedge-shaped form and intraperitoneal positioning, the liver molds itself to its neighbours, which means structures like the stomach, duodenum, colon, and kidney leave clear impressions on its surface.

In imaging, these relationships look different depending on the plane. In an axial view, you really appreciate the vessels: the IVC running posteriorly, the portal vein branching transversely, and the stomach sitting anteromedial to the left lobe. In a coronal plane, you can see the vertical stacking: the diaphragm above, the liver immediately beneath it, with the right kidney and colon sitting inferiorly and the IVC posterior. In the sagittal plane, you capture the depth: the anterior abdominal wall first, then the liver, with the diaphragm doming superiorly and the IVC coursing vertically just posterior to the right lobe.

Functionally, the liver’s close tethering to the diaphragm through the bare area and ligaments means that with inhalation, the liver moves inferiorly, and with expiration, it rises back up. The IVC, which is embedded within the posterior liver and then pierces the diaphragm, is also affected by these pressure changes, which is why in an ultrasound you should be able to actually see respiratory variation in IVC diameter

This relationship is clinically important in medical imaging as it is the standard reference for orientation, essentially serving as a universal position. Also, the abdominal wall is used as a landmark system for dividing the abdomen into quadrants. (RUQ, LUQ, RLQ,LLQ).

If I have to explain it simply to a peer, I would say that :

1. The External Oblique is the largest and most superficial muscle of the abdominal wall. It is located on the lateral and anterior part of the abdomen.

2. The internal Oblique is thinner than the external oblique and is located internally to the external oblique and superficially to the transverse abdominis.

3. The rectus abdominis is a long, flat muscle that extends vertically the whole length of the front of the abdomen. It is a medial muscle separated by the Linea alba and located anterior to the transversalis fascia and deep to the rectus sheath.

4. The transverse abdominis is the last of the three layers of the abdominal wall. It is inferior to the External Oblique and superior to the transversalis fascia.

Diagrams also helped me visualize the relationships of the peritoneum. The intraperitoneal cavity includes the stomach, spleen, liver, etc., which are noticeably more mobile and less anchored, and is completely surrounded by the peritoneum. The retroperitoneal would be the pancreas, kidneys, etc., which are located posteriorly and are less mobile but more anchored. 

Understanding the position of the peritoneum is clinically essential for organ locations and can assist in determining clinical implications.

This is especially relevant to me because I recently went through differential diagnosis for gallstones (tested negative and problem has seemingly resolved). My basic understanding was enough to understand that the liver was connected, but not that it could result in liver enzymes being detectable in the bloodstream. This has really helped me understand exactly what my physician was explaining to me. Kind of makes me feel silly now.

The head is in contact with the duodenum, the anterior aspect of the body contacts the stomach, and the tail is in contact with the spleen.

The head is 'boxed' in by the duodenum and is in a 'C-shape'.

The splenic artery runs superiorly to the pancreas. It also drains into the superior mesenteric vein.

The stomach and duodenum would be most impacted first due to them sitting anteriorly to the pancreas. Inflammation would apply pressure to them.

The pancreas is posterior to the stomach and intestines. The small intestine is placed within the large intestine like a picture frame. The gallbladder is tucked under the liver. There is something called the duodenum, and it is connected to the stomach and is the first part of the small intestine.

I was able to have a better understanding of placement with the use of visible body.

Inferior Relationships:

The liver’s inferior surface is not flat, but it is indented by the organs it rests upon. The gastric impression on the left lobe. The duodenal impression on the right lobe, which conforms to the first part of the duodenum. The colic impression on the right lobe, where it rests on the hepatic flexure of the colon. The renal impression on the posterior-inferior surface of the right lobe and finally the fossa for the gallbladder. 

Posterior Relationships:

The liver’s posterior surface is broad and irregular. It is in direct contact with the IVC, which runs in a deep groove. The liver also touches the abdominal part of the esophagus and is extensively adhered to the diaphragm by numerous ligaments. 

Medial Relationships: 

Medially, the left lobe of the liver is separated from the posterior wall of the lesser sac by the lesser omentum, forming part of the anterior wall go the lesser sac. You can also find the ports hepatis which is the gateway to the liver as it is the entry and exit point for the portal triad. The portal triad includes the hepatic portal vein, the proper hepatic artery, and the common hepatic duct. 

Imaging Perspectives: 

Axial Plane:  This plane, slices the liver like a loaf of bread, providing a cross-sectional view of the liver’s horizontal relationships. You can see its large size occupying the right upper quadrant and extending across the midline. It clearly shows the liver wrapping around the anterior and right lateral aspects of the IVC and its anterior relationship with the stomach. 

Coronal Plane: This shows a front to back view of the liver’s superior and inferior extent. You can visualize the dome of the diaphragm superior to the liver, as well as the gallbladder, right kidney, and hepatic flexure of the colon positioned inferiorly. 

Sagittal Plane: This shows a side to side view, demonstrating the liver’s vertical relationships. It shows the liver’s anterior position relative to the anterior abdominal wall and its posterior position relative to the IVC and the vertebral column. You can also see its inferior relationship with the duodenum and the head of the pancreas. 

Respiration: Due to its close connection to the diaphragm, the liver is constantly moving. During inspiration, the diaphragm contracts and moves inferiorly, causing the liver to also move inferiorly and slightly anteriorly. During expiration, the diaphragm relaxed and move superiorly, pulling the liver back to its starting point. This is similar to driving on a road with many small hills or speed bumps. The IVC is a relatively fixed structure, but its diameter changes with the movements of the liver and diaphragm, which helps to influence venous return to the heart. 

The pancreas sits posterior to the stomach and anterior to the aorta. The spleen sits to the left of the pancreas, with the tail of the pancreas ending close to the spleen's helium. The head of the pancreas is nuzzled into the c-shaped curve of the duodenum. the tail of the Pancreas is slightly superior to the head.

Because the pancreas is retroperitoneal the stomach which lies anterior is seperated from the pancreas by the lesser sac. this mens the too organs do not directly touch but the still remain close to eachother. With the pancreas being a retroperitoneal organ it is also has better proctection to trauma.

The head of of the pancreas is tightly places in the c- curve of the duodenum and this tight relationship is neccessary because the pancreatic duct and common bile duct come together to empty into the duodenum.

The spleen and the tail of the pancreas are connceted by the splenorenal ligament. this ligament contains the splenic vessels.

The duodenum helps shape the head of the pancreas because of how it is situated withing the c- curve.

Due to the close nature of the duodenum and pancreas the pancreaticoduodnal artery travels between both structures.

Swelling or a mass in the pancreas can cuase many problems. One problem would be an obstruction of the bile duct. this would cause a backup of bile from the liver and a backup of bilirubin and cuase jaundice. Another issue that could be cuased by a large mass would be a compression of structures like the stomach.

Axial Plane: You can see a large amount of the liver and can better visualize the different lobes all in one picture as you scroll through. You are able to visualize the Vessels running posteriorly including the portal veins throughout the liver.

Coronal Plane: Shows the liver from anterior to posterior. Sitting in the RUQ of the abdomen just below the diaphragm but sitting above the gallbladder and colon. You can really appreciate the way it follows the curvature of the diaphragm itself.

Sagittal Plane: Views it from side to side. It allows you to see the anterior and posterior relations. You can see how it extends inferiorly on the anterior surface or rather slopes posterior and anterior from the inferior part of the liver. You are able to see the gallbladder on the inferoanterior aspect of the liver.

The Porta Hepatis is where the Hepatic artery, portal vein and common bile duct pass through.

Since the Diaphragm and liver are attached anteriorly by the coronary ligament, when you take a breathe in your diaphragm will contract and move downward (inferior) causing liver to move inferiorly as well. Alternatively during expiration, the diaphragm moves superiorly as it relaxes which will pull the liver upward as well. The IVC is retroperitoneal and is a fixed structure so it doesn't move much but the diameter will change during inspiration and expiration.

What helped me understand was using visible body to rotate the model and hide organs. While doing this, I seen how the liver lies inferior to the diaphragm, fitting the shape of its dome-shaped surface. While, the IVC appears posterior to the liver and partially surrounds it. This made the spatial relationships finally click for me.

This relationship is clinically important because the diaphragm's movement during respiration shifts the liver inferiorly, which can alter the appearance of the IVC in imaging.

Based on imaging perspectives, axial shows the liver's horizontal span, coronal shows the liver tucked behind the stomach toward the spleen, and sagittal highlights the liver's depth against the great vessels.

Relating to the vascular supply of the liver, the splenic artery runs along its superior border, and the superior mesenteric vessels pass behind the neck.

From what I learned in the clinical examples lecture, a mass in the head often compresses the duodenum or bile duct first, sometimes causing painless jaundice.