Trunk vessels (aorta, vena cava, abdominal branches)
Hepatic veins
Venae hepaticae (dextra, intermedia et sinistra)
- Origin
- Formed by the convergence of central veins draining the hepatic lobules
- Insertion
- Exit the superior-posterior aspect of the liver to drain directly into the IVC just beneath the diaphragm (right, middle, and left hepatic veins)
- Function
- Conducts all deoxygenated, processed blood from the liver parenchyma into the systemic circulation
- Innervation
- Hepatic plexus
- Movement & chain
- Triphasic Doppler waveform reflecting cardiac cycles
- Palpation
- Evaluated via hepatic Doppler ultrasonography
- Clinical
- Budd-Chiari syndrome (hepatic venous outflow tract obstruction causing acute hepatic congestion, painful hepatomegaly, refractory ascites, with caudate lobe sparing), congestive hepatopathy ('nutmeg liver' in congestive heart failure).
- Segmental innervation
- T6-T9 spinal levels
- In clinical practice
- Doppler evaluation of hepatic vein phasicity (loss of triphasic pattern indicates congestion or obstruction), emergency TIPS/anticoagulation in Budd-Chiari
- Region in the model
- Trunk vessels (aorta, vena cava, abdominal branches)