Ligamentum teres

Gibson, P.R., Gibson, R.N., Ditchfield, M.R., Donlan, J.D. A comparison of duplex Doppler sonography of the ligamentum teres and portal vein with endoscopic demonstration of gastroesophageal varices in patients with chronic hver disease or portal hypertension, or both. J. Ultrasound Med. 1992 11 327 - 331... 

Ligamentum teres Right and left leaves of falciform ligament... 

The liver is covered with an anterior reflection of the peritoneum known as Ghsson s capsule. Other extensions of the peritoneum form ligaments that hold the Hver in place. Internal extensions of the capsule provide an internal supporting framework that divides the liver into lobules and ultimately surrounds blood vessels and nerves. One of the ligaments, the ligamentum teres, is the vestigial remnant of the umbilical vein and connects the umbilicus to the inferior border of the liver. When portal hypertension occurs, the umbilical veins may reopen, leading to venous dilation around the umbilicus (termed caput medusae). 

Tanaka Y, Ijiri R, Kato K, et al. HMB-45/Melan-A and smooth muscle actin-positive clear-cell epithelioid tumor arising in the ligamentum teres hepatis additional example of clear-cell sugar tumors. Am J Surg Pathol. 2000 24 1295-1299. 

The femoral head is uniquely vulnerable to vascular insult. The femoral head is two-thirds of a sphere which allows a large degree of movement in three planes. This large degree of movement afforded by the hip articulation is at the cost of a precarious blood supply. Apart from the ligamentum teres, there are no soft tissue attachments to the femoral head to enable arterial supply. Consequently, the blood supply to the femoral head is provided by the ligamentum teres and from generalised perfusion around the epiphysis. 

In the first year of life, metaphyseal vessels cross the physeal cartilage but after this point, the physis forms a barrier. From then onward, the blood supply is largely from branches of the circumflex vessels and to a lesser extent, the ligamentum teres. 

Fig. 2.1 Views of the liver anterior, posterior, inferior. (LL = left lobe, RL = right lobe, D = diaphragm, GB = gall bladder, FLV = fissure for ligamentum venosum, RL = round ligament (= lig. teres), IVC = inferior vena cava, FL = falciform ligament)...

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