Couinaud classification of hepatic segments (mnemonic)

Last revised by Craig Hacking on 17 Nov 2020

Pauli et al published a "handy" way to remember the Couinaud classification of hepatic segments 1.

Make a fist with your right hand. The fingers should be wrapped around the flexed thumb and the fist should face you. The segments are represented by the following:

  • segment 1: (caudate): the thumb, in the palm of the hand
  • segment 2: index finger proximal phalanx
  • segment 3: index finger middle phalanx
  • segment 4a: middle finger proximal phalanx
  • segment 4b: middle finger middle phalanx
  • segment 5: ring finger middle phalanx
  • segment 6: little finger middle phalanx
  • segment 7: little finger proximal phalanx
  • segment 8: ring finger proximal phalanx

The branches of the portal vein run in the plane of the interphalangeal joints.

The right, middle and left hepatic veins run in intersegmental planes represented by the plane of the interdigital spaces.

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Cases and figures

  • Figure 1: hand memory aid (photo)
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  • Figure 2: hand memory aid (photo)
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  • Figure 3: Couinaud liver segments
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  • Figure 4: annotated CT - axial
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  • Figure 5: annotated CT - coronal
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