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Physics C/O 2026 > AB1 Ch. 7-8 > Flashcards

AB1 Ch. 7-8 Flashcards

Liver and Biliary System

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1
Q

GB congenital anomalies

A

-Floating GB: low position in abdomen
-Hypoplasia: under development
-Agenisis: failure of the GB to develop

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2
Q

GB variants

A

-Bilobed: hourglass shaped
-Septated: 1 or more divisions of the GB
-Junctional fold: fold seen at the body and the neck of GB

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3
Q

Hepatic Oxygenation of blood -> liver

A

The remaining 25% of blood to liver

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4
Q

How much blood does the Portal System provide to the liver

A

75%

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5
Q

Image protocol for the liver to include the MPV

A

-phasic flow
-response to respirations
-cont., forward
-low velocity
-increase flow on resp.

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6
Q

Morrison’s pouch

A

In between liver and kidney

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7
Q

Epiploic of Winslow

A

Passageway between greater/lesser sacs just inferior to liver.

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8
Q

Normal Measurement of Liver

A

RT Lobe: 13-17 cm (length)
5-6 cm (width)
LT Lobe: variable

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9
Q

How to measure the Liver

A

Measure superior to inferior (very top left to very bottom right)

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10
Q

Elongated Left lobe

A

Extension of the left lobe laterally (can extend all the way to the spleen!)

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11
Q

Glisson’s Capsule

A

Encloses the liver with a fibrous capsule. (Highly echogenic)

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12
Q

Ligamentum Venosum

A

Was the duct venous that collapsed after birth. Separates LT lobe from Caudate lobe.

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13
Q

Falciform Ligament

A

Thin, sickle shaped fibrous structure. Not seen unless ascites is present!

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14
Q

Main Lobar Fissure

A

-Separates the RT/LT lobes.
-Main HV is located here.
-Identified location of the GB Fossa

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15
Q

Ligamentum Teres
aka “The Bulls-eye Lesion”

A

-Left umbilical vein after birth becomes ligament teres.
-Courses between medial/lateral segments of the left lobe.

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16
Q

Echogenicity of Liver to other structures:

A

-Pancreas (hypoechoic/isoechoic)
-RT Kidney (hyperechoic/isoechoic)
-Spleen (hypoechoic)

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17
Q

Protocol of Liver to include MPV

A

Image RT lobe to include MPV, color showing direction.

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18
Q

US appearance of CBD/GB

A

CBD: avascular anechoic tubular, thin bright walls
GB: Anechoic, thin bright walls and pear shaped

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19
Q

CBD/GB location

A

GB: In main lobar fissure
CBD: Anterior to Portal Vein

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20
Q

GB Wall measurement

A

(Less) <3 mm

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21
Q

GB Fossa

A

Indentation of RT lobe near GB

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22
Q

GB sections

A

neck, body, fundus

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23
Q

Route of Bile from Liver to GB

A

CCK secretion -> GB contracts -> Sphincter of Oddi relaxes -> Bile goes into cystic duct -> flows through CBD and enters duodenum

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24
Q

Diameter of Bile Duct

A

4-8mm
Hepatic Artery max is 2-6mm
normal measurment is 1-7 mm

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25
Q

Porta (gate) Hepatis (liver)
3 structures w/n hepatoduodenal ligament

A

Bile Duct is ventral/lateral
Hepatic Artery is ventral/medial
Portal Vein is dorsal

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26
Q

CCK

A

cholecystokinin, stimulates GB contractions

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27
Q

Spiral Valves of Heister

A

Fold that controls bile flow in cystic duct.

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28
Q

CBD is formed by

A

Common Hepatic and Cystic Ducts

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28
Q

Preprandial vs. Postprandial

A

pre: before meal
post: after meal

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29
Q

CBD Measurement

A

1-7mm
can be 10 after cholesectomy or age (40+)

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30
Q

Functions of Biliary Tract

A

Drains liver of bile, stress bile, and supplies blood to GB

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31
Q

Hartmans Pouch

A

Small sacculation on the GB neck.
(ABNORMAL)

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32
Q

Phrygian Cap

A

GB fundus is folded onto itself. (NORMAL/VARIATION/HAT)

33
Q

Clinical Indications for Biliary Tract

A

-RUQ (primary)
-+ Murphy sign (pin-point tenderness)
-Nausea
-Vomiting
-Pain in RT shoulder
-Jaundice/abnormal LFT’s
-Loss of appetite
-Intolerance to fatty/dairy foods

34
Q

IVC is ___ to the Caudate Lobe

A

Posterior

35
Q

Portal Veins

A

DECREASE in size as they near the diaphragm. Echogenic/Bright due to collagen tissues in WALLS

36
Q

Cont., Monophasic, Hepatopetal blood flow

A

Portal Veins

37
Q

Portal veins are intra or intersegmental?

A

INTRASEG.

38
Q

RT Intersegmental Fissure

A

Divides RT Lobe into anterior and posterior segments.

39
Q

Hepatic Veins

A

INCREASE in size when draining TOWARDS diaphragm.
-Anechoic
-No echogenic walls

40
Q

Triphasic, Pulsate, Hepatofugal blood flow

A

Hepatic Veins

41
Q

Is the Hepatic Veins INTER or INTRAsegmental

A

Intersegmental

42
Q

LT Intersegmental Fissure

A

Divides LT Lobe into medial and lateral segments

43
Q

Reidels Lobe

A

Tongue-like inferior extension of RT lobe that goes caudally to the iliac crest. Seen frequently in thin women.

44
Q

The diaphragm is ___ to the Liver

A

Superior

45
Q

Caudate Lobe

A

Smallest Lobe
-Lies posterior/superior to the RT Lobe

46
Q

LT Lobe

A

Varies in size
-Falciform lig. and ligamentum teres are located w/n this lobe
-supplied by left portal vein

47
Q

RT Lobe

A

6x larger than LT lobe
-supplied by right portal vein

48
Q

Location of Liver

A

Inferior to dome of diaphragm.
-Occupies major portion of RUQ.

49
Q

What is divided by the Hepatic Veins

A

The Liver. The different lobes come from the HV’s

50
Q

Functions of the Liver

A

-Bile production
-Excretion of Drugs, Bilirubin, Cholesterol, and Hormones
-Metabolizes fats, proteins, and carbs
-Enzyme activation
-Storage of vitamins and minerals
-Synthesis of plasma protein s.a. albumin and clotting factors
-Blood purification/detoxification

51
Q

US appearances of Renal Cortex (KIDNEY)

A

Hypoechoic to Liver

52
Q

US appearance of Liver

A

homogeneous (smooth) and somewhat echogenic

53
Q

Segments of Hepatic Veins

A

These separate the LT/RT lobes

54
Q

LT HV

A

Medial/Lateral division of LT lobe.

55
Q

Middle HV

A

LT/RT division

56
Q

RT HV

A

Anterior/Posterior division of RT lobe.

57
Q

Hepatopetal vs. Hepatofugal

A

Towards= Petal (normal)
Away= Fugal (abnormal)

58
Q

Function of the Portal Vein

A

Carries blood and nutrients from abdominal bowel to the liver.
(For metabolism and detoxification)

59
Q

Couinads Liver Segments

A

8!
-Used for hepatic lesions localization (Surgeons)
-Clockwise rotation

60
Q

Normal blood flow

A

RED on Color Doppler- blood flowing towards liver.

61
Q

US appearances of portal vein

A

-Anechoic tubular structure
-Bright echogenic walls
-spontaneous, phasic flow, intrasegmental

62
Q

Normal size for MPV

A

-13mm (diameter)
-5-6cm (length)
diameter should NOT increase 1.3cm

63
Q

How to measure the MPV

A

inner wall to inner wall

64
Q

Obtaining Doppler for MPV

A

-Tell your PT to “Just stop breathing” or “Don’t take a breath or exhale”
-Phasic Flow (above baseline)
-Continuous

65
Q

What forms the MPV

A

Spenlic Vein and Superior Mesentric Vein
-courses superiorly 5-6cm then divides into RT/LT branches.

66
Q

3 Main Tributaries of Portal System

A

-Splenic Vein (SPV)
-Superior Mesentric Vein (SMV)
-Inferior Mesentric Vein (IMV)

67
Q

Appearance of Bile Ducts

A

Avascular, anechoic tubular structures

68
Q

Bare Area

A

A portion of the posterior surface of the liver without a peritoneal covering.

69
Q

Situs Inversus

A

The transverse scan on a newborn, demonstrating the liver in the LUQ

70
Q

Hepotomegaly

A

Enlarged Liver

71
Q

Sonographic Sign to Differentiate CBD and Hepatic Artery

A

Pulsation should only be exhibited from an artery or vein

72
Q

Portal Triad

A

-Main Portal Vein
-Proper Hepatic Artery
-Common Hepatic Duct

73
Q

Probe/Frequency for scanning the Liver

A

1-9MHz for the Adult Liver
Curved Array

74
Q

Harmonics

A

Helps reduce artifacts.

75
Q

Gastroesophageal Junction (GEJ)

A

Located between aorta and edge of Liver.

76
Q

Liver Parenchyma

A

Made up of 50-100k individual lobules. Parenchyma means “tissue”

77
Q

The Portal Hepatic/Hilium of the Liver

A

A fissure where the major vessels and ducts enter/leave the organ. The major structures traversing Porta Hepatis are the
-Portal Vein
-Hepatic Artery
-Hepatic Duct

78
Q

+ Murphy Sign

A

When you apply pressure onto the patient, there will be focal (pin-point) tenderness.

79
Q

Frequency for GB

A

2-5MHz
Curved Array

80
Q

Improper PT Prep can lead to…

A

incorrect measurements of the GB Wall.

81
Q

SPALLANZANI HATES TO SEE YOU COMING

A

YOU CAN DO THIS

Physics C/O 2026 (7 decks)

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