Anatomy Practice #1 Flashcards by lindsay crouse

Which of the following can be used to differentiate Riedel lobe from hepatomegaly?

the left lobe is normal in size with Reidel lobe but enlarged with hepatomegaly

the Lig Venosum is not visible in cases of Riedel lobe but well seen in hepatomegaly

the right lobe is normal in size in Reidel lobe but enlarged with hepatomegaly

the Lig Venosum is not visible in cases of Riedel lobe but well seen in hepatomegaly

the left lobe is normal in size with Riedel lobe but enlarged with hepatomegaly

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What structure/vessel is indicated by #6?

SMA
splenic vein
SMV
splenic artery

SMA

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What structure/vessel is indicative by #4?

caudate lobe
right lobe
medial left lobe
lateral left lobe

medial left lobe

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Which statement best describes the location of the Lig Venosum?

forms the anterior border of the caudate lobe

lies between the right and left lobes of the liver

forms the posterior border of the right lobe

on ultrasound, it appears as a thick, triangular, echogenic foci in the left lobe of the liver

forms the anterior border of the caudate lobe

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All of the following are intrasegmental vessels of the liver, EXCEPT?

PVs
hepatic arteries
bile ducts
HVs

HVs

course between the liver segments (intersegmental)

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The Lig Venosum travels between:

the RPV and IVC
the MPV and IVC
the LPV and IVC
caudate lobe and right lobe

the LPV and IVC

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Which of the following statements correctly describes imaging of the dome of the liver?

intercostal scanning is the preferred scanning approach to evaluate the dome of the liver

the portal confluence should be used to locate the dome of the liver

because the dome is bordered superiorly by the diaphragm, lobe artifact commonly inhibits complete evaluation of this portion of the liver

deep inspiration is required to evaluate this portion of the liver

(subcostal approach with deep inspiration)

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Which of the following structures is labeled #6?

anterior right lobe
lateral left lobe
medial left lobe
posterior right lobe

medial left lobe

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What structure/vessel is indicated by #7?

splenic vein
splenic artery
SMV
SMA

splenic vein

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The pancreatic duct should normally be less than ____ in diameter in children and young adults.

0.5mm
1 mm
2mm
4mm

2mm

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The ____ is located within the inferior margin of the falciform ligament.

Lig Teres
Lig Venosum
MHV
LHV

Lig Teres

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During an abdominal ultrasound, a 4mm circular anechoic structure is identified at the posterior portion of the pancreas head. Color flow is not identified in the structure. What is it?

common hepatic duct
IMA
CBD
gastroduodenal artery

CBD

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What structure is indicative by the purple circle?

Caroli disease
MPV
chledochal cyst
portal triad

portal triad

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Which of the following structures is labeled #7?

medial left lobe
anterior right lobe
lateral left lobe
posterior right lobe

anterior right lobe

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A normal portal vein will:

increase in diameter after exercise
increase in diameter by placing patient in the upright position
decrease in diameter after eating
increase in diameter by more than 20% with deep inspiration

increase in diameter by more than 20% with deep inspiration

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The yellow arrow on the images represents which of the following structures?

medial left lobe
caudate lobe
Lig Teres
Lig Venosum

caudate lobe

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The MLF:

separates the IVC and medial left lobe
separates the anterior and posterior right lobes
separates anterior right lobe and medial left lobe
separates the medial and lateral left lobes

separates the anterior right lobe and medial left lobe

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The caudate lobe lies between what two structures?

MLF and GB
right and left PVs
IVC and medial left lobe
IVC and lateral left lobe

IVC and medial left lobe

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The ___ can be identified anterior to the pancreas tail

stomach
SMA
hepatic flexure of the colon
left kidney

stomach

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Which of the following hepatic ligaments separate the medial and lateral left lobes of the liver?

Lig Venosum
broad ligament
triangular ligament
falciform ligament

falciform ligament

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Which waveform represents a normal IVC waveform?

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Which of the following structures is labeled #1?

RHV
IVC
LHV
LPV

LHV

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What structure prevents free fluid in Morison pouch from moving into subphrenic space?

Lig Teres
falciform ligament
right hepatoduodenal ligaments
right coronary ligament

right coronary ligament

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Which structure is the MPV?

MPV = posterior vessel
hepatic artery = circular structure
dilated CBD = anterior vessel

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Which of the following structures is labeled #2? gastroduodenal artery SMA hepatic artery CBD

gastroduodenal artery

The caudate lobe occupies much of the ___ surface of the liver anterior superior posterior superior posterior inferior anterior inferior

posterior superior

What structure/vessel is indicated by #2? left lobe of the liver stomach head of pancreas duodenum

head of pancreas

In the porta hepatis, what structure is anterior to the PV and lateral to the proper hepatic artery? common hepatic duct common hepatic artery cystic duct duct of wirsung

common hepatic duct

What liver vessel is indicated by the yellow arrow? medial LPV anterior RPV posterior RPV lateral LPV

anterior RPV

Which of the following is located between the transversalis fascia and the posterior parietal peritoneum? pancreas stomach spleen linea alba

pancreas the retroperitoneal cavity is located between the transversalis fascia and posterior parietal peritoneum - pancreas is a retroperitoneal organ

What structure/vessel is indicated by #9? air within the intestines SMA spine AO IVC

spine

Which of the following ligaments separates the medial and lateral left lobes of the liver? Lig Teres Lig Venosum coronary ligament broad ligament

Lig Teres

Which of the following blood vessels delivers the majority of oxygenated blood that enters the liver? MPV proper hepatic artery HVs common hepatic artery

MPV (80%)

A patient presents for an abdominal sonogram due to a history of hepatic congestion. What structure (s) should be closely evaluated for related findings? RAs portal system LRV celiac axis

portal system

A small rounded prominence on the anteroinferior aspect of the normal caudate lobe is called Reidel lobe distal papillary process quadrate lobe elongated left lobe

distal papillary process

What structure/vessel is indicated by #8? Lig Teres caudate lobe Lig Venosum medial left lobe lateral left lobe

medial left lobe

Branches of which of the following vessels supply the pancreas with blood? SMA and right gastric artery proper hepatic artery and SMA gastroduodenal artery and proper hepatic artery SMA and gastroduodenal artery

SMA and gastroduodenal artery

____ merge to form the ampulla of Vater just prior to the duct entering the second portion of the duodenum CBD and CHD CBD and duct of Wirsung CBD and cystic duct CHD and cystic duct

CBD and duct of Wirsung

Which of the following structures is labeled #3? LHV IVC MHV LPV

IVC

Which of the following hormones is responsible for causing the GB to contract? cholecystokinin trypsin insulin lipase

cholecystokinin

Which portions of the GB and/or biliary tree are involved in the formation of a phrygian cap? neck and cystic duct body and fundus cystic duct and CBD neck and body

body and fundus

Hepatomegaly in a 5 year old is diagnosed using which of the following criteria? divide the patient's age in years by the number 2 to obtain the max normal liver length for the patient's age normal liver should not extend more than 1 cm below the costal margin multiply the patient's age in years by the number 2 to obtain the max normal liver length for the patient's age divide the patient's height in inches by the number 10 to obtain the max normal liver length for the patient's age

normal liver should not extend more than 1 cm below the costal margin

The right and left hepatic ducts come together to form the common hepatic duct: deep within the liver parenchyma at the level of the ampulla of vater at the pancreas head inside the liver, near the porta hepatis

inside the liver, near the porta hepatis

What structure is marked with the X on the image? splenic vein SMV CBD main pancreatic duct

main pancreatic duct

What structure/vessel is indicated by #6? medial rigth lobe caudate lobe anterior right lobe medial left lobe lateral left lobe

caudate lobe

If a liver mass is located between the MHV and RPV, in what lobe of the liver is the mass located? posterior right lobe anterior right lobe caudate lobe medial left lobe

anterior right lobe

Sonographically, the ___ appears to connect the GB neck and junction of right and left portal veins Lig Teres Lig Venosum intersegmental fissure MLF

MLF

Which of the numbered vessels is a part of the portal system? 1 2 3 1 and 3

What liver vessel is indicated by the green arrow? lateral LPV anterior RPV posterior RPV medial LPV

posterior RPV

Which liver segment is located immediately lateral to the Lig Teres? anterior right lobe medial left lobe caudate lobe lateral left lobe

lateral left lobe

Which of the following correctly lists the structures found in an intrahepatic portal triad? PV, HV, and bile duct PV, proper hepatic artery, and bile duct HV, proper hepatic artery, and bile duct common hepatic artery, HV, and PV

PV, proper hepatic artery, and bile duct

What structure/vessel is indicated by #5? caudate lobe lateral left lobe right lobe medial left lobe

lateral left lobe

A patient presents with a history of choledocholithiasis. How will you assess the CBD for the presence of a stone? locate the MPV and look for the CBD posterior to it demonstrate a long axis GB image and look for the CBD superior to it demonstrate a TV view of the pancreatic head and look for the CBD entering the anterior aspect demonstrate a longitudinal view of the MPV and look for the CBD anterior to it

demonstrate a longitudinal view of the MPV and look for the CBD anterior to it

the CBD is formed by: cystic duct + duct of Wirsung CHD + cystic duct varies per patient rght and left hepatic ducts + cystic duct

CHD + cystic duct

During an abdominal ultrasound, a small circular anechoic structure is identified at the anterior portion of the pancreas head. Color flow is identifies in the structure. What is it? CBD gastroduodenal artery celiac axis IMA

gastroduodenal artery

Trypsin breaks down ____, amylase breaks down ____ and lipase breaks down ____ during digestion protein, carbs, fat sugar, carbs, fat carbs, protein, fat fat, carbs, protein

protein, carbs, fat

The normal GB is usually less than __ in TRV diameter 3 mm 8 cm 5 cm 3 cm

5 cm

The liver is divided in the TRV plane by the: branching of the PVs course of the biliary vessels through the tissue branching of the HVs course of the fissures through the tissue

branching of the PVs

All of the following are true regarding Couinaud liver segmentation EXCEPT allows for liver resection/surgery without negatively affecting other segments each of the 8 segments has its own branch of the PV, HV, and bile duct divides the liver into 8 functional segments right and left lobes are divided by the branches of the MHV

right and left lobes are divided by the branches of the MHV

What structure/vessel is indicated by #3? MPV lateral branch of LPV medial branch of LPV LPV

lateral branch of LPV

The ___ lobe of the liver is located between the right and middle hepatic vein medial left lateral left anterior right caudate

anterior right

What vessels drain the blood from the caudate lobe? LPV coronary vein emissary veins umbilical vein

emissary veins

Which waveform represents a normal PV waveform?

___ is produced by the exocrine function of the pancreas and ___ is produced by the endocrine function of the pancreas sodium bicarbonate, amylase sodium bicarbonate, insulin insulin, trypsin amylase, lipase

sodium bicarbonate, insulin

Islets of Langerhans secrete ___ into ___ cholecystokinin, GB sodium bicarbonate, duodenum lipase, pancreatic duct insulin, bloodstream

insulin, bloodstream

The IVC is located posterior to the pancreatic ___ body tail neck head

head

What causes the HV flow to have a triphasic waveform? left atrial contraction and relaxation PHTN right atrial contraction and relaxation hepatic congestion

right atrial contraction and relaxation

What structure is indicated by the red arrow? MPV CBD proper hepatic artery common hepatic artery

proper hepatic artery

The accessory duct of the pancreas is called duct of santorini duct of heister duct of vater duct of wirsung

duct of santorini

Which of the following structures is labeled #4? RHV IVC MHV RPV

RHV

What lobe of the liver is indicated by #2? anterior right lobe medial left lobe posterior right lobe caudate lobe

anterior right lobe

An ERCP is commonly performed to evaluate: LRV RRV pyloric stenosis the Ampulla of Vater

Ampulla of Vater ERCP is used to diagnose and treat certain problems of the biliary or pancreatic ductal systems

What structure/vessel is indicated by #2? MPV medial branch of LPV lateral branch of LPV LPV

LPV

What structure is indicated by the blue arrow? LPV LHV MHV RPV

RPV

What structure/vessel is indicated by #12? spine SMA AO IVC

spine

What portion of the pancreas is indicated by the letter O? head neck uncinate process tail

head

Which of the following terms can be used to describe a normal Doppler tracing form the hepatic veins? triphasic monophasic non-pulsatile continuous

triphasic

What structure/vessel is indicated by #4? LLL body of pancreas tail of pancreas head of pancreas

body of pancreas

The medial segment of the left lobe lies between MHV and Lig Teres Lig Teres and spleen RHV and MHV Lig Venosum and IVC

MHV and Lig Teres

Which of the following structures is labeled #2? LHV IVC MHV LPV

MHV

What structure/vessel is indicated by #7? cadate lobe medial left lobe Lig Venosum Lig Teres lateral left lobe

Lig Venosum

While discussing the medical history with a patient, he tells you that the doctor recommended that he increase his intake of vitamin K due to some recent abnormal lab results. Which of the following lab values was abnormal? AFP PT RBC count ALP

What organ produces sodium bicarbonate? kidneys adrenal glands pancreas parathyroid gland

pancreas

What lobe of the liver is indicated by #1? posterior right lobe caudate lobe anterior right lobe medial left lobe

posterior right lobe

Which of the following terms can be used to describe the normal flow in the PV? continuous biphasic pulsatile hepatofugal

continuous

The cystic artery originates at the ____ and the cystic vein empties into the ___ common hepatic artery, MPV RHA, RPV RHA, RHV LHA, LPV

RHA, RPV

What structure/vessel is indicated by #3? SMA CBD gastroduodenal artery celiac

gastroduodenal artery

All of the following are true regarding the Lig Teres, EXCEPT round, hyperechoic foci near the porta hepatis located in the left intersegmental fissue recanalizes with cirrhosis is a remnant of the umbilical vein

round, hyperechoic foci near the porta hepatis

What structure is indicated by the yellow arrow? falciform ligament Lig Teres MLF Lif Venosum

MLF

In a normal adult patient, the CHD lumen measure less than or equal to ___ 6mm 2mm 2cm 4mm

4mm

The pancreatic tail is anterior to all of the following EXCEPT lesser omental sac splenic hilum upper pole of the left kidney left adrenal gland

lesser omental sac is anterior to the panceas

Which of the following statements is true regarding the Doppler tracing displayed? could represent a Doppler tracing of normal flow in the RHV could represent a Doppler tracing of normal flow in the MPV could represent a Doppler tracing of normal flow in the portal or hepatic venous system could represent a Doppler tracing of normal flow in the proximal AO

could represent a Doppler tracing of normal flow in the RHV

The majority of the liver is covered by a thick capsule composed of fibrous and elastic elements called ___ Morrison pouch Glisson capsule Bowman capsule Gerota fascia

Glisson capsule

Normal hepatic venous flow will demonstrate two large antegrade diastolic and systolic waves followed by a small antegrade component that corresponds with the atrial contraction two large antegrade diastolic and systolic waves followed by a small retrograde component that corresponds with the atrial contraction two large retrograde diastolic and systolic waves followed by a small retrograde component that corresponds with the atrial contraction two large retrograde diastolic and systolic waves followed by a small antegrade component that corresponds with the atrial contraction

two large antegrade diastolic and systolic waves followed by a small retrograde component that corresponds with the atrial contraction

What blood vessel separates the right and left lobes of the liver? common hepatic artery LHV MHV RPV

MHV

Which abdominal vessel is the best landmark to identify the body and tail of the pancreas? LRV RRV splenic vein SMV

splenic vein

Which lobe of the liver receives blood from the left and right portal veins? anterior right lobe medial left lobe caudate lobe posterior right lobe

caudate lobe

The ___ are called intersegmental vessels of the liver PVs HAs HVs HAs and HVs

HVs

On a TRV sonogram, the CBD enters at ___ aspect of the head of the pancreas and lays ___ to the IVC anterior, medial posterior, anterior posterior, posterior none of the above

posterior, anterior

The ___ separates the caudate lobe from the left lobe of the liver falciform ligament MLF Lig Venosum Lig Teres

Lig Venosum

Which of the following statements is true regarding the image displayed? GB has a normal variant called a phrygian cap near the fundal area GB has a normal variant called a phrygian cap near the neck GB has a septation within the fundus GB has a normal variant called Hartmann pouch near the fundal area

GB has a normal variant called phrygian cap near the fundal area

The formation of a Hartmann pouch usually occurs in what portion of the GB? cystic duct neck fundus body

neck

Which of the following produces insulin? islets of langerhans Kupffer cells in the liver pituitary gland acini glands of the pancreas

islets of langerhans

The purple arrow on the images represents which of the following structures? Lig Teres medial left lobe caudate lobe Lig Venosum

Lig Venosum

All of the following are true regarding the spiral valves of Heister EXCEPT located in the CBD may simulate stone located in the cystic duct may simulate shadow

located in the CBD

The bare area of the liver is in direct contact with right kidney diaphragm IVC RPV

diaphragm

What structure is indicated by the blue arrow? common hepatic artery MPV CHD CBD

CBD

A patient presents with a history of Reidel lobe. What are the expected findings on the ultrasound exam? caudate lobe will be at least 2x greater in size than the left right lobe of the liver will have a tongue-like extension that extends inferior to the lower pole of the right kidney liver will demonstrate diffuse fatty infiltration of the right lobe only left lobe will extend across the midline to touch the upper pole of the spleen

right lobe of the liver will have a tongue-like extension that extends inferior to the lower pole of the right kidney

In the porta hepatis, what structure is anterior to the PV and medial to the CBD? common hepatic artery cystic duct proper hepatic artery duct of Wirsung

proper hepatic artery

What structure is indicated by the green arrow? MPV common hepatic artery CBD porta hepatis

MPV

What structure/vessel is indicated by #5? tail of pnacreas left lobe of liver body of pacreas head of pancreas

tail of pancreas

The hepatoduodenal ligament contains which of the following structures? umbilical arteries and vein RPV, RHA, and cystic duct emissary veins MPV, proper hepatic artery, and CBD

MPV, proper hepatic artery, CBD

The right lobe of the liver is divided into ___ segments, while the left lobe is divided into ___ segments medial/lateral and anterior/posterior anterior/posterior and medial/lateral caudate/anterior and quadrate/posterior caudate/posterior and quadrate/anterior

anterior/posterior and medial/lateral

What causes the appearance of this normal variant of the uncinate process? hyperbilirubinemia polycythemia vera higher concentration of fat in the area of interest reduced concentration of fat in the area of interest

reduced concentration of fat in the area of interest

The first branch of the common hepatic artery is the gastroduodenal artery duodenal artery pancreatic artery cystic artery

gastroduodenal artery

Which of the following correctly describes the ducts of Luschka? associated with porcelain GB and GB carcinoma only visible in obese patients located within the 3rd segment of the duodenum bile thickening occurs within them

bile thickening occurs within them located in the GB wall can result in the stasis of bile/debris which leads to inflammatory disease

A Reidel lobe is a normal liver variant defined as tongue-like extension of right lobe tongue-like extension of caudate lobe elongated right lobe that comes in contract with the spleen elongated left lobe that comes in contact with the spleen

tongue-like extension of right lobe

Which of the following structures is labeled #5? anterior right lobe lateral left lobe medial left lobe posterior right lobe

lateral left lobe

In the normal liver, which of the following correctly describes the changes in flow in the hepatic artery after eating? increased end diastolic flow velocities decreased peak and end diastolic flow velocities no change occurs in the hepatic artery after eating increased RI

increased RI

What structure/vessel is indicated by #1? medial branch of LPV lateral branch of LPV medial left lobe LPV

medial branch of LPV

The abdominal organ that produces the majority of ALP is? liver spleen pancreas gallbladder

liver

The liver's exocrine function includes producing: hemoglobin urea bile heparin

bile

Which lab value is associated with the development of jaundice? BUN hematocrit leukocytes bilirubin

bilirubin

All of the following lab tests are used to evaluate the liver function EXCEPT sodium bicarbonate prothrobin time bilirubin AST

sodium bicarbonate

The purple arrows point to which of the following liver structures? Lig Venosum falciform ligament Lig Teres MLF

Lig Teres

The SMV: lies to the left of the SMA joins the PV to form the splenic vein joins the splenic vein posterior to the neck of the pancreas joins the splenic vein anterior to the neck of the panceas

joins the splenic vein posterior to the neck of the pancreas

A patient presents with intermittent RUQ pain for several months. A complete abdominal exam is performed with an image displayed from the spleen evaluation. What is the most likely finding displayed by the blue arrows? fractured spleen due to unknown trauma elongated left lobe of the liver adjacent to spleen Riedel lobe loculated ascites

elongated left lobe of the liver adjacent to spleen

The pancreas is found in what retroperitoneal space? perirenal retrofascial posterior pararenal anterior pararenal

anterior pararenal

In a patient with complete situs inversus, the liver will be: located in the LUQ located in the RLQ divided into 3 separate lobes absent

located in the LUQ

Which of the following is an acquired abnormality of the biliary system? sclerosing cholangitis Caroli disease choledochal cyst biliary atresia

sclerosing cholangitis

Which of the following structures is labeled #8? medial left lobe anterior right lobe lateral left lobe posterior right lobe

posterior right lobe

In a normal fasting adult, blood sugar levels should not exceed ____ of blood 50mg/100ml 100mg/100ml 150mg/100ml 200mg/100ml

100mg/100ml

Which liver vessel courses within the MLF? common hepatic artery RHV MPV MHV

MHV

Which of the following correctly describes the location of the RHV? courses inferiorly through the right intersegmental fissure courses inferiorly through the falciform ligament courses superiorly through the MLF courses superiorly through the right intersegmental fissure

courses superiorly through the right intersegmental fissure

Which of the following correctly describes the pediatric pancreas? the ducts are dilated at >2mm at birth and decrease in size throughout the first year cystic fibrosis leads to the production of mucus and the gland is reduced in echogenicity pancreatic echogenicity increases with age it normally decreases in echogenicity as the patient reaches adulthood

pancreatic echogenicity increases with age

Which vessel is the MPV?

the MPV is the large circular vessel that is anterior to the IVC