Ch. 2 Liver Flashcards
1
Q
the formation and development of blood cells
A
hematopoiesis
2
Q
What organ is responsible for hemopoiesis in early embryonic life?
A
Liver
3
Q
What is the largest parenchymal organ in the human body?
A
Liver
4
Q
What is the thin fibrous casing covering the liver?
A
Glisson’s capsule
5
Q
the region of the liver not covered by peritoneum
A
Bare area
6
Q
What is the largest lobe of the liver?
A
Right hepatic lobe
7
Q
the area of the liver where the portal vein and hepatic artery enter and the hepatic ducts exit; also referred to as the liver hilum
A
Porta hepatis
8
Q
What are the organs that is located in the portion of the liver that is uncovered?
A
- Bare area
- Area of the falciform ligament
- Gallbladder fossa
- Porta hepatis
- Area adjacent to the IVC
9
Q
What are the three hepatic lobes?
A
right, left, and caudate lobes
10
Q
______ of the liver contains hepatocytes, biliary epithelial cells, and Kupffer cells.
A
Lobules
11
Q
A
12
Q
What organ is responsible for hemopoiesis in early embryonic life?
A
Liver
13
Q
the formation and development of blood cells
A
hematopoiesis
14
Q
The largest parenchymal organ in the body
A
Liver
15
Q
the liver has _______ and ______ lobes
A
Left and right lobes
16
Q
the region of the liver not covered by peritoneum
A
Bare area
17
Q
What is the thin fibrous casing covering the liver?
A
Glisson’s capsule
18
Q
What is the largest lobe of the liver?
A
Right hepatic lobe
19
Q
the area of the liver where the portal vein and hepatic artery enter and the hepatic ducts exit; also referred to as the liver hilum
A
Porta hepatis
20
Q
What are the organs that is located in the portion of the liver that is uncovered?
A
- Bare area
- Area of the falciform ligament
- Gallbladder fossa
- Porta hepatis
- Area adjacent to the IVC
21
Q
What are the three hepatic lobes?
A
right, left, and caudate lobes
22
Q
Separates the anterior segment of the right lobe from the posterior segment of the right lobe
A
Right hepatic vein (right intersegmental fissure)
23
Q
The right lobe is separated from the left lobe by? These are located between the anterior segment of the right lobe and the medial segment of the left lobe
A
Middle hepatic vein (also gallbladder fossa or main lobar fissure)
24
Q
Separates the left lateral segment of the left lobe from the left medial segment of the left lobe
A
Left hepatic vein, (can also be ligament teres & falciform ligament), left intersegmental fissure
25
The caudate lobe is bounded anteriorly by the ____ and posteriorly by the ___.
Ligament venosum, IVC
26
The caudate lobe can be separated from the left lobe by the?
Ligament venosum
27
______ of the liver contains hepatocytes, biliary epithelial cells, and Kupffer cells.
Lobules
28
specialized macrophages within the liver that engulf pathogens and damaged cells
Kupffer cells
29
Name the portal triads
1. Small branches of the Portal Vein
2. Bile duct
3. Hepatic artery
30
An additional anatomic lobe of the liver. the _________ lobe is located between the gallbladder fossa and the round ligament.
Quadrate lobe
31
Which hepatic lobe is the largest?
the right lobe
32
Majority of the livers blood supply comes from the ____.
Main portal vein (and hepatic artery)
33
The ___ transports highly oxygenated blood directly to the liver from the abdominal aorta.
Common hepatic artery (one of the main branches of the celiac artery)
34
Portal vein provides the liver with approximately ___ of its total blood supply
75%
35
Normal portal vein measures less than ____.
13mm (enlargement indicative of portal hypertension)
36
The right lobe of the liver can be divided into ______ and ________ segment by the right hepatic vein, which lies within the right intersegmental fissure.
anterior and posterior segment
37
The left lobe of the liver is located within the ___________ and may extend to the _______ __________.
epigastrium; left hypochondrium
38
The left lobe may be divided into the _________ and ________ segment by the left hepatic vein, which lies within the left intersegmental fissure.
medial and lateral segment
39
The caudate lobe is located within the _________, and is bounded anteriorly by the ___________ ___________ and posteriorly by the ______.
epigastrium; ligamentum venosum; IVC
40
The porta hepatis is also called...
Liver hilum
41
The main portal vein of the liver is created by the union of the _______________ and _____________.
superior mesenteric vein and splenic vein
42
How much percentage does the portal vein provides for the liver's total blood supply?
approximately 75%
43
Enlargement of hepatic veins and IVC is seen with ______.
Right sided heart failure
44
Occlusion or narrowing of the hepatic veins is seen with ____.
Budd-Chiari syndrome
45
A decreased albumin level on a liver test might indicate.....
Chronic Liver Disease, Cirrhosis
46
An increased ALP on a liver test might indicate....
Hepatitis, Cirrhosis, Gallstones, extrahepatic biliary obstruction, metastatic liver disease, pancreatic carcinoma
47
An increased ALT on a liver test might indicate...
Obstructive Jaundice, Hepatitis, Biliary tract obstruction, Hepatocellular disease
48
An increased AST on a liver test can indicate....
Fatty liver, Cirrhosis, hepatitis, metastatic liver disease
49
An increased LDH on a liver test can indicate...
Obstructive Jaundice, Cirrhosis, Hepatitis
50
An increased AFP on a liver test can indicate...
Hepatocellular carcinoma
51
Does the main portal vein splits into right and left portal veins once it enters the liver?
True
52
The diameter of the main portal vein typically measures less then _____ mm in the anteroposterior dimension.
13 mm
53
enlargement of the main portal vein is indicative of
Portal hypertension
54
In the liver, the walls of the hepatic veins are brighter than the portal veins. True of False.
False. Portal vein walls are brighter.
55
Normal flow within the portal veins should be _________ and ________, with some variation noted with respiratory changes.
hepatopetal and monophasic
56
The hepatic veins drains to the ______.
IVC
57
Most people have three hepatic veins: right, middle, and left. True or False?
True
58
Hepatic veins have a _________ blood flow pattern secondary to their association with the right atrium and atrial contraction.
Triphasic
59
a syndrome described as the occlusion of the hepatic veins, with possible co-existing occlusion of the IVC
Budd-Chiari syndrome
60
The common hepatic artery carries ____________ ________ to the liver from the abdominal aorta
oxygenated blood
61
What kind of normal flow pattern does the hepatic artery have that appears in Doppler imaging?
low-resistance flow
62
The ________ sign describes the transverse image taken of the porta hepatis.
Mickey sign
63
Shortly after birth, the right branch of the umbilical vein called ________ _______ collapses and becomes the _________ _________.
ductus venosus; ligamentum venosum
64
After birth, the left branch of the umbilical vein will become a fibrous cord referred to as _____________ _______.
ligamentum teres
65
the reopening of canals or pathways
Recanalization
66
Recanalization can happen to the ligamentum teres when there's ___________.
hypertension
67
In transverse, the falciform ligament often appears.....
Hyperechoic, triangular-shaped structure between the hepatic lobes.
68
Diaphragmatic slip is also called....
Diaphragmatic muscular bundles
69
Diaphragmatic slip can typically occur in older patients and is caused by ____________ diaphragmatic muscle bundles.
hypertrophied diaphragmatic muscle bundles.
70
a tonguelike extension of the right hepatic lobe.
Riedel lobe
71
condition in which the organs of the abdomen and chest are on the opposite sides of the body
situs inversus
72
What is the normal texture of the liver?
Homogenous
73
The normal liver is homogeneous and it echogenicity is equal to or slightly greater than the parenchyma of the normal _____, and slightly less echogenic than the normal ____.
Kidney, spleen
74
The liver's echogenicity is either equal or slightly greater than the parenchyma of the normal right kidney. True or False?
True
75
What is the normal size of the liver in adults?
13 to 15cm in length
76
Anything greater than 15.5 cm liver size can be an indication of....
hepatomegaly
77
Hepatic steatosis is also called
Fatty liver
78
It's a liver disorder characterized by fatty deposits (triglycerides) within the hepatocytes.
Hepatic steatosis (fatty liver)
79
a type of fatty liver disease that causes inflammation of the liver's
Steatohepatitis
80
Fibrosis, cirrhosis, and hepatocellular carcinoma has been shown to be a precursor for...
Chronic liver disease/Steatohepatitis
81
In sonogram, diffuse infiltration of the liver looks like...
Diffusely echogenic & difficult to penetrate/imaged
82
With _______ ________ ________, the liver is involved with diffuse fatty infiltration , with certain areas spared.
Focal fatty sparing
83
List the sonographic findings for ______
1. Diffuse echogenic liver
2. Increases attenuation of the sound beam
3. Wall of the hepatic vasculature and diaphragm will not be easily imaged
diffuse fatty liver disease
84
Clinical findings of ______:
1. Asymptomatic
2. Alcohol abuse
3. Chemotherapy
4. Diabetes mellitus
5. Elevated liver function test (specifically AST and ALT)
6. Hyperlipidemia
7. Obesity
8. Pregnancy
fatty liver disease
85
Sonographic findings of ______would be described as:
Hyperechoic area adjacent to the gallbladder, near the porta hepatis, or part of a lobe may appear echogenic
focal fatty infiltration
86
the displacement or alteration of normal anatomy that is located adjacent to a tumor
mass effect
87
Inflammation of the liver
hepatitis
88
Two of the most common type of hepatitis are
Hepatitis A and B
89
Hepatitis may be triggered by systemic viruses such as ________ and _______-_____ virus
Herpes; Epstein-Barr
90
A condition where it causes the body to accumulate excess copper
Wilson's disease
91
A condition where there is a disproportionate absorption of dietary iron
Hemochromatosis
92
Enlargement of the liver and spleen
hepatosplenomegaly
93
Yellowing of the skin
jaundice
94
Sonographic findings of _____
1. hyperechoic area adjacent to the gallbladder, near the porta hepatis, or part of a lobe or an entire lobe may be spared
2. Can appear much like pericholecystic fluid when identified adjacent to the gallbladder
focal fatty sparing
95
a condition in which a patient becomes confused or suffers from intermittent loss of consciousness secondary to the overexposure of the brain to toxic chemicals that the liver would normally remove from the body
Hepatic encephalopathy
96
brain damage from bilirubin exposure in a newborn with severe jaundice
Kernicterus
97
increase in echogenicity of the walls of the portal triads
periportal cuffing
98
This is spread by fecal-oral route in contaminated water or food?
Hepatitis A
99
This is spread by contact with contaminated body fluids, mother to infant transmission or inadvertent blood contact?
Hepatitis B (most common with hepatitis A)
100
This is spread by means of contact with blood and body fluids, an additional concern for work related exposure?
Hepatitis C
101
___ is a more specific indicator of hepatic injury when elevated.
Alanine aminotransferase (ALT)
102
The patient presents with RUQ pain and elevated AFP. What is the most likely diagnoses?
Hepatoma
103
What is the sonographic appearance of periportal cuffing?
Starry sky sign
104
Sonographic findings of ______
1. Normal liver
2. Enlarged, hypoechoic liver
3. Periportal cuffing with "starry sky"
4. Gallbladder wall thickening
hepatitis
105
the elevation of blood pressure within the portal venous system
Portal hypertension
106
Most common cause of portal hypertension
Cirrhosis
107
Besides cirrhosis, what is the common causes of portal hypertension?
Portal vein thrombosis
Hepatic vein thrombosis
IVC thrombosis
Compression of the portal veins by a tumor
108
Because the liver becomes so scarred with cirrhosis, the blood flowing to the liver meets greater ____________ _________, resulting in portal hypertension or high blood pressure within the portal veins
Vascular resistance
109
One of the most common sonographically identifiable collaterals in portal hypertension is the ______________ of the paraumbilical vein
Recanalization
110
Clinical findings of _____:
1. chills
2. dark urine
3. elevated liver function tests (specifically ALP, ALT, AST, LDH, PT, and total bilirubin)
4. fatigue
5. fever
6. hepatosplenomegaly
7. jaundice
8. nausea
9. vomiting
Hepatitis
111
The junction between the stomach and the esophagus
gastroesophageal junction
112
What kind of color flow can you see in the coronary vein with a patient who has portal hypertension?
Reversed color flow
113
Along with hepatofungal flow, the portal vein diameter will exceed ____mm in the anteroposterior dimension
13mm
114
Along with hepatofugal flow, the superior mesenteric vein will exceed in ___mm
10mm
115
Wilson's disease will present sonographically similar to what disorder?
Hepatitis
116
Cavernous transformation of the portal vein is found in the presence of
portal vein thrombosis
117
Steatohepatitis is inflammation of the liver secondary to fatty liver disease and is precursor for what?
Chronic liver disease
118
The most common cause of cirrhosis is?
alcoholism
119
Cirrhosis causes an elevation in what lab values?
AST, LDH, ALT, bilirubin
120
An ominous sign of ruptured esophageal varices because if markedly increases mortality and morbidity.
Hematemesis
121
Vomiting blood
hematemesis
122
recognizable dilation of the superficial veins of the abdomen
Caput medusa
123
Remember this possibly pathway of disease:
Alcoholism → hepatic steatosis (fatty liver) → steatohepatitis → cirrhosis → portal hypertension → portal vein thrombosis → hepatocellular carcinoma
124
Clinical findings of _____:
Ascites
Diarrhea
Abnormal liver function tests (specifically elevated ALP, ALT, AST, bilirubin, PT, partial prothrombin time [PTT], total protein, and decreased albumin)
Fatigue
Hepatomegaly (initial)
Jaundice
Splenomegaly
Weight loss with muscle wasting
Caput medusae
Spider nevi
Palmar erythema
Gynecomastia
Fetor hepaticus
Facial telangiectasia
Hepatic encephalopathy
Testicular atrophy
Hemorrhoids
Cirrhosis
125
Sonographic findings of _____:
Hepatosplenomegaly (initial)
Shrunken, echogenic right lobe of the liver
Enlarged caudate and left lobes
Nodular surface irregularity
Coarse echotexture
Splenomegaly
Ascites
Monophasic flow within the hepatic veins
Hepatofugal flow within the portal veins
Cirrhosis
126
______ is used to evaluate the stiffness of the liver. Essentially, the stiffer the liver tissue, the more fibrosis present.
Elastography
127
When you suspect _____, always look for signs of portal hypertension, portal vein thrombosis, and hepatocellular carcinoma.
cirrhosis
128
__________ ________ maybe be placed to reduce the likelihood of complications resulting from portal hypertension
Surgical shunts
129
the therapy for portal hypertension that involves the placement of a stent between the portal veins and hepatic veins to reduce portal systemic pressure
transjugular intrahepatic portosystemic shunt (TIPS)
130
If you suspect cirrhosis when imagining, be sure to closely analyze the __________________ for evidence of recanalization of the paraumbilical vein
Left portal vein
131
the development of a clot within the portal vein
portal vein thrombosis
132
Portal vein thrombosis is seen in conditions such as..
HCC, portal hypertension, pancreatitis, cholecystitis, pregnancy, oral contraceptive use, and surgery
133
What are the symptoms of portal vein thrombosis?
Low-grade fever, leukocytosis, hypovolemia, elevated liver function tests, nausea, vomiting
134
With portal vein thrombosis, the cavernous transformation of the portal veins will appear??
Wormlike or serpiginous vessels
135
Portal occlusion can be the result of ________ _______ within the region of the portal vein
tumor invasion
136
It is caused by ischemic bowel disease that is typically fatal
Portal venous gas
137
Clinical findings of ______:
Recent bout of diverticulitis, appendicitis, inflammatory bowel disease, bowel obstruction, ulcers within the bowel, gastrointestinal cancer, or invasive procedures that involve stent placement (TIPS) or endoscopic analysis of the bowel
portal venous gas
138
What are the sonographic findings of portal venous gas?
1. Small, bright reflectors noted within the circulating blood inside the portal vein
2. Larger air collections may produce ring-down artifact
139
Clinical findings of _____:
Abdominal pain
Elevated liver function tests
Hypovolemia
Leukocytosis
Low-grade fever
Nausea
Vomiting
portal vein thrombosis
140
Sonographic findings of _____:
Echogenic thrombus within the portal vein
Cavernous transformation of the portal veins will appear as wormlike or serpiginous vessels within the region of the portal vein
portal vein thrombosis
141
Clinical findings of _____:
Abnormal liver function tests
Ascites
Diarrhea
Fatigue
Palpated hepatomegaly (initially)
Hepatic encephalopathy
Caput medusae
Tremors
Gastrointestinal bleeding
Jaundice
portal hypertension
142
Sonographic findings of _____:
Hepatomegaly (initially)
Shrunken right lobe of the liver
Enlarged caudate lobe of the liver
Nodular surface irregularity
Coarse echotexture
Splenomegaly
Ascites
Monophasic flow within the hepatic veins
Hepatofugal flow within the portal veins
Enlargement of the portal vein (diameter will exceed 13 mm in the anteroposterior dimension)
Enlargement of the superior mesenteric vein
Enlargement and reversed flow within the coronary vein
Enlarged hepatic arteries
Abdominal varicosities at the splenic hilum, renal hilum, and gastroesophageal junction
Patent paraumbilical vein (also called a recanalized paraumbilical vein)
portal hypertension
143
Occlusion of hepatic veins
Budd-Chiari syndrome
144
Budd-chiari syndrome can be seen in....
1. Congenital webbing disorders
2. Coagulation abnormalities
3. Tumor invasion of the HCC
4. Thrombosis
5. Oral contraceptive use for women
6. Pregnancy
7. Trauma
145
sonographic findings of ______
nonvisualization or reduced visualization of the hepatic veins, thrombus within the hepatic veins, enlarged caudate lobe, lack of flow within the hepatic veins, narrowing of the IVC
budd-chiari syndrome
146
Clinical findings of ______
1. Ascites
2. Elevated liver function tests
3. Hepatomegaly
4. Splenomegaly
5. Upper abdominal pain
Budd-Chiari syndrome
147
is the development of renal impairment and possible renal failure as a result of chronic liver disease and liver failure
Hepatorenal syndrome
148
Clinical findings of _____:
History of cirrhosis or other cause of liver failure
Reduced glomerular filtration rate
Increased serum creatinine
Decreased urine output
Hepatorenal syndrome
149
Sonographic findings of______
Sonographic findings consistent with cirrhosis
Kidneys may appear normal.
Hepatorenal syndrome
150
What is the pathology that is often associated with autosomal dominant polycystic kidney disease (ADPKD)?
Hepatic cysts
151
sonographic appearance ______
- Irregular shaped
- Cluster cysts with jagged walls which may produce a complex appearance.
- Smooth walls
- Appearance of acoustic enhancement
- Entirely anechoic
hepatic cysts
152
clinical findings of _____
1. Asymptomatic
2. Possible normal liver function tests
3. ADPKD
4. Hemorrhagic or large cysts may cause right upper quadrant pain
hepatic cysts
153
What is the other name for hydatid liver cyst?
These cyst develop from a parasite referred to as ____
Echinococcal cyst
Echinococcus granulosus
154
What are the sonographic findings of hydatid liver cyst?
1. Anechoic mass containing some debris
2. "Water lily" sign appears as an endocyst floating within the pericyst
3. Mother cyst containing one or more smaller daughter cyst
4. Mass may contain some elements of dense calcification
155
clinical findings of a ______
1. leukocytosis
2. low-grade fever
3. nausea
4. obstructive jaundice
5. RUQ tenderness
6. possible recent travel abroad
hydatid liver cyst
156
What are some treatments for hydatid liver cyst?
1. Surgical resection
2. Catheter drainage
3. Medical treatment
157
clinical findings of an ______:
1. hepatomegaly
2. RUQ pain
3. general malaise
4. diarrhea
5. fever
6. leukocytosis
7. elevated LFTs
8. mild anemia
Amebic Hepatic Abscess
158
the sonographic findings of an _____.
round, hypoechoic or anechoic mass or masses
May contain debris (with fluid-debris layering)
acoustic enhancement
amebic hepatic abscess
159
__ comes from the parasite entamoeba histolytica that grows in the colon & invades the liver via the portal vein.
amebic hepatic abscess
160
One of the most common causes of hepatic fibrosis in the world transmitted in contaminated water, bulls-eye lesion/turtleback sign?
Schistosomiasis
161
Spread of infection from inflammatory conditions, enters the liver through portal vein, hepatic artery, biliary tree from operative procedures?
Pyogenic hepatic abscess
162
Hepatic candidiasis is a spread of fungus (candida albican) in the blood to the liver and is prone to who?
immunocompromised
163
A __________ ________ _________ can result from the spread of infection from inflammatory conditions such as appendicitis, diverticulitis, cholecystitis, cholangitis, or endocarditis
Pyogenic hepatic abscess
164
the clinical findings of _____
1. Fever
2. Hepatomegaly
3. Leukocytosis
4. Possible abnormal liver function tests
5. Right upper quadrant pain
pyogenic hepatic abscess
165
the sonographic findings of ______
1. Complex cyst with thick walls
2. Mass may contain debris, septations, and/or gas
3. The air within the abscess may produce dirty shadowing or ring-down artifact
pyogenic hepatic abscess
166
Clinical findings for_____
Fever
Hepatomegaly
Abdominal pain
Diarrhea (may contain blood)
Schistosomiasis
167
Sonographic findings for ____
Bull’s-eye lesion
Anechoic center surrounded by hyperechoic ring
Periportal thickening
Turtleback sign (chronic appearance)
Schistosomiasis
168
A pathology in the liver where the spread of fungus named Candida albicans, in the blood to the liver.
Hepatic Candidiasis
169
the clinical findings of ______
1. Immunocompromised patients including cancer patients, recent organ transplant patients, and patients with human immunodeficiency virus
2. Right upper quadrant pain
3. Fever
4. Hepatomegaly
hepatic candidiasis
170
the sonographic findings of ______
1. multiple masses with hyperechoic central portions and hypoechoic borders (may be described as "target" or "halo" or "bulls-eye" lesions)
2. These masses are typically 1cm or smaller in size
3. Older lesions may calcify
hepatic candidiasis
171
What is the most common benign liver tumor?
cavernous hemangioma
172
Where is the most common location of cavernous hemangioma?
In the right lobe of the liver
173
Are cavernous hemangioma symptomatic?
False/No. they are asymptomatic
174
the sonographic findings of ______
1. Small, hyperechoic mass
2. Typically in the right lobe
cavernous hemangioma
175
The cavernous hemangioma is the most common benign liver mass. It is most often found in _____ in the right hepatic lobe.
women
176
What is the second most common benign liver tumor?
Focal nodular hyperplasia
177
True or false: Patients with focal nodular hyperplasia are most often asymptomatic but if the mass impinges upon surrounding anatomy or hemorrhage occur, pain will most likely ensue.
True
178
the clinical findings of ______
1. Asymptomatic
focal nodular hyperplasia
179
the sonographic findings of ______
1. Isoechoic, hyperechoic, or hypoechoic mass
2. Central scar may appear as hyperechoic or hypoechoic linear structures within the mass and will often reveal hypervascularity with colo Doppler
focal nodular hyperplasia
180
Although _________ ________ ________ is not caused by oral contraceptive use, the mass tends to be estrogen dependent, and can grow as the result of oral contraceptive use
Focal nodular hyperplasia
181
FNH often contains a central stellate scar and may be referred to as a ______because it may not be readily identifiable sonographically.
stealth lesion
182
This liver pathology is a rare benign liver tumor that is often associated with the use of oral contraceptives.
Hepatocellular adenoma
183
the clinical findings of:
1. Asymptomatic
2. Oral contraceptive use
3. Pain occurs with hemorrhage
hepatocellular adenoma
184
the sonographic findings of_____
1. Mostly hypoechoic
2. May be hyperechoic, isoechoic, or be comprised of mixed echogenicities
hepatocellular adenoma
185
True of False: a hepatic adenoma can be a consequence of trauma Or surgery
False. A hepatic HEMATOMA can be a consequence of trauma and surgery
186
the clinical findings of _____
1. Trauma
2. Recent surgery
3. Pain
4. Decreased hematocrit
hepatic hematoma
187
the sonographic findings of _____
1. Fresh clot may appear hyperechoic
2. Older hemorrhage can appear anechoic or complex
3. May be intrahepatic or subcapsular
hepatic hematoma
188
Clinical findings of ____
asymptomatic
hepatic lipoma
189
Sonographic findings of ____
hyperechoic mass
hepatic lipoma
190
___________ is the most common primary form of liver cancer, although it is not encountered as often as metastatic liver disease
Hepatocellular carcinoma
191
__________ is most often seen in men, and frequently accompanied by cirrhosis and chronic hepatitis.
Hepatocellular carcinoma
192
The tumor marker for hepatocellular carcinoma is?
AFP
193
the clinical findings of ______
1. Elevated AFP
2. Abnormal liver function tests (possibly)
3. Cirrhosis
4. Chronic hepatitis
5. Unexplained weight loss
6. Hepatomegaly
7. Fever
8. Palpable mass
9. Abdominal swelling with ascites
hepatocellular carcinoma
194
the sonographic findings of _____
1. Solitary, hypoechoic mass
2. Heterogeneous masses scattered throughout the liver
3. Mass with a hypoechoic halo and centeal echogenic portion (bulls eye)
4. Possible ascites
hepatocellular carcinoma
195
What is the most common form of liver cancer?
Metastatic liver cancer
196
the clinical findings of _______
1. Abnormal liver function test (possibly)
2. Weight loss
3. Jaundice
4. Right upper quadrant pain
5. Hepatomegaly
6. Abdominal swelling with ascites
hepatic metastasis
197
the sonographic findings of ______
1. Hyperechoic, hypoechoic, calcified, cystic, or heterogeneous masses
2. Mass or masses demonstrating a hypoechoic rim and central echogenic region
3. Diffusely heterogeneous liver
4. Possible ascites
hepatic metastasis
198
Describe the normal flow of the liver's portal veins
1. Hepatopetal
2. Continuous monophasic
3. Low velocity-btwn 20 and 40cm per second
199
In patients with advanced cirrhosis and portal hypertension, a _________ ________ maybe inserted via the jugular vein and ultimately placed between a hepatic vein and intrahepatic portion of the portal vein.
TIPS stent
200
What is the primary goals of TIPS?
To prevent the rupture and hemorrhage of gastroesophageal and other varices
201
What is the most common benign liver childhood tumor?
infantile hemangioendothelioma
202
the clinical findings of ______
1. Pediatric patient
2. May cause hepatomegaly
3. May be accompanied by hemangiomas of the skin
infantile hemangioendothelioma
203
the sonographic findings of ______
1. Homogeneous or complex hepatic mass
2. May contain calcifications or cystic spaces
infantile hemangioendothelioma
204
__________ is a malignant pediatric liver tumor.
Hepatoblastoma
205
What is the syndrome associated with hepatoblastoma?
Beckwith-Wiedemann syndrome
206
the clinical findings of ______
1. Pediatric patient
2. May be asymptomatic
3. Palpable abdominal mass
4. Hepatomegaly
5. Abdominal pain
6. Weight loss
7. Anorexia
8. Elevated AFP
9. Jaundice
hepatoblastoma
207
the sonographic findings of ______
solid, hyperechoic, or hetergeneous mass with calcifications
hepatoblastoma
208
utilizes a contrast agent that is injected into the patient intravenously in order to aid in the identification of liver lesions and to assess those lesions for signs of malignancy
contrast-enhanced (liver) ultrasound (CEUS)
209
separates the liver into 8 surgical segments, used to describe functional liver anatomy
couinaud classification
210
genetic disorder linked with the development of scar tissue accumulation within the lungs, liver, pancreas, kidneys, and/or intestines
cystic fibrosis
211
fruity, musty breath odor associated with severe chronic liver disease
fetor hepaticus
212
rare condition characterized by obstruction of the inferior vena cava by membranous or fibrous bands; can cause obstruction of the hepatic veins leading to Budd-Chiari syndrome
inferior vena cava web
213
elevation in bilirubin caused by obstruction of bile flow (ex. gallstone lodged in biliary tract or pancreatic mass)
posthepatic jaundice (also called obstructive jaundice)
214
when the liver cannot process the amount of hemolysis of the RBC resulting in buildup of circulating bilirubin in the bloodstream (ex. sickle cell disease)
prehepatic jaundice
215
nodular appearance of liver caused by multiple metastatic tumors
pseudocirrohsis
216
the medial segment of the left lobe, between gallbladder fossa and round ligament
quadrate lobe
217
The primary function of the liver is to essentially be the
major blood filter for the body, including detoxification and blood storage
218
Most of the blood in the portal vein originates from where?
intestine (contains beneficial nutrients and toxins that must undergo refining of the liver)
219
blood flow to the major GI organs including stomach, spleen, pancreas, intestines, liver, and small/large intestines, consists of celiac artery, SMA, IMA
splanchnic circulation
220
Normal portal veins (increase or decrease) as they approach the diaphragm
decrease
221
In utero, what supplies the fetus with oxygenated blood?
umbilical vein
222
The inferior extension of the caudate lobe is referred to as
papillary process
223
Unconjugated bilirubin (indirect)
non-water soluble form that travels to the liver via the bloodstream
224
Conjugated bilirubin (direct)
water soluble form that is excreted into the intestine in the bile and passed in the stool
225
Most common liver disorder in the western world
nonalcoholic fatty liver disease
226
Most common cause of chronic liver disease, hepatic failure, and liver cancer
nonalcoholic fatty liver disease
227
Leading indication for liver transplantation in the US
hepatitis C
228
syndrome characterized by cirrhosis, portal hypertension, and dilation of the umbilical and paraumbilical veins
Cruveilhier-Baumgarten Syndrome
229
With portal hypertension the coronary vein with demonstrate abnormal flow
toward esophagus and measure > 6mm
230
Portal vein compression which subsequently leads to portal vein obstruction is most commonly caused by
tumors of the adjacent organs or lympadenopathy
231
Primary cancers that metastasize to the liver
gallbladder, colon, stomach, pancreas, breast, lung
232
Hepatic artery should demonstrate a
continuous, low resistance waveform with quick upstroke and gradual deceleration with diastole, RI= 0.5-0.8
233
Most often TIPS is created between the
right portal vein and right hepatic vein
234
The primary goal for TIPS is to prevent
the rupture and hemorrhage of gastroesophageal and other varices
235
Normal flow velocity within a shunt
90-190 cm per second
236
Most common disease requiring a liver transplant is
hepatitis
237
Most common vascular complication of a liver transplant
hepatic artery thrombosis (signs of infarction which appear as hypoechoic wedge shaped area)
238
Most common malignant tumor of childhood, in the liver discovered before 5 years of age
hepatoblastoma (associated with Beckwith-Wiedmann)
