Ch. 2 Liver Flashcards
the formation and development of blood cells
hematopoiesis
What organ is responsible for hemopoiesis in early embryonic life?
Liver
What is the largest parenchymal organ in the human body?
Liver
What is the thin fibrous casing covering the liver?
Glisson’s capsule
the region of the liver not covered by peritoneum
Bare area
What is the largest lobe of the liver?
Right hepatic lobe
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
Porta hepatis
What are the organs that is located in the portion of the liver that is uncovered?
- Bare area
- Area of the falciform ligament
- Gallbladder fossa
- Porta hepatis
- Area adjacent to the IVC
What are the three hepatic lobes?
right, left, and caudate lobes
______ of the liver contains hepatocytes, biliary epithelial cells, and Kupffer cells.
Lobules
What organ is responsible for hemopoiesis in early embryonic life?
Liver
the formation and development of blood cells
hematopoiesis
The largest parenchymal organ in the body
Liver
the liver has _______ and ______ lobes
Left and right lobes
the region of the liver not covered by peritoneum
Bare area
What is the thin fibrous casing covering the liver?
Glisson’s capsule
What is the largest lobe of the liver?
Right hepatic lobe
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
Porta hepatis
What are the organs that is located in the portion of the liver that is uncovered?
- Bare area
- Area of the falciform ligament
- Gallbladder fossa
- Porta hepatis
- Area adjacent to the IVC
What are the three hepatic lobes?
right, left, and caudate lobes
Separates the anterior segment of the right lobe from the posterior segment of the right lobe
Right hepatic vein (right intersegmental fissure)
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
Middle hepatic vein (also gallbladder fossa or main lobar fissure)
Separates the left lateral segment of the left lobe from the left medial segment of the left lobe
Left hepatic vein, (can also be ligament teres & falciform ligament), left intersegmental fissure
The caudate lobe is bounded anteriorly by the ____ and posteriorly by the ___.
Ligament venosum, IVC
The caudate lobe can be separated from the left lobe by the?
Ligament venosum
______ of the liver contains hepatocytes, biliary epithelial cells, and Kupffer cells.
Lobules
specialized macrophages within the liver that engulf pathogens and damaged cells
Kupffer cells
Name the portal triads
- Small branches of the Portal Vein
- Bile duct
- Hepatic artery
An additional anatomic lobe of the liver. the _________ lobe is located between the gallbladder fossa and the round ligament.
Quadrate lobe
Which hepatic lobe is the largest?
the right lobe
Majority of the livers blood supply comes from the ____.
Main portal vein (and hepatic artery)
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)
Portal vein provides the liver with approximately ___ of its total blood supply
75%
Normal portal vein measures less than ____.
13mm (enlargement indicative of portal hypertension)
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
The left lobe of the liver is located within the ___________ and may extend to the _______ __________.
epigastrium; left hypochondrium
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
The caudate lobe is located within the _________, and is bounded anteriorly by the ___________ ___________ and posteriorly by the ______.
epigastrium; ligamentum venosum; IVC
The porta hepatis is also called…
Liver hilum
The main portal vein of the liver is created by the union of the _______________ and _____________.
superior mesenteric vein and splenic vein
How much percentage does the portal vein provides for the liver’s total blood supply?
approximately 75%
Enlargement of hepatic veins and IVC is seen with ______.
Right sided heart failure
Occlusion or narrowing of the hepatic veins is seen with ____.
Budd-Chiari syndrome
A decreased albumin level on a liver test might indicate…..
Chronic Liver Disease, Cirrhosis
An increased ALP on a liver test might indicate….
Hepatitis, Cirrhosis, Gallstones, extrahepatic biliary obstruction, metastatic liver disease, pancreatic carcinoma
An increased ALT on a liver test might indicate…
Obstructive Jaundice, Hepatitis, Biliary tract obstruction, Hepatocellular disease
An increased AST on a liver test can indicate….
Fatty liver, Cirrhosis, hepatitis, metastatic liver disease
An increased LDH on a liver test can indicate…
Obstructive Jaundice, Cirrhosis, Hepatitis
An increased AFP on a liver test can indicate…
Hepatocellular carcinoma
Does the main portal vein splits into right and left portal veins once it enters the liver?
True
The diameter of the main portal vein typically measures less then _____ mm in the anteroposterior dimension.
13 mm
enlargement of the main portal vein is indicative of
Portal hypertension
In the liver, the walls of the hepatic veins are brighter than the portal veins. True of False.
False. Portal vein walls are brighter.
Normal flow within the portal veins should be _________ and ________, with some variation noted with respiratory changes.
hepatopetal and monophasic
The hepatic veins drains to the ______.
IVC
Most people have three hepatic veins: right, middle, and left. True or False?
True
Hepatic veins have a _________ blood flow pattern secondary to their association with the right atrium and atrial contraction.
Triphasic
a syndrome described as the occlusion of the hepatic veins, with possible co-existing occlusion of the IVC
Budd-Chiari syndrome
The common hepatic artery carries ____________ ________ to the liver from the abdominal aorta
oxygenated blood
What kind of normal flow pattern does the hepatic artery have that appears in Doppler imaging?
low-resistance flow
The ________ sign describes the transverse image taken of the porta hepatis.
Mickey sign
Shortly after birth, the right branch of the umbilical vein called ________ _______ collapses and becomes the _________ _________.
ductus venosus; ligamentum venosum
After birth, the left branch of the umbilical vein will become a fibrous cord referred to as _____________ _______.
ligamentum teres
the reopening of canals or pathways
Recanalization
Recanalization can happen to the ligamentum teres when there’s ___________.
hypertension
In transverse, the falciform ligament often appears…..
Hyperechoic, triangular-shaped structure between the hepatic lobes.
Diaphragmatic slip is also called….
Diaphragmatic muscular bundles
Diaphragmatic slip can typically occur in older patients and is caused by ____________ diaphragmatic muscle bundles.
hypertrophied diaphragmatic muscle bundles.
a tonguelike extension of the right hepatic lobe.
Riedel lobe
condition in which the organs of the abdomen and chest are on the opposite sides of the body
situs inversus
What is the normal texture of the liver?
Homogenous
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
The liver’s echogenicity is either equal or slightly greater than the parenchyma of the normal right kidney. True or False?
True
What is the normal size of the liver in adults?
13 to 15cm in length
Anything greater than 15.5 cm liver size can be an indication of….
hepatomegaly
Hepatic steatosis is also called
Fatty liver
It’s a liver disorder characterized by fatty deposits (triglycerides) within the hepatocytes.
Hepatic steatosis (fatty liver)
a type of fatty liver disease that causes inflammation of the liver’s
Steatohepatitis
Fibrosis, cirrhosis, and hepatocellular carcinoma has been shown to be a precursor for…
Chronic liver disease/Steatohepatitis
In sonogram, diffuse infiltration of the liver looks like…
Diffusely echogenic & difficult to penetrate/imaged
With _______ ________ ________, the liver is involved with diffuse fatty infiltration , with certain areas spared.
Focal fatty sparing
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
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
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
the displacement or alteration of normal anatomy that is located adjacent to a tumor
mass effect
Inflammation of the liver
hepatitis
Two of the most common type of hepatitis are
Hepatitis A and B
Hepatitis may be triggered by systemic viruses such as ________ and _______-_____ virus
Herpes; Epstein-Barr
A condition where it causes the body to accumulate excess copper
Wilson’s disease
A condition where there is a disproportionate absorption of dietary iron
Hemochromatosis
Enlargement of the liver and spleen
hepatosplenomegaly
Yellowing of the skin
jaundice
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
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
