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ABDOMEN REGISTRY > Chapter 1. Liver > Flashcards

Chapter 1. Liver Flashcards

1
Q

The liver is divided into what three lobes?

A

Right lobe, left lobe, caudate lobe

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2
Q

What is the quadrate lobe of the liver?

A

The quadrate lobe is a misnomer and is the medial aspect of the left lobe

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3
Q

What is another term used for the 1st order of division for the liver?

A

Lobar/Hemiliver anatomy

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4
Q

In the 1st order of division, how are the right and left lobes divided? Describe the landmarks that are transected with this method.

A

An imaginary plane located between the GB and the IVC divides the liver into the right and left lobes. This plane transects the IVC, middle hepatic vein, and GB.

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5
Q

What is another tern for the 2nd order of division?

A

Sector/Segmental anatomy

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6
Q

How is the liver divided in the 2nd order of division?

A

The right and left lobes are further divided in the 2nd division by the hepatic veins into 4 separate parts.
Left lateral
Left medial
Right anterior
Right posterior

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7
Q

How does the caudate lobe receive blood supply?

A

Branches of the right and left portal veins feed the caudate lobe

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8
Q

How is the caudate lobe drained?

A

Emissary veins drain directly into the IVC

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9
Q

The caudate lobe is located —— to the ligamentum venosum,
——- to the porta hepatis, —- and —– to the IVC, and — to the lesser sac.

A

Posterior, posterior, anterior and medial, lateral

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10
Q

If the caudate lobe appears to be enlarged, what should be considered?

A

Compression of the IVC

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11
Q

What is another term for the 3rd order of division?

A

Segment/Subsegment anatomy

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12
Q

List segments I through VIII and label each with its corresponding portion of the lobe

A

Segment I -> Caudate lobe
Segment II -> Left lateral superior
Segment III -> Left lateral inferior
Segment IVa -> Left medial superior
Segment IVb -> Left medial inferior
Segment V -> Right anterior inferior
Segment VI -> Right posterior inferior
Segment VII -> Right posterior superior
Segment VIII -> Right anterior superior

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13
Q

What vessels are intersegmental?

A

Hepatic veins are intersegmental, coursing between the lobes and segments. Interlobar and intersegmental.

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14
Q

What vessels are intrasegmental?

A

The vessels of the portal triad and or portal veins are intrasegmental. These vessels course to the center of each segment. Intrasegmental and intralobar.

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15
Q

What gives the portal veins their echogenic walls?

A

A fibrofatty sheath, Glissons capsule

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16
Q

What structures make up the portal triad?

A

Common hepatic duct, Hepatic artery (proper), Main portal vein

17
Q

The ligamentum venosum is a remnant of the

A

Ductus venosus

18
Q

The ligamentum venosum divides what two lobes from each other

A

the ligamentum venosum separates the left lobe from the caudate lobe

19
Q

The ligamentum teres is a remnant of the

A

Umbilical vein

20
Q

Where does the umbilical vein course to

A

It runs from the umbilicus to the left portal vein

21
Q

In a patient with portal hypertension, what might be seen at the ligamentum teres?

A

The ligamentum teres may recanalize to form a portosystemic venous collateral

22
Q

Flow away from the liver

A

hepatofugal

23
Q

Flow towards the liver

A

Hepatopetal

24
Q

Describe in percentages how the liver receives its blood supply

A

75% from the PV. 25% from the HA. Appox. 1500 mL/min

25
Q

Describe in percentages how the liver receives its oxygenation

A

HA 50%, PV 50%.

26
Q

What is the normal diameter measurement for the portal vein

A

<13 mm is considered normal

27
Q

What does a PV diameter of >13 mm suggest?

A

Portal hypertension

28
Q

What type of waveform do the hepatic veins have?

A

Triphasic

29
Q

Where is the HA located in reference to the MPV?

A

The HA runs parallel, anterior, and to the left of the MPV

30
Q

What portion of the liver do the coronary ligaments surround?

A

The bare area

31
Q

An inferior projection of the right lobe, more commonly seen in women

A

Riedel’s lobe

32
Q

What measurement is considered hepatomegaly

A

> 15.5 cm. Hepatomegaly is indicated in 75% of patient population

33
Q

Describe the normal echogenicity of the liver in comparison to the renal cortex

A

The liver should be slightly more hyperechoic to homogenous compared to the normal renal cortex

34
Q

Define sonolucent

A

meaning without echoes

35
Q

List the normal echogenicity in decreasing order of the following organs - Liver, spleen, renal cortex, renal sinus, pancreas.

A

Renal sinus
Pancreas
Liver/Spleen
Renal cortex

ABDOMEN REGISTRY (6 decks)

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