Chapter 10----Liver (Hagen and Tempkin) Flashcards
“A tonguelike extension of the right lobe of the liver”
Riedel’s lobe
A normal left hepatic lobe is ____________ in size and shape.
Variable
Any of the following except the ______ may be identified as a fibrous cord that was patent before birth and extends upward from the diaphragm to the anterior wall.
a. hepatoduodenal ligament
b. umbilical vein
c. round ligament
d. ligamentum teres
Hepatoduodenal Ligament
Blood flow to the caudate lobe is supplied by the
Right and Left Portal Veins
Each of the following is a blood plasma protein or clotting factor except
a. fibrinogen.
b. prothrombin.
c. albumin.
d. arginine.
Arginine
In patients with severe portal hypertension, the left portal vein may communicate with the
Umbilical Vein
Kupffer cells are specialized liver cells that play a major role in the body’s
Defense
Prominent pulsatility of the Doppler waveform in the portal vein is
a. normal.
b. abnormal.
Abnormal
(Abnormally prominent pulsatility may be observed in patients with right heart failure, tricuspid regurgitation, portal hypertension, or a fistula between an hepatic and a portal vein)
Proximal to the _____________, the left portal vein takes a C-shaped, superior course in the liver.
Falciform Ligament
The boundaries of the bare area of the liver
falciform, coronary, and triangular ligaments.
The free inferior margin of the left lobe lies adjacent to all of the following except the
a. splenic artery and vein.
b. gastric body and antrum.
c. body of the pancreas.
d. hepatic flexure.
Hepatic Flexure
(The free inferior margin of the left lobe is closely related to the gastric body and antrum of the stomach. It frequently lies anterior to the body of the pancreas, the splenic vein, and the splenic artery)
The hepatic arteries and common bile duct course ______________ to the portal veins at the level of the porta hepatis.
Anteriorly
The inferior surface of the liver is marked by indentations from each of the following except the:
a. first part of the duodenum.
b. hepatic flexure of the colon.
c. head of the pancreas.
d. right adrenal gland.
head of the pancreas
The left hepatic vein and the left hepatic lobe are separated from the caudate lobe by the
fissure for the ligamentum venosum.
The left portal vein serves as ________ between the medial and lateral left lobe.
an intersegmental boundary
The liver metabolizes
fats, carbohydrates, and proteins.
(The liver metabolizes fats, carbohydrates, and proteins and forms bile and urea. Additional metabolic functions of the liver include the storage of minerals and vitamins, formation of vitamin A, metabolism of steroid hormones, and degradation and detoxification of drugs, such as alcohol and barbiturates.)
The liver occupies a major portion of the _____________ region.
Right Hypochondriac
The main lobar fissure represents a
boundary between the right and left lobes
The normal sonographic appearance of the liver is
homogeneous—moderately echogenic throughout
The portal system supplies _____ of the total blood flow to the liver.
75%
The portal veins and hepatic arteries enter the liver and the hepatic ducts exit through the
porta hepatis
The quadrate lobe of the liver is also referred to as
the medial portion of the left lobe
The right and left lobes of the liver are related to the _______ of the diaphragm.
undersurface
The three main tributaries to the portal confluence are the inferior mesenteric vein, the superior mesenteric vein, and the
Splenic
The visceral surface of the liver is superior and anterior to each of the following except the
undersurface of the diaphragm.
The ____________ surface of the liver normally rests on the abdominal organs.
Inferior
Tumor invasion of the portal vein may be observed in association with cancerous lesions of the liver or with metastases. Color Doppler scanning demonstrates tumor vascularity within the portal vein lesion by the presentation of: high resistance venous signals.
low resistance arterial signals
Which description of the location of the liver is correct?
a. Inferior to the dome of the diaphragm
b. Superior to the bony lumbar region of the posterior abdominal wall
c. Anterior to the right costal margin
d. Posterior to the esophagogastric junction
Inferior to the Dome of the Diaphragm
Which is NOT a major component of the bile secreted by the liver?
a. Cholesterol
b. Fat
c. Bilirubin
d. Lecithin
Fat
Which is NOT related to the caudate lobe of the liver? Select one: a. Splenic vein b. Left portal vein c. Inferior vena cava d. Ligamentum venosum
Splenic Vein
Which of the following is a function of the liver?
a. Serving as a reservoir of blood
b. Synthesizing blood proteins and heparin
c. Storing minerals and vitamins
d. All of the above
All the Above
All of the following describe normal portal venous flow except:
a. Low-flow velocity
b. Hepatofugal flow `
c. Spontaneous flow
d. Phasic flow
Hepatofugal flow
This could indicate portal hypertension
All of the following statements are true about the features most often observed in an extrahepatic mass except:
a. External invagination of the liver capsule
b. Formation of a triangular fat wedge Incorrect
c. Discontinuity of the liver capsule
d. Anteromedial shift of the IVC
External invagination of the liver capsule
All of the following statements are true about the features most often observed in an intrahepatic mass except:
a. Anterior displacement of the right kidney
b. Displacement of the hepatic vascular radicles
c. External bulging of the liver capsule
d. Posterior shift of the IVC
Anterior displacement of the right kidney
Budd-Chiari syndrome is a rare disorder caused by obstruction of the
Hepatic Veins
Common malignancies affecting the pediatric population include all of the following except:
a. Neuroblastoma
b. Wilms tumor
c. Leukemia
d. Hepatoblastoma
Hepatoblastoma
Dilated intrahepatic bile ducts may be seen with all of the following except:
a. Intrahepatic mass in the area of the porta hepatis
b. Gallstones in the fundus of the gallbladder
c. Obstructive stone in the cystic duct
d. Lymphadenopathy in the porta hepatis
Gallstones in the fundus of the gallbladder
Diminished vascular structures within the liver parenchyma most likely represent:
Cirrhosis
Echinococcal cysts have the highest incidence in countries in which:
Sheep Grazing is common
Severe elevation of alkaline phosphatase is associated with:
Biliary obstruction
Elevation of serum bilirubin results in:
Jaundice
Fatty infiltration may be observed in all patients except those with:
a. Diabetes mellitus
b. Chronic alcoholism
c. Hepatoportal fistula
d. Hepatitis
Hepatoportal fistula
Hepatocellular disease can be defined as a process that affects the
Hepatocytes and interferes with liver function
In glycogen storage disease, type I is the most common and is also known as __________ disease
Von Gierke
In severe hepatocellular destruction, the aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels are:
HIGH
Jim MacDonald, a sheep farmer, arrives at the hospital with right upper quadrant pain, fever, and an elevated white blood cell count. He states that 3 months earlier, he was kicked in the ribs. An irregular mass showing low-level echoes is found on the sonogram. What is your differential diagnosis?
Echinococcal cyst
Patients who have hepatocellular carcinoma are likely to have had:
Cirrhosis
Sonographic findings of acute hepatitis include:
Liver parenchyma is slightly more echogenic than normal; attenuation may be present. Portal vein borders are more prominent than usual.
The amebic abscess may reach the liver through the
portal vein
The falciform ligament extends from the umbilicus to the diaphragm in a parasagittal plane containing the:
Ligamentum Teres
The fossae of the right portal vein (RPV) and gallbladder are found in the:
Main Lobar Fissure
The liver is suspended from the diaphragm and anterior abdominal wall by the:
Falciform Ligament
The most common benign tumor of the liver is
Cavernous hemangioma
The most common form of neoplastic involvement of the liver is:
Metastases
The most common site for echinococcal virus growth is in the:
Liver
Typical symptoms a patient may have with an abscess formation include all of the following except:
Decreased white blood cell count
What benign liver tumor has been found in patients with type I glycogen storage disease?
Adenoma
What benign liver tumor is located near the free edge of the liver, solitary, well-circumscribed, and a nonencapsulated multinodular mass?
Focal nodular hyperplasia (FHN)
All of the following actions can be attempted to improve an image of the near field of the liver to see borders EXCEPT:
Use a curved array transducer.
Which one of the following is noted in type I glycogen storage disease?
Hyperechoic liver and hepatomegaly
Which one of the following tumors consists of large blood-filled spaces?
Cavernous hemangioma
