Chapter 14

Question 1

Liver Anatomy

Answer 1

-Occupies the major portion of the right hypochondrium
-Extends inferiorly into the epigastrium and laterally into the left hypochondrium
-Superiorly, it reaches the dome of the diaphragm; posteriorly, it borders the bony region of the posterior abdominal wall
-Bulk of the liver lies beneath the right costal margin
-Anterosuperior surface of the liver fits snugly into the dome of the diaphragm, separated from
overlying pleural cavities and
pericardium

Question 2

Caudate Lobe

Answer 2

-Smallest lobe
-Separated from the left hepatic lobe, IVC, and ligamentum venosum

Question 3

Hepatic Veins

Answer 3

-Increase in size as they drain toward the diaphragm
-Triphasic hepatofugal blood flow
-indistinct, anechoic borders

Question 4

Proper Hepatic Artery

Answer 4

-Divides into right, middle, and left hepatic arteries
-Cystic artery is a branch of the right hepatic artery
-low-resistance blood flow

Question 5

Portal Veins

Answer 5

-Decrease in size as they approach the diaphragm
-continuous, monophasic hepatopetal blood flow
-echogenic walls due to thick collagenous tissue in the walls

Question 6

Morison’s Pouch

Answer 6

Space between anterior right kidney and right lobe of liver

Question 7

Normal size of the adult liver

Answer 7

Weight: Males 1400-1800g
right lobe midclavicular: 13-17cm
left lobe: highly variable

Question 8

Physiology

Answer 8

The liver is a primary center of metabolism, supporting multiple body systems and activities. In support of digestive and excretory systems, the liver metabolizes fats, carbohydrates, and proteins and forms bile and urea

Question 9

Functions of the Liver

Answer 9

-stores vitamins and other metabolic substances
-reservoir for blood that is released as it regulates blood volume and blood flow through the body
-serves as a major source of body heat as a result of the many hepatocellular chemical reactions that take place within it.

Question 10

Sonographic Appearance of the Normal Liver

Answer 10

-homogeneous and moderately echogenic
-hypoechoic to normal renal cortex
-bile ducts appear as avascular anechoic tubular structures

Question 11

Reidel’s lobe

Answer 11

-Tonguelike inferior extension of the right lobe, as far caudally as the iliac crest
- Identified when liver tissue extends well below the inferior pole of the right kidney during normal respiration

Question 12

Sonographic Applications

Answer 12

Ultrasound examinations of the liver are indicated for the following:
- Suspected liver enlargement
- Suspected hepatic or perihepatic masses
- Suspected abscesses
- Suspected obstruction
- Portal hypertension
- Portal or hepatic vein thrombosis
- Elevated liver function tests

Question 13

Associated Tests

Answer 13

-CT (computed tomography)
-paracentesis
-liver biopsy