Chapter 2- Liver Flashcards
In early embryonic life what is the liver responsible for?
Hemopoiesis
What is hemopoiesis?
The formation and development of blood cells
What is lobe is considered the largest?
Right lobe
How many lobes is the liver composed of?
3- left, right and caudate
What is Wilson’s disease?
A congenital disorder that causes the body to accumulate too much copper
What is the liver covered by?
Glissons capsule
What is the portion of the liver not covered by Glissons capsule called?
The bare area
What are the vital functions of the liver?
Carbohydrate metabolism
Fat metabolism
Amino acid metabolism
removal of waste products
Vitamin and mineral storage
Drug inactivation
Synthesis and secretion of bile
Blood reservoir
Lymph production
Detoxification
How many segments does the couinaud system divide the liver into?
8 segments
What is the medial segment of the left lobe aka?
Quadrate lobe
What is the smallest hepatic lobe?
Caudate lobe
Which lobe is divided into anterior and posterior and by what?
Right lobe is divided into anterior and posterior segments by the right hepatic vein
What separates the right and left liver lobes?
Middle hepatic vein or GB fossa
The left hepatic vein divides the left liver lobe into what segments?
Medial and lateral segment
The left lobe can also be divided into medial and lateral by?
Ligamentum teres and Falciform ligament
The caudate lobe can be separated from the left lobe by?
Ligamentum venosum
The caudate lobe is bounded anteriorly by what? And posteriorly by what?
Anteriorly by the ligamentum venosum and posteriorly by the IVC
Where does the main portal vein enter the liver?
Porta hepatis
What is another name for the liver hilum?
Porta hepatis
What union of vessels creates the main portal vein?
Superior mesenteric vein and splenic vein
Where is the portal splenic confluence?
Where the two superior mesenteric vein and Splenic vein merge with the inferior mesenteric vein
The portal vein provides the liver with approximately how much of its blood supply?
75%
Enlargement of the portal vein is indicative of what?
Portal hypertension
Why are portal veins considered intrasegmental?
Because they course within the liver segments
Via sonogram, Why do the portal vein walls appear much brighter than those of the hepatic veins?
Higher collagen content
What should normal flow within the portal veins be?
Hepatopedal and monophasic
When can re canalization of the umbilical vein occur?
Portal hypertension
The left umbilical vein after birth becomes the?
Ligamentum teres
What landmarks helps you find the ligamentum venosum?
It is anterior to the caudate lobe and located between the caudate lobe and left hepatic lobe
What structure appears as a hyperechoic, triangular-shaped structure between the left and right hepatic lobes?
Falciform ligament
What other structure is identifiable within the lower margins of the Falciform ligament?
Ligamentum teres
The main lobar fissure houses what vessel?
Middle hepatic vein
Transverse image of portal triad: the face of Mickey is what vessel?
Portal vein
What is described as a tongue like extension of the right hepatic lobe?
Riedel lobe
What variant causes an inferior extension of the caudate lobe and can resemble a mass?
Papillary process of caudate lobe
The normal liver measurement for an adult should be?
13 to 15cm
What are some indirect signs of hepatomegaly?
Extension of right lobe beyond the lower pole of the right kidney, rounding of the inferior tip of the right lobe, and extension of left lobe well into the left upper quadrant
What is another name for fatty liver disease?
Hepatic steatosis
Fatty liver disease can be classified into what 2 categories?
Nonalcoholic and alcoholic fatty liver disease
Which type of fatty liver disease is cited as the most common liver disorder in the Western world?
Nonalcoholic fatty liver disease
What is the most common cause of chronic liver disease?
Nonalcoholic fatty liver disease
What type of fatty liver disease is both acquired and reversible?
Nonalcoholic fatty liver disease
What is steatohepatitis?
Inflammation of the liver that has been shown to be a precursor for chronic liver disease, leading to fibrosis, cirrhosis, and hepatocellular carcinoma (HCC) in some individuals.
Fatty changes within the liver can be described as what?
Diffuse or focal
Diffuse infiltration can cause the liver to look how?
The liver to appear diffusely echogenic, and it will be more difficult to penetrate.
The liver segment affected by focal fatty infiltration will appear how?
as an area of increased echogenicity and can thus appear much like a solid, hyperechoic mass
It is likely that signs of sparing or infiltration will occur where?
adjacent to the gallbladder, near the porta hepatis, and the left medial segment.
What is Focal fatty sparing?
diffuse fatty infiltration, with certain areas spared. This area of sparing can appear much like a solid, hypoechoic mass or possibly even fluid.
What are some clinicals findings of fatty liver disease?
Asymptomatic, alcohol abuse, chemotherapy, Diabetes mellitus, elevated liver function test, hyperlipidemia, obesity, and pregnancy
What is hepatitis?
Inflammation of the liver
Hepatitis can be classified into what 2 categories?
Acute or chronic
What are the different types of hepatitis?
A, B, C, D, E, and G
What are the 2 most common forms of hepatitis?
Hep A and B
How does Hep A spread?
By fecal-oral route via contaminated food or water
How is Hep B spread?
Spread by contact with contaminated bodily fluids, mother-to-infant transmission, or inadvertent blood contact (drug use)
What is the current leading indication for Liver transplantation?
Hep C
What causes hemochromatosis?
Inherited condition resulting from excessive iron
