Chapter 5 the liver Flashcards
In which vessel does the right branch bifurcate into an anterior branch and a posterior branch
Portal vein
What structure along with the left hepatic vein separates the left hepatic lobe from the caudate lobe
Ligamentum Venosum Fissure
What separates the intrahepatic right lobe from the left lobe
Main lobular fissure
What straddles the midline, is superior to the head of the pancreas, and is anterior to the IVC
Caudate lobe
The functional or true right and left intrahepatic lobar divisions are between what structures
IVC and the gallbladder fossa
In addition to a central portal vein branch and hepatic artery, what other structure is contained in each of the 8 segments described
Bile duct
Porta hepatis (portal triad) contains the portal vein, hepatic artery, and what other structure?
Common hepatic duct
On a longitudinal image, which of the following major vessels is located to the right of midline with the cephalic portion curving ventrally
IVC
To visualize the normal or abnormal anatomical areas of the subdiaphragmatic, subhepatic, and hepatorenal spaces, the sonographer would select what anatomic scanning location
Subcostal
Which vessel supplies the liver with oxygen-rich blood
Portal Vein
MC organ on the left lateral border of the liver is often demonstrated by strong C- shaped echoes
Stomach
Which scanning plane should the sonographer initially select the best visualize the lower liver segment
Right anterior oblique
What structure can present as a thick lucent band sometimes identified anterior to the spine, IVC, or aorta
Crus of the diaphragm
What is the location of a mass detected anterior and to the left of the ligamentum vemosum
Left lobe
T is the term that describes embryonic production of blood cells
Hemopoiesis
Approx what percentage of the liver’s blood is supplied by the hepatic artery
25%
Fatty infiltrative disease has the same echo appearance as which pathology
Cirrhosis
As blood reservoir, the liver has the capacity to enlarge and store how much blood
200-400 mL
A marked increase of AST variance, greater than 1000 U/mL is clinically indicative of what pathology
Acute severe fulminating hepatitis
What is most likely explanation when a 43 y/o woman is clinically jaundiced and has a marked elevated serum conjugated bilirubin level
Obstructive jaundice
What are the clinical implications for a 52 y/o man with a liver sonograpy exam suggesting long standing liver disease and the presence of alpha-fetoprotein
Primary carcinoma
If a malignant neoplasm appears as an anechoic mass, what is a likely explanation for this echo characteristic
Dilated hepatic ducts
What is the most common primary liver malignancy in an adult
Hepatoma
Severe sound attenuation is associated with which pathology
Cirrhosis
Which vessels are used to delineate the right and left lobs; the right posterior and right anterior segments; and the left medial and left lateral segments
Hepatic veins
Which doppler finding indicates a thrombosis following a transjuglar intrahepatic portosystemic shunt
Absent flow
What area is carefully scanned on a follow-up exam on a patient with a hx of cavernous transformation
Porta hepatis
What doppler signal would be expected in the portal vein of a patient with portal hypertension
Heptafugal flow
What vascular tumor is composed of blood vessel cells with a nonspecific sonographic appearance
Hemangioma
What imaging modality is considered noninvasive
Sonography
Tumor marker frequently elevated in cases of hepatocellualr carcinoma
AFP
Liver enzyme most specific to hepatocellular damage
ALT
An enzyme found in all tissues but in largest amount in the liver
AST
Technique uses ultrasound to asses stiffness of parenchyma
Elastography
Fold in the parietal peritoneum that extends from the umbilicus to the diaphragm and contains the ligament teres
Falciform ligament
Fibroeleastic connective tissue layer that surrounds the liver
Glisson capsule
Blood flow away from the liver
Hepatofugal
Blood flow towards the liver
Hepatopetal
Remnant of ductus venosus seen as echogenic line separating caudate lobe from the left lobe
Ligamentum Venosum
Remnant of the left umbilical vein
Ligamentum Teres
Fissure where the portal vein and hepatic artery enter the liver and common hepatic duct exits
Porta Hepatis
Anatomic variant in which right lobe is enlarged and extends inferiorly
Reidel lobe
What is the normal liver length along the right surface
15-17 cm
Which benign liver tumor commonly occurs in patients with glycogen storage disease
Adenoma
What is recanalized paraumbilical vein typically the result of
Portal hypertension
