Key Pearls Liver

Question 1

The liver is the _________ ________in the abdominal cavity, measuring 21-22.5cm in its greatest transverse diameter, 13-17.5cm in its greatest vertical height, 10-12.5cm in anteroposterior depth

Answer 1

Largest organ

Question 2

The liver occupies __________, _________ and __________ (as far as the mamillary line)

Answer 2

right hypochondrium, epigastrium, left hypochondrium

Question 3

Most of the liver is covered by _____________ but a large area sits directly on the diagphram

Answer 3

Peritoneum

Question 4

The ________space between the liver (or spleen) and the diaphragm is a common site for _________formation

Answer 4

Subphrenic space, abscess

Question 5

the _______ _______ ________lies between the right lobe of the liver, the right kidney and the right colic flexure

Answer 5

right posterior subhepatic space

Question 6

The right subhepatic space is located inferior to the _______ lobe of the liver and includes ________, which lies between the posterior aspect of the right lobe and upper pole of the right kidney

Answer 6

Right, Morrison’s Pouch

Question 7

Elevation in serum bilirubin results in _______, a yellow discoloration of the skin, sclerae and body

Answer 7

jaundice

Question 8

Evaluation of the liver parenchyma includes

Answer 8

Assessment of size, configuration, homogeneity, and contour

Question 9

Hepatocellular disease affects the _________and and interferes with the liver function

Answer 9

hepatocytes

Question 10

The _________is a parenchymal liver cell that performs all of the functions ascribes to the liver

Answer 10

Hepatocyte

Question 11

There are many subcategories of diffuse liver disease, including

Answer 11

Fatty infiltration, acute and chronic hepatitis, early alcoholic liver disease and acute and chronic cirrhosis

Question 12

Fatty liver is an ________, __________disorder of the metabolism, resulting in accumulation of triglycerides within the hepatocyes

Answer 12

Acquired, reversible

Question 13

On ultrasound, the acute hepatitis patient ma demonstrate _________liver texture or the portal veins may be more ___________, the liver is slight more _________and _________ may be present

Answer 13

Normal, echogenic (Starry sky sign), echogenic, attenuation

Question 14

In chronic hepatitis, liver parenchyma is _________with _______brightness of the portal triads, but the degree of attenuation is _______as great as seen with fatty infiltration

Answer 14

coarse, decreased, not

Question 15

Cirrhosis is a chronic degenerative condition in which hepatic lobes are ___________, _________degenerates and ______are infiltrated with ________

Answer 15

Covered with fibrotic tissue, parenchyma, lobules, fat

Question 16

The process of cirrhosis is chronic and progressive, with ______ and ______as end stage

Answer 16

liver cell failure and portal hypertension

Question 17

With sonography, cirrhosis may appear as ________, _________echogencity, ________of hepatic parenchyma secondary to firborsis and surface nodularity

Answer 17

hepatomegaly, increased, coarsening

Question 18

Chronic cirrhosis may show _______, espeialy well demonstrated if ______is present

Answer 18

surface nodularity, ascites

Question 19

Patients with leukemia have multiple _________, ______ hepatic masses that are _______with no aocutsic enhacmenet

Answer 19

small, discrete, solid

Question 20

Non-Hogdkins lymphoma may appear as ________ ________mass lesiosn

Answer 20

Target hypoechoic

Question 21

Hofkins lymphoma may appear as _________, ______chnages within the liver

Answer 21

Diffuse parenchymal changes

Question 22

What are the three specific patterns of metastatic disease

Answer 22

1) well defined hypoechoic
2) well defined echogenic
3) diffuse distortion of the normal homogenous parenchyma

Question 23

HCC presents as what patterns

Answer 23

1) Solitary massive tumor
2) multiple nodules throughout the liver
3) Diffuse infiltrative disease

Question 24

Mesocaval shunt attaches

Answer 24

Middistal superior mesenteric vein to the inferior vena cava

Question 25

Splenorenal shunt attaches

Answer 25

splenic vein to left renal vein

Question 26

portacaval shunts treat what

Answer 26

portal hypertension by anastomosis of the portal vein

Question 27

portacaval shunt treats what

Answer 27

Attaches the main portal vein at the superior mesenteric vein–splenic vein confluence to the anterior aspect of the inferior vena cava

Question 28

Hepatic abscesses occur most often as complications of

Answer 28

biliary tract disease
surgery
trauma

Question 29

Biliary obstruction distal to the cystic duct may be caused by

Answer 29

Stones in the common duct, extrahepatic mass in porta hepatitis or stricture of common duct

Question 30

Why is focal nodular hyperplasia sometimes difficult to image

Answer 30

Same echogenicity as the