Key Pearls Liver Flashcards
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
Largest organ
The liver occupies __________, _________ and __________ (as far as the mamillary line)
right hypochondrium, epigastrium, left hypochondrium
Most of the liver is covered by _____________ but a large area sits directly on the diagphram
Peritoneum
The ________space between the liver (or spleen) and the diaphragm is a common site for _________formation
Subphrenic space, abscess
the _______ _______ ________lies between the right lobe of the liver, the right kidney and the right colic flexure
right posterior subhepatic space
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
Right, Morrison’s Pouch
Elevation in serum bilirubin results in _______, a yellow discoloration of the skin, sclerae and body
jaundice
Evaluation of the liver parenchyma includes
Assessment of size, configuration, homogeneity, and contour
Hepatocellular disease affects the _________and and interferes with the liver function
hepatocytes
The _________is a parenchymal liver cell that performs all of the functions ascribes to the liver
Hepatocyte
There are many subcategories of diffuse liver disease, including
Fatty infiltration, acute and chronic hepatitis, early alcoholic liver disease and acute and chronic cirrhosis
Fatty liver is an ________, __________disorder of the metabolism, resulting in accumulation of triglycerides within the hepatocyes
Acquired, reversible
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
Normal, echogenic (Starry sky sign), echogenic, attenuation
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
coarse, decreased, not
Cirrhosis is a chronic degenerative condition in which hepatic lobes are ___________, _________degenerates and ______are infiltrated with ________
Covered with fibrotic tissue, parenchyma, lobules, fat
The process of cirrhosis is chronic and progressive, with ______ and ______as end stage
liver cell failure and portal hypertension
With sonography, cirrhosis may appear as ________, _________echogencity, ________of hepatic parenchyma secondary to firborsis and surface nodularity
hepatomegaly, increased, coarsening
Chronic cirrhosis may show _______, espeialy well demonstrated if ______is present
surface nodularity, ascites
Patients with leukemia have multiple _________, ______ hepatic masses that are _______with no aocutsic enhacmenet
small, discrete, solid
Non-Hogdkins lymphoma may appear as ________ ________mass lesiosn
Target hypoechoic
Hofkins lymphoma may appear as _________, ______chnages within the liver
Diffuse parenchymal changes
What are the three specific patterns of metastatic disease
1) well defined hypoechoic
2) well defined echogenic
3) diffuse distortion of the normal homogenous parenchyma
HCC presents as what patterns
1) Solitary massive tumor
2) multiple nodules throughout the liver
3) Diffuse infiltrative disease
Mesocaval shunt attaches
Middistal superior mesenteric vein to the inferior vena cava
Splenorenal shunt attaches
splenic vein to left renal vein
portacaval shunts treat what
portal hypertension by anastomosis of the portal vein
portacaval shunt treats what
Attaches the main portal vein at the superior mesenteric vein–splenic vein confluence to the anterior aspect of the inferior vena cava
Hepatic abscesses occur most often as complications of
biliary tract disease
surgery
trauma
Biliary obstruction distal to the cystic duct may be caused by
Stones in the common duct, extrahepatic mass in porta hepatitis or stricture of common duct
Why is focal nodular hyperplasia sometimes difficult to image
Same echogenicity as the
