Lesson 5 (Part 2) Flashcards
What does the falciform ligament do?
Divides the left and right lobes of the liver
- anatomically
What does the round ligament do?
Divides the medial and lateral portion of the left liver lobe
What does the ligamentum venosum do?
Divides the caudate lobe from the lateral left lobe
What does the coronary ligament do?
Connects the posterior liver to the diaphragm
What do the right and left triangular ligaments do?
Connects the liver to the body wall
Where is the bare area of the liver located?
On the posterior superior aspect of the liver
What does the bare area of the liver have direct contact with?
The diaphragm
Is the bare area of the liver intraperitoneal or retroperitoneal?
Retroperitoneal
What does the falciform ligament look like on a ultrasound?
Hyperechoic spot on the medial liver
- runs sagittally
What does the ligamentum venosum ligament look like on a ultrasound?
It is an echoic line anterior to the IVC
What are your landmarks for the ligamentum venosum? (2)
- IVC
- Hepatic artery
- caudate lobe is in between
What does the main lobar fissure connect?
The gallbladder to the right portal vein
What does the main lobar fissure look like on an ultrasound?
Echoic band
- similar to a ligament
What makes up the vasculature of the liver? (2)
- Hepatic veins
2. Hepatic arteries
What are the first tributaries of the liver?
Hepatic veins
Which is more superior, the hepatic arteries or the hepatic veins?
Hepatic veins
- hepatic arteries are more inferior
What is the only fissure we see anatomically?
The main lobar fissure
What happens to the hepatic veins are it moves toward the IVC?
They get larger
Where do the hepatic veins course to?
The IVC
Where does the liver start and as you go to the left what happens to it?
The liver starts posterior and gets more anterior as you move left
Intersegmental
There is a clear division between borders
What is an example of intersegmental?
Hepatic veins
Intrasegmental
Courses within
What is an example of intrasegmental?
Portal veins
Where do you measure when you measure the liver?
Posterior superior to anterior inferior tip
What is the range of measurement for the midclavicular line for the right lobe?
13cm-17cm
What is the range measurement for the left lobe?
Variable
- different on every person
How do we establish if the liver is too big in an ultrasound?
The surround relative organs
What is the echogenicity of the liver?
Moderately echogenic throughout
- hypoechoic compared to the spleen
- hyperechoic compared to the kidney
What is the echotexture of the liver?
Homogenous
What is the contour of the liver?
Smooth borders
What is the shape of the left lobe?
Triangular shape
What is the shape of the right lobe?
Variable
What are 2 scanning approaches for the liver?
- Subcostal
- under the ribs - Intercostal
- between the ribs
What are 2 different positions the patient can be in to scan the liver?
- Supine
- On the side
- left lateral decubitus
