Lesson 5 (Part 2)

Question 1

What does the falciform ligament do?

Answer 1

Divides the left and right lobes of the liver

- anatomically

Question 2

What does the round ligament do?

Answer 2

Divides the medial and lateral portion of the left liver lobe

Question 3

What does the ligamentum venosum do?

Answer 3

Divides the caudate lobe from the lateral left lobe

Question 4

What does the coronary ligament do?

Answer 4

Connects the posterior liver to the diaphragm

Question 5

What do the right and left triangular ligaments do?

Answer 5

Connects the liver to the body wall

Question 6

Where is the bare area of the liver located?

Answer 6

On the posterior superior aspect of the liver

Question 7

What does the bare area of the liver have direct contact with?

Answer 7

The diaphragm

Question 8

Is the bare area of the liver intraperitoneal or retroperitoneal?

Answer 8

Retroperitoneal

Question 9

What does the falciform ligament look like on a ultrasound?

Answer 9

Hyperechoic spot on the medial liver

- runs sagittally

Question 10

What does the ligamentum venosum ligament look like on a ultrasound?

Answer 10

It is an echoic line anterior to the IVC

Question 11

What are your landmarks for the ligamentum venosum? (2)

Answer 11

1. IVC
2. Hepatic artery

• caudate lobe is in between

Question 12

What does the main lobar fissure connect?

Answer 12

The gallbladder to the right portal vein

Question 13

What does the main lobar fissure look like on an ultrasound?

Answer 13

Echoic band

- similar to a ligament

Question 14

What makes up the vasculature of the liver? (2)

Answer 14

1. Hepatic veins

2. Hepatic arteries

Question 15

What are the first tributaries of the liver?

Answer 15

Hepatic veins

Question 16

Which is more superior, the hepatic arteries or the hepatic veins?

Answer 16

Hepatic veins

- hepatic arteries are more inferior

Question 17

What is the only fissure we see anatomically?

Answer 17

The main lobar fissure

Question 18

What happens to the hepatic veins are it moves toward the IVC?

Answer 18

They get larger

Question 19

Where do the hepatic veins course to?

Answer 19

The IVC

Question 20

Where does the liver start and as you go to the left what happens to it?

Answer 20

The liver starts posterior and gets more anterior as you move left

Question 21

Intersegmental

Answer 21

There is a clear division between borders

Question 22

What is an example of intersegmental?

Answer 22

Hepatic veins

Question 23

Intrasegmental

Answer 23

Courses within

Question 24

What is an example of intrasegmental?

Answer 24

Portal veins

Question 25

Where do you measure when you measure the liver?

Answer 25

Posterior superior to anterior inferior tip

Question 26

What is the range of measurement for the midclavicular line for the right lobe?

Answer 26

13cm-17cm

Question 27

What is the range measurement for the left lobe?

Answer 27

Variable

- different on every person

Question 28

How do we establish if the liver is too big in an ultrasound?

Answer 28

The surround relative organs

Question 29

What is the echogenicity of the liver?

Answer 29

Moderately echogenic throughout

• hypoechoic compared to the spleen
• hyperechoic compared to the kidney

Question 30

What is the echotexture of the liver?

Answer 30

Homogenous

Question 31

What is the contour of the liver?

Answer 31

Smooth borders

Question 32

What is the shape of the left lobe?

Answer 32

Triangular shape

Question 33

What is the shape of the right lobe?

Answer 33

Variable

Question 34

What are 2 scanning approaches for the liver?

Answer 34

1. Subcostal
   - under the ribs
2. Intercostal
   - between the ribs

Question 35

What are 2 different positions the patient can be in to scan the liver?

Answer 35

1. Supine
2. On the side
   - left lateral decubitus