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Ultrasound 1 > Liver > Flashcards

Liver Flashcards

1
Q

The primitive gut is formed during which week of embryonic life?

A

4th week

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2
Q

List the 4 parts of the primitive gut

A
  1. foregut
  2. midgut
  3. hindgut
  4. tailgut
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3
Q

In which part of the primitive gut does the liver develop from?

A

foregut

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4
Q

Which part of the primitive gut gets resabsorbed?

A

tailgut

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5
Q

Which umbilical vein is left behind during embryonic life?

A

LT umbilical vein

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6
Q

Which umbilical vein degenerates during embryonic life?

A

RT umbilical vein

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7
Q

What does the LT umbilical vein do when it is left behind during embryonic life?

A

carries oxygenated blood from the placenta to the fetus

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8
Q

How is the formation of the liver parenchyma completed?

A

Liver cells are corded within and join the blood sinuses of the umbilical vein and vitelline veins

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9
Q

What makes up the hepatobiliary system?

A
  • liver
  • bile ducts
  • gallbladder
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10
Q

What is the largest abdominal organ?

A

Liver

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11
Q

About how long is the liver?

A

15 cm long (13-17cm)

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12
Q

A parenchymal liver cell that performs all the functions ascribed to the liver

A

hepatocyte

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13
Q

Specialized phagocytes in the liver that acts as the liver’s defense against bacteria/viruses

A

Kupffer cells

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14
Q

(On US) Kidneys are ________ compared to the liver parenchyma

A

hypoechoic/isoechoic

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15
Q

(On US) the spleen is ________ compared to the liver parenchyma

A

isoechoic

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16
Q

(On US) the pancreas is more ________ compared to the liver parenchyma

A

echogenic

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17
Q

What regions does the liver lie in?

A
  • right hypochondrium
  • epigastrium
  • left hypochondrium
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18
Q

What quadrants does the liver lie in?

A
  • RUQ
  • LUQ
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19
Q

Where does the stomach lie in reference to the liver?

A

lies lateral to the left lobe

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20
Q

What suspends the liver from the diaphragm?

A

coronary ligament

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21
Q

What suspends the liver from the anterior abdominal wall?

A

falciform ligament

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22
Q

What is the bare area?

A

a large area of the liver that rests directly on the diaphragm

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23
Q

What is the subphrenic space?

A

between the liver and diaphragm

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24
Q

Where is a common site for abscess formation?

A

subphrenic space

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25
Where is the Morison's pouch located?
- right subhepatic space - inferior to the liver - between the posterior RT liver and superior pole of RK
26
What percentage of blood does the PV system supply to the liver?
70%
27
What percentage of blood does the HA supply to the liver?
30%
28
What percentage of oxygen does the PV system supply to the liver?
50%
29
What percentage of oxygen does the HA supply to the liver?
50%
30
What does the portal triad consist of?
1. PV 2. HA 3. Common bile duct
31
Where does the venous blood supply from the GI tract go?
drains INTO the liver through the PV system
32
What does the portal triad look like on US?
Mickey Mouse sign
33
The PV is contained within a connective tissue that produces a _________ border on US.
echogenic
34
List the 4 lobes of the liver
1. left 2. quadrate 3. caudate 4. right
35
What divides the liver into LT/RT lobes?
Couinaud's system of hepatic nomenclature
36
The LT lobe has what kind of sections: medial/lateral OR anterior/posterior?
medial/lateral
37
What separates the LT lobe from the caudate lobe?
ligamentum venosum
38
After birth, the ductus venosus closes and becomes what?
ligamentum venosum
39
What lobe is located between the MHV and LHV?
quadrate
40
What is the small lobe on the posterior surface of the LT lobe?
caudate
41
What is the anterior border of the caudate lobe?
ligamentum venosum
42
What is commonly the posterior border of the caudate lobe?
IVC
43
The RT lobe has what kind of sections: medial/lateral OR anterior/posterior?
anterior/posterior
44
thin connective tissue covering the liver
Glisson's capsule
45
STOPPED AT SLIDE 18, STARTED AT 74
STOPPED AT SLIDE 18, STARTED AT 74
46
What pathology develops secondary to congestive heart failure with signs of hepatomegaly?
Passive Hepatic Congestion
47
What is the sonographic appearance of passive hepatic congestion?
- dilation of HV's, IVC, and potentially PVs - to-fro tracing
48
What pathology is caused by increased resistance to venous flow through the liver?
Portal HTN
49
What happens when Portal HTN occurs?
- the liver can't process the blood, it backs up and increases pressure within the portal veins - the increase in pressure causes the PVs to slow and then reverse in flow
50
Where are the most frequent sites of varices?
- esophagus - stomach - rectum
51
Abnormally large, swollen veins that occur from increased pressure within the portal venous system, secondary to liver disease/failure?
Varices
51
What is the sonographic appearance of Portal HTN?
- ascites - splenomegaly - dilation of portal, splenic, mesenteric veins - MPV dilation > 13 mm - reversal of PV flow - development of collateral vessels (varices)
51
What do the PVs do to relieve pressure when there is Portal HTN?
create collateral channels (varices/varicose veins)
52
What are the most common veins that are affected by varices?
- coronary vein (AKA left gastric vein) - esophageal veins
53
What does the coronary vein drain?
esophageal veins
54
What is secondary to liver dysfunction?
Varices
55
What is secondary to portal HTN from chronic liver disease?
recanalized umbilical vein
56
What happens when a recanalized umbilical vein occurs?
to relieve pressure off the PVs, the LIG T re-opens to take on some of the built-up pressure from the liver failing
57
What is the sonographic appearance of a recanalized umbilical vein?
- tubular structure with patent flow extending from the LIG T through to the abdominal wall, coursing inferior to the umbilicus - liver looks abnormal - possible ascites
58
NEED FLASHCARD ON SLIDE 81 CAVERNOUS TRANS
NEED FLASHCARD ON SLIDE 81 CAVERNOUS TRANS
59
Shunts for the liver can either be _________ or _________?
- intrahepatic - extrahepatic
60
What are the 3 kinds of extrahepatic shunts?
1. portacaval shunt 2. mesocaval shunt 3. splenorenal shunt
61
What kind of shunt is created from within the blood vessel?
intrahepatic
62
What shunt drains portal-splenic confluence to IVC?
portacaval shunt
63
What shunt attaches to the SMV to the IVC?
mesocaval shunt
64
What shunt attaches the splenic vein to the renal vein?
splenorenal shunt
65
What kind of shunt is the TIPS shunt?
intrahepatic
66
What does "TIPS" shunt stand for?
Transjugular Intrahepatic Portosystemic Shunt
67
What does the TIPS shunt do?
- drains the RPV into the RHV - sometimes drains RPV into IVC
68
What pathology is the thrombosis of 1, 2, or all 3 HVs?
Budd-Chiari Syndrome
69
What causes Primary Budd-Chiari Syndrome?
congenital obstruction and presence of membranous webs in IVC or at the entrance of LHV and MHV into the IVC
70

Ultrasound 1 (8 decks)

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