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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
Q

Where is the Morison’s pouch located?

A
  • right subhepatic space
  • inferior to the liver
  • between the posterior RT liver and superior pole of RK
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26
Q

What percentage of blood does the PV system supply to the liver?

A

70%

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27
Q

What percentage of blood does the HA supply to the liver?

A

30%

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28
Q

What percentage of oxygen does the PV system supply to the liver?

A

50%

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29
Q

What percentage of oxygen does the HA supply to the liver?

A

50%

30
Q

What does the portal triad consist of?

A
  1. PV
  2. HA
  3. Common bile duct
31
Q

Where does the venous blood supply from the GI tract go?

A

drains INTO the liver through the PV system

32
Q

What does the portal triad look like on US?

A

Mickey Mouse sign

33
Q

The PV is contained within a connective tissue that produces a _________ border on US.

A

echogenic

34
Q

List the 4 lobes of the liver

A
  1. left
  2. quadrate
  3. caudate
  4. right
35
Q

What divides the liver into LT/RT lobes?

A

Couinaud’s system of hepatic nomenclature

36
Q

The LT lobe has what kind of sections: medial/lateral OR anterior/posterior?

A

medial/lateral

37
Q

What separates the LT lobe from the caudate lobe?

A

ligamentum venosum

38
Q

After birth, the ductus venosus closes and becomes what?

A

ligamentum venosum

39
Q

What lobe is located between the MHV and LHV?

A

quadrate

40
Q

What is the small lobe on the posterior surface of the LT lobe?

A

caudate

41
Q

What is the anterior border of the caudate lobe?

A

ligamentum venosum

42
Q

What is commonly the posterior border of the caudate lobe?

A

IVC

43
Q

The RT lobe has what kind of sections: medial/lateral OR anterior/posterior?

A

anterior/posterior

44
Q

thin connective tissue covering the liver

A

Glisson’s capsule

45
Q

STOPPED AT SLIDE 18, STARTED AT 74

A

STOPPED AT SLIDE 18, STARTED AT 74

46
Q

What pathology develops secondary to congestive heart failure with signs of hepatomegaly?

A

Passive Hepatic Congestion

47
Q

What is the sonographic appearance of passive hepatic congestion?

A
  • dilation of HV’s, IVC, and potentially PVs
  • to-fro tracing
48
Q

What pathology is caused by increased resistance to venous flow through the liver?

A

Portal HTN

49
Q

What happens when Portal HTN occurs?

A
  • 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
Q

Where are the most frequent sites of varices?

A
  • esophagus
  • stomach
  • rectum
51
Q

Abnormally large, swollen veins that occur from increased pressure within the portal venous system, secondary to liver disease/failure?

A

Varices

51
Q

What is the sonographic appearance of Portal HTN?

A
  • ascites
  • splenomegaly
  • dilation of portal, splenic, mesenteric veins
  • MPV dilation > 13 mm
  • reversal of PV flow
  • development of collateral vessels (varices)
51
Q

What do the PVs do to relieve pressure when there is Portal HTN?

A

create collateral channels (varices/varicose veins)

52
Q

What are the most common veins that are affected by varices?

A
  • coronary vein (AKA left gastric vein)
  • esophageal veins
53
Q

What does the coronary vein drain?

A

esophageal veins

54
Q

What is secondary to liver dysfunction?

A

Varices

55
Q

What is secondary to portal HTN from chronic liver disease?

A

recanalized umbilical vein

56
Q

What happens when a recanalized umbilical vein occurs?

A

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
Q

What is the sonographic appearance of a recanalized umbilical vein?

A
  • 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
Q

NEED FLASHCARD ON SLIDE 81 CAVERNOUS TRANS

A

NEED FLASHCARD ON SLIDE 81 CAVERNOUS TRANS

59
Q

Shunts for the liver can either be _________ or _________?

A
  • intrahepatic
  • extrahepatic
60
Q

What are the 3 kinds of extrahepatic shunts?

A
  1. portacaval shunt
  2. mesocaval shunt
  3. splenorenal shunt
61
Q

What kind of shunt is created from within the blood vessel?

A

intrahepatic

62
Q

What shunt drains portal-splenic confluence to IVC?

A

portacaval shunt

63
Q

What shunt attaches to the SMV to the IVC?

A

mesocaval shunt

64
Q

What shunt attaches the splenic vein to the renal vein?

A

splenorenal shunt

65
Q

What kind of shunt is the TIPS shunt?

A

intrahepatic

66
Q

What does “TIPS” shunt stand for?

A

Transjugular Intrahepatic Portosystemic Shunt

67
Q

What does the TIPS shunt do?

A
  • drains the RPV into the RHV
  • sometimes drains RPV into IVC
68
Q

What pathology is the thrombosis of 1, 2, or all 3 HVs?

A

Budd-Chiari Syndrome

69
Q

What causes Primary Budd-Chiari Syndrome?

A

congenital obstruction and presence of membranous webs in IVC or at the entrance of LHV and MHV into the IVC

70
Q
A

Ultrasound 1 (8 decks)

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