LIVER Flashcards
FUNCTIONS: -BILE
-METABOLISM OF FATS,PROTIEN,CARBS
-STORAGE OF GLYCOGEN,VITAMINS,MINERALS
-BLOOD DETOX
-SYNTHESIS OF PLASMA PROTEINS (ALBUMIN)
LIVER
RIGHT AND LEFT LOBES DIVIDES BY PLANE BETWEEN THE ____ AND ____
GB AND IVC
BLOOD SUPPLY
RT LOBE=
LT LOBE=
CAUDATE=
RPV
LPV
BOTH PV
CAUDATE LOBE LIES ON THE POST-SUP SURFACE BETWEEN THE ____ AND ______ ____ ______
IVC AND MEDIAL LEFT LOBE
IVC ENLARGMENT=
CAUDATE COMPRESSED
HEPATIC VEINS COURSE BETWEEN LOBES OF _________
SEGMENTS
THE PORTAL TRIAD ENCASED BY ______ ______ GIVING HYPERECHOIC WALLS
GLISSONS CAPSULE
MAIN LOBAR FISSURE DIVIDES _____&_______ LOBES BY IVC AND GB FOSSA
RIGHT AND LEFT
RT LOBE DIVIDES INTO ____&_____ SEGMENTS
ANTERIOR AND POSTERIOR
LT LOBE DIVIDES INTO ______&_______SEGMENTS
MEDIAL AND LATERAL
-REMANENT OF DUCTUS VENOSUM
-SEPARATES LT LOBE FROM CAUDATE
LIGAMENTUM VENOSUM
-REMANENT OF UMB V
LIGAMENTUM TERES
IN PORTAL HYPERTENSION LIGAMENTEM ______ RECANALIZES TO FORM COLLATERALS
TERES
______ IS A DIFFUSE PROCESS OF FIBROSIS AND DISTORTION OF THE NORMAL LIVER.
CIRRHOSIS
MOST COMMON CAUSE OF CIRRHOSIS
HEP C
CIRRHOSIS IS THE MAJOR CAUSE OF _____ ________
PORTAL HYPERTENSION
INCREASED LIVER FUNCTIONS IN CIRRHOSIS ARE
AST(SGOT),GGT, ALT(SGPT), LDH,CONJUGATED BILIRUBIN
RT SIDED HEART FAILURE=
IVC ENLARGEMENT
-PTS PRESENT WITH UPPER GI BLEED FROM ESOPHAGEAL VARICES RUPTURING THAT EXTEND FROM THE RT AND LT GASTRIC (CORONARY V)
PORTAL HYPERTENSION
TORTOUS COLLATERALS AROUND UMBILICUS
CAPUT MEDUSA
-PLACED TO LOWER PV PRESSURE AND AVOID RUPTURE OF VARICES AND DECREASE ASCITES
TIPS
TIPS IS PLACED BETWEEN A _______ AND ______
HEPATIC V AND PORTAL V (TYPICALLY THE RHV AND RPV)
INDICATIONS FOR LIVER TX
ADULTS= IRREVERSABLE _______
CHILDREN= _______ ______
CIRRHOSIS
BILIARY ATRESIA
TUMORAL CAUSES OF PV THROMBOSIS
HCC,METS,PANCREATIC CARCINOMA
NONTUMORAL CAUSES OF PV THROMBOSIS
CIRRHOSIS, PANCREATITIS, IBS, TRAUMA, PORTAL LYMPHADENOPATHY
MULTIPLE WORM LIKE COLLATERALS PARALLEL TO PV
CAVERNOUS TRANSFORMATION
OBSTRUCTED HEPATIC V AND POSSIBLY IVC
-CAUDATE LOBE IS SPARED BECAUSE OF EMISSARY V,LOBE ENLARGES WITH ATROPHY OF RT AND LT LOBES
BUDD CHAIRI
IN INFANTS, INTRAHEPATIC PV GAS IS DUE TO ________ _________
NECROTIZING ENTERCOLITIS
A HEMORRHAGIC CYST WILL APPER WITH RUQ PAIN,INTERNAL ECHOES, AND _________ HEMATOCRIT
DECREASING
MOST COMMON BENIGN TUMOR OF THE LIVER
-HYPERCHOIC,POSTERIOR ENHANCEMENT
-MAY APPEAR AS HYPOCHOIC IF LIVER IS FATTY
-MAY ENLARGE WITH PREGNANCY OR ESTROGEN ADMINISTRATION
CAVERNOUS HEMANGIOMA
-ACCUMULATION OF TRYGLYCERIDES WITHIN HEPATOCYTES
-OBESITY
-INCREASED ECHOGENICITY
FATTY INFILTRATION (STEATOSIS)
FOCAL REGIONS WITH INCREASED ECHOGENECITY COMMONLY OCCURRING AT PORTA HEPATIS
FOCAL FATTY INFILTRATION
FOCAL REGIONS OF NORMAL LIVER PARENCHYMA WITHIN FATTY LIVER
-COMMONLY FOUND ADJACENT TO GB, PORTA HEPATIS, CAUDATE LOBE
FOCAL FATTY SPARING
-GENETIC DISORDER,CANT BREAK DOWN GLYCOGEN
-ASSOCIATED WITH FATTY INFILTRATION AND HEPATIC ADENOMAS
GLYCOGEN STORAGE DISEASE
** COPPER DEPOSITION IN LIVER**
WILSON DISEASE**
IRON DEPOSITION IN LIVER
HEMATOCHROMATOSIS
_____ ___ IS THE NATIONS LEADING CAUSE OF BOTH CHRONIC HEPATITIS AND CIRRHOSIS
HEP C
MICRONODULAR CIRRHOSIS (<1CM) IS ASSOCIATED WITH ______
ALCOHOLISM
MACRONODULAR CIRRHOSIS (1-5CM) IS ASSOCIATED WITH ______
CHRONIC VIRAL HEPATITIS
-MOST COMMON PARASITIC INFECTION IN HUMANS
-MAJOR CAUSE OF PORTAL HYPERTENSION WORLDWIDE
-PERIPORTAL FIBROSIS
-OCCLUDED PV
-NOT COMMON IN US
SCHISTOMIASIS
(ON TEST WIL SAY PT IS A SHEPARD)
-TAPEWORMS
-RAW PORK
-WATER LILY SIGN OR CYST WITHIN CYST
-CASONI TEST
ECHINOCOCAL CYST (HYDATID CYST)
-FUNGAL INFECTION OF BLOOD THAT RESULTS IN SMALL ABCESSES IN LIVER
-TARGET SIGN, BULLS EYE,WHELL WITHIN WHEEL,UNIFORMLY HYPOECHOIC FOCUS, ECHOGENIC FOCUS
-LESS THAN 10% CASES
CANDIDIASIS (FUNGAL ABSCESS)
-DUE TO ENTRAMOEBA HISTOLYTICA (10% OF CASES)
-OCCURS EXCLUSIVELY IN TRAVERLERS
-RUQ PAIN,FEVER, INCREASED LIVER TESTS, DIARRHEA, LEUKOCYTOSIS
-ROUND HYPOECHOIC/COMPLEX MASS TYPICALLY IN RT LOBE
AMEBIC ABSCESS
DIFF OF AMEBIC VS PYOGENIC IS DIFFICULT. IF PT HAS TRAVELLED=
AMEBIC
1 ORGANISM CAUSING AIDS
PNEUMOCYSTIS CARINNI
MOST COMMON ASSOCIATED WITH HIV
-POOR NATIONS
TUBERCULOSIS
HERPES TRANSMITTED IN BODY FLUIDS
CYTOMEGALOVIRUS
SPREAD BY CATS BY STOOLS
TOXOPLASMOSIS
COMMON EARLY SIGN IS NECK,ARMPIT,GROIN SWELLING
LYMPHOMAS
TUMOR OF THE BLOOD VESSEL WALLS
KAPOSIS SARCOMA
INTESTINE PARASITES
CRYPTOSPORDIOSIS
FETAL CIRCULATION
UMB V > LPV > DUCTUS VENOSUS > IVC
HEPATIC BLOOD FLOW IS ___% PV AND ____% PHA
75 AND 25
___ MM IS THE UPPER LIMITS OF THE PV DIAMETER
13
PHA RUNS PARALLEL TO THE
MPV
HEPATOMEGALY IS LIVER MEASURING > ____CM SUP-INF DIMENSION
15.5
______ LOBE IS A N INFERIOR PROJECTION ON THE RT LOBE WHICH IS SEEN IN WOMEN
RIEDELS
-COLLECTION OF MACROPHAGES (FOCI)
-CAUSED BY HISTOPLASMOSIS OR TUBERCULOSIS INFECTION
GRANULOMAS
THE ____ MAY ORIGINATE (REPLACED) FROM THE SMA. IF REPLACED RHA IS SEEN POST TO THE HEAD OF THE ______ AND MPV
RHA
PANCREAS
-LIVER INFLAMMATION RESULTING FROM INFECTIOUS OR NONINFECTIOUS AGENTS
-ELEVATED ALT, AST, CONJUGATED AND UNCONJUGATED BILIRUBIN
HEPATITIS
HEP A IS ACQUIRED
FECAL/ORAL
HEP B AND C IS ACQUIRED
BLOOD/BODILY FLUIDS
-LIVER ENLARGEMENT
-“STARRY NIGHT” (PERIPORTAL CUFFING)
-HYPERECHOIC PV WALLS
ACUTE HEPATITIS
-HYPERECHOIC LIVER
-SMALL LIVER
-DECREASED ECHOGENICITY OF PV WALL
CHRONIC HEPATITIS
BILIARY TRACT DISEASE IS THE MOST COMMON SOURCE OF _____ LIVER ABSCESS
-RT LOBE MORE COMMONLY EFFECTED
-COMPLEX MASS, GAS, REVERB. ARTIFACT
-S/S: RUQ PAIN, LEUKOCYTOSIS, FEVER AND ELEVATED LIVER TESTS
-80% OF HEPATIC ABSCESSES IN US
PYOGENIC
-BENIGN SOLID LIVER MASS
-CENTRAL FIBROUS SCAR (HALLMARK SIGN)
-“STEALTH LESION”
-CENTRIFUGAL LESION
FOCAL NODULAR HYPERPLASIA
-CHILDBEARING AGE
-ORAL CONTRACEPTIVE PILLS AND OTHER ESTROGENS
-ASSOCIATED WITH GSD
-PT MAY PRESNT WITH PAIN D/T TUMOR HEMORRAGE
-CENTRIPETAL ENHANCEMENT
HEPATIC ADENOMAS
-HYPERECHOIC MASS
-PROP. SPEED ARTIFACT
HEPATIC LIPOMA
-MOST COMMON PRIMARY** MALIGNANCY
-ELEVATED AFP
-SINGLE MASS LESION OR DIFFUSE MAKES IT HARD TO DIFFERENTIATE
HCC
* LIVER _____ IS THE MOST COMMON LIVER MALIGNANCY WHILE ____ IS THE MOST COMMON PRIMARY* LIVER MALIGNANCY
METS AND HCC
MALIGNAT LIVER NEOPLASM OCCURING IN INFANTS AND CHILDREN
HEPATOBLASTOMAS
PT(INR), PTT AND PLATLETS ARE MONITORED PRIOR TO AN INVASIVE PROCEDURE TO INSURE PROPER ______
CLOTTING
METS;
HYPER= GI TRACT
HYPO= LYMPHOMA
BULLS EYE/TARGET=LUNGS
CALCIFIED=MUCINOUS ADENOCARCINOMA
CYSTIC=LEIOMYOSARCOMA
