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DSM Abd > Liver > Flashcards

Liver Flashcards

1
Q

Liver

A

The largest organ in the body, next to the
skin
Weighs approx 1500 grams in the adult
Intraperitoneal organ

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2
Q

Liver position

A

-Occupies almost all of the right hypochondrium, the greater part of the epigastrium, and the left hypochondrium
-Inferior to the diaphragm
-The posterior border is in contact with the
right kidney and inferior vena cava
-The aorta lies posterior to the left lobe of the liver

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3
Q

Liver is covered by

A

Glisson’s Capsule

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4
Q

The subphrenic space

A

between the liver and the diaphragm

common site for abscess formation.

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5
Q

The right subhepatic space

A

includes Morison’s pouch

common space for periotoneal fluid or blood to collect

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6
Q

Lesser sac

A

enclosed portion of the peritoneal space posterior to the liver and stomach
another site for abscess formation

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7
Q

Only a small area is left uncovered

A

the bare area

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8
Q

In early embryonic life

A

responsible for hemopoiesis

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9
Q

Lobules contain

A

hepatocytes, biliary epitheleal cells, and Kupfer cells

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10
Q

Each lobule surrounded by

A

portal triads, small branches of PV,BD, and HA

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11
Q

Separates anterior and posterior segment of the right lobe

A

Right hepatic vein

Right intersegmental ligament

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12
Q

Lobes of Liver

A

Right lobe, Left lobe, Caudate lobe

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13
Q

Separates the lateral and medial segment of the left lobe of the liver

A

Left hepatic vein Left intersegmental fissure Ligamentum teres Falciform ligament

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14
Q

Separates the right lobe from the left lobe

A

Middle hepatic vein
Main lobar fissure
Gallbladder fossa

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15
Q

Right Lobe

A

Largest of the 3 lobes

Contains 3 fossae: 1. porta hepatis 2.gallbladder 3. IVC

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16
Q

divides the right and left lobes

A

Main lobar fissure

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17
Q

Riedels lobe

A

A congenital variant,can sometimes be seen as an anterior projection of the liver sometimes extending down to the iliac crest

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18
Q

Left Lobe

A

Size varies, Can be found just under xiphoid process

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19
Q

Divides the caudal aspect into medial and lateral segments

A

Falciform ligament and the fissure for the ligamentum teres

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20
Q

Attaches the liver to the diaphragm & anterior abdominal wall

A

Falciform ligament

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21
Q

Falciform ligament

A

contains the ligamentum teres, triangular or rounded hyperechoic structure which is the termination of the falciform ligament

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22
Q

Smallest lobe, Situated inferior to the ligamentum venosum

and superior to the inferior vena cava

A

Caudate Lobe

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23
Q

Main lobar fissure

A

boundary between the right and left lobes of the liver

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24
Q

On longitudinal scan- it may be seen as a hyperechoic line extending from the portal vein to the neck of the gallbladder

A

Main lobar fissure

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25
Q

extends from the umbilicus to the diaphragm,

contains the ligamentum teres

A

Falciform ligament

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26
Q

appears as a bright, echogenic triangle on transverse scan, separates the medial and lateral segments of the left lobe of the liver

A

Ligamentum teres

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27
Q

Ligamentum venosum

A

fibrous remnant of the ductus venosus of the fetal circulation

28
Q

supplies 70-75 percent of the blood volume to the liver from the digestive system

A

Portal venous system

29
Q

hepatopetal

A

toward the liver

30
Q

The RPV

A

the largest and further divides into the anterior and posterior

31
Q

enters the liver at the portahepatis

A

Main portal vein (MPV)

32
Q

divides into the right (RPV) and left portal veins (LPV)

A

Main portal vein (MPV)

33
Q

Left portal vein

A

lies more anterior and cranial than the RPV

34
Q

Divides into the medial and lateral branch

A

Left portal vein

35
Q

Lies within a thick band of connective tissue

coursing through the central portion of the lateral segment of the left lobe

A

Left portal vein

36
Q

What do hepatic veins flow into?

A

Inferior Vena Cava

37
Q

What veins have hepatofugal flow (below the baseline)?

A

Hepatic Veins

38
Q

What veins have hepatopetal flow (above the baseline)?

A

Portal Veins

39
Q

Why do portal veins have bright walls?

A

bright connective tissue called Glisson’s Capsule

40
Q

What veins drain blood from liver back to IVC?

A

Hepatic Veins

41
Q

What 3 components are hepatic veins divided into?

A

Right (RHV), Middle (MHV), and Left (LHV)

42
Q

What direction is flow going towards in hepatic veins?

A

Hepatifugle

43
Q

How are hepatic veins distinguished from portal veins?

A

Hepatic veins lack bright walls

44
Q

Do hepatic veins have high or low velocity? & Is the velocity of flow greater or less than portal veins?

A

Low; greater due to closer proximity to heart

45
Q

What percentage of the livers blood supply comes from hepatic arteries?

46
Q

The common hepatic artery comes off which branch of the aorta?

A

Celiac trunk

47
Q

Hepatic enzymes

A

Increased quantities in the blood is a sensitive indicator of hepatocellular disorder.

48
Q

As the hepatic arteries course toward the right and towards porta hepatis, what is it called?

A

Proper hepatic artery

49
Q

At the porta hepatis, what does the proper hepatic artery divide into?

A

Right, middle, and left

50
Q

What does the right hepatic artery course between

A

Bile Duct and Portal Vein

51
Q

What are the primary functions of the liver?

A

Metabolism, Digestion, Storage, Detoxification, and Phagocytosis

52
Q

What metabolic function converts dietary sugars into glucose and releases glucose into blood?

A

Carbohydrate Metabolism

53
Q

Hypoglicemic

A

not enough sugar in the blood

54
Q

Hyperglicemic

A

too much sugar in the blood

55
Q

What metabolic function converts hepatocytes into lipoproteins?

A

Fat Metabolism

56
Q

What metabolic function converts amino acids into albumin and other proteins?

A

Protein Metabolism

57
Q

In liver disease, decreased production of proteins can lead to hemorrhage. This deficiency is due to lack of what vitamin?

58
Q

What cells engulf and breakdown toxic matter in the liver?

A

Kupffer cells

59
Q

List the different liver function tests

A

AST, ALT, LDH, Alk Phos, Bilirubin, PT, Albumin and globulins

60
Q

Aspartate aminotransferase (AST)

A

enzyme produced in high-metabolic tissues

may indicate cirrhosis, fatty liver, hepatitis, and metastatic liver disease

61
Q

Alanine aminotransferase (ALT)

A

more specific in evaluating liver disease the AST

may indicate hepatitis, hepatocellular disease, and obstructive jaundice

62
Q

Lacate Dehydrogenase (LDH)

A

may indicate hepatitis, cirrhosis, obstructive jaundice

63
Q

Serum Bilirubin (bilirubin)

A

pigment released when red blood cells are broken down
Conjugated- biliary tract disease
Unconjugated- hepatocellular disease
Total - cirrhosis and other chronic liver disease

64
Q

Alkaline Phosphate (alk phos)

A

produced by liver, bone, intestines, and placenta
indicates cirrhosis, extrahepatic biliary obstruction, gallstones, hepatitis, metastatic liver disease, and pancreatic carcinoma

65
Q

Prothrombin (PT)

A

liver enzyme that is part of the blood clotting system

dependent on adequate intake of Vitamin K

66
Q

Liver Scanning (correct TGC, gain, depth, focus, and frequency)

A

TGC - adjusted to balance far and near field echoes
Gain - adjusted to show liver as homogeneous
Depth - Rt Lobe should be positioned on lower border
Focus - near posterior border of liver
Frequency - 2.5-5 MHz in adults 5-7 MHz in children

67
Q

porta hepatis

A

a deep fissure in the inferior surface of the liver through which all the neurovascular structures (except hepatic veins) and hepatic ducts enter or leave the liver

DSM Abd (9 decks)

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