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Liver (Rumack) > Liver > Flashcards

Liver Flashcards

1
Q

Functional division of the liver

A

Right lobe
Left lobe
Caudate lobe

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2
Q

Main lobar fissure

A
  • Separates right lobe of liver from left lobe
  • passes from GB to IVC
  • where middle hepatic vein located
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3
Q

Right lobe of the liver is further divided into:

A

Anterior/ posterior

By right intersegmental fissure

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4
Q

Left lobe of the liver is divided into

A

Medial/ Lateral

By left intersegmental fissure

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5
Q

Caudate lobe

A
  • posterior aspect of the liver
  • posterior border is IVC
  • anterior border is LIGAMENTUM VENOSUM
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6
Q

Papillary process

A
  • anteromedial extension of the caudate lobe

- may mimic lymphadenopathy

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7
Q

Middle hepatic vein

A
  • within the main lobar fissure

- separates anterior right lobe from medial segment of the left lobe

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8
Q

Right hepatic vein

A
  • runs within right intersegmental fissure

- divides right lobe into anterior and posterior segments

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9
Q

Right and left portal veins

A

Right and left portal veins run centrally within segments except ASCENDING PORTION of left portal vein

W/c runs in left intersegmental fissure

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10
Q

Left intersegmental fissure

A
  • separates left lobe into medial/ lateral segments

- divided into cranial, middle and caudal sections

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11
Q

Fissure for ligamentum teres

A

Most caudal division of the left lobe

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12
Q

Hepatoduodenal ligament

A
  • main portal vein
  • proper hepatic artery
  • common bile duct
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13
Q

Dual blood supply of the liver

A
  1. Portal vein- carries incompletely oxygenated venous blood (80%) from intestines and spleen
  2. Hepatic artery
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14
Q

Portal triad

A
  • portal vein
  • hepatic artery
  • bile duct
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15
Q

Common hepatic artery variations (45% of population)

A
  1. Replaced left hepatic artery originating from left gastric artery 10%
  2. Replaced right hepatic artery originating from SMA 11%
  3. Replaced common hepatic artery originating from SMA 2.5
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16
Q

Congenital portal vein anomalies

A
  • atresias
  • strictures
  • obstructing valves
17
Q

Most common accessory veins

A

-drain the superoanterior segment of right lobe (segment 8)

18
Q

Differential diagnosis for complex -appearing liver cyst (with thick septae or nodules)

A
  • cystic metastases

- biliary cystadenoma

19
Q

Four groups for hydatid cysts

A
  1. Simple cysts containing no internal architecture except sand
  2. Cysts with detached endocyst secondary to rupture
  3. Cysts with daughter cyst matrix (echogenic material between daughter cysts)
  4. Densely calcified masses
20
Q

“Clay-pipestem fibrosis”

A

Schistosomiasis

21
Q

Sonographic features of schistosomiasis

A
  • widened echogenic portal tracts (up to 2cm)
  • initially liver is enlarged
  • periportal fibrosis—> contracted liver
22
Q

Causes of cirrhosis

A

Micronodular cirrhosis

-mc cause is alcohol consumption
“mIcro”=Inom 🍺

Macronodular cirrhosis

-mc cause is chronic viral hepatitis
“mACro” =hepA, Ang dilAw! 😅

23
Q

Sonographoc patterns associated with cirrhosis

A
  1. Volume redistribution
  2. Coarse echotexture
  3. Nodular surface
  4. Regenerating nodules
  5. Dysplastic nodules
24
Q

Normal hepatic vein waveform

A
  • triphasic
  • two large antegrade diastolic and systolic waves
  • small retrograde wave (atrial kick)
25
Q

Two abnormal patterns (hepatic vein)

A

Decreased amplitude of phasic oscillations with loss of reversed flow and a flattened waveform

26
Q

Normal portal vein pressure

A

5-10 mmHg or

14cmH2O

27
Q

Two abnormal patterns (hepatic vein)

A

Decreased amplitude of phasic oscillations with loss of reversed flow and a flattened waveform

28
Q

Normal portal vein pressure

A

5-10 mmHg or

14cmH2O

29
Q

Portal hypertension

A
  1. Wedge hepatic vein pressure or direct portal vein pressure more than 5mmHg greater than IVC pressure
  2. Splenic vein pressure greater than 15mmHg
  3. Portal vein pressure (measured surgically) greater than 30 cm H2O

Liver (Rumack) (1 decks)

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