Liver: A&P Flashcards
The encasement name
Glisson’s capsule - thick, fibrous layer of connective tissue
Anatomic landmarks
hepatic veins, portal veins, arteries, bile ducts, ligaments, fissures
Location in quadrants/regions
Most of RUQ and epigastric
Location anatomically
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anatomically right of stomach and superior to gallbladder
Fundus lies ___ and ___ to left lobe of liver
Rest of stomach is positioned ____ to the liver
Duodenum lies ___ to the right lobe of liver
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Fundus lies posterior and lateral to the left lobe of the liver
The rest of the stomach is positioned inferior to the liver
The duodenum lies adjacent to the right lobe of liver
Ligaments secure liver in ___ by attaching to the ___, ____, _____, and _____
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Ligaments secure liver in the RUQ by attaching to the diaphragm, stomach, abominal wall, retroperitoneum
Falciform ligmanet contains, and funcitons
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ligamentum teres
divides liver into right and left lobes
Which of the following statements accurately characterizes the liver?
A. The liver serves as a useful acoustic imaging window for underlying structures.
B. The liver is encapsulated in Gerota’s fascia.
C. A majority of the liver is enclosed within the peritoneum.
D. All of the above
E. A and C only
A. The liver serves as a useful acoustic imaging window for underlying structres
and
C. A majority of the liver is enclosed within the peritoneum
Right lobe is ___ than the left lobe and accounts for ___ of parenchymal tissue of liver under traditional anatomic classification
Right lobe is much larger than left lobe and accounts for 2/3rds of parenchymal tissue
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Right hepatic vein subdivides right lobe of liver into ___ and ___ segments and drains them
Middle hepatic vein demarcates the true __ and ___ lobes
Left hepatic vein divides the left lobe into ___ and ___ segments and drains them
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R. Hepatic vein subdivides right lobe into anterior and posterior segments
Mid. hepativ vein seperates the liver into left and right lobes
L. Hepativ vein divides left lobe into medial and laterial segments
Sonographers seperate liver into ___, ___, and ___ segments
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Right, left, caudate segments
Which of the following statements regarding the traditional anatomic liver classification is correct?
A. Morphological classifications are based upon the external surface anatomy of the liver.
B. The left lobe is much larger than the right lobe of the liver.
C. The falciform ligament divides the liver into right and left lobes.
D. All of the above
E. A and C only
A. Morphological class. are based upon external surface anatomy
and
c. The falciform ligament divides the lvier into right and left lobes
The __________ is located along the inferior surface of the liver and serves to separate the quadrate and caudate lobes of the liver.
A. falciform ligament
B. gallbladder
C. porta hepatis
D. A and B only
E. B and C only
C. Porta hepatis
When viewed from inferior the caudate and quadrate lobe can be seen seperated by the porta hepatis - an entry/exit for hepatic vessels
Anatomic landmark to identify CBD
CBD lies anterior to portal vein and lateral to hepatic artery
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Efferent (away from) blood supply is via __, __, and ___ __ __ which then returns O2 depleted blood back to the ______
Blood supply being carried away is done through the right, middle and left hepatic veins which then returns O2 depleted blood back to the IVC
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Which of the following statements correctly characterizes liver anatomy?
A. The liver is secured within the right upper quadrant by ligaments that attach to the diaphragm, stomach, anterior abdominal wall, and retroperitoneum.
B. Liver ligaments have a hypoechoic appearance relative to surrounding liver parenchyma.
C. Ligaments are used to subdivide liver anatomy under certain liver anatomy classification systems.
D. All of the above
E. A and C only
A. The liver is secured within the RUQ by ligaments that attach to the diaphragm, stomach, anterior abd. wall, and retroperitoneum
Roles of liver
Digestion
metabolism
synthesis (clotting)
resevoir
immune (filtration)
detoxification
storage
endocrine (vit. D activication, t4/t3 conversion)
Measuring liver & typical value
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from inferior tip to the dome @ level of diaphragm
greater than 16 cm considered enlarged
Echogenicity of liver and ligaments
Liver hyperechoic relative to renal cortex and hypoechoic relative to spleen
Ligaments are hyperechoic due to collagen and fat, in short axis seen as the hyperechoic shape at pointer
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There are __ hepatic veins and they have ___ walls.
Describe hep. veins in relation to IVC
3 hepativ veins:
Right hepatic vein enters right aspect of IVC, largest of the veins
Middle hepatic vein enters IVC on its anterior surface
Left hepatic vein enters left anterior aspect of IVC, smallest of veins
thin walls
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Portal veins have more ____ walls and sits inferior to the ___
More echogenetic walls and sits inferior to the CBD
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Label sagittal (long) image
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A. left lobe
B. splenic artery
C. splenic vein
D. Aorta
Label sagittal (long) image
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A. left lobe
B. ligamentm venosum
C. caudate lobe
d. diaphragm
Portal tried contents
Hepatic artery, common bile duct (CBD), portal vein
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How to measure the liver
inferior tip to the dome at the level of diaphragm, less than 16 cm is normal
Normal liver parenchyma should be ___ relative to renal cortex
Normal liver parenchyma should be ____ relative to the spleen
Normal liver should be hyperechoic relative to the renal cortex
Normal liver should be hypoechoic relative to spleen
Portal veins flow ___ liver
Hepatic veins flow ____ liver
Portal veins flow towards the liver
Hepatic veins flow away from liver
What is used to identifiy GB neck?
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Main lobar fissure - thin hyperechoic ine that connects long axis neck of GB with right portal vein
Also seperates right and left lobes of liver
Right lobe is anterior to diaphrahgm and Morison’s pouch T/F
True.
Diaphragm seen as hyperechoic along superior margin of liver
Morison’s pouch is between the right kidney and curve of liver
When viewing left lobe the ___ and ___ can be seen as anechoic lumens
IVC (anatomic right) and AO (anatomic left) can be seen