liver, gallbladder, pancreas Flashcards
Fluid accumulation caused by a rupture of a pancreatic pseudocyst into the abdomen; free floating panc enzymes are very dangerous to surrounding structures
Pancreatic ascites
Hereditary disease that causes excessive production of thick mucus
Cystic fibrosis
Enlargement of gallbladder
Hydrops
Abnormal increase in WBCs caused by infection
Leukocytosis
“Sterile abcess” or collection of panc enzymes that collect in the abdomen, usually in or near pancreas
Pancreatic pseudocyst
Space or cavity that is filled with fluid, but doesn’t have a true endothelial lining
Pseudocyst
Enzyme secreted by pancreas to aid in digestion of carbohydrates
Amylase
Hormone that cause glycogen formation from glucose in the liver and allows circulating glucose to enter tissue cells
Insulin
Pancreatic function that involves digestion
Exocrine
Pancreatic function involving hormone insulin
Endocrine
Serves as posterior border to body of pancreas
Splenic vein
Head of panc
Lies in c-loop; gastroduodenal artery anteriolateral border, and CBD is posteriolateral border
Forms right, sup border of body and head of panc. Gives rise to gastroduodenal art.
Splenic artery
Lies post. To neck or body of panc, and ant. To uncinate process
SMV
Small, curved tip of head of pancreas.
Uncinate process
Lies in epigastrium ant. To SMV and SMA, AO, and IVC.
Pancreas
Junction of splenic vein and main portal vein; post to body of panc.
Portal-splenic confluence
Tapered end of panc. That lies in left hypochondrium near hilus of spleen and upper pole of left kidney.
Tail of panc.
Positive sign implies exquisite tenderness over the area of the gallbladder upon palpitation
Murphy’s sign
Stones in bile duct
Choledocholithiasis
Small septum within GB, usually arising from post. Wall
Junctional fold
Cystic growth on CBD that may cause obstruction
Choledochal cyst
Inflammation of GB; may be acute or chronic
Cholecystitis
Small polyploid projections from GB wall
Adenomyomatosis
Inflammation of bile duct
Cholangitis
Calcification of GB wall
Porcelain GB
GB variant in which part of GB folds in on itself
Phrygian cap
Small part of the GB the lies near cystic duct where stones may collect
Hartmann’s cap
Connects the GB with the common hepatic duct
Cystic duct
Small opening in duodenum in which panc duct and CBD enter to release secretions
Ampulla of vater
Extends from point where common hepatic duct meets cystic duct; drains into duodenum after it joins with main panc duct
CBD
Develops when normal venous channels become obstructed
Collateral circulation
Pus-forming collection of fluid
Pyogenic abcess
Affects hepatocytes and interferes with liver function
Diffuse hepatocellular disease
Most common form of neoplasm of liver; primary sites are colon, breast and lung
Metastatic disease
Hypoecheoic mass with an echogenic central core
Bull’s eye lesion
Classification of liver disease where main prob is blocked bile excretion within liver or biliary system
Obstructive disease
Blood urea nitrogen; lab measurement of amount of nitrogenous waste and creatinine in blood
BUN
Liver disease where hepatocytes are primary problem
Hepatocellular disease
Enzyme of liver
Bile
Asparate aminotransferase-enzyme of liver
Ast
Alanine aminotransferase
ALT
Yellow pigment in bile formed by breakdown of RBCs; excreted by liver and stored in gallbladder
Bilirubin
Enters liver at porta hepatis
Pv and hepatic art
Extends from umbilicus to diaphragm in sagital plane and contains ligamentum teres
Falciform ligament
Boundary between right and left lobes of liver; seen as hyperechoic line on sagital image extending from PV to neck of GB
Main lobar fissure
Lies in epigastrium and left hypochondrium
Left lobe of liver
Area sup. to liver not covered by peritoneum
Bare area
Separates left lobe from caudate lobe; shown as echogenic line in transverse and sagital images
Ligamentum venosum
Smallest lobe of liver
Caudate lobe
Congenital variant; sometimes seen as anterior projection of liver. May extend as far as iliac crest
Reidel’s lobe
Liver is covered by a thin layer of connective tissue called
Glisson’s capsule
The only type of sugar that can be used in the body as a form of energy is
Glucose
The accompanying loss of oncotic pressure in the vascular system allows fluid to migrate into the interstitial space, resulting in _________ in dependent areas
Edema
Within homogeneous parenchyma lie the thin walled ______________, the brightly reflective _______________, the _______________ arteries! and the _____________ duct.
Hepatic veins
Portal veins
Hepatic
Hepatic
Four criteria to assess when evaluating liver parenchyma
- Size
- Configuration
- Homogeneity
- Contour
In focal sparing, the most common affected areas are ant. To the _________ or portal vein and the post. Portion of the _____________ of the liver.
Gallbladder
Liver
List four of the eight sonographic findings for cirrhosis of the liver
Hepatomegaly in early stages
Liver volume decreases in rt lobe and inc. in lt and caudate lobe
Increased echogenicity
Decreased vascularity
Benign, congenital tumor consisting of large, blood-filled cystic spaces
Cavernous hemangioma
Bile is principal medium of secretion of bilirubin and
Cholesterol
Sonographically, the common duct lies ________ and to the _______ of the portal vein in the region of the porta hepatis and gastrohepatic ligament
Anterior
Right
The hepatic artery lies _________ and to the ________ of the portal vein
Anterior
Middle (medial??)
On a transverse scan, the common duct, hepatic artery, and portal vein make up what’s called the
Mickey Mouse sign
Normal wall thickness of GB
3 mm
Hyperplastic change in GB wall
Andenomyomatosis
Pancreas is more ________ and _______ than liver
Isoechoic and hyperechoic
Major post. Landmarks of panc are the
AO and IVC
Superior border of panc is the tortuous
Splenic artery
Receives tributaries from lobules and enters medial second part of duodenum with CBD at ampulla of vater
Duct of virusung
Pancreas is both an _________ and __________ gland
Endocrine
Exocrine
Failure of pancreas to furnish sufficient insulin leads to
Diabetes
Pancreas cells that perform exocrine function
Acini
There are specific enzymes of the panc. That may become altered in pancreatic disease, namely
Amylase and lipase
Controls blood sugar levels in body
Glucose
An acute attack of pancreatitis is commonly related to
Alcoholism or biliary tract disease
Normal common bile duct measues
6mm
Right and left hepatic ducts merge to form
Common hepatic duct
Hepatic duct joins the cystic duct to form the
Common bile duct
Majority of pancreas lies in
Retroperitoneum
Pancreas found behind
Lesser
Omental sac
What passes through a groove posterior to the pancreatic head
Common bile duct
Symp:history of alcoholsism, acute pancreatitis, decrease in hypotension and hematocrit
Dx: hemorrhagic pancreatitis
Painless jaundice, weight loss, decrease in apetite
Adenocarcinoma of pancreas
Twice normal level of amylase indicates
Acute pancreatitis
Most common in sheep herding countries
Eccinococcal cysts
Budd-chiari syndrome caused by obstruction of
Hepatic veins
Where does AO enter heart
Right atrium
