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ABDOMINAL I21 > Liver WB EX except 5,7 > Flashcards

Liver WB EX except 5,7 Flashcards

1
Q

MLF fissure divedes

A

L and R lobe

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2
Q

L, R, M hepatics dived what way

A

longitudinally

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3
Q

R and L portal veins divide what way

A

transversly

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4
Q

Glissons capsule is

A

the liver covering

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5
Q

What two ligmaents &/or fissures divide the L lobe into medial and lateral portions

A

Falciform ligament and Ligamentum teres

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6
Q

Main portal vein as well as MLF divides into

A

L and R lobes

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7
Q

Whats more ecogenic portal veins or hepatic veins?

A

Portal

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8
Q

What carries blood from the bowels into the liver?

A

Portal V

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9
Q

What drains blood from the liver into the IVC?

A

Hepatic V

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10
Q

What carries oxygenated blood from the aorta to the liver?

A

Hepatic A

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11
Q

What two vessels carry blood to liver?

A

Portal v and Hparic A

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12
Q

Brief overview of metabolism

A

phy and chem process

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13
Q

Brief overview of digestion

A

bile

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14
Q

Brief overview of storage

A

Iron and vitamins

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15
Q

Brief overview of detox

A

drugs and poisons

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16
Q

Define Bilirubin

A

break down of red blood cells

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17
Q

Hepatobillary systym includs

A

liver, bile ducts, and gall bladder. Metabolic and excretory fuctions

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18
Q

Hepatic disease is, and treated how

A

hepatocytes imediate problem ex. viral hepititis destroys cells TX: medically with drugs to decrease Albumin

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19
Q

Obstructive disease is, and is treated how

A

Bile excretion is blocked, liver malfunctions as secondary result. TX: surgically Severe increase in bilitubin and Alkaine Phos

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20
Q

Raw materials such as carbs(sugars), amino acids (protien), are absorbed from intestines and transported to…

A

the circulatory system

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21
Q

Carbs

A

Glucose - energy liver maintains steady state of glucose

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22
Q

Glucose is converted to what for storage

A

glycogen (starch)

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23
Q

Hypoglycemis

A

low glucose affects brain and organs

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24
Q

Hperglycemis

A

Increased glucose levels

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25
Q

Fats

A

Monoglyceride and diglycerides

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26
Q

Live is the primary site for metabolism of fats and is absorbed in intestenises in the form of

A

Monglycerides and diglycerides

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27
Q

Dietary fats are converted in to the hepatocytes to

A

lipoprotiends the transported and stored

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28
Q

Fatty liver

A

Fat croweds hepatocytes, pregnacy obesity liver disease and diabeties.

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29
Q

Protiens: Indirect- Direct-

A

Indirect: amino acids absorbed from gut Direct: raw materials stored in body

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30
Q

primary site for Albumin…

A

liver

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31
Q

Albumin

A

Helps maintain oncotic presure within vascular supply

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32
Q

Chronic liver disease has increased or decreased Albumin

A

decreased, hypoalbuminemia Edima, swelling may occur

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33
Q

Sever liver disease = advanced cirrhosis leading to the development of

A

ascites

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34
Q

Ascites #1 cause

A

Portal hypertension

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35
Q

Live is the primary source of blood coagulation name two..

A

fibrogen (1) and prothrobim (2)

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36
Q

Liver disease does what to blood coagulation

A

decreases coagulation, uncontrollable hemorage, can lead to death

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37
Q

In bile duct obstruction -

A

there is limited fat absorbtion

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38
Q

in hepatocellular disease

A

K improves but doesnt restore

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39
Q

Clotting Tests Pro-time Partial thromboplastin

A

test result in percent of time to clott long period = low percent patient time/ normal time to clot = %

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40
Q

Hepatic Enzymes

A

Protie catalysts that leak into blood stream when hepatocytes or injurded or dead.

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41
Q

increased hepatic enzymes in blood = what patho

A

Hepaticellular dissorder

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42
Q

HIgh serum levels in hepatocellular and biliary obstruction

A

Hepat = 300 untils Biliary = 1000 units

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43
Q

Abnormal Alkaline is the only symptom in

A

Metastic disease

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44
Q

Hepatic Detox

A

break down Ammonium, notrogen metabloism converted into nontoxic urea

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45
Q

BUN

A

Measures urea in blood

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46
Q

Sever liver disease has high or low BUN results

A

low due to no urea production

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47
Q

Fector hpaticus

A

fruity or pudgent breath due to ammonium

48
Q

Low BUM equals high

A

NH4 ammonium accumulation resulting in brain dysfunction

49
Q

Bilirubin detox break down of _____ excretes _____ to gut via _______

A

break down of RBC important detox excreted bilirubin to the gut via biliary tree (RBC on live 120 days)

50
Q

Retociloendothelial cells in spleen trap what and break them down?

A

RBC

51
Q

Bilirubin attaches to what?

A

Albumin

52
Q

Metabolic steps take pace in hepatocyte when RBC is released

A
  1. uptake - seperate bilirubin and albumin 2.Conjugation - Bilirubin + glucronide = bilirubin diglycuronide 3. Excretion - bilitubin transported to cell memb
53
Q

Once bilirubin is releaced from hepatocyte it is released into ______ delievered to ______ the exserted into _______

A

bile ducts Bowel Fesces

54
Q

Hepatocellular Tests Direct and indirect fraction what one is chemically conjucated and unconjugated

A

Direct - chem conjugated bilirubin Indirect - unconjugated bilirubin

55
Q

Total bilirubin =

A

direct + indirect = 1mg/100 ml or less

56
Q

Transplant will increase the congugated bilirubin or uncongucated

A

uncongugated

57
Q

Biliary obstruction vs. Hepatocelular bilirubin

A

less than 35/100 greater than 35/100

58
Q

Examples of Indirect and direct bilirubin

A

indirect - hemolysis direct - hepato, and biliary obstruction

59
Q

AST - asparate

A

Released due to death pr injury to producing cells cirrohsis and acute hep

60
Q

ALT - alanin

A

live specific Hepatocellular disease, toxic hep = increased Alchoholic ALT is higher in Hep

61
Q

LDH - Lactic acid

A

cell death injury = increase primary detection of myocardial or pulmonary infraction

62
Q

Alk phos

A

HIgh alk phos = cirrohsis and hepatitis

63
Q

3 causes of increased bilirubin

A

RBC destruction Malfunction of liver cells Blocked ducts leading from cells

64
Q

Diseases that are both indirect and direct =

A

Hepatitis, hepaticmetastises, lymphoma, cirohsis

65
Q

Prothrombin time

A

Clot time Increased clot time due to liver disease Cirrohsis and metastatix

66
Q

Albumin and Clobulin tests

A

Depressed synthesis of protiens

67
Q

MLF

A

Sperated L and R lobe

68
Q

Left intestinal fissure and L portal V

A

L lobe into medial and lateral

69
Q

The liver is more hyperechoic that the

A

kindey

70
Q

the liver is less hyperechoic than the

A

spleen and pancreas

71
Q

In focal sparing whats effected

A

the anterior callbladder and posterior L lobe are effeced

72
Q

Fatty infilration =

A

increase lipid accumulation

73
Q

Fatty infiltration sono findings

A

increased echo, lobe enlargemnt, focal sparing

74
Q

Sono findings for Cirrhosis

A

Coarse, increased atttenuation, decreased vasulature

75
Q

Inflamatory disease symptomes

A

fever, RUQ P, increased WBC count

76
Q

Hemangioma

A

benign congenital tumor consisting of blood filled cystic spaces

77
Q

The four criteria assessed when evaluating the liver parenchyma

A

Size, configuration, homogeneity, and contour

78
Q

hepatocellular disease affects the ___ and interferes with liver function ezymes

A

hepatocytes

79
Q

the hepatic enzyme levels are elevated with ___ necrosis

A

cell

80
Q

fatty infiltration implies increased ___ accumulation in the hepatocytes and results from significant injury to the liver or a systemic disorder leading to impaired or excessive metabolism of fat.

A

lipid

81
Q

describe the sonographic findings for fatty infiltration of the liver

A

Moderate to severe fatty infiltration shows increased echogenicity on ultrasound. Enlargement of the lobe affected by fatty infiltration is evident. The portal vein structures may be difficult to visualize because of increased attenuation of the ultrasound. Increased attenuation also causes a decrease in penetration of the sound beam, which may be a clue for the sonographer to think of fatty liver disease. Fatty infiltration is not always uniform and may demonstrate areas of focal sparing. The most common areas of focal sparing are located anterior to the gallbladder and portal vein and the posterior portion of the left lobe.

82
Q

in focal sparing, the most common affected areas are anterior to the ___ or the portal vein and the posterior portion of the ___ ___ of the liver

A

Gallbladder, left lobe

83
Q

On ultrasound examination, the liver parenchyma in chronic hepatitis is ___ with ___ brightness of the portal triads, but the degree of attenuation is not as great as seen in fatty infiltration

A

coarse, decreased

84
Q

Cirrhosis is a chronic degeneration of the liver in which the lobes are covered with fibrous tissue, teh parenchyma ___, and the lobules are infiltrated with ___

A

degenerates, fat

85
Q

Glycogen storage disease is associated with ___ ___, focal nodular ____, and hepatomegaly

A

Hepatic adenomas, hyperplasia

86
Q

List the criteria that the sonographer should use to determine whether the mass is extrahepatic or intrahepatic

A

Intrahepatic masses may cause: displacement of the hepatic vascular radicles, external bulging of the liver capsule, or posterior shift of the IVC. Extrahepatic masses may show internal invagination or discontinuity of the liver capsule, formation of a triangular fat wedge, anteromedial shift of the IVC, or anterior displacement of the right kidney

87
Q

List the signs and symptoms of a patient who has inflammatory disease of the liver

A

Fever, white cell elevation, and right upper quadrant pain

88
Q

A(n) ____ is any new growth of new tissue, either benign or malignant.

A

neoplasm

89
Q

A(n) ____ is a benign congenital tumor consisting of large, blood-filled cystic spaces.

A

hemangioma

90
Q

The pathogenesis of hepatocellular carcinoma is related to ___, chronic ___ virus infection, and hepatocarcinogens in food

A

cirrhosis, hepatitisB

91
Q

Describe the pathologic patterns seen in carcinoma of the liver

A

Solitary massive tumor, multiple nodules throughout the liver, or diffuse infiltrative masses in the liver

92
Q

The liver is the third most common organ injured in the abdomen after the ___ and the __

A

spleen, kidney

93
Q

An increase in portal venous pressure or hepatic venous gradient is defined as ___ ___

A

portal hypertension

94
Q

Portal hypertension may also develop when hepatopetal flow is impeded by ___ or __ invasion

A

thrombus, tumor

95
Q

The umbilical vein may become __ secondary to portal hypertension.

A

recanalized

96
Q

The pulse repetition frequency allows one to record lower velocities at the PRF is ___

A

decreased

97
Q

The Doppler sample volume should be ___ than the diameter of the lumen

A

smaller

98
Q

Explain what color doppler velocity is dependent on

A

direction of flow, velocity, and angle to flow

99
Q

Acute abdominal pain, massive ascites, and hepatomegaly secondary to thrombosis of the hepatic veins or inferior vena cava characterize __-__ syndrome, which has a poor prognosis.

A

budd-chiari

100
Q
A
100
Q
A
101
Q
A
102
Q
A
103
Q
A
104
Q
A
105
Q
A
106
Q
A
107
Q
A
108
Q

describe the abnotmality

A

acute hepatitis w/ portal vein borders slightly more echogenic than normal

109
Q
A
110
Q
A
111
Q
A
112
Q

describe the lesion in the RUQ and list the most likely differentials in this asymptomatic pt

A

carernnous hemangioma. well defined irregular lesion is seen in dome of right lpobe of the live. differential considerations include METS, hepatoma (HCC), adenoma, and focular hyperplasia

113
Q

a pt w/ an incidental finding on US during the evaluation of the liver. what is your differential?

A

incidental finding of a large solid mass in right lobe- most likely represents hepatocellular carcinoma

pt also has small amout of pleural effusion noted in sagital image

DD- metastatic disease

114
Q

wht liver abnormality is demonsttated?

A

polysystic liver disease w. multiple cysts throughout the liver and kidney

ABDOMINAL I21 (11 decks)

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