Other lessons needed for midterm Flashcards
where is the liver located?
- Right hypocondrium (RUQ)
- Extends to Epigastrium and into left hypocondrium
what is the superior border of the liver?
diaphragm
what are the posterior borders of the liver?
lumbar region of the posterior abdominal wall
what is the anterior border of the liver?
abdominal wall, Ribs
what is inferior to the liver?
Pancreas, Rt Kidney, duodenum, colon, GB, lesser curvature of Stomach
what is another name for the anterior aspect of the liver?
parietal
what is another name for the posterior aspect of the liver?
visceral
what are the 3 fissures of the liver?
- Main Lobar Fissure (or Median)
- Left Intersegmental Fissure
- Right Intersegmental Fissure
what are the ligaments of the liver?
- Falciform Ligament
- Ligamentum Teres or Round Ligament
- Ligamentum Venosum Ligament
- Hepatoduodenal Ligament
- Gastrohepatic Ligament
- Coronary Ligament
- Right and Left Triangular Ligaments
LOOK AT WHERE THESE ARE ON SLIDES
what are the ligaments used as sonographic landmarks?
- falciform ligament
- Ligamentum Teres ( Round ligament)
- Ligamentum Venosum
where is the Hepatoduodenal Ligament?
Covers the porta hepatis entrance to the liver
where is the Gastrohepatic Ligament?
connects lesser stomach to liver
where is the coronary ligament?
connects posterior liver to diaphragm
where is the right and left triangular ligaments?
connects liver to body wall
where is the bare area?
- Located in the Posterior Superior aspect of the Liver
- Direct contact with Diaphragm
- Only part of the liver not covered by Peritoneum
- “Therefore if fluid is located here it is NOT Intraperitoneal”
what is intersegmental division?
Definite division between borders (hepatic veins)
what is intrasegmental division?
borders between unclear (portal veins) 1 exception to rule
what should the size of the liver be?
- measuring posterior superior to anterior inferior tip
- Midclavicular line for Right lobe range= 13 to 17 cm
- Left lobe- variable
what is the echogenicity of the liver?
- Slightly hyperechoic or isoechoic compared to renal cortex
- Hypoechoic compared to the spleen
what is the echotexture of the liver?
Homogeneous and moderately echogenic throughout
what is the contour of the liver?
smooth borders
what are the scanning approaches to the liver?
- Subcostal (means under ribs)
- Intercostal (between ribs)
what are the patient positions when scanning the liver?
Supine
Left lateral decubitus
what are the 4 lobes the liver is divided into?
- Lt. Lobe
- Rt. Lobe
- Caudate Lobe
- Quadrate lobe
what roughly divides the liver into right and left lobes?
main lobar fissure
what runs within the main lobar fissure?
middle hepatic vein and main portal vein
what vessel can help us divide the liver?
the IVC
the left lobe is divided into?
- lateral
- medial
the right lobe is divided into?
- anterior
- posterior
what divides the superior aspect of the liver?
hepatic veins
what divides the liver in the middle?
portal veins
what does each of couinauds segments contain?
- blood supply
- lymphatics
- biliary drainage
LOOK AT NAMING CAUDINADS SEGMENTS
ON POWERPOINT AND IN NOTES
What is the liver’s functions?
-Detoxifcation
-Metabolic Break down & remove old blood cells
-Secrete approx. ½ pint of bile per day
-Store several substances
-Production of important Plasma proteins &
hematopoiesis in fetal life
what are the 3 cells that the liver produces?
Functioning Hepatocytes
Kupffer cells
Biliary Epithelial Cells
what does the Functioning Hepatocytes do?
Detoxification
Form Bile – aides in digestion of fats
what does the Kupffer cells do?
Also find in spleen
Immunity
Protect Hepatocytes
what does the Biliary Epithelial Cells do?
Lines the biliary ducts
liver has a low ____________ due to dual blood supply
incidence of infarction
what does the portal system do?
Transports nutrients from intestines to liver
blood is filtered in the liver
what are the hepatic veins?
accompany the portal veins
- Very small compared to portals
- Not well seen with ultrasound
- 20 to 30 % of liver’s blood supply
- Provide Oxygen to the Liver
what are the ducts?
- Carry Bile which helps in Digestion
- Very small within the liver sometimes see along PV’s
- Bile brought by these ducts to the duodenum to help digest Food
what is apart of the portal triad?
- Hepatic Arteries
- Portal Veins
- Ducts
what is the part of the liver called where the portal triad enters?
porta hepatis
what is the left (my left) ear of mickey?
CBD
what is the body of mickey?
main portal vein
what is the right (my right) ear of mickey?
proper HA
what are some normal variants of the liver?
- reidels lobe (large right lobe)
- distal papillary process of caudate lobe
- elongated left lobe
