Other lessons needed for midterm

Question 1

where is the liver located?

Answer 1

• Right hypocondrium (RUQ)

- Extends to Epigastrium and into left hypocondrium

Question 2

what is the superior border of the liver?

Answer 2

diaphragm

Question 3

what are the posterior borders of the liver?

Answer 3

lumbar region of the posterior abdominal wall

Question 4

what is the anterior border of the liver?

Answer 4

abdominal wall, Ribs

Question 5

what is inferior to the liver?

Answer 5

Pancreas, Rt Kidney, duodenum, colon, GB, lesser curvature of Stomach

Question 6

what is another name for the anterior aspect of the liver?

Answer 6

parietal

Question 7

what is another name for the posterior aspect of the liver?

Answer 7

visceral

Question 8

what are the 3 fissures of the liver?

Answer 8

• Main Lobar Fissure (or Median)
• Left Intersegmental Fissure
• Right Intersegmental Fissure

Question 9

what are the ligaments of the liver?

Answer 9

• 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

Question 10

what are the ligaments used as sonographic landmarks?

Answer 10

• falciform ligament
• Ligamentum Teres ( Round ligament)
• Ligamentum Venosum

Question 11

where is the Hepatoduodenal Ligament?

Answer 11

Covers the porta hepatis entrance to the liver

Question 12

where is the Gastrohepatic Ligament?

Answer 12

connects lesser stomach to liver

Question 13

where is the coronary ligament?

Answer 13

connects posterior liver to diaphragm

Question 14

where is the right and left triangular ligaments?

Answer 14

connects liver to body wall

Question 15

where is the bare area?

Answer 15

• 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”

Question 16

what is intersegmental division?

Answer 16

Definite division between borders (hepatic veins)

Question 17

what is intrasegmental division?

Answer 17

borders between unclear (portal veins) 1 exception to rule

Question 18

what should the size of the liver be?

Answer 18

• measuring posterior superior to anterior inferior tip
• Midclavicular line for Right lobe range= 13 to 17 cm
• Left lobe- variable

Question 19

what is the echogenicity of the liver?

Answer 19

• Slightly hyperechoic or isoechoic compared to renal cortex
• Hypoechoic compared to the spleen

Question 20

what is the echotexture of the liver?

Answer 20

Homogeneous and moderately echogenic throughout

Question 21

what is the contour of the liver?

Answer 21

smooth borders

Question 22

what are the scanning approaches to the liver?

Answer 22

• Subcostal (means under ribs)

- Intercostal (between ribs)

Question 23

what are the patient positions when scanning the liver?

Answer 23

Supine

Left lateral decubitus

Question 24

what are the 4 lobes the liver is divided into?

Answer 24

• Lt. Lobe
• Rt. Lobe
• Caudate Lobe
• Quadrate lobe

Question 25

what roughly divides the liver into right and left lobes?

Answer 25

main lobar fissure

Question 26

what runs within the main lobar fissure?

Answer 26

middle hepatic vein and main portal vein

Question 27

what vessel can help us divide the liver?

Answer 27

the IVC

Question 28

the left lobe is divided into?

Answer 28

- lateral | - medial

Question 29

the right lobe is divided into?

Answer 29

- anterior | - posterior

Question 30

what divides the superior aspect of the liver?

Answer 30

hepatic veins

Question 31

what divides the liver in the middle?

Answer 31

portal veins

Question 32

what does each of couinauds segments contain?

Answer 32

- blood supply - lymphatics - biliary drainage

Question 33

LOOK AT NAMING CAUDINADS SEGMENTS

Answer 33

ON POWERPOINT AND IN NOTES

Question 34

What is the liver's functions?

Answer 34

-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

Question 35

what are the 3 cells that the liver produces?

Answer 35

Functioning Hepatocytes Kupffer cells Biliary Epithelial Cells

Question 36

what does the Functioning Hepatocytes do?

Answer 36

Detoxification | Form Bile – aides in digestion of fats

Question 37

what does the Kupffer cells do?

Answer 37

Also find in spleen Immunity Protect Hepatocytes

Question 38

what does the Biliary Epithelial Cells do?

Answer 38

Lines the biliary ducts

Question 39

liver has a low ____________ due to dual blood supply

Answer 39

incidence of infarction

Question 40

what does the portal system do?

Answer 40

Transports nutrients from intestines to liver | blood is filtered in the liver

Question 41

what are the hepatic veins?

Answer 41

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

Question 42

what are the ducts?

Answer 42

- 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

Question 43

what is apart of the portal triad?

Answer 43

- Hepatic Arteries - Portal Veins - Ducts

Question 44

what is the part of the liver called where the portal triad enters?

Answer 44

porta hepatis

Question 45

what is the left (my left) ear of mickey?

Answer 45

CBD

Question 46

what is the body of mickey?

Answer 46

main portal vein

Question 47

what is the right (my right) ear of mickey?

Answer 47

proper HA

Question 48

what are some normal variants of the liver?

Answer 48

- reidels lobe (large right lobe) - distal papillary process of caudate lobe - elongated left lobe