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Abdomen > Quiz 2 Revised > Flashcards

Quiz 2 Revised Flashcards

1
Q

Where is the falciform ligament located?

A

Abdomen

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2
Q

What is the falciform ligament attached to?

A

Liver, diaphragm, and anterior abdominal wall

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3
Q

What structure attaches the liver to the diaphragm and anterior wall?

A

Falciform ligament

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4
Q

What is the smooth fibrous covering of the liver called?

A

Glisson’s Capsule

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5
Q

Which vessel separates the left lobe from the right lobe of the liver?

A

Middle hepatic vein

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6
Q

Which vessel separates the right lobe of the liver into two segments?

A

Right hepatic vein

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7
Q

Which liver function lab values are most important?

A

Aspartate aminotransferase (AST), Alanine aminotransferase (ALT)

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8
Q

The medial and lateral segments of the left lobe of the liver are separated by what structures?

A

Lt intersegmental fissure & Lt hepatic vein

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9
Q

What does the main lobar fissure connect?

A

Connects gallbladder fossa to the IVC

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10
Q

What are the branches of the left portal vein?

A

Medial and lateral

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11
Q

What are the branches of the right portal vein?

A

Anterior and posterior

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12
Q

Which vein carries blood into the liver from the digestive organs?

A

Portal veins

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13
Q

Which vein carries blood out of the liver towards the inferior vena cava in the shape of a ‘V’?

A

Hepatic

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14
Q

Which liver function test indicates liver cell necrosis if increased?

A

Aspartate Aminotransferase (AST)

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15
Q

Which liver function test indicates liver cell necrosis if increased and enzymes are present?

A

Alanine aminotransferase (ALT)

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16
Q

Which liver test value provides insight on how well the liver is processing & excreting waste?

A

Bilirubin

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17
Q

Which liver test value is part of the blood clotting mechanism?

A

Prothrombin

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18
Q

Which liver test values are plasma proteins made by the liver, and a decrease in level signifies liver cell damage?

A

Albumin & globulins

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19
Q

Which liver test value are enzymes found in the liver?

A

Alpha fetoprotein

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20
Q

Which liver test value is increased in alcoholism?

A

Gamma glutamyl transferase

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21
Q

What is the anterior border of the caudate lobe?

A

IVC

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22
Q

Describe where each of the liver segments is located.

A

Segment 1: caudate lobe, Segment 2-4: left lobe, Segment 5-8: right lobe

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23
Q

Where does the blood in the portal vein come from?

A

SMA & Splenic vein

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24
Q

This is where the splenic vein and superior mesenteric vein join to form the portal vein.

A

Portal confluence

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25
Q

This is a group of three structures that include the portal vein, hepatic vein, and bile duct.

A

Portal triad

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26
Q

What is the bare area of the liver?

A

Only part of the liver not covered by peritoneum

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27
Q

Where is the bare area of the liver located?

A

It is located on the posterior and superior portion

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28
Q

Homogeneous parenchyma, interruptions in homogeneous appearance, normal echo brightness, slightly greater than renal cortex, slightly less than pancreas, hypoechoic to spleen is the appearance of ?

A

Normal liver

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29
Q

Digestion, storage, blood clotting, metabolism, detoxification, immune response, hormone & protein production, and bilirubin processing are the functions of ?

A

The liver

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30
Q

What is bilirubin?

A

The breakdown product of hemoglobin in red blood cells

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31
Q

What are the 3 ways bilirubin can occur?

A

• Excessive destruction of RBC
• Malfunction of liver cells
• Obstruction in biliary system

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32
Q

Where is Morrison’s pouch?

A

Between the posterior right liver lobe and the right kidney

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33
Q

What is the difference between visceral and parietal peritoneum?

A

Parietal peritoneum lines the wall of the cavity while visceral envelopes the organs except at hilum.

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34
Q

This is describing which omentum: Is the primary compartment of the peritoneal cavity, extends across the anterior abdomen and from the diaphragm to the pelvis, and contains all intraperitoneal organs of the abdominal cavity?

A

Greater sac

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35
Q

This is describing which omentum: Is the primary compartment of the peritoneal cavity, extends across the anterior abdomen and from the diaphragm to the pelvis, & contains all intraperitoneal organs of the abdominal cavity?

A

Lesser sac (Omental burse)

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36
Q

What are the potential spaces in the peritoneal cavity?

A

• Left anterior subphrenic space
• Right anterior subphrenic space
• Left posterior subhepatic space
• Right posterior subhepatic space
• Right and left para colic gutters spaces
• Vesicorectal space / vesicouterine pouch
• Rectouterine space

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37
Q

This is a scanning technique that focuses specifically on the peritoneal.

A

FAST

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38
Q

Why is the FAST technique used?

A

Assess the peritoneal potential spaces for free fluid in trauma situations

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39
Q

The FAST technique can detect as little as how much free fluid?

A

200 mL

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40
Q

What are the two types of ascites?

A

Transudative & Exudative

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41
Q

This is what type of ascites: Characterized by a lack of protein, has a simple appearance (anechoic) and is often associated with portal hypertension and congestive cardiac disease?

A

Transudative

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42
Q

This is what type of ascites: Fluid contains a large amount of protein and cellular material, appears anechoic with debris, associated with renal failure, inflammatory or ischemic bowel disease, peritonitis, and malignancy?

A

Exudative

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43
Q

Transudative is what type of fluid collection?

A

Passive

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44
Q

Exudative is what type of fluid collection?

A

Active

45
Q

What is it called when blood is collecting into the peritoneal cavity caused by trauma including iatrogenic trauma (biopsy)?

A

Hemoperitoneum

46
Q

What is diffuse hepatocellular disease?

A

Group of disorders

47
Q

This is the area/areas of increased echogenicity within normal liver tissue?

A

Focal fatty infiltration

48
Q

This is the area of the liver parenchymal tissue that is spared?

A

Focal fatty spring

49
Q

Obesity, excessive alcohol intake, poorly controlled hyperlipidemia, diabetes, excess corticosteroids, pregnancy, total parenteral hyperalimentation (excessive eating), severe hepatitis, glycogen storage disease, cystic fibrosis, & pharmaceutical are the causes of ?

A

Fatty infiltration

50
Q

What does diffuse hepatocellular affect and interfere with?

A

Affects hepatocytes & interferes with function of the liver

51
Q

True or False: Diffuse hepatocellular affects the entire liver parenchyma, and produces overall change in echogenicity and size?

A

True

52
Q

What lab values are associated with fatty infiltration?

A

Aspartate Aminotransferase (AST) & Alanine Aminotransferase (ALT)

53
Q

Hepatomegaly or NL in size, increased echogenicity, granular texture, obscurity of portal veins, paucity of hepatic vessels, difficulty in penetration, liver/kidney echo brightness disparity are the appearance of ?

A

Fatty infiltration

54
Q

Which disease is an inherited disease characterized by the abnormal storage and accumulation of glycogen in the tissue, especially in the liver and kidneys?

A

Glycogen storage disease

55
Q

Which glycogen storage disease is most common?

A

Von Gierke’s

56
Q

What is hepatitis?

A

Inflammation of the liver

57
Q

How is hepatitis spread?

A

Reactions to viruses or toxins

58
Q

This hepatitis is spread by eating infected food or water?

A

Hepatitis A

59
Q

This hepatitis is spread by sexual contact, blood transfusions, or sharing contaminated needles?

A

Hepatitis B

60
Q

This hepatitis is spread through direct contact with the blood or body fluid of a person who has the disease?

A

Hepatitis C

61
Q

This hepatitis is spread through contact with infected blood, unprotected sex, and infected needles?

A

Hepatitis D

62
Q

Jaundice, anorexia, GI symptoms, fatigue, joint pain, flu symptoms, dark urine are the symptoms of ?

A

Hepatitis

63
Q

What type of hepatitis on ultrasound may show liver may appear normal, liver echogenicity may be decreased, accentuation of portal vein walls, liver may be enlarged and tender, & GB wall may be thickened?

A

Acute hepatitis

64
Q

What type of hepatitis on ultrasound may show liver echo pattern may be coarse, liver echogenicity may be increased, portal vein walls may be decreased in echogenicity in comparison to liver?

A

Chronic hepatitis

65
Q

What is a diffuse process in which liver parenchyma is replaced by fibrosis and abnormal nodules, it is irreversible and progressive?

A

Cirrhosis

66
Q

Ascites, dilated portal vein, portosystemic varices, hepatofugal portal flow, increased hepatic arterial flow, splenomegaly, & recanalized ligamentum teres are the findings of ?

A

Cirrhosis

67
Q

What is the normal measurement of the portal vein?

A

13 mm

68
Q

What is the normal measurement of the splenic vein?

A

10 mm

69
Q

What are the liver segments called?

A

1: caudate, 2: Lt lateral superior, 3: Lt lateral inferior, 4a: Lt medial superior, 4b: Lt medial inferior, 5: Rt inferior anterior, 6: Rt inferior posterior, 7: Rt superior posterior, 8: Rt superior anterior

70
Q

What was the ligamentum teres in fetal life?

A

It was the obliterated umbilical vein of fetal circulation

71
Q

Describe Riedel’s lobe of the liver.

A

A tongue-like extension of the right lobe, more common in females

72
Q

What are the first two levels of branches of the main portal vein?

A

Left portal vein and right portal vein

73
Q

This is defined as the occlusion of some or all of the hepatic veins and/or occlusion of the IVC?

A

Budd Chiari

74
Q

Primary or secondary: Is the resultant occlusion of the hepatic veins or IVC by a congenital web or fibrous cord?

A

Primary

75
Q

Primary or secondary: It is the occlusion of the hepatic veins and/or IVC occurs by tumor or thrombus formation?

A

Secondary

76
Q

They are cysts that are usually small, less than 2-3cm, and are multiple throughout the liver parenchyma are an appearance of ?

A

Polycystic liver disease

77
Q

What is a hydatid cyst caused by?

A

Taenia echinococcus or Echinococcus granulosus - parasitic tapeworm

78
Q

What is a typical ultrasound of an echinococcal cyst?

A

• Mother cyst with daughter cyst
• Honeycomb cyst
• Water lily cyst

79
Q

How could you define inflammatory disease of the liver?

A

Pus forming mass within the liver usually due to bacterial or parasitic infection

80
Q

Pain, fever, pleuritis, nausea, vomiting, diarrhea, & hepatomegaly are the symptoms of ?

A

Pyogenic abscess

81
Q

What lab values are associated with a pyogenic abscess?

A

Leukocytosis, increased LFTs, & anemia

82
Q

More common in right lobe, 1 cm to very large, shape variable (usually round or oval), irregular poorly defined walls, anechoic to very echogenic, 1/2 have posterior enhancement, may have shadowing, or comet tail artifact, & peripheral hypervascularity is the appearance of ?

A

Pyogenic abscess

83
Q

Who is at risk for an amoebic abscess?

A

Patients that have had a history of GI infections

84
Q

What are the symptoms of an amoebic abscess?

A

Abdominal pain, diarrhea, melena

85
Q

What will happen if a patient with an amoebic abscess does not get medical treatment?

A

Mortality rate is 100%

86
Q

Typically subcapsular, low amplitude cyst fill in, thickened irregular walls, & good through transmission is the appearance of ?

A

Amoebic disease

87
Q

What is the most common organism that causes infection in patients who are immunocompromised?

A

Pneumocystis carinii

88
Q

What is hepatic candidiasis?

A

Liver complication on HIV or other immunocompromised patients

89
Q

What is the cause of hepatic candidiasis?

A

Species of candida albicans

90
Q

What is the most common benign liver tumor?

A

Cavernous hemangioma

91
Q

Classically round, highly echogenic, well defined, solid mass, some have posterior enhancement, homogeneous, however, larger hemangiomas are more heterogeneous and may have posterior enhancement, & avascular is the appearance of ?

A

Cavernous hemangioma

92
Q

What is the second most common benign liver tumor?

A

Focal nodular hyperplasia

93
Q

Variable echotextures, more or less echogenic than liver or isoechoic to the liver, more common in the right lobe, mass is well circumscribed and many have a central scar, multiple nodules are separated by fibrous bands, size: .5 - 20 cm, & color shows vessels radiating in a stellate configuration from the center of the mass is the appearance of?

A

Focal nodular hyperplasia

94
Q

Which benign liver tumor is made up of hepatocytes, Kupffer cells, and fibrous connective tissue and bile duct elements?

A

Focal Nodular Hyperplasia

95
Q

Who is at risk for a liver adenoma?

A

People who take oral contraceptives and men who take steroids

96
Q

What is the typical treatment for a liver adenoma?

A

Surgery

97
Q

What is a liver lipoma made of?

A

Fat cells

98
Q

More echogenic than liver, hypoechoic to liver, isoechoic to liver, typically 8-15 cm by detection, may contain peripheral halo, & increased vascularity throughout mass and surrounding mass Is the appearance of ?

A

Liver adenoma

99
Q

Who is most at risk to develop HCC?

A

People 60 or over, three times more in men than women

100
Q

Which lab value is most significant for HCC?

A

AFP

101
Q

Weight loss, low grade fever, nausea, vomiting, RUQ pain, jaundice caused by bile ducts obstruction, pruritis caused by jaundice, ascites, & portal hypertension, tumor invasion causing portal vein obstruction are the symptoms of ?

A

HCC

102
Q

What is the most common liver malignancy?

A

Liver metastases

103
Q

What is the most common site for metastatic cancer in the body?

A

• GI tract
• Breast & lung
• Pancreas
• Colorectal
• Ovaries

104
Q

No specific ultrasound appearance – variable, may be a solitary tumor or multiple tumors, may be focal may be hypoechoic, hyperechoic, isoechoic, or complex, & ascites may be present is the appearance of ?

A

HCC

105
Q

Which labs might be elevated with metastatic disease?

A

CEA & AFP may be normal or elevated

106
Q

A patient with liver metastases may present with which symptoms?

A

• Jaundice
• Pain
• Hepatomegaly
• Weight loss
• Abdominal swelling or bloating
• RUQ or abdominal pain
• Asymptomatic

107
Q

Bulls eye sign (Target sign) and ‘Patchy pattern’ or ‘moth eaten’ is the appearance of ?

A

Liver metastatic disease

108
Q

What is CEUS?

A

A medical imaging technique that uses an intravenous contrast agent to improve clarity of scans.

109
Q

What is CEUS used for?

A

To detect diseases and conditions, evaluate organ function, monitor cancer therapy, and detect heart diseases.

Abdomen (4 decks)

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