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Abdomen Section 2 > Test review > Flashcards

Test review Flashcards

1
Q

ligaments

A

Falciform Ligament

ligamentum teres

ligamentum venosum

coronary ligament

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2
Q

Falciform ligament

A

extends from umbilicus to the diaphragm in parasagittal plane

contains the ligamentum teres

anteriorposterior axis extendes from right rectus muscle to bare area

echogencis reflections contintribute to hepatic ligament and attach to undersurface of diaphragm

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3
Q

ligamentum teres

A

appears as a bright echogenic focus as the termination of the falciform ligament

separates the medial and lateral segments of the left lobe

Usually appears triangularly on images

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4
Q

ligamentum venosum

A

separates the left and caudate lobes of the liver

seen just inferior to the dome as a linear horizontal line

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5
Q

Coronary ligament

A

The wide coronary ligament connects the central superior portion of the liver to the diaphragm.

Located on the lateral borders of the left and right lobes, respectively, the left and right triangular ligaments connect the superior ends of the liver to the diaphragm

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6
Q

Fissures of the liver

A

Main lobar

Right intersegmental fissure

Left intersegmental fissure

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7
Q

Main Lobar Fissure

A

divides the left and right lobes

hyperechoic line extending from portal vein to neck of GB

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8
Q

Right intersegmental fissure

A

Divides right lobe into anterior and posterior segments.
Identified by right hepatic vein

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9
Q

Left intersegmental fissure

A

Divides left lobe into medial and lateral segments.
Identified bt left hepatic vein

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10
Q

Liver function tests

A

Alkaline Phosphatase

Alanine Aminotransferas

Aspartate Aminotransferase

Lactic Acid dehydrogenase

Bilirubin (direct, indirect and total)

Prothrombin Time

Albumin

Globulins

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11
Q

Alkaline Phosphatase

A

Enzyme produced primarily by liver, bone and placenta.

elevation related to

hepatic matastasis

hepatitis

lymphoma

cholestasis secondary to drugs

cirrhosis

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12
Q

Alanine Aminotransferase

ALT

A

More specific than AST

slightly elevated in acute cirrhosis, hepatic metastasis, pancreeatitis

mild to moderate increase in obstructive jaundice,

moderate to high increase in hepatocelluar disease and infectious or toxic hepatitis

AST is higher in alcoholic hepatitis

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13
Q

Aspartate Aminotransferase

A

An enzyme present in many tissues that have high metabolic rate

released when cells are injured or damaged

released in abnormally high levels

Elevation associated with cirrhosis, acute hepatitis, hepatic necrosis and mononucleosis

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14
Q

Lactic Acid dehydrogenase

LDH

A

found in tissues of several systems

cellular injury and death cause enzyme to be released

moderate increase for mononucleosis

mildly elevated in hepatitis, cirrhosis and obstructive jaundice

primary use in detecting myocardial or pulmonary infarction

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15
Q

bilirubin

A

product of breakdown of hemoglobin in old RBC’s

liver converts to bile pigments secreted by liver cells into bile ducts

rise in serum leaks and gives skin a jaundices or yellow coloration

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16
Q

indirect bilirubin

A

rise in this test is seen with increased RBC destruction

(anemias, trauma from hematoma or hemorrhagic pulmonary infarct)

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17
Q

direct bilirubin test

A

product circulates in the bolld and is excreted into the bile after reaching the liver

conjugated with glucuronide

elevatoin usually related to obstructive jaundice (stones or neoplasm)

increase is more in hepatatic metastasis, hepatitis, lymphoma, cholestasis, secondary to drugs and cirrhosis

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18
Q

prothrombin time

A

liver enzyme part of blood clotting mechaniam

productoin depends on adequate intake and use of vitamin K

increases in presence of liver disease with cellular damage

cirrhosis and metatasitc disease casue prolonged time

19
Q

Albumin

A

sensitive test for metabolic derangement of liver

low results suggest decreased protein synthesis in hepatocellular damaged patients

20
Q

globulins

A

common elevation in chronic liver disease

21
Q

Glycongen Storage disease

A

inherited characterized by abnormal storage and accumulation of glycongen in tissues (liver, kidneys)

six categories divided based on clinical symptoms and specific enzyme defects

most common type I or von Gierke’s disease

22
Q

type I or von Gierke’s disease

A

glycongen storage disease in chich abnormally large amounts of glycogne are deposited in the liver and kidneys

23
Q

sonographic appearance of glycogen storage dsease

A

present with hepatomegaly,

increased echogenicity

slightly increased attenuatoin (similar to fatty infiltrate)

associated with hepatic adenomas, focal nodular hyperplasia and hepatomegaly

adenoma presents as well demarcated round homogeneous echogenic tumors

if tumor is large in may be slightly inhomogeneous

24
Q

benign liver tumors

A

Cavernouse hemagioma

LIver cell adenoma

focal nodule hyperplasia

hepatic cystadenoma

25
Q

Cavernous Hemagioma

A

binign congenital tumor consisting of large blood filled cystic spaces

most common benign tumor of liver

more frequently in females

usually asymptomatic, may bleed causing RUQ pain.

enlarge slowly and undergo degeneration, fibrosis and calcification

found in hepatic parenchyma or in posterior RL more than LL

26
Q

Liver Cell Adenoma

A

tumor of the glandular epithelium in which cells are arranged in recognizable glandular structure

normal or slightly atypical hepatocytes, frequently containing areas of bile stasis, focal hemorrhage or necrosis

lesion found more in women and related to oral contraceptive use

presents iwth RUQ pain secondary to rupture with bleeding

increased in type I glycogen storage disease

27
Q

focal nodule hyperplasia

A

second most common benign liver mass

thought to arise from developmental hyperplastic lesions related to an area of congenital vascular formatoin

typically one well circumscribed lesion but may be more than one mass, many located alond subcapsular area of liver, may be pedunculated and have central scar

consists of normal hepatocytes, kupffer cells, bile duct elements, fibrous connective tissue bands of fibrous tissue separate the nodules

28
Q

focal nodular hyperplasia

A

found in women under 40

asymptomatic

more in RL

29
Q

hepatic cystadenoma

A

contains cystic structures within the lesoin

rare neoplasm occuring in middle aged women

most have palpable abdominal mass

30
Q

Normal variants of the Gallbladder

A

Bilobed gallbladder

Septated gallbladder

Phrygian cap

Hartmann pouch

Junctional fold

31
Q

Bilobed gallbladder

A

Hourglass appearance

32
Q

Septated gallbladder

A

Appear as thin separations within the gallbladder

33
Q

Phrygian cap

A

Gallbladder fundus is folded onto itself

34
Q

Hartmann pouch

A

Outpouching of gallbladder neck

35
Q

Junctional fold

A

Prominent fold located at the junction of the gallbladder neck

36
Q

Gallbladder size

A

—Size is variable,

but approx 7-10cm in length and 2.5-4cm in width

37
Q

Heister’s valves function

A

—in the neck keeps the cystic duct from kinking

38
Q

Anatomy of the Bile Ducts

A

—Consists of the right and left hepatic duct,

common hepatic duct,

common bile duct,

pear shaped gallbladder,

and cystic duct

39
Q

Right and left hepatic ducts

A

—come from the right lobe of the liver in the Porta hepatis and unite to form the CHD

40
Q

Common Hepatic Duct

A

approx 4mm in diameter, joins the cystic duct(draining the gallbladder) and is now called the CBD

41
Q

CBD ends

A

by piercing into the wall of the duodenum where is joins the main pancreatic duct and together, they open into the duodenum through a small opening called the ampulla of Vater

42
Q

CBD (prox portion) location

A

—lies lateral to the hepatic artery and anterior to the portal vein (left ear of Mickey Mouse)

43
Q

CBD measurement

A

—Normal measurement is

44
Q

Cystic Duct-

A

approx 4 cm long,

connects the neck of the gallbladder to the CHD to form the CBD

normally not seen by ultrasound

Abdomen Section 2 (8 decks)

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