test review reverse

Question 1

reverse

Falciform Ligament

ligamentum teres

ligamentum venosum

coronary ligament

Answer 1

ligaments

Question 2

reverse

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

Answer 2

Falciform ligament

Question 3

reverse

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

Answer 3

ligamentum teres

Question 4

reverse

separates the left and caudate lobes of the liver

seen just inferior to the dome as a linear horizontal line

Answer 4

ligamentum venosum

Question 5

reverse

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

Answer 5

Coronary ligament

Question 6

reverse

Main lobar

Right intersegmental fissure

Left intersegmental fissure

Answer 6

Fissures of the liver

Question 7

reverse

divides the left and right lobes

hyperechoic line extending from portal vein to neck of GB

Answer 7

Main Lobar Fissure

Question 8

reverse

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

Answer 8

Right intersegmental fissure

Question 9

reverse

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

Answer 9

Left intersegmental fissure

Question 10

reverse

Alkaline Phosphatase

Alanine Aminotransferas

Aspartate Aminotransferase

Lactic Acid dehydrogenase

Bilirubin (direct, indirect and total)

Prothrombin Time

Albumin

Globulins

Answer 10

Liver function tests

Question 11

reverse

Enzyme produced primarily by liver, bone and placenta.

elevation related to

higher in obstruction

hepatic matastasis

hepatitis

lymphoma

cholestasis secondary to drugs

cirrhosis

Answer 11

Alkaline Phosphatase

Question 12

reverse

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

Answer 12

Alanine Aminotransferase

ALT

Question 13

reverse

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

Answer 13

Aspartate Aminotransferase

Question 14

reverse

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

Answer 14

Lactic Acid dehydrogenase

LDH

Question 15

reverse

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

Answer 15

bilirubin

Question 16

reverse

rise in this test is seen with increased RBC destruction

(anemias, trauma from hematoma or hemorrhagic pulmonary infarct)

Answer 16

indirect bilirubin

Question 17

reverse

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

Answer 17

direct bilirubin test

Question 18

reverse

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

Answer 18

prothrombin time

Question 19

reverse

sensitive test for metabolic derangement of liver

low results suggest decreased protein synthesis in hepatocellular damaged patients

Answer 19

Albumin

Question 20

reverse

common elevation in chronic liver disease

Answer 20

globulins

Question 21

reverse

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

Answer 21

Glycongen Storage disease

Question 22

reverse

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

Answer 22

type I or von Gierke’s disease

Question 23

reverse

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

Answer 23

sonographic appearance of glycogen storage dsease

Question 24

reverse

Cavernouse hemagioma

LIver cell adenoma

focal nodule hyperplasia

hepatic cystadenoma

Answer 24

benign liver tumors

Question 25

# reverse 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

Answer 25

Cavernous Hemagioma

Question 26

# reverse 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

Answer 26

Liver Cell Adenoma

Question 27

# reverse 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

Answer 27

focal nodule hyperplasia

Question 28

# reverse found in women under 40 asymptomatic more in RL

Answer 28

focal nodular hyperplasia

Question 29

# reverse contains cystic structures within the lesoin rare neoplasm occuring in middle aged women most have palpable abdominal mass

Answer 29

hepatic cystadenoma

Question 30

# reverse Bilobed gallbladder Septated gallbladder Phrygian cap Hartmann pouch Junctional fold

Answer 30

Normal variants of the Gallbladder

Question 31

# reverse Hourglass appearance

Answer 31

Bilobed gallbladder

Question 32

# reverse Appear as thin separations within the gallbladder

Answer 32

Septated gallbladder

Question 33

# reverse Gallbladder fundus is folded onto itself

Answer 33

Phrygian cap

Question 34

# reverse Outpouching of gallbladder neck

Answer 34

Hartmann pouch

Question 35

# reverse Prominent fold located at the junction of the gallbladder neck

Answer 35

Junctional fold

Question 36

# reverse —Size is variable, but approx 7-10cm in length and 2.5-4cm in width

Answer 36

Gallbladder size

Question 37

# reverse —in the neck keeps the cystic duct from kinking

Answer 37

Heister’s valves function

Question 38

# reverse —Consists of the right and left hepatic duct, common hepatic duct, common bile duct, pear shaped gallbladder, and cystic duct

Answer 38

Anatomy of the Bile Ducts

Question 39

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

Answer 39

Right and left hepatic ducts

Question 40

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

Answer 40

Common Hepatic Duct

Question 41

# reverse 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

Answer 41

CBD ends

Question 42

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

Answer 42

CBD (prox portion) location

Question 43

# reverse 6mm \< 60yrs of age increase 1mm per 10 yrs of aging

Answer 43

CBD measurement

Question 44

# reverse approx 4 cm long, connects the neck of the gallbladder to the CHD to form the CBD normally not seen by ultrasound

Answer 44

Cystic Duct-

Question 45

bililrubin mild to severe increase

Answer 45

hepatocellular disease

Question 46

serum albumin decreased

Answer 46

hepatocellular disease

Question 47

AST moderate to severe increase

Answer 47

hepatocellular disease

Question 48

ALT moderate to severe increase

Answer 48

hepatocellular disease

Question 49

Alkaline Phosphatase minimal to moderate increase

Answer 49

hepatocellular disease

Question 50

bilirubin severe increase

Answer 50

obstruction

Question 51

albumin normal

Answer 51

obstruction

Question 52

AST mild increase

Answer 52

obstruction

Question 53

ALT mild increase

Answer 53

obstruction

Question 54

Alkaline phosphatase severe increase

Answer 54

obstruction

Question 55

normnal measurement 4mm

Answer 55

Common Hepatic Duct

Question 56

tumor at the bifurcatoin of the hepatic ducts may cause asymmetric obstruction of the biliary tree

Answer 56

Klatskin's tumor

Question 57

uncommon cause for extrahepatic biliary obstruction resulitng from an impacted stone in cystic duct

Answer 57

Mirizzi sundrome

Question 58

normal to increased hepatic enzymes increased ALK phosphatase increased birect bilirubin

Answer 58

Fatty infiltrate liver

Question 59

increased AST increased ALT increased bilirubin leukopenia

Answer 59

Acute hepatitis

Question 60

increased AST increased ALT increased bilirubin leukopenia

Answer 60

Chronic hepatitis

Question 61

increased Alk Phos increased direct bilirubin increased AST increased ALT leukopenia

Answer 61

Cirrhosis

Question 62

disturbance of acid-base balance

Answer 62

Glycogen storage disease

Question 63

increase iron levels in blood

Answer 63

hemochromatosis