Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MIDS 127 - abdo > The Liver (hardly knew her!) > Flashcards

The Liver (hardly knew her!) Flashcards

1
Q

What is the average liver size?

A

13-16cm length wise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In the liver, which vessel does the right branch bifurcate into an anterior and posterior branch?

A

Right portal vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

In the liver, if a malignant neoplasm appears as an anechoic mass, what is a likely explanation for this echo characteristic?

A

The central liquefaction of necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the two capsule layers?

A

The visceral peritoneum and the Glisson capsule (highly echogenic, encases hepatic artery/portal vein/bile ducts within the liver)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where is Morrison’s Pouch?

A

It is a potential space between the liver and right kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe the main lobar fissure (MLF) of the liver.

A

Separates left and right lobes, contains main hepatic vein, gallbladder, and IVC fossa. Seen between GB neck and RPV.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the right intersegmental fissure (liver).

A

Divides right lobe into anterior and posterior segments. Landmark: Right hepatic vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe left intersegmental fissure (liver).

A

Divides left lobe into medial and lateral segments.

Landmarks: Left hepatic vein, ascending branch of LPV, ligamentum teres (inferior)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

The hepatic veins run between segments (________) and lobes (_______).

A

Intersegmental

Interlobar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The portal vein runs within segments (__________).

A

Intrasegmental

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a Riedel’s lobe?

A

Downward projection of the anterior edge of RLL to the right of the gallbladder.
Can be mistaken for hepatomegaly.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What vessels does the liver get its blood supply from?

A

Hepatic arteries & portal veins.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What do the portal veins do?

A

Drain blood from GIT, spleen, pancreas, and GB.
RPV divides into the anterior and posterior segmental branches.
LPV divides into the medial and lateral segmental branches.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Where do the hepatic veins drain into?

A

The IVC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the porta hepatis?

A

Fissure where portal vein and hepatic artery enter the liver and bile duct exists the liver.

Bile duct is ventral and lateral, hepatic artery is ventral and medial, portal vein is dorsal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How large must the intrahepatic ducts be to be considered dilated?

A

Greater than 2mm.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are some of the hepatic functions?

A

Bile formation and secretion, carbohydrate metabolism, fat metabolism, protein metabolism, reticuloendothelial tissue activity, storage depot, blood reservoir, heat production, detoxification, lymph formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How is bilirubin created?

A

Formed from destroyed RBC’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe conjugated (direct) bilirubin.

A

Conjugated by liver enzymes, becomes water soluble, pooped and peed out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe unconjugated (indirect) bilirubin.

A

Remains in the blood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Describe indirect bilirubin increase.

A

Caused by increased RBC breakdown or diseases that affect liver’s ability to conjugate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe direct bilirubin increase.

A

Hepatitis, cirrhosis, obstructive liver disease; directly affects the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is Alanine aminotransferase (ALT)?

A

Responsible for majority of tissue energy production; levels elevate when liver cell damage occurs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is Aspartate aminotransferase (AST)?

A

Found in all tissues that use energy but large amount in liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is Alkaline Phosphatase (ALP)?

A

Found in many tissues and is normally excreted in bile; INCREASED when biliary obstruction occurs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is lactic dehydrogenase (LDH)?

A

Found in all tissues, not typically used for liver evaluation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is y-Glutamyl Transpeptidase (GGT)?

A

Transport of amino acids and peptide across cell membranes; most sensitive indicator of alcoholism; INCREASED in liver disease and posthepatic obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is Prothrombin Time (PT)?

A

Pathological deficiency of clotting factors due to liver dysfunction or absence of Vitamin K

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is Albumin? What organ synthesizes it?

A

Role in total water distrubtion/osmotic pressure - mostly synthesized by the liver.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What does increased Albumin indicate?

A

Dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What does decreased albumin indicate?

A

Chronic liver disease, ascites, right sided heart failure, cancer, peritonitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

How large does the liver have to be for hepatomegaly?

A

Larger than 16cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What causes hepatomegaly?

A

Infection, hepatic tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is Steatosis?

A

Fatty infiltration; fat accumulation in the hepatocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is more common in Steatosis, focal or diffuse?

A

Diffuse, affects whole organ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the main cause of Steatosis?

A

Alcohol abuse and obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is NAFL or NASH?

A

Non alcoholic fatty liver.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is cirrhosis?

A

Diffuse destruction of the normal architecture of the liver lobules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What’s the most common cause of cirrhosis?

A

Alcohol abuse

40
Q

What are the lab values for Cirrhosis? What is increased/decreased?

A

Bilirubin elevated
ALP may be elevated
Albumin decreased
a-globulin proteins increased

41
Q

What are the SS of Cirrhosis?

A

fatigue, weight loss, diarrhea, hepatomegaly, jaundice, ascites, RUQ or epigastric aching pain, fullness

42
Q

What kind of capsule surface does Cirrhosis have?

A

Lumpy, abnormal

43
Q

What is the SA of chronic cirrhosis?

A 
Liver is small (especially RLL)
Caudate lobe extremely obvious
Surface nodularity
Fine to coarse echotexture
Potential portal hypertension findings
44
Q

What is Hepatitis?

A

Inflammation of the liver

45
Q

What are the five types of Hepatitis?

A

A - Parental, fecal-oral, ingesting infected food or water
B - Sexual contact (STD), mother/infant contaminated needles, blood, body fluids
C - Sexual contact, contaminated needles, blood, body fluids
D - Infected blood, unprotected sex, infected needles but must have Hep B already
E - Drinking contaminated water

46
Q

What is acute hepatitis’ SA?

A

Normal to hypoechoic parenchyma, but PV will be echogenic (starry sky sign) and GB will can be thickened

47
Q

What is the SA of chronic hepatitis?

A

Fibrosis with coarse and hyperechoic parenchyma

48
Q

What is Glycogen Storage Disease? What is the most common type?

A

Defective enzyme that allows excessive deposits of glycogen to be stored in liver, intestinal tract, and kidneys

Type 1: von Gierke disease is most common type

49
Q

What is the SA of von Gierke disease?

A

Increased echogenicity across organ, decreased penetration, hepatomegaly, potential solid liver masses (adenomas)

50
Q

What is passive liver congestion?

A

Edematous liver secondary to vascular congestion is a complication related to heart failure.

51
Q

What is the SA of passive liver congestion?

A

Dilated hepatic veins, dilated IVC with little or no change with respiration.

52
Q

Where are congenital cysts most common in the liver?

A

RLL

53
Q

Describe Polycystic Liver Disease (PLD) and its 2 forms.

A

A congenital cyst

Isolated PLD - only in the liver
ADPKD (autosomal dominant polycystic kidney disease) - more common, cysts in liver and kidneys

Most common in women in 30’s/40’s

Asymptomatic unless large

54
Q

Describe hematoma.

A

Acquired cyst that is a collection of blood.

Associated with pregnancy-induced hypertension, but can be caused by trauma

SS: RUQ pain

55
Q

What is a peribiliary cyst?

A

Acquired cyst

Small (.2-2.5cm) cysts around the porta hepatis

More commonly found in patients with severe liver disease

SA: Clustered tubular appearing cysts that parallel the bile ducts and PV’s in the center of the liver

56
Q

What is the most common source for a pyogenic abscess?

A

Most common source is from the biliary tract

57
Q

What is the most common hepatic abscess?

A

Pyogenic abscess

58
Q

What is the SS for a pyogenic abscess?

A

Pain, fever, leukocytosis, elevated LFT’s, hepatomegaly, nausea and vomiting.

59
Q

What causes pyogenic abscesses?

A

Appendicitis, acute diverticulitis, IBD…

60
Q

What is the SA of a pyogenic abscess?

A

Single or multiple masses
Most commonly affects RLL
Irregular walls, poorly defined
Heterogenous

61
Q

What causes an Amebic Abscess?

A

Ingesting contaminated food/water

62
Q

What is the SS of Amebic Abscesses?

A

RUQ pain, hepatomegaly, diarrhea, fever, chills, jaundice, black tarry stools, elevated LFTs

63
Q

What is the SA of an Amebic Abscess?

A

Most commonly in the RLL, along the liver capsule, internally avascular

64
Q

What is Schistosomiasis?

A

Parasitic infection, worms in contaminated water penetrate the skin. Can cause portal hypertension, cirrhosis

65
Q

What causes a “clay-pipe stem” appearance?

A

Schistomiasis. Hyperechoic thickened portal venous walls.

66
Q

What is another name for Hydatid diease?

A

Echinococcal Cyst

67
Q

What is Hydatid Disease?

A

A parasitic tapeworm, larvae ingested and hatch in the intestines and migrate often to liver

68
Q

What are the SS of an Echinococcal Cyst?

A

Pain, anaphylactic shock, elevated ALP, jaundice if obstruction

69
Q

What causes a honeycomb appearance? Or looks like a congealed water-lily sign?

A

Hydatid Disease/Echinococcal Cyst

70
Q

What is the SA of HIV-AIDS?

A

Starry sky pattern, multi-organ calcifications. Also can have fatty infiltration.

71
Q

What is Candida Albicans?

A

A fungal infection. Occurs in immunocompromised hosts.

72
Q

What is the SS of Candida Albicans?

A

RUQ pain, fever, hepatomegaly

73
Q

What is the SA of Candida Albicans?

A

A wheel within a wheel sign, hypoechoic rim. Can become uniformly hyperechoic and calcify as it heals.

74
Q

What is the most common BENIGN liver tumour?

A

Cavernous Hemangioma

75
Q

Are cavernous hemangiomas (liver) most common in women or men?

A

Women (5x)

76
Q

What is the SA of a cavernous hemangioma?

A

Homogenous hyperchoic mass, well defined margins and possible posterior enhancement. Avascular (flow too slow). Can be solitary or multiple. Usually smaller than 3cm

Most commonly posterior RLL and subcapsular

77
Q

What is FNH?

A

Focal Nodular Hyperplasia

78
Q

Who is the most common population for FNH?

A

Women in childbearing years, linked to OCP.

79
Q

Who is the most common population for liver cell adenoma?

A

Women in childbearing age, associated with long-term OCP use.

80
Q

What describes: subtle isoechoic well-circumscribed lesion with a central stellate scar, usually less than 5cm. Most commonly RLL and solitary?

A

Focal Nodular Hyperplasia

81
Q

What describes: Solitary, hyperechoic with hypoechoic halo, has vascularity, is encapsulated and well-circumscribed?

A

Liver Cell Adenoma

82
Q

What kind of speed error artifact can be seen with lipoma?

A

Speed error artifact

83
Q

What is the most common MALIGNANT tumour?

A

Hepatocellular Carcinoma (aka Hepatoma)

84
Q

What causes HCC?

A

Chronic liver disease (especially cirrhosis), viral infections, parasitic liver infections

85
Q

What has an increased risk with hemochromatosis, some metabolic and glycogen storage diseases?

A

Hepatoma (HCC)

86
Q

What is the most common population for HCC?

A

Men (x3)

87
Q

What are the SS of HCC?

A

Jaundice, ascites, metabolic disturbances, weight loss, n/v, RUW pain, pruritus, splenomegaly, palpable mass, hepatomegaly.

INCREASED LAB VALUES: ALP, AST, ALT, AFP

88
Q

What complications can arise from hepatocellular carcinoma?

A

Biliary obstruction, portal hypertension, potral vein thrombosis

89
Q

What does HCC look like?

A

Focal multiple or diffuse. Cirrhotic livers - hypoechoic masses. Typically large mass with smaller satellite lesions. Vascularity. Invades PV (60% of cases)

90
Q

What is a Liver Hemangiosarcoma or Angiosarcoma?

A

Rare but aggressive, occurs in older population, large solid or mixed lesion.

91
Q

What is the 2nd most common site for mets?

A

Liver

92
Q

What types of neoplasms are hyperechoic?

A

Colon, RCC, hemangioma, lipoma, neuroendocrine, adenoma (borderline)

93
Q

What neoplasms are isoechoic + hyperechoic?

A

HCC (hypo)
FNH (iso)
Lymphoma (hypo)
Adenoma (hypo)

94
Q

What is the male’s most common neoplasm?

A

HCC

95
Q

What is the female’s most common neoplasms?

A

FNH, hemangioma, adenoma.

ALL tied to OCP.

MIDS 127 - abdo (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions