Registry Liver

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each segment has its own (3): portal vein
hepatic art
bile duct
because of this division of self-contained units each segment can be resected wo __ remaining liver.: damaging
liver anatomy that divides liver int functional segments: couinauds's liver anatomy
three lobes of liver: right, left, caudate
right lobe is divided into __ and __ segments. lt lobe is divided into __ and __: anterior, posterior
left, medial
caudate lobe lies on ___ surface of liver between medial lt lobe and __: posterior-superior
ivc
caudate lobe is supplied by branches of __ and __ portal venous and hepatic arterial systems. it is drained by small veins called __ that enter directly into ivc: left, right
emissary
__ anatomy is based on the distribution of the portal veins: segmental
hepatic veins divie the liver ___ into four sections. each of these sections is further divided ___ by an imaginary plane through the lt and rt portal veins: longitudinally
transversely
how many segments are in couinaud's anatomy: 8
name the 9 couinauds segments and corresponding liver segment: 1-caudate
hepatic veins course __ lobes and segments: between
hepatic veins are interlobal and ___: intersegmental
t/f? hepatic veins have non-echogenic walls: t
the vessels of the portal triad course to the ___ of each segment (intrasegmental): center
the portal triad is encased by a fibrofatty sheath called __ that gives it hyperechoic walls: glisson's capsule
portal triad includes (3): main portal vein
proper hepatic hartery
common hepatic duct
divides right and left hepatic lobes by an oblique plane between the ivc and gallbladder fossa: main lobar fissure
3 landmarks of main lobar fissure: gallbladder
ivc
middle hepatic vein
may be identified between the gallbladder neck and junction of right and left portal veins: main lobar fissure
main lobar fissure divides the __ segment of the right lobe and the __ of the left lobe: anterior
medial
divides right lobe into anterior and posterior segments: right intersegmental fissure
landmark of right intersegmental fissure: rhv
divides left lobe into med and lateral segments: left intersegmental fissure
4 landmarks of left intersegmental fissure: lhv, ascending left portal vein, falciform ligament, ligamentum teres
remnant of ductus venosus, separates lt lobe from caudate lobe: ligamentum venosum
remnant of umb vein which runs from umbilicus to left portal vein: ligamentum teres
recanalizes to form a portosystemic venous collateral: lig teres
remnant of the ductus venosus. runs from the lt portal vein to ivc separating the lt lobe from caudate lobe: ductus venosum
direction of fetal circulation(5): umbilicus->umbilical vein(lig teres)->left portal vein->ductus venosus (lig v)->ivc
pv has __ velocity continuous lfow toward the liver with mild __: low, undulations
hepatic blood flow is approx __ ml/min: 1500
flow toward liver is __. flow away from liver is __: hepatopetal, hepatofugal
proper hepatic art supplies __-__ % blood VOLUME to liver. portal vein supplies __-__%: 25-30%, 70-75%
proper hepatic artery supplies __-__% oxygen to liver and pv supplies __-__%: 45-50%, 50-55%
upper limits of normal for pv, large diameter may be seen in portal htn: 13mm
hepatic vn waveforms are typically __ reflecting right atrial filling, contraction, and relaxation: triphasis
proper hep art runs __ to mpv. it's located __ to pv: parallel, anteromedial (ant and left)
classic anatomy of rt and lt hepatic art arising from the proper hep art is seen in approx __ of patients.: 55
the right hep art may originate (replaced) from the __ (11%) of time and seen coursing __ to mpv: sma, posterior
the left hepatic artery may originate from the ___ 10% of time: left gastric artery
doppler waveforms demonstrate flow throughout diastole, indicating a __ resistant system. in a post liver transplant a high resistant hepatic artery may suggest organ __: low, rejection
remnant fo umb vn extending from umbilicus to left portal vein. recanalizes in cirrhosis to function as a venous collateral: ligamentum teres
peritoneal reflection or fold created by the passage of the embryonic umbilical vein from the umbilicus to the left branch of the portal veins: falciform ligament
peritoneal reflections which suspend the liver from the diaphragm: coronary ligament
coronary ligament- surrounds __. in this area the liver is in direct contact with the liver. this area is not a part of the ___ space, thus ascites is not seen in this area: bare area, peritoneal
peritoneal reflections to the far right and far left of the bare area: right and left triangular ligament
in the rt interseg fissure, divides the ant and post segments of rt lobe: rhv
in the main lobar fissure, separates the rt and lt lobe: mhv
in the lt intersegmental fissure, divides med and lat segments of the lt lobe: lhv
in the intrasegmental ant segment of rt lobe, courses centrally in ant segment of right lobe: rpv (ant branch)
in intrasegmental post segment of rt lobe, courses centrally in post segment of rt lobe: rpv (post branch)
is ant to caudate lobe, separates caudate lobe from medial segment (2): lpv, lig venosum
ant to caudate lobe, separates caudate from median segment of lt lobe (2): lpv (horizontal segment) and lig venosum
in left intersegmental fissure and divides medial from lateral segment of lt lobe (2): lpv (ascending) and ligamentum teres
liver size is measured in the sup-inf dimension on the __ sagital plane. organ size will vary with height, weight, and body surface area: mid-clavicular
hepatomegaly is indicated with a greater than __ cm sup-inf dimension or when the rt lobe extends __ to lower pole of rt kidney: 15, inferior
inferior projection of the rt lobe which is commonly seen in women. may be mistaken for hepatomegaly when measuring sup-inf dimension: riedel's lobe
present as small calcifications in liver and spleen: granulomas
granulomas are caused by these 2 and common in North America in the great lakes basin and in mid-western U.S.: tuberculosis, histoplasmosis
"starry night" sono appearance is seen with?: acute hepatitis
sono: hypoechoic liver parenchyma, liver enlargement, hyperechoic portal vein walls: acute hepatitis
sono: hyperechoic liver parencyma, small liver, decreased echogenicity of portal vein walls: chronic hepatitis
only this produces air/gas: pyogenic abscess
occurs mostly in rt lobe, reaches liver via bile ducts, portal vns, hepatic arteries, or lymph. seen as complex mass, echogenic gas, reverberation artifact. symptoms are ruq pain, leukocytosis, fever, elev lfts: pyogenic abscess
___ is needed to confirm diagnosis of pyogenic abscess: aspiration
occurs when a parasite from the intestines reaches the liver via the portal vn. most common extraintestinal complication of amoebic dysentery: amoebic abscess
clinically: ruq pain, diarrhea, fever, leukocytosis, elever lft, elevated rt dome of diaphragm by x ray: amebic abscess
sono: round hypoechoic, complex mass, typically occurs near dome of right lobe, contiguous with liver capsule: amebic abscess
mycotic infection of the blood that results in small abscesses in the liver. the appearance of these lesions can change over hte course of the disease process: fungal abscess (candidiasis)
4 appearances of fungal abscess: wheel within a wheel, bull's eye, uniformly hypoechoic focus, echogenic focus
sono; lesion with a peripheral hypoechoic zone, an inner echogenic wheel and a hypoechoic center. this is the earliest manifestation and most recognizable: "wheel within a wheel" sono of fungal abscess
lesion appears like this when the hypoecoic center calcifies from "wheel within a wheel": bull's eye
most common presentation sonographically of fungal abscess: hypoechoic focus
calcification representing scar formation seen late in teh disease process for fungal abscess: echogenic focus
results of parasitic tapeworm assoc with sheep and cattle-raising countries.: echinococcal cyst
eggs of echinococcus granulosus ar eswallowed by the intermediate host (man/shepard. the eggs pass into the __ system where the larvae hatch and move into the liver: portal venous
4 sono of echinococcal cyst: simple cyst, cyst with detached endocyst (cyst w/i a cyst), cyst with multiple daugher cysts, calcified mass
casoni skin test (70%) sensitivity, detection of antibodies, indirect hemagglutination, and indirect florescent antibody test are used to detect __: echinococcal cyst
assoc with anaphalactic shock: echinococcal cyst
one of the most common parasitic infections in humans and causes portal htn worldwide: schistosomiasis
the unique life cycle of ___ limits endemic areas to tropical zones around the world: schistosomiasis
in schisto, eggs reach the liver throught the portal vein inciting a granulomatous reaction resulting in ___. the intrahepatic portal vns occlude resulting in portal htn: periportal fibrosis
sono: occluded intrahepatic portal veins, thickening and increased echogenicity of the portal vein walls, 2ndary splenomegaly, ascites, esophageal variceal bleeding, portosystemic collaterals: schistosomiasis
sono: pneumocystis carinii(hepatic), fatty liver, hepatomegaly, hepatitis, non-hodgkins lymphoma, candidiasis, cholangitis, acalculous cholecystitis, kaposi's sarcoma: AIDS

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Number of cards 85

Created By premierbobbie