Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
LIVER
| Term | Definition |
|---|---|
| Right Hepatic Vein | Separates right lobe in to Anterior and Posterior segments. - largest |
| Middle Hepatic Vein | Separates the Right and Left lobe of the liver - enters IVC |
| Left Hepatic Vein | Separates the left lobe in to Medial and Lateral segments - smallest |
| Falciform Ligament | Extends from the Umbilicus to the Diaphragm. - Attaches liver to the Anterior Abdominal wall and Diaphragm - SEPARATES Right and Left lobe Anteriorly |
| Ligamentum Teres | Obliterated remnant of the fetal umbilical vein - AKA Round Ligament - Suspended within the Falciform Ligament |
| Ligamentum Venosum | A remnant of the ductus venosus in fetal life - seen as an echogenic line separating the caudate lobe from the left lobe - shunts 1/2 of blood from umbilical vein to the IVC |
| Glissons Capsule | - Covers liver - Layer pf thick connective fibrous tissue - Also covers portal vessels |
| Not Covered in Peritoneum | - Bare area - Hilum (back side of port hepatis) - Gallbladder Fossae |
| Liver | - Intraperitoneal organ - Lies in left and right hypochondrium - BEST acoustic window |
| Mid-Clavicular | - Approximate length 15 - 17 cm |
| Right Lobe of Liver | - Largest Lobe - 3 Fossae: Porta hepatis, GB, IVC - Anatomically separated by the Falciform Ligament |
| Left Lobe of Liver | - Lies in epigastric & left hypochondrium - Always smaller than the RL |
| Caudate Lobe | - Posterior & Superior - Landmark for IVC and ligamentum venosum - right margin (process) extends in a tongue like projection - Has own blood supply |
| IVC | Cuts liver into right and left lobe - located at the posterior portion of the liver |
| Hepatic Veins | -Hepatofugal - Intersegmental & interlobar - NO bright walls - NO high amplitude reflections - ^ Increase in diameter towards diaphragm & IVC - Flow is dependent on activity of Right Atrium |
| Portal Triad | Sonographic "Mickey Mouse" Sign - Portal vein - Hepatic Artery - Common Hepatic Duct |
| Main enzyme of the liver: | Amylase - breaks down starches |
| Liver Functions | - Formation of Bile - Metabolism - Storage - Blood reservoir - Heat production - Detoxification |
| The Liver Excretes: | - Bilirubin - Cholesterol - Drugs - Hormones *Phagocytosis* |
| The Liver Stores: | - Glycogen/ Glucagon - Amino Acids - Fats - Vit. A, D, and B complex - Iron - Copper |
| The liver metabolizes: | - Carbohydrates - Lipids - Proteins |
| Formation of Bile: | 800-1,000 mL per 24 hours Secretes 1-2 L daily |
| AST - Aspartate Aminotransferase (SGOT) | Enzyme found in liver, muscles & TISSUES Increased levels = - Acute Hepatitis - Cirrhosis - Fatty Changes |
| ALT - Alanine Aminotransferase (SGPT) | More specific to the liver - produced in hepatocytes Increased levels = - Dead/ damaged Hepatocytes - Hepatitis - Jaundice - Hepatocellular disease - Biliary tract disease - Shock - Drug toxicity |
| ALP - Alkaline Phosphatase | Enzyme produced in bile ducts, kidneys, bones and intestines Increase levels = - Hepatocellular disease - Biliary obstruction |
| LDH - Lactic Acid Dehydrogenase | Found in ALL tissues - detects myocardial & pulmonary infarction - Elevated = Liver mass |
| Bilirubin | Product of breakdown of old RBC's that are converted to bile pigments - Elevated levels lead to Jaundice |
| Direct - Conjugated Bilirubin | Increase with biliary tract obstruction & hepatocellular disease |
| Indirect - Unconjugated Bilirubin | Increase with hepatocellular disease & disorders causing increase in RBC hemolysis |
| AFP - Alpha Fetal Protein | Antigen found in fetus - presents in more than 50% of patients with hepatomas & hepatoblastomas |
| Normal liver Findings: | - Homogeneous - Isoechoic OR hyperechoic to renal parenchyma - Smooth Contour |
| Diffuse (Parenchymal) | - Heterogeneous - Hepatocellular disease (disease that affects the hepatocytes & interferes w liver function) - Ranges from simple fat changes to hepatitis or cirrhosis |
| Main Portal Vein | Formed by the confluence of the Splenic vein & SMV - Within hepatoduodenal ligament - Bifurcates at the portal hepatis - Anterior to IVC |
| Right portal Vein | Larger, more posterior & caudal than the LPV - branches into A & P divisions |
| Left Portal Vein | Smaller, more anterior & superior than RPV - Abruptly turns anteriorly - Recumbent of H shape |
| Portal Veins | - Enter porta hepatis and decrease in caliber as they course away - Decrease in caliber as they course thru liver - Intrasegmental & Intralobar - Course horizontally - HIGH amplitude reflections - Normal size = 13mm OR 1.3cm 70, 75, 80% |
| Fissures | A groove 1. Main Lobar |
| Hepatic Artery | Carries oxygenated blood from the aorta to the liver - Anterior to portal vein - Adjacent to common bile duct - supply 25% of total blood volume in liver Gastroduodenal Artery - arises from artery |
| Couinaud's Anatomy | - Describes hepatic lesion localization - Hepatic veins divide liver, longitudinally into 4 sections - 8 total segments of liver |
| Reidel's Lobe | - Congenital - NORMAL VARIANT - More common in women - Tongue like projection of the RLL - Extends into iliac crest |
| Situs Inversus | Liver on left side of body |
| Polysplenia/ Asplenia Complex | Liver may be symmetric to midline |
| True Liver Cysts | Congenital - Result from developmental defects in bile duct formation - Contain epithelia lining |
| Acquired Liver Cysts | Lack epithelial lining - Trauma - Parasite - Inflammatory |
| Cysts | Fluid filled mass with epithelial lining - RLL affected 2x as often - ASYMPTOMATIC |
| Adult Polycystic Disease | Incidence: 1 in 1,000 Affects females > men [4:1] - 50/70 years of age |
| Cysts Sonographic Appearance | - Anechoic - Thin walled - Ovoid - Well defined - Posterior acoustic enhancement |
| Cavernous Hemangioma | Asymptomatic - most common benign lesion - more common in women & RLL - Echogenic - Often solitary |
| Liver Cirrhosis | - Alcoholic liver disease - Inflammation & necrosis - Generally Hypoechoic |
| Fatty Infiltration | Acquired, benign reversible disorder of metabolism AKA Steatosis - Asymptomatic - Accumulation of fatty triglycerides - Typically effecting RL - Hyperechoic Alcohol abuse, Obesity |
| Focal Fatty Infiltration | - Non uniform areas - Increase in echogenicity & attenuation |
| Focal Fatty Sparing | - Hypoechoic texture - In medial segment of the LL OR Posterior segment of the RL, Anterior to the GB |
| Hepatitis | - Viruses - Toxins |
| HIV- AIDS | Most common opportunistic infection |
| Schistomiasis | Bacterial infection - from contaminated waters |
| Acute Hepatitis | - Decrease in echogenicity - Hypoechoic - "Starry Night" |
| Chronic Hepatitis | Cirrhosis |
| Hepatitis A | Fecal-oral, or food contamination |
| Hepatitis B | Sexual contact ~ STD - Mother breastfeeding - Contaminated needles |
| The Liver Synthesizes: | - Albumin - Clotting factors |
| Morrison's Pouch | The Hepatorenal recess AKA Subhepatic recess - Space that separates the liver from the Right Kidney - Hepatorenal interface |
Created by:
rachellmariaa