1.
6th leading cause of death: cirrhosis
2.
adult causes of presinusoidal hypertension: sepsis, tumor, oral contraceptives, pancreatitis, pancreatic cancer
3.
adult polycystic ds: inheirited ds that causes multiple cysts--asymptomatic but fatal if kidneys are involved--women 50 - 70--numerous 2 to 3 cm cysts
4.
AFP: fetal antigen also produced by liver, ovary, and testis cancer cells
5.
albumin and globulin: depressed synthesis of proteins, elev in chronic liver disease
6.
amebiasis: hypoechoic complex cyst with internal echoes
7.
amebiasis: parasite from infected food or water--gi symptoms pain diarrhea
8.
benign liver tumors: cavernous hemangioma, lipoma, adenoma, focal nodular hyperplasia
9.
bilirubin: breakdon of hgn in old rbcs
10.
candidiasis: fungus invades the bloodstream--fever, localized pain--bulls eye appearance--hypoechoic mass with echogenic cores
11.
caudate lobe: posterior portion of the liver, lies between the ivc and ligamentum venosum
12.
cavernous hemangioma: most common benign liver tumor, women 5:1, network of rbcs, < 3cm round hyperechoic mass, enlarge slowly hormone change can increase growth
13.
cavernous transformation: 1.chronic portal vein thrombosis
2. wormlike collaterals present
14.
cirrhosis: chronic degenerative ds of the liver involves cell death, fibrosis, and regeneration
15.
clinical signs of ph: Jaundice, hepatosplenomegaly, increased liver function test, ascites
16.
common causes of fattly infiltrations: reversible--caused by alcoholism, obesity, db, steroids, hep
17.
couinauds nomenclature: provides basis for surgical resection--allows exact pinpoint of location for lesions--8 sections based on portal and hepatic segments
18.
describe the location of the liver: 1. intraperitoneal except for the bare area
2. upper right quadrant
3. rt hypochondrium, epigastric, left hypochondrium
4. bulk lies under the rt costal margin
5. touches the dpgm on anterior, superior, and posterior surfaces
19.
divides left lobe into medial and lateral: left hepatic vein
20.
divides right lobe into anterior and posterior sections: right hepatic vein
21.
duodenum: medial to rt lobe
22.
echinococcal cysts (hydatid): parasitic tapeworm found in sheep feces--eggs hatch in lg intestine and enter through portal to house in rt lobe...under 20, jaundice, GI symptoms--
23.
echinococcal hydatid cyst: simple cyst to complex massappearance, may have water lily sign, daughter cysts are common
24.
echogenic line extending from the portal vein to the neck of the gb: main lobar fissure
25.
elevated AST, ALT, bilirubin: hepatitis, cirrhosis
26.
elvated lfts with cirrhosis: AST, ALT, bilirubin, prothrombin time
27.
falciform ligament: divides rt and lt lobes--extends from umbilicus to dpgm--contains ligamentum teres
28.
fatty infiltration: increased lipids in hepatocytes as cell injury leads to impaired fat metabolism---3 grades; slightly diffuse, moderately diffuse, marked increase
29.
focal nodular hyperplasia: 2nd most common benign liver tumor, bcp, may have central scar or hypoechoic ctr, increased bld flow
30.
Function of Portal System: acts like an arterial system picking up nutrient rich blood from the spleen, gall bladder, pancreas and intestines and delivering it to the liver to be processed
31.
glycogen storage ds: genetic disorder of carbohydrates--type 1 is Von Gierke's ds, infants to young adults--large, fatty liver, adenomas
32.
hematoma: trauma--maybe decreased hematocrit
33.
hep: elevated AST, ALT
34.
hepatitis: acute or chronic inflammation of the liver
35.
hepatoblastoma: infancy and children, abd mass / weight loss--n/v, increased afp---heterogenous mass with calcifications
36.
hepatocellular carcinoma--hepatoma: 80 % of cirrhosis pat--cirrhosis main predisposing factor-----ruq pain, weight loss, ascites----solid, multiple nodules / 30 - 68% will have portal vein thrombosis
37.
how is the left lobe divided: medial and lateral segments by the left hepatic vein
38.
how many functions does the liver perform: over 500
39.
how much does the adult liver weigh: 1600 grams
40.
how much of the livers blood supply comes from the portal system: 80%
41.
infantile hemangioendothelioma: benign rapid growing vascular tumor occuring in children---abd mass, congestive heart failure is high----presents as well defined mass with varied appearance
42.
inferior: concave with indentions for underlying viscera
43.
interlobar and intersegmental dividers of liver: hepatic veins
44.
intrasegmental liver divider: portal veins
45.
LDH: cellular injury causes production to increase, primarily used as indicator for myocardial and pulmonary infarction
46.
lipoma: rare, asymptomatic, hyperechoic fatty tumor
47.
liver cell adenoma: bcp, ruq pain & palp mass, glyc storage ds, surgical resection recommended due to risk of malig. & hem---varying appearance due to hemorrhage
48.
liver transplant: hep c most common cause requiring---HA thrombosis most serious complication
49.
lymphoma: enlarged lymph nodes, weight loss, decreased appetite, n/v----enlarged liver & spleen-----bulls eye appearance (discreet small multiple lesions)
50.
lymphoma: CA of the lymph nodes--Hodgkins, non-hodgkins, burkitt's, leukemia
51.
mesenchymal hamartoma: children under 2---diffuse enlargement of abdomen---presents as large complex mass 5 to 30 cm----benign
52.
mets: PT, ALT
53.
mets: common primary sites are gb, colon, pancreas, stomach, breast and lung---
54.
mets to liver: abnormal lfts, weight loss, decreased appetite, jaundice, pain---enlarged liver, multiple nodules with varied appearance
55.
name the ligaments: 1. coronary
2. falciform
3. gastric hepatic
4. hepatoduodenal
56.
other causes of cirrhosis: hepatitis, biliary cirrhosis, cholangitis
57.
pancreas: inferior to left lobe
58.
portal flow away from the liver: hepatofugal
59.
portal flow toward the liver is: hepatopetal
60.
portal hepatis / portal triad: hepatic artery, common bile duct, portal vein bound together by membrane and travel throughout the liver together
61.
portal hypertension: higher than normal pressure in the portal system resulting from impeded blood flow in the liver causes blood to back up causing dilation of the portal system
62.
posterior borders: rt kidney, ivc, aorta
63.
prothrombin time: liver enzyme that is part of the clotting process, production depends on adequate intake of vit k....increased in cirrhosis and mets
64.
pyogenic abcess: pus forming bacteria causes fever, anorexia, pain, malaise--hypoechoic round cyst with variable internal echoes
65.
Reidel's lobe: normal variant that causes rt lobe to extend past lower pole of kidney
66.
remnant of umbilical vein in fetal circulation: ligamentum teres
67.
schistosomiasis: most common parasitic infection due to bad water--enters through portal vein, can occlude--can puncture skin, migrate via lymph system--gi symptoms, pain, diarrhea
68.
schistosomiasis: PH, enlarged spleen, varices, ascites--as ds progresses symptoms of PH prevail with contracted liver
69.
smv: drain the small intestines and portions of the large, joins the splenic vein behind the head of the pancreas to form the main portal confluence
70.
sonographic appearance of acute hep: can appear normal or have overall decreased echogenicity, thick gb wall, enlarged spleen and liver
71.
sonographic appearance of cavernous transformation: thrombus in the porta hepatis, multiple tubelike structures representing collaterals
72.
sonographic appearance of cirrhosis: small liver, large spleen, cobblestone, disorganization of lobules, PH,ascites
73.
sonographic appearance of portal hypertension: 1. dilated portal vein greater than 13mm
2. dilated splenic vein > 10mm
2. dilated smv > 10 mm
4. splenomegaly, recanalized umbilical vein, portosystemic venous collaterals (varices), ascites
74.
sonographic of chronic hep: increased echogenicity as fatty changes lead to fibrosis and necrosis
75.
stomach location in relation to liver: fundus lies posterior and lateral to left lobe, body and pyloris lie below
76.
superior surface: convex and diaphragmatic
77.
symptoms of cirrhosis: weight loss, weakness, ascites, abd pain, nausea
78.
the inherited liver pathologies: congenital cysts, adult polycystic ds, glycogen storage ds
79.
true, simple cysts usually asymptomatic: congenital cysts
80.
used as a landmark to locate the gb when contracted or filled with stones: mlf
81.
what are the "functional" lobes of the liver: right left and caudate
82.
what are the cells responsible for phagocytosis of bacteria and other foreign pathogens: kuppfer cells
83.
what are the two blood supplies of the liver: hepatic arteries and hepatic portals
84.
what causes presinusoidal hypertension in children: sepsis, tumor, inflammation, dehydration
85.
what covers the liver: glisson's capsule
86.
what divides the rt lobe & how is it divided: the rt hepatic vein divides the rt lobe into anterior and posterior sections
87.
what divides true anatomic rt and lt liver?: Main lobar fissure
88.
what does the imv drain: large intestine
89.
what ds are associated with intrahepatic portal hypertension: hepatocellular ds: metastic ds, liver failure, biliary cirrhosis, budd chiari syndrom
90.
what is ALT & what does it indicate: alanine amniotransferase--slightly elev in acute hep, mets, pancreatits----high in chronic hep
91.
what is AST & when is it elevated: aspartate aminotransferase--elevated in acute hep, cirrhosis, mono
92.
what is portal vein thrombosis associated with: malignancy of liver, pancreas, portal, trauma and many others
93.
what is presinusoidal hypertension: extrahepatic portal hypertension caused by thrombus in the portal or splenic vein
94.
what is the measurement of the normal rt lobe: 12 cm or less...does not extend below lower pole of rt kidney
95.
what is the most common cause of intrahepatic portal hypertension: cirrhosis by 90%
96.
what is the treatment for ph?: TIPS
transjugular intrahepatic portosystemic shunt
a shunt reroutes blood from portal vein to hepatic vein--manage complications of ph and reduce pressure
97.
where are portal veins in relation to the pancres: posterior
98.
why use doppler in suspected case of ph: to assess flow / direction of flow in portals
