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Name the 3 lobes of the liver
Which lobe of the liver is the largest?
**Liver is an ______ organ.
**The liver is surrounded by peritoneum except for a small segment known as the ____ area.
**The liver is enclosed by a fibrous capsule called _______ capsule
The right lobe divides into ____ and _____ segments
The left lobe divides into _____ and ____ segments
**What is the divisional landmark between the right and left lobe?
**What actually divides the left and right lobe ?
Main lobar fissure and middle hepatic vein
Riedel's lobe is a normal variant that can be mistaken for an ______ liver.
**(Riedell's lobe) The liver will extend beyond the _____ pole of the _____ kidney.
**Caudate lobe is located on the _______ surface of the liver
**The caudate lobe is separated from the left lobe by the _______.
**Ligamentum venosum is a remnant of the ____.
Which ligaments are part of fetal circulation ?
ligamentum teres and ligamentum venosum
Morrison's pouch is the space between the ____ kidney and the liver.
**portal vein walls are ____ than hepatic vein walls
**Hepatic veins _____ in caliber as the vessel approaches the diaphragm
**Hepatic veins drain ______ towards the IVC
**The angle formed by the branching of hepatic radicles will point _____ to _____.
**describe hepatocellular disease
The liver cells(hepatocytes) are the immediate problem
**Describe obstructive disease
Bile excretion is blocked
List 6 common LFT's
1. Aspartate Aminotransferase (AST)
2. Alanine Aminotransferase (ALT)
3. Lactic Acid Dehydrogenase
4. Alkaline Phosphatase
5. Prothrombin Time
Which LFT is more specific for evaluating liver function ?
What is the best method for diagnosing liver disease?
An elevation in which LFT's suggest obstruction ?
alkaline phosphate and bilirubin
Normally the liver's parenchyma(tissue) has a uniform _____ pattern
Within the liver you can see:
1. Thin-walled hepatic veins
2. Bright reflective portal veins
3. Hepatic arteries
4. Hepatic ducts
**Each patient should be scanned with the following criteria assessment: (4)
1. size of the liver in the sagittal plane
2. attenuation of the liver parenchyma
3. liver texture
4. presence of hepatic vascular structures and ligaments
A measurement of ____cm or more indicates definite hepatomegaly
**Polycystic disease is a _______ disorder.
**Polycystic disease is characterized by the presence of _____.
multiple cysts in the liver
25-50% of patients with ____ have associated cysts in the liver
localized collection of blood
Most common cause of injury to the liver
blunt or penetrating trauma
**3 types of traumatic injury to the liver
1. intrahepatic hematoma
2. subscapular hematoma with separated but intact capsule
3. hepatic laceration with rupture of the capsule
the percentage of RBCs in the blood
General name for hepatitis
inflammatory and infectious disease of the liver
Sonographic characteristics of ACUTE hepatitis(4)
1. liver texture may appear normal
2. liver parenchyma is SLIGHTLY more echogenic
3. hepatomagly and splenomegaly
4. Gallbladder wall thickened
Chronic active hepatitis will eventually lead to ___.
Patients with a history of hepatitis B have a predisposing risk factor for developing a ____.
uncommon benign epithelial neoplasm
adenoma sonographic characteristics
Most commonly a well defined solid, echogenic mass in the liver
most common benign tumor of the liver
Cavernous Hemangioma sonographic characteristics
typically a well marginated hyperechoic mass containing homogenous internal echoes;
diffuse hepatocelluar disease
affects the hepatocytes and interferes with liver function
increased lipid accumulation in the hepatocytes
Fatty infiltration can be reversed (t/f)
Common causes of fatty infiltration (5)
2. Diabetes mellitus
4. Severe Hepatitis
(Fatty infiltration) sonographic characteristics
diffuse increase in echogenicity with in the fine homogenous echoes
In fatty infiltration there will be an ______ of the lobe affected
a chronic degenerative disease of the liver in which the lobes are covered with fibrous tissue; the parenchyma degenerates and the lobules are infiltrated with fat
(Cirrhosis) The process is _____ and progressive
What is the end stage of cirrhosis
liver cell failure and portal hypertension
What does the chronic stage of cirrhosis look like
Liver is small and hyperechoic, usually with ascites; may show nodularity of the liver edge
most common cause of cirrhosis
increased pressure in the portal-splenic venous system
How does portal hypertension develop?
hepatopedal (flow towards the liver) is impeded by thrombus or tumor invasion
**the most common mechanism for increased resistance to flow occurs in patients with _____.
most common cause for portal hypertension
Finding of Portal hypertension(4)
4. signs symptoms of hepatic failure
Budd-Chiari syndrome is characterized by __.
obstruction of the hepatic venous outflow
Hepatocellular carcinoma AKA
**Hepatocellular carcinoma lab values will show elevated _____ in more than 70% of cases
The liver is the most common site of ____ disease, because of its large blood supply
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