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Abdomen Registry Review
Terms in this set (92)
right lobe, left lobe, caudate lobe
Name the three lobes of the liver
caudate, left lateral superior, left lateral inferior, left medial superior, left medial inferior, right anterior superior, right anterior inferior, right posterior superior, right posterior inferior
Name the segments of the liver (9)
The liver's covering is called Glisson's capsule. What is another name for this covering?
Name the lining of the abdominal cavity
portal vein flow towards the liver
portal vein flow away from the liver
What vessels are considered to be intersegmental within the liver?
portal veins, hepatic artery, bile duct
Which vessels are considered to be intrasegmental within the liver
between the main portal vein and gallbladder
Describe the location of the main lobar fissure
middle hepatic vein
What is a landmark for the main lobar fissure?
right lobe, left lobe
Which two segments of the liver does the main lobar fissure separate?
The right intersegmental fissure divides the right lobe into _____ and _____ segments
right hepatic vein
What is the landmark for the right intersegmental fissure?
The left intersegmental fissure divides the left lobe into ____ and _____ segments
left hepatic vein
What is the landmark for the left intersegmental fissure?
prenatally conducts blood from the left portal vein to the inferior vena cava
What does the ductus venosus do?
The reflections, or coronary ligaments, at each corner of the bare area, are termed the right and left _____ ligaments
The _____ ligament is the reflection of the parietal peritoneum onto the liver surface, becoming the visceral peritoneum
Is Reidel's lobe more common in men or women?
greater than 15.5 cm
What constitutes hepatomegaly?
bile ducts, hepatic artery, portal vein, lymphatic system
Through what avenues do pyogenic abscesses develop in the liver?
What lobe of the liver do pyogenic abscesses usually occur in?
Are pyogenic abscesses in the liver usually solitary or multiple?
Pyogenic abscesses usually appear ______, rounded, fluid-filled with variable degrees of internal echoes or debris
hypoechoic enlarged parenchyma with enhanced visualization of portal veins
Describe the sonographic appearance of acute hepatitis
hyperechoic small liver with decreased echogenecity of portal vein walls
Describe the appearance of chronic hepatitis
A fungal infection in the liver will have a _______ appearance
colon, portal vein, right
Ameobic abscesses in the liver are due to protozoan parasites, which enter the intestinal tract and reside in the _____. The liver may extend into the liver via the _______. Most occur in the ____ lobe and the indirect hemagglutination test is used for diagnosis
hypoechoic, prominent, enhancement
The sonographic appearance of an ameobic abscess in the liver:
*round or oval _____ mass
*absence of a ______ wall
*fine, low-level internal echoes
*contiguous with diaphragm
_____ disease is prevalent in sheep and cattle raising countries. Humans are occasionally the hosts when eggs are ingested. The embryos travel from the GI tract to the liver via the ______ vein
pericyst, endocysts, hydatid sand, calcified
The typical appearance of an echinococcal cyst (hydatid disease) is that of a large (_______) containing one or more daughter cysts (________). Fine internal echoes (______) are also found within these cysts.
*An echinococcal cyst undergoes a sequence of changes, ending as a collapsed _______ mass
_____ is one of the most common parasitic infections worldwide (Africa and South America).
portal vein, portal hypertension
The most significant vascular event associated with schistosomiasis is intrahepatic ________ occlusion by the larvae
*The occlusion leads to ______, splenomegaly, varices, and ascites
Schistosomiasis appears sonographically as distended, ______ debris-filed intrahepatic portal veins
What is the most common organism causing infections in AIDS and other immunocompromized patients?
Sonographically, pneumocystis carinii appears as _______ echogenic foci
Focal fatty infiltration appears as regions of ______ echogenecity present within a background of normal liver parenchyma
Focal fatty infiltration is commonly seen at the _______
Focal fatty sparing appears as islands of normal liver parenchyma which appear as ______ masses within a dense fatty infiltrated liver
Focal fatty sparing is commonly seen adjacent to the ______
glycogen storage disease
________ results in large quantities of glycogen being deposited in the hepatocytes of the liver and convoluted tubules of the kidney
_______ are liver masses associated with glycogen storage disease. They are also linked to the usage of oral contraceptic agents
focal nodular hyperplasia
It is difficult to distinguish hepatic adenomas from _____
hepatocellular death, fibrosis, regeneration
What are three major pathologic mechanisms of cirrhosis?
ascites, jaundice, hepatomegaly
What is the classic clinical presentation of a patient with cirrhosis? (3)
ascites, splenomegaly, varices
What are the clinical signs of portal hypertension? (3)
intraluminal thrombus, increased vein diameter, cavernous transformations
What are the sonographic findings of portal vein thrombosis? (3)
________ is characterized by occlusion of the hepatic veins
hepatic vein thrombosis, ascites, portal hypertension, hepatomegaly
Sonographic findings of Budd chiari (acute) (4)
hepatic vein thrombosis, ascites, portal hypertension, caudate lobe enlargement
Sonographic findings of chronic Budd Chiari
________ are the most common benign tumors of the liver. The majority are small and asymptomatic.
Cavernous hemangiomas may enlarge during ______ or with estrogen replacement therapy
small, hyperechoic, enhancement
A cavernous hemangioma typically appears as a ____, well-degined, _____ mass with possible posterior acoustic _______
solitary, small, with a central fibrous scar
*hemorrhage is uncommon
*Described as stealth lesion
Focal nodular hyperplasia as a common benign liver mass that appears:
hemangioma, lipoma, echogenic mets, focal fatty infiltration
Name four well defined hyperechoic liver masses
What is the most common primary malignant tumor of the liver:
Although the sonographic appearance of hepatocellular carcinoma is variable, it is typically seen as a ______ mass
Etiologic factors of _______ include alcoholic cirrhosis, chronic hepatitis B and C infections
With hepatocellular carcinoma, there is a propensity toward _______ invasion
In patients with portal hypertension, ________ decompress the portal system
transjugular intrahepatic portosystemic shunts
What does TIPS stand for?
TIPS functionality is determined by demonstrating
1. flow within the _____
2. presence of _____ flow direction within the right and left portal veins
junctional fold, phrygian cap
What are the two types of gallbladder folding?
WES sign, double arc shadow sign
What are the two terms that describe a stone filled contracted gallbladder
it is helpful in assessing biliary obstruction. An obstructed bile duct should increase in size following a fatty meal, while a non-obstructed bile duct should decrease in size
What is the purpose of administering a fatty meal to a patient?
obstructive jaundice, intrahepatic cholestasis, biliary tree obstruction
What does a significant elevation of conjugated bilirubin levels indicate? (3)
Gallbladder wall thickening is diagnosed when the wall is greater than
cholecystitis, ascites, hypoelbuminemia, hepatitis, congestive heart failure, renal disease, AIDs, sepsis
What are some reasons for gallbladder wall thickening?
mobile echogenic foci with posterior shadowing
What is the sonographic criteria for gallstones?
cholesterol, calcium bilirubinate, calcium carbonate
What are gallstones composed of? (3)
______ is usually precipitated by a stone obstructing the cystic duct. This results in an obstruction of venous drainage, and inflammation of the gallbladder wall with variable degrees of necrosis and infection
RUQ pain, fever, chills, leukocytosis
What are the clinical symptoms of acute cholecystitis?
gallstones, murphy's sign, diffuse wall thickening, gallbladder dilatation, sludge
What are the five sonographic criteria that define acute cholecystitis?
________ is an infection associated with gas forming bacteria within the wall of the gallbladder
Sonographically, _________ appears as gas shadowing from the wall of the gallbladder
Hydrops of the gallbladder is defined as a distended, non-inflamed gallbladder due to total obstruction of the ________. The trapped bile is reabsorbed and the gallbladder is filled with a clear mucinous secretion derived from the mucosa.
Is gallbladder hydrops usually symptomatic?
Gallbladder _____ should be suspected on ultrasound when an obstructing stone is noted in an enlarged, but non-tender gallbladder
________ are diverticula within the wall of the gallbladder
The pathology associated with rokitansky-aschoff sinuses is ________
Is gallbladder carcinoma common?
intraluminal mass, asymmetrical wall thickening, mass-filled gallbladder
Sonographic appearance of gallbladder carcinoma includes:
liver mets, lymphadenopathy, bile duct dilation
Other findings that would confirm the diagnosis of gallbladder carcinoma include: (3)
gallstones, carcinoma of the pancreas
What are the two most common causes of biliary tract obstruction?
alkaline phosphatase, direct bilirubin, GGT
What lab values are most likely to be elevated due to biliary tract obstruction? (3)
shotgun sign, parallel channel sign
What are the two signs that indicate intrahepatic bile duct dilation?
__________ is an extrahepatic bile duct obstruction due to a stone within the cystic duct. The stone causes extrinsic mechanical compression of the common hepatic duct
With Mirizzi's syndrome, will the CBD be enlarged?
Sonographically, ______ is characterized by variable length echogenic foci in the distribution of the biliary tree, resulting in acoustic shadowing and reverberation
Pneumobilia is commonly seen in the ______ of the liver, as this is the direction of bile flow
Pneumobilia is most commonly seen after an _____
Choledocal cysts usually occur in _____ women. Symptoms of pain, jaundice, and an abdominal mass may be present
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