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42 Cards in this Set

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Name of the surgical segments in which segment has its own blood supply, lymphatics and biliary drainage.
Couinaud
Fibrous capsule that surrounds the liver
Glisson's capsule
What are the three lobes of the liver?
*Right-largest
*Left
*Caudate
Largest lobe of the liver
Right
Segments of right liver lobe
*Anterior
*Posterior
Segments of left liver lobe
*Medial
*Lateral
Boundaries of caudate lobe
Posterior = IVC
Anteroinferior = Prox LPV
Anterolateral = Fissure of LV
Inferior = MPV
Four hepatic fissures
*Main lobar fissure
*Right intersegmental fissure
*Left intersegmental fissure
*Fissure for ligamentum venosum
Hepatofugal
"To Flee"
Flow away from the lvier
Hepatopetal
"To Seek"
Flow towards the liver
Normal portal venous flow
Hepatopetal
Continous, low resistance
*pearl; PV and HA flow should demonstrate flow in the same direction with color Doppler
Normal hepatic venous flow
Pusatile (triphasic)
Flow exiting the liver
Normal hepatic artery flow
Low-resistance
Hepatopetal
*pearl; PV and HA flow should demonstrate flow in the same direction with color Doppler
Bare Area
Area of liver not covered by peritoneum
Falciform ligament
Obliterated umbilical vein
Riedel's lobe
Tongue-like extension of right lobe
Normal variant
Morrisons Pouch
Right hepatorenal space
Normal liver size and echogenicity
<15 cm
Homogeneous, medium-level echoes
Liver Cyst
True cyst (epithelial lining)
Anechoic, smooth thin wall, increased through transmission
Complications: Hemorrhage, infection then may contain internal echoes or septations
Acute Hepatitis
Sonographic appearance
*Hypoechoic liver parenchyma
*Mild liver enlargement
*Hyprechoic portal walls (Starry Starry Night)
Chronic Hepatitis
Sonographic appearance
*Hyperechoic liver parenchyma
*Liver atrophy
*Decrease echogenicity of portal walls
Clinical presentation of cirrhosis
Triad
*Hepatomegaly
*Jaundice
*Ascites
Cirrhosis
Sonographic appearance
*Size: depends on stage
Early = enlarged
Late = atrophy
*Echotexture
Increased echogenicity and "coarse" echo pattern
*Surface
Nodular-use high frequency linear transducer to evaluate
Large nodules may appear isoechoic or hypoechoic
Types of Portal Hypertension
*Extrahepatic presinusoidal
*Intrahepatic presinusoidal
*Intrahepatic
*Intrahepatic postsinusoidal
Cavernous Transformation
Occurs with portal vein thrombosis; represent enlarged periportal collaterals
Benign Hepatic Neoplasms
*Cavernous hemangioma
*Focal Nodular Hyperplasia
*Hepatic Adenoma
*Hepatic Lipomas
Malignant Hepatic Neoplasms
*Hepatocelluar Carcinoma
*Hepatoblastoma
*Metastatic Disease
What is the classic clinical presentation for cirrhosis?
*Hepatomegaly
*Jaundice
*Ascites
What three major pathologic mechanisms create cirrhosis?
*Cell death
*Fibrosis
*Regeneration
Define focal fatty infiltration
Regions of increased echogenicity representing focal areas of fatty infiltration
Define focal fatty sparing
Islands or regions of normal liver amidst a fatty liver
List the four causes of portal hypertension
*Extrahepatic presinusoidal
*Intrahepatic presinusoidal
*Intrahepatic
*Intrahepatic postsinusoidal
List the five major sites of portosystemic venous collaterals
*Gastroesophageal varices
*Paraumbilica vein
*Splenorenal and gastrorenal
*Intestinal
*Hemorrhoidal
Most common benign tumor of the liver
Cavernous Hemangioma
Rare, benign congenital liver tumor containing central stellate star
Focal Nodular Hyperplasia
Benign liver tumor commonly seen in women with a history of taking oral contraceptives
Hepatic Adenoma
Hepatic tumor characterized by causing a propagation speed artifact
Hepatic Lipoma
Two major causes of hepatocellular carcinoma
*Alcholism
*Chronic Hepatitis B
Other names for hepatocellular carcinoma
Hepatoma
Rare malignant tumor in children. 3rd most common abdominal tumor in children
Hepatoblastoma
List the branches of the biliary tree
*RT and LT intrahepatic ducts
*Common hepatic duct
*Cystic duct
*Common bile duct
*Pancreatic duct
Ducts of the pancreas
*Main = Duct of Wirsung
*Secondary = Duct of Santorini