Abdominal Sonography - Liver Study Guide 2019
What are the segments to Couinauds anatomy?
I. Caudate lobe II. Left lateral superior III. Left lateral inferior IV. Left medial superior and inferior V. Right anterior inferior VI. Right posterior inferior VII. Right posterior superior VIII. Right anterior superior
What is cavernous hemangioma?
Most common benign neoplasm of the liver; large network of vessels that appear round and echogenic. Most common in women.
What is hepatocellular carcinoma?
Most common primary malignant neoplasm.
What is an amebic abscess?
Collection of pus formed by disintegrated tissue in a cavity.
What is an echinococcal cyst?
Cyst from a tapeworm that infects the host.
What are collateral channels and why do they form?
Develops when normal venous channels become obstructed.
What is hepatocellular disease? What is obstructive disorder?
Disease where hepatocytes are the primary problem. Disease where blocked bile excretion is the primary problem.
What is lymphoma?
cancer of the lymphatic system
What is hepatitis?
inflammation of the liver
What is an pyogenic abscess?
pus-forming abscess.
What is passive hepatic congestion?
Backup in the venous system resulting in heart failure.
What other developmental anomalies exist for the liver?
- Situs inversus (position swapped with other organ) - Accessory Fissures - Vascular anomalies - mostly hepatic artery
What are the main functions of the liver?
1. Forms bile 2. Activity of reticuloendothelial 3. Metabolism 4. Blood reservoir 5. Heat production 6. Detoxification 7. Storage
What is bile?
A bitter greenish-brown alkaline fluid that aids digestion and is secreted by the liver and stored in the gallbladder.
What is Glisson's capsule?
A smooth fibrous capsule that covers the surface of the liver
What are the liver function tests?
AFP AST ALT Biliruben (direct and indirect) Serum protein ALP LDH PT
What is glycogen storage disease?
Abnormal accumulation of glycogen in the tissues, especially liver and kidneys. Hereditary.
What is a fatty liver? What causes this? What is fatty focal sparing?
Accumulation of lipids in hepatocytes. Caused by obesity, alcoholism, diabetes, pregnancy... Focal fatty sparing is seen as "masslike" hypoechoic areas; shows up when fatty liver is healing.
How do the types of hepatitis vary?
Acute hepatitis: Can look normal at first, then the liver becomes darker and vasculature becomes brighter; starry night appearance. Chronic hepatitis: Liver becomes brighter, texture becomes course, portal walls start to fade and blend in. Leads to portal hypertension.
What is focal nodular hyperplasia?
Benign tumor of the liver compoased of Kupffer cells, hepatocytes, and biliary structures, but lacks the typical normal lobular hepatic features of portal triads and central veins.
Describe the portal venous system.
Blood supply from the GI tract to the liver.
What is the main lobar fissure?
Boundary between the right and left lobes of the liver
What is metastatic disease?
Cancer spreading from other organs (breast, GI, lung).
What is hepatic Candidiasis and who does it often occur within?
Candidal fungus that invades the blood stream and affects the organs. Occurs within immunocompromised people (chemo patients, HIV...)
What is hemochromatosis?
Excess amount of iron.
What is agenesis of the liver?
Failure to form liver
What is granulomatous disease?
Genetic disorder in which phagocytes are unable to kill certain bacteria and fungi.
What can you see within liver trauma patients?
Hematoma, liver laceration...
What is Portal Venous Hypertension? What causes this?
Increased pressure in the liver. Can be caused by thrombus blocking hepatopedal flow.
What is a pneumocystis carinii?
Infection in AIDS carriers.
What is cirrhosis?
Irreversible progressive fibrosis; liver becomes smaller and denser. Scarring and necrosis is present.
What is the difference between a portacaval shunt and a TIPS shunt?
Portacaval shunt connects the IVC and portal vein. TIPS shunt connects the portal vein and the hepatic vein.
What is an adenoma?
Rare, benign tumor that consists of normal or slightly atypical hepatocytes.
What is the ligamentum teres?
Remnant of umbilical vein; separates the medial and lateral portions of the left lobe of the liver.
What is the ligamentum venosum?
Separates the left lobe from the caudate lobe
What is the falciform ligament?
The large ligament, a remnant of the umbilical vein that separates the left and right liver lobes. Attaches liver to anterior abdominal wall.
What is a perbiliary cyst?
Tiny cyst (-.2 - 2.5cm) that is commonly found in patients with severe liver disorder; located within the porta hepatis at the junction of the right and left hepatic ducts
How is Couinauds anatomy of the liver utilized?
The liver segments are based on the portal and hepatic venous segments, with each segment having its own blood supply, lymphatics, and biliary drainage.
What is a portacaval shunt?
Treatment for portal hypertension; connection made between IVC and portal vein.
