Practical Aspects Quiz 2
The Common Bile Duct Length is between?
1-7mm
What are the 8 associated tests with liver?
1. Albumin 2. Bilirubin 3. Alkaline Phosphate (ALP) 4. AST 5. ALT 6. Beta Globulin 7. Cholesterol 8. LDH
What associates tests have radiation?
1. Computed Tomography (CT) 2. Angiography 3. Radionuclide Scintigraphy
What are the 3 types of Choledochal (or choledochus) cyst & which one is the most common?
1. Congenital Cystic Dilation (most common) 2. Intraduodenal 3. Congenital
What are the 2 functions of the Biliary System?
1. Drain the Liver of Bile 2. Store the Bile until it is needed to aid digestion
The Gallbladder is divided into?
1. Fundus 2. Body 3. Neck
What are 5 variants of the Gallbladder?
1. Hartman's Pouch: small sacculation (outpouching) in area of the gallbladder neck 2. Phrygian Cap: most common variation in Gallbladder shape. Gallbladder Fundus is partially folded onto it self, so that it appears similar to the third year in Sworn by early Roman freed slaves 3. Bilobed: hourglass-shaped 4. Septated: characterized by one or more internal divisions of the Gallbladder 5. Junction always Fold: Fold seen at the body and neck of the Gallbladder
What organs is the Biliary System associated with?
1. Liver 2. Pancreas/Gallbladder
What is the Sonographic Appearance of the Gallbladder?
Anechoic or nearly anechoic pear-shaped structure with thin, bright wall margins
The Right Hepatic Vein divides the Right Lobe of the Liver into ____________________ and ____________________ segments
Anterior and Posterior Segments
The Right intersegmental Fissure divides _____________________ and _____________________ segments along with the Right Hepatic Vein
Anterior, and Posterior
What is the Sonographic Appearance of the Bile Ducts?
Avascular Anechoic Tubular structure with thin, bright wall margins and
Hepatic Veins course _______________
Between (inter)
What is the first portion of Couinaud's Liver Segmentation?
Caudate Lobe is the first segment of Couinauds Liver and goes Counterclockwise
When Fats and Amino Acids are ingested, the Duodenal Mucosa releases what?
Cholecystokinin (CCK)
The Common Hepatic Duct joins the Cystic Duct to form the?
Common Bile Duct
The Right and Left Hepatic Duct join to form the?
Common Hepatic Duct
What is Gallbladder Agenesis?
Complete failure of the gallbladder to develop
The Left Portal Vein courses ___________,_____________________ from the Main Portal Vein and branches off into _____________________ and ____________________ divisions
Courses left,horizontally and branches off into medial and lateral divisions
What branches off the Right Hepatic Artery that we normally can't see?
Cystic Artery
Portal Veins _________________________ in size as they approach the diaphragm
Decrease
What is the difference between duplicated gallbladder and a double gallbladder?
Duplicated gallbladder is with or without duplication of cystic duct and for the double gallbladder only one is functioning even though 2 gallbladders are present
True or False: The Portal System connects with the Venous System
False, the Portal system does NOT connect with the Venous System
The Liver is a _____________________ System
Filtration System
What is a Floating Gallbladder?
Gallbladder that is low position, near dome of liver
The Liver is enclosed by a fibrous capsule known as the:
Glisson's Capsule
Gallbladder venous drainage is done by the?
Hepatic Portal System
Hepatic Veins have __________________________ blood flow toward the IVC and have indistinct anechoic borders
Hepatofugal blood flow (triphasic)
Portal Veins have __________________________ blood flow and have echogenic walls due to thick collagenous tissue
Hepatopetal blood flow (monophasic)
Portal Vein walls appear distinctively brighter because of their __________________________________ and ____________________________
High collagen content and sheath covering
The Sonographic Apperance of the Liver is:
Homogeneous, and moderately echogenic (hyperechoic)
Hepatic Veins ____________________ in size as they drain toward the diaphragm
Increase
Inferior Mesenteric Vein courses _________________________ to _____________________________
Inferior to Superior
The Superior Mesenteric Vein courses __________________ to __________________ as it drains the large intestines via smaller branches
Inferior to Superior
The Right Subphrenic Space is located ______________________ to the diaphragm and ______________________ to the Liver
Inferior to the Diaphragm and Superior to the Liver
The Greater Sac is in the _______________________________ Cavity
Intraperitoneal Cavity
The Inferior Mesenteric Vein drains the ____________________________
Large intestine
The Splenic Vein courses ________________________ from the Spleen and then ___________________________ directly Posterior to the Pancreas Neck?
Laterally from the Spleen, and then Medially
The Caudate Lobe is separated from the Hepatic Lobe by the Proximal portion of the _________________________________ and the Fissure for the _________________________________
Left Hepatic Vein and Ligamentum Venosum
What associated tests have no radiation?
Magnetic Resonance Imaging (MR,MRI)
What is the landmark for locating the Gallbladder and Gallbladder Fossa?
Main Lobar Fissure which is a hyperechoic line between the Portal Vein and Gallbladder
The Superior Mesenteric Vein joins the Splenic Vein to form the ____________________________________
Main Portal Vein
The Left Hepatic Vein divides the Left Lobe of the Liver into __________________ and ____________________ segments
Medial and Lateral Segments
Intersegmental Fissure divides __________________ and _________________segments along with left hepatic vein's and what 2 things can be seen here as well?
Medial and Lateral segments, and the Falciform Ligament and Ligamentum Teres are located within this Fissure
Which section of the Gallbladder will have Gallstones?
Neck of the Gallbladder has the most Pathology
The Subhepatic Space is located ___________________ and ___________________ to the Liver and forms part of _________________________________
Posterior and Inferior to the Liver and forms part of Morison's Pouch
Morison's Pouch space is between the _____________________Subphrenic Space and ____________________ Subhepatic Space
Posterior, Posterior
The Liver occupies the major portion of the __________________________________________ region and extends inferiorly into the ___________________________ region and laterally into the ________________________________________
Right Hypochondrium Region and extends inferiorly into the Epigastrium Region and laterally into the Left Hypochondrium
The Rex Cantalie divides the Liver into ______________ and __________ hemilivers
Right and Left
The Right Portal Vein courses _____________ from the Main Portal Vein and branches into _______________________ and _______________________ divisions
Right from the Main Portal Vein, and branches into anterior and posterior divisions
Normal Diameter of the Main Portal Vein
Should not exceed 1.3cm or 13mm
What prevents reflux of gastrointestinal fluids into the Biliary System?
Sphincter of Oddi
The Cystic Duct contains a series of mucosal folds called the?
Spiral Valves of Heister
The Main Portal Vein is formed by the union of the _____________________________ and the _______________________________________________
Splenic Vein and the Superior Mesenteric Vein
The Main Portal Vein courses _______________________ approximately 5-6cm
Superiorly
The Falciform Ligament separates Segment _____ from ________
The Falciform Ligament separates segment 3 from 4
When the Sphincter of Oddi is closed what happens?
The Gallbladder is filled with Bile
What is the function of the Liver?
The liver is a primary center of a metabolism, supporting multiple body systems and activities. In support of digestive and excretory systems, the liver metabolizes fats, carbohydrates, and proteins and forms bile and urea
What is the function of the Portal System?
To carry blood and nutrients from the bowel and abdominal organs to the liver for metabolism in detoxification
What is Hypoplasia Gallbladder?
Underdeveloped Gallbladder
Portal Veins course _______________
Within (intra)
The renal cortex is _________________________ to the liver
hypoechoic
What organ produces Bile?
liver produces bile and is carried to the gastrointestinal system by the Biliary Tract
Define Hepatofugal?
portal vein flow away from the liver
Define Hepatopetal?
portal vein flow toward the liver
What is the most Common Biliary Duct Varient?
Accessory Hepatic Ducts
Define Reidel's lobe?
A tongue-like inferior extension of the right lobe as far caudally as the iliac crest
Name some reasons Ultrasound examinations of Biliary System are indicated?
1. RUQ pain 2. Positive Murphy's sign 3. Nausea 4. Vomiting 5. Pain radiating to the right shoulder or scapula 6. Jaundice or abnormal LFT 7. Loss of Appetite 8. Intolerance to fatty foods or dairy products
The Liver is Mainly located in the?
1. Right Upper Quadrant 2. Right Coastal Region (7-10th rubs) 3. Right Hypochondrium
The Portal system has what 6 veins?
1. Superior Mesenteric Vein 2. Splenic Vein 3. Inferior Mesenteric Vein 4. Main Portal Vein 5. Right Portal Vein 6. Left Portal Vein
What's the average measurement of the Right Lobe of the Liver?
13-17cm
The Common Bile Duct empties into the?
2nd part of the Duodenum
The Right Lobe is ____ times larger than the Left Lobe
6 times larger
The Liver is:
A Reservoir for blood that is released as it regulates blood volume and blood flow through the body
