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Flashcards in Anatomy power point reverse Deck (41)
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1
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Largest organ in body

located in right hypochondrium, epigastrium and left hypochondrium 

inferior to the diaphragm

Liver

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posterior border in contact with right kidney and inferior vena cava

aorta lies posterior to the left lobe

Liver location

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between liver and diaphragm 

common site for abscess formation

 

Subphrenic space

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includes morrison's pouch, a common space for periotoneal fluid or blood to collect

right subhepatic space

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inferior to the left lobe of the liver

pancreas location

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lies on the visceral surface of the liver

Main lobar fissure is the sonographic landmark leading to the fossa

 

Gall Bladder

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Right

left

Caudate

Lobes of the liver

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largest of 3 lobes

contains 3 fossae

Congenital variant, Riedels lobe

 

Right liver lobe

RLL

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porta hepatis

gallbladder

inferior vena cava

RLL fossae

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sometimes seen as an anterior projectoin of the liver

sometimes extending down the iliac crest

 

RLL Reidels Lobe

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Size varies from patient to patient

men seem to have smaller lobe

found just under the xiphoid process

if larger makes great acoustic window for pancreas and aorta

Left Liver Love

LLL

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small lobe

situated inferior to the ligamentum venosum

superior to the inferior vena cava

Caudate Lobe

CL

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Main Lobar fissure

LIgamentum Teres

Ligamentum venosum

Liver Ligaments and fissures

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boundry between right and left lobes of liver

on longitudinal scan may be seen as a hyperechoic line extending from portal vein to neck of gallbladder

Main lobar fissure

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appears as bright echogenic triangle on transverse scan

separates the medial and lateral segments of the left lobe of the liver

ligamentum teres

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appears as hyperechoic line separating the left lobe from the caudate lobe

ligamentum venosum

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Portal venous system

Main portal vein

 

Liver Vascular supply

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supplies 80% of blood flow to the liver from the digestive system

flow should be toward the liver-hepatopetal (toward the liver)

portal venous system

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enters the liver at the portahepatis

divides into the right and left portal veins

RPV and LPV

Main Portal Vein

MPV

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largest portal vein

further divides into anterior and posterior branches

Right Portal vein

RPV

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drain blood from the liver back inot the IVC

3 components: Right RHV, Middle MHV and Left LHV

can be distinguished from the portal veins by lackj of bright walls

Hepatic Veins

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Supplies blood to liver (20%)

branch of the celiac artery from the aorta

Hepatic Arteries

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metabolism-carbs and protein

Digestion

storage

detoxification

Liver functions

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AST

ALT

LDH

Alk phos

Bilibrubin

PT

Albumin 

Globulins

Liver Function Tests

LFT

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TGC adjusted to balance near and far echos

overall gain-adjusted to adequatley penetrate the entire right lobe and a smooth homogeneous pattern

depth posterior right lobe positioned at the lower border of screen

focuses near the posterior border

transducer freq.  Avg adult 2.5-5MHz, pediatric 5-7MHz

Liver scanning

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size in the longitudinal plane

attentuation of the parechyma

texture

presence of hepatic vascular structures, ligaments and fissures

Liver Scanning evaluation

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should be anechoic with wall thickness less than 3mm

no fluid between wall and liver

Gallbladder

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polyps

gallstones

tumors

thick walls with fluid around

sludge

all of above

Gall Bladder pathology

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Head, body, tail, uncinate process

seen in transverse scan

GDA and CBD lelineate the lateral border of the head

splenic vein delineates the posterior border

sometimes see pancreatic duct

normal is 2mm or less

 

Pancreas

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Cortex

Hilum

pyramids

calyx

 

Kidney