Liver Flashcards
(34 cards)
1
Q
Purposes of the liver
A
metabolism, detoxification, excretion, storage
2
Q
Metabolism in the liver
A
- major center of metabolism for carbs, lipids, & amino acids
- glucose production
3
Q
Detoxification in the liver
A
drug inactivation
4
Q
Excretion in the liver
A
remove waste products via bile
5
Q
Storage in the liver
A
- stores vitamins & minerals (iron)
- storing too much can result in tumor growth (not always harmful)
6
Q
Disruption
A
any disruption damages liver cells
7
Q
Functioning unit of the liver
A
Hepatocytes & Kupffer cells
8
Q
Hepatocytes
A
- functional unit of liver
- synthesis of proteins & lipids
- immune response
- metabolism
- detoxification
9
Q
Kupffer cells
A
- part of hepatocytes
- hepatic cells that remove bile pigment, old blood cells, & by-products of phagocytosis from blood
- deposited into bile ducts
10
Q
Central veins
A
- turn into hepatic veins
- all throughout the liver, too small to see
11
Q
Liver cells
A
- small & don’t slow down blood flow
- if cells swell up, it compresses space & portal vein can not flow in as easily
12
Q
Liver location/shape/size
A
- in RUQ, part of it can be in LUQ
- shape & size are variable
- left lobe is over IVC & aorta
- right lobe is over kidneys & gallbladder (medial section)
13
Q
Riedel’s lobe
A
- not a lobe, variant of anatomy
- left lobe is shorter, right lobe elongated downward
14
Q
Caudate lobe
A
- in the middle of the liver (segment 1) on anterior edge of IVC
- bordered by ligamentum venosum anteriorly, IVC posteriorly, PV inferiorly
- if something vascular disrupts liver, caudate lobe might be spared b/c it gets blood from lots of places
15
Q
Middle of liver
A
where hepatic vein goes into IVC
16
Q
Supporting Structures
A
- ligaments that attach liver to diaphragm and arterial wall
- heart is in the midline
17
Q
Coronal ligaments
A
- referring to the heart
- liver to diaphragm
18
Q
Triangular ligaments
A
- left & right
- hold up corners of the liver
- liver to diaphragm
19
Q
Falciform ligament
A
- fibrous
- between 2 lobes of the liver
- causes surface indention
- connects to ligamentum teres
20
Q
Ligamentum teres
A
- old umbilical attachment
- on anterior & inferior part of left lobe
- joins umbilical segment of left portal vein
- may recanalize in portal hypertension
- divides left lobe
- in segment IV & is the center point
21
Q
Bare area
A
- can’t see on a scan
- no glistens capsule
- on posterior right lobe, no peritoneal covering of liver
22
Q
Main lobar fissure
A
- space/crease between 2 main lobes
- separates right & left lobe
- GB to PV
23
Q
Ligamentum venosum
A
- anterior to caudate/IVC
- to the left of caudate
24
Q
Couinaud’s Segments: 8
A
I - Caudate
II - Lt Lat Superior
III - Lt Lat Inferior
IV - Lt Medial - Quadrate lobe
V - Rt Inf Anterior
VI - Rt Inf Posterior
VII - Rt Sup Posterior
VIII - Rt Sup Anterior
25
Can you tell immediately what segment of the liver you are in?
No, sweep through scan to make sure
26
What segments are posterior to the hepatic vein?
VI or VII
27
What divides the superior and inferior segments on the right side of the liver?
Right portal vein
28
Vertical dividers
- hepatic veins, Rt & Mid
- Rt = anterior/posterior right lobe
- Mid = left & right lobes
29
Horizontal dividers
- portal veins, Rt & Lt
- Rt = superior/inferior right lobe
- Lt = superior/inferior left lobe
30
What to evaluate for in sonography of the liver
- echogenicity - compare to adjacent structure
- echotexture
- size
31
Sonographic appearances
- homogeneous echotexture
- parenchyma = medium level echoes
- vasculature & bile ducts = anechoic structures
- portal veins = echogenic walls
- ligaments
- know their expected location
32
What scan plane is the only view that provides ant/post & sup/inf dividers?
sagittal
33
How does blood flow through the liver?
goes through central vein that ends up in hepatic vein
34
Where do you measure the common bile duct?
- at portal triad (porta hepatis)
- look for portal vein & hepatic artery
