Liver

Question 0

Dome shaped

Anterior, superior and posterior parts

Covered with visceral peritoneum except posteriorly in the bare area

Answer 0

Diaphragmatic

Question 1

Lies mainly in the RUQ of the abdomen occupies most of the R hypochondrium, the upper epigastrium and extends into the L hypochondrium

Answer 1

Liver

Question 2

Ligaments

Answer 2

Falciform ligament

Coronary ligament

R/L triangular ligaments

Ligamentum teres / round ligament

Ligamentum venosum

Question 3

Remnant of umbilical vein

Between left lobe and quadrate lobe

Answer 3

Ligamentum teres / round ligament

Question 4

Remnant of ductus venous

Between left lobe and caudate lobe

Answer 4

Ligamentum venosum

Question 5

The median umbilical ligament is a remnant of what fetal structure?

Answer 5

Urachus

Question 6

Gubernaculum

Answer 6

Round ligament

Question 7

Urachus

Answer 7

Median umbilical ligament

Question 8

Ductus venosum

Answer 8

Ligamentum venosum

Question 9

Ductus arteriosus

Answer 9

Ligamentum arteriosum

Question 10

Umbilical vein

Answer 10

Ligamentum teres

Question 11

Umbilical artery

Answer 11

Medial umbilical ligament

Question 12

Ductus venosus

Answer 12

Ligamentum venosum

Question 13

Foramen ovale

Answer 13

Fossa ovalis

Question 14

Ductus arteriosus

Answer 14

Ligamentum arteriosum

Question 15

A pediatric surgeon is resecting a possible malignant mass from the liver of a neonate. The surgeon divides the round ligament during surgery. A fibrous remnant of which of the following fetal vessels is severed?

Answer 15

Left umbilical vein

Question 16

Caudate lobe is located in what functional surgical segment of liver?

Answer 16

Medial superior

Question 17

Segments

Answer 17

I - Medial superior
II - Lateral superior
III - Lateral inferior
IV - Medial inferior
V - Anterior inferior
VI - Posterior inferior
VII - Posterior superior
VIII - Anterior superior

Question 18

APICES of triangular cross-sections of portal lobules are CENTRAL VEINS; PORTAL AREAS for the CENTERS of these lobules

Based on BILE FLOW

Answer 18

Portal Lobule

Question 19

Based on blood flow

DIAMOND-SHAPED AREA of the liver whose axis is the straight line between neighboring central veins and whose short acis is the intersecting line between neighboring portal areas

Answer 19

Liver Acinus - ACINUS OF RAPPAPORT

Question 20

3 zones of LIVER ACINUS

Answer 20

Zone 1 - closest to the portal tract and receives the most O2

Zone 2

Zone 3 - farthest and receives the least O2, most susceptible to ischemic injury

Question 21

Examination of a 54 y/o man reveals an isolated tumor located at the Porta hepatis. The tumor most likely compresses on which structure?

Answer 21

Branches of PORTAL VEIN

Question 22

Portal triad

Answer 22

Portal vein

Common bile duct

Hepatic artery

Question 23

Blood supply

Answer 23

Portal vein - formed by union of superior mesenteric & splenic veins; 70%

Hepatic vein - branch of celiac artery; 30%

Question 24

Liver biopsy done usually at?

Answer 24

R 10th ICS in MAL

Question 25

Right ICS 8,9 or 10 just after the patient exhales Skin --> superficial fascia --> external oblique muscle --> intercostal muscles --> costal parietal pleura --> costodiaphragmatic rcess --> diaphragmatic parietal pleura --> diaphragm --> peritoneum

Answer 25

Liver biopsies

Question 26

Affects the development of intra & extrahepatic bile ducts MC cause of persistent jaundice in infancy SSX: jaundice, dark urine, clay-colored stool Liver biopsy: bile duct proliferation with dilatation of bile canaliculi & bile plugs

Answer 26

Congenital biliary atresia

Question 27

Granulomatous destruction of medium-sized intrahepatic bile ducts Mitochondrial pyruvate dehydrogenase autoantibodies

Answer 27

Primary biliary cirrhosis

Question 28

Inflammation, fibrosis & segmental dilatation of both intra & extrahepatic bile ducts Often in association with chronic ulcerative colitis

Answer 28

Primary sclerosing cholangitis

Question 29

Removing one of the liver segments (5 total segments) or one of the liver subsegments (9 total subsegments) Hepatic veins as landmark, mark the periphery of the liver segment

Answer 29

Surgical resection

Question 30

Divided into R & L lobe by interlobar fissure Secured in position by attachment of hepatic veins to the IVC (allows very little rotation of the liver during surgery)

Answer 30

Liver

Question 31

Left lobe contains

Answer 31

Calcified ligament Ligamentum teres (remnant of umbilical vein) on inferior border

Question 32

Located on diaphragmatic surface No peritoneum

Answer 32

Bare area of the liver