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Abdomen > Liver Anatomy > Flashcards

Liver Anatomy Flashcards

1
Q

Rank these from most hyperechoic to most hypoechoic
Liver
Pancreas
Renal Sinus
Renal Cortex

A

Renal Sinus
Pancreas
Liver
Renal Cortex

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2
Q

What is the largest internal organ

A

Liver

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3
Q

T or F:
The liver is intraperitioneal

A

True

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4
Q

The liver is all intraperitoneal expect for which part of it’s anatomy

A

Bare Area

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5
Q

The liver is covered by what type of capsule

A

Glisson’s Capsule

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6
Q

The Glisson’s Capsule is ____ & ____

A

Fibro Elastic
Protective

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7
Q

What is the avg. weight of the liver

A

1,200-1,600 grams

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8
Q

What is the avg. length of the liver

A

15cm

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9
Q

If you have a smaller person than their liver could be ____ and if you have a larger person than their liver could be ____

A

Smaller, Larger

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10
Q

What are the windows to image the liver

A

Liver offers great window
Subdiaphragmatic
Intercostal
Decubitus

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11
Q

What is the gross anatomy of the liver

A

Glisson’s Capsule
Intraperitoneal - Posterior and superior
Several ligaments suspend liver in place

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12
Q

What are the 7 ligaments of the liver

A

2 Triangular - R & L
2 Coronary - A & P
1 Falciform
Lesser Omentum - Hepatogastric & Hepatoduodenal

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13
Q

The falciform ligament connected the liver to

A

Anterior wall and diaphgram

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14
Q

The falciform ligament extends from the umbilicus to

A

Diaphragm in sagittal plane

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15
Q

The falciform ligament contains what ligament

A

Ligamentum Teres

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16
Q

The coronary ligaments connect the ____ surface of the liver to

A

Superior surface
Undersurface of diaphragm

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17
Q

In the superior aspect of the liver, the leaves of the falciform ligament separate to form the

A

Coronary ligaments

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18
Q

What borders of the coronary ligaments outline the bare area

A

Anterior and posterior

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19
Q

The triangular ligaments are located at the

A

R & L corners of coronary ligaments and bare area

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20
Q

The triangular ligaments connect the R & L liver to

A

Diaphragm

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21
Q

The lesser omentum is a total of __ ligaments and those are the _____ & ____

A

2 ligaments
Hepatogastric
Hepatoduodenal

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22
Q

What are the 3 normal variants of the liver

A

Riedel’s Lobe
Small left lobe
Situs inversus totalis

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23
Q

What is the Riedel’s lobe and it extends from

A

Tongue like extension of right lobe
Extends inferior to right kidney

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24
Q

If you have a small left lobe it may not

A

Extend past the midline

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25
Q

If you have situs inversus totalis the liver will be located in what quadrant

A

LUQ

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26
Q

The liver is divided into various ____

A

Segments

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27
Q

The ___ and ___ veins help make the divisions ____ & ____ location

A

Portal & Hepatic veins
Consistent and reliable location

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28
Q

Liver division is needed when any liver ____ is performed

A

Resection

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29
Q

In the Couinaud’s Anatomy each segment has it’s own vascular

A

Inflow
Outflow
Biliary Drainage

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30
Q

These 3 veins make up the longitudinal divisions

A

Right Hepatic Vein
Middle Hepatic Vein
Left Hepatic Vein

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31
Q

The RHV is located in the ___ ____ ____ and divides the right lobe into right ____ (posterior) and right ___ (anterior) sections

A

Right intersegmental fissure
Right lateral and right medial

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32
Q

The MHV lies in the ___ ___ ___ and divides the liver into

A

Main lobar fissure
R & L lobes or R & L Hemiliver

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33
Q

The MHV has the vertical plane running from ____ to ___ ____ also known as the ___ ___

A

IVC to Gallbladder Fosse
Cantile’s Line

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34
Q

In the MHV the right is the right ___ section and the left is the left ___ section

A

Medial section
Medial section

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35
Q

The LHV is located

A

Left intersegmental fissure

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36
Q

The LHV divides the ___ lobe into left ___ and left ___sections

A

Left lobe
Left medial
Left Lateral

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37
Q

In transverse division of the liver are made from the _ & _ __ veins

A

Right and left portal veins

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38
Q

What is the traditional system of the 3 lobes

A

Right lobe - 1
Left lobe - 1
Caudate lobe - 3

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39
Q

What is the traditional system of the 5 segments

A

Right anterior (1) and posterior (2) segments
Left lateral (3) and medial (4) segments
Caudate lobe (5)

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40
Q

The main lobar fissure divides the liver into
And can be seen connecting

A

R & L lobes
Connecting RHV and GB fossa

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41
Q

The main lobar fissure is a true

A

Cleft/fissure

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42
Q

This vein courses within the fissure

A

MHV

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43
Q

The left lobe is the left intersegmental fissure that divides into

A

Medial and lateral segments

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44
Q

These 3 structures run within the left intersegmental fissure

A

LHV
Ascending branch of LHV
Falciform ligament/ligamentum teres

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45
Q

T or F
The left intersegmental fissure is a true fissure

A

False
Is not a true fissure

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46
Q

The LHV divides the ___ portion of the ___ lobe into ___& ___ segments

A

Superior portion
Left lobe
Medial & Lateral segemtns

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47
Q

The ascending branch of the LHV is used to divide the ___ portion of the ___ lobe into __ & __ segments

A

Mid portion
Left love
Medial and lateral segments

48
Q

The falciform ligament is used to divide the ___ portion of the __ lobe into __ and __ segments

A

Inferior portion
Left lobe
Medial and lateral segments

49
Q

The quadrate lobe is the absolute obsolete term referring to the ___ ___ portion of the ___ segment of the ___ lobe

A

Posterior inferior portion
Medial segment
Left lobe

50
Q

The right lobe is separated into ___ and ___ segments by the right ___ ___

A

Anterior and posterior segments
Right intersegmental fissure

51
Q

T or F
The right intersegmental fisure is not a true fissure

A

True

52
Q

The RHV travels in the

A

Right intersegmentsl fissure

53
Q

The caudate lobe is located on the

A

Posterior surface of the left lobe

54
Q

T or F
Caudate lobe is completely separate lobe and has it’s own vascular circulation

A

True

55
Q

What are the landmarks of the caudate lobe with their location

A

Ligamentum venosum - Anterior
IVC - Posterior
MPV - Inferior

56
Q

The ligamentum venosum separates the __ and ___ lobe

A

Left and caudate lobe

57
Q

Where can the ligamentum venosum be seen ___ to ___ of liver as linear ____ line ___ to the ___ lobe

A

Inferior to dome of liver
Linear horizontal line
Anterior to the caudate lobe

58
Q

What is the vascularity of the liver

A

Hepatic Veins
Portal Veins
Hepatic Arteries

59
Q

The venous drainage of the liver is via the

A

Hepatic veins

60
Q

Where are the hepatic veins located and are they intrasegmental or intersegmental

A

Intersegmental/Interlobar
Between segments and lobes

61
Q

The smaller hepatic veins unite to form these 3 veins and dump into the

A

LHV, MHV, RHV
Dump into IVC

62
Q

T or F
The hepatic veins do not sonographically have distinguishable walls

A

True

63
Q

The hepatic veins course

A

Long in the liver

64
Q

The hepatic veins carries blood out of the liver to the

A

IVC

65
Q

Where can you see the larger branches of the hepatic veins

A

Superior aspect of the liver

66
Q

___% of people have more than _ main hepatic veins

A

30%
3 main hepatic veins

67
Q

The MHV may join the ___ prior to entering the ___

A

LHV
IVC

68
Q

This vein supplies 70-90% of blood to the liver

A

Portal vein

69
Q

The portal veins carry what type of blood with what type of changes with respiration

A

Carry deoxygenated, nutrient rich blood
Have phasic changes w/ respiration

70
Q

This vein has a “hockey” stick appearance on U.S

A

Portal vein

71
Q

The portal veins arise from the

A

Splenic vein
Superior & inferior mesenteric vein

72
Q

The MHV enters into the

A

Porta hepatis

73
Q

The MPV immeditely divides into ___ and ___ at the __ ___ which then branch into the right ___ & ___ and left ___ & ___ branches

A

RPV & LPV
Porta Hepatis
R Anterior & Posterior
Left Lateral & Medial

74
Q

What is the purpose of the porta venous blood

A

Secondary flow of blood

75
Q

The secondary flow of blood allows the liver to remove & prevent

A

Remove bacteria from bloodstream
Prevent harmful agents from entering the general circulation

76
Q

The porta venous blood also bring required ___ to the

A

Nutrient to the liver protein synthesis

77
Q

The portal veins travel within the ___ & ___:
Are they considered intrasegmental or intersegmental?

A

Intrasegmental
Segments and lobes

78
Q

T or F
Portal veins course transversely

A

True

79
Q

The portal veins have what type of borders due to

A

Echogenic borders due to triad

80
Q

The portal veins carry blood ___ the liver

A

Into

81
Q

The portain veins have little

A

Phasicity

82
Q

The portal veins course within the ___/___

A

Segments/lobes

83
Q

T or F
The hepatic veins course transversely

A

False
Course longitudinally

84
Q

The hepatic veins have no

A

Echogenic walls

85
Q

The hepatic veins carry blood ___ of the liver and into the ___

A

Out of the liver
Into the IVC

86
Q

The hepatic vein has ___ flow

A

Phasic

87
Q

The hepatic veins course between

A

Segments/lobes

88
Q

The hepatic arteries supply approx. __% of total ___ ___ to the liver with this type of blood

A

25% total blood volume
Oxygenated blood

89
Q

The common hepatic artery branches off the and gives off a branch from the ___ artery and becomes the ___ ___ ___

A

Celiac axis
Gastroduodenal artery
Becomes proper hepatic artery

90
Q

Within the porta hepatis the proper hepatic artery branches into ___ & ___ ___ arteries.
They flow __ __ throughout the liver with __ ___ flow

A

Right and left hepatic arteries
Flow portal triad with low resistive flow

91
Q

Most common variant is a replaced
Instead it would arise off the ___ instead

A

Hepatic artery
Arise from Superior mesentaric artery

92
Q

What is the porta hepatis

A

Area at the enterance of the liver

93
Q

How is the porta hepatis usally identified sonographically

A

By MPV crossing into IVC

94
Q

What is the portal triad that enters into the liver

A

Portal vein
Hepatic artery
Bile duct

95
Q

The intrahepatic stuctures are within the

A

Glisson’s capsule

96
Q

What are the structures located within the Glisson’s capsule

A

Liver
Parenchyma
Branches of portal system
Hepatic arteries & veins
Peripheral bile ducts

97
Q

Where are the extrahepatic structures located outside of the

A

Outside the liver parenchyma and Glission’s capsule

98
Q

The extrahepatic structures includes all the structures in the

A

Porta hepatis

99
Q

The extrahepatic structures appear on U.S as if they are in the ___, however because they don’t ___ the liver ___, the structures aren’t ____

A

In the liver
Don’t penetrate the liver capsule
Structures aren’t intrahepatic

100
Q

What are the functional units of the liver

A

Lobules

101
Q

How many lobule units are

A

50,000-100,000

102
Q

What do the lobule functional units consist of

A

Liver cells
Sinusoids
Central vein
Portal vein
Hepatic artery
Bile cancaliculi
Lymph vessels

103
Q

What are sinusoids

A

Capillary-like connections in lobules traveling between columns of hepatocytes

104
Q

What do sinusoids do for the liver

A

Carry inflow of portal venous and hepatic arterial blood

105
Q

How many ml of blood enters the sinusoids per minute

A

1,450 ml

106
Q

The sinusoids bring blood to the

A

Central vein

107
Q

What are hepatocytes

A

Functioning cells surrounding the sinusoids

108
Q

Where are the Kupffer cells located

A

Scattered along walls of sinusoids

109
Q

The Kupffer cells are ___ cells that remove ___ ___ from the ___ such as

A

Phagocytic cells
Remove toxic substances from the blood
Bacteria, old RBC’s, debris

110
Q

Both ___ cells & ___ remove ___ from the ______

A

Kupffer cells and hepatocytes remove substances from the blood stream

111
Q

Central veins of each lobule join together and eventually become the

A

Intersegmental main hepatic veins

112
Q

The branches of the ___ ___, ___ ___, and ___ ___ are arranged around the ___ of each lobule

A

Portal vein, hepatic artery, and bile ducts
Arranges around the outside of each lobule

113
Q

What are bile cancaliculi

A

Blind-ended channels where the biliary tree originates

114
Q

Where does the biliary tree originate

A

Bile canaliculi

115
Q

The inflow of blood is from the ___ and ___ –> Blood flows through ___ and into the ___ where these cells ingest ___ and these cells remove needed ___ –> The ___ material and ___ goes into spaces of ___ –> Blood flow into ___ ___ –> __ __ –> ___

A

Portal vein & hepatic artery
Through the branches
Into sinusoids where Kupffer cells ingest bacteria, hepatocytes remove needed substances
Lymph material and fluid goes into spaces of Disse
Flow into Central vein –> hepatic veins –> IVC

116
Q

What is Morrison’s Pouch?

A

Space between the posterior subphrenic and posterior subhepatic space of RUQ

Abdomen (10 decks)

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