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URR 13 Flashcards

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1
Q

divides right lobe into anterior and posterior segments

A

right hepatic vein

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2
Q

drains left lobe

A

left hepatic vein

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3
Q

divides left lobe into medial and lateral segments

A

left hepatic vein

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4
Q

drains left medial and right anterior lobes

A

middle hepatic vein

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5
Q

divides liver into right and left lobes

A

middle hepatic vein

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6
Q

most common variation in hepatic vein anatomy

A

accessory hepatic vein

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7
Q

______ can caused increased resistance to flow exiting the liver

A

congestive heart failure

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8
Q

Indications to can hepatic veins

A

CHF
thrombosis
liver tumor
hepatic congestion
Budd Chiari syndrome
Liver disease

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9
Q

The LHV and MHV are best seen in the transverse view at the level of the”

A

xiphoid process

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10
Q

The RHV is best seen in a longitudinal view from a _____ approach

A

right intercostal

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11
Q

______ approach angle towards patient’s right should demonstrates 3 hepatic veins entering IVC

A

oblique subcostal

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12
Q

The diameter and flow of hepatic veins vary with:

A

respiration

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13
Q

The hepatic veins ____ in size as they near IVC

A

increase

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14
Q

The hepatic veins have ______ walls compared to the portal veins

A

thinner
less echogenic

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15
Q

Normal flow of hepatic veins

A

hepatofugal

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16
Q

flow moving away from the liver

A

hepatofuga

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17
Q

Hepatic veins have more _____ and _____ than normal portal veins

A

cardiac pulsatility
respiratory phasicity

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18
Q

Hepatic flow is considerd ____ on the Doppler tracing due to cardiac pulsatility caused by _____, ____, and ____

A

triphasic
atrial contraction, relaxation, filling

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19
Q

Norma hepatic vein flow demonstrates two large ____ diastolic and systolic waves, followed by a small ____ component that corresponds with atrial contraction

A

antegrade
retrograde

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20
Q

functional unit of the liver

A

lobules

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21
Q

Lobules are composed of:

A

hepatocytes

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22
Q

_____ tracts course adjacent to the lobules of liver tissue

A

portal triad

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23
Q

____ surround the periphery of the hepatic veins

A

hepatocytes

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24
Q

functions of hepatocytes

A

synthesize, metabolize, and excrete compounds

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25
The walls of the sinusoids contain ____ and ____ cells that phagocytize bacteria and foreign material
endothelial Kupffer
26
Hepatic functions
metabolism of digestive products storage of vitamins, iron, glycogen, fat, amino acids detoxification bile production and excretion albumin and globulin formation lymph production
27
Carbohydrates are metabolized to:
maintain blood sugar
28
Fats are metabolized to:
provide energy
29
Proteins are metabolized to:
release amino acids
30
removes poisonous substances, bacteria, alcohol
detoxification
31
exocrine function of the liver
bile production and excretion
32
Liver cells conjugate bilirubin and the _____ secrete bile into ductal system
bile canalculi
33
liver enzyme levels in blood
liver function tests
34
Increased levels with ____ causing more enzymes to leak into blood stream
liver damage
35
Increased levels are seen with acquired and inherited liver disease ____, ____, ____, ____
hepatitis fatty liver hemochromatosis Wilson disease
36
Liver tissue contains higher levels of ____ than ____
ALT AST
37
Changes in ALT levels are more specific to:
liver disease
38
Because AST is found in other organs, isolated elevation of AST levels indicates:
Nonhepatic issues
39
What is AST?
Aspartate Aminotransferase
40
AST is present in ___, ____, ____, ____, and ___
liver kidneys skeletal muscles heart muscles brain
41
There is mild increase in AST with:
fatty changes of liver
42
AST is NOT elevated with:
isolated biliary obstruction
43
Causes for increased AST with normal ALT
myocardial infarction CHF muscle injury CNS disease other NONhepatic disorders
44
What is ALT?
Alanine Aminotransferase
45
ALT is necessary for:
energy production
46
ALT is released into the blood with:
liver cell damage
47
ALT is used to evaluate the level of"
jaundice
48
ALT is used to monitor ___ and ___
hepatitis cirrhosis
49
There is a mild increase in ALT with:
fatty changes of liver
50
ALT is increased with:
hepatitis cirrhosis liver tumors biliary obstruction Reye syndrome
51
Higher ration of AST/ALT due to higher AST levels is seen with:
liver damage and necrosis of tissue with alcoholic liver disease, cirrhosis, and liver metastasis
52
Lower ratio of AST/ALT due to higher ALT levels seen with:
acute hepatitis nonmalignant hepatic obstruction
53
Causes for increased AST with normal ALT
myocardial infarction, CHF, muscle injury, CNS disease, other NONhepatic disorders
54
What is ALP?
alkaline phosphatase
55
ALP is found in the ___, ____, and ___
liver bone placenta
56
ALP is normally excreted with:
bile
57
ALP increases with biliary obstruction from:
tumors cholelithiasis biliary atresia
58
If ALP is elevated due to ____, other liver enzymes are elevated like GGTP
hepatocellular disease
59
If ALP is elevated alone, then the cause may be related to :
bone disease pregnancy hyperparathyroidism
60
What is GGTP?
Gamma-glutamyl transpeptidase
61
GGTP is normally found in ____ and ____
liver cells biliary epithelium
62
GGPT is the most sensitive indicator for:
alcoholism
63
There is marked increase in GGTP with:
liver disease post-hepatic biliary obstruction
64
There is moderate increase in GGTP seen with:
liver damage due to alcohol, drugs, and chemotherapy
65
Increased GGTP + ALP =
biliary obstruction
66
Increased GGTP + ALT =
hepatocellular disease
67
What is LDH?
lactic dehydrogenase
68
LDH increases with liver damage due to:
cancer cirrhosis chronic viral hepatitis
69
What is PT?
Prothrombin time
70
Used to detect levels of clotting factors in the blood
prothromin time
71
There are ___ different clotting factors need to clot blood
12
72
The liver produces how many factors that are needed to clot blood?
1
73
Increased PT means
takes a longer time to form clot
74
Decreased PT means:
takes a shorter time to produce clot
75
The liver converts prothrombin to thrombin using ____
vitamin K
76
Increasing vitamin K intake with ____ PT because increased thrombin levels function as clotting agent for the blood
decrease
77
Liver disease can affect PT conversion process causing increased PT which indicates an increased risk for:
hemorrhage
78
Increased of prolonged PT =
metastasis liver disease coagulant therapy prolonged biliary obstruction
79
If PT is increased and administration of Vitamin K is given, it may help distinguish ____ from ____
hepatocellular disease cholestasis
80
Little or no improvement in PT after Vitamin K indicated:
parenchymal liver disease
81
What is INR?
International Normalized Ratio
82
Makes up variations in PT testing between labs
INR
83
What is the unit for INR?
no unit because it is a ratio
84
Normal INR
0.9-1.3
85
Normal INR for a patient on coagulopathy
2.0-3.0
86
What is AFP?
alpha-fetoprotein
87
AFP is a normal protein produced by the ____ and ____
fetal liver yolk sac
88
AFP decreases after:
age 1
89
Increased serum AFP levels are seen with:
primary liver cancers liver metastasis hepatitis non-seminomatous testicular cancers pregnancy
90
The most significant increase of AFP is seen with:
hepatocellular carcinoma
91
CA 125 is elevated with:
ovarian cancer, endometriosis, lung cancer
92
CA 72-4 is elevated with:
ovarian cancer, gastrointestinal cancers
93
CA 19-9 is elevated with:
pancreatic cancer; can be elevated with colorectal and bile duct cancers
94
What is CEA?
Carcinoembryonic Antigen
95
CEA is associated with:
colorectal cancers and malignant lesions
96
HCG in men is associated with:
testicular cancers
97
has been conjugated by liver for digestive use
direct bilirubin
98
Direct Bilirubin abnormally increases with:
biliary tract obstruction hepatitis cirrhosis
99
has NOT been conjugated by the liver for digestive use
indirect bilirubin
100
Indirect bilirubin abnormally increases with:
liver cell damage/disease and anemia

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