Liver

An increase with ALP is associated with what abnormality?

cirrhosis

extra hepatic biliary obstruction

gallstones

hepatitis

metastatic liver disease

pancreatic carcinoma

An increase in AST is associated with what abnormality?

biliary tract obstruction

hepatitis

hepatocellular disease

obstructive jaundice

An increase in Gamma-glutamyl transferase is associated with what abnormality?

Refuse liver disease

Post hepatic obstruction

An increase in LDH is associated with what abnormality?

Cirrhosis

Hepatitis

Obstructive jaundice

An increase in serum bilirubin is associated with what abnormality?

Unconjugated direct bilirubin

• acute hepatocellular disease

Conjugated indirect bilirubin

• Billary tract obstruction

Total bilirubin

• Cirrhosis, hepatitis, and other liver cell disease

What is the difference between prolonged PT and short and PT?

Prolong PT = metastasis of the liver hepatitis

Shorten PT = extra hepatic duct obstruction

An increase in AFP is associated with what abnormality?

Hepatocellular carcinoma (hepatoma)

Hepatoblastoma

What do lobules contain?

Hepatocytes

Biliary epithelial cells

Kupffer cells

Where is the quadrant lobe located and what is it referred to?

It is located between the gallbladder fossa and the round ligament

It is referred to as medial segment of the left lobe (not a main lobe)

Where is the caudate lobe located and what ligament separates it from the lobe?

It is located in the epigastrium and bounded anteriorly by the ligamentum venosum and posteriorly by the IVC

It is separated by the ligamentum venosum

What are the primary vessels of the splanchnic circulation?

Celiac artery

SMA

IMA

What is one of the main branches of the celiac artery?

The common hepatic artery

A decrease in albumin is associated with what abnormality?

Chronic liver disease

Cirrhosis

What is the main portal vein created by?

It is created by the union of the SMA and splenic vein

(sometimes the IMA)

Where is the portal confluence located and what are the other names?

It is located posterior to the neck of the pancreas and anterior to the IVC

It is also referred to as portal splenic confluence and portal venous confluence

The portal vein provides how much blood to the liver?

75 to 80%

When the MPV enters the liver, how does it split?

It splits into right and left branches

(splits like hepatic veins)

What is enlargement of the portal vein called?

Portal hypertension

What do portal veins look like when they approach the diaphragm?

Decrease in size

How do the hepatic veins look like when they approach the diaphragm?

Increase in size

The portal vein is also considered _______ because they course within the segments of the liver

Intrasegmental

How do the portal veins look and what is the flow?

They appear bright due to the increase amount of collagen within the walls

The flow is hepatopetal and monophasic

After a meal, it increases in flow

What is the flow of the hepatic veins and why?

Triphasic flow

Cause of their association with the right atrium and atrial contraction.

Enlargement of hepatic veins and IVC is seen with?

Right sided heart failure

Occlusion or narrowing of the hepatic veins is seen with?

Budd-Chiari syndrome

What 3 structures are located within the porta hepatis (liver hilum)

Main portal vein

Common bile duct

Hepatic artery

What is a branch of the celiac artery?

The common hepatic artery

What is the normal flow of the hepatic artery?

It is low resistance

Where does the hepatic artery take its course?

Anterior to the MPV in the porta hepatis

In longitudinal it is anterior to the MPV and posterior to the CBD

In utero the umbilical vein supplies the fetus, travels into the liver and bifurcates into left and right branches. What is the right branch called in utero and what is it called after birth?

In utero = ductus venosus

After birth = ligamentum venosum

In utero the umbilical vein supplies the fetus, travels into the liver and bifurcates into left and right branches. What is the left branch called in utero and after birth?

In utero = umbilical vein

After birth = ligamentum teres or round ligament (ascends along the falciform ligament)

Recanalizatiom of the paraumbilical vein in the ligamentum teres can occur in the presence of?

Portal hypertension

What fissure connects the neck of the gallbladder to the right portal vein?

The Main Lobar Fissure

What may present as a pseudomass on ultrasound?

Diaphragmatic slip