ARDMS Abdomen Ultrasound Registry Review Exam Questions And Answers (Verified And Updated)

ARDMS Abdomen Ultrasound Registry Review Exam Questions And Answers (Verified And Updated) How many segments does the Couinaud system divide the liver into? - answerEight surgical segments What divides the right lobe of the liver into an anterior and posterior segment? - answerRight hepatic vein What vessel separates the right and left lobe? Where does it lie (fissure)? - answerMiddle hepatic vein, which lies in the main lobar fissure LLL is divided into medial and lateral segments by: - answerLeft hepatic vein The caudate lobe is separated from the LLL by which ligament? - answerligamentum venosum Main portal vein is created by the merging of which two vessels? What is this area referred to as? - answerSuperior mesenteric vein and splenic vein. Known as the splenic portal confluence What is the name of the capsule surrounding the liver? - answerGlisson capsule Normal AP measurement of the MPV? - answer13mm or less What is an enlarged (13mm) portal vein signify? - answerPortal hypertension Normal MPV flow? - answerHepatopetal and monophasic w/ some respiratory variation Where do the hepatic veins drain? - answerIVC These veins are considered both interlobar and intersegmental - answerhepatic veins. They are located between the segments and the lobes normal hepatic vein flow - answer-Hepatofugal - away from liver -pulsatile, triphasic due to right atrial pressure changes -respiratory variation Narrowing or occlusion of the hepatic veins is indicative of: - answerBudd-Chiari syndrome The liver hilum is also know as - answerThe porta hepatis flow pattern of the hepatic artery should be - answerlow resistance since it is feeding the liver After birth the umbilical vein becomes - answerligamentum teres aka round ligament -runs along with the falciform ligament -will usually be seen near left portal vein in left liver Where can the main lobar fissure be seen? - answer-in sag plane -will appear to connect the neck of the GB with the RPV -also separates right and left hepatic veins hepatic steatosis - answerfatty liver Causes of fatty liver disease - answerFatty deposits within the hepatocytes. Once it becomes cirrhosis, it is non-reversible. 1. Alcoholic fatty liver disease 2. Non-alcoholic fatty liver disease: -obesity -starvation -chemotherapy -diabetes mellitus -hyperlipidemia -pregnancy -von Gierke disease (glycogen storage dx) -total parental nutrition -cystic fibrosis steatohepatitis - answerinflammation of the liver associated with fat precursor for chronic liver dx leading to fibrosis, cirrhosis, and HCC hepatomegaly size - answer15cm need to correlate with clinical hx don't confused Riedel's lobe as hepatomegaly Fatty liver symptoms and labs - answerSymptoms: -usually asymptomatic Labs: -Increased LFTs (especially AST and ALT) Sono appearance of fatty liver dx and focal fatty infiltration - answer-Diffusely echogenic liver -Increased attenuation of sound beam -Walls of hepatic vasculature and diaphragm will not be easily imaged due to increased attenuation -Fatty changes will be diffuse or focal Focal fatty infiltration sono app: -hyperechoic area next to the GB, near the porta hep, or part of lobe may appear echogenic Focal fatty sparing sonographic appearance - answer-entire liver is involved with diffuse fatty infiltration with certain areas spared -Area of sparing can look like a solid hypoechoic mass -Hypoechoic area will be near GB, porta hep, or entire lobe may be spared -Can appear to look like pericholecystic fluid Two most common types of hepatitis: - answerA and B A: Fecal-oral route: contaminated water or food