ARDMS Abdomen Davies Exam Questions And
Correct Answers
You are scanning a patient with a known mass in the left medial segment of the liver.
What anatomic landmark can you use to identify the left medial segment separate from
the right anterior segment of the liver? - ANSWER Middle Hepatic Vein
Which organ is the largest visceral organ in the body ? - ANSWER Liver
Where does the major portion of the liver, the right lobe is located? - ANSWER in the
right upper quadrant of the abdomen
Which of the organs have covering of the peritoneum for the most part and only a small
area posterior to the dome is called the bare area? - ANSWER the Liver
Which of the organs is enclosed in a layer of fibrous tissue, glisson's capsule? -
ANSWER the Liver
You suspect enlargement of the caudate lobe in a patient with liver disease. What
structure located at the anterior border of the caudate lobe will help you to identify this
lobe of the liver? - ANSWER Fissure for the ligamentum venosum
You are asked to rule out the presence of a recannalized paraumbilical. Which anatomic
structure is a useful landmark in location of this structure? - ANSWER Ligamentum teres
With which structure does the left portal vein have contact? - ANSWER Ligamentum
teres
From which site does the paraumbilical vein originate? - ANSWER takes origin from the
,left portal vein and leaves the liver at the ligamentum teres
Which vessel courses within the main lobar fissure? - ANSWER middle hepatic vein
Oxygenated blood to the liver is supplied by the: - ANSWER Portal vein and hepatic
artery
You are performing a sonogram on a lean female and note a long, thin extension of the
inferior aspect of the right lobe of the liver. The most likely represents: - ANSWER
Reidel's lobe
What forms the caudal border of the left portal vein? - ANSWER Ligamentum teres
What ligament divides the left lobe of the liver into medial and lateral segments? -
ANSWER Ligamentum teres
You are asked to perform a Doppler study of the hepatic veins in the liver. What
characteristic differentiates the hepatic veins from the portal veins? - ANSWER the
portal veins are accompanied by branches of the biliary tree and hepatic artery
You have found a mass anterior and to the left of ligamentum venosum. This mass is
located in which lobe of the liver ? - ANSWER Left Lobe
The thin capsule surrounding the liver is known as: -ANSWER Glisson's capsule
What travels through the liver both interlobar and intersegmental? -ANSWER Hepatic
veins
You are performing an ultrasound of the liver in a small patient using a 5MHz curved
linear array. You have increased the overall gain to its maximum and the posterior
border of the liver and diaphragm cannot be seen. What do you do? - ANSWER Rescan
, the liver with a lower frequency transducer.
Describe the probe placement and imaging plane you would use to demonstrate the
three hepatic veins and inferior vena cava in the one view? ANSWER Subcostal oblique
approach with the probe angled superiorly and to the patient's right.
You are performing a follow-up sonogram on a patient in which a 5-mmcyst was
previously identified at the anterior border of the left lobe liver. Although using a 3.5
MHz curved linear array probe, you do not visualize the cyst. What would best help in
improving the visibility of this cyst? - ANSWER Rescan the left lobe with a higher
frequency transducer. Visibility of small cysts is limited by spatial resolution. To improve
spatial resolution, the best option is to increase the imaging frequency.
What would you do to improve the spatial resolution to be able to visualize small cysts,
since it has a poor spatial resolution? - ANSWER The best choice is to increase the
imaging frequency
You are scanning a patient with a high liver. Images obtained in the subcostal location
do not well demonstrate the liver tissue. What would you do? - ANSWER Scan the patient
in deep inspiration
A patient is referred for ultrasound evaluation of a questionable mass in the dome of the
liver seen on a CAT scan. What would improve visualization in this area of the liver? -
ANSWER Perform a subcostal scan with the probe angled superior and the patient in
deep inspiration
A patient is referred for a liver ultrasound with the clinical history of a raised serum
alpha-fetoprotein level. What do you look for? - ANSWER Hepatocellular carcinoma
A non-pregnant individual with an elevated serum alpha-fetoprotein is associated with
what? - ANSWER Hepatocellular carcinoma, germ cell tumor of gonadal,
retroperitoneal, or mediastinal origin. Sometimes with cancer of pancreas, stomach, or
biliary system.
Correct Answers
You are scanning a patient with a known mass in the left medial segment of the liver.
What anatomic landmark can you use to identify the left medial segment separate from
the right anterior segment of the liver? - ANSWER Middle Hepatic Vein
Which organ is the largest visceral organ in the body ? - ANSWER Liver
Where does the major portion of the liver, the right lobe is located? - ANSWER in the
right upper quadrant of the abdomen
Which of the organs have covering of the peritoneum for the most part and only a small
area posterior to the dome is called the bare area? - ANSWER the Liver
Which of the organs is enclosed in a layer of fibrous tissue, glisson's capsule? -
ANSWER the Liver
You suspect enlargement of the caudate lobe in a patient with liver disease. What
structure located at the anterior border of the caudate lobe will help you to identify this
lobe of the liver? - ANSWER Fissure for the ligamentum venosum
You are asked to rule out the presence of a recannalized paraumbilical. Which anatomic
structure is a useful landmark in location of this structure? - ANSWER Ligamentum teres
With which structure does the left portal vein have contact? - ANSWER Ligamentum
teres
From which site does the paraumbilical vein originate? - ANSWER takes origin from the
,left portal vein and leaves the liver at the ligamentum teres
Which vessel courses within the main lobar fissure? - ANSWER middle hepatic vein
Oxygenated blood to the liver is supplied by the: - ANSWER Portal vein and hepatic
artery
You are performing a sonogram on a lean female and note a long, thin extension of the
inferior aspect of the right lobe of the liver. The most likely represents: - ANSWER
Reidel's lobe
What forms the caudal border of the left portal vein? - ANSWER Ligamentum teres
What ligament divides the left lobe of the liver into medial and lateral segments? -
ANSWER Ligamentum teres
You are asked to perform a Doppler study of the hepatic veins in the liver. What
characteristic differentiates the hepatic veins from the portal veins? - ANSWER the
portal veins are accompanied by branches of the biliary tree and hepatic artery
You have found a mass anterior and to the left of ligamentum venosum. This mass is
located in which lobe of the liver ? - ANSWER Left Lobe
The thin capsule surrounding the liver is known as: -ANSWER Glisson's capsule
What travels through the liver both interlobar and intersegmental? -ANSWER Hepatic
veins
You are performing an ultrasound of the liver in a small patient using a 5MHz curved
linear array. You have increased the overall gain to its maximum and the posterior
border of the liver and diaphragm cannot be seen. What do you do? - ANSWER Rescan
, the liver with a lower frequency transducer.
Describe the probe placement and imaging plane you would use to demonstrate the
three hepatic veins and inferior vena cava in the one view? ANSWER Subcostal oblique
approach with the probe angled superiorly and to the patient's right.
You are performing a follow-up sonogram on a patient in which a 5-mmcyst was
previously identified at the anterior border of the left lobe liver. Although using a 3.5
MHz curved linear array probe, you do not visualize the cyst. What would best help in
improving the visibility of this cyst? - ANSWER Rescan the left lobe with a higher
frequency transducer. Visibility of small cysts is limited by spatial resolution. To improve
spatial resolution, the best option is to increase the imaging frequency.
What would you do to improve the spatial resolution to be able to visualize small cysts,
since it has a poor spatial resolution? - ANSWER The best choice is to increase the
imaging frequency
You are scanning a patient with a high liver. Images obtained in the subcostal location
do not well demonstrate the liver tissue. What would you do? - ANSWER Scan the patient
in deep inspiration
A patient is referred for ultrasound evaluation of a questionable mass in the dome of the
liver seen on a CAT scan. What would improve visualization in this area of the liver? -
ANSWER Perform a subcostal scan with the probe angled superior and the patient in
deep inspiration
A patient is referred for a liver ultrasound with the clinical history of a raised serum
alpha-fetoprotein level. What do you look for? - ANSWER Hepatocellular carcinoma
A non-pregnant individual with an elevated serum alpha-fetoprotein is associated with
what? - ANSWER Hepatocellular carcinoma, germ cell tumor of gonadal,
retroperitoneal, or mediastinal origin. Sometimes with cancer of pancreas, stomach, or
biliary system.
