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Describe the patient preparation, patient positions for the liver examination.
- Patient prep: NPO 8 hrs
- Patient position: supine
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Describe the standard protocol for the liver examination.
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List the hepatic venous tributaries that merge with the IVC.
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List the hepatic arterial tributaries starting at the celiac axis or trunk.
- Common hepatic artery to the proper hepatic artery to the right, middle, and left hepatic arteries.
- Inferiorly the gastroduodenal artery feeds the pancreas.
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Name the ligament that lies on the anterior surface of the liver that is not seen sonographically in normal patients.
falciform ligament
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Name the ligament that divides the left lobe from the caudate lobe.
ligamentum venosum
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Name the ligament that is the remnant of the fetal umbilical vein.
ligamentum teres
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List the initial tributaries of the MPV.
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List the vessels that form the MPV.
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List the initial tributaries of the LPV.
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List the inital tributaries of the RPV.
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List the three lobes in the segmental anatomy system.
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The RHV divides what?
Right lobe into anterior and posterior segments
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The MHV divides what?
Right and left lobes
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The LHV divides what?
Left lobe into lateral and medial segements
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The ligamentum teres divides what?
Left lobe into lateral and medial segments
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THe gallbladder and the IVC fossa divide what?
The live into right and left lobes
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The main lobar fissure divides what?
The liver into right and left lobes
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Describe the sonographic features associated with the hepatic veins.
- Thin, anechoic walls
- Get larger with inspiration
- Largest in diameter at the superior, posterior aspect of the liver (near the IVC)
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Describe the sonographic features associated with the portal veins.
- Thick echogenic walls
- Largest in diameter @ the level of the porta hepatis
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List the triad of vessels that course parallel throughout the liver parenchyma.
- Portal veins
- Hepatic arteries
- Bile ducts
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List and describe the typical transducer types and frequencies used for the liver examination.
- Sector or Curvilinear
- Use the highest clinically appropriate frequency (between 2 & 5 MHz)
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List and describe the patient preparation and patient positions for the biliary system (gallbladder).
- Patient preparation: NPO 8 hrs
- Patient positions: supine and decubitus (to note stone movement)
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Describe the standard scanning protocol for the pancreas.
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Describe the standard scanning protocol for the gallbladder.
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The _______ ducts merge to form the common hepatic duct.
hepatic
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The _________ and the ______ ducts merge to form the common bile duct.
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Normal measurement for the gallbladder wall?
≤3mm
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Normal measurement for the gallbladder (AP and length)
- GB length: ≤5-7cm
- GB AP: ≤3-4cm
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Normal measurement of the common duct at the level of the porta hepatis
≤4-5mm
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Normal measurement of the distal common bile duct
≤6-8mm
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List and describe the patient preparation and patient positions along with transducer placement for the pancreas.
- Patient preparation: NPO 8 hrs
- Patient position: supine
- Transducer placement: angled forward towards feet. Scan long to organ
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The splenic vein is located _______ in relation to the body of the pancreas.
posterior
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The SMA is located _______ in relation to the splenic vein.
posterior
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The LRV is located _______ in relation to the SMA.
posterior
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The RRA is located ________ in relation to the IVC.
posterior
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The GDA is located ________ in relation to the pancreatic head.
anterior
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The CBD is located ________ in relation to the pancreatic head.
posterior
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List the three tributaries of the celiac trunk.
- Common hepatic artery
- Splenic artery
- Left gastric artery
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List the five anatomic divisions of the pancreas.
- 1 head
- 2 neck
- 3 uncinate
- 4 body
- 5 tail
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The main pancreatic duct is termed ______________ and enters the duodenum via the ____.
duct of Wirsung/ CBD
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The SMV is located _____ in relation to the uncinate process.
anterior
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