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 from the right anterior
segment of the liver? - ANSMiddle Hepatic Vein
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 identify this lobe of the liver? -
ANSFissure 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? - ANSLigamentum Teres
*The left portal vein is in contact with the ligamentum teres. A paraumbilical vein begins at the
left portal vein and exits the liver at the ligamentum teres.
Which vessel courses within the main lobar fissure? - ANSMiddle Hepatic Vein
Oxygenated blood is supplied to the liver via the: - ANSPortal Vein and Hepatic Artery
You are performing a sonogram on a slender female and notice a long, thin extension of the
inferior aspect of the right lobe of the liver. This most likely represents: - ANSReidel's lobe
Which of the following forms the caudal border of the left portal vein?
A. Ligamentum venosum
B. Hepatoduodenal ligament
C. Main Lobar Fissure
D. Coronary Ligament
E. Ligamentum teres - ANSLigamentum teres
What ligament divides the left lobe of the liver into medial and lateral segments? -
ANSLigamentum teres
You are asked to perform a Doppler study on the hepatic veins in the liver. What differentiates
the hepatic veins from the portal veins? - ANSThe portal veins are accompanied by branches of
the biliary tree and hepatic artery
You have detected a mass anterior and to the left of the ligamentum venosum. This mass is
located in what lobe of the liver? - ANSLeft Lobe of the Liver
The thin capsule surrounding the liver is known as: - ANSGlisson's capsule
, Which of the following course interlobar and intersegmental within the liver?
A. Bile ducts
B. Portal veins
C. Hepatic arteries
D. Lymphatics
E. Hepatic veins - ANSE. Hepatic Veins
You are performing an ultrasound exam of the liver on a small patient with a 5 MHz curved
linear array. Although you have increased the overall gain to its maximum setting, the posterior
border of the liver and diaphragm are not visualized. What should you do? - ANSRescan the
liver with a lower frequency transducer
*Lower frequency transducers provide greater penetration than higher frequency transducers.
Another way to increase the penetration is to increase the transmit power. Decreasing the
transmit power will decrease penetration. Moving the focal zone into the near field will not
improve penetration.
How would you correctly describe the probe placement and imaging plane you would use to
demonstrate the 3 hepatic veins and IVC in one view? - ANSSubcostal oblique approach with
the probe angled superiorly and to the patients right
You are performing a follow-up sonogram on a patient in which a 5-mm cyst was previously
identified at the anterior border if the left lobe of the liver. Although you are using a 3.5 MHz
curved linear array transducer, you do not see the cyst. What would be most helpful in
improving the visibility of this cyst? - ANSRescan the left lobe with a higher frequency
transducer
*Visibility of small cysts is limited by spatial resolution. To improve resolution, the best option is
to increase the imaging frequency.
You are imaging a patient with a high liver. Subcostal images do not clearly demonstrate the
liver tissue. What should you do? - ANSScan 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 method would improve visualization in this area of the liver? -
ANSPerform a subcostal scan with the probe angled superior and the patient in deep inspiration
A patient is referred for a liver ultrasound with a clinical history of elevated alpha-fetoprotein
level. What should you look for? - ANSHepatocellular Carcinoma (HCC)
* A non-pregnant patient with elevated levels of AFP may have hepatocellular carcinoma.
However, low levels of AFP do not rule out the presence of HCC. Other abnormalities
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