1.
What is the normal liver length along the right surface?
Correct Answer
C. 15-17 cm
Explanation
The normal liver length along the right surface is 15-17 cm. This measurement is within the range of typical liver lengths and is considered to be within the normal range.
2.
What separates the left lobe from the caudate lobe?
Correct Answer
B. Ligamentum Venosum
Explanation
The ligamentum venosum separates the left lobe from the caudate lobe. The ligamentum venosum is a fibrous band that is a remnant of the fetal ductus venosus. It runs along the inferior border of the liver and connects the left branch of the portal vein to the inferior vena cava. It acts as a landmark and helps to define the boundaries between the left lobe and the caudate lobe of the liver.
3.
Which of the following lies within the main lobar fissure?
Correct Answer
C. Middle hepatic vein
Explanation
The middle hepatic vein lies within the main lobar fissure. The main lobar fissure is a deep groove that separates the right and left lobes of the liver. The middle hepatic vein runs within this fissure, dividing the liver into two main segments: the right hepatic segment and the left hepatic segment. The other options, such as the main portal vein, right hepatic vein, and left hepatic vein, are not located within the main lobar fissure.
4.
Based on the segmental division of the liver, the quadrate lobe is the?
Correct Answer
B. Medial segment of the left lobe
Explanation
The quadrate lobe is the medial segment of the left lobe of the liver.
5.
You are asked to locate a mass found within The right posterior segment of the liver. Which vessel separates the right anterior segment of the liver from the right posterior segment?
Correct Answer
C. Right hepatic vein
Explanation
The right hepatic vein separates the right anterior segment of the liver from the right posterior segment. This vein drains blood from the right posterior segment and carries it back to the heart. The left hepatic vein drains blood from the left lateral segment, while the middle hepatic vein separates the right anterior segment from the left lateral segment. The main portal vein is responsible for delivering nutrient-rich blood to the liver from the digestive system.
6.
Which of the following statements regarding the differences between hepatic and portal veins is FALSE?
Correct Answer
D. Hepatic veins decrease in caliber as they course toward the diapHragm
Explanation
The correct answer is "Hepatic veins decrease in caliber as they course toward the diaphragm." This statement is false because hepatic veins actually increase in caliber as they course toward the diaphragm.
7.
Which of the following is both interlobar and intersegmental?
Correct Answer
C. Hepatic veins
Explanation
The hepatic veins are both interlobar and intersegmental. They are interlobar because they run between the lobes of the liver, connecting the lobes together. They are also intersegmental because they run between the liver segments, which are functional units of the liver. The portal vein, bile duct, and hepatic arteries are not interlobar or intersegmental structures.
8.
Which of the following supplies oxygenated blood to the liver?
Correct Answer
B. Hepatic artery
Explanation
The correct answer is the Hepatic artery. The hepatic artery is responsible for supplying oxygenated blood to the liver. It carries oxygen-rich blood from the heart to the liver, ensuring that the liver receives the necessary oxygen for its metabolic functions. The other options, such as the portal vein, hepatic veins, and hepatoduodenal artery, do not supply oxygenated blood to the liver.
9.
Which of the following functions does the liver NOT perform?
Correct Answer
C. Production of digestive enzymes amylase and lipase
Explanation
The liver performs various functions in the body, including the formation of bile, production of clotting factors, and storage of vitamins A, B12, and D. However, the liver does not directly produce digestive enzymes amylase and lipase. These enzymes are primarily produced by the pancreas and are involved in the breakdown of carbohydrates and fats, respectively.
10.
What structure sometimes makes the lateral aspect of the right liver lobe difficult or challenging to visualize?
Correct Answer
A. Costal margin
Explanation
The costal margin is a structure that sometimes obstructs the view of the lateral aspect of the right liver lobe. This is because the costal margin is the lower border of the ribcage and can partially cover the liver, making it challenging to visualize the liver from a lateral perspective.
11.
What is the normal echo amplitude relationship between the pancreas, kidney, and liver parenchyma starting with the most hyperechoic and progressing to the least hyperechoic?
Correct Answer
C. Pancreas, liver, kidney
Explanation
The correct answer is Pancreas, liver, kidney. This is because the pancreas is typically the most hyperechoic (brighter) compared to the liver and kidney. The liver is usually less hyperechoic than the pancreas but more hyperechoic than the kidney. The kidney is typically the least hyperechoic (darker) compared to the pancreas and liver. Therefore, the normal echo amplitude relationship, starting with the most hyperechoic and progressing to the least hyperechoic, is Pancreas, liver, kidney.
12.
Approximately what percentage of the liver his blood is supplied by the portal system?
Correct Answer
C. 75
Explanation
The correct answer is 75. The portal system is responsible for supplying approximately 75% of the blood to the liver. This system carries nutrient-rich blood from the digestive organs, such as the stomach and intestines, to the liver for processing and detoxification. The remaining 25% of the liver's blood supply comes from the hepatic artery, which carries oxygen-rich blood from the heart.
13.
On a transverse scan, the right portal vein is the landmark because it separates what liver structures?
Correct Answer
B. Right hepatic anterior and posterior segments
Explanation
The right portal vein separates the right hepatic anterior and posterior segments of the liver.
14.
What is the basic functional unit of the liver?
Correct Answer
C. Liver lobule
Explanation
The liver lobule is the basic functional unit of the liver. It is a small, hexagonal-shaped structure that consists of hepatocytes (liver cells) arranged in a radial pattern around a central vein. The lobule is responsible for performing various functions of the liver, such as detoxification, metabolism, and synthesis of proteins. The hepatocytes within the lobule work together to process and filter blood, produce bile, and carry out other essential liver functions. Therefore, the liver lobule is the fundamental building block that allows the liver to carry out its vital role in maintaining overall health and homeostasis.
15.
A 61-year-old man with elevated bilirubin has several gallbladder calculi and dilated hepatic ducts. What is a likely explanation when sonography visualizes that the right lobe has a normal echo pattern but extends quite far into the abdominal cavity?
Correct Answer
D. Reidel's lobe
Explanation
Reidel's lobe is a condition where the right lobe of the liver extends further into the abdominal cavity than usual. This can be visualized on sonography as a normal echo pattern of the right lobe but with an extended appearance. In this case, the elevated bilirubin levels and presence of gallbladder calculi and dilated hepatic ducts suggest an underlying liver or biliary pathology. Reidel's lobe is a benign condition and is not associated with neoplasm, abscess, or metastases.
16.
What anatomy is associated with the word costal?
Correct Answer
C. Ribs
Explanation
The word "costal" is associated with ribs. This term refers to anything related to the ribs, such as the costal cartilage or the intercostal muscles. It is commonly used in medical terminology to describe structures or conditions involving the ribs. The other options, such as gallbladder, biliary system, and liver, are not anatomically associated with the term "costal".
17.
What liver structure has been confused as a pancreatic head mass?
Correct Answer
B. Caudate lobe
Explanation
The caudate lobe of the liver is located posteriorly and can be mistaken for a pancreatic head mass due to its proximity to the pancreas. The falciform ligament is a fold of peritoneum that attaches the liver to the anterior abdominal wall. The quadrate lobe is a small portion of the liver located between the gallbladder and the ligamentum teres. The portal triad refers to the hepatic artery, portal vein, and bile duct that run together within the liver.
18.
To determine the physiological function of the liver, you would select which imaging modality?
Correct Answer
D. Nuclear medicine
Explanation
Nuclear medicine would be selected to determine the physiological function of the liver because it uses radioactive tracers to create images of the organ and detect any abnormalities or diseases. This imaging modality allows for the evaluation of liver function, such as blood flow, metabolism, and the uptake and excretion of substances. It provides valuable information about the liver's overall health and can help diagnose conditions like liver cancer, cirrhosis, and hepatitis.
19.
Which of the following laboratory tests CANNOT evaluate liver function?
Correct Answer
D. BUN
Explanation
BUN (Blood Urea Nitrogen) is a laboratory test that evaluates kidney function, not liver function. The liver function is typically assessed using tests such as ALT (Alanine Aminotransferase), AST (Aspartate Aminotransferase), and ALP (Alkaline Phosphatase). These tests measure the levels of enzymes produced by the liver and can indicate liver damage or disease. BUN, on the other hand, measures the amount of urea nitrogen in the blood, which is a waste product filtered by the kidneys. Therefore, BUN is not suitable for evaluating liver function.
20.
You receive an order for abdominal sonogram with an indication of an elevated AFP. Based on the results what pathology are you looking for?
Correct Answer
C. Hepatocellular carcinoma
Explanation
An elevated AFP (alpha-fetoprotein) is a tumor marker commonly associated with hepatocellular carcinoma, a type of liver cancer. Therefore, when receiving an order for an abdominal sonogram with an indication of an elevated AFP, the pathology that the healthcare professional would be looking for is hepatocellular carcinoma.
21.
Which of the following is NOT a diffuse liver disease?
Correct Answer
B. Hepatoma
Explanation
Hepatoma is not a diffuse liver disease because it refers to a specific type of liver cancer, also known as hepatocellular carcinoma. Diffuse liver diseases, on the other hand, involve widespread damage or inflammation throughout the liver, such as fatty infiltration, cirrhosis, and hepatitis.
22.
The liver is surrounded by a fibrous capsule called______? And is located within the abdominal cavity.
Correct Answer
Glisson
Explanation
The fibrous capsule that surrounds the liver is called Glisson. It is located within the abdominal cavity.
23.
After birth, the ductus venosus closes to becomes the ________ and the left umbilical vein's become the ________?
Correct Answer
Ligamentum Venosum
Ligamentum teres
Explanation
After birth, the ductus venosus, which is a blood vessel that connects the umbilical vein to the inferior vena cava, closes and becomes the Ligamentum Venosum. The left umbilical vein, which carries oxygenated blood from the placenta to the fetus, also closes and becomes the Ligamentum teres. These changes occur as part of the normal development and adaptation of the circulatory system in the newborn.
24.
The anatomic division divides the liver into four lobes. Select all that apply .
Correct Answer(s)
A. Right lobe
B. Left lobe
E. Caudate lobe
F. Quadrate lobe
Explanation
The liver is anatomically divided into four lobes: the right lobe, left lobe, caudate lobe, and quadrate lobe. The right lobe is the largest lobe and is located on the right side of the liver. The left lobe is located on the left side of the liver. The caudate lobe is a smaller lobe located on the posterior surface of the liver. The quadrate lobe is a small lobe located on the undersurface of the liver. These divisions help in understanding the structure and function of the liver.
25.
The portal triad is made up of all the following EXCEPT?
Correct Answer
D. Aorta
Explanation
The portal triad is a structure found in the liver that consists of the portal vein, bile duct, and hepatic artery. These three structures work together to supply the liver with blood and nutrients, as well as to remove waste products. The aorta, on the other hand, is a major artery that carries oxygenated blood from the heart to the rest of the body, and is not part of the portal triad.
26.
The intersegmental fissure divides the left lobe into anterior and posterior segments?
Correct Answer
B. False
Explanation
Medial and lateral
27.
On a longitudinal image which major vessel courses posterior to the left lobe and it's to the left of the midline?
Correct Answer
A. Aorta
Explanation
On a longitudinal image, the major vessel that courses posterior to the left lobe and is to the left of the midline is the Aorta.
28.
Which of the following supplies the liver with blood that is rich in nutrients?
Correct Answer
B. Portal vein
Explanation
The correct answer is the portal vein. The portal vein is responsible for supplying nutrient-rich blood to the liver. It collects blood from the digestive organs, such as the stomach and intestines, and carries it to the liver for processing and detoxification. This blood contains nutrients that have been absorbed from the digestive system, allowing the liver to perform its various functions, including metabolism and storage of nutrients. The other options listed, such as the aorta, IVC, and hepatic artery, do not specifically supply the liver with blood that is rich in nutrients.
29.
Which term describes enlargement of the liver?
Correct Answer
D. Hepatomegaly
Explanation
Hepatomegaly is the term used to describe the enlargement of the liver. It is a medical condition where the liver becomes larger than its normal size. This can be caused by various factors such as liver diseases, alcohol abuse, certain medications, or infections. Hepatomegaly can be detected through physical examination, imaging tests, or blood tests. Treatment for hepatomegaly involves addressing the underlying cause and may include lifestyle changes, medications, or in severe cases, surgery.
30.
Which vessel is formed by the junction of the splenic and superior mesenteric vein?
Correct Answer
D. Portal vein
Explanation
The correct answer is Portal vein. The portal vein is formed by the junction of the splenic and superior mesenteric veins. It is responsible for carrying blood from the gastrointestinal tract and spleen to the liver.
31.
Which vessel branches off the celiac axis and supplies the liver with oxygenated blood?
Correct Answer
C. Hepatic artery
Explanation
The hepatic artery branches off the celiac axis and supplies the liver with oxygenated blood. The celiac axis is a major branch of the abdominal aorta, which supplies blood to various abdominal organs. The hepatic artery specifically delivers oxygen-rich blood to the liver, ensuring that the liver receives the necessary nutrients and oxygen for its metabolic functions. The portal vein, on the other hand, carries nutrient-rich blood from the digestive organs to the liver for processing, while the hepatic vein drains deoxygenated blood from the liver back to the heart.
32.
Which vessels are usually identified first by the fibrous connective tissue you that surrounds them and provides a bright echogenic pattern?
Correct Answer
C. Portal veins
Explanation
The fibrous connective tissue that surrounds the portal veins usually provides a bright echogenic pattern, making them easily identifiable. The hepatic artery and hepatic veins may also be surrounded by fibrous connective tissue, but it is the portal veins that are typically identified first due to their distinct echogenic appearance. The aorta is not typically surrounded by fibrous connective tissue and does not exhibit the same bright echogenic pattern as the portal veins.
33.
What is the relationship for the amount of AST in the blood compared to the number of cells damaged and to the time interval between injury and test?
Correct Answer
D. Direct proportion
Explanation
The relationship between the amount of AST in the blood and the number of cells damaged as well as the time interval between injury and test is a direct proportion. This means that as the number of cells damaged and the time interval increase, the amount of AST in the blood also increases. There is a direct correlation between these variables, indicating that the more cells are damaged and the longer the time since the injury, the higher the amount of AST in the blood.
34.
Which vessels converge to form three large trunks that drain into the IVC?
Correct Answer
D. Hepatic veins
Explanation
The hepatic veins converge to form three large trunks that drain into the inferior vena cava (IVC). These veins carry deoxygenated blood from the liver back to the heart.
35.
How are hepatic veins distinguished from the portal venous system?
Correct Answer
C. They can be seen draining into the IVC
Explanation
Hepatic veins are distinguished from the portal venous system by the fact that they can be seen draining into the IVC (inferior vena cava). The portal venous system, on the other hand, carries blood from the digestive organs to the liver. This differentiation is important in understanding the flow of blood within the liver and its circulation throughout the body.
36.
Using couinaud's method of liver segmentation, what provides the boundaries for each segment?
Correct Answer
A. Hepatic veins
Explanation
In Couinaud's method of liver segmentation, the boundaries for each liver segment are provided by the hepatic veins. The hepatic veins are responsible for draining deoxygenated blood from the liver and they divide the liver into distinct segments based on their anatomical distribution. Therefore, the hepatic veins play a crucial role in determining the boundaries of each segment in Couinaud's method of liver segmentation.
37.
On a supine longitudinal section, what organ should be visualized posterior to the left hepatic lobe and anterior to the splenic artery and vein?
Correct Answer
A. Pancreas
Explanation
On a supine longitudinal section, the organ that should be visualized posterior to the left hepatic lobe and anterior to the splenic artery and vein is the pancreas. The pancreas is located deep in the abdomen, behind the stomach and in front of the spine. In this specific section, it is positioned between the left hepatic lobe and the splenic artery and vein.
38.
Useful clinical history and clinical symptoms the sonographer should be aware of in a patient who presents with acute abdominal pain include all of the following except :
Correct Answer
D. Weight
Explanation
In a patient presenting with acute abdominal pain, useful clinical history and symptoms that the sonographer should be aware of include past history, previous diagnostic examinations and pertinent laboratory findings, age, and present condition. However, weight is not typically considered as a relevant factor in assessing the cause of acute abdominal pain.
39.
Central upper abdominal pain most likely would be associated with which of the following diseases?
Correct Answer
C. Acute pancreatitis
Explanation
Central upper abdominal pain is a characteristic symptom of acute pancreatitis. Acute pancreatitis is inflammation of the pancreas, which can be caused by various factors such as gallstones, alcohol consumption, or certain medications. The pain is typically severe and may radiate to the back. Other symptoms of acute pancreatitis may include nausea, vomiting, fever, and abdominal tenderness. Crohn's disease, diverticulitis, and PID may cause abdominal pain, but they are not specifically associated with central upper abdominal pain.
40.
Distribution of blood to the liver, spleen, and stomach occurs via the?
Correct Answer
B. Celiac trunk
41.
When Venous obstruction occurs within the liver or an extrahepatic portal veins, which condition exists?
Correct Answer
B. Portal hypertension
Explanation
When venous obstruction occurs within the liver or an extrahepatic portal veins, the condition that exists is portal hypertension. This refers to an increase in blood pressure within the portal vein system, which carries blood from the gastrointestinal tract, spleen, and pancreas to the liver. The obstruction can be caused by various factors such as liver cirrhosis, blood clots, or tumors. Portal hypertension can lead to complications such as variceal bleeding, ascites, and hepatic encephalopathy.
42.
As portal venous flow to the liver decreases, hepatic arterial flow…
Correct Answer
B. Increases
Explanation
As portal venous flow to the liver decreases, hepatic arterial flow increases. This is because the liver needs a constant supply of blood to function properly, and when the portal venous flow decreases, the liver compensates by increasing the flow through the hepatic artery. This ensures that the liver continues to receive enough oxygen and nutrients to carry out its metabolic functions.
43.
Clinical signs of hepatic vein obstruction are characterized by all of the following except:
Correct Answer
B. Shrunken liver
Explanation
Clinical signs of hepatic vein obstruction are characterized by hepatomegaly, ascites, and pain. Shrunken liver is not a characteristic clinical sign of hepatic vein obstruction.
44.
The location and distribution of intraperitoneal fluid are influenced by all the following except:
Correct Answer
C. Respiration
Explanation
The location and distribution of intraperitoneal fluid are influenced by patient position, viscosity of the fluid, and personnel adhesions. Respiration, however, does not affect the location and distribution of intraperitoneal fluid.
45.
The triphasic waveform seen in the hepatic veins reflect the contractility of the?
Correct Answer
A. Right atrium
Explanation
The triphasic waveform seen in the hepatic veins reflects the contractility of the right atrium. This is because the hepatic veins drain blood from the liver back into the heart, specifically into the right atrium. The triphasic waveform indicates the contraction and relaxation of the right atrium as it receives blood from the body and prepares to pump it into the right ventricle. Therefore, the correct answer is the right atrium.
46.
The adult liver is considered enlarged after the Anteroposterior diameter exceeds
Correct Answer
C. 15 cm
Explanation
The adult liver is considered enlarged after the Anteroposterior diameter exceeds 15 cm. This measurement is used to determine if the liver is larger than normal, which could be indicative of various liver diseases or conditions. A liver enlargement of 15 cm or more suggests that there may be an underlying issue that needs to be further investigated and treated.
47.
Gain settings should be placed to demonstrate the normal liver as a medium shade of gray
Correct Answer
A. True
Explanation
The gain settings should be adjusted to display the normal liver as a medium shade of gray because this ensures optimal visualization of the liver tissue. If the gain settings are too high, the liver will appear too bright and may obscure any abnormalities or subtle differences in tissue texture. On the other hand, if the gain settings are too low, the liver will appear too dark and details may be missed. Therefore, setting the gain to display the liver as a medium shade of gray allows for accurate interpretation of the ultrasound image.
48.
Which of the following structure separates the left lobe of the liver from the right lobe?
Correct Answer
C. Middle hepatic vein and main lobar fissure
Explanation
The middle hepatic vein and main lobar fissure separate the left lobe of the liver from the right lobe. The middle hepatic vein is located in the middle of the liver and divides the liver into two major lobes, while the main lobar fissure is a deep groove that runs along the liver's surface and further separates the left and right lobes. Therefore, this combination of structures is responsible for the anatomical separation of the left and right lobes of the liver.
49.
The right lobe of the liver is separated into anterior and posterior segment by the:
Correct Answer
C. RHV
Explanation
The right lobe of the liver is divided into anterior and posterior segments by the right hepatic vein (RHV). The RHV is one of the major veins that drains blood from the liver. It runs through the liver and separates the two segments, allowing for separate blood supply and drainage. This division is important for surgical procedures and understanding the anatomy of the liver.
50.
Which of the following hepatic structures is interlobar in location?
Correct Answer
C. Hepatic vein
Explanation
The hepatic vein is interlobar in location. It is located between the liver lobes and carries deoxygenated blood from the liver to the inferior vena cava. The hepatic artery, portal vein, and biliary duct are all located within the liver but are not specifically interlobar in location.