3C-Gall Bladder

Question 1

NAME THOSE DUCTS! Bile is secreted by hepatocytes into the bile ______, from which it flows in the ___________ —–>________ and then into the gallbladder via the ______.

Answer 1

canaliculi…right & left hepatic ducts….common hepatic duct…cystic duct

Question 2

Plumbing: Bile is stored until stimulation of gall bladder contractions expels the bile back through the ______ into the __________ and, via the ________, into the duodenum.

Answer 2

cystic duct….common bile duct….sphincter of Oddi

Question 3

What are the two results of CCK release from the intestine on the bile pathway?

Answer 3

1. Contract the gall bladder smooth muscle 2.Relax the Sphincter of Oddi

Question 4

What does Secretin do to the bile pathway?

Answer 4

Stimulates Water and Ion secretion by the bile ducts.

Question 5

What effect does Ach (parasym) have on the bile pathway?

Answer 5

Contracts the SMOOTH muscle of the gall bladder.

Question 6

What causes the gall bladder to relax?

Answer 6

Sympathetic action on BETA-2 receptors on the gall bladder (relaxed) and the sphincter of Oddi (closed)!!!

Question 7

What are the 4 symptoms of acute Chole-cystitis?

Answer 7

1.Right upper quadrant pain 2.fever 3.Leukocytois 4.refered pain to the shoulder/back.

Question 8

What is the most common association with chronic cholecystitis?

Answer 8

presence of gall stones (causes fibrosis/thickening of GB)

Question 9

What are the two main complications from untreated acute cholecystitis?

Answer 9

Gangrene and Perforation

Question 10

What is the medical term for presence of gallstones?

Answer 10

Chole-LITH-iasis

Question 11

Are gallstones more common in women or men?

Answer 11

Women. 20% of women and 5% of men between the ages of 50 and 65 have gallstones.

Question 12

What % of gall stones are cholesterol stones?

Answer 12

90%

Question 13

What are three factors involved in formation of cholesterol gall stones?

Answer 13

1.Bile Stasis 2.Saturation of Cholesterol 3.Inflammation

Question 14

Many persons with gallstones have what symptoms? Gallstones cause symptoms when they obstruct bile flow. Small stones (e.g. – __________) may pass into the common bile duct, producing symptoms of _______ and _______. Larger stones are more likely to obstruct flow and cause ________.

Answer 14

NO early symptoms…

Question 15

What is the pain felt by a gall stone in the cystic duct?…It can often fall back into the GB and stop pain.

Answer 15

Biliary Colic

Question 16

What are the 7 risk factors for CholeLithiasis?

Answer 16

1.Gender (women) 2.Pregnancy(hormones) 3.Oral Contraceptives 4.Genetics 5.Obesity 6.RAPID weight loss 7.Diabetes Mellitus

Question 17

What are the 3 types of stones that can arise in cholelithiasis?

Answer 17

1.Cholesterol stones 2.Black Pigment stones(blood) 3.brown pigment stones (biliary infection)

Question 18

Do we need a gall bladder? What structure can become dilated after a cholecystectomy?

Answer 18

NOPE, Common Bile duct can become dilated after time and dump more bile into the duodenum (Vanessa’s story)

Question 19

What are the 3 instruments used for a laparoscopic cholecystectomy?

Answer 19

1.Cannula(tube) 2.Laparoscope(telescope) 3.Cameras