3C A&P and Pathology of Gall bladder

Question 1

Where does bile flow from the bile canaliculi?

Answer 1

R/L hepatic ducts, common hepatic duct, and then into the gallbladder via the cystic duct

Question 2

Which sphincter must the bile pass to get into the duodenum?

Answer 2

Sphincter of Oddi

Question 3

What does CCK do?

Answer 3

Contracts gall bladder and relaxes the sphincter of Oddi

Question 4

What does secretin do?

Answer 4

Stimulates ion and water secretion by the bile ducts

Question 5

What does ACh do?

Answer 5

Contracts gall bladder, basically a ParaSNS response

Question 6

What relaxes the gall bladder to fill during the interdigestive periods?

Answer 6

SNS via beta-2 receptors relaxes gall bladder to fill and the sphincter of Oddi is closed

Question 7

What is cholecystitis?

Answer 7

RUQ pain, fever, and leukocytosis associated with gall bladder inflammation usually related to gallstone disease

Question 8

What are associated complaints of chelycystitis?

Answer 8

Nausea, vomiting, anorexia

Question 9

What does chronic cholecystitis lead to?

Answer 9

Fibrosis and thickening of the gallbladder

Question 10

What are the complications of cholecystitis?

Answer 10

May abate in 7-10 days. Most common complication is the development of gallbladder gangrene (up to 20% of cases) and subsequent perforation (up to 2% of cases)

Question 11

Cholelithiasis (gallstone presence) increases with what?

Answer 11

Age as 20% of women and 5% of men b/w 50 and 65 have gallstones

Question 12

In US and europe, what kind of gall stones are 90% of the time?

Answer 12

Cholesterol stones

Question 13

what are the three factors involved in the formation of cholesterol stones?

Answer 13

Bile stasis (sludge)
Supersaturation of bile with cholesterol
Inflammation of gallbladder

Question 14

T/F many persons with gallstones have no symptoms?

Answer 14

T

Question 15

What is biliary colic usually caused by?

Answer 15

gall bladder contracting in response to hormonal and neural stimulation, usually due to a fatty meal, forcing a stone against the gallbladder outlet or cystic duct opening and leading to pain thoracic/lumbar, the right shoulder/ scapula

Question 16

What are the risk factors for cholelithiasis?

Answer 16

Gender - higher in women.
Pregnancy - sex hormones cause bile to become supersaturated with cholesterol
Oral contraceptive use
Obesity
Rapid weight loss
Diabetes

Question 17

90% of gall stones are cholesterol, what are the other 10%?

Answer 17

Black pigment stones and brown pigment stones

Question 18

Is the gall bladder essential for life?

Answer 18

NO, can survive w/o