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Block II Exam > Biliary System: bile, gallbladder, spleen > Flashcards

Biliary System: bile, gallbladder, spleen Flashcards

1
Q

If there is a tumor in the head of the pancreas, which duct will most likely be obstructed?

A

Common bile duct

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2
Q

What duct is located at the head of the pancreas and receives contents from cystic and hepatic duct?

A

bile duct

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3
Q

Obstruction of the bile duct results in pain and ___.

A

Jaundice

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4
Q

Above the cystic duct insertion is what duct?

A

The common hepatic duct

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5
Q

Below cystic duct insertion is what duct?

A

Bile duct

“Below is Bile”

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6
Q

Which duct drains the liver?

A

Common hepatic duct

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7
Q

Bile exits the hepatic duct and enter what duct into the gallbladder?

A

The cystic duct

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8
Q

What artery will supply the pancreas if the gastroduodenal artery is occluded/ligated?

A

Superior mesenteric artery

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9
Q

What artery is found at the free edge of the hepatoduodenal ligament?

A

The proper hepatic artery

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10
Q

What are the three structures that make up the portal triad?

A

hepatic portal vein
hepatic proper artery
bile duct

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11
Q

What are the symptoms of bile being in the bloodstream (reverse of flow)?

A

yellow eyes and jaundice

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12
Q

If the common bile duct is obstructed, what will be the collateral pathway for drainage of bile from the liver or gallbladder?

A

There is no collateral pathway for drainage.

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13
Q

What is the job of the pancreatic duct?

A

Not involved in the flow of bile. Drains pancreatic enzymes from duodenum.

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14
Q

Obstruction of right or left hepatic duct will still allow drainage from liver and gallbladder. True or False.

A

True

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15
Q

Obese, Nausea and intermittent, acute pain in upper right abdomen, jaundice are all symptoms as a result of what duct being obstructed

A

Common bile duct

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16
Q

What artery supplies the spleen as it crosses and supplies the tail of the pancreas?

A

Splenic artery

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17
Q

Uncinate of the pancreas is referring to what part of the pancreas

A

The inferior part of the head

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18
Q

What supplies the uncinate process of the pancreas?

A

Branches of the SMA— inferior (posterior and anterior) pancreaticduodenal arteries

A uncinate tumor can compress the SMA

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19
Q

What vein is formed by the confluence of the SMV and splenic vein, and passes deep to the neck of the pancreas?

A

Portal vein

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20
Q

cholecystitis combined with jaundice indicates a blockage of release of bile into the duodenum are signs of what duct being occluded?

A

The common bile duct

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21
Q

What is cholecystitis?

A

Inflammation of the gallbladder; most frequently associated with the presence of gallstones

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22
Q

What causes obstructive jaundice?

A

Obstruction in the common hepatic duct and common bile duct; preventing communication between the liver and duodenum

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23
Q

What causes pancreatitis?

A

occlusion of pancreatic duct

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24
Q

Cholecystokinin cause the release of?

A

Bile from the gallbladder

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25
Q

Bile leaves cystic duct to enter what two ducts before reach the duodenum?

A

Common bile duct and hepatopancreatic ampulla (of vater)

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26
Q

What transmits the proper hepatic artery, portal vein, common hepatic duct, autonomic nerves, and lymph vessels?

A

Porta hepatis

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27
Q

Portal hypertension, fatty stool, malnutrition, and liver hypoxia are symptoms of a tumor in what region?

A

Porta hepatis

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28
Q

To remove the gallbladder safely, surgeon must clamp what artery?

A

The cystic because it supplies the gallbladder

29
Q

A laceration of what organ causes hypovolemic shock and severe blood loss?

A

Spleen

30
Q

Spleen rests against the diaphragm and what ribs?

A

9,10,11 in the left hypochondriac regi on

31
Q

Pain in the umbilical region can be indicative of referred pain from __?

A

Large intestine, colon

32
Q

Gallstones can ulcerate through the wall of the fundus of the gallbladder into the:

A

through the transverse colon

33
Q

Gallstones can ulcerate through the wall of the body of the gallbladder into the:

A

duodenum

34
Q

Air accumulation in the gallbladder and biliary tree signifies that there is gallstone obstruction in the hepatic duct or common bile duct. True or false

A

False

35
Q

Gallstones can pass freely through what?

A

Small intestines

36
Q

Gallstones will likely occur where ?

A

in the common bile duct and neck of gallbladder—

37
Q

Gallstones are made of

A

cholesterol or bilirubin

38
Q

What kind of gallstone (cholelith) ulcerates through the body of the gallbladder and into the duodenum?

A

gallstone ileus

39
Q

episodes of pain with rushes, gurgling, and tingling sounds are heard upon auscultation and obstruction of the bowel shown on CT scan is most likely due to an obstruction of what

A

Ileocecal junction

40
Q

What is Kerh’s sign ?

A

A clinical indication of a ruptured spleen and is characterized by intense radiating pain to the left shoulder.

41
Q

What is Mittelschmerz?

A

This can occur in the middle of a woman’s menstrual cycle when the Graafian follicle ruptures and the ovum is released from the ovary.

42
Q

What is a clinical indication of gallbladder inflammation and pain referred in the right shoulder, also owing to diaphragmatic irritation.

A

Rovsing’s sign

43
Q

What is the importance of iliopsoas muscle?

A

if the kidney, ureters, cecum, appendix, appendix, sigmoid colon, pancreas, lumbar lymph nodes, and nerves to posterior abdominal wall are diseases, a positive sign will be observed.

44
Q

The obturator sign may cause painful spasms of what muscle?

A

adductor muscles of the thigh and sensory deficits in the medial thigh.

45
Q

The cystic duct contains what valve which is a redundant mucosal fold that maintains patency of the duct.

A

spiral valve (of Heister)—does not direct the flow of bile

46
Q

What could be a point of constriction with inserting a catheter into the cystic duct?

A

spiral valve (of Heister)

47
Q

Bile peritonitis is caused by the leaking of what structure?

A

The ducts of Luschka (not present in all individuals)

48
Q

What procedure is the removal of the gallbladder?

A

Cholecystectomy

49
Q

The cystic duct, right hepatic artery and cystic artery are removed/ligated during what procedure?

A

Cholecystectomy

50
Q

Pancreatic pseudocyst is likely to occur where?

A

On the floor of the omental bursa.—which is anterior to the pancreas

51
Q

What major vessel is most likely obstructed if there is a tumor at the neck of the pancreas?

A

Portal vein—splenic vein drains pancreas and empties it here.

52
Q

Physical examination reveals epigastric pain that migrates towards patient’s right side and posterior to the scapula. Jaundice does not occur. Where is the gallstone located?

A

Hartmann’s pouch

53
Q

Where is Hartmann’s pouch located?

A

at the junction of the neck and the cystic duct of gallbladder

54
Q

No jaundice in the presence of a gallstone is a sign that the gallstone occurs where?

A

in the Hartmann’s pouch

55
Q

Obstruction of pancreatic duct could cause pain in what region?

A

umbilical region

56
Q

The hepatopancreatic ampulla (also known as ampulla vater) is located at the junction of

A

pancreatic and common bile duct and common bile duct.

57
Q

If Indirect inguinal hernia is present and causes groin pain. What nerve is most likely affected?

A

Ilioinguinal nerve

58
Q

If there is a perforating ulcer in the third part of the duodenum, then it will affect what structures?

A

Aorta and inferior vena cava

59
Q

The third part of the duodenum is crossed by what structure?

A

The SMA

60
Q

What are the borders of the cystohepatic triangle (of Calor)?

A

Inferior border of liver
Common hepatic duct
Cystic Duct

61
Q

Which of the following structures within the triangle of Calot may be identified and ligated during a cholecystectomy

A

triangle of Calot

62
Q

During a cholecystectomy which organs cannot be seen directly?

A

Retroperitoneal organs

63
Q

The bile duct and the main pancreatic duct join at the ampulla of Vater to open into the beginning portion of what structure?

A

Second part of duodenum

64
Q

Visceral afferent postganglionic fibers from pancreas (accompany sympathetic nerves are) are located where?

A

In the celiac ganglia

65
Q

What nerves innervates the foregut?

A

Visceral Sympathetic nerves

66
Q

Foregut structures have relations to what plexus and ganglion?

A

Celiac

67
Q

Midgut structures have relations to what plexus and ganglion?

A

Superior mesenteric

68
Q

Hindgut structures have relations to what plexus and ganglion?

A

Inferior mesenteric

Block II Exam (16 decks)

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