Biliary System

Question 1

Parts of the biliary tract

Answer 1

• Gallbladder
• Bile ducts
• Intrahepatic ducts
• Right/left hepatic ducts
• Common hepatic duct
• Cystic duct
• Common bile duct
• Pancreatic ducts

Question 2

Area located along the posterior and inferior portion of the RLL

Answer 2

GB fossa

Question 3

Appearance of normal gallbladder

Answer 3

Partially filled balloon or pear-shaped

Question 4

3 parts of the gallbladder

Answer 4

Neck - the tapered portion that leads to the ductal system
Body - Mid portion of the GB
Fundus - rounded bottom of the pouch

Question 5

Normal length of GB

Answer 5

7 - 10 cm length
3 - 4 cm width
Walls should be < 3 mm

Question 6

In order to scan the GB how long should patients be NPO?

Answer 6

6 - 8 hours

Question 7

Which vessel supplies the gallbladder and liver

Answer 7

Proper hepatic artery

Question 8

Cystic artery originates directly from the..

Answer 8

Common hepatic artery

rarely from the gastroduodenal artery

Question 9

Venous drainage of the GB is by way of the ..

Answer 9

Hepatic portal system

Question 10

_______ is located in the duodenum, regulates the passage of bile into the duodenum and, at the same time, prevents reflux of the gastrointestinal fluids into the biliary system

Answer 10

Sphincter of Oddi

Question 11

Bile is produced by the..

Answer 11

Liver

Question 12

Bile is composed of..

Answer 12

82% of water
12% of bile acids
remainder includes cholesterol, bilirubin, proteins, electrolytes, and mucus

Question 13

Bile in the gallbladder vs. in the liver

Answer 13

More concentrated (In GB)

Question 14

The duodenal mucosa releases cholecystokinin when..

Answer 14

fats and amino acids are ingested

Question 15

Congenital Anomalies

Answer 15

• Bilobed
• Duplicated
• Septated or folded (normal variant)
• Phrygian cap (fundus)
• Hartmann’s pouch (infundibulum at neck)
• Junctional fold (neck or body

Question 16

Bile from liver reached GB through the..

Answer 16

hepatic and cystic ducts

Question 17

Left and right hepatic ducts are..

Answer 17

Intrahepatic (enclosed by liver tissue)

Question 17

Cystic duct connect the ____ to the ____

Answer 17

Gallbladder to the CHD

Question 18

Bile must pass through the ______ to reach the GB

Answer 18

Cystic duct

Question 19

Cystic duct normal length..

Answer 19

4 cm length
3 cm diameter

Question 20

The spiral valves of Heister

Answer 20

prevents duct from over distending or collapsing; can mimic gravel.

Question 21

CBD appears like a ______

Answer 21

Mickey mouse
due to the CBD being lateral and anterior to MPV (HA is medial and anterior)

Question 22

CBD normal length..

Answer 22

8 - 11 cm length
no more than 6 mm diameter

Question 23

CBD diameter post-cholecystectomy

Answer 23

up to 10 mm

Question 24

Reason for u/s exam of biliary system

Answer 24

- RUQ pain - Nausea - Vomiting - Positive Murphy's sign - Pain radiating to the right shoulder - Jaundice - loss of appetite - Intolerance to fatty foods or dairy

Question 25

GB possible complications

Answer 25

- GB and adjacent liver masses - Cholelithiasis (gallstones) - Possible obstruction of biliary system - Choledocholithiasis (stone in ductal system) - Cholecystitis (Inflammation of GB)

Question 26

Cholelithiasis

Answer 26

gallstones

Question 27

Choledocholithiasis

Answer 27

stone in ductal system

Question 28

Cholecystitis

Answer 28

Inflammation of GB