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Abdomen & Superficial Structures > Biliary System > Flashcards

Biliary System Flashcards

0
Q

At what point is the CBD formed?

A

when CHD & cystic duct anastomose, near hepatic artery

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1
Q

At what point is the CHD formed?

A

when R & L hepatic ducts anastomose, @ level of porta hepatis

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2
Q

normal diameter of CHD

A

4 mm

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3
Q

normal diameter of CBD

A

4 mm

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5
Q

structure that releases CCK

A

duodenum

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6
Q

hormone responsible for GB contraction

A

CCK

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7
Q

rule of thumb for CBD/CHD diameter

A

4 mm up to age 40, plus 1 mm for each decade afterward

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8
Q

relationship of CHD to right portal vein

A

anterior

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9
Q

relationship of CHD to right hepatic artery

A

anterolateral

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10
Q

relationship of CBD to main portal vein

A

anterior & right

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11
Q

connective tissue through which the CBD passes

A

through the hepatoduodenal ligament

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12
Q

normal CBD diameter, post-cholecystectomy

A

up to 10 mm

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13
Q

connective tissue through which the CHD passes

A

along free edge of lesser omentum

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14
Q

relationship of HA to MPV

A

anterior & left

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15
Q

relationship of CBD to HA

A

right

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16
Q

relationship of HA to CBD

A

left

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17
Q

relationship of MPV to HA

A

posterior & right

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18
Q

relationship of MPV to CBD

A

posterior & left

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19
Q

narrowest part of the extrahepatic biliary tract

A

intraduodenal/4th segment of CBD

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20
Q

intraduodenal CBD segment

A

4

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21
Q

infraduodenal CBD segment

A

3

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22
Q

retroduodenal CBD segment

A

2

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23
Q

supraduodenal CBD segment

A

1

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24
Q

CBD segment that enters 2nd part of duodenum

A

4

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25
Q

4th CBD segment

A

intraduodenal

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26
Q

3rd CBD segment

A

infraduodenal

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27
Q

2nd CBD segment

A

retroduodenal

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28
Q

1st CBD segment

A

supraduodenal

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29
Q

structure where the CBD enters the duodenum

A

sphincter of Oddi

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30
Q

function of the sphincter of Oddi

A

regulates bile flow

31
Q

From where does the cystic duct arise?

A

GB neck

32
Q

shape of cystic duct

A

S-shaped

33
Q

normal diameter of cystic duct

A

3-4 mm

34
Q

mucosal folds of the GB

A

spiral valves of Heister

35
Q

function of the spiral valves of Heister

A

structural

36
Q

normal diameter of intrahepatic ducts

A

2 mm

37
Q

path of intrahepatic ducts

A

with portal veins

38
Q

structural support feature of the GB

A

spiral valves of Heister

39
Q

relationship of GB to main lobar fissure

A

posterior & inferior to distal portion

40
Q

typical GB length

A

8-9 cm

41
Q

typical GB diameter

A

3-5 cm

42
Q

most dependent portion of GB in LLD

A

fundus

43
Q

most dependent portion of GB in supine

A

neck

44
Q

normal GB wall thickness

A

< 3 mm

45
Q

microscopic folds of epithelial cells along the inner border of the GB

A

RA sinuses

46
Q

normal volume of bile in the GB

A

40-70 mL

47
Q

How does the GB concentrate bile?

A

secretes mucous and absorbs water

48
Q

hormone released by duodenum to stimulate bile secretion

A

cholecystokinin

49
Q

CCK

A

cholecystokinin

50
Q

What does CCK stimulate?

A

stimulates GB contraction and relaxation of the sphincter of Oddi

51
Q

How long after a meal before the GB is contracted?

A

30 minutes

52
Q

effects of a cholecystectomy on the CBD & sphincter of Oddi

A

dilation of CBD up to 10 mm, initial loss of tone for sphincter of Oddi, sphincter of Oddi regains tone after 6 months

53
Q

main contents of bile

A

water, cholesterol, bilirubin, inorganic salts, bile acid salts

54
Q

amount of bile salts formed by the liver each day

A

1 gram

55
Q

common causes of jaundice

A

hemolytic anemia, hepatic disease, obstructive jaundice, inability of bilirubin to conjugate

56
Q

junctional fold

A

fold at GB body and neck

57
Q

GB infundibulum, aka

A

GB neck

58
Q

GB neck, aka

A

GB infundibulum

59
Q

Hartman’s pouch

A

outpouching of GB neck

60
Q

Phrygian cap

A

partial fold of GB fundus

61
Q

anatomical variant of GB exhibiting a fold btwn the GB body and neck

A

junctional fold

62
Q

anatomical variant of GB exhibiting a partial fold of the GB fundus

A

Phrygian cap

63
Q

anatomical variant of GB exhibiting an outpouching of the GB neck

A

Hartman’s pouch

64
Q

ideal location of CBD measurement

A

region of the porta hepatis, btwn HA and pancreatic head, not AT the hepatic artery

65
Q

where to place calipers on the CBD

A

inner wall to inner wall

66
Q

biliary indications of increased ALP in the blood

A

indicative of extrahepatic biliary obstruction

67
Q

biliary indications of increased conjugated bilirubin in the blood

A

indicative of bile duct disease, intra- or extrahepatic obstruction

68
Q

biliary indications of increased unconjugated bilirubin in the blood

A

indicative of hemolysis, abnormal hepatocellular uptake

69
Q

biliary indications of increased leukocytes in the blood

A

infection of GB or bile ducts, injury to bile ducts

70
Q

Which liver enzyme is found in the blood associated with extrahepatic biliary obstruction?

A

ALP

71
Q

Which test evaluates GB function?

A

HIDA (nuclear medicine)

72
Q

ERCP

A

endoscopic retrograde cholangiopancreatography

73
Q

Which test involves the injection of contrast material into the bile ducts and pancreatic ducts?

A

ERCP

Abdomen & Superficial Structures (7 decks)

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