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Flashcards in Biliary system and UGI Deck (166):
1

Radiographic examination of the biliary system involves studying the manufacture, transport and storage of what?

bile

2

How much does the liver weigh?

3-4 pounds

3

What is the largest solid organ in the body?

liver

4

the liver occupies most of what quadrants?

RUQ & LUQ

5

how long is the widest part of the liver?

8-9 inches

6

what is the largest vertical dimension of the liver?

6-7 inches

7

what is the flow of bile?

liver-right & left hepatic duct-common hepatic duct-cystic duct-galbladder-cystic duct-common bile duct-hepatopancreatic ampulla-hepatopancreatic sphincter-duodenum of small intestine

8

what is the hepatopancreatic ampulla also called?

ampulla of vater

9

what is the hepatopancreatic sphincter also called?

sphincter of oddi

10

two major lobes of the liver are divided by what?

falciform ligament

11

what are the 2 major lobes of the liver?

right and left lobe

12

two minor lobes located on the medial aspect of the right lobe?

quadrate lobe or caudate lobe

13

what is the hilum of the liver called?

porta hepatitis

14

where is the hilum of the liver located

between 2 minor lobes

15

what function of the liver is most applicable to radiographic studies?

production of bile

16

how much bile does the liver secrete daily?

800-1000ml (1 quart)

17

what is the major function of bile?

to aid in the digestion of fats by emulsifying fat globules and the absorption of fat following its digestion

18

what is bile made of?

liquid substance composed of mainly bile salts, bile pigments, cholesterol and water

19

what facilitates the absorption of fats?

bile salts

20

if bile contains either insufficient bile salts or excessive cholesterol the cholesterol may form what?

gallstones

21

bile formed int he liver and travels to what ducts

right and left hepatic

22

hepatic ducts join to form ?

common hepatic duct

23

how much bile does the gallbladder hold?

30-40mL of bile

24

how big is the gallbladder?

7-10cm (3-4in long)

25

3 main parts of the gallbladder?

fundus, body and neck

26

the neck of the gallbladder continues on to form what?

cystic duct

27

How long is the cystic duct?

3-4 cm long

28

the cystic ducts contains folds called?

spiral valve

29

what is the function of the spiral valves?

prevent distention or collapse of cystic duct

30

3 primary functions of the gallbladder?

store, concentrate bile and contract when stimulated

31

bile is concentrated within the gallbladder as a result of a process called?

hydrolysis (removal of water)

32

what is choleliths?

gallstones

33

what forms the most common type of gallstones?

cholesterol coming out of solution

34

the foods stimulate the mucosa of the duodenum to secrete a hormone called?

cholecystokinin

35

what does cholecystokinin do in the pancreas?

stimulates the pancreas to secrete pancreatic juice and cause the hepatopancreatic sphincter to relax, which permits the flow of both bile and pancreatic juice into the duodenum

36

how long is the common bile duct?

7.5 cm long

37

where is the common bile duct located?

descends behind superior portion of duodenum and head of pancreas to enter descending portion of the duodenum

38

what is the pancreatic duct also called?

duct of wirsung

39

what two ducts come together to form the hepatopancreatic ampulla?

common bile duct and pancreatic duct

40

pancreatic duct and common bile duct remain separated in what % of people?

40%

41

what is a common site for impaction of gallstones?

hepatopancreatic ampulla

42

the presence of the hepatopancreatic sphincter causes a protrusion into the lumen of the duodenum known as what?

duodenal papilla

43

what position places the gallbladder closer to the IR?

prone

44

what does the supine position do for the gallbladder?

drain the gallbladder into the duct system

45

contrast medium was ingested orally for a cholecystogram and was called ?

oral cholecystogram (OCG)

46

what are the 4 advantages of US of the gallbladder over ocg's

no ionizing radiation, able to detect small calculi, no contrast medium, less patient prep

47

what does chole- mean?

relationship with bile

48

what does cysto- mean?

bag or sac

49

what does choledocho-

common bile duct

50

what does cholangio- mean

bile duct

51

what does cholecyst-mean ?

gallbladder

52

what does choledocholithiasis mean?

presence of having stones in the biliary ducts

53

what are some symptoms of choledocholithiasis

pain, jaundice, tenderness in RUQ, pancreatitis

54

what are the 4 F's for gallstones?

female, fat, forty, and fertile

55

what percent of gallstones are radiolucent?

85-90%

56

what is milk calcium bile?

Emulsion of biliary stones in the gallbladder, emulsion builds up of calcium deposits within gallbladder may be difficult to diagnose with ocg

57

what is cholecystitis?

inflammation of the gallbladder, can be acute or chronic

58

what is neoplasms?

growths that can be benign or malignant, cancer of GB can be aggressive

59

what is biliary stenosis?

narrowing of one of biliary ducts, may restrict flow of bile leading to obstruction

60

what is deglutition

swallowing

61

what is dysphagia

difficulty swallowing

62

what is dysphasia

difficulty speaking

63

what is cathartic?

an agent causing active movement of bowels

64

what are the accessory organs of the UGI?

salivary glands, pancreas, liver, gallbladder

65

what is the route of the alimentary canal?

oral cavity, pharynx, esophagus, stomach, duodenum and small intestine, large intestine, anus

66

what is the length of the GI tract?

about 30 feet long form the esophagus to the end of large intestine

67

about how long is the esophagus?

10inches

68

about how long is the stomach?

10 inches

69

about how long is the small intestine?

23 feet (stretched out)

70

about how long is the large intestine?

5 feet

71

During life, with good muscle tone, the actual length of the small intestine is about how many feet long?

15-18

72

what are the 3 primary functions of the digestive system,?

intake and digestion(carbs, lipids, protein), absorption (essential elements absorbed from alimentary canal), elimination

73

what are the two common radiographic procedures?

esophagram and upper GI

74

what is the purpose of the esophagram

study the form and function of the pharynx and the esophagus

75

what is the purpose of the UGI?

study the form and function of the distal esophagus, stomach, and duodenum

76

the roof of the oral cavity is formed by what?

hard and soft palates

77

what is the function of the uvula?

to prevent food from entering pharynx prematurely

78

where does the soft palate begin

beings at the last color and is suspended from the posterior border of the hard palate

79

what forms the hard palate?

palatine process of the maxillary bone and the 2 horizontal portion of the palatine bone

80

three pairs of salivary glands secrete into the oral cavity?

parotid, submandibular, and sublingual

81

where is the parotid salivary gland located?

inferior and anterior to the ears

82

where is the submandibular salivary gland located

posterior part of the floor of the mouth

83

where is the sublingual salivary gland located

below the tongue on the floor of the mouth

84

what is saliva made up of?

99.5% water and .5 salt and digestive enzymes

85

how much saliva is secrete daily?

1000-1500mL

86

what is mumps?

inflammation of the parotid glands

87

what is the second organ of the digestive system?

pharynx

88

what is the pharynx often referred as

throat

89

the pharynx serves as a passage way for what?

food and air

90

what 3 parts is the pharynx divided into?

nasopharynx, oropharynx, and laryngopharynx

91

what is the cartilage that covers opening of larynx during swallowing?

epiglottis

92

what are the 7 cavities that communicate with the three portions of the pharynx

nasopharynx: tympanic cavities(2) via the eustachian tubes, and nasal cavities (2)
oropharynx: oral cavity
laryngopharynx: larynx, and esophagus

93

what does esophagus translate too?

carry food

94

what is the function of the esophagus?

transport food and fluids from the pharynx to the stomach

95

what landmarks does the esophagus fall between?

cricoid cartilage (c5-c6) to stomach (T11)

96

what are the 4 layers of the esophagus?

fibrous, muscular, submucosal, and mucosal

97

what are the 2 indentations present in the esophagus?

aortic arch, and left primary bronchus

98

distal esophagus passes through an opening in the diaphragm called what and located at what level?

esophageal hiatus at level of T10

99

what is a condition where the upper portion of the stomach protrudes through the esophageal hiatus is called?

hiatal hernia

100

what is the abdominal segment (slightly expanded) of the esophagus that is about 1 inch in length called?

cardiac antrum

101

what is the opening/junction between the stomach and the esophagus called

esophagogastric junction (cardiac orifice) at T11

102

what is the wavelike series of involuntary contractions that propels solid and semisolid materials through the entire alimentary canal

peristalsis

103

what does ventriculus mean?

little belly in latin

104

what is the most dilated portion of the alimentary canal

stomach

105

what is the muscle that controls the esophagogastric junction

cardiac sphincter

106

what is the notch located superior to the esophagogastric junction?

cardiac notch

107

what is the opening leaving the stomach

pyloric orifice

108

what is the muscle that controls the pyloric orifice?

pyloric sphincter

109

what is the medial concave border of the stomach

lesser curvature

110

what is the convex lateral border of the stomach

greater curvature

111

how many times longer is the greater curvature compared to the lesser

4-5x longer

112

what does the greater curvature extend between

cardiac notch and the pylorus

113

in the upright position the fundus is usually filled with a bubble of swallowed air called?

gastric bubble

114

the body of the stomach begins at the cardiac notch and ends at a constricted ring like area called?

angular notch (incisura angularis)

115

what is the terminal portion of the stomach ro right or medial of angular notch?

pylorus

116

the pylorus is divided into 2 portions called ?

pyloric antrum and pyloric canal

117

what does rugae translate into?

wrinkles

118

what do the rugae do for the stomach?

assist with mechanical digestion of food within stomach

119

in the supine position barium would be in what part of the stomach?

fundus

120

in the supine position air/gas would be in what part of the stomach?

pylors

121

what does the RAO position do for barium/ air study?

allows air to form in the fundus and the barium to be in the pylorus

122

what is the first part of the small intestine

duodenum

123

most of the duodonem and pancreas are infra, intra or retropertioneal?

retroperitoneal

124

what are the 4 parts of the duodenum?

superior, descending, horizontal and ascending

125

what part of the duodenum is intrapertoneal?

first (superior) portion

126

what part of the duodenum is commonly studies for a site of ulcers?

superior portion

127

what is the longest segment of duodenum?

descending

128

what is the junction of the duodenum and the jejunum called?

duodenojejunal flexure

129

what is the duodenojejunal flexure relatively fixed and held in place by?

ligament of trite (suspensory muscle of the duodenum)

130

what are the two types of digestion

mechanical and chemical (all chemical changes food undergoes as it travels through the alimentary canal)

131

how long does the take for the stomach to empty after an average meal

2-6 hours

132

how long does it take for solid/semisolid food to go from the mouth to the stomach? liquid?

4-8 seconds for solid, 1 second for liquid

133

how long does chyme take to pass through the entire small intestine

3-5 hours

134

where does most absorption of digestive products take place

small intestine

135

in a hyperstenic patient the level of the stomach extends from?

T9-T12

136

the duodenal bulb in a hyperstenic patient is at the level of

T11

137

in the Asthenic/Hypostenic patient the stomach extends from?

T11-L5

138

the duodenal bulb in a Asthenic/Hypostenic patient is at the level of

L3-L4

139

in the sthenic patient the stomach extends from ?

T10-11 to L2

140

in the upright position organs tend to drop how many inches from normal position

1-2 inches

141

polyps, diverticula and ulcers of the stomach are better demonstrated with what kind of study?

double contrast study

142

what are the two types of carbon dioxide gas used?

calcium citrate and magnesium citrate

143

what are the 3 cardinal principles of radiation?

time, distance, shielding

144

what are the 4 ways to demonstrate esophageal reflux

breathing technique, water test, compression paddle technique, and toe touch test

145

what are the 2 types of breathing techniques

valsalva maneuver and mueller maneuver

146

what is achalasia?

cardiospasm, motor disorder of esophagus in which peristalsis is reduced along distal 2/3 of esophagus

147

what are anatomic anomalies?

may be congenital or caused by disease

148

what is barrettes esophagus?

replacement of normal squamous epithelium ulcer tissue in lower esophagus

149

what will produce a strictures or streaked like appearance in distal esophagus?

barretts esophagus

150

what is esophageal varices

dilation of veins in the distal esophagus

151

what will esophageal varices present like on a radiograph?

wormlike or cobblestone appearance

152

what is zenkers diverticulum?

large outputting of the esophagus

153

what is a bezoar?

mass of undigested martial that becomes trapped in stomach-hair veggie fibers

154

what are diverticula?

pouchlike herniationsof a portion of mucosal wall

155

what percent of gastric diverticula arise in posterior aspect of stomach

70-90

156

what projection best demonstrates diverticula

lateral

157

what is a schatzki's ring

ringlike constriction at distal esophagus

158

where would you find a schatzkis ring

sliding hiatal hernia

159

what is hypertrophic pyloric stenosis

obstruction of pylorus

160

where would u find a duodenal ulcer

2nd or 3rd part of duodenum

161

where would you find a peptic ulcer

mucosa of esophagus, stomach or duodenum

162

where would you find a gastric ulcer

gastric mucosa

163

what % of ulcers lead to perforation

5

164

how long should a child under 1 be NPO for

4 hours

165

how long should a child older than 1 be NPO for

6 hours

166

how much barium should be given to a child NB-1?
1-3?
3-10?
older than 10?

NB-1: 2-4 oz
1-3: 4-6
3-10: 6-12
over 10-12-16