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Flashcards in Biliary tree Deck (40):
1

Shape and size of the gall bladder

7-10cm long
Pear shaped
Can hold 30-50ml bile

2

Which abdominal region does the gall bladder lie in

Right hypochondrium

3

Where does the gall bladder lie

In a fossa between the right and quadrate lobes (visceral surface) on the inferior aspect of the liver

4

Peritoneal covering of the gall bladder

Peritoneum completely surrounds the fundus and also binds the body and neck to the liver

5

3 parts of the gall bladder

Fundus
Body
Neck

6

What is the gall bladder fundus

Rounded end portion that projects into the inferior surface of the liver

7

What's the largest part of the gall bladder

Body

8

What might the gall bladder's body be in contact with

Transverse colon
Proximal duodenum

9

What is the mucosal fold in the gall bladder neck

Hartmann's pouch

10

What's the most common site for gallstones to become lodged

Hartmanns pouch

11

How is the gall bladder attached to the liver

CT of the livers fibrous capsule

12

What does the neck of the gall bladder join to

Cystic duct

13

Where do the biliary ducts conduct bile from and to

From the liver to the duodenum

14

What do hepatocytes secrete bile into

Canaliculi

15

What do the canaliculi drain into

Interlobular biliary ducts -> collecting bile ducts -> right and left hepatic ducts

16

What do the left and right hepatic ducts merge to form

The common hepatic duct

17

What does the common hepatic duct join with and what does this form

Joins with the cystic duct to form the common bile duct

18

Where does the common bile duct pass relative to the duodenum

Posterior to the proximal duodenum

19

What does the common bile duct join with before it empties into the duodenum
What does this for

Joins with the pancreatic duct, forming the hepatopancreatic ampulla of Vater

20

What is the opening for bile into the duodenum called
How is it regulated

Major duodenal papilla
Regulated by a muscular valve called the sphincter of Oddi

21

Where do gall stones form and what's the consequence at each location

Gall bladder - asymptomatic
Cystic duct - acute cholecystitis
Common bile duct - biliary obstruction
Terminal duct - pancreatitis

22

What is anterior and superior to the gall bladder

Inferior border of the liver
Anterior abdominal wall

23

What is posterior to the gall bladder

Transverse colon
Proximal duodenum

24

What is inferior to the gall bladder

Biliary tree
Duodenum

25

What are some types of gall stones

Cholesterol (more common)
Pigment

26

What increases the risk of gallstones

Increasing age
Pregnancy
Obesity
Female gender

27

How is a cholecystectomy performed

Key hole surgery

28

Treatment for gallstones (if symptomatic)

Cholecystectomy
Painkillers and antibiotics given before surgery to reduce pain and limit infection

29

Arterial supply of the gall bladder and cystic duct

Coeliac trunk -> common hepatic artery -> right hepatic artery -> cystic artery

30

Where does the cystic artery arise

In the cystohepatic triangle of Calot (between the common hepatic duct, cystic duct and visceral surface of the liver)

31

Venous drainage of the neck of gall bladder and cystic duct

Cystic veins

32

What do cystic veins drain into

Enter the over directly or drain through the hepatic portal vein

33

Venous drainage of the fundus and body of gall bladder

Pass into visceral surface of the liver and drain into the hepatic sinusoids

34

Sympathetic and sensory Innervation of the gall bladder

Coeliac plexus

35

Parasympathetic Innervation of the gall bladder

Vagus nerve

36

Result of parasympathetic stimulation of the gall bladder

Contraction of gall bladder and secretion of bile into the cystic duct

37

What is the main stimulator of bile secretion
Where is it secreted from

Cholecystokinin
Secreted from the duodenum and travels in the bloodstream

38

What does lymph from the gall bladder drain into

Cystic node

39

Where is the cystic node

Gall bladder neck

40

What does the cystic node drain into

Hepatic lymph node -> coeliac node