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Flashcards in Chapter 11 Gallbladder Deck (75)
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1

Extends from the point where the common hepatic duct meets meet the cystic duct; drains into the duodenum after it joins with the pain pancreatic duct

common bile duct

2

Storage pouch for bile

gallbladder

3

Small opening in the duodenum in which the pancreatic and common bile duct enter to release secreations

ampulla of Vater

4

Massive enlargement of the gallbladder

hydrops

5

Tiny valves found within the cystic duct

Heister's valve

6

Refers to common bile and hepatic ducts when cystic duct is not seen

common duct

7

Connects the gallbladder to the common hepatic duct

cystic duct

8

Central area of the liver where the portal vein, common duct, and hepatic artery enter

porta hepatis

9

Small part of the gallbladder that lies near the cystic duct where stones may collect

Hartmann's pouch

10

Travels horizontally through the pancreas to join the common bile duct at the ampulla of Vater

pancreatic duct

11

Small muscle that guards the ampulla of Vater

sphincter of Oddi

12

Yellow pigment in bile formed by the breakdown of red blood cells

bilirubin

13

Removal of gallbladder

cholecystectomy

14

Gallbladder variant in which part of the fundus is bent back on itself

phrygian cap

15

Bile duct system that drains the liver into the common bile duct

common hepatic duct

16

Gallstones in the gallbladder

cholelithiasis

17

Calcification of the gallbladder wall

porcelain gallbladder

18

Inflammation of the bile duct

cholangitis

19

Excessive bilirubin accumulation causes yellow pigmentation of skin; first seen in the whites of the eyes

jaundice

20

Small polypoid projections from the gallbladder wall

adenomyomatosis

21

Sonographic pattern found when the gallbladder is packed with stones

wall echo shadow (WES) sign

22

Cancer at the bifurcation of the hepatic ducts; may cause asymmetrical obstruction of the biliary tree

Klatskin's tumor

23

Low level echos found along the posterior margin of the gallbladder; move with change in position

Sludge

24

Hormone secreted into the blod by the mucosa of the upper small intestine; stimulates contraction of the gallbladder and pancreatic secretion of enzymes

cholecystokinin

25

Variant of adenomyomatosis; cholesterol polyps

cholesterolosis

26

Inflammation of the gallbladder; may be acute or chronic

cholecystitis

27

Cystic growth on the common duct that may cause obstruction

choledochal cyst

28

Small septum within the gallbladder, usually arising from the posterior wall

junctional fold

29

Small, well-defined soft tissue projection from the gallbladder wall

polyp

30

Stones in the bile duct

choledocholithiasis

31

Positive sign implies exquisite tenderness over the area of the gallbladder upon palpation

Murphy's sign

32

The gallbladder serves as a reservoir for _________ that is drained from the hepatic ducts in the liver.

bile

33

The common hepatic duct is joined by the cystic duct to to form the ________________.

common bile duct

34

The main pancreatic duct joins the commone bile duct, and together they open through a small ampulla (the ampulla of _______________) into the duodenal wall.

Vater

35

The end parts of the common bile duct and main pancreatic duct and the ampulla are surrounded by circular muscle fibers know as the ___________________.

Sphincter of Oddi

36

The arterial supply of the gallbladder is from the _______________ artery, which is a branch of the right hepatic artery.

cystic

37

List two primary functions of the extrahepatic biliary tract.

Transportation of bile from liver to intestine
Regulation of it's flow

38

Describe the normal function of the gallbladder during digestion.

When gallbladder and bile ducts are functioning normally, they respond in a fairly uniform manner during various phases of digestion. Concentration of bile in the gallbladder occurs during a state of fasting. Stimulation produced by the influence of food causes the gallbladder to contract, resulting in an outpouring of bile into the duodenum.

39

Bile is the principal medium for excretion of bilirubin ______________.

cholesterol

40

The ______________ from the small intestine stimulate the liver to make more bile. This activates intestinal and pancreatic enzymes.

bile salts

41

The sign that indicates an extrahepatic mass compressing the common bile duct, which can produce an enlarged gallbladder, is called _________________.

Courvoisers sign

42

Sonographically, the common duct lies ____________ and to the _______________ of the portal vein in the region of the porta hepatis and gastrhepatic ligament.

anterior; right

43

The hepatic artery lies __________ and to the __________ of the portal vein.

anterior; left

44

To ensure maximum dilation of the gallbladder, the patient should be given nothing to eat for at least _____________ hours before the ultrasound.

4-6 hours

45

The patient is initially examined with ultrasound in full ____________.

inspiration

46

The patient should also be rolled into a steep ______________ or upright position (to ensure there are no stones within the gallbladder) in an attempt to separate small stones from the gallbladder wall or cystic duct.

decubitus

47

The gallbladder may be identified as a(n) ______________ oblong structure located anterior to the right kidney, lateral to the head of the pancreas and duodenum.

sonolucent

48

The gallbladder commonly resides in a(n) ____________ on the medial aspect of the liver

Fossa

49

Because of ___________ tissue within the main lobar fissure of the liver (which lies between the gallbladder and the right portal vein), this bright linear reflector is a reliable indicator of the location of the gallbladder.

Fat

50

A small _______________ fold has been reported to occur along the posterior wall of the gallbladder at the junction of the body and infundibulum.

echogenic

51

On a transverse scan, the common duct, hepatic artery, and portal vein have been referred to as the _______________ sign.

Micky Mouse

52

To obtain a cross section of the portal triad, the transducer must be directed in a slightly ___________ path from the left shoulder to right hip.

Oblique

53

On sagittal scans, the right branch of the hepatic artery usually passes _______________ to the common duct.

posterior

54

The common duct is seen just ______________ to the portal vein before it dips posteriorly to enter the head of the pancreas.

anterior

55

When the right subcostal approach is used, the common hepatic duct is seen as a tubular structure anterior to the portal vein. The right branch of the ____________ artery can be seen between the duct and the portal vein as a small circular structure.

hepatic

56

The most classic symptom of gallbladder disease is __________________ pain, usually occurring after ingestion of greasy food.

right upper quadrant

57

A gallbladder attack may cause pain in the ___________ shoulder

right

58

The normal wall thickness of the gallbladder is less than _______ mm.

3

59

Clinically the patient with acute cholecystitis presents with these symptoms:

acute RUQ pain, fever, leukocytosis

60

The ______ sign is described as a contracted bright gallbladder with posterior shadowing caused by a packed bag of stones.

WES

61

A fairly rare complication of acute cholecystitis associated with the presence of gas-forming bacteria in the gallbladder wall and lumen with extension into the bilary ducts is called ___________________.

emphysematous cholecystitis

62

Clinically the patient falls under five "F's"

Fat, female, forty, fertile, fair

63

Explain why the patient's position should be shifted during the ultrasound examination

To see if stones move and to get a better view of stones.

64

Describe factors that produce a shadow in the gallbladder.

acoustic impedance of the gallstones; refraction through them or diffraction around them; their size, central or peripheral location, and position in relation to focus of beam & intensity of beam.

65

_________________ may be the result of pancreatic juices refluxing into the bile duct because of an anomalous junction of the pancreatic duct into the distal common bile duct, causing duct wall abnormaility, weakness, and outpouching of ductal walls.

choledochal cysts

66

A hyperplastic change in gallbladder wall is __________________.

adenomyomatosis

67

The differential for a porcelain gallbladder would include a packed bag or ___________ sign.

WES

68

What is the most notable sonographic finding with carcinoma of the gallbladder?

gallbladder wall is markedly abnormal and thickened.

69

The most common cause of biliary ductal system obstruction is the presence of a(n) ______________ or _______________ within the ductal system.

tumor; thrombus

70

The job of the sonographer is to localize the level and cause of the obstruction. List the three primary areas where the obstruction occurs.

Intrapancreatic, suprapancreatic and porta hepatic

71

An uncommon cause for extrahepatic biliary obstruction as a result of an impacted stone in the cystic duct creating extrinsic mechanical compression of the common hepatic duct is _____________ syndrome.

Mirizzi

72

________________ causes increasing pressure in the biliary tree with pus accumulation.

Cholangitis

73

The majority of stones in the common bile duct have migrated from the gallbladder. Common duct stones are usually associated with ___________________.

calculous cholecystitis

74

___________________ within the duodenum may also give rise to a dirty shadow in the right upper quadrant.

air or gas

75

On ultrasound, multiple cystic structures that converge toward the porta hepatis are seen in _____________ disease.

Caroli's