Gall Bladder

Question 1

four parts

Answer 1

cystic duct
body
fundus
neck

Question 2

anterior

Answer 2

right liver lobe

Question 3

posterior

Answer 3

right kidney, transverse colon, proximal duodenum

Question 4

superior

Answer 4

inferior border of liver, anterior abdominal wall

Question 5

inferior

Answer 5

biliary tree and 2nd part of duodenum

Question 6

lateral

Answer 6

right liver lobe

Question 7

medial

Answer 7

duodenum

Question 8

biliary tree

Answer 8

pipework of the gall bladder

Question 9

cystic duct + hepatic duct =

Answer 9

common bile duct

Question 10

fundus

Answer 10

expanded end which hangs below inf surface of the liver
contact with the ant abdominal wall
below right 9th costal cartilage

Question 11

body

Answer 11

directed upwards, backwards and lies to the left

Question 12

neck

Answer 12

narrow, curves on itself forming an S-shape
lies upwards and forwards curving sharply downwards into the cystic duct

Question 13

cystic duct

Answer 13

3cm long, passes downwards and backwards from the neck to the RHS of the hepatic duct
mucous membrane has a series of folds - spiral valves

Question 14

what does the peritoneum cover

Answer 14

only the inferior surface, as in contact with liver, held by the visceral peritoneum that covers the liver

Question 15

muscle layer

Answer 15

long fibrous tissue with additional oblique muscle fibres

Question 16

sub mucous and mucous

Answer 16

branching folds of lamina propria, extensive capillaries and small venues
no lymphatics
only mucus secreting glands in lamina propria at the neck
small rugae when empty distend when full

Question 17

gall bladder

Answer 17

pear shaped
7-10cm
fills with 40-50ml of bile
attaches to post surface of the liver by connective tissue

Question 18

region

Answer 18

right hypochondriac

Question 19

what can cause blockage

Answer 19

gall stones

Question 20

what system is it part of

Answer 20

biliary system, consisiting of ducts which convey bile from liver to the gall bladder, which links with the pancreas then into the duodenum at the pancreatic-duodenal papilla

Question 21

lymphatics

Answer 21

coeliac node
common duct inferior to retro portal node
to superior mesenteric node -> para-aortic nodes near renal vein

Question 22

lymph node pathway

Answer 22

cystic N -> hepatic N -> pre-aortic N -> thoracic N

Question 23

nervous control

Answer 23

contractions occur 30 minutes after food, bile is pushed through the bile duct to duodenum
muscle walls contract causes the sphincter to relax allowing bile to enter the duodenum
contractions are stimulated by CCK, relaxation of the sphincter is in response to CCK and is a reflex response

Question 24

sympathetic

Answer 24

hepatic plexus + coeliac plexus

Question 25

para-sympathetic

Answer 25

hepatic branch of vagus nerve

Question 26

hormonal control

Answer 26

products from fat digestion stimulates the duodenal mucosa to secure CCK when goes to the venous blood from the duodenal mucosa to portal general circulation arterial blood to stimulate the control of the GB walls

Question 27

blood supply

Answer 27

aorta -> coeliac trunk -> common hepatic artery -> right hepatic artery -> cystic artery cystic artery supplies the GB cystic vein -> portal vein -> IVC -> heart

Question 28

what is the structure of the bile duct

Answer 28

same as the AC

Question 29

where does the hepatic duct go to

Answer 29

common hepatic duct, the right and left hepatic ducts join to form the common hepatic duct outside the portal fissure. CHD travels down joining the cystic duct from the GB on the RHS forming the common bile duct, which joins the main pancreatic duct at the hepatic-pancreatico ampulla

Question 30

cystic duct structure

Answer 30

mucosal membrane with irregular circular folds forming spiral valves, Bile passes through twice once on its way to the gall bladder and when it is expelled from the GB into the common bile duct and then onto the duodenum