GALLBLADDER

Question 1

Situated in the right hypochondrial region of the abdomen, beneath the liver’s right lobe.
Located at Segment IVB and Segment V of the liver

Answer 1

GALL BLADDER

Question 2

➢ Pear-shaped
➢ Measures around 7-10 cm in length
➢ Average capacity: 30-50 mL

Answer 2

GALL BLADDER

Question 3

Function of the gallbladder

Answer 3

Primarily stores bile
Concentrates bile
Releases bile

Question 4

Hormone released by the duodenum in response to fat)

Answer 4

cholecystokinin

Question 5

Contains the highest amount of smooth muscle, which is important for its contraction during bile storage and release

Answer 5

FUNDUS of the gallbladder

Question 6

➢ Location: The body lies in contact with the visceral surface of the liver
➢ Orientation: It is directed upward, backward, and to the left
➢ Function: Acts as the main storage area for bile and contains a lot of elastic tissue, which allows the body to distend when it stores bile.

Answer 6

BODY of the gallbladder

Question 7

➢ An outpouching between the body and neck of the gallbladder, present in 40-60% of the population
➢ Importance: This pouch is a significant landmark for identifying the cystic duct. If not mobilized, it can be challenging to locate the cystic duct.
➢ Relation: It is bound to D1 (first part of the duodenum) by the right edge of the lesser omentum, specifically the cholecystoduodenal ligament. This ligament needs to be opened to identify the cystic duct.

Answer 7

INFUNDIBULUM (HARTMANN’S POUCH)

Question 8

lies in the deepest part of the gallbladder fossa and can extend slightly into the hepatoduodenal ligament, which contains the portal triad (portal vein, hepatic artery, common bile duct).

Answer 8

Neck of the gall bladder

Question 9

These are infoldings in the wall of the cystic duct that help maintain patency. If absent, there can be continuous flow of bile into the gallbladder, potentially leading to bloating or difficulty in transcystic cholangiogram and cauterization.

Answer 9

SPIRAL VALUES OF HEISTER

Question 10

These are the bile ducts located within the liver. They are situated in the portal canals of the liver where they receive the bile canaliculi. They join with one another to form the larger ducts.

Answer 10

Intrahepatic Ducts/Interlobular Ducts:

Question 11

These ducts collect bile from the left and right lobes of the liver, respectively, and converge to form the common hepatic duct at the porta hepatis

Answer 11

Left and Right Hepatic Ducts

Question 12

Function: responsible for transporting bile produced by hepatocytes towards the common hepatic duct

Answer 12

INTRAHEPATIC BILIARY TREE

Question 13

Intrahepatic billiary tree is composed of?

Answer 13

Intrahepatic Ducts/Interlobular Ducts:
Left and Right Hepatic Ducts:

Question 14

Transporting bile from the liver and gallbladder to the duodenum.o Regulating bile flow

Answer 14

EXTRAHEPATIC BILIARY TREE

Question 15

EXTRAHEPATIC BILIARY TREE
Is composed of?

Answer 15

o Common Hepatic Duct
o Cystic Duct
o Common Bile Duct
o Ampulla of Vater

Question 16

Clamped during Pringle’s maneuver

Answer 16

Supra-duodenal-portion of the common bile duct

Question 17

Where common bile duct and pancreatic duct unite

Answer 17

Ampula of vater

Question 18

Used during surgery to control bleeding (maneuver)

Answer 18

Pringle’s maneuver

Question 19

Opens into the duodenum at the major duodenal papilla along with the bile duct.

Answer 19

Main pancreatic duct of Wirsung

Question 20

Opens slightly above the main duct at the minor duodenal papilla and often communicates with the main duct.D. RELAT

Answer 20

Minor Duct of Santorini

Question 21

*A smooth muscle sphincter around the bile duct and pancreatic duct that controls bile and pancreatic enzyme release into the duodenum.
*Maintains the patency of the ampulla of Vater

Answer 21

Sphincter of Oddi

Question 22

opening of bile and pancreatic duct

Answer 22

Papilla of Vater / Major Papilla

Question 23

opening for the accessory pancreatic duct

Answer 23

Minor Papilla

Question 24

The central gateway for structures entering and exiting the liver. It is located on the inferior surface of the liver and serves as a key anatomical landmark, especially in hepatic surgeries.

Answer 24

PORTA HEPATIS (LIVER HILUM)

Question 25

A deep fissure on the inferior surface of the liver, marking the porta hepatis.

Answer 25

Fissure of Rouvière

Question 26

Acts as a reference point in liver surgeries, particularly for clamping blood flow (e.g., during a Pringle maneuver to control hemorrhage)

Answer 26

PORTA HEPATIS (LIVER HILUM)

Question 27

MAIN BLOOD SUPPLY OF THE GALLBLADDER

Answer 27

CYSTIC ARTERY Branch of right hepatic artery (a branch of proper hepatic artery) ** nearly always is found within the hepatocystic triangle (triangle of Calot)

Question 28

Border of Triangle of Calot

Answer 28

Borders: o Superiorly: inferior border of the liver o Medially: common hepatic duct o Inferiorly: cystic duct

Question 29

Lymph drainage of Gallbladder

Answer 29

cystic lymph node situated near the neck of the gallbladde

Question 30

Nerve Supply of the Gall bladder

Answer 30

Sympathetic and parasympathetic vagal fibers form the celiac plexus.

Question 31

produced by the mucous membrane of the duodenum on the arrival of fatty food from the stomach

Answer 31

CHOLECYSTOKININ

Question 32

Gallstones in the gallbladder

Answer 32

CHOLELITHIASIS (GALLSTONE DISEASE)

Question 33

Location: Gallbladder➢ Inflammation of the gallbladder

Answer 33

CHOLECYSTITIS

Question 34

➢ Gallstones in the CBD Location: common bile duct (CBD)

Answer 34

CHOLEDOCHOLITHIASIS

Question 35

Infection and inflammation of bile ducts Location: bile ducts

Answer 35

CHOLANGITIS

Question 36

Classic symptoms of cholangitis ➢ Includes: fever, epigastric or right upper quadrant pain, jaundice

Answer 36

CHARCOT’S TRIAD

Question 37

Extension of Charcot’s triad ➢ Occurs when cholangitis progresses rapidly, leading to septic shock and altered mental status ➢ Includes: fever, jaundice, right upper quadrant pain, septic shock and mental status changes

Answer 37

REYNOLD’S PENTAD

Question 38

➢ Results when there is an impacted stone without cholecystitis ➢ Bile will be unable to enter the gallbladder due to obstructed cystic duct, but the gallbladder epithelium will continue to secrete mucus, and gallbladder will become distended with clear-white mucinous material. ➢ May result in edema of gallbladder wall, inflammation, infection and perforation.

Answer 38

HYDROPS OF THE GALLBLADDER

Question 39

➢ Refers to the yellow color of skin, nail beds, and sclerae (whites of the eyes) caused by bilirubin deposition, secondary to increased bilirubin levels in the blood (hyperbilirubinemia) ➢ Although not a disease, jaundice is usually a symptom of anunderlying disorder

Answer 39

JAUNDICE (ICTERUS)

Question 40

➢ An important anatomical landmark on the visceral surface of the right lobe of the liver, located parallel to the porta hepatis. ➢ It is often used as a surgical reference point during hepatobiliary procedures, especially laparoscopic cholecystectomy, to help identify safe dissection zones and avoid bile duct injury. ➢ Does NOT contain the right hepatic duct but rather serves as a plane of separation between the right anterior and posterior segments of the liver (Couinaud segments V and VI). ➢ It is not part of the porta hepatis, but it can be seen as an extension running parallel to it.

Answer 40

FISSURE OF ROUVIÈRE