Gallbladder and biliary test 3 Flashcards Preview

abdomen > Gallbladder and biliary test 3 > Flashcards

Flashcards in Gallbladder and biliary test 3 Deck (56):
0

What is the biliary system?

consists of right and left hepatic duct

common hepatic duct

cbd

GB

cystic duct

1

What plays a role in the digestive process to store and transport bile?

Biliary System

2

What ducts emerge from the right lobe of the liver in the porta hepatis?

right and left hepatic ducts

3

What size is the common hepatic duct?

approx 4 mm

4

What joins with the cystic duct to form the CBD?

common hepatic duct

5

What is the measurement of the CBD?

< 6mm

6

Where is the common bile duct in the first part of its course?

it lies in the right free edge of the lesser omentum

7

Where is the CBD in the second part of its course?

situated posterior to the first part of the duodenum

8

The CBD is joined by the main pancreatic duct and together they open though the ____________into the duodenal wall

ampulla of Vater

9

What circular muscle fibers surround the CBD, main pancreatic duct, and the ampulla?

Sphincter of Oddi

10

What is the cystic duct?

connects neck of GB with common hepatic duct for form the CBD

11

What helps prevent kinking of the cystic duct?

Heister valve aka spiral valve

12

Where is the GB found?

RUQ - anterior aspect

related to the visceral surface of the liver fossa

pear-shaped sac

13

Where is the GB found?

posterior to the rt lobe of the liver

14

Is the GB in the intraperitoneal or the retroperitoneal?

Intraperitoneal

15

what are the three segments of the GB?

fundus

body

neck

16

sonographically what is the superior part of the GB?

fundus

17

Where is the fundus?

projects below the inferior margin of the liver and comes into contact with the anterior abd wall

18

Where is the body of GB?

lies in contact with the visceral surface of the liver

19

Where is the neck of the GB?

continuous with the cystic duct

(which turns to join the right side of the common hepatic duct to form the common bile duct)

20

What are the cellular layers of the GB?

outer serosal

subserous

muscular

inner mucosal

21

What is found in the outer serosal layer of the GB?

Rokitanksy - Aschoff sinus

little sections in the GB wall

22

what does the muscular layer of the GB contract to?

Cholecystokinin (hormone that secrets bile) CCK

23

What is the arterial supply of the GB?

cystic artery

(branch of the rt hepatic artery)

24

What is Hartmann's pouch?

when the gallbladder folds back on itself at the neck

gallstones tend to collect here

25

What is the most common variant of the folds in the gallbladder?

junctional fold

appears between the body and neck

26

What is phrygian cap??

folding of the fundus of the gallbladder

27

Partial septations and folds in the gallbladder are normal variants....true or false?

true

28

What is the primary function of the extrahepatic biliary tract?

transportation of bile from liver to the intestine

regulation of flow

29

When does concentration of bile in the GB occur?

during a state of fasting

30

How does the wall of the gallbladder look when it's contracted?

thickened

31

What happens to the extrahepatic bile ducts after a cholcystectomy?

they dilate...usually less than 10mm

patients older than 60 - duct can be up to 10mm and be normal

32

What is the criteria for a sonographic eval of the GB?

NPO 8-12 hrs

begin patient supine

second roll patient LLD or upright position
transverse, sag, and oblique scans are made over the upper abd

identify: GB, biliary system, liver rt kidney and head of pancreas

33

What are the indications that a GB scan is needed?

RUQ pain

positive Murphy's sign

pain radiating to shoulder

nausea and vomiting

loss of appetite

jaundice

34

What is the typical wall thickness of the GB wall?

< 3mm

35

What is hydrops?

dilation of the gallbladder (>5 trv, >10 sag)

not related only to gb

36

when the right and left hepatic ducts merge what does it create?

the common hepatic duct

37

the hepatic duct runs ___________ to the portal vein

parallel

38

In the third part of its course, the CBD lies where?

in a groove on the posterior surface of the head of the pancreas

39

where does the common bile duct end?

by piercing the medial wall of the second part of the duodenum

40

The cystic vein drains directly into what?

the portal vein

41

What is another name for the normal variant "complete septation" as it refers to the GB?

double gallbladder

42

What stimulates the GB to contract and what is the result?

the influence of food

resulting: outpouring of bile into the duodenum

43

why would you roll a patient into a steep decubitus or upright position when you suspect stones?

to separate small stones from gallbladder wall or cystic duct

44

what is the main lobar fissure?

a bright linear reflector within the liver connecting the gallbladder and the right or main portal vein is a reliable indicator of the location of the gallbladder

45

What makes the "Mickey Mouse" sign?

common duct, hepatic artery, and portal vein

46

the hepatic artery lies __________ and __________ to the portal vein

anterior

medial

47

the CBD lies _________ and ___________ to portal vein

anterior

lateral

48

What is bile made of?

water

bile salts

and other organic substances

49

What is the bile's two major functions in the body?

breaks down the fats that you can eat so that your body can utilize them

bile is a very powerful antioxidant

50

When you have increased WBC what do you most likely have?

cholecystitis

51

When evaluating the lab values for serum bilirubin, unconjugated/indirect what would you be looking for?

pre-hepatic or hepatic abnormality

elevates for hematologic disease

52

when considering the lab values for serum bilirubin, conjugated/direct, what clues will it give you?

post hepatic abnormality

elevates in hepatocellular disease

elevates for biliary obstruction

53

When you have a biliary obstruction what lab value is elevated?

alk phos (ALP)

54

What do AST and ALT lab values indicate?

liver disease

55

what is PT?

prothrombin time - clotting time