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ABD/SMALL PARTS I > Gallbladder/Biliary System > Flashcards

Gallbladder/Biliary System Flashcards

1
Q

The gallbladder is divided into what 3 parts

A

neck
body
fundus

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2
Q

What is the name of the valve that controls the bile flow in the cystic duct

A

Heister’s Valve

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3
Q

When performing a gallbladder ultrasound you must evaluate what 4 areas of anatomy

A

gallbladder
common bile duct
liver
pancreas

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4
Q

The portal vein and hepatic artery flow is ____ the liver

A

toward

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5
Q

The flow in the bile ducts is _____ from the liver

A

away

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6
Q

connection from the gallbladder to the bile ducts

A

Cystic duct

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7
Q

What two things converge to form the CBD, which carries bile from the liver to the duodenum

A

Cystic Duct

Common Hepatic Duct

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8
Q

What is known as the Wirsung’s duct and joins to enter the duodenum at the Ampulla of Vater

A

CBD

main pancreatic duct

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9
Q

Muscular “gatekeeper” that relaxes to allow bile/pancreatic enzymes from the ampulla of vater to the duodenum

A

Sphincter of Oddi

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10
Q

Name 3 types of folds of the gallbladder and where they occur

A

Hartmann’s- neck
Phrygian Cap- fundus
Junctional Fold- between body and infundibuim

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11
Q

What is the term for removal of the Gallbladder

A

cholecystectomy

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12
Q

Is there any expected change in size of the CBD after the gallbladder is removed? How?

A

Yes

dilation

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13
Q

What is the appearance of the Gallbladder if the patient is not NPO

A

small and thick walled due to its contracted state

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14
Q

The purpose of changing the patient’s position during the exam is to demonstrate what

A

The mobility of gallstones and to make sure that no stones are lodged in the neck of cystic duct

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15
Q

The gallbladder should be less that ___cm in the anterior/posterior dimension from the transverse plane

A

5

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16
Q

The gallbladder wall should measure less than

A

3 mm

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17
Q

Where is the CBD routinely measured

A

At the point where right hepatic artery courses between the main portal vein and the bile duct

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18
Q

Typically, the CBD should be

A

5-6 mm or less

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19
Q

The CBD diameter increases with age. After 60 the normal CBD diameter increases

A

1mm per decade

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20
Q

What is round and distended, non-inflamed GB due to obstruction of the cystic duct

A

Hydrops/Mucocele

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21
Q

What is demonstrated when a pt. indicates exquisite tenderness of the rt costal margin over the area of the gallbladder. Is this an indication of disease?

A

Murphy’s sign

Yes

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22
Q

Name 4 appearances signs associated with dilated intrahepatic ducts

A

Parallel channel sign
double barrel shot gun
stellate confluence
too many tubes

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23
Q

“fatty” hormone that may be administered which causes the gallbladder to contract

A

cholecystokinin

24
Q

If a patient was positive for obstruction the gallbladder would appear

A

distended (fat)

25
What are the 5 Fs of gallbladder disease
``` female fertile forty fair fat ```
26
Name 4 primary causes of Gallbladder wall thickening
Cholecystitis AIDS Cancer Adenomyomatosis
27
gravity dependent, non-shadowing, echogenic material, made up of calcium bilirubinate granules and cholesterol crystals
GB sludge
28
Term for inflammation of the gallbaldder
cholecystitis
29
The symptoms of Cholecystitis include
``` RUQ pain Murphys sign possible fever gallstones elevated WBC diffuse GB wall thickening ```
30
An elevation of what suggests obstruction at the ampulla of vater
amylase
31
What of the gallbladder involves purulent material (pus) within the gallbladder due to bacteria-containing bile
Empyema
32
What is the technical term for gallstones
Choleithiasis
33
What are the 3 diagnostic criteria for gallstones
echogenic posterior shadow mobility
34
What is the WES sign short for
Wall Echo Shadow
35
What is another name for the WES sign that could be used for that sonographic appearance
double arc
36
What pathology is the term WES referring to
gallbladder full of stones
37
What is the technical term for gas in the biliary tree
pneumobilia
38
What condition is also known as strawberry gallbladder
cholesterolosis
39
The mortality rate for Gallbladder Carcinoma is near
100%
40
What % of patients with GB Carcinoma will also have cholelithiasis (gallstones)
80-90
41
Name 3 sonographic appearances of GB carcinoma
focal thickening of GB wall intraluminnal GB mass GB replaced by mass
42
Absence of the extrahepatic biliary tree and is suspected in infants and jaundice
Biliary Atresia
43
inflammation of the bile ducts, usually due to infection secondary to intestinal infection
cholangitis
44
What are the symptoms of Cholangitis
fever jaundice RUQ pain
45
extraheptic biliary obstruction due to an impacted stone in the cystic duct, causing mechanical compression of the common hepatic duct
Mirizz Syndrome
46
cholangiocarcinoma is also known as
Klatskin tumor
47
Tumor that occurs at the bifurcation of the common hepatic duct into right and left. It results in intra-hepatic but not extra-hepatic duct dilation
cholangiocarcinoma
48
The 2 most common lessions causing biliary obstruction are
gallstones | carcinoma of the head of the pancreas
49
What labs are typically elevated with biliary obstruction
serum alkaline phosphatase conjugated bilirubin GGT (gamma-glutamyl)
50
An obstruction in the distal portion of the CBD will result in dilation of
extra & intra-hepatic duct
51
What does the term choledocholithiasis mean
stones in the bile duct
52
What is the most common cause of choledocholithiasis
extra-hepatic obstructive jaundice
53
What diagnostic tests may be performed if choledocholithiasis is suspected
ERCP PTC CT ultrasound
54
rare condition caused by weakness in the bile duct wall, causing cystic dilation of the intra and extra-hepatic bile ducts
choledochal cyst
55
What is the sonographic appearance of the choledochal cyst
2 cystic structures in RUQ: 1. Gallbladder 2. the dilated ducts
56
In what part of the world are choledochal cyst prevalent
asia
57
Most common cause of malignant neoplasm obstructing the biliary tree
pancreatic adenocarcinoma

ABD/SMALL PARTS I (9 decks)

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