Gallbladder Normal + Path

Question 1

Where is the gallbladder located?

Answer 1

posteroinferior portion of the right lobe of liver

Question 2

Describe the biliary tree

Answer 2

right and left hepatic ducts —> common hepatic duct —> joins with cystic duct to form CBD —> joins main pancreatic duct to form Ampulla of Vater (hepatopancreatic duct) at 2nd part of duodenum —> sphincter of Oddi

Question 3

What is the function of cholecystokenin?

Answer 3

contracts the gallbladder and relaxed the sphincter of Oddi

Question 4

The CBD should not exceed? When can it exceed this number?

Answer 4

7 mm; cholecystectomy or old age (older than 70)

Question 5

What are the Valves of Heister? Where are they located?

Answer 5

prevent the cystic duct and gallbladder neck from overdistending or kinking; gallbladder neck and cystic duct

Question 6

The gallbladder should not exceed what length?

Answer 6

8-12 cm

Question 7

The thickness of the gallbladder wall should not exceed?

Answer 7

3 mm

Question 8

The upper CHD should not exceed?

Answer 8

4 mm

Question 9

The gallbladder wall should be measured in what plane?

Answer 9

transverse

Question 10

Describe a floating gallbladder

Answer 10

low gallbladder position in the abdomen

Question 11

True or False: A duplicated gallbladder can be without or with duplication of the cystic duct

Answer 11

True

Question 12

What is a junctional fold?

Answer 12

fold seen at the body and neck of the gallbladder

Question 13

What is it called when the gallbladder neck folds back on itself causing an outpouching?

Answer 13

Hartmann’s Pouch or Infundibulum

Question 14

What is the most common variation of the gallbladder?

Answer 14

Phrygian Cap

Question 15

Describe the Phrygian Cap

Answer 15

Gallbladder fundus is folded into itself

Question 16

What is cholelithiasis? What is another name for it?

Answer 16

calcified mixture of cholesterol, bilirubin, and calcium; gallstones

Question 17

Describe the sonographic appearance of cholelithiasis

Answer 17

mobile, echogenic foci with posterior shadowing

Question 18

Cholelithiasis has elevated?

Answer 18

Elevated ALP/bilirubin

Question 19

What is the WES sign? When is it present?

Answer 19

Wall, Echogenicity, Shadow; When gallbladder is compacted with gallstones (chronic cholecystitis)

Question 20

True or False: With a WES sign, only the anterior lumen is seen

Answer 20

True

Question 21

The Valves of Heister can cause what artifact?

Answer 21

shadowing

Question 22

Describe choledocholithiasis

Answer 22

stones in the bile duct; common biliary tract pathology

Question 23

What is sludge?

Answer 23

Bile coagulates; can lead to gallstones

Question 24

What can cause sludge?

Answer 24

Prolonged fasting

Question 25

How does sludge appear sonographically?

Answer 25

Low level echoes

Question 26

How much bile is made by the liver per day?

Answer 26

1 pint

Question 27

How is bilirubin made?

Answer 27

Liver breaks down hemoglobin of RBC and produces yellow pigment (bilirubin)

Question 28

What is the function of the gallbladder?

Answer 28

stores and concentrates bile

Question 29

How does the gallbladder make bile more concentrated?

Answer 29

takes water and electrolytes and reabsorbs them

Question 30

What is the most common inflammatory disease of the gallbladder?

Answer 30

Acute cholecystitis

Question 31

Describe acute cholecystitis

Answer 31

Large gallbladder, possible cholelithiasis

Question 32

Describe chronic cholecystitis

Answer 32

Small gallbladder, wall thickening, WES sign, cholelithiasis common

Question 33

True or False: Chronic cholecystitis is associated with positive Murphy’s sign

Answer 33

False; Acute

Question 34

Dilated intrahepatic ducts are also called?

Answer 34

Radicals

Question 35

Describe a cholesterol polyp

Answer 35

fixed; **no shadow**

Question 36

Describe adenomyomatosis

Answer 36

benign and echogenic with shadowing in striped pattern

Question 37

What is pneumobilia?

Answer 37

gas/air in biliary tree

Question 38

What is pneumobilia usually caused by?

Answer 38

surgery or infection

Question 39

With chronic cholecystitis, what is elevated?

Answer 39

ALP, AST, ALT and bilirubin if there is jaundice

Question 40

With acute cholecystitis, what is elevated?

Answer 40

ALP

Question 41

What combines to form the ampulla of vater?

Answer 41

CBD and main pancreatic duct

Question 42

The main pancreatic duct is also called?

Answer 42

duct of wirsung

Question 43

Describe the sphincter of oddi

Answer 43

surrounds ampulla of vater and controls release of bile

Question 44

The CBD travels ______ to the first part of the duodenum

Answer 44

posterior

Question 45

The ampulla of vater is also called?

Answer 45

hepatopancreatic duct

Question 46

If the patient has had a cholecystectomy, what can be used to find the gallbladder fossa?

Answer 46

Main lobar fissure; Rex cantline

Question 47

True or False: Radicals light up with color doppler

Answer 47

False; ducts do not light up

Question 48

After bile passes through the CBD, it enters the ____ part of the duodenum

Answer 48

2nd

Question 49

The CBD runs _____ to the 1st part of the duodenum

Answer 49

posterior

Question 50

The CBD runs _____ to the 1st part of the duodenum

Answer 50

posterior

Question 51

Radicals are associated with the elevation of what LFT?

Answer 51

alkaline phosphatase