Gallbladder Path I

Question 1

sphincter of oddi

Answer 1

muscle at ampulla of vater

Question 2

ampulla of vater

Answer 2

opening - emptying into duodenum

Question 3

hartmanns pouch

Answer 3

pocket for stone location in gallbaldder

Question 4

histo of gallbladder

Answer 4

single layer of smooth muscle

BM - under epithelial cells

tumor transverse BM - to lymphatics

Question 5

aberrant location of gallbladder

Answer 5

deep in liver

Question 6

coele

Answer 6

latin for cavity or space

Question 7

cyst

Answer 7

abnormal lined closed space with fluid

-speudo - unlined

Question 8

caroli disease

Answer 8

polycystic renal disease

Question 9

ectasia

Answer 9

aneurysm in vasculature

Question 10

choledochal cyst

Answer 10

-of common bile duct**

don’t remove surgically

most common in clinical

Question 11

choledochocele

Answer 11

dilation at opening to duodenum

Question 12

phyrigian cap

Answer 12

no clinical significance - but important to surgeon

infolding at tip of gallbladder

most common anomaly of gallbladder

causes indentation

Question 13

gallbladder wall

Answer 13

very thin

Question 14

cholelithiasis

Answer 14

gallstones

very common

majority don’t know it

Question 15

risk of gallstones

Answer 15

infections - cholecystitis
obstruction
gallbladder cancer - chronic presence
acute pancreatitis

Question 16

3 types of gallstones

Answer 16

cholesterol - most common
black
brown

Question 17

cholesterol stones

Answer 17

majority
-yellow tan appearance

flat edges - long time - rubbing up against eachother

Question 18

fat, female, fertile, forty

Answer 18

cholesterol gallstones

Question 19

calcium carbonate

Answer 19

give hardness to cholesterol stone

and make seeing it on xray easier

Question 20

path of cholesterol stones

Answer 20

supersaturation in gallbladder or biliary tree

lithogenic - easier to form stone

hypomotility - leads to sludge - important for stone formation
-thick stuff

-nidus - where stones crystallize on

Question 21

cyst

Answer 21

abnormal bile flow - more likely stone formation

Question 22

lumen of gallbladder

Answer 22

abnormal - more likely lithogenic bile to form stones

Question 23

sludge

Answer 23

in gallbladder

can allow stone formation and bacterial growth

Question 24

accretion of cholesterol

Answer 24

stone formation

Question 25

nidus

Answer 25

nucleation for cholesterol formation of stone

Question 26

increased cholesterol secretion

Answer 26

age, estrogen, obesity

Question 27

pima indians

Answer 27

more cholesterol stones

Question 28

crohns disease

Answer 28

more cholesterol stones

Question 29

stone formation

Answer 29

supersatiration crystallization - nidus flow - turbulence accretion - sludge biliary tree/gallbladder -and other organs - kidneys, bladder, prostate, salivary glands, pancreas

Question 30

cholesterolosis

Answer 30

accumulation of cholesterol in mucosa of gallbladder gives white yellow dots with red bkg - strawberry gallbladder can cause gallbladder pain

Question 31

strawberry gallbladder

Answer 31

cholesterolosis diagnosis**

Question 32

black stones

Answer 32

polymers of unconjugated bilirubin usually very small see on xray with chronic hemolysis

Question 33

chronic hemolysis

Answer 33

black stones

Question 34

brown stones

Answer 34

unconjugated bilirubin and cholesterol with infection - e. coli and liver flukes - c. sinensis** softer and crumble don't see on xray

Question 35

c. sinensis

Answer 35

liver fluke - brown stone

Question 36

cholecystitis

Answer 36

inflammation of gallbladder

Question 37

choledocholithiasis

Answer 37

stones in bile duct

Question 38

gallstone location

Answer 38

most formed in gallbladder - can get stuck in cystic duct - pushed to common bile duct

Question 39

gallstone stuck in cystic duct

Answer 39

more stones - stasis wall of gallbladder - can experience ischemia - induces inflammation - chronic or acute predisposition to infection**

Question 40

gallstone in common bile duct

Answer 40

obstruct bile from gallbladder and from liver backup behind stone - leads to more stone formation - jaundice - infection - cancer

Question 41

ascending cholangitis

Answer 41

ascending infection up biliary tree with gallstone

Question 42

gallstone in common hepatopancreatic duct

Answer 42

acute pancreatitis can occur with all the problems in liver and gallbladder

Question 43

gallstone high up in bilary tree

Answer 43

abscess and infection

Question 44

acalculous cholecystitis

Answer 44

critically ill hypovolemic shock - ischemia to gallbladder - no stones

Question 45

biliary dyskinesia

Answer 45

young women gallbladder pain due to sphincter of oddi** pressure gradient to the gallbladder