Lesson 2A (Part 1)

Question 1

What is the biliary system made up of? (3)

Answer 1

1. Intrahepatic bile ducts
   - part of the triad
2. GB
3. CBD

Question 2

What do hepatocytes produce?

Answer 2

Bile

Question 3

Where is bile transported through?

Answer 3

Through the right and left intrahepatic bile ducts to the porta hepatis where they converge to form the common hepatic duct

Question 4

How does common hepatic duct transport bile into the GB?

Answer 4

Through the cystic duct

Question 5

What controls the flow of bile?

Answer 5

Valves of Heister in the cystic duct

Question 6

Where is the extrahepatic CBD compared to the cystic duct and CHD?

Answer 6

It is distal to it

Question 7

What does the GB do? (4)

Answer 7

1. Stores and concentrates bile
2. Transports bile through the CBD to the duodenum
3. When fat enters the digestive system, cholecystokinen is released into the bloodstream and stimulates the release of bile into the CBD and duodenum
4. Bile enters the Ampulla of Vater along with enzymes from the pancreas through the duct of Wirsung to aid in the digestion of fats in our digestive system

Question 8

What is the GB and cystic duct supplied by?

Answer 8

The cystic artery

Question 9

What is the cystic artery a branch from?

Answer 9

Right hepatic artery

Question 10

What is routinely looked at when scanning the biliary system? (2)

Answer 10

1. Liver

2. Pancreas

Question 11

Why is the liver and pancreas scanning when looking at the biliary system?

Answer 11

Because they are intertwined in their functions and affects each other

Question 12

How do you get indirect bilirubin?

Answer 12

When the liver breaks down old red blood cells and then changes it to direct where the GB discrete it

Question 13

What is the normal total bilirubin value?

Answer 13

0. 3-1.1 dL

- indirect

Question 14

What is the direct bilirubin value?

Answer 14

0. 1-0.4 dL

- direct

Question 15

What is bilirubin?

Answer 15

A product from the breakdown of hemoglobin in old red blood cells

Question 16

What does leakage of bilirubin into the tissue give?

Answer 16

Jaundice

Question 17

What does bilirubin reflect?

Answer 17

The balance between production and excretion of bile

Question 18

What is elevation of direct or conjugated bilirubin associated with? (4)

Answer 18

1. Obstruction
2. Hepatitis
3. Cirrhosis
4. Liver metastases

Question 19

What is elevation of indirect or unconjugated bilirubin associated with?

Answer 19

Nonobstructive conditions

- eg) steatosis

Question 20

ALP

Answer 20

Alkaline phosphatase

- an enzyme

Question 21

What is ALP produced by? (3)

Answer 21

1. Liver
2. Bone
3. Placenta

Question 22

Where is ALP excreted through?

Answer 22

Bile ducts

Question 23

What is marked elevation of ALP associated with?

Answer 23

Jaundice

Question 24

ALT

Answer 24

Alanine aminotransferase

Question 25

Where is ALT found in high concentrations?

Answer 25

Liver

Question 26

Where is ALT found in low concentrations? (3)

Answer 26

1. Heart 2. Muscle 3. Kidneys

Question 27

What enzyme remains elevated longer, AST or ALT?

Answer 27

ALT

Question 28

What is ALT used to asses?

Answer 28

Jaundice

Question 29

What is elevated levels of ALT associated with? (3)

Answer 29

1. Cirrhosis 2. Hepatitis 3. Biliary obstruction

Question 30

What is mild elevations levels of ALT associated with?

Answer 30

Liver metastases