QUIZ 6 Flashcards
(20 cards)
Biliary system consists of:
-The RT/LT Branches of Hepatic Duct
-Common Hepatic Duct (CHD)
-Cystic Duct
-Gallbladder (Neck, Body, Fundus)
-Common Bile Duct
Common bile duct (CBD)
diameter up to 6 mm It is joined by the main pancreatic duct (Duct of Wirsung) and goes into the duodenal papilla through the ampulla of Vater - Sphincter of Oddi (controls release) where it releases bile into the GI tract at the second portion of the duodenum to aid with digestion.
Where do the right and left hepatic ducts emerge from?
from the right lobe of the liver at the porta hepatis and unite to form the common hepatic duct (CHD). The common hepatic duct (CHD) joins with the cystic duct to form the Common Bile Duct.
The gallbladder is found ___ to the liver
posterior
Normal Lenth of GB
Normal length= 7-10cm. GB wall < 3mm
3 parts of GB
divided into neck, body and fundus. The neck of the GB tapers and connects to the cystic duct.
The purpose of the biliary tract?
to collect, store, concentrate, and deliver bile produced/secreted by the liver. It is released into the duodenum for digestion which helps with absorption of fats.
The portal triad consists of
portal vein, common hepatic duct/common bile duct (depends), and proper hepatic artery. In the transverse view called “Mickey Mouse” sign.
Patient preparation:
Nothing by mouth (NPO) for 8-12 hours to help eliminate bowel gas.
Patient position:
Supine and left lateral decubitus position, usually with deep inspiration.
Transducer: 2.5 to 4 MHz
GB Supine Long MED/LAT
sweep and take images medial to lateral (follow long axis of GB)
GB Supine Trans S/I
sweep and take images superior to inferior (follow short axis of GB)
Phrygian Cap - M/C
A fold between the body and the fundus of the GB. Looks like the smurfs hat
Cholelithiasis (aka Gallstones)
Presence of one or more calculi (stones) in the gallbladder. Composed of Cholesterol, Calcium Bilirubin, and/or Calcium Carbonate.
Clinical Indications/Risk Factors of Gallstones
Most common symptom is biliary colic (pain due to gallstones). Other findings include nausea, vomiting, and pain that radiates to the shoulders, possible fever. But can be asymptomatic. *Patients who are fat, female, fertile, (flatulent), fair, and over forty have shown a higher incidence of gallstones (usually called 5 F’s) *Some texts add Flatulence.
Gallstones on Ultrasound
Echogenic/hyperechoic structure(s), Mobile/Gravity Dependent, Posterior Shadowing.
Choledocholithiasis
Stone (cholelithiasis) in the ducts
Clinical Indications/Risk Factors of Choledocholithiasis
RUQ pain & jaundice. Risk factors are the same as those for cholelithiasis. Also, those with recent cholecystectomy may have stones sneak into the duct during surgery.
Choledochal Cyst
A congenital condition involving cystic dilatation of bile ducts; there are five classes of choledochal cysts. Most common type is type 1 and involves dilation of the CBD.
Clinical Indications/Risk Factors of Choledochal Cyst
Presents with an abdominal mass, jaundice, pain, and fever. They can lead to cholangitis, portal hypertension, pancreatitis, and liver failure. Usually discovered in infancy or the first decade of life.
Radiological Image of Choledochal Cyst
Appears as two cystic structures in the right upper quadrant (dilated duct & GB). Aneurysmal appearance of bile duct. Can be described as a fusiform cystic mass in the area of the porta hepatis - extensive biliary dilatation.
