7.2 Bile Formation, Storage and Roles Flashcards
The common bile duct is formed by the joining of…
The common hepatic duct (from the liver) and the cystic duct (from the gall bladder).
How does bile end up in the gall bladder?
- Bile flows from liver (where it’s made) to common bile duct
- If sphincter of the bile duct closes (like when not eating) , it backs up, until it enters the Gall Bladder via the cystic duct
The medical term for gallstones in the gall bladder is…
Cholelithiasis (chole = bile, lith = stone, iasis = process)
The medical term for gallstones in the liver is…, and in the bile duct is…
Liver: hepatolithiasis
Bile duct: choledocholithiasis
The gall bladder is _____peritoneal, and the biliary tree is ______peritoneal
Gall bladder: intraperitoneal (w/ liver)
Biliary tree: retroperitoneal
List one hormone that would cause/prevent the sphincter of oddi from relaxing
Cause to contract: somatostatin
Cause to relax: Cholecystochinin
Where is bile formed? What does it contain? How does it reach the biliary tree?
- Formed in hepatocytes
- Contains cholesterol (in the form of bile salts), phospholipids, water, and bilirubin
- Release through bile canaliculi on canalicular surface of hepatocytes. Combine into ductules, then common bile duct.
Enterohepatic circulation describes how…
Substances are secreted from the liver (such as bile), and are resorbed from the intestine (bile = distal ileum), forming a circulatory pattern.
Where in the GI tract is bile resorbed? Approximately what proportion of the original secretion is resorbed?
- Distal ileum
- About 95% of the original secretion is retained
After being reabsorbed in the distal ileum, a majority of bile salts are returned to the beginning of enterohepatic circulation via which vein?
Hepatic portal vein
What are the three types of gallstones, and their primary constituents?
- Cholesterol (supersaturated w/ cholesterol)
- Black pigment stones (calcium bilirubinate; haemolytic, black = death)
- Brown pigment stones (bacterial/parasitic infection)
Describe uncomplicated gallstone disease
- Gallstone pushed into outlet of gallbladder
- Temporary obstruction
- Pain without inflammation
What is Mirizzi syndrome?
Gallstone stuck in cystic duct, compressing on common hepatic duct
Describe the presentation of biliary “colic”. What are three important negative signs?
- Abrupt onset
- Dull RUQ pain, worsened after meals (esp. fatty meals)
- Constant (not colicky after all)
- May have sweating, nausea, vomiting
Negatives:
1. Fever
2. Tachycardia
3. Peritoneal signs
What causes biliary colic
Obstruction (usually by gallstones) in the neck of the gallbladder
