Biliary (Hagen and Tempkin) Flashcards
In the transverse view, the order of structures, from midline to right, is
portal vein, head of the pancreas, duodenum, liver, and gallbladder
The gastroduodenal artery is a branch of the
Common Hepatic Artery
The left and right hepatic ducts form the
Common Hepatic Duct
The relationship of the gallbladder and the right kidney can be stated as:
The right kidney is posterior to the GB
The relationship of the portal vein, common bile duct. and hepatic artery can be stated as:
CBD is lateral to PV and HA is medial to PV
The route of bile secretion directly from the liver to the gallbladder is via the
Cystic Duct
A normal gallbladder appears round on the longitudinal view.
TRUE/ FALSE
False
__________ (CCK) is a peptide hormone that increases ________ _________of bile, and stimulates the GB to _________
- Cholecystokinin
- hepatic production of bile
- contract
Following the main portal vein, the gallbladder is seen just superior to the right portal vein. ____
TRUE/FALSE
False
Normally, the gallbladder wall is greater than 3 mm thick.
TRUE/FALSE
False
It should be less than 3 mm thick.
The cystic artery passes posterior to the common hepatic duct and anterior to the common duct. ____
TRUE/FALSE
False
The common bile duct can be found medial and posterior to the main portal vein. ____
TRUE/FALSE
False
The common bile duct enters the duodenum through the hepatopancreatic ampulla. ____
TRUE/FALSE
True
The common bile duct is formed by the union of the common hepatic duct and the cystic duct.
TRUE/FALSE
True
The common bile duct is routinely seen on ultrasound
TRUE/FALSE
True
The common hepatic duct is routinely seen on ultrasound. ____
TRUE/FALSE
True
The cystic duct is routinely seen on ultrasound. ____
TRUE/FALSE
False
The gallbladder fossa can be identified close to the main lobar fissure
TRUE/FALSE
True
The gallbladder is routinely identified with ultrasound
TRUE/FALSE
True
The gallbladder remains stationary despite changes in the patient’s position.
TRUE/FALSE
False, it is a mobile organ therefore it moves with patient position
The hepatic artery is found slightly medial and anterior to the main portal vein. ____
TRUE/FALSE
True
The landmarks that help identify the gallbladder on longitudinal section are the __________, ___________, and ________
Portal vein, Main lobar fissure, and right kidney
The right and left hepatic duct is routinely seen on ultrasound.
TRUE/FALSE
False
The length of the gallbladder is highly variable. ____
TRUE / FALSE
True
The most inferior portion of the common bile duct is called the infraduodenal portion
TRUE/FALSE
False
A condition causing RUQ pain in which small polypoid masses arise from the anterior gallbladder wall is _________
adenomyomatosis
A fusiform dilation of the common bile duct that causes obstruction is known as __________
choledochal cyst
A gallbladder that folds near the area of the neck is called ________
Hartmann Pouch
A Phrygian cap of the gallbladder is:
folding of the fundus
A positive Murphy sign is a clinical finding associated with:
cholecystitis
A thick calcified gallbladder wall describes which one of the following conditions?
Porcelain GB
Air within the biliary tree, secondary to common bile duct stents, is called:
Pneumobilia
All of the following sonographic appearances are found in cases of gallbladder carcinoma except:
a. Sludge
b. Wall thickening
c. Cholelithiasis
d. Intraluminal wall mass
sludge
Classic symptoms of gallbladder disease include all of the following except:
Hematuria
Gas-forming bacteria in the gallbladder appear on ultrasound as_____
Bright echo with a comet tail artifact
In a 60-year-old adult, the normal common bile duct should not measure more than _____ mm.
6
Remember the CBD can line up by decades
In cases of choledocholithiasis, stones tend to lodge in the:
Ampulla of Vator
Inflammation of the gallbladder is:
Cholecystitis
Patients positive for the AIDS are at risk for developing:
Cholangitis
The bright linear echo within the liver connecting the gallbladder and the right or main portal vein is called the:
Main Lobar Fissure
The common bile duct is joined by the main pancreatic duct. Together they open through the _____ into the duodenal wall.
Ampulla of Vator
The cystic duct connects the ___________ of the gallbladder with the common hepatic duct to form the ___________.
Neck, CBD
The diameter of the common hepatic duct is approximately ________ millimeters (mm).
4
The distal duct lies ___________ with the anterior wall of the inferior vena cava (IVC)
Parallel
The hepatic duct is joined by the ___________ to form the ___________ .
cystic duct
CBD
The most common cause of biliary ductal obstruction is the presence of a ductal:
Tumor
The most common tumor sites that can spread carcinoma to the biliary tree include all of the following except the:
a. Colon
b. Breast
c. Melanoma
d. Kidney
kidneys
The physiologic effect of a fatty meal includes all of the following except:
a. Stimulation of cholecystokinin (CCK)
b. Contraction of the gallbladder
c. Decrease bile flow to the liver
d. Relaxation of the sphincter of Oddi
Decrease bile flow to the liver
The right and left hepatic ducts emerge from the right lobe of the liver in the porta hepatis and unite to form the:
Common Hepatic Duct
The sonographic appearance of cholelithiasis is best described as:
Mobile, hyperechoic focus demonstrating posterior shadowing
The valves of Heister are tiny valves found within the
Cystic duct
Thickening of the gallbladder wall may be caused by all of the following except:
Acute Pancreatitits
Which one of the following describes the most common sonographic appearance of gallbladder carcinoma?
Irregular echogenic mass projecting from the gallbladder wall
Which one of the following is a function of the gallbladder?
storage of bile
Which one of the following is most characteristic of nonshadowing, low-amplitude echoes in a dependent gallbladder?
Sludge
