Biliary system

Question 1

Not essential for life; contains the Spiral valves of Heister

Answer 1

Gallbladder

Question 2

GB layers (4 layers from inner to outer)

Answer 2

-mucosa
- Lamina propria (fibromuscular layer)
-Muscularis
-serosa

Question 3

Gallbladder size and wall

Answer 3

-GB 8-12cm
-GB wall 2-3mm

Question 4

is the gateway that controls the passage of bile and prevents from from backflow

Answer 4

sphincter of Oddi

Question 5

endocrine vs exocrine

Answer 5

-endocrine secret hormones, ductless, and travel by blood
-exocrine secret enzymes, travels with ducts, used in digestion

Question 6

hormone CCK full name

Answer 6

cholecystokinin

Question 7

this organ is both an endocrine and exocrine organ

Answer 7

pancreas

Question 8

which vessels bring deoxygenated blood to the liver

Answer 8

portal vein

Question 9

which branches of the GB are considered extrahepatic and intrahepatic

Answer 9

-cystic duct and CHD are intrahepatic
-CBD is extrahepatic

Question 10

CBD courses inferiority under the pancreas and empties into the duodenum via

Answer 10

ampulla of Vater

Question 11

indentation where the GB is normally situated

Answer 11

gallbladder fossa

Question 12

function of the GB

Answer 12

store bile

Question 13

function of CCK

Answer 13

signals sphincter of Oddi to relax, GB to contract

Question 14

bile composition (most abundant to least, 5 total)

Answer 14

-water
-bile salts
-cholesterol
-bile acid
-pigment (bilirubin and bilverdin)

Question 15

If there’s an obstruction in GB/CBD a patients feces will be what color and why

Answer 15

the feces will have a grayish color because the intestines are not getting its bilirubin and bilverdin

Question 16

different types of GB abnormalities (8 total)

Answer 16

-septation
-agenosis
-hourglass
-junction fold
-choledochalcyst
-Phrygian cap
-Hartmann pouch
-bilobed

Question 17

what is a positive murphy’s sign

Answer 17

severe pain in RUQ, clear indication of GB stones

Question 18

difference between GB stones, sludge, GB polyp

Answer 18

-GB stones are mobile, round, solid, sonographic shadowing
-sludge is mobile, the beginning of stone formation, viscous bile, attenuation
-polyp is attached to the anterior wall of the GB, color flow will show blood flow, well defined, no shadowing

Question 19

Cholelitheasis

Answer 19

GB stones

Question 20

cholecystitis

Answer 20

inflammation of GB wall over 3mm

Question 21

acalculous cholecystitis

Answer 21

no stones, bacteria causing infection, thickened GB wall

Question 22

choledocholithiasis

Answer 22

stones in the CBD

Question 23

Overall length of pancreas

Answer 23

12-18cm

Question 24

the two ducts within the pancreas

Answer 24

-duct of Wirsung (pancreatic duct)
-Duct of Santorini (accessory duct)

Question 25

5 segments of the pancreas

Answer 25

-head
-neck
-uncinate process
-body
-tail

Question 26

Sonographic appearance of pancreas

Answer 26

slightly more echogenic (hyperechoic) than liver, homogeneous, smooth boarders

Question 27

location of GDA and CBD on pancreas

Answer 27

-GDA is posterior lateral on the head of pancreas
-CBD is anterior lateral on the head of pancreas

Question 28

what is directly posterior to the uncinate process of the pancreas

Answer 28

-SMV and SV (Portal Splenic Confluence)

Question 29

which artery supplies the majority of blood flow to the pancreas

Answer 29

splenic artery

Question 30

what percentage of the pancreas is endocrine and exocrine

Answer 30

-10% endocrine
-90% exocrine

Question 31

which hormones are produced by the pancreas

Answer 31

insulin(beta) and glucAgon(Alpha)

Question 32

enzymes made by pancreas; “Tri A Lip Pro”

Answer 32

-Tripsin
-Amylase
-Lipase
-Protease

Question 33

branches of the Celiac Artery
”LGA-CHA-SPA”

Answer 33

-LGA (Lt. Gastric A.)
-CHA (Common Hepatic A.)
-SPA (Splenic A.)

Question 34

escaping enzymes that form fluid collections, cystic to those with debris, no distinct boarders, brought on by trauma or pancreatitis

Answer 34

psuedocysts

Question 35

acronym for retroperitoneal organs SADPUCKER

Answer 35

-suprarenal gland
-AO
-duodenum (except for prox 2cm of duodenum)
-pancreas
-ureters
-colon (ascending & descending only)
-kidneys
-esophagus
-rectum

Question 36

cancer that forms in the glandular tissue, which lines certain internal organs and makes/releases substances in the body such as mucus, digestive juices, and other fluids. Most common cancer of breasts, lungs, esophagus, pancreas, uterus, etc.

Answer 36

adenocarcinoma

Question 37

Function of the red pulp in the pancreas

Answer 37

phagocytosis

Question 38

Stores RBC’s, not essential for life, peritoneal structure, aids in blood filtration and phagocytosis, superior lateral to left kidney, lymphoid organ

Answer 38

spleen

Question 39

function of the white pulp of the spleen

Answer 39

-Lymphoid tissue for ingestion/digestion of harmful pathogens that has entered the bloodstream

Question 40

normal size of the spleen

Answer 40

8-13cm

Question 41

normal lab for spleen

Answer 41

-Hematocrit: decrease indicates possible internal bleeding
-Bacteremia: Positive= bacteria in blood= sepsis
-Leukocytosis: increase in leukocytes above 10,000 = infection
-Leukopenia: decrease in leukocytes below 5,000 = reaction of certain drugs or bone marrow disorder
-Thrombocytopenia: decrease in thrombocytes/platelets between 150,000-350,000 due to internal hemorrhage