Biliary system Flashcards by Jonathan Crispin

Not essential for life; contains the Spiral valves of Heister

Gallbladder

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GB layers (4 layers from inner to outer)

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

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Gallbladder size and wall

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

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

sphincter of Oddi

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endocrine vs exocrine

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

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hormone CCK full name

cholecystokinin

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this organ is both an endocrine and exocrine organ

pancreas

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which vessels bring deoxygenated blood to the liver

portal vein

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which branches of the GB are considered extrahepatic and intrahepatic

-cystic duct and CHD are intrahepatic
-CBD is extrahepatic

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

ampulla of Vater

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indentation where the GB is normally situated

gallbladder fossa

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function of the GB

store bile

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function of CCK

signals sphincter of Oddi to relax, GB to contract

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bile composition (most abundant to least, 5 total)

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

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

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

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different types of GB abnormalities (7 total)

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

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what is a positive murphy’s sign

severe pain in RUQ, clear indication of GB stones

difference between GB stones, sludge, GB polyp

-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

Cholelitheasis

GB stones

cholecystitis

inflammation of GB wall over 3mm

acalculous cholecystitis

no stones, bacteria causing infection, thickened GB wall

choledocholithiasis

stones in the CBD

Overall length of pancreas

12-18cm

the two ducts within the pancreas

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

5 segments of the pancreas

-head -neck -uncinate process -body -tail

Sonographic appearance of pancreas

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

location of GDA and CBD on pancreas

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

what is directly posterior to the uncinate process of the pancreas

-SMV and SV (Portal Splenic Confluence)

which artery supplies the majority of blood flow to the pancreas

splenic artery

what percentage of the pancreas is endocrine and exocrine

-10% endocrine -90% exocrine

which hormones are produced by the pancreas

insulin(beta) and glucAgon(Alpha)

enzymes made by pancreas; “Tri A Lip Pro”

-Tripsin -Amylase -Lipase -Protease

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

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

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

psuedocysts

acronym for retroperitoneal organs SADPUCKER

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

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.

adenocarcinoma

Function of the red pulp in the pancreas

phagocytosis

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

spleen

function of the white pulp of the spleen

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

normal size of the spleen

8-13cm

normal lab for spleen

-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