Biliary system and UGI Flashcards
1
Q
Radiographic examination of the biliary system involves studying the manufacture, transport and storage of what?
A
bile
2
Q
How much does the liver weigh?
A
3-4 pounds
3
Q
What is the largest solid organ in the body?
A
liver
4
Q
the liver occupies most of what quadrants?
A
RUQ & LUQ
5
Q
how long is the widest part of the liver?
A
8-9 inches
6
Q
what is the largest vertical dimension of the liver?
A
6-7 inches
7
Q
what is the flow of bile?
A
liver-right & left hepatic duct-common hepatic duct-cystic duct-galbladder-cystic duct-common bile duct-hepatopancreatic ampulla-hepatopancreatic sphincter-duodenum of small intestine
8
Q
what is the hepatopancreatic ampulla also called?
A
ampulla of vater
9
Q
what is the hepatopancreatic sphincter also called?
A
sphincter of oddi
10
Q
two major lobes of the liver are divided by what?
A
falciform ligament
11
Q
what are the 2 major lobes of the liver?
A
right and left lobe
12
Q
two minor lobes located on the medial aspect of the right lobe?
A
quadrate lobe or caudate lobe
13
Q
what is the hilum of the liver called?
A
porta hepatitis
14
Q
where is the hilum of the liver located
A
between 2 minor lobes
15
Q
what function of the liver is most applicable to radiographic studies?
A
production of bile
16
Q
how much bile does the liver secrete daily?
A
800-1000ml (1 quart)
17
Q
what is the major function of bile?
A
to aid in the digestion of fats by emulsifying fat globules and the absorption of fat following its digestion
18
Q
what is bile made of?
A
liquid substance composed of mainly bile salts, bile pigments, cholesterol and water
19
Q
what facilitates the absorption of fats?
A
bile salts
20
Q
if bile contains either insufficient bile salts or excessive cholesterol the cholesterol may form what?
A
gallstones
21
Q
bile formed int he liver and travels to what ducts
A
right and left hepatic
22
Q
hepatic ducts join to form ?
A
common hepatic duct
23
Q
how much bile does the gallbladder hold?
A
30-40mL of bile
24
Q
how big is the gallbladder?
A
7-10cm (3-4in long)
25
3 main parts of the gallbladder?
fundus, body and neck
26
the neck of the gallbladder continues on to form what?
cystic duct
27
How long is the cystic duct?
3-4 cm long
28
the cystic ducts contains folds called?
spiral valve
29
what is the function of the spiral valves?
prevent distention or collapse of cystic duct
30
3 primary functions of the gallbladder?
store, concentrate bile and contract when stimulated
31
bile is concentrated within the gallbladder as a result of a process called?
hydrolysis (removal of water)
32
what is choleliths?
gallstones
33
what forms the most common type of gallstones?
cholesterol coming out of solution
34
the foods stimulate the mucosa of the duodenum to secrete a hormone called?
cholecystokinin
35
what does cholecystokinin do in the pancreas?
stimulates the pancreas to secrete pancreatic juice and cause the hepatopancreatic sphincter to relax, which permits the flow of both bile and pancreatic juice into the duodenum
36
how long is the common bile duct?
7.5 cm long
37
where is the common bile duct located?
descends behind superior portion of duodenum and head of pancreas to enter descending portion of the duodenum
38
what is the pancreatic duct also called?
duct of wirsung
39
what two ducts come together to form the hepatopancreatic ampulla?
common bile duct and pancreatic duct
40
pancreatic duct and common bile duct remain separated in what % of people?
40%
41
what is a common site for impaction of gallstones?
hepatopancreatic ampulla
42
the presence of the hepatopancreatic sphincter causes a protrusion into the lumen of the duodenum known as what?
duodenal papilla
43
what position places the gallbladder closer to the IR?
prone
44
what does the supine position do for the gallbladder?
drain the gallbladder into the duct system
45
contrast medium was ingested orally for a cholecystogram and was called ?
oral cholecystogram (OCG)
46
what are the 4 advantages of US of the gallbladder over ocg's
no ionizing radiation, able to detect small calculi, no contrast medium, less patient prep
47
what does chole- mean?
relationship with bile
48
what does cysto- mean?
bag or sac
49
what does choledocho-
common bile duct
50
what does cholangio- mean
bile duct
51
what does cholecyst-mean ?
gallbladder
52
what does choledocholithiasis mean?
presence of having stones in the biliary ducts
53
what are some symptoms of choledocholithiasis
pain, jaundice, tenderness in RUQ, pancreatitis
54
what are the 4 F's for gallstones?
female, fat, forty, and fertile
55
what percent of gallstones are radiolucent?
85-90%
56
what is milk calcium bile?
Emulsion of biliary stones in the gallbladder, emulsion builds up of calcium deposits within gallbladder may be difficult to diagnose with ocg
57
what is cholecystitis?
inflammation of the gallbladder, can be acute or chronic
58
what is neoplasms?
growths that can be benign or malignant, cancer of GB can be aggressive
59
what is biliary stenosis?
narrowing of one of biliary ducts, may restrict flow of bile leading to obstruction
60
what is deglutition
swallowing
61
what is dysphagia
difficulty swallowing
62
what is dysphasia
difficulty speaking
63
what is cathartic?
an agent causing active movement of bowels
64
what are the accessory organs of the UGI?
salivary glands, pancreas, liver, gallbladder
65
what is the route of the alimentary canal?
oral cavity, pharynx, esophagus, stomach, duodenum and small intestine, large intestine, anus
66
what is the length of the GI tract?
about 30 feet long form the esophagus to the end of large intestine
67
about how long is the esophagus?
10inches
68
about how long is the stomach?
10 inches
69
about how long is the small intestine?
23 feet (stretched out)
70
about how long is the large intestine?
5 feet
71
During life, with good muscle tone, the actual length of the small intestine is about how many feet long?
15-18
72
what are the 3 primary functions of the digestive system,?
intake and digestion(carbs, lipids, protein), absorption (essential elements absorbed from alimentary canal), elimination
73
what are the two common radiographic procedures?
esophagram and upper GI
74
what is the purpose of the esophagram
study the form and function of the pharynx and the esophagus
75
what is the purpose of the UGI?
study the form and function of the distal esophagus, stomach, and duodenum
76
the roof of the oral cavity is formed by what?
hard and soft palates
77
what is the function of the uvula?
to prevent food from entering pharynx prematurely
78
where does the soft palate begin
beings at the last color and is suspended from the posterior border of the hard palate
79
what forms the hard palate?
palatine process of the maxillary bone and the 2 horizontal portion of the palatine bone
80
three pairs of salivary glands secrete into the oral cavity?
parotid, submandibular, and sublingual
81
where is the parotid salivary gland located?
inferior and anterior to the ears
82
where is the submandibular salivary gland located
posterior part of the floor of the mouth
83
where is the sublingual salivary gland located
below the tongue on the floor of the mouth
84
what is saliva made up of?
99.5% water and .5 salt and digestive enzymes
85
how much saliva is secrete daily?
1000-1500mL
86
what is mumps?
inflammation of the parotid glands
87
what is the second organ of the digestive system?
pharynx
88
what is the pharynx often referred as
throat
89
the pharynx serves as a passage way for what?
food and air
90
what 3 parts is the pharynx divided into?
nasopharynx, oropharynx, and laryngopharynx
91
what is the cartilage that covers opening of larynx during swallowing?
epiglottis
92
what are the 7 cavities that communicate with the three portions of the pharynx
nasopharynx: tympanic cavities(2) via the eustachian tubes, and nasal cavities (2)
oropharynx: oral cavity
laryngopharynx: larynx, and esophagus
93
what does esophagus translate too?
carry food
94
what is the function of the esophagus?
transport food and fluids from the pharynx to the stomach
95
what landmarks does the esophagus fall between?
cricoid cartilage (c5-c6) to stomach (T11)
96
what are the 4 layers of the esophagus?
fibrous, muscular, submucosal, and mucosal
97
what are the 2 indentations present in the esophagus?
aortic arch, and left primary bronchus
98
distal esophagus passes through an opening in the diaphragm called what and located at what level?
esophageal hiatus at level of T10
99
what is a condition where the upper portion of the stomach protrudes through the esophageal hiatus is called?
hiatal hernia
100
what is the abdominal segment (slightly expanded) of the esophagus that is about 1 inch in length called?
cardiac antrum
101
what is the opening/junction between the stomach and the esophagus called
esophagogastric junction (cardiac orifice) at T11
102
what is the wavelike series of involuntary contractions that propels solid and semisolid materials through the entire alimentary canal
peristalsis
103
what does ventriculus mean?
little belly in latin
104
what is the most dilated portion of the alimentary canal
stomach
105
what is the muscle that controls the esophagogastric junction
cardiac sphincter
106
what is the notch located superior to the esophagogastric junction?
cardiac notch
107
what is the opening leaving the stomach
pyloric orifice
108
what is the muscle that controls the pyloric orifice?
pyloric sphincter
109
what is the medial concave border of the stomach
lesser curvature
110
what is the convex lateral border of the stomach
greater curvature
111
how many times longer is the greater curvature compared to the lesser
4-5x longer
112
what does the greater curvature extend between
cardiac notch and the pylorus
113
in the upright position the fundus is usually filled with a bubble of swallowed air called?
gastric bubble
114
the body of the stomach begins at the cardiac notch and ends at a constricted ring like area called?
angular notch (incisura angularis)
115
what is the terminal portion of the stomach ro right or medial of angular notch?
pylorus
116
the pylorus is divided into 2 portions called ?
pyloric antrum and pyloric canal
117
what does rugae translate into?
wrinkles
118
what do the rugae do for the stomach?
assist with mechanical digestion of food within stomach
119
in the supine position barium would be in what part of the stomach?
fundus
120
in the supine position air/gas would be in what part of the stomach?
pylors
121
what does the RAO position do for barium/ air study?
allows air to form in the fundus and the barium to be in the pylorus
122
what is the first part of the small intestine
duodenum
123
most of the duodonem and pancreas are infra, intra or retropertioneal?
retroperitoneal
124
what are the 4 parts of the duodenum?
superior, descending, horizontal and ascending
125
what part of the duodenum is intrapertoneal?
first (superior) portion
126
what part of the duodenum is commonly studies for a site of ulcers?
superior portion
127
what is the longest segment of duodenum?
descending
128
what is the junction of the duodenum and the jejunum called?
duodenojejunal flexure
129
what is the duodenojejunal flexure relatively fixed and held in place by?
ligament of trite (suspensory muscle of the duodenum)
130
what are the two types of digestion
mechanical and chemical (all chemical changes food undergoes as it travels through the alimentary canal)
131
how long does the take for the stomach to empty after an average meal
2-6 hours
132
how long does it take for solid/semisolid food to go from the mouth to the stomach? liquid?
4-8 seconds for solid, 1 second for liquid
133
how long does chyme take to pass through the entire small intestine
3-5 hours
134
where does most absorption of digestive products take place
small intestine
135
in a hyperstenic patient the level of the stomach extends from?
T9-T12
136
the duodenal bulb in a hyperstenic patient is at the level of
T11
137
in the Asthenic/Hypostenic patient the stomach extends from?
T11-L5
138
the duodenal bulb in a Asthenic/Hypostenic patient is at the level of
L3-L4
139
in the sthenic patient the stomach extends from ?
T10-11 to L2
140
in the upright position organs tend to drop how many inches from normal position
1-2 inches
141
polyps, diverticula and ulcers of the stomach are better demonstrated with what kind of study?
double contrast study
142
what are the two types of carbon dioxide gas used?
calcium citrate and magnesium citrate
143
what are the 3 cardinal principles of radiation?
time, distance, shielding
144
what are the 4 ways to demonstrate esophageal reflux
breathing technique, water test, compression paddle technique, and toe touch test
145
what are the 2 types of breathing techniques
valsalva maneuver and mueller maneuver
146
what is achalasia?
cardiospasm, motor disorder of esophagus in which peristalsis is reduced along distal 2/3 of esophagus
147
what are anatomic anomalies?
may be congenital or caused by disease
148
what is barrettes esophagus?
replacement of normal squamous epithelium ulcer tissue in lower esophagus
149
what will produce a strictures or streaked like appearance in distal esophagus?
barretts esophagus
150
what is esophageal varices
dilation of veins in the distal esophagus
151
what will esophageal varices present like on a radiograph?
wormlike or cobblestone appearance
152
what is zenkers diverticulum?
large outputting of the esophagus
153
what is a bezoar?
mass of undigested martial that becomes trapped in stomach-hair veggie fibers
154
what are diverticula?
pouchlike herniationsof a portion of mucosal wall
155
what percent of gastric diverticula arise in posterior aspect of stomach
70-90
156
what projection best demonstrates diverticula
lateral
157
what is a schatzki's ring
ringlike constriction at distal esophagus
158
where would you find a schatzkis ring
sliding hiatal hernia
159
what is hypertrophic pyloric stenosis
obstruction of pylorus
160
where would u find a duodenal ulcer
2nd or 3rd part of duodenum
161
where would you find a peptic ulcer
mucosa of esophagus, stomach or duodenum
162
where would you find a gastric ulcer
gastric mucosa
163
what % of ulcers lead to perforation
5
164
how long should a child under 1 be NPO for
4 hours
165
how long should a child older than 1 be NPO for
6 hours
166
how much barium should be given to a child NB-1?
1-3?
3-10?
older than 10?
NB-1: 2-4 oz
1-3: 4-6
3-10: 6-12
over 10-12-16
