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KaBoom > Biliary System - Part 1 > Flashcards

Biliary System - Part 1 Flashcards

1
Q

Biloma

A

An extrahepatic collection of extravasated bile from

trauma, surgery, or gallbladder disease

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2
Q

Caroli disease

A

A segmental, saccular, or beaded appearance to the intrahepatic biliary ducts

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3
Q

Cholecystokinin

A

Hormone secreted in the small intestine that stimulates GB contraction and secretion of pancreatic enzymes
- stimulation occurs after food reaches the duodenum

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4
Q

Cholesterosis

A

Type of cholesterolosis associated with a strawberry appearance to the GB

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5
Q

Courvoisier sign

A

Painless jaundice associated with an enlarged GB caused by the obstruction of the distal common bile duct by an external mass
- typically adenocarcinoma of the pancreatic head

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6
Q

Emphysematous cholecystitis

A

Gas in the GB wall or lumen

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7
Q

Hartmann pouch

A

Small posterior pouch near the GB neck

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8
Q

Klatskin tumour

A

Carcinoma located at the junction of the right and left hepatic ducts

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9
Q

Mirizzi syndrome

A

Impacted stone in the cystic duct causing compression on the common hepatic duct resulting in jaundice

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10
Q

Porcelain GB

A

Calcification of the GB wall

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11
Q

What are the functions of the biliary system? (3)

A
  1. Transport bile to the GB through the bile ducts
  2. Store and concentrate bile in the GB
  3. Transport bile through the bile ducts to the duodenum
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12
Q

What does the extrahepatic ducts include? (2)

A
  1. Cystic duct

2. Common duct

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13
Q

When does bile flow?

A

When the intraductal pressure is lower than the hepatic secretory pressure

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14
Q

What does the cystic duct drain?

A

GB

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15
Q

What is the mean length of a cystic duct?

A

4cm

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16
Q

What does the cystic duct contain?

A

Spiral valves of Heister

17
Q

Where does the cystic duct course?

A

Posteriorly and inferiorly merging with the CHD to form the CBD

18
Q

Is the cystic duct routinely imaged on US?

A

No

19
Q

What forms the CBD? (2)

A
  1. CHD

2. Cystic duct

20
Q

Where does the CBD course?

A

Inferiorly

- joining the main pancreatic duct at the ampulla of Vater to enter the descending portion of the duodenum

21
Q

Where does the CBD lie compared to the main portal vein and the proper hepatic artery?

A
  1. MPV = anterior

2. PHA = lateral

22
Q

What is the average intraluminal diameter of the CBD?

A

4mm

- should not exceed 6mm in adults

23
Q

At what age does the CBD begin to increase? And by how much per decade?

A
  1. Age 60

2. 1mm per decade

24
Q

What happens to the CBD after a fatty meal?

A

It will either decrease in size or remain the same

25
Q

What is the US appearance of intrahepatic bile ducts? (4)

A
  1. Anechoic non-vascular tubular structures coursing with in the hepatic parenchyma
  2. Smooth hyper echoic walls
  3. Normal intraluminal diameter of the CHD
  4. The right and left hepatic bile ducts generally lie anterior to the corresponding
    portal vein
26
Q

What is the US appearance of extrahepatic bile ducts? (3)

A
  1. Anechoic non-vascular tubular structure anterior to the main portal vein
  2. Smooth hyper echoic walls
  3. Normal intraluminal diameter of the CBD
27
Q

What are the functions of the GB? (3)

A
  1. Concentrates bile through the GB epithelium
  2. Stores concentrated bile
  3. Contracts to release bile when the hormone cholecystokinin is released into the
    bloodstream
28
Q

What are the 3 parts that make up the GB?

A
  1. Fundus
  2. Body
  3. Neck
29
Q

Fundus of the GB

A

Most inferior and anterior portion of the GB

- has a blind end

30
Q

Body of the GB

A

Midportion between then neck and fundus

31
Q

Neck of the GB

A 
Narrow, tapering tubelike structure
- most superior portion
- smallest
transverse diameter
- fixed anatomic relationship to the main lobar fissure and right portal vein
32
Q

What are the 4 layers of the GB wall?

A
  1. Outer serosal
    - visceral
  2. Subserous
    - connective tissue
  3. Muscular
    - contracts
  4. Inner epithelial
    - mucosal
33
Q

What is the location of the GB? (4)

A
  1. GB fossa on the posterior surface of the liver
  2. Lies lateral to the IVC and anterior and medial to the right kidney
  3. Lies posterior and inferior to the main lobar fissure
  4. GB neck lies most superior

KaBoom (81 decks)

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