Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ABD > Biliary Tract Anatomy & Labs > Flashcards

Biliary Tract Anatomy & Labs Flashcards

1
Q

The RT and LT hepatic ducts join to for the ______ ______ ______.

A

Common hepatic duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The GB is located at the ______ end of the MLF.

A

inferior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The GB neck tapers to form the _____ ______ which joins with the ____ _____ _____ to form the _____ _____ _____.

A

cystic duct, common hepatic duct, common bile duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The CHD is _____ the liver.

A

outside

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

The MPV, CHD, PHA form the ______ ______ at the _____ ______. Some refer to this as the mickely mouse sign.

A

portal triad, porta hepatis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

In the portal triad, the CHD is _______ and to the ______ of the MPV and the PHA is ______ and to the ______ of the MPV.

A

anterior/right

anterior/left

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

T/F - The cystic duct is commonly visualized.

A

F - it is uncommon so we use the term “common duct” to refer to the extrahepatic ductal system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What forms the ampulla of Vater?

A

CBD and main pancreatic duct (Duct of Wirsung)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the valve of Heister’s and what is its function?

A

spiral fold in the GB which controls bile flow in the cystic duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a Hartmann’s pouch?

A

abnormal sacculation (diverticulum) of the neck of the GB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a phrygian cap?

A

fold between the body and fundus of the GB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a junctional fold?

A

fold between the body and neck (infundibulum) of the GB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

The CBD passes _______ to the first part of the duodenum and pancreatic head, joining the duct of Wirsung at the _____ ____ _____.

A

posterior, ampulla of Vater

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

The GB is divided into what 3 parts?

A

neck, body, fundus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Muscular valve that controls the flow of digestive juices (pancreatic, bile) through the ampulla of Vater into the second part of the duodenum.

A

Sphincter of Oddi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

The ampulla of Vater empties though the _______ ______.

A

duodenal papilla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Normal GB wall thickness.

A

<3mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Cholecystokinin

A

hormone released into the blood in response to ingestion of fatty foods, causing GB contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Reasons for performing a fatty meal test

A

equivocal bile duct dilation
abnormal labs (conjugated bilirubin, alkaline phosphatase)
if the duct increases in size, positive result
if the duct decreases in size or is unchanged, negative result

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Where should the CHD be measured?

A

At the porta hepatis, outside the liver where the RHA courses between the MPV and CHD, lumen only

21
Q

The size of the extrahepatic bile duct is the most sensitive means of distinguishing _______ from ______ jaundice.

A

medical (pre-hepatic/hepatic)

surgical (post hepatic)

22
Q

Measurement criteria for CHD

A

Normal <5mm
Equivocal 6-7mm
Dilated >8mm (consider age and surgery)

23
Q

Upper normal value of the CHD in elderly patients

A

10mm

24
Q

The CHD diameter increases with age, _____ mm decade rule. So at age 60, _____ mm is normal and at age 80, ____mm is normal.

A

1mm
6mm
8mm

25
Q

Postcholecystectomy, the CHD acts like a reservoir for bile so it may normally increase in size up to ____mm

A

10mm

26
Q

What parts of the biliary tree dilate with a distal common bile duct obstruction?

A

entire system distends including the GB

27
Q

What parts of the biliary tree dilate with a common hepatic obstruction?

A

only the CHD and intrahepatic ducts will dilate

GB will be contracted

28
Q

What parts of the biliary tree dilate with an obstruction at the junction of the RT and LT hepatic ducts?

A

only the intrahepatic ducts, GB will be contracted

29
Q

Bilirubin

A

end product of hemoglobin breakdown

30
Q

Total bilirubin

A

conjugated + unconjugated

31
Q

Conjugation

A

process of removing protein (albumin) from unconjugated bilirubin, making it soluble

32
Q

______ is important for bilirubin disposal. It not only renders the pigment excretable by the liver, but also detoxifies the waste product.

A

conjugation

33
Q

Indirect hyperbilirubinemia

A

unconjugated

34
Q

direct hyperbilirubinemia

A

conjugated

35
Q

Unconjugated (indirect) hyperbilirubinemia results from (3)

A

impaired hepatic bilirubin uptake
increased bilirubin production
impaired conjugation of bilirubin

36
Q

Conjugated (direct) hyperbilirubinemia results from (1)

A

defective bile outflow

37
Q

The kidneys do not filter ______ bilirubin as they are bound to albumin.

A

unconjugated

38
Q

The presence of bilirubin in the urine indicates_______ hyperbilirubinemia.

A

conjugated, remember that the kidneys cannot filter unconjugated

39
Q

Unconjugated hyperbilirubinemia results from impaired hepatic bilirubin uptake due to (5)

A 
CHF
liver varices
TIPS
Drugs
Contrast agents
40
Q

Unconjugated hyperbilirubinemia results from increased bilirubin production due to (2)

A

hemolysis - rupture or destruction of RBCs
or
ineffective erythropoiesis - production of RBCs

41
Q

Unconjugated hyperbilirubinemia results from impaired conjugation of bilirubin due to (2)

A 
Gilbert syndrome (3-7% adult pop)
Crigler-Najjar Syndrome Type I and II (rare, only few 100 cases)
42
Q

2 autosomal recessive disorders of bile metabolism resulting in underactivity of the conjugating enzyme system due to lack of the enzyme uridine diphosphate glycosyl transferase. Leads to unconjugated hyperbilirubinemia.

A

Gilbert syndrome

Crigler-Najjar Syndrome Type I and II

43
Q

Defective bile outflow from a bile duct obstruction results in reflux of ______ into plasma and direct hyperbilirubinemia.

A

conjugates

44
Q

Conjugated hyperbilirubinemia results from defective bile outflow due to (4)

A

hepatitis
biliary obstruction
hepatic insult due to sepsis
cardiogenic shock

45
Q

High levels of ______ bilirubin may secondarily elevate the level of _____ bilirubin.

A

conjugated, unconjugated

46
Q

alkaline phosphatase

A

ALP

enzyme that is concentrated in the bile ducts and also found in bone, liver, and placenta

47
Q

_____ increases with bone growth (children) and pregnancy (liver, placenta)

A

ALP

48
Q

_____ increases in diseases that impair bile formation, specifically bile duct obstruction

A

ALP

49
Q

ALP increases with (11)

A 
choledocholithiasis
pancreatic carcinoma
cholangiocarcinoma
cholangitis
Mirizzi syndrome
choledochal cyst (Caroli's disease)
GB carcinoma
primary sclerosing cholangitis
primary biliary cirrhosis
bone growth and diseases
pregnancy

ABD (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions