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Abdomen and Superficial Structures 1 > Biliary Tree > Flashcards

Biliary Tree Flashcards

1
Q

biliary tree begins at the liver _____

A

lobules

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2
Q

intercommunicating network located between hepatocytes called _____. Anastomose to form _____

A

bile canaliculi
lobular bile ducts

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3
Q

RT and LT hepatic ducts formed by the union of _____ ducts

A

lobular

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4
Q

intrahepatic ducts should measure no more than ____ in diameter

A

2mm

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5
Q

at the porta hepatis the right and left duct join to form the ___

A

CHD

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6
Q

CHD is ____ to PV and ______ to rt hepatic artery

A

anterior
anterior and lateral

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7
Q

CHD joins the cystic duct and forms the ____

A

CBD

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8
Q

CBD length is determined by

A

insertion point

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9
Q

CBD travels ______ to MPV

A

anterior and lateral

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10
Q

normal diameter if CBD

A

up to 4mm up to 40 and then add 1mm for every decade of life (ex. 50=5mm)

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11
Q

CBD diameter in a post-cholecystectomy patient

A

up to 10mm

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12
Q

CBD travels through _________ ligament

A

hepatoduodenal

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13
Q

the hepatoduodenal and hepatogastric ligament make up the

A

lesser omentum

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14
Q

mickey mouse made of

A

HA MPV and CBD

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15
Q

the HA is anterior and ___ of the PV and the CBD is anterior and ____ of thr PV

A

left
right

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16
Q

CBD is divided into ___ parts relating to its position to the ____

A

4
duodenum

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17
Q

what is the 4th part of the CBD called

A

intraduodenal

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18
Q

4th part of the CBD enters the ____, inserts into the _____. The _____ regulates bile flow.

A

2nd part duodenum
ampulla of Vater
Sphincter od Oddi

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19
Q

whats the narrowest part of the extrahepatic biliary tract

A

4th part CBD (double-check notes)

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20
Q

if you see the cystic duct on US it means it is

A

dilated

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21
Q

cystic duct joins the CHD ____ above the duodenum

A

1-2cm

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22
Q

cystic duct arises from the _____ aspect of the ___of the gallbladder

A

superior
neck

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23
Q

cystic duct is ____ shaped, ____ diameter, ___ in length

A

s
3mm
4cm

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24
Q

cystic ducts contains and function

A

valves of Heister
mucosal folds that prevent the duct from over-distending or collapsing

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25
Q

GB is on the _____ _____ surface of the right liver

A

posterior
inferior

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26
Q

GB is located in the GB _____

A

fossa

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27
Q

GB is _____ and ____ to MLF

A

posterior
caudal

28
Q

GB is intra/retroperitoneal

29
Q

what portion of GB varies with patient position

A

body
fundus

30
Q

4 landmarks for identifying the GB

A

MLF (most reliable)
RPV
duodenum
Rt kidney (only in trans)

31
Q

GB shape

A

pear or teardrop

32
Q

GB length and diameter

A

8-9cm
3-5cm

33
Q

divisions of GB

A

fundus
body (corpus)
neck (fixed)

34
Q

what is the most dependent portion of the GB in LLD

35
Q

what is the most dependent portion of the GB in supine

36
Q

GB wall should measure less than____ in a fasting state

37
Q

4 layers of GB

A

mucosal: inner/concentrates bile
muscular
subserous: CT
serosa: outer layer

38
Q

Rokitansky-Aschoff (RA) sinuses

A

multiple folds along the inner border of the GB
not seen on US unless pathology

39
Q

how much bile does the GB store

40
Q

what does the GB do to bile

A

concentrates bile by secreting mucous and absorbing water

41
Q

bile secretion is controlled by _____

42
Q

with ingestion of fats and amino acids, the duodenum releases _____ which stimulates the GB to ____ and the sphincter of Oddi to _______

A

cholecystokinin (CK)
contract
relax

43
Q

GB contraction occurs within _____ following a meal

A

30 minutes

44
Q

what happens when GB removed

A

initially sphincter of oddi loses tone=bile flows into duodenum during fasting and non fasting states
after about 6m, sphincter regains tone
CBD may be dilated up to 10mm

45
Q

what colour is bile

A

yellow-green

46
Q

what is bile produced by

A

hepatocytes

47
Q

what is bile composed of (5)

A

water
cholesterol
bilirubin
inorganic and bile salts

48
Q

bile ____ fats and helps absorb _______

A

emulsifies
fatty acids

49
Q

how much bile salts are formed a day by the liver

A

1 gram/day

50
Q

______ is a precursor of bile salts - supplied by diet or synthesized by the _____

A

cholesterol
liver

51
Q

bilirubin is an end product of _______ decomposition

A

hemoglobin

52
Q

bilirubin is a bile ____ conjugated by the _____

A

pigment
liver

53
Q

jaundice AKA

54
Q

what is jaundice

A

yellowish tint seen in body tissue due to large quantities of bilrubin

55
Q

blood supply to GB (arterial supply/venous drainage)

A

A: cystic artey
V: cystic vein (drains to portal venous system)

56
Q

junctional fold

A

fold between GB neck/body

57
Q

hartman’s pouch

A

Outpouching in GB neck

58
Q

Phrygian cap

A

when GB partially folded onto itself in the region of the fundus

59
Q

can septations occur in GB

60
Q

sagittal shape of GB vs transverse

A

pear vs circle

61
Q

GB study patient prep

A

NPO at least 6-8 hours

62
Q

scan GB with what probe

A

2-6 MHz probe

63
Q

asses GB in what positions

A

supine and LLD
erect and prone can be used also torule out stoned in neck/cystic duct

64
Q

to measure bile ducts patients is in what postion

A

LPO or LLD

65
Q

measure bile duct at _____ area and measure from ____ wall to ____ wall. Do not measure at point where bile duct crosses the ___

A

porta hepatis
inner
inner
HA

Abdomen and Superficial Structures 1 (7 decks)

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