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billary system Flashcards

1
Q

narrowing of bile ducts

A

Biliary stenosis

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2
Q

acute or chronic inflammation of the GB

A

Cholecystitis

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3
Q

presence of gallstones

A

Cholelithiasis

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4
Q
  • general term for radiographic study of the biliary system
A

Cholegraphy

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5
Q
  • radiographic investigation of the GB
A

Cholecystography

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6
Q
  • radiographic investigation of the biliary ducts
A

Cholangiography

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7
Q

radiography of both the gallbladder & biliary ducts

A

Cholecystangiography or cholecystocholangiography

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8
Q

relationship with bile

A

Chole

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9
Q

bag or sac

A

Cysto

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10
Q

common bile duct

A

Choledocho

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11
Q

bile ducts

A

Choloangio

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12
Q

gallbladder

A

Cholecyst

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13
Q

hormone that stimulates the contraction of gallbladder

A

Cholecystokinin

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14
Q

IR: 18x24cm
Ppx: prone; erect
Pp:
Prone:
- right side of abdomen centered
- rest head on left cheek – to rotate the vertebrae slightly toward to the left
Erect:
- center gallbladder
- used to demonstrate the mobility of the gallbladder
- detect the presence of stones that are too small to cast individual shadows
- differentiate papilloma or other tumor shadows from cholesterol calculi shadows
CR: perpendicular

A

PA PProjection

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15
Q

IR: 18x24cm lengthwise
Ppx: recumbent for oblique & lateral projections
Pp: LAO position
- prone
- elevated right side (15-40°)
CR: perpendicular
Instruction – end of exhalation

A

PA Oblique LAO

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16
Q
  • used to differentiate gallstones from renal stones or calcified mesenteric lymph nodes
  • used to separate the superimposition of the gallbladder & the vertebrae
    IR: 18x24cm lengthwise
    Ppx: recumbent for oblique & lateral projections
    Pp: Lying on the right side
A

Right Lateral Position

17
Q
  • used to demonstrate:
    o stone that are heavier than bile & that are too small to visible other
    than when accumulated in the dependent portion of the gallbladder
    o stone that are lighter than bile & that are visualized only by stratification
  • used for patient who cannot stand for an erect position
    IR: 18x24cm
    Ppx : lateral recumbent
    Pp: body elevated 2 to 3 inches on a suitable support
    CR: horizontally
A

AP Projection
R lateral decubitus
position

18
Q
  • used primarily to draw the gallbladder superiorly, where it will not superimpose
    by the intestinal contents
    Ppx: upright
    Pp:
  • right side of abdomen centered to VGCH
  • patient to grasp the sides of the stand or table
  • brace abdomen against grid or table
  • lean thorax posteriorly in a forced lordotic position
    Location of gallbladder:
  • 8th rib or L2 & L3 – right side
    o place film 1-2” away from the vertebral column
  • obese – 2-3” higher than the normal
  • thin – 2-3” lower than the normaltion
    Inspiration – downward medially
    Expiration - upward laterally
A

PA Lordotic Projection

19
Q

Purpose:
- investigate biliary ducts & gallbladder of noncholecystectomized patients
- when the structures are not visualized by OCG
- patient cannot take orally the CM due to vomiting or diarrhea
- investigate biliary ducts of cholecystectomized patients

A

INTRAVENOUS CHOLANGIOGRAPHY

20
Q
  • preoperative exploration of biliary tract
  • used for patients w/ jaundice when the ductal system has been shown dilated by CT or ultrasonography but cause of obstruction is unclear
  • patient right side surgically prepared & appropriately drapped – CM inserted through a Chiba needle into the right lateral intercostal space &
    advance toward the liver hilum
  • patient under local anesthesia
  • procedure done under fluoroscopy – serial or spot AP projections
A

PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAPHY (PTC) OR
TRANSABDOMINAL CHOLANGIOGRAPHY

21
Q
  • carried during biliary tract surgery
  • following drainage of the bile, & in the absence of obstruction, CM is introduced into the major intrahepatic ducts as well as the extrahepatic ducts.
A

OPERATIVE (IMMEDIATE) CHOLANGIOGRAPHY

22
Q

examination performed by way of the T-shaped tube left in the common bile duct (CBD) for postoperative drainage

A

POSTOPERATIVE CHOLAGIOGRAPHY
(delayed or T-tube cholangiography)

23
Q
  • Surgicoradiologic procedure wherein a water-soluble, iodinated CM is introduced into the main pancreatic duct (duct of Wirsung) for investigation of the pancreas
  • Done by:
    o efflux filling from an injection made into the CBD when these two passages share a common channel before emptying into the duodenum
    o direct injection through the transduodenal catheterization of the duct
  • MSP centered to grid at level of xiphoid process
A

PANCREAS: OPERATIVE PANCREATOGRAPHY

24
Q
  • use to diagnose the biliary & pancreatic pathologic conditions
  • useful diagnostic method when the biliary ducts are not dilated & when no obstruction exists at the ampulla
  • performed by passing a fiber-optic endoscope through the mouth onto the duodenum under fluoroscopic control
    o to ease passage of endoscope – patients throat sprayed w/ local anesthesia
  • causes temporary pharyngeal paresis
    o food & drink usually prohibited for at least 1hr after the procedure
  • food w/held for up to 10 hrs after procedure
    o minimize irritation to the stomach & small bowel
  • Endoscopist locates the hepatopancreatic ampulla (ampulla of Vater)
    o small cannula is passed through the endoscope & directed into the ampulla
    o CM injected into the CBD
  • Oblique radiographs taken to prevent overlap of the CBD & pancreatic duct
A

ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP)

contrast (6 decks)

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