Ch. 4 Bile Ducts Flashcards
A vital digestive fluid that is produced by the liver
Bile
_________ is a major component of bile, although it includes other elements such as bilirubin, biliverdin, and bile acids.
Cholesterol
What is the function of the biliary tree?
provide a conduit for bile to drain from the liver into the small intestine
The gallbladder is attached to the biliary tree by the??
cystic duct
Liver -> biliary radicles -> right or left hepatic duct -> common hepatic duct -> cystic duct -> gallbladder -> common bile duct -> ampulla of Vater -> sphincter of Oddi -> duodenum
Name the order of bile flow
The merging point of the pancreatic duct and common bile duct just before the sphincter of Oddi
Ampulla of Vater
Other term for ampulla of vater
Hepatopancreatic ampulla
The muscle that controls the emptying of bile and pancreatic juices into the duodenum
Sphincter of Oddi/Hepatopancreatic sphincter
The patient should have nothing to eat or drink for at least _____ hours before examining the biliary tree.
Four
A common bile duct diameter that exceeds ____mm is typically considered abnormal
6mm
If the CBD is enlarged, what should a sonographer do?
Diligently scan the entire right upper quadrant, including the complete biliary tree, liver, gallbladder, and pancreas.
How should a sonographer measure the CBD?
Caliper placement should be from inner to inner wall
For patients older than 60 years who have had a cholecystectomy a max diameter of _____ may be normal.
10mm
When biliary tree obstruction or disease is suspected, look for an elevation in
ALP, ALT, serum bilirubin, GGT, urobilirubin (in additon to amylase and lipase)
Intrahepatic ducts are considered dilated if they exceed
2mm
The enlargement of the common duct to the size of the adjacent portal vein within the porta hepatis is referred to as
double barrel “shotgun sign” or “parallel tube sign”
Coexisting dilation of the common duct and pancreatic duct is referred to as
“double-duct sign”
The CBD segment closest to the pancreatic head is considered
most distal segment of the biliary tree
Biliary dilation will occur where to the level of obstruction?
proximal
Most common level of obstruction to occur is
the distal CBD
Where the most distal segment of the biliary tree
The common bile segment closest to the pancreatic head
Where is the most common level of obstruction of the bile ducts is likely to occur?
Distal common bile duct
Name the most common causes of CBD obstruction
1.Choledocholithiasis
2. chronic pancreatitis
3. Acute pancreatitis
4. Pancreatic carcinoma
This occurs as a consequence of bilirubin accumulation within the tissues of the body
Jaundice
The yellowish pigment found in bile which can turn the skin and the whites of the eyes yellow if allowed to accumulate
Bilirubin
A condition in which bile is stagnant and allowed to develop into sludge or stones
biliary stasis
Obstruction within the bilary tree the patient will eventually suffer from
posthepatic (obstructive) jaundice
Excessive bilirubin leads to elevated
serum bilirubin