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RT 77 pathology > ch. 6 hepatobillary system > Flashcards

ch. 6 hepatobillary system Flashcards

1
Q

What is the hepatobillary system composed of?

A
  1. Liver
  2. Gallbladder
  3. Biliary tree
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2
Q

Is the pancreas included in the hepatobilary system?

A

no but it is closely related because it shares a portion of the bilary ductal system

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3
Q

Largest SOLID organ in the body is the _______

A

liver

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4
Q

The right lobe and left lobe are separated by ____

A

falciform ligament

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5
Q

Name the functions of the liver

A
  1. substance metabolism
    2 Synthesis of sunstance
  2. Detox of substance
  3. Stores vitamen B
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6
Q

The liver has a dual supply of blood that comes from ___ & ____

A
  1. hepatic artery ( takes oxygenated blood to the liver)

2. Portal vein ( returns venous blood to the inferior vena cava)

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7
Q

What are the functions of the hepatic artery and the portal vein

A

Dual supply of blood that comes from
1. hepatic artery ( takes oxygenated blood to the liver)

  1. Portal vein ( Returns venous blood to the inferior vena cava)
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8
Q

____ drains bile that is produced by the liver and drains it into the duodenum

A

Biliary tree

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9
Q

What is the purpose of the biliary tree

A

drains bile produced by the liver into the duodenum

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10
Q

What forms the common bile duct

A
  1. Cystic duct

2. common hepatic duct

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11
Q

The short part of the common bile duct after joining the pancreatic duct is known as _____

A

hepatopancreatic ampulla
aka
ampulla of vater

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12
Q

Ampulla of vater is also known as

A

hepatopancreatic ampulla

It is the short portion of the commonbile duct and the pancreatic duct m

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13
Q

Rt and Lt hepatic ducts forms the _____

A

Common hepatic duct

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14
Q

Name the Biliary tree

A
  1. RT and LT duct forms the
  2. Common hepatic duct that meets with the
  3. Cystic duct , these 2 form
  4. Common bile duct that meets with the
  5. Pancreatic duct that forms the
  6. Hepatopancreatic amulla ( ampulla of vater)
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15
Q

what is another name for the hepatopancreatic sphincter?

Function _____

A

Spinchter of Oddi

regulate the bile flow into the duodenum

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16
Q

Sphincter of oddi is also known as ____.

Function___

A

Hepatopancreatic sphincter

regulates bile into the duodenum

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17
Q

_____ regulate the flow of bile into the duodenum

A

Hepatopancreatic sphincter

aka spinchter of oddi

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18
Q

Hormone that is released in the presence of fatty food in the stomach.

A

Cholecystokinin

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19
Q

The release of bile into the duodenum is triggered by ____.

A

Cholecystokinin

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20
Q

What is the purpose of bile

A

Emulsifies fats for absorption

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21
Q

Pear shaped sac found on the underside of the right liver :_______

A

Gallbladder

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22
Q

What is the function of the gallbladder

A

store bile that is produced by the liver

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23
Q

The gallbladder recieves bile from the liver via the _____

A

hepatic duct

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24
Q

Elongated, flat organ that croses to the left side of the abdomen and behind the stomach

A

Pancreas

Functions as both exocrine and endocrine glads

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25
Q

Name the 3 digestive enzyme that is produced by the pancreas (Exocrine function)

A
  1. Trypsin- Breaks down protien
  2. Amylase- Breaks down starches
  3. Lipase- Breaks down lipids

*DIscarged through the pancreatic duct into the duodenum)

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26
Q

describe the endocrine function of the pancreas

A

Pancreas is composed of specialized cells ( Islets of langerhans)

these cells are categorized as:

  • Alpha cells- produce glucagon
  • Beta cells- produce insulin
  • these two regulate carb metabolism

Both are discharged in the blood

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27
Q

What is pnuemobilia

A

gas in the biliary tree

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28
Q

What does PTC stand for?

What is it _____?

What does it do ?

A
  1. Percutaneous Transhepatic Cholangiography
  2. Exam done to visualize the biliary tree with the use of a Chiba needle inserted in the tree.
  3. Identify medical jaundice (hepatocellular dysfunction
    ) from surgical jaundice (biliary obstruction)

or identify a tumor in the distal common bile duct

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29
Q

what is the difference between medical jaundice and surgical jaundice

which exam determines this

A

medical= hepatocellular dysfunction

surgical = biliary obstruction

determine with PTC

30
Q

jaundice caused from biliary obstruction is known as ____

A

Sugical jaundice

31
Q

Jaundice caused by hepatocellular dysfunction is known as ___

A

Medical jaundice

32
Q
  1. What does ERCP stand for?
  2. What is it____
  3. What does it examin
A
  1. Endoscopic Retrograde Cholangiopancreatogram
  2. Procedure done by a GI doctor with the use of an endoscope to vizualize the biliary system and pancreatic duct. The endoscope travels to the duodenum and then a catheter is pushed to the common bile duct / pancreatic duct in which retrograde injection of contrast is injected
  3. used for :
    non-dilated ducts, stone extraction and stent placement
33
Q

what does ERCP stand for

A

Endoscopic Retrograde Cholangiopancreatogram

34
Q

Stones in the biliary tree are seen radiographically as ____

A

Air bubbles

35
Q

What is operative cholangiography

A

Exam done during surgery in which a needle is inserted into the Cystic duct or CBD with contrast to vizualize biliary calculi or need for CBD exploration

36
Q

Why is it important that no air bubbles be injected into the ductal system during an operative cholangiogram?

A

becuase the bubbles can mimic stones

37
Q

What is a T-tube cholangiography

A

exam performed after cholecystectomy to check the patency of the CBD and for calculi with the use of T-tube and contrast.

38
Q

What is the modality of choice to evaluate the gallbladder

why???

A

Real time sonography

can also evaluate: Portal hypertension and portosytemic collateral circulation

Because:

  • Non-invasive
  • No radiation exposure
  • Body size and type does not matter
39
Q

When is CT used to visualize the hepatobiliary system

A

when there is suspected malignancy and to examine the masses of gallbladder, liver and pancreas

40
Q

What is a Cholescintigraphy

A

Nuclear medicine study

41
Q

Describe Cirrhosis

Classifications
Pathology

A

Chronic liver condition that destroys the function and structure of the liver
Inflammatory
Both additive. And subtractive
Caused by hepatocyte damage

42
Q

Portal hypertension can result in what 2 conditions

  1. ____
  2. ____
A
  1. Esophageal variaces
    (dilation of the esophageal veins)
  2. Ascites= Fluid collection in the perotoneal cavity
43
Q

Describe viral hepatits

A
  • There are 6 types of hepatits A-E & G
  • They cause acute inflammation of the liver that then interferes with excreting bilirubin which is a pigment in bile.
  • Results in jaundice fatigue and anorexia
44
Q

When is hepatits classified as chornic

A

If liver inflammation persists over 6 months

45
Q

Describe hepatitis A

A
  • Most common and highly contagious.
  • Short period of time and does not lead to chronic hepatitis or cirrhosis
  • Spread through food or fecal material that is contaminate

inflammatory
None

46
Q

Describe hepatits B

Contraction___

classification
pathology

A
  • Contracted through perenteral routs of serum or blood
  • longer incubation period and can result in chronic hepatits and liver failure

inflammatory

none

47
Q

Describe Hep C

Contaction____?

A
  1. Contracted by parenteral RNA virus such as blood transfusions
  2. Can cause acute or chronic hepatits
  3. 10 - 20% of cases lead to cirrhosis

Inflammatory
None

48
Q

What percent of hepatits C cases leads to cirrhosis

A

10-20 %

49
Q

What is cholelitiasis

classification

pathology

A 
Gallstones
-occurs mostly in woman 
- Can be single stone 
or multiple stones 
(small stones can become stuck in the bile duct causing obstruction or jaundice )

inflammatory

additive

50
Q

Acute inflammation of the gallbladder

A

Cholecystitis
inflammatory
None
If left untreated can cause infarction and gangrenous state which results in rupture of the walls

51
Q

Obstruction in the small bowel that results from a gallstone that erodes from the gallbladder and creates a fistula to the small bowel

A

gallstone ileus

52
Q

Define gallstone ileus

A

Obstruction in the small bowel that results from a gallstone that erodes from the gallbladder and creates a fistula to the small bowel

53
Q

what is pancreatitis

Exam to diagnose___

classification
pathology

A

inflammation of the pancreas
* Most complex and challenging disorder of the abdomen

Exam: CT scan

2 types:

  • acute: does not affect the makeup of the pancreas
  • Chronic

affects the histologic makeup of the pancreas = Irreversible changes

inflammatory
none

54
Q

what is Most complex and challenging disorder of the abdomen

A

pancreatitis

inflammatory
none

55
Q

Fluid collection caused by pancreatitis

A

pseudocyst

56
Q

Discoloration of the skin to yellow that is a sign of a disease

calcification -

Pathology

A

Jaundice
inflammatory
none

2 types:
*Medical (non-obstructive) occurs when there is destruction of RBC

*Surgical (Obstructive) occurs when bile can not enter the duodenum due to obstruction

57
Q

Describe hepatocellular adenoma

Exam to diagnose

classification
pathology

A

Benign tumor of the liver

Seen by CT and U/S
neoplastic
additive

58
Q

Describe hemangioma

Exam to diagnose

A 
most common tumor of the liver 
*Benign neoplasm of blood vessels 
Subtractive
Neoplastic 
*CT scan
59
Q

What is the most common liver tumor

classification
pathology

A

hamangioma (benign)
( Neoplasm of blood vessels)

Neoplastic
Subtractive

60
Q

Port wine stain is used to decribe ____

A

heangioma

61
Q

A primary neoplasm of the liver is known as

A

Hepatocellular carcinoma

Additive
Neoplastic

62
Q

A secondary liver cancer is known as

Where does it come from____

Exam to diagnose __

A

Metastatic liver disease

  • more common than primary neoplasm because of the blood filtration in the liver
  • Comes from: Colon, pancreas, stomach, lung and breast

Exam: Ultrasound

Neoplastic
Subtractive

63
Q

Describe carcinoma of the gallbladder

Exam to diagnose:
Radiographic appearacnce ___

A

Malignant neoplasms of the gallbladder.
Does not often occur

Neoplasic
None
CT and U/S

Porcealin gallbladder

64
Q

Appearance of a porecelain gallbladder can indicate which pathology

classification

Pathology

A

Carcinoma of the gallbladder

neoplastic
None

-Malignant neoplasm of gallbaldder.

65
Q

Describe carcinoma of the pancrease

Exam to diagnose_

A

fatal cancer of the pancreas

  • when the carcinoma is located in the head of the pancrease it may be visible on barium studies
    CT scan

Neoplastic
Additive

66
Q

fatal cancer of the pancreas

Classification

pathology

A

carcinoma of the pancreas

neoplastic

additive

67
Q

Malignant neoplasms of the gallbladder.
Classification
Pathology

A

Gallbladder carcinoma

neoplastic
None

68
Q

____ Used to see Solitary, round increased echogenic lesion

A

sonography

69
Q

____ Used to Label red cells attracted to vascular tumor

A

nuclear medicine

70
Q

Why exam identifies medical janders from surgicals jaundice

A

PTC

Percutaneous Transhepatic Cholangiography

71
Q

Term for gas in biliary tree

A

Pneumobilia

RT 77 pathology (13 decks)

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