Chapter 11 Flashcards
What is the biliary system composed of?
Right and left hepatic ducts,
Common hepatic duct (CHD),
Common bile duct (CBD),
Pear-shaped gallbladder, and Cystic duct
True or False: The bile ducts follow the same course as the hepatic artery and portal vein.
True
Hepatic and bile ducts are enclosed in what?
Common collagenous sheath
Rt. and Lt. hepatic ducts join to form the?
CHD
Common hepatic duct and cystic duct join to form the?
CBD
How is each duct formed by?
By the union of bile canaliculi from the liver lobules
Normal size of CBD?
6mm or 1mm per decade of life
Proximal portion of the CBD is?
lateral to the hepatic artery and anterior to the portal vein
Distal portion of the CBD is?
in a grove on the posterior surface of the head of the panc.
Where does the CBD end?
by piercing the medial wall of the duodenum where it joins the main pancreatic duct
Define gallbladder and its divisions?
Pear-shaped sac in the anterior aspect of the RUQ, closely related to visceral surface of the liver
Divided into- fundus, body and neck
What is the normal size of the gallbladder?
Typically GB- 2.5-4 cm in diameter and 7-10 cm in length. Walls are less than 3 mm thick
Define hydrops
dilation of the gallbladder
Define Hartmanns Pouch
gallbladder is folded back on itself at the neck
Define Phrygian Cap
folding of the fundus
Function of the Gallbladder
Serves as a reservoir for bile
Has the ability to concentrate the bile
What is the function of the Heisters Valve?
Heister’s valve in the neck of the gallbladder help to prevent kinking of the duct
What can happen in the space between the liver and gallbladder?
infection or inflammation can occur
True or False: The gallbladder does not lie in various locations
False
Gallbladder has been found to lie in various ectopic locations, remember this if you are having a difficult time trying to locate the GB
Failure of the gallbladder to develop is?
agenesis of the gallbladder
These patients may still have the biliary ductal system, which can become inflamed and filled with stones
What is the vascular supply to the gallbladder?
arterial supply is from the cystic artery a branch of the rt. Hepatic artery. Cystic vein drain directly into the portal vein.
What are the primary functions of the extrahepatic biliary tract?
Transport bile from liver to intestines
Regulation of its flow
Liver secretes approximately 1-2 liters of bile/day
What happens in the fasting state?
Tone of the sphincter of Oddi increases, very little bile passes into the duodenum
Because of the increase in tone the pressure in the CBD increases and bile is forced into the GB
What happens in the non-fasting state?
When we eat the GB contracts and bile is passed into the duodenum
Tone of the sphincter of Oddi is decreased
Contracted gallbladder appears as a thick-walled structure with a slit of bile. Nearly impossible to see luminal or wall abnormalities in a contracted GB
Concentration of bile in the GB occurs in the ______state.
Fasting
What happens when the gallbladder is removed?
When the GB is removed the sphincter of Oddi loses tone and pressure within the CBD drops to that of the intraabdominal pressure
Bile is no longer retained in the bile ducts but is free flowing into the duodenum during fasting and digestive phases
Dilation of the extrahepatic bile ducts occurs after cholecystectomy—usually less than 1 cm
Products of steroid hormones, drugs and poisons are secreted in the bile