Chapter 12 Biliary Tract Flashcards
Where is the liver located
RUQ, extends below the 10th rib
How much does the liver weigh?
3-4 pounds
What does the liver produce? Where is it stored? How much is produced?
Produces bile
Stored in the gallbladder
1 quart/day
How many lobes are in the liver?
2 major
2 minor
What are the two major lobes? Which is bigger?
Left and right; right is bigger
What separates the two major lobes?
Falciform ligament
What are the two minor lobes? Where are they located?
Quadrate - between the gallbladder and falciform ligament
Caudate - posterior to the quadrate lobe
What contours over the surface of the caudate lobe
Inferior vena cava
From the liver, bile travels to the _______ or directly to the _______
Gallbladder
Duodenum
What duct is formed from the right and left hepatic ducts combining
Common hepatic duct
What does the common hepatic duct turn into?
The common bile duct
The common bile duct joins the pancreatic duct before it empties into the duodenum through the:
Hepatopancreatic sphincter (sphincter of Oddi)
What percentage of people have a separate opening for the common bile duct and pancreatic duct?
40%
How long is the common bile duct?
3 in (7.5cm)
Where is the common bile duct located
Behind the superior portion of the duodenum and head of the pancreas
Where does the common bile duct empty after connecting with the pancreatic duct
Descending portion of the duodenum
What is the appoximate size of a gallbladder
3-4 in (7-10 cm) long and 1 in (3 cm) wide
What are the 3 parts of the gallbladder
Fundus
Body
Neck
What is the distal end of the gallbladder
Fundus
What is the narrow proximal end of the gallbladder and what duct does it make?
Neck; cystic duct
How much bile is stored in the gallbladder
30-40 CC’s (2-2.5 tbsp)
What is the best position to empty the gallbladder
Supine
What are the 3 functions of the gallbladder
Store bile
Concentrate bile
Contract
How is bile concentrated in the gallbladder
Removal of water - hydrolysis
When does the gallbladder contract
When fats or fatty acids are in the duodenum
What hormone causes the gallbladder to contract and the bile duct to open
Cholecystokinin (CCK)
How long is the cystic duct?
1.5 in (3-4 cm)
What is the spiral valve?
Several membranous folds along the length of the cystic duct
What does the spiral valve prevent
Distention or collapse of the cystic duct
Where is the gallbladder located for an asthenic person?
Near the iliac crest and close to the midline
What position does an asthenic person need to be in to best visualize the gallbladder
35-40 LAO (move spine away from gallbladder)
Where is the gallbladder located for a sthenic/hyposthenic person?
Between xiphoid tip and lower lateral rib margin
What position does an sthenic/hyposthenic person need to be in to best visualize the gallbladder
20-25 degree LAO
Where is the gallbladder located for a hypersthenic person?
Located high and more lateral
What position does an hypersthenic person need to be in to best visualize the gallbladder
15-20 degree LAO
What modality is the best way to visualize the gallbladder
Ultrasound
The gallbladder and biliary ducts cannot be seen on a diagnostic radiograph unless the patient has:
Contrast media
What is an OCG?
Oral cholecystogram
What are possible reasons to have an OCG?
Nausea
Heartburn
Vomitting
What forms gallstones?
Increased levels of bilirubin, calcium, or cholestrol
Who is at a greater risk of getting gallstones?
Women, especially pregnant women
When is milk calcium bile best demonstrated?
Right lateral decub
