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Abdominal Imaging 115/112 > Chapter 13- Gallbladder > Flashcards

Chapter 13- Gallbladder Flashcards

1
Q

What structures are part of the Biliary System

A

Gallbladder and bile ducts.

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2
Q

The gallbladder is located in the gallbladder fossa. Where in the liver is this located?

A

The posterior inferior portion of the Right Lobe of the Liver

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3
Q

The neck of the gallbladder does not change position. What is the name for this?

A

Fixed Position.

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4
Q

What is the function of the Gallbladder?

A

It is a reservoir for storing bile.

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4
Q

The gallbladder has a fixed anatomic relationship to what 2 structures?

A

Main Lobar Fissure and Portal Vein

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5
Q

What is the function of the liver?

A

Hepatocytes in the liver produce bile

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6
Q

What is the function of the bile ducts?

A

They drain the liver of bile and empties into the duodenum

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7
Q

List 3 of the compounds that make up bile

A

Bile Salts, Water,, Billirubin

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8
Q

Bile Salts are the most important component of bile. What do they do?

A

They break down fats during digestion.

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9
Q

Does the gallbladder look the same in every patient?

A

No, size and shape vary greatly.

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10
Q

What is the normal sonographic appearance of the gallbladder

A

anechoic with echogenic walls

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11
Q

What is the inner layer of the gallbladder called?

A

Mucosa

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12
Q

What is the middle layer of the gallbladder called?

A

Fibromuscular

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13
Q

What is the outer layer of the gallbladder called?

A

Serous

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14
Q

Inside the gallbladder, there are many small, inward folds. What are these folds called?

A

Rugae

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15
Q

What is the purpose of Rugae?

A

they increase the surface area to aid in concentrating bile through the absorption of water and secretion of mucous

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16
Q

What ducts converge to form the common hepatic duct

A

The R and L hepatic ducts

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17
Q

The gallbladder neck tapers at one end to form what structure?

A

The cystic duct

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18
Q

The cystic duct joins with the common hepatic duct. what does this union form?

A

The Common Bile Duct

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19
Q

The common bile duct and main pancreatic duct join to form the…?

A

Ampulla of Vater

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20
Q

The ampulla of vater empties through the duodenal papilla. What structure controls this?

A

The Sphincter of Oddi

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21
Q

What is the muscle that controls the flow of pancreatic juices and bile into the duodenum?

A

The sphincter of Oddi

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22
Q

What do the Valves of Heister do?

A

They are spiral folds that control bile flow in the cystic duct. They prevent the cystic duct from over distending or collapsing.

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23
Q

Do the Valves of Heister actually contain valves?

A

No.

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24
Q

Which 3 structures produce, transport, and then store the bile?

A

The liver produces bile, it is carried by the biliary ducts to the gallbladder where it is stored.

25
Q

When bile is released, it is transported through the Ampulla of Vater. Where does it go?

A

The duodenum.

26
Q

What happens when the sphincter of Oddi is closed?

A

The gallbladder is forced to fill with bile.

27
Q

When we eat, what peptic hormone is released by the duodenum?

A

Cholecystokinin (CCK)

28
Q

What does Cholecystokinin (CCK) do?

A

CCK stimulates the gallbladder to contract and tells the sphincter to relax. This allows bile into the duodenum.

29
Q

How thick should the gallbladder wall be?

A

3 mm or less.

30
Q

What should the diameter of the Right, Left, and Common Hepatic Ducts be?

A

0.1-0.2 cm

31
Q

What should the diameter of the Common Bile Duct be?

A

0.1-0.7 cm

32
Q

What should the diameter of the Cystic Duct be?

A

0.1-0.4

33
Q

How long should the normal gallbladder be?

A

8-12 cm long

34
Q

When is a gallbladder considered Hydropic?

A

When it is enlarged: measuring more than 5 cm in a transverse plane.

35
Q

Describe a Phrygian Cap. What percent of patients have one?

A

A normal variant of the gallbladder
when the fundus is folded onto the body. It is found in 1-6% of patients.

36
Q

Describe a Junctional Fold and what it may be confused with on ultrasound.

A

A fold anywhere in the gallbladder wall. It could be confused with polyps or calculi and cause high-amplitude echos.

37
Q

What is Hartmanns Pouch

A

A small sac that may be seen in the area of the gallbladder neck

38
Q

Describe a floating gallbladder

A

a gallbladder positioned low in the abdomen

39
Q

Describe agenisis of the gallbladder

A

no gallbladder due to failure to develop

40
Q

Describe a bilobed gallbladder

A

“hourglass” or V- shaped

41
Q

Describe a septated gallbladder

A

One or more internal divisions

42
Q

Describe a duplicated gallbladder

A

2 complete gallbladders

43
Q

Describe a gallbladder with hypoplasia

A

an underdeveloped gallbladder.

44
Q

In the portal triad’s “mickey mouse” symbol, which vessel is the right side of the patient or “left ear”

A

The common bile duct

45
Q

Where do we obtain the most accurate sonographic measurement of the Common Bile Duct?

A

In Porta Hepatis

46
Q

What is the general rule for the measurement of the Common Bile Duct? Give an example.

A

About 1mm for every decade of life. for a 20 year old patient, their CBD should measure around 2mm.

47
Q

What is the most common location for a stone in the biliary tract?

A

The gallbladder

48
Q

What could happen if a stone passes to the joining of the bile and pancreatic duct?

A

It could cause pancreatitis

49
Q

What is Billiruben?

A

a compound made from the breakdown of Red Blood Cells.

50
Q

Which wall of the gallbladder should you measure, how do you measure it, and what scan plane should you use?

A

The anterior wall, outer edge to outer edge, and in Transverse

51
Q

How many patient positions should you use when scanning the gallbladder? Why?

A

2 positions because the gallbladder fundus is not in a fixed position so it moves around. It’s important to move the patient in case pathology is hidden in a supine position.

52
Q

What patient positions are accepatable when measuring the gallbladder?

A

Supine and LLD or Semi-Erect

53
Q

What MUST you do when you are scanning a patient in a non-supine position? Why?

A

Label the patient’s position on the images so the radiologist knows how the patient was laying.

54
Q

What two questions should you ask specifically to a gallbladder patient?

A

How long since last time eating? What did you eat?

55
Q

Why would you ask when a patient last ate?

A

In non-emergency situations we NEVER scan a patient who ate less than 4 hours previously, since the gallbladder would not be distended.

56
Q

When and Why would you ask a patient what they last ate?

A

During a biliary/gallbladder exam. The radiologist may want to know if they’ve recetnly had fatty foods.

57
Q

What scan plane is used to measure the Common Bile Duct? How do you meausre it?

A

In a sagittal scan plane. It is measured from inner wall to inner wall.

58
Q

What is the width of the gallbladder

A

3-5 cm diameter

59
Q

Where are the spiral valves of heister found specifically?

A

In the lumen of the cystic duct.

60
Q

What is Murphy’s sign

A

Right Upper Quadrant pain. It is used in a physical exam to diagnose cholecystitis

Abdominal Imaging 115/112 (8 decks)

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