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ABDOMEN REGISTRY > Chapter 3: Gallbladder > Flashcards

Chapter 3: Gallbladder Flashcards

1
Q

The gallbladder is located posterior to which lobe of the liver

A

The right lobe

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2
Q

Name the three layers of the gallbladder wall from innermost to outermost

A

Mucosal, fibromuscular, serosal

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3
Q

What connects the gallbladder to the rest of the biliary system

A

The cystic duct

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4
Q

What is the most common location for stones and why

A

The fundus, because is the most dependent part

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5
Q

What hormone causes gallbladder contraction

A

Cholecystokinin

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6
Q

The _____ artery is a small branch of the right hepatic artery, and supplies blood to the gallbladder

A

Cystic artery

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7
Q

What does a bilobed gallbladder (normal variant) looks like

A

Like an hourglass

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8
Q

The Phrygian cap is the most common gallbladder variant. Describe it

A

The fundus is folded

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9
Q

Describe the septate gallbladder variant

A

Thin separations within gallbladder

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10
Q

What is the Hartman pouch variant

A

Outpouching of gallbladder neck

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11
Q

What is the junctional fold variant

A

Fold at the neck junction

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12
Q

A floating gallbladder can twist off the blood supply and this is called

A

Gallbladder torsion or gallbladder vulvulus

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13
Q

Which type of gallbladder is totally surrounded by liver

A

Intrahepatic gallbladder

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14
Q

The gallbladder holds about ___ ml of bile

A

40

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15
Q

The normal length of the gallbladder is between ____ and ____ cm

A

8-10

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16
Q

The normal diameter of the gallbladder should be

A

4-5 cm

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17
Q

The gallbladder wall should measure

A

3mm

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18
Q

Describe Cholelithiasis

A

Stones within gallbladder lumen

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19
Q

What are the symptoms of cholelithiasis

A

(Can be asymptomatic)
Biliary colic, pain after meals, nausea and vomiting, pain that radiates to shoulders

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20
Q

Stones typically consist of a mixture of what

A

Cholesterol, calcium, bilirubinate, and calcium carbonate

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21
Q

Cholelithiasis is most commonly seen in _____ patients

A

Female

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22
Q

What are some risk factors that can lead to Cholelithiasis

A

Obesity, pregnancy, increased parity, gestational diabetes, estrogen use, Crohn disease, total parenteral nutrition, rapid weight loss

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23
Q

Sludge is most often associated with biliary _____

A

Stasis

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24
Q

What are the symptoms of sludge

A

Asymptomatic

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25
What is tumefactive sludge
Thick sludge that looks like a mass. Make sure it moves to rule out a mass
26
What is hepatization of the gallbladder referred to
When the gallbladder is completely filled with tumefactive sludge, it looks isoechoic to the liver
27
What are the symptoms of gallbladder polyps
Asymptomatic
28
______ polyps are the most common type
Cholesterol
29
Polyps tend to measure less than ____ mm
10
30
Large polyps or fast growing ones are concerning for
Carcinoma
31
Polyps are often seen with cholesterolosis, which is
Build up cholesterol in wall
32
What is hyperplastic cholecytosis
A group of proliferative and degenerative gallbladder disorders
33
Hyperplastic cholecytosis includes what two disorders
Adenomyomatosis and cholesterolosis
34
What is a strawberry gallbladder
Diffuse polyploid appearance of the gallbladder
35
What is adenomyomatosis
When the muscular layer of the gallbladder becomes thickened
36
When the muscular layer of the GB is thickened (adenomyomatosis) what does this produce
Tiny pockets called Rokitansky Aschoff sinuses
37
What are the symptoms of adenomyomatosis
Asymptomatic
38
Adenomyomatosis will produce what artifact
Comet tail
39
What is emphysematous cholecystitis
Form of acute cholecystitis caused by gas forming infection
40
What are the Sonographic findings of emphysematous cholecystitis
Dirty shadowing reverberation or ring down artifact
41
What are the clinical findings of emphysematous cholecystitis
RUQ pain (negative Murphy sign) Fever Diabetic patient
42
Emphysematous cholecystitis can become into _____
Sepsis
43
What is acute cholecystitis
Sudden onset of gallbladder inflammation. Commonly caused by a stone stuck in the neck or cystic duct
44
What are the symptoms of acute cholecystitis
RUQ tenderness with positive Murphy sign Nausea and vomiting Fever Pain that radiates to shoulder Jaundice (if there’s an obstruction)
45
What lab values are expected to be elevated when acute cholecystitis is present
WBCs Bilirubin (with obstruction) ALP, ALT, GGT
46
What are the sonographic findings of acute cholecystitis
Gallstones, wall thickening, enlargement of gallbladder, pericholecystic fluid, and sludge
47
What is a gangrenous cholecystitis
A direct evolution of acute cholecystitis
48
What are the sono findings of gangrenous cholecystitis (in addition to those of acute cholecystitis)
Focal wall necrosis Bulges of the wall Sloughed membranes Ulcerative craters
49
Perforation of the GB has a high mortality rate. Would the pt demonstrate a positive Murphy sign with this finding
No
50
Chronic cholecystitis results from the intermittent ________ of cystic ducts by stones
Obstruction
51
Patients with chronic cholecystitis will have what symptoms
Intolerance to fatty foods and nontender gallbladder
52
What lab values may be elevated with chronic cholecystitis
ALP, AST, and ALT
53
What are the sono findings of chronic cholecystitis
Thickened wall, stones, WES sign, contracted GB
54
Acalculus cholecystitis presents with all symptoms and findings of _________, except no stones are present
Cholecystitis
55
What is empyema/ suppurative cholecystitis
When the gallbladder is filled with pus. It will appear echogenic
56
Xanthogranulomatous cholecystitis results from chronic infection in GB, what are the findings related to this
Intramural accumulation of inflammatory cells (echogenic debris) Asymmetrical thickening of wall
57
An enlarged gallbladder is also called
Hydropic gallbladder
58
An enlarged gallbladder can be caused by a blockage of the _____ duct, or other parts of the biliary tree
Cystic
59
What are the symptoms of an enlarged gallbladder
Maybe asymptomatic. Pts can have epigastric pain, nausea or vomiting
60
What is a Courvoisier gallbladder
Enlarged, palpable gallbladder caused by a pancreatic head mass
61
Gallbladder hydrops in infants can be associated with what disease
Kawasaki disease
62
What are the symptoms of a porcelain gallbladder
Asymptomatic
63
What is porcelain gallbladder
Calcification of gallbladder wall
64
Xray or CT is often used to confirm the diagnosis of ______ GB
Porcelain
65
______ carcinoma is the most common cancer of the biliary tract, even though is rare
Gallbladder
66
Gallbladder carcinoma is caused by chronic irritation of the wall by_____
Stones
67
Pts who suffer from chronic cholecystitis have an increased risk of developing _______
Gallbladder carcinoma
68
What are the symptoms of gallbladder carcinoma
Asymptomatic at first. Then, nausea, vomiting, weight loss, RUQ pain, jaundice and hepatomegaly
69
What does gallbladder carcinoma look like on ultrasound
Nonmobile hypoechoic mass in the lumen, or as diffuse wall thickening. May contain stones
70
Gallbladder carcinoma is suspected if there’s a mass or polyp measuring more than ___cm
1
71
What is the gold standard imaging for gallbladder
Ultrasound

ABDOMEN REGISTRY (13 decks)

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