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ARRT (Abdominal US) > Chapter 4 The Bile Duct > Flashcards

Chapter 4 The Bile Duct Flashcards

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1
Q

The yellowish pigment found in bile that is produced by the breakdown of old RBC by the liver is

A

Bilirubin

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2
Q

Which segment of the biliary tree tends to dilate first with obstruction

A

Extrahepatic

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3
Q

Clinical findings of choledocholithiasis (3):

A
  1. Jaundice
  2. Elevated ALP, ALT, GGT and bilirubin with obstruction
  3. RUQ pain
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4
Q

The biliary duct wall should never measure more than

A

2mm

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5
Q

A klatskin tumor is a form of:

A

Cholangiocarcinoma

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6
Q

Clinical findings of Cholangiocarcinoma (6):

A
  1. Jaundice
  2. Pruritus
  3. Weight loss
  4. Pain
  5. Elevated bilirubin
  6. Elevated ALP
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7
Q

The most common level for biliary obstruction to occur is

A

Distal CBD

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8
Q

The muscle that controls the emptying of bile and pancreatic juices into the duodenum is the:

A

Sphincter of oddi

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9
Q

______ could accidentally introduce bacteria into the biliary tree and thus cause cholangitis

A

Endoscopic retrograde

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10
Q

_____ would be the most distal portion of the biliary tree

A

CBD

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11
Q

Pneumobilia will produce ______ artifact

A

Ring-down

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12
Q

______is considered the most proximal portion of the biliary tree

A

Inteahepatic radicles

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13
Q

If a gallstone, causing obstruction is located within the distal common hepatic duct, which of the ducts will dilate

A

Intrahepatic ducts

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14
Q

The spiral valves of Heister are located within the

A

Cystic duct

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15
Q

The presence of an echogenic dot in the nondependent part of the dilate duct representing small fibrovascular bundles is seen with

A

Caroli disease

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16
Q

Air within the biliary tree is referred to as

A

Pneumobilia

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17
Q

Inflammation of the bile ducts is referred to as

A

Cholangitis

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18
Q

The klatskin tumor is located

A

At the junction of the right and left hepatic ducts

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19
Q

_____is associated with the sonographic triangular cord sign

A

Biliary atresia

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20
Q

A gallstone located within the biliary tree is referred to as

A

Choledocholithiasis

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21
Q

The merging point of the pancreatic duct and CBD at the level of duodenum is referred to as the

A

Ampulla of vater

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22
Q

_______is associated with Charcot triad

A

Cholangitis

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23
Q

Primary biliary tree cancer is referred to as

A

Cholangiocarcinoma

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24
Q

Ascariasis is caused by:

A

A parasitic roundworm

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25
Q

A congenital disease in which there is narrowing or obliteration of the bile ducts is referred to as

A

Biliary atresia

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26
Q

The yellowish staining of the whites of the eyes and the skin secondary to a liver disorder or biliary obstruction is referred to as

A

Jaundice

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27
Q

The common bile duct, the cystic duct, and part of the common hepatic duct are considered:

A

Extrahepatic in location

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28
Q

The most common level for an obstruction to occur is the:

A

Distal common bile duct

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29
Q

______is coexisting dilation off the common bile duct and pancreatic duct

A

Double duct sign

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30
Q

______ describes the enlargements of the common duct to the size of the adjacent portal vein within the portal hepatis

A

Shotgun sign or parallel tube sign

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31
Q

The intrahepatic ducts are considered dilated if they exceed

A

2mm

32
Q

Biliary dilation will occur proximal to the

A

Level of obstruction

33
Q

What is the common cause of obstructive jaundice

A

Gallstones in the common bile duct

34
Q

Stones typically form in the gallbladder and pass into the

A

Biliary tree

35
Q

______describes the presence of gallstones within the bile ducts

A

Choledocholithiasis

36
Q

Clinical findings of choledocholithiasis (3):

A
  1. jaundice
  2. elevated ALP,ALT, GGT, and bilirubin
  3. pain
37
Q

Inflammation of the biliary ducts is termed

A

Cholangitis

38
Q

Types of cholangitis

A

•acute bacteria
•AIDS
•recurrent pyogenic cholangitis
•sclerosing

39
Q

_____is an infection of the small intestine that is caused by ascaris lumbricoides, a parasitic roundworm

A

Ascariasis

40
Q

Important points of oriental cholangitis (2):

A
  1. Endemic to Asia
  2. Seen in America because of immigration
41
Q

Biliary atresia is described as the

A

Narrowing or obliteration of all or a portion of the biliary tree

42
Q

Primary biliary tree cancer is referred to as

A

Cholangiocarcinoma

43
Q

_______are the most common manifestation of Cholangiocarcinoma

A

Klatskin tumor

44
Q

Klatskin tumor are located at the

A

Junction of the right and left hepatic ducts

45
Q

The function of the biliary tree is to provide a

A

Conduit for bile to drain from the liver into the small intestine

46
Q

Bile, a viral digestive fluid is produced by the

A

Liver

47
Q

A common bile duct diameter that exceeds ______ is typically considered abnormal

A

6mm

48
Q

The gallbladder is attached to the biliary tree by the

A

Cystic duct

49
Q

Bile forest accumulates in the

A

Small intrahepatic biliary radicles in the Liver

50
Q

_____ prevents the cystic duct from collapsing or distending

A

Spiral valves of heister

51
Q

_______ is the opening that allows bile and pancreatic juices to flow into the duodenum

A

Sphincter of oddi
(hepatopancreatic sphincter)

52
Q

______is the presence of echogenic dots in the nondependent part of the dilated duct representing small fibrovascular bundles

A

Central dot sign

53
Q

______is a congenital disorder characterized by segmental dilation of the intrahepatic ducts

A

Caroli disease

54
Q

When are choledochal cyst usually discovered

A

Infancy or in the first decade of life

55
Q

Choledochal cysts Can lead to (3):

A
  1. Portal hypertension
  2. Pancreatitis
  3. Liver failure
56
Q

Clinical findings of biliary atresia (2):

A
  1. neonatal jaundice
  2. elevated AST, ALT, and bilirubin
57
Q

Sonographic findings of a choledochal cyst

A
  1. Cystic mas the area of the porta hepatis (separate from the gallbladder)
  2. Biliary dilation
58
Q

_______is an avascular, echogenic, triangular or tubular structure anterior to the portal vein, representing the replacement of the extrahepatic duct with fibrous tissue in the porta hepatis

A

Triangular cord sign

59
Q

_____is a congenital disease that is thought to be caused by a viral infection at birth

A

Biliary atresia

60
Q

Clinical findings of ascariasis

A
  1. asymptomatic
  2. Symptoms of inflammation of the biliary tree, gallbladder or pancreas
61
Q

Clinical findings of cholangitis

A

•Charcot triad: fever, RUQ pain, jaundice
•leukocytosis
•elevated ALP, ALT, GGT, and bilirubin

62
Q

Sonographic findings of cholangitis

A

•biliary dilation
•biliary sludge or pus
•choledocholithiasis
•bile duct wall thickening

63
Q

Sonographic findings of pneumobilia

A
  1. Echogenic linear structures within the ducts that produce ring down artifacts and dirty shadowing
64
Q

Sonographic findings of choledocholithiasis

A
  1. Echogenic foci within the bile duct that may or may not shadow
  2. May have biliary dilation
65
Q

Sonographic findings of caroli disease

A

•segment dilation of the intrahepatic ducts
•May also have cystic renal disease
•central dot sign

66
Q

Clinical findings of caroli disease (4):

A
  1. Pain
  2. Fever
  3. Jaundice
  4. Signs of portal hypertension
67
Q

Clinical findings of a choledochal cyst

A

•jaundice
•pain
•fever
•abdominal mass

68
Q

Clinical findings of pneumobilia (2):

A
  1. Recent biliary or gastric surgery, emphysematosis or acute cholecystitis, or fistula formation
  2. Symptoms of acute cholecystitis
69
Q

Important points of acute bacterial cholangitis

A

•caused by bacterial accumulation secondary to obstruction
• introduced during ERCP for choledocholithiasis
• pus

70
Q

Important points of AIDS cholangitis

A
  1. Associated with advanced HIV and AIDS
  2. Results from inflection with cryptosporidium or cystomegalovirus
71
Q

Important points of sclerosing cholangitis (4):

A
  1. Fibrotic thickening of the bile ducts
  2. Most often affects young men
  3. Associated with inflammatory bowel disease or ulcerative colitis
  4. Increase risk of cholangiocarcinoma
72
Q

Sonographic findings of ascariasis (2):

A
  1. Worm within the biliary ducts as an echogenic linear structure
  2. Movement of the worm
73
Q

Sonographic findings of cholangiocarcinoma (2):

A
  1. Dilated intrahepatic ducts that abruptly terminate at the level of the tumor
  2. A solid mass May be noted within the liver or ducts
74
Q

Sonographic findings of biliary atresia (3):

A
  1. Absent biliary ducts
  2. Triangular cord sign
  3. Sonographic signs of cirrhosis and portal hypertension
75
Q

Clinical findings of cholangiocarcinoma

A
  1. jaundice
  2. weight loss
  3. pain
  4. elevated bilirubin
  5. elevated ALP

ARRT (Abdominal US) (14 decks)

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