Chapter 6 Gallbladder and Biliary system

Question 1

What two ducts unite to form the common bile duct before it enters the duodenum

Answer 1

Cystic duct and common hepatic duct

Question 2

What variant presents with a kinked or folded back fundus

Answer 2

Phrygian cap

Question 3

What is the likely cause for echoes originating from within the gallbladder with acoustic shadows

Answer 3

Cholelithiasis

Question 4

What is a choledochal cyst

Answer 4

Dilated extrahepatic duct

Question 5

When should the sonographer NOT be able to image a thickened gallbladder wall

Answer 5

Postcholecystectomy

Question 6

Which 8 cm duct is located in the lesser omentum’s right free edge, passes posterior to the first duodenal part, and is distally siutated in a groove on the posterior surface of the pancreatic head

Answer 6

Common Bile Duct

Question 7

When the patient is in the standard anatomic position, what is the course of the portal vein

Answer 7

Transverse

Question 8

What vessel supplies the gallbladder with blood

Answer 8

Cystic artery

Question 9

With a normally functioning gallbladder, what is stimulated by ingesting a fatty meal

Answer 9

Contraction

Question 10

What small normal tubular structure does NOT demonstrate a doppler signal

Answer 10

Common bile duct

Question 11

What is the best explanation if the sonogram reveals a focal area of high echogenicity with acoustic attenuation (shadowing)

Answer 11

Cholelithaisis

Question 12

What is a diagnostic explanation for a 40 year old woman with RUQ pain, mild jaundice, and elevated alkaline phosphate

Answer 12

Cholelithaisis

Question 13

What echogenic intraluminal projection does not change location with a change in the patients position and does not cast an acoustic shadow

Answer 13

Polyp

Question 14

Acute cholecystitis is most likely to occur secondary to which entity

Answer 14

Calculi impaction in the cystic duct

Question 15

What is the normal gallbladder wall thickness measured parallel to the sound beam adjacent to the liver

Answer 15

1-3 mm

Question 16

If the patient has a known history of porcelain gallbladder, what will the sonographer observe

Answer 16

Varying amounts of calcification in the gallbladder wall

Question 17

What symptom describes tenderness over the gallbladder with probe pressure

Answer 17

Murphys sign

Question 18

What condition describes acute or chronic inflammation of the gallbladder

Answer 18

Cholecystitis

Question 19

What anatomic structure is located lateral and to the left of the common bile duct

Answer 19

Hepatic Artery

Question 20

Inflammation of the bile duct

Answer 20

Cholangitis

Question 21

Surgical removal of the gallbladder

Answer 21

Cholecystectomy

Question 22

Hormone which stimulates gallbladder contraction

Answer 22

Cholecystokinin

Question 23

Calculi located within the bile duct

Answer 23

Choledocholithaisis

Question 24

Air within the bile ducts

Answer 24

Pneumobilia

Question 25

Fold within the neck or body of the gallbladder

Answer 25

Juctional fold

Question 26

What is the upper limit of normal for the measurement of the gallbladder wall

Answer 26

3 mm

Question 27

What is the normal measurement for an intrahepatic bile duct

Answer 27

less than 2 mm

Question 28

What anatomical landmark can help locate a gallbladder that is difficult to visualize

Answer 28

Main lobar fissure

Question 29

What is the most common malignancy to metastasize of the gallbladder

Answer 29

Melanoma

Question 30

With a distal obstruction such as a mass in the head of the pancreas, which part of the biliary tree is the first to dilate

Answer 30

Gallbladder