Chapter 8 Gallbladderbiliary Tree Flashcards
The Gallbladder is apart of which system?
The gallbladder is apart of the digestive system.
What are the the two position to examine a patient for the gallbladder?
The patient should be examined in SUPINE AND LEFT LATERAL DECUB/POSTERIOR OBLIQUE
What do Gallstones produce on ultrasound?
Gallstones produce on ultrasound as a clean shadow
How do you determine a Murphy sign is present ?
Murphy sign is present by “applying pressure with the transducer directly over the gallbladder”
Congenital Anomalies of Gallbladder and Biliary System
1: Agenesis Gallbladder
2: Septate Gallbladder
-multiseptated Gallbladder
3:Interposition of the Gallbladder
4:Biliary Atresia
What is the definition of septate gallbladder?
SEPTATE GALLBLADDER -is known as “gallbladder septum appears as a thin linear echo may mimic a junctional fold”
What is the definition of Multiseptated of Gallbladder?
MULTISEPTATED GALLBLADDER is known as “one of the rarest congenital gallbladder malformations and has variable sonographic appearances; fine multiple linear septa, A honeycomb pattern of clustered septations resulting in multiple communicating cyst like compartments, septa may custer in the neck and body region of the gallbladder “
What is the definition of Interposition of the gallbladder?
INTERPOSITION OF THE GALLBLADDER “is the absence of the common hepatic duct and the cystic duct “
What is the definition of Biliary Atresia ?
BILIARY ATRESIA - is the most common type of obstructive biliary disease in infants and young children. Destruction of the extrahepatic biliary system occurs because of inflammation and sclerosing cholangiopathy( damage to one of more bile ducts caused by inadequate blood flow) progressive obliteration of the extrahepatic ducts and in many instances the gallbladder takes place. The obliteration extends into the intrahepatic ductal system, as it progresses, fibrosis and obliteration of biliary tree takes place. Biliary atresia is twice as common in males.
What are the Complications of untreated Biliary Artesia?(5 things)
COMPLICATIONS OF UNTREATED BILIARY ATRESIA;
1. Cirrhosis
2. Cholangitis - inflammation of the bile ducts
3. Portal hypertension
4. Malabsorption
5. Failure of biliary drainage
What is a CHOLEDOCHAL CYSTS known as?
CHOLEDOCHAL CYSTS is known as “a swelling (cyst) of common bile duct. 3 to 4 times more common in females; can be caused by a congenital weakness in the duct wall. Sonographically it appears as a localized cystic mass separate from the gallbladder in the region of the porta hepatis or intrahepaticaly”
What is Biliary sludge known as?
BILIARY SLUDGE is known as “sludge represents precipitates formed in the bile. It consists of a collection of calcium bilirubinate, mucus, and lesser amounts of cholesterol crystals within viscous bile that contains high concentration of mucus and other proteins. Sludge can produce the classic pain of gallstones and sometimes is a precursor to gallstone disease.”
What are the acquired disease of the Gallbladder?
1: Biliary Sludge
2:Hepatization
3: Tumefactive Sludge
4:Choleithiasis (GallStones)
What are the symptoms of Cholelithiasis (GallStones)?
Symptoms of Cholelithiasis is :
1. RUQ pain /steady or occurring after meals can radiate to shoulder or epigastric area
2. nausea/vomiting
3. Elevated ALP
4. AST & ALT elevation when cystic duct or cbd is obstructed
What are the Diagnosis and Treatment of Cholelithiasis ?
Diagnosis and Treatment of Cholelithiasis is known as:
Varies depending on frequency and the severity of the attacks as well as size of stones , small stones can cause ductal obstruction
- Cholecystectomy - surgical removal of gallbladder
What is the definition of COURVOISIER GB?
COURVOISIER GB is known as “A gallbladder that is enlarged, palpable and not tender that is caused by a mass in the pancreatic head obstructing the bile duct “
What is HYDROPIC GB known as?
HYDROPIC GB - a distended gallbladder caused by an obstruction of the gb neck or cystic duct. It is abnormally distended and filled with thick bile, mucus or pus
What is CHOLEDOCHOLITHIASIS known as?
CHOLEDOCHOLITHIASIS- STONE WITHIN THE BILE DUCT
What is CHOLANGITIS known as?
CHOLANGITIS- A rare chronic inflammatory and fibrosing disorder of the intrahepatic and extrahepatic biliary system
What are the three parts of the Gallbladder?
The three parts of the Gallbladder is Neck, Body, Fundus.
How do you measure a gallbladder?
Normal Gallbladders are measure wall to wall
What is the normal measurement of a gallbladder wall?
Normal measurement of a gallbladder wall is less than 3mm.
What is the physiology of biliary system and gallbladder?
The biliary system transports bile, which is produced continually by hepatic parenchymal cells, to the duodenum, where it aids in digestion. Bile contains bile pigments(chiefly bilirubin) bile acids, cholesterol, lecithin and mucin. Bile helps emulsify and promotes the absorption of fats, and also facilitates the actions of lipase ( pancreatic enzyme)
When food especially fats enter the small intestine ( when we eat) CHOLECYSTOKININ - (a hormone secreted into the blood by the small intestine that stimulates gallbladder contraction) Is secreted by the proximal small intestine, causing the gallbladder to contract and the sphincter of Oddi to relax. The SPHINCTER OF ODDI is a small smooth muscle sphincter
strategically placed at the junction of the bile duct and the duodenum. Bile is then released into the cystic duct, flows through the common bile duct and enters into the duodenum.
The cystic duct and common hepatic duct joined together to make ?
The cystic duct and common hepatic duct joined together to make common bile duct.
