Chapter 8 Gallbladderbiliary Tree Flashcards

1
Q

The Gallbladder is apart of which system?

A

The gallbladder is apart of the digestive system.

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2
Q

What are the the two position to examine a patient for the gallbladder?

A

The patient should be examined in SUPINE AND LEFT LATERAL DECUB/POSTERIOR OBLIQUE

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3
Q

What do Gallstones produce on ultrasound?

A

Gallstones produce on ultrasound as a clean shadow

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4
Q

How do you determine a Murphy sign is present ?

A

Murphy sign is present by “applying pressure with the transducer directly over the gallbladder”

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5
Q

Congenital Anomalies of Gallbladder and Biliary System

A

1: Agenesis Gallbladder
2: Septate Gallbladder
-multiseptated Gallbladder
3:Interposition of the Gallbladder
4:Biliary Atresia

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6
Q

What is the definition of septate gallbladder?

A

SEPTATE GALLBLADDER -is known as “gallbladder septum appears as a thin linear echo may mimic a junctional fold”

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7
Q

What is the definition of Multiseptated of Gallbladder?

A

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 “

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8
Q

What is the definition of Interposition of the gallbladder?

A

INTERPOSITION OF THE GALLBLADDER “is the absence of the common hepatic duct and the cystic duct “

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9
Q

What is the definition of Biliary Atresia ?

A

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.

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10
Q

What are the Complications of untreated Biliary Artesia?(5 things)

A

COMPLICATIONS OF UNTREATED BILIARY ATRESIA;
1. Cirrhosis
2. Cholangitis - inflammation of the bile ducts
3. Portal hypertension
4. Malabsorption
5. Failure of biliary drainage

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11
Q

What is a CHOLEDOCHAL CYSTS known as?

A

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”

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12
Q

What is Biliary sludge known as?

A

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.”

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13
Q

What are the acquired disease of the Gallbladder?

A

1: Biliary Sludge
2:Hepatization
3: Tumefactive Sludge
4:Choleithiasis (GallStones)

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14
Q

What are the symptoms of Cholelithiasis (GallStones)?

A

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

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15
Q

What are the Diagnosis and Treatment of Cholelithiasis ?

A

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

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16
Q

What is the definition of COURVOISIER GB?

A

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 “

17
Q

What is HYDROPIC GB known as?

A

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

18
Q

What is CHOLEDOCHOLITHIASIS known as?

A

CHOLEDOCHOLITHIASIS- STONE WITHIN THE BILE DUCT

19
Q

What is CHOLANGITIS known as?

A

CHOLANGITIS- A rare chronic inflammatory and fibrosing disorder of the intrahepatic and extrahepatic biliary system

20
Q

What are the three parts of the Gallbladder?

A

The three parts of the Gallbladder is Neck, Body, Fundus.

21
Q

How do you measure a gallbladder?

A

Normal Gallbladders are measure wall to wall

22
Q

What is the normal measurement of a gallbladder wall?

A

Normal measurement of a gallbladder wall is less than 3mm.

23
Q

What is the physiology of biliary system and gallbladder?

A

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.

24
Q

The cystic duct and common hepatic duct joined together to make ?

A

The cystic duct and common hepatic duct joined together to make common bile duct.

25
Q

What is the EXTRAHEPATIC DUCTS is made up of ?

A

EXTRAHEPATIC DUCTS is made up of the common bile duct and common hepatic duct. (CBD +CHD= Ex Ducts )

26
Q

Cholecystokinin is known as ?

A

Cholecystokinin is known as a hormone secreted into the body by the small intestine that stimulates gallbladder contraction

27
Q

What are the INTRAHEPATIC DUCTS ?

A

INTRAHEPATIC DUCTS carry bile inside the liver.

28
Q

Normal Gallbladder is seen as on sonography appearance?

A

Normal Gallbladder is seen as on sonography appearance as thin echogenic walls and anechoic lumen and posterior enhancement.

29
Q

Hartman Pouch is located and known as ?

A

Hartman Pouch is known as a fold located the neck of gallbladder.

30
Q

Phrygian cap is known as and located?

A

Phrygian cap is known as a fold and located fundus.

31
Q

Tumefactive sludge is known?

A

Tumefactive sludge is known sludge from long standing biliary obstruction frequently does not layer but often resembles a polyploid mass that can mimic a gb neoplasm.

32
Q

What is the definition of “Cholecystitis”?

A

Cholecystitis is acute or chronic inflammation of the gallbladder

33
Q

What is the definition of Cholangitis?

A

The definition of Cholangitis - inflammation of the bile duct

34
Q

Sludge is known as ?

A

Sludge is known as -solid, semisolid, or the thickened bile within the gallbladder or bile ducts.

35
Q

“PNEUMOBILIA” is known as?

A

“PNEUMOBILIA” is known as air within the bile ducts

36
Q

Definition of the Cystic duct?

A

Cystic duct is - the duct of the gallbladder that joins with hepatic duct to form the common bile duct

37
Q

What is the Spincter of ODDI

A

Spincter of ODDI is -small smooth muscle sphincter strategically placed at the junction of the bile duct and the duodenum

38
Q

What are the 4 complications of cholecystitis ?

A

4 Complications of Cholecystitis
-Empyema -pus in the gallbladder
-gallbladder perforation- occurs in the fundus because of chronic inflammation and low blood flow to this area
-gangrenous Cholecystitis- absent of blood supply or infection
-emphysematous Cholecystitis- rare from of acute Cholecystitis. (Gas forming bacteria invade the gallbladder

39
Q

What does ADENOCARCINOMAS make up?

A

ADENOCARINOMAS make up the vast majority of malignancies