Extrahepatic Biliary System Flashcards
Component of the extra- hepatic biliary apparatus:————
❖The Right & left hepatic ducts drains bile from the ——- and —— functional lobe of the liver
❖Emerges at the ———
Component of the extra- hepatic biliary apparatus
1. Right and Left Hepatic duct
2. Common hepatic duct
3. Gall bladder and cystic duct
4. Common bile duct.
❖The Right & left hepatic ducts drains bile from
the right and left functional lobe of the liver
❖Emerges at the porta- hepatis
❖Common hepatic duct:
• It is formed by the union of ———
ducts near the right end of the ——
• It is approx. —cm before it ends where the cystic duct from the gall bladder joins it to form the ———.
❖Common hepatic duct:
• It is formed by the union of right and left hepatic
ducts near the right end of the porta hepatis.
• It is approx. 3cm before it ends where the
cystic duct from the gall bladder joins it to form the common bile duct.
The gallbladder
• It is a gastrointestinal organ located within the —— region of the abdomen.
• it is intraperitoneal, —- -shaped sac lies within a fossa formed between the inferior aspects of the —— and —— lobes of the liver.
• It’s — to — cm long & — to —cm wide ,Volume: —- to — ml
• It is divided into three sections: ——
✓The fundus is the rounded base, angled so that it faces the ——
✓The neck is continuous with the —— duct, part of
the biliary tree
The gallbladder
• It is a gastrointestinal organ located within the right hypochondrial region of the abdomen.
• it is intraperitoneal, pear-shaped sac lies within a fossa formed between the inferior aspects of the right and quadrate lobes of the liver.
• It’s 7-10 cm long & 3-4 cm wide ,Volume: 30-50ml
• It is divided into three sections: the fundus, body, and neck.
✓The fundus is the rounded base, angled so that it faces the abdominal wall
✓The body lies in a depression in the surface of the lower part of the liver
✓The neck is continuous with the cystic duct, part of
the biliary tre
gallbladder anatomical relations
It lies in close proximity to the following structures:
• Anteriorly and superiorly:——
• Posteriorly:———
• Inferiorly ———
gallbladder anatomical relations
It lies in close proximity to the following structures:
• Anteriorly and superiorly: inferior border of the liver and the anterior abdominal wall.
• Posteriorly:
transverse colon and the proximal duodenum.
• Inferiorly – biliary tree and remaining parts of the duodenum.
The gall bladder is supply by the —— artery a branch of the —— artery( coeliac trunk)
• Drainage by —— vein and it lymph is drainage into the —— group of nodes
• Innervated by the ——- plexus (sympathetic & sensory) and —— nerve(parasympathetic)
The gall bladder is supply by the cystic artery a branch of the Hepatic artery( coeliac trunk)
• Drainage by portal vein and it lymph is drainage into the cystic group of nodes
• Innervated by the coeliac plexus (sympathetic & sensory) and vagus nerve(parasympathetic)
❖Cystic duct:
• It is about — to — cm long
• It begins at the —— of the gall bladder and joins the hepatic duct to form the common bile duct.
• It mucous membrane lining has a series of —— folds (spiral fold), from —to — in number
• The spiral fold are called ——
❖Cystic duct:
• It is about 3-4cm long
• It begins at the neck of the gall bladder and joins the hepatic duct to form the common bile duct.
• It mucous membrane lining has a series of crescentic folds (spiral fold), from 5 -12 in number
• The spiral fold are called (Valve of Heister)
Common bile duct:
• It is about —cm long &
—mm wide
• It formed by union of —— and ——
• It is divided into 4 part according to their course:
Sphincter of ———- is on the common bile duct
Sphincter of——— is on the pancreatic duct
Common bile duct:
• It is about 8cm long &
6mm wide
• It formed by union of common hepatic duct and cystic duct
• It is divided into 4 part according to their course
✓Supraduodenal ✓Retroduodenal ✓Infraduodenal ✓Intraduodenal N.B
Sphincter of choledochus & Sphincter of pancreaticus
Sphincter of choledochus, sphincter of pancreaticus and sphincter ampulla make up
Sphincter of oddi
❖Applied Anatomy
• ————: It is located at the porta hepatis of the liver – where the hepatic ducts & neurovascular structures enter/exit the liver
•———: is a small anatomical space in the abdomen
• ——— is a diverticulum that can occur at the neck of the gall bladder.
❖Applied Anatomy
• Hepatocystic triangle: It is located at the porta hepatis of the liver – where the hepatic ducts & neurovascular structures enter/exit the liver
• Calot’s triangle: is a small anatomical space in the abdomen
• Hartmann’s pouch
The cystohepatic triangle (or hepatobiliary triangle) is an anatomic space bordered by the ——inferiorly, the ————medially, and the —— superiorly.
The cystohepatic triangle (or hepatobiliary triangle) is an anatomic space bordered by the cystic duct inferiorly, the common hepatic duct medially, and the inferior surface of the liver superiorly.
Applied Anatomy
———: It is elicited in patients with acute cholecystitis by asking the patient to take in and hold a deep breath while palpating the right subcostal area. If pain occurs on inspiration, when the inflamed gallbladder comes into contact with the examiner’s hand
———-: It is a motility disorder that affects the gallbladder and sphincter of Oddi.
Applied Anatomy
Murphy’s sign: It is elicited in patients with acute cholecystitis by asking the patient to take in and hold a deep breath while palpating the right subcostal area. If pain occurs on inspiration, when the inflamed gallbladder comes into contact with the examiner’s hand, Murphy’s sign is positive
Biliary dyskinesia: It is a motility disorder that affects the gallbladder and sphincter of Oddi.
Applied Anatomy
Murphy’s sign: It is elicited in patients with acute cholecystitis by asking the patient to take in and hold a deep breath while palpating the right subcostal area. If pain occurs on inspiration, when the inflamed gallbladder comes into contact with the examiner’s hand, Murphy’s sign is——-
L
Positive
Content of the calot/ cystohepatic triangle
Cystic artery
Right hepatic artery
Lymph node of lund
Lymphatics
