Extrahepatic Biliary System

Question 1

Enumerate Components of Extrahepatic biliary ducts

Answer 1

3 ducts + gall bladder
* Hepatic Duct(s)
* cystic duct
* Gall bladder

Question 2

origin of right & left hepatic Duct

Answer 2

from Porta hepatis (most anterior structure)

Question 3

Length of Common hepatic duct

Answer 3

3-4 cm

Question 4

Course of Common hepatic duct

Answer 4

1. forms as union of the 2 right & left hepatic ducts
   2.Descends in lesser omentum, where it is Anterior to Portal V & right to (proper) Hepatic A
   3.Ends by uniting with Cystic Duct to form Common bile duct

Question 5

Length of Cystic duct

Answer 5

3-4 cm (same as common hepatic duct)

Question 6

Origin of Cystic duct

Answer 6

Neck of Gall bladder

Question 7

Cystic duct mucousa Projects inwards to —-

Answer 7

Form spiral valve that keeps duct open

Question 8

Length of Common bile duct

Answer 8

3-4 inches

3-4 cm is Common Hepatic & cystic Ducts

Question 9

Enumerate parts of Common bile duct

Answer 9

4 parts (seperated by duodenum):
* Supraduodenal
* Retroduodenal
* Infraduodenal
* Intraduodenal

Question 10

Course of Supraduodenal Part of Common bile duct

Answer 10

passes in free border of lesser omentum, anterior to portal vein & right to hepatic A, seperated from IVC by Epiploic foramen

Question 11

Course of retroduodenal part of Common bile duct

Answer 11

It descends behind second inch of 1st part of duodenum, in front of portal vein & right to Gastroduodenal A, seperated from IVC by the portal V

Question 12

Course of Infraduodenal Part of Common bile duct

Answer 12

Descend behind head of Pancreas & in front of IVC

Question 13

Explain how gall bladder is fixed to the liver

Answer 13

• by visceral peritoneum around inferior surface of liver
• Loose connective tissue containing Cystic A
• Cystic veins from gall bladder to liver

Question 14

Length of Gall bladder

Answer 14

3-4 inches long

Question 15

Function of gall bladder

Answer 15

Concentrates bile 10 times & stores it

Question 16

Anterior & posterior relations of fundus of gall bladder

Answer 16

• Anterior: Anterior abdominal wall
• Posterior: transverse colon

Question 17

Superior & inferior relations of body of gall bladder

Answer 17

• Superior: inferior surface of liver (gall bladder fossa)
• Inferior:
  1. transverse colon
  2. end of 1st part duodenum & begining of 2nd part

Question 18

Dilation present in neck of Gall bladder is called

Answer 18

Hartman’s pouch

Question 19

Superior & inferior relations of Neck of gall bladder

Answer 19

• Superior: Cystic Artery (seperating gall bladder from liver)
• inferior: 2nd inch of 1st. part of duodenum

Question 20

Arterial supply & venous drainage of gall bladder

Answer 20

• Cystic A & many small arteries
• Cystic Veins

Question 21

Nerve supply of Gall bladder

Answer 21

• Parasympathetic: Vagus N (through Celiac plexus)
• Sympathetic: greater spanchnic nerves (T-5-T9)