Gall Bladder Flashcards
four parts
cystic duct
body
fundus
neck
anterior
right liver lobe
posterior
right kidney, transverse colon, proximal duodenum
superior
inferior border of liver, anterior abdominal wall
inferior
biliary tree and 2nd part of duodenum
lateral
right liver lobe
medial
duodenum
biliary tree
pipework of the gall bladder
cystic duct + hepatic duct =
common bile duct
fundus
expanded end which hangs below inf surface of the liver
contact with the ant abdominal wall
below right 9th costal cartilage
body
directed upwards, backwards and lies to the left
neck
narrow, curves on itself forming an S-shape
lies upwards and forwards curving sharply downwards into the cystic duct
cystic duct
3cm long, passes downwards and backwards from the neck to the RHS of the hepatic duct
mucous membrane has a series of folds - spiral valves
what does the peritoneum cover
only the inferior surface, as in contact with liver, held by the visceral peritoneum that covers the liver
muscle layer
long fibrous tissue with additional oblique muscle fibres
sub mucous and mucous
branching folds of lamina propria, extensive capillaries and small venues
no lymphatics
only mucus secreting glands in lamina propria at the neck
small rugae when empty distend when full
gall bladder
pear shaped
7-10cm
fills with 40-50ml of bile
attaches to post surface of the liver by connective tissue
region
right hypochondriac
what can cause blockage
gall stones
what system is it part of
biliary system, consisiting of ducts which convey bile from liver to the gall bladder, which links with the pancreas then into the duodenum at the pancreatic-duodenal papilla
lymphatics
coeliac node
common duct inferior to retro portal node
to superior mesenteric node -> para-aortic nodes near renal vein
lymph node pathway
cystic N -> hepatic N -> pre-aortic N -> thoracic N
nervous control
contractions occur 30 minutes after food, bile is pushed through the bile duct to duodenum
muscle walls contract causes the sphincter to relax allowing bile to enter the duodenum
contractions are stimulated by CCK, relaxation of the sphincter is in response to CCK and is a reflex response
sympathetic
hepatic plexus + coeliac plexus
para-sympathetic
hepatic branch of vagus nerve
hormonal control
products from fat digestion stimulates the duodenal mucosa to secure CCK when goes to the venous blood from the duodenal mucosa to portal general circulation arterial blood to stimulate the control of the GB walls
blood supply
aorta -> coeliac trunk -> common hepatic artery -> right hepatic artery -> cystic artery
cystic artery supplies the GB
cystic vein -> portal vein -> IVC -> heart
what is the structure of the bile duct
same as the AC
where does the hepatic duct go to
common hepatic duct, the right and left hepatic ducts join to form the common hepatic duct outside the portal fissure.
CHD travels down joining the cystic duct from the GB on the RHS forming the common bile duct, which joins the main pancreatic duct at the hepatic-pancreatico ampulla
cystic duct structure
mucosal membrane with irregular circular folds forming spiral valves, Bile passes through twice once on its way to the gall bladder and when it is expelled from the GB into the common bile duct and then onto the duodenum
