Gall Bladder Flashcards

1
Q

four parts

A

cystic duct
body
fundus
neck

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2
Q

anterior

A

right liver lobe

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3
Q

posterior

A

right kidney, transverse colon, proximal duodenum

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4
Q

superior

A

inferior border of liver, anterior abdominal wall

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5
Q

inferior

A

biliary tree and 2nd part of duodenum

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6
Q

lateral

A

right liver lobe

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7
Q

medial

A

duodenum

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8
Q

biliary tree

A

pipework of the gall bladder

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9
Q

cystic duct + hepatic duct =

A

common bile duct

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10
Q

fundus

A

expanded end which hangs below inf surface of the liver
contact with the ant abdominal wall
below right 9th costal cartilage

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11
Q

body

A

directed upwards, backwards and lies to the left

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12
Q

neck

A

narrow, curves on itself forming an S-shape
lies upwards and forwards curving sharply downwards into the cystic duct

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13
Q

cystic duct

A

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

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14
Q

what does the peritoneum cover

A

only the inferior surface, as in contact with liver, held by the visceral peritoneum that covers the liver

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15
Q

muscle layer

A

long fibrous tissue with additional oblique muscle fibres

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16
Q

sub mucous and mucous

A

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

17
Q

gall bladder

A

pear shaped
7-10cm
fills with 40-50ml of bile
attaches to post surface of the liver by connective tissue

18
Q

region

A

right hypochondriac

19
Q

what can cause blockage

A

gall stones

20
Q

what system is it part of

A

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

21
Q

lymphatics

A

coeliac node
common duct inferior to retro portal node
to superior mesenteric node -> para-aortic nodes near renal vein

22
Q

lymph node pathway

A

cystic N -> hepatic N -> pre-aortic N -> thoracic N

23
Q

nervous control

A

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

24
Q

sympathetic

A

hepatic plexus + coeliac plexus

25
Q

para-sympathetic

A

hepatic branch of vagus nerve

26
Q

hormonal control

A

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

27
Q

blood supply

A

aorta -> coeliac trunk -> common hepatic artery -> right hepatic artery -> cystic artery

cystic artery supplies the GB

cystic vein -> portal vein -> IVC -> heart

28
Q

what is the structure of the bile duct

A

same as the AC

29
Q

where does the hepatic duct go to

A

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

30
Q

cystic duct structure

A

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