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Surgery.(GIT 2).Gallbladder > Gall bladder.1. Anatomy and Physiology of The Biliary system > Flashcards

Gall bladder.1. Anatomy and Physiology of The Biliary system Flashcards

1
Q

Anatomy of The Biliary system

A
  1. Components
  2. Blood supply
  3. Lymphatic drainage
  4. Nerve supply
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2
Q

Components in Anatomy of The Biliary system

A
  1. Gall bladder

2. Extra-hepatic biliary tracts

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3
Q

Gall bladder in Components in Anatomy of The Biliary system

A
  1. SHAPE
  2. VOLUME
  3. LOCATION
  4. PARTS
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4
Q

SHAPE of Gall bladder in Components in Anatomy of The Biliary system

A

pear-shaped

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5
Q

VOLUME of Gall bladder in Components in Anatomy of The Biliary system

A

with a normal capacity of about 50 ml.

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6
Q

LOCATION of Gall bladder in Components in Anatomy of The Biliary system

A
  • on the visceral surface of the liver

* at the plane dividing its 2 surgical lobes.

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7
Q

PARTS of Gall bladder in Components in Anatomy of The Biliary system

A
  1. The fundus
  2. The body
  3. The infundibulum
  4. The neck
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8
Q

The fundus in PARTS of Gall bladder in Components in Anatomy of The Biliary system

A
  • usually located at the tip of the ninth costal cartilage

* completely covered by peritoneum.

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9
Q

The body in PARTS of Gall bladder in Components in Anatomy of The Biliary system

A

occupies the gall bladder fossa of the liver.

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10
Q

The infundibulum in PARTS of Gall bladder in Components in Anatomy of The Biliary system

A
  • Definition

* Alternative name

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11
Q

Definition of The infundibulum in PARTS of Gall bladder in Components in Anatomy of The Biliary system

A

It’s the angulated portion of the body

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12
Q

Alternative name for The infundibulum in PARTS of Gall bladder in Components in Anatomy of The Biliary system

A

Hartmann’s Pouch

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13
Q

The neck in PARTS of Gall bladder in Components in Anatomy of The Biliary system

A

connected to the cystic duct

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14
Q

Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system

A

a. Common hepatic duct (CHD)
b. Cystic duct
c. Common bile duct (CBD)

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15
Q

Common hepatic duct (CHD) in Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system

A

It is formed by the union of the right and left hepatic ducts in the porta hepatis.

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16
Q

Cystic duct in Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system

A
  • Size

* Mucosa

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17
Q

Size of Cystic duct in Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system

A

It is 2-3 cm long and 2-3 mm in diameter.

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18
Q

Mucosa of Cystic duct in Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system

A

Its mucosa is thrown into crescent-like folds called spiral valve of Heister.

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19
Q

spiral valve of Heister in Mucosa of Cystic duct in Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system

A

crescent-like folds of the mucosa of the cystic duct

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20
Q

Common bile duct (CBD) in Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system

A
  1. Beginning
  2. Ending
  3. Dimensions
  4. Parts
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21
Q

Beginning of Common bile duct (CBD) in Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system

A

begins at the union of the cystic duct & CHD

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22
Q

Ending of Common bile duct (CBD) in Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system

A

ends at the ampulla of Vater in the postero-medial part of the 2nd part of the duodenum.

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23
Q

The ampulla of Vater in Ending of Common bile duct (CBD) in Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system

A

surrounded by the sphincter of Oddi.

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24
Q

Dimensions of Common bile duct (CBD) in Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system

A

It varies in length from 5 to 10 (7.5) cm and the average diameter is about 3-8 mm

” i.e the decade + 2”. maximum the 6th decade

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25
Parts of Common bile duct (CBD) in Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system
It can be divided into 4 parts ( or 3 parts) : 1. Supra-duodenal 2. Retro-duodenal 3. Infra-duodenal 4. Intra-duodenal
26
Supra-duodenal part in Parts of Common bile duct (CBD) in Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system
1. Visibility by U/S 2. Size 3. Location
27
Visibility by U/S of Supra-duodenal part in Parts of Common bile duct (CBD) in Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system
The only part seen by U/S
28
Size of Supra-duodenal part in Parts of Common bile duct (CBD) in Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system
About 2.5 cm long
29
Location of Supra-duodenal part in Parts of Common bile duct (CBD) in Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system
runs in the free margin of the lesser omentum
30
Retro-duodenal part in Parts of Common bile duct (CBD) in Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system
1. Visibility by U/S | 2. Location
31
Visibility by U/S of Retro-duodenal part in Parts of Common bile duct (CBD) in Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system
Not seen by U/S
32
Location of Retro-duodenal part in Parts of Common bile duct (CBD) in Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system
Passes behind the 1st part of the duodenum
33
Infra-duodenal part in Parts of Common bile duct (CBD) in Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system
1. Visibility by U/S | 2. Location
34
Visibility by U/S of Infra-duodenal part in Parts of Common bile duct (CBD) in Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system
Not seen by U/S
35
Location of Infra-duodenal part in Parts of Common bile duct (CBD) in Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system
Lies in a groove in the posterior surface of the pancreas.
36
Intra-duodenal part in Parts of Common bile duct (CBD) in Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system
1. Location | 2. Formation of ampulla of Vater
37
Location of Intra-duodenal part in Parts of Common bile duct (CBD) in Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system
Passes through the wall of the 2nd part of the duodenum
38
Formation of ampulla of Vater in Intra-duodenal part in Parts of Common bile duct (CBD) in Components of Extra-hepatic biliary tracts in Components in Anatomy of The Biliary system
Intra-duodenal part Joins the main pancreatic duct, & together form a dilated segment that is known as the ampulla of Vater.
39
Blood supply in Anatomy of The Biliary system
1. The Gall Bladder | 2. The extrahepatic bile ducts
40
The Gall Bladder in Blood supply in Anatomy of The Biliary system
1. Arteries | 2. Veins
41
Arteries of The Gall Bladder in Blood supply in Anatomy of The Biliary system
It is supplied by the cystic artery, which usually arises from the right hepatic artery.
42
Veins of The Gall Bladder in Blood supply in Anatomy of The Biliary system
Venous return consists of * small veins that directly enter the liver bed * a cystic vein that enters the right branch of the portal vein.
43
The extrahepatic bile ducts in Blood supply in Anatomy of The Biliary system
* The cystic artery above * The gastro-duodenal artery below The blood vessels supplying the ducts usually run longitudinally at the 3 and 9 o'clock positions
44
Lymphatic drainage in Anatomy of The Biliary system
cystic lymph node of Lund
45
cystic lymph node of Lund in Lymphatic drainage in Anatomy of The Biliary system
1. Site 2. Afferent vessels 3. Efferent vessels
46
Site of cystic lymph node of Lund in Lymphatic drainage in Anatomy of The Biliary system
lies in front of the junction of the cystic and common hepatic duct
47
Afferent vessels of cystic lymph node of Lund in Lymphatic drainage in Anatomy of The Biliary system
The lymph vessels of the gall bladder
48
Efferent vessels of cystic lymph node of Lund in Lymphatic drainage in Anatomy of The Biliary system
pass to the hilar and to the celiac lymph nodes
49
Nerve supply in Anatomy of The Biliary system
1. Parasympathetic fibres 2. Sympathetic fibres 3. Sensory supply
50
Parasympathetic fibres in Nerve supply in Anatomy of The Biliary system
1. Origin | 2. Action
51
Origin of Parasympathetic fibres in Nerve supply in Anatomy of The Biliary system
From the hepatic division of the anterior vagal trunk
52
Action of Parasympathetic fibres in Nerve supply in Anatomy of The Biliary system
1. Secreto-motor 2. Responsible for contraction of the gall bladder and relaxation of the sphincter of Oddi .
53
Origin of Sympathetic fibres in Nerve supply in Anatomy of The Biliary system
From the celiac plexus from the greater splanchnic nerve.
54
Sensory supply in Nerve supply in Anatomy of The Biliary system
1. Transmitted along the Greater splanchnic nerve to T 7-9 | 2. Right phrenic nerve C 3-5
55
The reason why Pain of Gall bladder may be referred to the epigastrium
as It's transmitted along the Greater splanchnic nerve to T 7-9
56
the reason why Pain of Gall bladder may be referred to the right shoulder
as it's transmitted along Right phrenic nerve C 3-5
57
Physiology of The Biliary system
1. Amount of Bile Per day 2. Control of Bile secretion 3. Composition of Bile 4. Function of Gall bladder
58
Amount of Bile Per day in Physiology of The Biliary system
Normal adults secrete 500-1000 ml bile per day.
59
Control of Bile secretion in Physiology of The Biliary system
1. Neurogenic Control | 2. Hormonal Control
60
Main Control of Bile secretion in Physiology of The Biliary system
Hormonal control
61
Neurogenic Control in Control of Bile secretion in Physiology of The Biliary system
1. Vagal stimulation increases secretion. | 2. Splanchnic stimulation decreases bile flow
62
Hormonal Control in Control of Bile secretion in Physiology of The Biliary system
Bile flow is stimulated by cholecystokinin
63
cholecystokinin in Hormonal Control in Control of Bile secretion in Physiology of The Biliary system
1. Alternative name | 2. Site of release
64
Alternative name for cholecystokinin in Hormonal Control in Control of Bile secretion in Physiology of The Biliary system
Previously called pancreozymin
65
Site of release of cholecystokinin in Hormonal Control in Control of Bile secretion in Physiology of The Biliary system
released from the duodenal mucosa and small intestine.
66
Composition of Bile in Physiology of The Biliary system
1. Water 2. Electrolytes 3. Bile salts 4. Cholesterol and phospholipids. 5. bile pigments
67
Percentage of water in Composition of Bile in Physiology of The Biliary system
97%
68
Concentration of Electrolytes in Composition of Bile in Physiology of The Biliary system
The same concentration as the plasma.
69
Bile salts in Composition of Bile in Physiology of The Biliary system
formed from The major bile acids which are cholic, deoxycholic, and chenodeoxycholic acids.
70
Bile pigments in Composition of Bile in Physiology of The Biliary system
The yellow colour of bile
71
The reason of the yellow color of bile in Bile pigments in Composition of Bile in Physiology of The Biliary system
due to the presence of the pigment bilirubin diglucuronide which is the breakdown product of haemoglobin
72
Function of Gall bladder in Physiology of The Biliary system
1. Storage and Concentration of bile 2. Secretion of mucus 3. Excretion of excess cholesterol and conjugated bilirubin
73
Function of Secretion of mucus in Function of Gall bladder in Physiology of The Biliary system
1. Protects the mucosa from the lytic action of bile | 2. Facilitates passage of bile through the cystic duct.

Surgery.(GIT 2).Gallbladder (3 decks)

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