gallbladder Flashcards
apa yang terletak di anterior - superior gallbladder?
batas inferior liver dan dinding abdominal anterior
apa yang terletak di posterior gallbladder?
transverse colon dan duodenum proximal
apa yang terletak di inferior gallbladder?
pohon biliari dan sisa duodenum
what are the anatomical sections of the gallbladder?
the pylorus, body, and neck
what does the pylorus reflect?
inferior border of liver at the midclavicular line
where is the body of the gallbladder in relation to the liver?
adjacent to the posterior inferior of the liver
what part of the neck of the gallbladder is the main location of…?
the hartmann’s pouch, cholestasis
what does “cholestasis” mean etymologically?
chole means bile and stasis means to stand still, so the bile is still and unflowing
by what means does the bile unflow?
impaired hepatocyte bile secretion, biliary tree lodging, hartmann’s pouch lodging
how do you classifiy cholestasis?
intra and extrahpeatic
what factors may cause intrahepatic cholestasis?
hepatitis
what factors may cause extrahepatic cholestasis?
biliary atresia (in infants), bile duct obstruction, primary sclerosing cholangitis
what causes biliary atresia?
bacterial infection, unproper embrionic development
what is a bile canaliculi?
the duct preceeding the biliary tree that stores the bile produced by hepatocytes temporarily
what is the morphology of cholestasis?
bile flow is slow, the canaliculi and the hepatocytes are therefore filled with bile from reverse flow.
what happens to the canaliculi?
becomes thicker and bigger (elongated bile plugs)
what happens to the hepatocytes during cholestatis?
accumulation of bile pigments and then feathery degeneration
what happens when the hepatocytes and clinical features implode from overfilling?
kupffer cells will come in and eat the bile (then filled by the bile pigments)
what matter gets to the blood when bile regurgitation happens?
bilirubin, bile salt, and cholestrol
what happens when bilirubin gets into the bloodstream?
dark urine, jaundice
what happens when bile salt gets into the bloodstream?
pruritis (itching) of the soles and the palms
what happens when cholestrol gets into the bloodstream?
xanthoma (fat accumulation on skin)
the bile supply to the intestine being interrupted causes what to happen?
pale stool and ADEK vitamins malabsorbtion
what comes after the right and left hepatic duct?
the common hepatic duct
what is the superiormost structure of the biliary tree
the right and left hepatic duct that binds to become the common hepatic duct
what does the common hepatic duct connect with? what does it form?
the cystic duct to form the common bile duct
what does the common bile duct connect with? what does it form?
the pancreatic duct to form the hepatopancreatic ampulla of Vater
why do gallstones form?
imbalance of cholestrol and/or bile salts or failure of emptying the gallbladder
what is the cool name for gallstone?
cholelithiasis
what can gallstone cause the gallbladder?
inflammation called cholecystitis
what is it called when the gallstone lodges the common bile duct?
choledocholithiasis
what can common bile duct lodging cause?
cholangitis
what is the charcot’s triad
fever, RUQ pain, jaundice
what is reynold’s pentad
fever, RUQ pain, jaundice, sepsis (hypotension), and altered mental state (confusion)
what are the 2 types of gallstone?
cholestrol and pigment stones?
why pigment stones?
because it’s not only bilirubin, but also calcium
what is contained in cholesterol stones?
they contain crystalline cholesterol monohydrates
what are the 2 subdivisions of pigment stones?
black and brown
what is the black one made of
calcium bilirubinate + calcium carbonate + <20% cholesterol
what is the brown one made of?
calcium bilirubinate + calcium soaps of fatty acid + <20% cholesterol
why are females more prone to get cholelithiasis
estrogen increases estrogen and lowers bile acid
why do black stones happen?
increase of unconjugated bilirubin (crohn, thallasemia, sickle cell, sferocitosis, microangiopathic hemolytic anemia)
why do brown stones happen?
bile stasis from clonorchis sinensis, roundworms, and e coli
