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Abdomen > gallbladder and biliary > Flashcards

gallbladder and biliary Flashcards

1
Q

the gallbladder is located on the fossa on _____ ________ portion of the liver

A

posterior inferior

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2
Q

the gallbladder can have a ____ of positions and the ___ ____ fissure is used as an identifying landmark

A

variety
main lobar

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3
Q

the gallbladder is used as a storage sac for ____

A

bile

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4
Q

the gallbladder shape can be ___, conical, ____ gourd-like, pear shaped

A

round
teardrop

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5
Q

the gallbladder is a musculo-______ sac

A

membranous

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6
Q

the gallbladder is located ____ to the right liver lobe. ___ to the right kidney and ____ to the pancreas head and duodenum

A

posterior
anterior
lateral

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7
Q

normal gallbladder size in SAG is __-__ cm and in TRANS is ___ cm

A

7-10cm
3cm

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8
Q

the normal gallbladder wall thickness is <___mm

A

3mm

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9
Q

in the gallbladder the _____ is a hemispheric blind end, normally the most inferolateral portion that extends caudal and anterior below the inferior margin of the right hepatic love at the level of the 9th costal cartilage

A

fundus

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10
Q

the neck of the gallbladder is in a fixed position at ____ ____ fissure

A

main lobar

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11
Q

the gallbladders blood supply is from the ___ artery ( branch of the right hepatic artery )

A

Cystic

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12
Q

the gallbladder blood drainage is from the ___ vein into the ___ venous system

A

cystic
portal

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13
Q

the ____ duct connects the neck of the GB to the common hepatic duct

A

cystic duct

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14
Q

the ____ duct contains spiral valves of Hester which prevent the GB from _____

A

cystic
collapsing

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15
Q

the cystic duct is ____ to Gb neck and not normally seen on ultrasound

A

superior

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16
Q

the cystic duct merges with the CHD to form the ____

A

CBD

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17
Q

spiral valves of heister is found within the ___ duct. it controls inward and outward flow of bile and keeps duct from kinking

A

cystic duct

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18
Q

the intrahepatic bile ducts is located within the liver anterior lateral to the ____ veins

A

Portal

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19
Q

the intrahepatic bile ducts are the most ___ bile ducts

A

proximal

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20
Q

the right and left intrahepatic ducts emerge to form the common hepatic duct at the level of the porta____

A

hepatic

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21
Q

the common bile duct is formed by the union of the ___ ___ ___ and ____ ___

A

CHD
cystic duct

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22
Q

the duodenal ____ is the opening into the duodenum

A

papilla

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23
Q

_____ of ODDI controls flow of bile and pancreatic juices into duodenum

A

sphincter

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24
Q

the _____ is used to store bile

A

gallbladder

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25
Q

bile is a surfactant, emulsifier that breaks down ____ its made up of bile ___, ____ and a small amount of _____

A

fats
salts
cholesterol
bilirubin

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26
Q

in the gallbladder contractions are controlled by ______

A

cholecystokinin

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27
Q

_____ is the main pigment found in bile

A

bilirubin

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28
Q

bile is produced by the breakdown of ____

A

hemoglobin

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29
Q

____ is responsible for color in feces

A

Bilirubin

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30
Q

bilirubin pigment is associated with ____

A

jaundice

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31
Q

the CBD ____ and concentrate bile

A

store

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32
Q

the CBD deliver bile to the ______

A

duodenum

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33
Q

the normal size of the CBD is __-___mm

34
Q

an increase of serum alkaline phosphate indicates mechanical obstruction to flow of _____

35
Q

______ cap Is a fold between the funds and body of gallbladder

A

Phrygian cap

36
Q

junctional fold also called _____ pouch is a fold between the body abdomen infundibulum of gallbladder its the most frequent variation

A

hartmann’s

37
Q

normal gallbladder on ultrasound

lumen is ____, wall is pencil ___ and echogenic the wall measurement taken in transverse of ____ wall and the normal length is no greater than ____mm

A

anechoic
thin
anterior
3mm

38
Q

biliary ___ is concentrated bile-thickened

39
Q

_____ ____ is sometimes a precursor to a stone formation

A

billiard sludge

40
Q

cholelithiasis is also known as _____

A

Gallstones

41
Q

cholelithiasis (gallstones) is more common in ____ (4;1) and ___% of the population will develop stones

42
Q

the 5 F’s of gallbladder disease is _____, ____, ____, ___ and ____

A

Female
Fat
Feritle
Forty
Fair

43
Q

some signs and symptoms of cholelithiasis ( gallstones) the patient may be ____ up to 60-80%. the patients generally present with RUQ pain that occurs after ___ or radiates to the upper ____, ____ or ___ area as well as nausea vomiting or intolerance to fatty foods

A

asymptomatic
meals
back
shoulder
epigastric

44
Q

with gallstones ___ and ___ are more costly

45
Q

____ sign is also known as double - arc shadow sign

46
Q

The ___ ___ shows the contracted gallbladder containing stones

47
Q

acute _____ ( inflammation of GB wall) up to 95% of cases result from impacted stones with GB neck or cystic duct

A

cholecystitis

48
Q

with acute cholecystitis patients present with RUQ pain that radiates to shoulder, the positive ____ sign ( rebound tenderness over the GB area ) , nausea , vomiting and fever

49
Q

acute cholecystitis may require ____ ___ ( life threatening )

A

emergency surgery

50
Q

_____ cholecystitis is caused by repeated attacks of ___ cholecystitis with subsequent ___ of the GB wall

A

chronic
acute
fibrosis

51
Q

chronic cholecystitis is a long term ____ of the GB due to infection , ____ or metabolic ____

A

inflammation
obstruction
disorders

52
Q

_____ gallbladder is a rare, calcium incrustation of the GB wall and a form of chronic cholecystitis

53
Q

_____ is a benign proliferation of gallbladder wall tissue, it may be focal or diffuse and comet tail artifact may be seen due to trapped cholesterol stones in the RA sinuses and is usually asymptomatic

A

Adenomyomatosis

54
Q

GB _____ is progressive , rapidly spreading to other structures . Its also rare .Poor prognosis- mortality 100%

55
Q

GB carcinoma is usually seen in elderly and most commonly in ____ >60

56
Q

GB carcinoma is highly associated with ___

A

cholelithiasis

57
Q

a bile duct ____ can be intrahepatic or extra hepatic location and is caused by stones, tumors within the bile ducts, or by a primary sclerosis cholangitis liver mass and pancreas disease

A

obstruction

58
Q

with a bile obstruction bile duct are dilated ____ to the obstruction level

59
Q

a biliary obstruction is suspected when patients present with _____

60
Q

with biliary obstruction jaundice is caused by elevated _____

61
Q

the antler branching pattern or stellate branching pattern, the parallel channel sign, shotgun sign or too many tubes sign is seen with a biliary _____

A

obstruction

62
Q

choledocholithiasis is biliary obstruction caused by ____ in the bile ducts

63
Q

_____ syndrome is when a stone is impacted in cystic duct of neck of GB

64
Q

with ____ syndrome cholecystectomy is the preferred treatment

65
Q

______ are enlarged lymph nodes in the areas of the porta hepatis and they can put pressure on the bile ducts and cause dilation in the proximal and intrahepatic ducts .

A

Lymphadenopathy

66
Q

Carcinoma in the head of the _____ may obstruct the distal CBD

67
Q

with pancreatic head carcinoma all proximal ducts could become ____

68
Q

______ is a malignant neoplasm of bile ducts, most common are adenocarcinomas, followed by squamous

A

cholangiocarcinoma

69
Q

there are ____ types of cholangiocarcinoma

70
Q

The 3 types of cholangiocarcinoma are
_____ ( peripheral)
______ ( most common ; develops outside the CBD)
____ - klatskin’s tumor ( located between left and right hepatic ducts causes intrahepatic dilation)

A

Intrahepatic
Distal
Hilar

71
Q

the subtypes of cholangiocarcinoma are
_____ - most common
____ - most common
_____- found in distal CBD

A

sclerosing
nodullar
papillary

72
Q

the most common subtypes of cholangiocarcinoma are ____ ____

A

nodular sclerosing

73
Q

_____ tumor is cholangiocarcinoma at the right and left hepatic bifurcation, dilation is only of the intrahepatic ducts, Lack of joining of left and right hepatic ducts

A

Klatskin’s

74
Q

choledochal cyst type 5 is ____ disease which is multiple cysts

A

Caroli’s

75
Q

____ disease is a congenital anomaly its usually asymptomatic first 5-20 years its a segmental saccular cystic dilation of major intrahepatic ducts

A

Caroli’s

76
Q

Caroli’s disease can appear as a ___ of ___

A

string of beads

77
Q

the central dot sign is associated with ___ ___-

A

Caroli’s disease

78
Q

____ is inflammation of the bile ducts

A

cholangitis

79
Q

there are 4 types of cholongitis
- ____ cholangitis
- primary _____ cholangitis
- ___ related cholangitis
- recurring ____ cholangitis

A

bacterial
sclerosing
AID’s
pyogenic

80
Q

main cause of ___ is biliary failure secondary to percutaneous biliary procedures or other biopsies

81
Q

_____ is air within the biliary tree secondary to biliary intervention, Biliary-enteric anastomoses, or common bile duct stents

A

Pneumobilia

Abdomen (6 decks)

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