Gallbladder and Biliary Tree Flashcards
(28 cards)
What is the role of the gallbladder
Stores and concentrates bile
Where does the gallbladder lie
Posteroinferior (visceral) surface of the liver
Lies close to the duodenum
What are the parts of the gallbladder
Fundus
Body
Neck
Where does the body of the gallbladder sit
Gallbladder fossa on the visceral surface of the liver
Tapers towards the neck, which communicates with the cystic duct
Where is the surface marking of the fundus of the gallbladder
Fundus at the tip of the 9th costal cartilage at the point where the midclavicular line intersects the right costal margin
Describe the production of bile
Continuously produced by hepatocytes in the liver
First excreted into bile canaliculi (small channels)
Drains into larger calibre
Ultimately converge to form right and left hepatic ducts that exit the liver at the porta hepatis
Where does the bile duct run
Free edge of the lesser omentum
What lies at the gallbladder neck and cystic duct
Spiral fold (spiral valve) at the junction
What is the blood supply of the gallbladder
Cystic artery (arises from the right hepatic artery)
What is the innervation of the gallbladder
Parasympathetic
Sympathetic
Why might gallbladder pain be felt in the right shoulder
Irritates the diaphragm
Innervated by phrenic nerve C3-5
C3-5 also receive somatic sensory information from the skin over the shoulder
What is visceral sensation of the gallbladder
T5-9
Pain referred to epigastrium
What is another name for the hepatopancreatic ampulla
Ampulla of Vater
What is the name of the major duodenal papilla
Regulated by a muscular valve - Sphincter of Oddi
What are the components of bile
Bile acids
Cholesterol
Phospholipids
Bile pigments (bilirubin, biliverdin)
Electrolytes
Water
What are the constituents of bile split up into
Bile acid-dependent
Bile acid-independent components
What is the bile-acid dependent component produced by
Hepatocytes
Hepatocytes secrete bile acids, bile pigments and cholesterol into canaliculi
What are the small channels that transport the bile acid dependent portion towards the bile ducts
Canaliculi
Where is the bile acid-independent component made
Ductal cells that line bile ducts
Secrete alkaline solution (similar to the fluid made by the pancreatic duct cells)
What hormone stimulate secretion of bile acid-independent components
Secretin
What hormone stimulates bladder contraction and relaxes the sphincter of Oddi
Cholecystokinin - released by the duodenum after eating
What are the two primary bile acids
Cholic acid
Chenodeoxycholic acid
What amino acids are conjugated with to form bile salts
Glycine
Taurine
What are bile salts
Amphipathic - hydrophobic and hydrophilic