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Abdomen Ultrasound > Gallbladder/Biliary Tree > Flashcards

Gallbladder/Biliary Tree Flashcards

1
Q

Function of GB

A

Concentrate & store bile

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2
Q

Identifying landmarks of GB

A

Right PV & Main lobar Fissure

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3
Q

Anatomy of GB

A

Neck, Body, Fundus

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4
Q

Normal size of GB wall

A

3 mm

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5
Q

GB Volume Equation

A

(L * W * H) .52

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6
Q

Cystic Duct connects

A

GB Neck to Common Hepatic Duct

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7
Q

First/last to dilate if CBD is backed up

A

Gallbladder is first, CBD is last

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8
Q

Flow of bile

A

Liver → R/L Hepatic Ducts → Common Hepatic Duct → Cystic Duct → Gallbladder → Common Bile Duct → Pancreatic Duct → Ampulla of Vater → Sphincter of Oddi → Duodenum

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9
Q

Intrahepatic Dilation

A

Dilation which pushes bile back into liver; occurs at CHD, LHD, RHD

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10
Q

Extrahepatic Dilation

A

Pushes bile away from liver; blockage after cystic duct

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11
Q

Spiral Valves of Heister

A

Connect gallbladder neck to cystic duct; control inward/outward flow of bile

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12
Q

Anatomy of Ampula of Vater (aka)

A

Hepatopancreatic Ampulla; Consists of duodenal papilla & Sphincter of Oddi

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13
Q

Sphincter of Oddi

A

Controls flow of bile & pancreatic juices into duodenum

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14
Q

Cholecystokinin (CCK)

A

Controls the flow of bile

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15
Q

Vessels from Posterior → Anterior

A

IVC, Portal Vein, Hepatic Artery, Bile Duct

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16
Q

Bile

A

Breaks down fat & RBC; made up of bile salts cholesterol, bilirubin

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17
Q

Bilirubin

A

Pigment formed from breakdown of RBC, associated w/ jaundice

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18
Q

Avg size of bile duct

A

< 5 mm

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19
Q

Avg size of bile duct after cholecystectomy

A

10 mm or 1 cm

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20
Q

Direct Bilirubin

A

Bilirubin prevented from going into liver by an obstruction

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21
Q

Indirect Bilirubin

A

Loss of bilirubin due to hepatic damage; problem in the process of making bilirubin

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22
Q

Lab Values Associated w/ GB

A

Bilirubin, alkaline phosphatase, lactic dehydrogenase

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23
Q

Phygian Cap

A

Fold between the body and fundus

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24
Q

Junctional Fold

A

aka Hartman Pouch; fold between body & neck of GB

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25
Q

GB Variants

A

Phygian cap, junctional fold, septation, agenesis, duplication

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26
Q

Gallstones aka ____, formed from

A

Cholelithiasis; Formed by irregular bowel movements resulting in bile stasis, abnormal bile composition, infection

27
Q

4 F’s

A

Fat, female, forty, fertile

28
Q

Symptoms of Gallstones

A

Asymptomatic, RUQ pain, fatty food intolerance

29
Q

US Appearance of Gallstones

A

Highly echogenic, posterior shadowing, mobile

30
Q

Mirizzi Syndrome

A

Stone impacted in the cystic duct or neck of GB; result in dilated intrahepatic ducts

31
Q

WES Triad

A

Wall echo shadowing; 2 thin curved parallel lines caused by an excess of gallstones

32
Q

Sludge Ultrasound Appearance

A

Low level echoes, non-shadowing, slow moving

33
Q

Cholecystisis

A

Inflammation of GB
Acute: Due to blockage of cystic duct
Chromic: Due to infection, obstruction, or metabolic disorder

34
Q

Symptoms of Acute Cholecystitis

A

RUQ pain, fever, nausea, vomiting, leukocytes

35
Q

Appearance of Cholecystitis

A

Gallstones, wall thickening, Murphy’s sign, round GB, sludge

36
Q

Complications of Acute Cholecystitis

A

Empyema (pus), emphysematous cholecystitis, gangrenous cholecystitis, GB perforation, abscess

37
Q

Hydrops (aka)

A

Mucocele, thin-walled, distended gallbladder due to prolonged obstruction; filled w/ mucus, pus, or bile

38
Q

GB Polyps

A

Benign masses attached to wall of GB; no shadowing or change in position

39
Q

Porcelain GB

A

Calcification of GB wall; associated w/ chronic cholecystitis, cholelithiasis, carcinoma

40
Q

Adenomyomatosis

A

Benign growth of GB wall; main characteristic: comet tail artifact due to stones trapped in RA sinuses

41
Q

RA Sinues

A

Rokitansky-Aschoff

42
Q

Cholesterolosis

A

Accumulation of sterols/fats in GB wall; small non-shadowing masses projecting into GB; strawberry GB

43
Q

GB Carcinoma Prevalance

A

Rare but more common in elderly & females; high association w/ gallstones

44
Q

GB Carcinoma Symptoms

A

Loss of appetite, nausea, vomiting, RUQ pain, jaundice

45
Q

Ultrasound Appearance of GB Carcinoma

A

Irregular wall borders, wall thickening, mass in lumen, gallstones, enlarged lymph nodes

46
Q

Most common metastases of GB Carcinoma

47
Q

Choledocal Cyst

A

Congenital, mostly in infants w/ failure to thrive, intermittent jaundice, and palpable RUQ mass; dilation of CBD

48
Q

Caroli’s Disease

A

Rare congenital condition that causes the bile ducts to be larger than usual leading to the formation of bile duct stones

49
Q

Complications of Caroli’s Disease

A

Lithiasis in bile ducts, recurring cholangitis

50
Q

Appearance of Caroli’s Disease

A

Multiple beads resembling “string like beads”

51
Q

Biliary Atresia

A

Narrowing/obliteration of ducts due to obstruction

52
Q

Intrinsic Biliary Atresia

A

Obstruction within bile ducts; choledocholithiasis, cholangiocarcinoma, inflammation due to cholangitis

53
Q

Extrinsic Biliary Atresia

A

Obstruction due to factor occurring outside bile ducts; pancreatitis, pancreatic mass, pancreatic psudocyst, hepatic mass, periductal adenopathy

54
Q

Appearance of Biliary Atresia

A

Tubular lucencies w/ deer antlers/stellate branches, Shotgun/Parallel Sign

55
Q

Choledocholithiasis

A

Biliary obstruction caused by stones in the bile ducts (formed in GB)

56
Q

Common location of choledocholithiasis

A

Distal CBD near Ampulla of Vater

57
Q

Choledocholithiasis is associated with patients with

A

Cholelithiasis and chronic cholecystitis

58
Q

Symptoms of choledocholithiasis

A

RUQ pain, jaundice, elevated bilirubin, biliary colic, hepatomegaly

59
Q

Cholangiocarcinoma

A

Malignant carcinoma of the bile ducts

60
Q

3 Types of Cholangiocarcinoma

A

Scirrhous, Polyploid, Klatskin’s Tumor

61
Q

Klatskin’s Tumor

A

Carcinoma located at the junction of the right and left hepatic ducts, or porta hepatis

62
Q

Cholangitis

A

Chronic inflammatory and fibrotic disorder of the biliary ducts

63
Q

Ultrasound Appearance of Cholangitis

A

Thickened wall, sludge, dilated bile ducts

64
Q

Symptoms of Cholangiocarcinoma

A

RUQ pain, pruritis, jaundice, weight loss/anorexia, biliary colic, palpable abdominal mass

Abdomen Ultrasound (4 decks)

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