gallbladder (W4) Flashcards
cholethias
gallstones in GB
etiology
unknown
RF
gender
age
estrogen
lifestyle- obese/sednentary
diet
family history
where is bile produced?
liver
where is bile stored?
gallbladder
patho of cholethias
bile stasis
super saturated with cholesterol
precipitation
small stone
pass through to bile duct, pain/obstruction/cholecystitis
where is gallbladder located?
RUQ
s/s of cholelithias
silent- think small/not moving
severity- move/obstruction
billary collic
what is a billary collic
pain in RUQ that may radiate to shoulder
fatty meal, about 6 hours after
with steady severe pain
manifestations of cholithias
jaundice
dark amber urine that foams when shaken
clay stool
steatorrhea
pruritis
intolerance of fatty foods
bleeding tendencies
why does jaundice occur
bile cannot flow to duodenum
why does dark amber urine that foams when shaken occur
soluble bilirubin in urine
why does clay stool occur
bilirubin does not reach the small intestine
why does steatorrhea occur
fatty stool because no bile salts in duodenum to digest fat
why doe pruritis occur
deposit of bile in skin
why does intolerance of fatty foods occur
no bile in small intestine to aid with digestion
why do bleeding tendencies occur
decrease absorption of vitamin K
gallstones form as a result of
abnormal accumulation of bile salts and other substances- cholesterol!
cholecystitis
most common cause is the obstruction from gallstones/biliary sludge
other causes: prolonged immobility, fasting, bacterial infection, parental nutrition, DM
cholecystitis pathogenesis
obstruction- inflammation
gallbladder becomes: edematous, hyperemic, distended
cholecystitis over time
scarring and decreased functioning (eventually ineffective- removal)
cholecystitis manifestations
similar s/s to cholelithiasis
bc of inflammation component: fever, n/v, restlessness, diaphoresis
lab values: bilirubin, liver enzymes, WBC, amylase (pancreatic enzyme)
can lead to peritonitis- infection in site that is suppose to be sterile
analgesic (ketoralac/morphine)
pain control
antiemetics
nausea and vommitting
anticholinergics
to decrease gallbladder secretions and stop smooth muscle spasms
bile acids (rarely used)
dissolves stones
most gallstones are composed of
cholesterol
