Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

*Ultrasound* > GB > Flashcards

GB Flashcards

1
Q

The 4/5-week embryo develops a bud from the foregut that grows _____ (direction); the cranial portion becomes the _____ and the _____.

A

Cephalad
Liver
Hepatic bile ducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In the _____ portion of the growing bud, a second bud develops, also called the _____, and this becomes the gall bladder and cystic duct.

A

caudal

diverticulum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

This is a rare condition that results from the failure of the cystic bud to develop in the 4th week of intrauterine life.

A

agenesis of the GB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

This condition often occurs with duplication of the cystic duct and may be diagnosed prenatally.

A

duplication of the GB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

The GB’s main function is to

A

store bile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

T or F? When stored in the GB, bile becomes less concentrated and therefore more powerful in its ability to do its work.

Why?

A

False

MORE concentrated = MORE powerful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

This organ is often also removed automatically with gastric bypass surgery.

A

GB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What hormone is released with the ingestion of food (especially fats), that signals the relaxtion of the valve at the end of the CBD (the sphincter of _____) which lets the bile enter the small intestine.

A

cholecystokinin

Oddi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does the release of cholecystokinin signal (2)

A

the relaxation of the sphincter of Oddi

the contraction of the GB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When the GB contracts, what happens?

A

It squirts the concentrated bile into the small intestine where it helps with the emulsification or breakdown of fats in the meal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

This is a muscular valve that controls the flow of digestive juices (bile and pancreatic juice) through the Ampulla of Vater into the second part of the duodenum.

A

Sphincter of Oddi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

This is relaxed by the release of cholecystokinin (CCK).

A

Sphincter of Oddi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What 2 vessels merge at the Ampula of Vater?

A

CBD and Pancreatic Duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

This consists of cholesterol, lecithin, calcium, bile salts, acids and waste materials among other things.

A

Bile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What happens within bile that is a cause of gallstones?

A

the bile salts and cholesterol become umbalanced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

T or F? Bile is continually being made and secreted by the liver in varying amounts into bile ducts.

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Some of the bile that is made and secreted go directly into the _____ and some into the _____.

A

small intestines

GB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

This also acts as a reservoir that uptakes excess bile when there is pressure in the bile ducts.

A

GB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

The 2 major functions of bile are

A

1) emulsifies fats so that the body can use them

2) acts as an antioxident to help remove toxins from the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

The GB lies in the _____ margin of the liver, between the RLL and LLL.

A

inferior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

This vessel may be used to help find the GB fossa, which is in the same anatomic plane.

A

MHV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Most hepatic ultrasounds will see and use this as a landmark for the GB fossa.

A

MLF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

The GB derives its blood supply from the _____.

A

cystic artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

The cystic artery arrises from the _____ and supplies the GB with blood.

A

RHA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

T or F? You can’t see the cystic artery or cystic vein on U/S.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Sometimes the proper hepatic artery skips the RHA and connects directly to the _____.

A

cystic artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

The GB is divided into _____ (#) parts, which are

A

3
neck
body
fundus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

The GB neck terminates in the _____.

A

narrow infundibulum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

This area of the GB is a common location for impaction of gallstones.

A

infundibulum (Hartmann’s Pouch)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

This is a region of the GB neck that may be angulated in some people.

A

infundibulum

Hartmann’s Pouch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Failure to identify the GB on an exam is most often due to

A

a previous cholecystectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Occasionally it is hard to find the GB in an exam because of this condition, which leads to a collapsed and fibrosed GB.

A

chronic cholecystitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

The GB may lie in _____ positions and be difficult to locate.

A

ectopic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

The GB may fold onto itself, the body onto the _____ or the _____ onto the body.

A

neck

fundus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

When the GB fundus folds onto the body, this is known as a _____ and has no clicial significance.

A

phrygian cap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

This is a GB composed of 2 or more intercommunicating compartments divided by a THIN septa.

A

Septate GB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

This is an GB composed of 2 or more intercommunicating compartments divided by a THICK septa.

A

Hourglass GB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

The GB is located at the _____ end of the MLF in the area we call the GB _____.

A

inferior

fossa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

The _____ (vessels) converge to form the RHD and LHD.

A

intrahepatic bile ducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

The _____ (vessels) converge to form the CHD.

A

RHD and LHD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

The GB neck tapers to form the _____ which joins with the CHD to form the CBD.

A

cystic duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

The _____ and _____ join to form the Ampulla of Vater.

A

CBD

Main Pancreatic Duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Within the cystic duct and sometimes the GB neck, small mucosal folds exist called

A

Spiral Valves of Heister

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

T or F? Sometimes you will see the Spiral Valves of Heister on U/S.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

The Spiral Valves of Heister control the bile flow in the _____ (vessel).

A

cystic duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Spiral Valves of Heister are problematic at times because _____ can get stuck in them.

A

gallstones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

The GB appears as a _____ (echogenicity) oblong structure _____ (relationship/location) to the right kidney, _____ (relationship/location) to the head of the pancreas and duodenum, indenting the _____ to medial aspect of the RLL.

A

sonolucent
anterior
lateral
inferior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

The GB size should be less than _____ transversely and less than _____ sagitally.

A

4cm

10cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

The wall thickness of the GB should be less than _____ and measured at the _____ portion.

A

3mm

fundus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

The GB is located in the _____ (quadrant), between the _____ and _____.

A

RUQ
RLL
LLL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

The bright linear reflector within the liver that connects the GB and the RPV or MPV is the

A

MLF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

T or F? A prominent GB may be normal in some people because of their fasting state.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

If the GB appears too large, administration of a _____ _____ and further evaluation may differentiate between normal and abnormal. If contraction does not occur, the _____ area should be studied for suspicious masses.

A

fatty meal

pancreatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

The contracted GB wall appears thick and may obscure _____ or _____ abnormalities.

A

luminal

wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

The exam of a GB should be performed after a minimum of _____ hours of fasting.

A

6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

A well contracted GB changes in the following ways (3):

A

1) strong, reflective outer contour
2) poorly reflective inner contour
3) sonolucent area between both reflecting structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

T or F? A GB ultrasound MUST be performed in at least 2 different patient positions.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

If the GB is not visualized, what should be done?

A

Maneuvers to evaluate the GB fossa are essential to avoid missing GB pathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

The rule of thumb for measuring the GB is to compare it to the _____ in the _____ plane. The width of the GB should always less than _____.

A

right kidney
transverse
5cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Within the liver parenchyma, the bile ducts follow the same course as the _____ and the _____. All of these vessels are contained in a _____ _____ _____ that forms the _____ _____.

A

portal veins
hepatic artery
common collagenous sheath
portal triad

61
Q

The proximal portion of the CBD is _____ to the PHA and _____ to the MPV.

A

lateral

anterior

62
Q

The CBD becomes more posterior after it descends behind the _____ bulb and enters the _____.

A

duodenal

pancreas

63
Q

The distal CBD lies _____ to the anterior wall of the IVC .

A

parallel

64
Q

The 5 common risk factors for gallstone disease are

A

1) Forty something
2) Female
3) Fat
4) Fertile
5) Fair skinned

65
Q

Although most patients are asymptomatic of gallstone disease, some develop a complication that is most often

A

biliary colic

66
Q

Biliary colic is

A

recurrent episodes of abdominal pain

67
Q

Sonography is considered highly sensitive in the detection of gallstones because

A

the variable size and number of stones within the GB give them different appearances on ultrasound

68
Q

The reason gallstones are highly reflective is because of the

A

large difference in the acoustic impedance of stones and adjacent bile

69
Q

The high reflective gallstones appear _____ (echogenicity) with strong _____ _____ _____ .

A

echogenic

posterior acoustic shadowing

70
Q

Stones smaller than _____ may not shadow but will still appear _____.

A

5mm

echogenic

71
Q

This is the key feature of stones that allows differentiation from polyps or other entities.

A

mobility

72
Q

Do small stones or large stones cause more complications and pain usually? Why?

A

small

because they can travel out of the GB and get lodged in the ducts

73
Q

List 4 possible positions to demonstrate mobility of stones during scanning.

A

1) RLD
2) LLD
3) upright
4) standing

74
Q

This appears as the GB wall in the near field, followed by a sliver of anechoic bile, then bright echo of a stone, followed by acoustic shadowing.

A

WES sign

75
Q

WES stands for

A

wall echo shadowing

76
Q

WES is also known as

A

double arc

77
Q

Cholelithiasis is

A

gallstones

78
Q

Choledocholithiasis is

A

gallstones in the CBD

79
Q

T or F? Blockage and infection caused by stones in the biliary tract can be life threatening. However, with prompt diagnosis and treatment, the outcome is usually very good.

A

true

80
Q

This is a rare condition in which the GB becomes filled with a pasty semi-solid substance made mostly of calcium carbonate.

A

Milk of Calcium Bile

81
Q

Milk of Calcium Bile is also called

A

Limey Bile

82
Q

Milk of Calcium bile involves a semi-solid substance made mostly of

A

calcium carbonate

83
Q

Milk of Calcium Bile or Limey Bile is often associated with (caused by) _____.

A

GB stasis

84
Q

T or F? Milk of Calcium Bile or Limey Bile often causes acute cholecystitis.

A

False (it rarely does)

85
Q

The appearance of Milk of Calcium Bile/Limey Bile is

A

high echogenic material with posterior acoustic enhancement

86
Q

This is made up of residual particles that remain in the GB after it sends bile from the liver to the intestines to further break down food. If the GB doesn’t empty correctly, proteins can be left behind resulting in this.

A

sludge

87
Q

This can solidify in the GB, causing gallstones.

A

sludge

88
Q

3 other terms for GB sludge are

A

biliary sludge
biliary sand
microlithiasis

89
Q

Why do people that have been fasting or are critically ill have problems with GB sludge?

A

Because since they aren’t eating, cholecystichinin isn’t being released, so the GB isn’t contracting to release the stored bile from the GB.

90
Q

The kinds of people with a higher risk for sludge are/have experienced (7)

A 
Pregnant
Rapid weight loss
Prolonged fasting/critically ill
Bone marrow transplant
Biliary stasis
Cystic duct obstruction
Cholecystitis
91
Q

Why is the GB often removed automatically during gastric bypass surgery?

A

Because the rapid weight loss can result in sludge filling the entire GB

92
Q

Complications of sludge are (4)

A

1) gallstones
2) biliary colic (pain)
3) acalculous cholecystitis (“no stone inflammation”)
4) pancreatitis

93
Q

Amorphous, low level echoes within the GB in the dependent position with no shadowing is probably

A

sludge

94
Q

If sludge mimics polypoid tumors, it is called either _____ or _____.

A 
tumefactive sludge
sludge balls (organization of the sludge)
95
Q

Occasionally, the sludge in the GB has the same echotexture as the liver, leading to camouflage of the GB, this is called

A

hepatization of the GB

96
Q

Camouflage of the GB =

A

hepatization of the GB

97
Q

What are GB polyps?

A

Tumor or tumor-like projections arising from the GB mucosa.

98
Q

T or F? Although most polyps are benign, some early GB carcinomas present as polypoid lesions.

A

True

99
Q

Polyps need to be followed up for a(n) _____ in size and changes which may suggest _____ _____.

A

increase

malignant transformation

100
Q

The most common kind of polyp is a _____ polyp.

A

cholesterol

101
Q

What size polyp requires follow-up?

A

5-10mm

102
Q

Inflammation of the GB is called

A

cholecystitis

103
Q

A relatively common disease accounting for some patients in the ER with abdominal pain is

A

acute cholecystitis

104
Q

Acute cholecystitis is caused by _____ in more than 90% of cases.

A

gallstones

105
Q

With cholecystitis, impaction of stones in the cystic duct or the GB neck results in obstruction with _____ distention, _____, superinfection, and eventually _____ of the GB.

A

luminal
ischemia
necrosis

106
Q

This is associated with RUQ pain, fever, and leukocytosis

A

acute cholecystitis

107
Q

Can you tell the difference between acute and chronic cholecystitis on an ultrasound?

A

No

108
Q

Sonographic findings of cholecystitis are (7)

A

1) Thickened GB wall
2) distention of the GB lumen
3) gallstones
4) impacted stone in cystic duct or gb neck
5) pericholecystic fluid collections
6) positive Murphy’s sign
7) hypermic GB wall with doppler

109
Q

_____ (hormone) elevation suggests obstruction at the level of the Ampula of Vater (with cholecystitis).

A

amylase

110
Q

7 complications of acute cholecystitis are

A

1) gangrenous cholecystitis
2) emphysematous cholecystitis
3) empyema
4) GB perforation
5) acalculous cholecystitis
6) torsion of the GB
7) pericholecystic abscess

111
Q

This is loss of tissue due to decreased blood supply (with cholecystitis).

A

gangrenous cholecystitis

112
Q

3 signs of gangrenous cholecystitis are

A

1) wall striations
2) intraluminal membranes
3) pericholecystic fluid

113
Q

This condition means the GB wall is necrosing

A

gangrenous cholecystitis

114
Q

This is acute cholecystitis due to GB wall ischemia and infection. This condition occurs most often in _____ men.

A

emphysematous cholecystitis

diabetic

115
Q

This complication of cholecystitis may result in a fever because of infection involved with this condition.

A

emphysematous cholecystitis

116
Q

Pus from bacteria-containing bile within the GB is

A

empyema

117
Q

Purulent =

A

pus

118
Q

This complication of cholecystitis is initiated with obstruction of the cystic duct.

A

empyema

119
Q

Localized fluid collection in the GB fossa is

A

GB perforation

120
Q

If the fluid leaks from GB perforation, these complications can occur (3)

A

1) peritonitis
2) pericholecystic abcess
3) biliary fistula

121
Q

This is acute cholecystitis without gallstones.

A

acalculous cholecystitis

122
Q

Acalculous cholecystitis is associated with existing conditions such as (6)

A

1) prolonged use of TPN
2) abdominal surgery
3) trauma
4) severe burns
5) sepsis
6) AIDS

123
Q

This is rare but patients may present with symptoms of acute cholecystitis. This is seen most often in females and sonographically looks like a massively distended and inflamed GB lying in an unusual horizontal position.

A

torsion of the GB

124
Q

GB in unusual HORIZONTAL postion =

A

torsion of the GB

125
Q

Another word for torsion is

A

volvulus

126
Q

If torsion of the GB is >180 degrees, _____ sets in.

A

gangrene

127
Q

With torsion of the GB, a twist of the _____ (vessel) and _____ (vessel) may be visible.

A

cystic artery

cystic duct

128
Q

T or F? GB torsion is rarely diagnosed preoperatively.

A

True

129
Q

This is characterized by recurring symptoms of biliary colic due to multiple previous episodes of acute cholecystitis.

A

chronic cholecystitis

130
Q

Do acute and chronic cholecystitis appear different sonographically?

A

No

131
Q

Findings with chronic cholecystitis may include (3)

A

1) thick fibrotic GB wall
2) sludge
3) obstruction of the cystic duct by a stone

132
Q

An unusual variant of chronic cholecystitis is

A

xanthogranulomatous cholecystitis

133
Q

Xanthogranulomatous cholecystitis causes spreading to _____.

A

adjacent organs

134
Q

The GB is thickened and irregular with extension of yellow inflammation to adjacent organs. This condition is extremely difficult to suspect preoperatively as it macroscopically resembles carcinoma of the GB. This is

A

Xanthogranulomatous cholecystitis

135
Q

CBD should be less than _____, unless over the age of _____, in which it will often increase an extra mm a year.

A

6mm

60

136
Q

Although the CBD should be less than 6mm below the age of 60, if the GB is removed it can be up to _____.

A

1 cm

137
Q

When is GB removal usually necessary?

A

when gallstones begin causing problems

138
Q

GB wall thickness should be less than _____ and the most common cause of GB wall thickening is _____.

A

3mm

cholecystitis

139
Q

Other causes, besides cholecystitis, of GB wall thickening are

A 
hypoalbuminemia
ascites
hepatitis
CHF
pancreatitis
140
Q

There are many causes of GB wall thickening, but with acute cholecystitis, a difference can sometimes be that

A

marked thickening of the wall with visible stratification, as seen in general edmatous states, is not present

141
Q

The origin of the RPV to the GB fossa is the

A

MLF

142
Q

Normal GB wall thickness can be up to _____ thick after eating.

A

5mm

143
Q

Postprandial means

A

after eating

144
Q

What is hyperplastic cholecystitis?

A

polyps

145
Q

Will benign ascites thicken the GB wall?

A

Yes

146
Q

Will malignant ascites thicken GB wall?

A

No

147
Q

The most common anatomic variants of the GB are

A

junctional folds

148
Q

The term for after you eat is

A

Postprandial

*Ultrasound* (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions