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DSM Abd > GB > Flashcards

GB Flashcards

1
Q

What shape is a normal gallbladder?

A

pear-shaped hollow organ

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2
Q

What are the parts of the GB?

A

neck, body, fundus

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3
Q

What is the size of the GB?

A

7-10 cm in length 2.5-4 cm in width

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4
Q

An increase in size of a GB is called what?

A

hydrops

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5
Q

What keeps the cystic duct of the neck of the GB from kinking?

A

Heister’s valves

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6
Q

What is the vascular supply of the GB?

A

cystic artery and cystic vein

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7
Q

Where does the GB lie?

A

intrahepatic, migrating to the surface of the liver

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8
Q

What is the GB covered by?

A

a peritonal layer on most of it and an adventicia layer on the covering the rest

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9
Q

What does the GB store

A

approx. 50 mL of bile

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10
Q

How does bile get into the GB?

A

Bile is forced into the GB due to an increased pressure within the CBD produced by the action of the Sphincter of Oddi

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11
Q

How does bile get out of the GB?

A

As the stomach empties the food into the duodenum, the intestines secrete enzymes and bile salts that stimulate the GB to contract and push bile into the duodenum

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12
Q

How does the GB concentrate bile?

A

folds within the mucous membrane of the wall (with honeycomb appearance) unite with each other

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13
Q

What ducts are in the biliary system?

A

right and left hepatic duct, common hepatic duct, common bile duct, cystic duct and GB

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14
Q

The right and left hepatic ducts come from the right lobe of the liver in the porta hepatis and unite to form what?

A

Common Hepatic Duct

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15
Q

The common hepatic duct joins the ____ duct to form the ____ ____ ____ .

A

cystic; common bile duct

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16
Q

The common bile duct ends by piercing into the wall of the duodenum to join the ____ _____ ____. Together they open into the duodenum through the ____ ____ ____.

A

Main Pancreatic Duct; Ampulla of Vater

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17
Q

The CBD lies laterally to the ____ ____ and anterior to the ____ ____ .

A

Hepatic artery; portal vein

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18
Q

WHat is the normal measurement of the CBD?

A

1 mm per decade; 6mm = 60 yrs

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19
Q

The cystic duct connects the neck of the GB to the ___ ____ ____.

A

Common hepatic duct

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20
Q

What is the med term for removal of the gallbladder?

A

cholecystectomy

21
Q

Where does bile goes when a patient has a cholecystectomy?

A

Bile is stored in the CBD, which makes it larger in diameter; it freely moves into the duodenum at fasting or non-fasting states

22
Q

hydropic gallbladder

A

enlargement of the gb

23
Q

Courvoisier gallbladder

A

An enlarged often palpable on physical exam

caused by a pancreatic head mass

24
Q

Cholelithiasis

A

Echogenic, mobile, shadowing structure(s)
within the lumen of the gallbladder
Stones that lodge within the cystic duct or neck
of the gallbladder may not move
 WES sign may be present (gallbladder
completely filled with stones)

25
Q

Asymptomatic  Biliary colic  Abdominal pain after fatty meals  Epigastric pain  Nausea and vomiting  Pain that radiates to shoulders

A

Cholelithiasis

26
Q

Echogenic, nonshadowing, and nonmobile
masses that projects from the gallbladder wall into the gallbladder lumen
 Also called adenoma

A

polyps

27
Q

polyps

A

Asympomatic  Caused by a disturbance in cholesterol
metabolism and accumulation of cholesterol within the wall of the gallbladder
 May be single or multiple  Most measure less than 5mm  Benign  If these adenomas grow rapidly or >2cm,
worrisome for gallbladder carcinoma

28
Q

Adenomyomatosis

A

Benign hyperplasia of the
gallbladder
 Epithelium and muscular layers
of the wall have tiny sinuses called Rokitansky-Aschoff
sinuses. These contain cholesterol crystals that produce comet tail artifacts
 May be focal or diffuse

29
Q

Acute cholecystitis

A

Sudden onset of gallbladder inflammation
 Focal tenderness, caused by inflammation is
termed a positive sonograghic Murphy’s sign
 Murphy’s sign is local tenderness over the
gallbladder with transducer pressure

30
Q

Chronic cholecystitis

A

Most common form of gallbladder

inflammation

31
Q

Gallbladder carcinoma

A 
Rare, although most common cancer of the
biliary tract
 Caused by chronic irritation of the gallbladder
wall by gallstones
 Size > 2cm , suspicous for carcinoma vs poloyp  Color doppler can reveal vessels within the
malignancy
 Most common metastatic disease of the
gallbladder is malignant melanoma
32
Q

RUQ tenderness  Epigastric or abdominal pain  Leukocytosis  Possible elevation in alkaline phosphatase,
aminotransferase, and/or bilirubin
 Fever  Pain that radiates to the shoulders  Nausea and vomitting

A

Acute cholecystitis

33
Q

Gallstones  Positive sonographic Murphy’s sign  Gallbladder wall thickening  Pericholecystic fluid  Sludge

A

Acute cholecystitis

34
Q

Acalculous cholecystitis

A

Presents with all the clinical and sonographic
findings of cholecystitis except no gallstones
are present
 More commonly seen in children, recently
hospitalized patitents , and those who are
immunocompromised
 Uncommon  Caused by decreased blood flow through the
cystic artery
 Can also be caused by extrinsic compression of
the cystic duct by a mass or lymphadenopathy

35
Q

Rare  Seen mostly in elderly females

A

torsion of the gallbladder

36
Q

Porcelain gallbladder

A

Results from the calcification of the gallbladder
wall
 Occurs mainly in older female patients  May appear sonographically similar to WES
sign
 Has been associated with the potential
development of gallbladder carcinoma (25%

37
Q

Weight loss  Right upper quadrant pain  Jaundice  Nausea and vomiting  Hepatomegaly

A

Gallbladder carcinoma

38
Q

Nonmobile mass within the gallbladder lumen
that measures >2cm
 Gallstones seen in approx 90%  Diffuse or focal gallbladder wall thickening  Irregular mass that may completely fill the
gallbladder fossa
 Invasion of the mass into surrounding liver
tissue

A

Gallbladder carcinoma

39
Q

the opening that allows bile and pancreatic juices to flow into the duodenum

A

The spincter of Oddi

40
Q

Choledocholithiasis Primary –

A

formation of stones in the bile duct
resulting from a disease that leads to stasis or
dilation of the ducts

41
Q

Caroli’s disease

A

form of Primary Choledocholithiasis

42
Q

Choledocholithiasis Secondary

A

Stones found in the bile duct that has migrated down

from the gallbladder

43
Q

Cholangitis

A

Inflammation of the

biliary ducts >5mm

44
Q

Caroli’s disease

A

Congenital disorder  Found in younger adult or pediatric population
 Characterized by segmental diliation of the
intrahepatic ducts
 May appear segmental, saccular, or berry shaped
 Often seen in association with cystic renal disease
and may precede the development of cholangiocarcinoma, a hepatic abscess, cholangitis and sepsis

45
Q

Dilated intrahepatic ducts that abruptly terminate at the level of the tumor
A solid mass may be noted within the liver or ducts

A

Cholangiocarcinoma

46
Q

Biliary atresia and Choledochal Cyst

A

Congenital disease thought to be caused by a viral
infection at birth, although some think it may be an inherited disorder
A narrowing or obliteration of all or a portion of the
biliary tree
This leads infants to suffer from cirrhosis and portal
hypertension

47
Q

Choledochal cyst

A

4 types
Most common being described as the cystic dilatation of the Common bile duct
Discovered in infancy or the first decade of life
Jaundice Pain Fever

48
Q

Dilated intrahepatic ducts that abruptly
terminate at the level of the tumor
 A solid mass may be noted within the liver or
ducts
 Klatskin tumor- found at the junction of the left
and right hepatic ducts

A

Cholangiocarcinoma

49
Q

Cholangiocarcinoma

A

Jaundice  Pruitis  Unexplained weight loss  Abdominal pain  Elevated bilirubin  Elevated alkaline phosphatase

DSM Abd (9 decks)

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