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Abdomen > GB Review > Flashcards

GB Review Flashcards

1
Q

The gallbladder serves as a storage sac for what?

A

Bile

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2
Q

What is the normal size of the gallbladder?

A

7-10cm in SAG
3cm TRV

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3
Q

Where is the gallbladder located? (3)

A

Posterior to the RLL
Anterior to the rt kidney
Lateral to the pancreas head & duodenum

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4
Q

What are the layers of the GB wall? (3)

A

Inner most: epithelial mucosa
Middle: musclaris smooth muscle
Outer: serosa

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5
Q

What is the normal thickness of the gallbladder wall?

A

<3mm

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6
Q

Where are the spiral valves of Heister found and what do they do?

A

They are found within cystic duct
They control inward/ outward flow of bile
Keep duct from kinking

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7
Q

What are the four parts of the common bile duct?

A

Supra duodenum
Retro duodenum
Infra duodenum
Intra duodenum

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8
Q

What duodenum lies in the right free edge?

A

Supra

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9
Q

Which duodenum lies in a groove on posterior surface?

A

Infra

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10
Q

Which duodenum is anterior parallel to the IVC?

A

Intra

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11
Q

This is a fluid that is made and released by the liver and stored in the GB?

A

Bile

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12
Q

What is the normal size of the CBD?

A

1-4mm
4-6 mm (grey scale)

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13
Q

What are the various variants of the gallbladder? (5)

A

Phrygian cap
Junctional fold
Duplication
Agenesis
Septations

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14
Q

What is the pathway of Bile from GB to the duodenum?

A

Liver cells produce bile
Flows into rt & lt hepatic ducts
Converge to form common hepatic duct
Cystic duct joins common hepatic duct to form CBD
CBD exits liver through porta hepatitis
CBD courses posterior to 1st portion of duodenum
CBD passes through posterior portion of pancreatic head
CBD meets main pancreatic duct
Enter duodenum at Ampulla of Vater

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15
Q

Which variant folds between fundus and body of GB?

A

Phrygian cap

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16
Q

Which variant fold between the body and infundibulum of GB; most frequent variation?

A

Junctional

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17
Q

Which variants are rare (3)?

A

Duplication
Agenesis
Septations

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18
Q

What is biliary sludge?

A

Thickened concentrated bile

19
Q

Who is most at risk to develop cholelithiasis?

A

Females over 40

20
Q

What are the five Fs of gallbladder disease?

A

Female
Fat
Fertile
Forty
Fair

21
Q

What is the sonographic appearance of gallstones? (4)

A

Murphys signs
Sludge
Diffuse wall thickening >3mm
Pericholecystic fluid

22
Q

Describe the WES sign.

A

Known as double arch shadow sign

23
Q

Describe the differences between acute and chronic cholecystitis.

A

Acute: severe inflammation of GB, Life threatening, caused by stone blocking cystic duct
Chronic: long term inflammation of GB, caused by repeated attacks of acute cholecystitis

24
Q

What is a porcelain gallbladder and what does it look like on ultrasound?

A

Rare, calcium incrustation of the GB wall
May be difficult to assess due to wall shadowing

25
Q

Describe a strawberry gallbladder.

A

An accumulation of triglycerides and sterols in the GB wall

26
Q

What is the prognosis for GB carcinoma and who is most at risk to develop it?

A

Seen in elderly women >60
Poor prognosis- mortality rate close to 100%

27
Q

What are the signs and symptoms of gallstones?

A

Nausea
Vomiting
Intolerance to fatty foods
RUQ pain after meals

28
Q

What are the signs and symptoms of cholecystitis?

A

RUQ pain
Fever, chills
Nausea vomiting
Leukocytosis
Increased serum bilirubin

29
Q

What does the antler branching pattern refer to?

A

Biliary obstruction

30
Q

When a stone is impacted or lodged in the neck of the gallbladder or the cystic duct, this is called what?

A

Mirizzi Syndrome

31
Q

How could pancreatic head carcinoma affect the biliary system?

A

May obstruct the distal CBD

32
Q

What are the various types and subtypes of cholangiocarcinoma?

A

Types:
Intrahepatic (peripheral)
Distal (most common)
Hilar (klatskins tumor)
Subtypes:
Sclerosing
Nodular
Papillary

33
Q

Describe the five types of choledochal cysts.

A

Type 1: localized
Type 2: diverticulum
Type 3: invagination
Type 4: dilation
Type 5: carolis disease

34
Q

Describe the ultrasound appearance of hemobilia and pneumobilia.

A

Hemobilia: Heterogenous, hyperechoic clots within GB
Pneumobilia: bright echogenic, ring down reverberation, tiny air bubbles with change of position

35
Q

How does age affect biliary dilation?

A

1mm may be added to normal measurement for each decade past 60 year olds.

36
Q

Which choledochal type is the cystic dilation of the CBD?

A

Type 1

37
Q

Which choledochal type is from the CBD?

A

Type 2

38
Q

Which choledochal type is of the CBD that goes into the duodenum?

A

Type 3

39
Q

Which choledochal type is of the entire CBD and the common hepatic duct?

A

Type 4

40
Q

Which choledochal type have multiple cysts?

A

Type 5

41
Q

What should the position be for the neck?

A

Neck is in fixed position at main lobar fissure

42
Q

What should the position be for the body and fundus?

A

Variable in position

43
Q

How long is the cystic duct?

A

2-6cm long

44
Q

When prepping a patient for GB scan what do they need to do?

A

NPO 8-12 hours prior to exam

Abdomen (5 decks)

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