HEPATOBILIARY SYSTEM Flashcards
This is the largest organ inside the body
liver
What are the functions of the liver
synthesize & detoxify substancs
What 2 arteries are connected to the liver
hepatic artery and portal vein
this is where the storage & concentration of bile takes place
gallbladder
system of ducts that acts to drain bile from the liver to the duodenum
Biliary Tree
What is the correct passage way of the bile in the biliary tree?
- right and left hepatic duct
- common hepatic duct
- gallbladder
- common bile duct
what duct is between the hepatic duct and the gallbladder
cystic duct
where does the bile exit
common bile duct
what is another term for the hepatopancreatic duct
sphincter of ODDI
what is the combined duct of the hepatic & pancreatic
Ampulla of Vater or hepatopancreatic ampulla
Which hormone triggers the release of the bile to the duodenum
cholecystokenin
this is an elongated flat digestive organ
pancreas
2 functions of pancreas
endocrine and exocrine
this is concerned in the production of 3 digestive enzymes
exocrine
what are the 3 digestive enzymes produced in the exocrine
amylase, trypsin and lipase
this enzyme assist in the digestion of protein
trypsin
what is the function of amylase
assist the digestion of large molecules of starch into maltose then into glucose
what is the function of lipase
assist in breaking down lipids into fatty acids & glycerol
this are specialized cells in the endocrine function of the pancrease
islet of langerhans
what does the endocrine function do?
IL releases alpha cells (produces glucagon; increase sugar) & beta cells (insulin; decrease sugar)
Visualize the biliary tree & involves insertion of a needle into the biliary tree by puncture directly through the wall of the abdomen
PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAPHY
what kind of needle is used in percutaneous transhepatic cholangiography?
Uses a flexible, 22-gauge, skinny needle (CHIBA)
When is the percutaneous transhepatic cholangiography used?
detecting presence of calculi/tumor in the distal CBD
this is Performed by gastroenterologist
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY
the ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY is used to?
- Visualize the biliary system & main pancreatic duct
- Provides drainage for the pancreatic enzymes into both the digestive tract & the common bile duct
What kind of instrument is used in the ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY
thin catheter
- Performed during surgery at the time of a cholecystectomy to detect biliary calculi
OPERATIVE CHOLANGIOGRAPHY
How much CM is injected during an operative cholangiography?
6 ml
- Used after cholecystectomy to demo patency of the CBD and to check for calculi
T-TUBE CHOLANGIOGRAPHY
What kind of tube is used in T-TUBE CHOLANGIOGRAPHY
t-shaped tube
- Good choice for imaging the gallbladder & biliary tree
diagnostic ultrasound
What mode is used during the ultrasound of gallbladder & biliary tree?
m-mode
- Accepted modality for following malignancies * assessing masses
CT SCAN
- Helpful in evaluating complications of cholecystitis such as perforations & abscess formations
CT SCAN
- Does not require a contrast agent
MRI CHOLANGIOPANCREATOGRAPHY
a known toxin causing cellular damage
alcohol
as alcohol cant be stored in the body, what processes does the liver need to do?
the liver must convert it through oxidation, to alcohol dehydrogenase, acetaldehyde, and acetate, all of w/c to reduce cellular function
this is the most frequent early response to alcohol abuse
fatty liver
- Fatty infiltration may be demoed by
ct/sonography
In CT scan, a liver is considered to be fatty if…
its HU is equal to the HU of the spleen (Under normal circumstances, the liver should appear light-gray and the spleen dark gray)
who is prone to fatty liver disease?
- Obsess individuals w/ type 2 diabetes mellitus, metabolic syndrome, HYPERLIPIDEMIA
- Chronic liver condition in w/c liver parenchyma & architecture are destroyed, fibrous tissue is laid down, & regenerative nodules are formed
liver cirrhosis
what is ascites
- Accumulation of fluid w/in the peritoneal cavity
- Seen as a result of portal hypertensions & the leakage of excessive fluids from the portal capillaries
ascites
- Acute inflammation of the gallbladder
cholecystitis
symptoms of cholecystitis
a sudden onset of pain, faver, nausea, vomiting
cholecystitis is common in?
individuals w/ chronically symptomatic cholelithiasis
what modality demoes cholecystitis the best?
- CHOLESCINTOGRAPHY
- Inflammation of the pancreatic tissue
pancreatitis
- One of the most complex & clinically challenging disorders of the abdomen & is classified as acute/chronic, accdg. To clinical, morphologic & histologic criteria
pancreatitis
what are the causes of pancreatitis
- Causes include excessive & chronic alcohol consumption, obstruction of the hepatopancreatic ampulla by a gallstone or tumor & even the injection of contrast media during ERCP
- Yellowish discoloration of the skin & whites of the eyes, is not a disease itself but rather a sign of disease
jaundice
what’s the difference between medical and surgical jaundice?
MJ - non-obstructive; occurs because of hemolytic disease, in w/c too many RBC are destroyed/ because of liver damage from cirrhosis or hepatitis
SJ - obstructive; occurs when biliary system is obstructed & prevents the bile from entering the duodenum. A common cause of this obstruction is blockage of the CBD caused by stones/masses
another term for cholelithiasis
gallstones
- Hardened deposits of digestive fluid
cholelithiasis
symptoms of cholelithiasis
bloating, nausea, & pain in the right upper quadrant
most people get it by eating/drinking something that’s tainted by fecal matter.
hepatitis a
the incubation period of hepatitis a
15-50 days
transmitted parenteral through injections or unprotected sex
hepa b
incubation period of hepa b -
50-150 days
what is hepatitis c?
– comes from infected blood that gets into your blood. Can be caused by shared needles of in connection w/ HIV. Symptoms may not show for many years.
who are at most risk for hepa c
baby boomers
what is hepatocellular adenoma?
benign tumor of liver
what modalities are used to demo hepatocellular adenoma
ct/sonography
- Benign neoplasm composed of newly formed blood vessels & these may form in other places w/in the body
hemangioma
- Most common type of primary liver cancer
- Occurs most often in people w/ chronic liver diseases like cirrhosis
hepatocellular carcinoma
- more common than primary carcinoma because of the liver’s role in filtering blood
metastatic liver disease
it is the most common site for metastasis
liver
- “Porcelain gallbladder”
carcinoma of gallbladder
usually rapidly fatal & its diagnosis is difficult because of the location of the pancreas & lack of symptoms before the extensive local spread
carcinoma of pancreas/ pancreatic cancer
