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Normal Anatomy > Lesson 10 (Part 2) > Flashcards

Lesson 10 (Part 2) Flashcards

1
Q

What is the number one imaging modality for the biliary system?

A

Ultrasound

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2
Q

Why is U/S the number 1 modality for scanning the gallbladder? (3)

A
  1. We see fluid well
  2. Can identify stones easily
  3. Is in real time so we can see the stones move
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3
Q

What are clinical indications for scanning the gallbladder? (2)

A
  1. Pain

2. Jaundice

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4
Q

Jaundice

A

A medical condition of yellowing of the skin

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5
Q

What are 3 patient history questions regarding the gallbladder?

A
  1. Have you had any surgery?
  2. Does it hurt to push directly on the gallbladder?
    - positive Murphy’s sign
  3. Do they experience pain after eating?
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6
Q

What are the measurements of the gallbladder in transverse?

A

<4cm

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7
Q

What is the measurement of the wall thickness in gallbladder?

A

<3mm

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8
Q

What is the echogenicity of the gallbladder (lumen)?

A

Anechoic

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9
Q

What is the echogenicity of the walls of the gallbladder?

A

Hyperechoic or echogenic

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10
Q

What is the contour of the gallbladder?

A

Smooth

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11
Q

What does the gallbladder look like in sagittal position?

A

Anechoic and pear shaped with echogenic walls

- should see fundus, body and neck

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12
Q

What does the gallbladder look like in transverse position?

A

Round/oval anechoic structure with echogenic walls

- looks similar to the aorta or IVC (so be careful)

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13
Q

What happens when someone does not fast for a gallbladder scan? (3)

A
  1. The gallbladder contacts
  2. Lumen is anechoic with random echoes
  3. Thicker walls
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14
Q

When is it common for women to get gall stones?

A

During pregnancy

- or right after

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15
Q

How long do patients fast for a biliary system scan?

A

6-8 hours

- min 4

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16
Q

What are 2 typical positions patients can lay in for a biliary system scan?

A
  1. Supine

2. Left lateral decubitus

17
Q

What are 2 windows used to scan the biliary system?

A
  1. Anterior
    - subcostal approach
  2. Intercostal
18
Q

Why is it important to scan the gallbladder in 2 patient positions?

A

Because if you think you are seeing stones and you turn the patient on their side they should move because we scan in live time
- otherwise it could be an artifact in your image

19
Q

What wall do we measure and why? (2)

A
  1. Anterior wall

2. Because it is closer to the transducer

20
Q

What does gravity dependant mean?

A

That we can tell if the stones are mobile or not

21
Q

Where is the fundus situated in the supine position?

A

More anterior

- higher up

22
Q

Where is the fundus situated in the decubitis position?

A

More posterior

- lower down

23
Q

What are 2 important questions to ask a patient before you scan the gallbladder?

A
  1. Have they fasted
  2. Have they had any surgeries
    - need to make sure they have a gallbladder
24
Q

What are 4 landmarks for the gallbladder?

A
  1. Right upper quadrant
  2. Right kidney
  3. Main lobar fissure
  4. Trans liver portal vein
    - starting point
25
Q

What are the challenges with scanning the gallbladder? (2)

A
  1. Its close to the bowel
    - could cause shadowing
  2. Reverberation artifact
26
Q

How to overcome challenges when scanning the gallbladder? (3)

A
  1. Change the patients position
    - gravity helps clear it up
  2. Exam the origin to distinguish between normal and the pathology
  3. Have them breath in
27
Q

What button on the ultrasound machine can help with clearing up the gallbladder?

A

Harmonics

- THI

28
Q

What is it called when the common hepatic duct meets the cystic duct?

A

The common bile duct

29
Q

If you follow the common bile duct where does it lead you to?

A

The pancreatic head

30
Q

What is the normal caliber of the CHD/CBC?

A

<7mm

31
Q

What does >7mm caliber for the gallbladder indicate?

A

That there is a problem

32
Q

What is the size of the CBD affected by? (2)

A
  1. Age

2. After surgery

33
Q

What happens to the CBD as you get older?

A

It gets more dilated

34
Q

What happens to the CBD after surgery?

A

It gets bigger

35
Q

Why does the CBD get bigger after surgery?

A

It has to do more work and gets bigger due to the flow of bile

Normal Anatomy (47 decks)

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