Lesson 2A (Part 1) Flashcards
What is the biliary system made up of? (3)
- Intrahepatic bile ducts
- part of the triad - GB
- CBD
What do hepatocytes produce?
Bile
Where is bile transported through?
Through the right and left intrahepatic bile ducts to the porta hepatis where they converge to form the common hepatic duct
How does common hepatic duct transport bile into the GB?
Through the cystic duct
What controls the flow of bile?
Valves of Heister in the cystic duct
Where is the extrahepatic CBD compared to the cystic duct and CHD?
It is distal to it
What does the GB do? (4)
- Stores and concentrates bile
- Transports bile through the CBD to the duodenum
- When fat enters the digestive system, cholecystokinen is released into the bloodstream and stimulates the release of bile into the CBD and duodenum
- Bile enters the Ampulla of Vater along with enzymes from the pancreas through the duct of Wirsung to aid in the digestion of fats in our digestive system
What is the GB and cystic duct supplied by?
The cystic artery
What is the cystic artery a branch from?
Right hepatic artery
What is routinely looked at when scanning the biliary system? (2)
- Liver
2. Pancreas
Why is the liver and pancreas scanning when looking at the biliary system?
Because they are intertwined in their functions and affects each other
How do you get indirect bilirubin?
When the liver breaks down old red blood cells and then changes it to direct where the GB discrete it
What is the normal total bilirubin value?
- 3-1.1 dL
- indirect
What is the direct bilirubin value?
- 1-0.4 dL
- direct
What is bilirubin?
A product from the breakdown of hemoglobin in old red blood cells
What does leakage of bilirubin into the tissue give?
Jaundice
What does bilirubin reflect?
The balance between production and excretion of bile
What is elevation of direct or conjugated bilirubin associated with? (4)
- Obstruction
- Hepatitis
- Cirrhosis
- Liver metastases
What is elevation of indirect or unconjugated bilirubin associated with?
Nonobstructive conditions
- eg) steatosis
ALP
Alkaline phosphatase
- an enzyme
What is ALP produced by? (3)
- Liver
- Bone
- Placenta
Where is ALP excreted through?
Bile ducts
What is marked elevation of ALP associated with?
Jaundice
ALT
Alanine aminotransferase
Where is ALT found in high concentrations?
Liver
Where is ALT found in low concentrations? (3)
- Heart
- Muscle
- Kidneys
What enzyme remains elevated longer, AST or ALT?
ALT
What is ALT used to asses?
Jaundice
What is elevated levels of ALT associated with? (3)
- Cirrhosis
- Hepatitis
- Biliary obstruction
What is mild elevations levels of ALT associated with?
Liver metastases
