Liver and Biliary System Flashcards
What is the largest gland in the body
Liver
Falciform ligament divides liver into two major lobes:
-right lobe
-left lobe
two minor lobes evident on visceral surface:
-caudate lobe
-quadrate lobe
is collected by ducts and carried to gallbladder for storage or passes into duodenum
Bile
two blood supplies:
-hepatic artery
-portal vein
supplies oxygenated blood from abdominal aorta
hepatic artery
carries blood from digestive system to be filtered by liver
portal vein
primary function from imaging standpoint of the liver is :
production of bile
the biliary system main function:
- to drain waste products from the liver into the duodenum
- to help in digestion with the controlled release of bile
Biliary system consists of :
bile ducts and the gallbladder
two main hepatic ducts in the liver:
-right
-left
right and left hepatic ducts join to form:
common hepatic duct
common hepatic duct unites with:
cystic duct to form common bile duct
Thin-walled musculomembranous sac usually found on visceral
surface of right lobe of liver
Gallbladder
route for the biliary stystem:
1.right/left hepatic ducts
2. common hepatic duct
3. cystic duct: hangs from GB
4. common bile duct
5. pancreatic duct
6. hepatopancreatic ampulla or ampulla of vater
Gallbladder functions:
Functions to store and concentrate bile
when does gallbladder evacuate bile
when activated by hormone, cholecystokinin
neck of gallbladder is consistent with:
cystic duct
produces/ regulates insulin
- cancer prone
Pancreas
as a secretion it aids in the emulsification of fats
Bile
the distal end of the common bile duct is the:
spincter of Oddi, which opens into the duodenum
Biliary Tract Procedures
-Percutaneous transhepatic cholangiography
-Postoperative (T-tube) cholangiography
-Endoscopic retrograde cholangiopancreatography
(ERCP)
percutaneous
through the skin
unites with the pancreatic duct, which then enters the heatopancreatic ampulla or ampulla of vater
common bile duct
jaundice
liver not functioning properly
-yellow
-Abbreviated PTC
-Performed on patients with jaundice when the ductal system has
been demonstrated as dilated by computed tomography (CT) or
sonography, but the cause is unclear
-May also be used to place a drainage catheter to treat obstructive
jaundice
Percutaneous Transhepatic
Cholangiography
-Patient is supine
-Right side surgically prepared and draped
-Local anesthetic administered
-Special “skinny” needle (Chiba) inserted
-Water-soluble iodinated contrast injected
under fluoroscopy
-After ductal system is filled, spot AP projections
are made
Percutaneous Transhepatic
Cholangiography
Also called delayed cholangiography
* Performed via a T-shaped tube left in
the common hepatic and common bile
ducts for postoperative drainage
* Also called delayed cholangiography
* Performed via a T-shaped tube left in
the common hepatic and common bile
ducts for postoperative drainage
Postoperative (T-Tube)
Cholangiography
Patient positioned in RPO
position with right upper
quadrant centered to IR
* Contrast media injected
into T-tube under
fluoroscopy
* Spot and conventional
images made as indicated
Postoperative (T-Tube)
Cholangiography
- Used to diagnose biliary and pancreatic pathologic conditions
- Useful method when ducts are not dilated and ampulla is not obstructed
- Performed by passing a fiber-optic endoscope through the mouth into
the duodenum under fluoroscopy - Patient’s throat is sprayed with a local anesthetic to make passage of
endoscope easier - The hepatopancreatic ampulla is cannulated
- Contrast is injected into the common bile duct
- Spot and conventional images are taken as indicated
ERCP- Endoscopic Retrograde Cholangiopancreatography
RAO or lateral position
What level is the gallbladder at
level of the elbow depending on body habitus
deoxygenerated blood
portal vein
oxygenerated blood
hepatic artery
hormone that activates gallbladder to release bile
cholecystokinin
What produces the bile in the gall bladder system?
the liver
when the right and left hepatic duct come out the liver what do they make
they make the common hepatic duct
When the liver makes the bile and we are not using it but we are going to store it where?
in the gallbladder
What are the components of the gallbladder
-neck
-body
-fundus
The bile stays in the gallbladder til we need it what hormone excites it and tells it to release it
cholecystokinlin
Cystic ducts comes from the gallbladder and meets with the common hepatic duct to form what
the common bile duct
the common bile duct meets up with what
the pancreatic duct
when the common bile meets up with the pancreatic duct it empties where
in the duodenum spincter of Oddi
Most common study for the gallbladder:
-ERCP
-PTC
- T tube cholangiography
What does ERCP stand for?
Endoscopic Retrograde Cholangiopancreatography
What does the pancreas produce
insulin
What does PTC study stand for?
Percutaneous Transhepatic Cholangiography
Is done after the gallbladder is removed
- a t tube
-for bile
T- tube cholangiography
used to diagnose biliary and pancreatic pathologic conditions
- useful method when ducts are not dilated and ampulla is not obstrutced
-contrast is injected into the common bile duct
Endoscopic retrograde cholangiopancreatography (ERCP)
- largest and most active gland in the body
- two main lobes and several lobules
- lobules produce bile that is carried away and store in the gallbladder
- stores glycogen
- detoxifies waste
- plays a major role in metabolism
Liver
- thin walled sac with capacity of approximately 2 oz
- concentrates and stores bile and evacuates bile during digestion
- concentration of gallbladder is controlled by the hormone cholecystokinin
Gallbladder
contraction of gallbladder is controlled by what hormone
cholecystokinin
