Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ARRT > The gallbladder and biliary system > Flashcards

The gallbladder and biliary system Flashcards

1
Q

the right and left hepatic ducts emerge from the right lobe of the liver in the _____ and unite to form the common hepatic duct; runs parallel with the portal vein

A

porta hepatis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

the common hepatic duct is approximately _____ in diameter and descends within the edge of the lesser omentum; it is joined by the cystic duct to form the common bile duct

A

4 mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

the normal common bile duct has a diameter of up to _____

A

6 mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

the CBD joins the main pancreatic duct, and together they open through a small ampulla (called the _____) into the duodenal wall

A

ampulla of vater

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

the end parts of both ducts and the ampulla are surrounded by circular muscle fibers known as the _____

A

sphincter of Oddi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

the cystic duct is about _____ long and connects the neck of the gallbladder with the CHD to form the CBD

A

4 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

the neck of the GB is _____ toward the porta hepatis

A

posteromedially

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

generally the normal GB measures about _____ in diameter and _____ in length; the walls are less than _____ thick

A

2.5 to 4 cm; 7 to 10 cm; 3mm; dilation of the GB is known as hydrops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

the GB may fold back on itself at the neck, forming _____

A

Hartmann’s pouch; other anomalies include partial septation; complete septation (double GB); and folding of the fundus (phrygian cap)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

______ in the neck of the GB helps to prevent kinking of the duct

A

heister’s valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

the arterial supply of the GB is from the _____, which is a branch of the right hepatic artery

A

cystic artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

_____ of the extrahepatic ducts (usually less than 1 cm) occur after cholecystectomy

A

dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

_____ is the principal medium for excretion of bilirubin and cholesterol

A

bile; bile salts from the intestines stimulate the liver to make more bile, they activate intestinal and pancreatic enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

______ sign indicates an extrahepatic mass compressing the common bile duct, which can produce an enlarge GB

A

Courvoisior’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

_____ and _____ may indicate stones in the CBD

A

nausea and vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

______ may develop when a tiny stone blocks the bile duct between the gallbladder and the intestines, producing pressure on the liver and forcing bile into the blood

A

jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

_____ or thickened bile frequently occurs from bile stasis

A

sludge; low-level echos layering in dependent parts of GB; prominent GB size; changes with position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

biliary cause of _____ include cholecystitis, adenomyomatosis, cancer, acquired immunodeficiency syndrome, cholangiopathy, and sclerosing cholangitis

A

wall thickening; non biliary include diffuse liver disease, pancreatitis, portal hypertension, and heart failure, ascites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

_____ is an inflammation of the GB that may have one of several forms; acute, chronic, acalculous, emphsysematous, or gangrenous

A

cholecystitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

the most common cause of _____ cholecystitis is gallstones; stones maybe impacted in hartmann’s pouch or cystic duct

A

acute; increased serum amylase, abnormal LFT’s; dilation of the rounding of GB; + murphy sign; thick GB wall with irregular wall; stones; pericholecystic fluid (same signs with acalculous)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

with _____ cholecysitis, there is gas-forming bacteria in GB with abnormal LFT’s; 50% of times in diabetics

A

emphysematous; bright echoes in area of GB with ring down or comet tail artifact may appear as WES

22
Q

with _____ cholecysitis, medium to coarse echogenic densities that fill the GB lumen in absence of duct obstruction; no shadow; not gravity dependent; and does not layer

A

gangrenous; causes the GB to undergo necrosis because of prolong infection; the walls may become inflamed with hemorrhage

23
Q

_____ is the most common disease of the GB; check bilirubin levels; dilated GB wall

A

Cholelithiasis; gravity dependent calcification in GB; the tiny stones are more dangerous because they can enter the bile ducts and obstruct the outflow of bile

24
Q

with cholelithiasis the patient normally falls under the five F’s, what are they?

A

fat, female, fertile, forty, and fair

25
Q

_____ of the GB is a rare condition that is found more in elderly females and is associated with a mobile GB with a long suspensory mesentery

A

torsion; causes acute cholecystitis

26
Q

a _____ GB is a rare occurrence that is defined as calcium incrustation of the GB wall; wall is thickly calcified with shadowing

A

porcelain; female predominance; found in patients over 60; small percent may develop carcinoma of the GB

27
Q

_____ cholecystosis is represented by a variety of degenerative and proliferative changes of the GB characterized by hyperconcentration, hyperexcitability, and hyperexcretion

A

hyperplastic; cholesterolosis and adenomyomatosis are 2 types of this condition; malignancy is suspected when the polyp is singular and measures greater than 10mm

28
Q

_____ is a condition in which cholesterol is deposited within the lamina propria of the GB; echogenic structure in extrahepatic duct; dilated biliary tree

A

cholesterolosis; increase in direct bilirubin; abnormal liver enzymes; leukocytosis; increased alkaline phosphatase; referred to as the strawberry GB

29
Q

______ of the GB are small, well-defined soft tissue projections from the GB wall

A

polyps; cholesterol polyps are the most common pseudotumor of the GB; they are small, smooth ovoid wall projections; no shadow; comet tail

30
Q

_____ are benign neoplasms of the GB with a premalignant potential; usually is a solitary lesion

A

adenoma; occurs as flat elevations located in the body of the GB, almost always near the fundus; does not change with position; no shadow produced

31
Q

with _____ papillomas may occur single or in groups and may be scattered over a large part of the mucosal surface of the GB; does not move position changes; comet-tail artifact

A

adenomyomatosis

32
Q

primary carcinoma of the GB is associated with _____ most cases; the mass is heterogenious, solid or semi-solid, there is dilated biliary ducts causing a shotgun sign (PV and dilated duct)

A

cholelithiasis; most frequently in women 60 years or older; adjacent liver is often invaded by direct continuity extending through tissue spaces, the ducts of Luschka, and the lymph channels,

33
Q

_____ cysts are an unusual diverse group of diseases that may manifest as congenital, focal, or diffuse cystic dilatation of the biliary tree; may result form pancreatic juice refluxing

A

choledochal; jaundice; localized dilated cystic CBD; diverticulum in CBD; invagination of CBD into duodenum; dilated CBD and CHD

34
Q

_____ is a rare congenital abnormality that is most likely inherited in an autosomal recessive fashion; 2 types simple classic form, and more common form that is associated with periportal hepatic fibrosis

A

Caroli’s disease; strongly associated with cystic disease of the kidney; multiple cystic structures in the area of the ductal system; sludge or calculi may reside in the dilated ducts

35
Q

sonography cannot image the biliary ducts routinely until their size dilates to greater than _____

A

4mm; ducts greater than 6mm is considered borderline and more than 10 mm is dilated

36
Q

_____ dilation occurs before intrahepatic, because ducts expand centrifugally from the point of obstruction

A

extrahepatic

37
Q

what are the 3 primary areas for obstruction to occur in extrahepatic ducts?

A

intrapancreatic, suprapancreatic, and porta hepatic

38
Q

what are the 3 important conditions that cause the majority of biliary obstruction at the level of the distal duct

A

pancreatic carcinoma, choledocholithiasis, and chronic pancreatitis with stricture formation

39
Q

_____ obstruction originates between the pancreas and porta hepatis

A

suprapancreatic

40
Q

a ______ tumor is a specific type of cholangiocarcinoma that can occur at the bifurcation of the CHD, with involvement of both the central left and right duct

A

klatkin’s tumor; isolated intrahepatic duct dilation indicates cholangiocarcinoma

41
Q

_____ syndrome is an uncommon cause for extrahepatic biliary obstruction resulting from an impacted stone in the cystic duct, which creates extrinsic mechanical compression of the CHD

A

Mirizzi

42
Q

choledocholithiasis is common duct stones; they are usually associated with _____

A

calculous cholecystitis; they tend to become impacted into the ampulla of Vater

43
Q

biliary trauma secondary to percutanous biliary procedures or liver biopsies account for the majority of _____ cases

A

hemobila; blood in the biliary tree

44
Q

_____ is air within the biliary tree

A

pneumobilia; bright echogenic linear structure that follow the portal triads; posterior dirty shadowing and reverberation artifact is seen

45
Q

_____ is an inflammation of the bile duct

A

cholangitis; elevated lab values of serum alkaline phosphatase and bilirubin; decompression of CBD is necessary; may be hypoechoic or echogenic with stones

46
Q

______ is a parasitic roundworm that uses a fecal-oral route of transmission; may be 20-30 cm long and 6 cm diameter; travels from the small bowel

A

ascariasis; gives a target appearance;

47
Q

_____ biliary tumors are rare and are primarily limited to cystadenoma and cystadenocarcinoma

A

intrahepatic; cystic mass with multiple septa and papillary excrescences

48
Q

_____ cholangiocarcinoma is found in the distal CBD

A

papillary

49
Q

_____ is the second most common primary malignancy of the liver

A

intrahepatic cholangiocarcinoma; large hepatic mass; hypovascular

50
Q

_____ cholangiocarcinoma usually begins in the right or left bile duct and then extends into the proximal duct and distally into the common hepatic duct and contralateral bile duct; can lead to atrophy of involved lobes

A

hilar; should also evaluate the hepatic artery for adenopathy and metastases; elevated cholestatic liver parameters

51
Q

_____ cholangiocarcinoma may extend into the adjacent lymph nodes; tumor mass may be sclerosing or polypoid

A

distal; sclerosing tumor is nodular with focal irregular ductal constriction and wall thickening; hypoechoic and hypovascular; poorly defined margins

52
Q

what is the most common sites that can spread to the biliary system?

A

breast, colon, or melanoma

ARRT (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions