Week 4 Flashcards
What is cholecystitis?
Inflammation of the gallbladder
What is cholelithiasis?
Gallstone (within gallbladder)
What does choledocholithiasis refer to?
Gallstone within the bile duct
What is cholangitis?
Infection of the bile duct
What does MRCP stand for?
Magnetic resonance cholangiopancretography
What does ERCP stand for?
Endoscopic retrograde cholangiopancreatography
Describe the anatomy of the biliary tree
Biliary canaliculi, interlobular bile ducts, septal bile ducts, intrahepatic ducts, right and left hepatic duct, common hepatic duct, common bile duct
Where does the common bile duct pass?
Behind the duodenum, and through the head of the pancreas
What does the common bile duct join with, and what does this form?
Joins with main pancreatic duct to form hepatopancreatic ampulla (of vater)
Where does the ampulla of vater empty?
2/3rds down the duodenum
What is the function of the gallbladder, and what is its capacity?
Reservoir for bile and concentrates bile (reabsorbing salts and water), 30-50ml
Where is the gallbladder?
Lies in the gallbladder fossa, on the inferior surface of the right lobe of the liver
What are the three regions of the gallbladder?
Neck, body and fundus
What connects the gallbladder to the common bile duct?
Cystic duct, which joins the common hepatic join to form the common bile duct
What is the epithelium of the gallbladder
Columnar epithelium
What are the components of bile?
Bile acids, water, electrolytes, cholesterol, phospholipids and conjugated bilirubin
What are bile acids synthesised from?
Cholesterol
Where does bile acid synthesis occur?
Hepatocyte
What are the main primary bile acids?
Cholic, and chenodeoxycholic acids
How are primary bile acids conjugated to secondary bile acids?
Addition of amino acids group (taurine or glycine), before active export from hepatocyte
How is bile secreted from the gallbladder?
Vagal stimulation promotes GB contraction, and cholecystokinin mediated GB contraction and relaxation of sphincter of Oddi
Where is cholecystokinin released from, and what is this in response to?
CCK is released from the duodenum in response to presence of fat
What stimulates liver ductal secretion of bile?
Secretin
How is gallbladder relaxation and sphincter of Oddi closure mediated?
By sympathetic nerves, and by gut hormones vasoactive intestinal polypeptide (VIP) and somatostatin
What is a function of bile acids?
Promote intestinal absorption of fats by emulsification and formation of micelles
Describe another function of bile acids
Enhance absorption of fat soluble vitamins