week 5: Gallbladder & Biliary

Question 1

part of bile duct system that drains liver into bile duct

Answer 1

common hepatic duct

Question 2

diameter of CBD

Answer 2

6mm

Question 3

what does the biliary system consist of

Answer 3

right & left hepatic ducts, CBD, gallbladder, cystic duct

Question 4

3 functions of the biliary system

Answer 4

1. transport bile –> gallbladder
2. store bile until needed for digestion
3. transport bile from GB–> duodenum

Question 5

proximal portion of CBD is __ to hepatic artery and ___ to portal vein

Answer 5

1. lateral

2. anterior

Question 6

the right and left hepatic ducts unite to form ___

Answer 6

common hepatic duct

Question 7

hepatic artery arise from celiac axis and travels ___ to the portal vein and ___ to the common bile duct

Answer 7

1. anterior

2. medial

Question 8

what is the “mickey mouse” sign

Answer 8

portal vein head, hepatic artery as left ear, bile duct as right ear

Question 9

what is a normal variant that alters the anatomy of the porta hepatis.

Answer 9

replaced right hepatic artery that arises from SMA

Question 10

cystic duct connects ___ and ____ to form CBD

Answer 10

1. neck of gallbladder

2. common hepatic duct

Question 11

pear-shaped organ that is found on the inferior margin of the liver between the right and left lobes of the liver

Answer 11

gallbladder

Question 12

landmarks for the gallbladder

Answer 12

1. MHV (bw R & L lobe)
2. inter lobar fissure (separate R &L lobe)
3. portal vein (near neck of GB)
4. right kidney
5. RUQ

Question 13

what happens to gallbladder during embryonic development

Answer 13

migrates to the surface of liver and acquires a peritoneal covering

Question 14

gallbladder is a ____ organ that lies in the ___ position

Answer 14

1. intraperitoneal

2. intrahepatic

Question 15

part of GB that usually projects below the inferior margin of the liver, where it comes into contact with the anterior abdominal wall at the level of the ninth right costal cartilage.

Answer 15

fundus

Question 16

part of GB that lies in contact with the visceral surface of the liver and is directed upward, backward, and to the left.

Answer 16

body

Question 17

part of the GB that becomes continuous with the cystic duct, and joins the right side of the common hepatic duct to form the common bile duct.

Answer 17

neck

Question 18

gallbladder fossa is located where / in what segment(s)?

Answer 18

• posterioinferior surface of right lobe

- seg. V and 4b

Question 19

T/F: gallbladder is related to the main lobar fissure

Answer 19

TRUE

Question 20

T/F: gallbladder is mobile and will change positions when the patient moves

Answer 20

TRUE

-why we have to image in 2 patient positions

Question 21

the __is situated lateral, caudal, and ante- rior to the neck.

Answer 21

fundus

Question 22

The neck of the gallbladder is oriented ____ toward the porta hepatis.

Answer 22

posteromedially

Question 23

average measurement of gallbladder

Answer 23

• 2.5 to 4 cm in diameter
• 7 to 10 cm in length
• The walls are less than 3 mm thick.

Question 24

Biliary ducts are subdivides into ___ and ___

Answer 24

1. intrahepatic

2. extrahepatic

Question 25

completely or partially enclosed by liver tissue, R & L hepatic ducts

Answer 25

intrahepatic

Question 26

what are the extrahepatic ducts

Answer 26

1. CHD (common hepatic duct) 2. CD (cystic duct) 3. CBD (common bile duct)

Question 27

intrahepatic ducts course with

Answer 27

R&L portal veins, and hepatic arteriole branches

Question 28

T/F: intrahepatics are in fixed relation to RL portal veins

Answer 28

FALSE | -can be anterior, posterior, torturous

Question 29

CHD is formed by ___ and ___ joining at level of ___

Answer 29

1 &2. R and L intrahepatic ducts | 3. porta hepatis

Question 30

CHD courses ___ to the GB neck

Answer 30

inferiorly

Question 31

___ joins with cystic duct (CD) to form CBD

Answer 31

Common hepatic duct (CHD)

Question 32

Arterial supply of the gallbladder is from

Answer 32

cystic artery | -part of right hepatic artery

Question 33

The ___ vein drains directly into the portal vein.

Answer 33

cystic

Question 34

primary functions of the extrahepatic biliary tract

Answer 34

1. the transportation of bile from the liver to the intestine 2. regulation of bile flow.

Question 35

Concentration of bile in the gallbladder occurs during ___

Answer 35

fasting

Question 36

what causes the concentration of bile in the gallbladder

Answer 36

pressure within CBD via sphincter of oddi

Question 37

what causes outpour of bile into duodenum

Answer 37

gallbladder contraction due to influence of food

Question 38

what happens when gallbladder is removed

Answer 38

- sphincter of Oddi loses tonus - pressure within the common bile duct drops - free flow of bile into duodenum during fasting & digestive phase

Question 39

what stimulates the live to make more bile

Answer 39

bile salts

Question 40

bile is principle medium for ___

Answer 40

excretion

Question 41

probe for GB exam

Answer 41

curvilinear or section probe 2.5-5 MHz

Question 42

why does patient need to fast 6 hrs before GB exam

Answer 42

to ensure max dilation of GB

Question 43

GB is ___ to right kidney

Answer 43

anterior

Question 44

GB is ___ to pancreas head and duodenum

Answer 44

lateral