week 5: Gallbladder & Biliary Flashcards
part of bile duct system that drains liver into bile duct
common hepatic duct
diameter of CBD
6mm
what does the biliary system consist of
right & left hepatic ducts, CBD, gallbladder, cystic duct
3 functions of the biliary system
- transport bile –> gallbladder
- store bile until needed for digestion
- transport bile from GB–> duodenum
proximal portion of CBD is __ to hepatic artery and ___ to portal vein
- lateral
2. anterior
the right and left hepatic ducts unite to form ___
common hepatic duct
hepatic artery arise from celiac axis and travels ___ to the portal vein and ___ to the common bile duct
- anterior
2. medial
what is the “mickey mouse” sign
portal vein head, hepatic artery as left ear, bile duct as right ear
what is a normal variant that alters the anatomy of the porta hepatis.
replaced right hepatic artery that arises from SMA
cystic duct connects ___ and ____ to form CBD
- neck of gallbladder
2. common hepatic duct
pear-shaped organ that is found on the inferior margin of the liver between the right and left lobes of the liver
gallbladder
landmarks for the gallbladder
- MHV (bw R & L lobe)
- inter lobar fissure (separate R &L lobe)
- portal vein (near neck of GB)
- right kidney
- RUQ
what happens to gallbladder during embryonic development
migrates to the surface of liver and acquires a peritoneal covering
gallbladder is a ____ organ that lies in the ___ position
- intraperitoneal
2. intrahepatic
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.
fundus
part of GB that lies in contact with the visceral surface of the liver and is directed upward, backward, and to the left.
body
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.
neck
gallbladder fossa is located where / in what segment(s)?
- posterioinferior surface of right lobe
- seg. V and 4b
T/F: gallbladder is related to the main lobar fissure
TRUE
T/F: gallbladder is mobile and will change positions when the patient moves
TRUE
-why we have to image in 2 patient positions
the __is situated lateral, caudal, and ante- rior to the neck.
fundus
The neck of the gallbladder is oriented ____ toward the porta hepatis.
posteromedially
average measurement of gallbladder
- 2.5 to 4 cm in diameter
- 7 to 10 cm in length
- The walls are less than 3 mm thick.
Biliary ducts are subdivides into ___ and ___
- intrahepatic
2. extrahepatic
completely or partially enclosed by liver tissue, R & L hepatic ducts
intrahepatic
what are the extrahepatic ducts
- CHD (common hepatic duct)
- CD (cystic duct)
- CBD (common bile duct)
intrahepatic ducts course with
R&L portal veins, and hepatic arteriole branches
T/F: intrahepatics are in fixed relation to RL portal veins
FALSE
-can be anterior, posterior, torturous
CHD is formed by ___ and ___ joining at level of ___
1 &2. R and L intrahepatic ducts
3. porta hepatis
CHD courses ___ to the GB neck
inferiorly
___ joins with cystic duct (CD) to form CBD
Common hepatic duct (CHD)
Arterial supply of the gallbladder is from
cystic artery
-part of right hepatic artery
The ___ vein drains directly into the portal vein.
cystic
primary functions of the extrahepatic biliary tract
- the transportation of bile from the liver to the intestine
- regulation of bile flow.
Concentration of bile in the gallbladder occurs during ___
fasting
what causes the concentration of bile in the gallbladder
pressure within CBD via sphincter of oddi
what causes outpour of bile into duodenum
gallbladder contraction due to influence of food
what happens when gallbladder is removed
- sphincter of Oddi loses tonus
- pressure within the common bile duct drops
- free flow of bile into duodenum during fasting & digestive phase
what stimulates the live to make more bile
bile salts
bile is principle medium for ___
excretion
probe for GB exam
curvilinear or section probe 2.5-5 MHz
why does patient need to fast 6 hrs before GB exam
to ensure max dilation of GB
GB is ___ to right kidney
anterior
GB is ___ to pancreas head and duodenum
lateral
