Biliary tract and upper gastrointestinal system; CH 14

esophogram

(Barium swallow) a radiographic examination specifically of the pharynx and esophagus. It studies the form and function of the swallowing aspect of the pharynx and esophagus

biliary calculi

(Gallstones)

submandibular salivary glands

(Submaxillary) under the mandible or maxilla

upper gastrointestinal series

(UGI) (upper gi) a procedure designed to study the distal esophagus, stomach, and duodenum

esophagogastric junction

(cardiac orifice) The opening between the esophagus and stomach

Three parts of the pharynx

1- Naso 2- Oro 3- Laryngeal/hypo

What are the 3 primary functions of the digestive system

1- the intake and/or digestion of food' water, vitamins, and minerals 2- absorb digested food particles along with water, vitamins and essential elements from the alimentary canal, into the blood or lymphatic capillaries 3- eliminate any unused material in the form of semisolid waste products

The liver performs more than ______ different functions

100

How much is secreted by the delivery glands daily

1000-1500 mL

How much does the liver weigh?

3 or 4 pounds, or 1/36 of the total body weight in an average adult

Cystic duct

3-4 cm long and contains several membranous folds along its length called spiral valves

How much bile does the gallbladder usually hold?

30-40 mL

What percent of individuals have separated common bile ducts and pancreatic ducts?

40%

How many lobes does the liver have?

4; 2 major and 2 minor only the 2 major are seen

What percentage of individuals have joined common bile and pancreatic ducts?

60%

How many percent of patients who have a gallbladder carcinoma also has stones

80%

How much bile does the liver secrete per day?

800-100 mL, or about 1 quart, of bile per day

Saliva is ___% water and ___% solutes or salts and certain digestive enzymes

99.5% 0.5%

What is the gallbladder shaped as?

A pear

What abdominal ragion does the liver occupy?

Almost all of the right hypochondrium, a major part of the epigastrium, and a significant part of the left hypchondrium

When the common bile and pancreatic ducts are joined what is it called?

Ampulla,. hepatopancreatic ampulla, or ampulla of Vater

what enzyme does saliva contain and what does it do?

Amylase, begins the digestion of starches

What separates the body of the stomach from the pyloric portion of the stomach

Angular notch (incisura angularis)

what is the preferred contrast medium for the entire alimentary canal?

Barium sulfate mixed with water; shows up white on the radiograph

Sublingual salivary glands

Below the tongue

Chole

Bile

food is ingested in the form of:

Carbohydrates, lipids, and proteins

The large right lobe is seperated from the smaller left lobe by the what?

Falciform ligament

Spiral valves

Function to prevent distention or collapse of the cystic duct

Bile is concentrated within the gallbladder as a result of what?

Hydrolysis (removal of water)

what leads to the formation of gallstones?

Increased levels of bilirubin, calcium, or cholesterole

What contours over the surface of the caudate lobe?

Inferior vena cava (IVC)

How long is the common bile duct?

It averages about 7.5 cm in length and has the internal diameter about the size of a drinking straw

Quadrate lobe

Located on the inferior surface of the right lobe between the gallbladder and falciform ligament.

what part of the pharynx is not part of the digestive system

Nasopharynx

What are the advantages to using sonography?

No ionizing radiation, detection of small calculi, no contrast medium, less patient preparation

Greater curvature

On the lateral border of the stomach, 4 to 5 times longer than the lesser, forms a concave border

lesser curvature

On the medial border of the stomach, forms a concave border

What is the lowest border of the kidney?

On the right side (lateral) to the tenth rib just above the right kidney

Where are the 2 minor lobes located?

Posterior to the right lobe of the kidney

What position would place the gallbladder closest to the IR?

Prone

2 parts of the pyloric portion of the stomach

Pyloric antrum, and pyloric canal

The opening or orifice as it leaves the distal stomach is termed the:

Pyloric orifice or pylorus. It is a thickened muscular ring that relaxes periodically during digestion to allow stomach or gastric contents to move into the first part of the small intestine.

What quadrant does the liver occupy?

RUQ

What are the accessory organs of the digestive system

Salivary glands, pancreas, liver, and gallbladder.

During swallowing, the ______ ______ closes off the nasopharynx to prevent swallowed substances from regurgitating into the nose, and the _________ prevents this material from reentering the mouth

Soft palate; mouth

what has replaced oral cholecystography?

Sonography

Hepatopancreatic ampulla

Sphincter of Oddi, located near the teminal opening of the hepatopancreatic ampulla into the duodenum. They are circular muscle fibers. They relax when CCK increases in the bloodstream. It causes a protrusion into the lumen of the duodenum (Duodenal papilla (papilla of vater)

What position would best drain the gallbladder into the duct system

Supine

What is the main section of the gallbladder?

The body

The fundus of the gallbladder

The distal end and the broadest part of the gallbladder

Milk calcium bile

The emulsion of biliary stones in the gallbladder

parotid salivary glandS

The largest located beneath and just anterior to the external ear canal

The neck of the gallbladder

The narrow proximal end that continues as the cystic duct

What is also known as the duct of Wirsung

The pancreatic duct

What border of the liver is its greatest verticle dimension?

The right (lateral), 6-7 inches

What is the function of bile?

To aid in the digestion of fats by emulsifying or breaking down fat gobules and the absorption of fat following its digestion

What are the 3 primary functions of the gallbladder?

To store bile, concentrate bile, and contract when stimulated

True or False: Bile also contains cholesterol, which is made soluble in the bile by bile salts

True

True or False: CCK causes the gallbladder to contract, and causes increased exocrine activivty by the pancreas

True

True or False: The common bile duct descends behind the superior portion of the duodenum and the head of the pancreas to enter the second or descending portion of the duodenum

True

True or False: The normal gallbladder is from 7 to 10 cm long and about 3 cm wide.

True

True or false: specific salivary glands secrete a thickened fluid that contains mucus. This lubricates food that's being chewed so that the food can form into a ball, or bolus, for swallowing

True

What border of the liver is the widest?

Upper border; about 8-9 inches

What causes the gallbladder to contract?

When foods such as fats or fatty acids are in the duodenum. The foods stimulate the duodenal mucosa to secrete the hormone cholecystokinin (CCK). Increased levels of CCK in the blood cause the gallbladder to contract and the terminal opening of the common bile duct to relax.

How are gallstones formed?

When too much water is absorbed or if the cholesterol becomes to concentrated

cardiac spincter

a small circular muscle, allows food and fluid to pass through the cardiac orifice (esophagogastric junction)

bacterial infection and ischemia (obstruction of blood supply) may also produce _________ cholecystitis?

acute

Chronic cholecystitis

almost always associated with gallstones but may also be an outcome of pancreatitis or carcinoma of the gallbladder.

mumps

an inflammation and enlargement of the parotid glands caused by the mumps virus. ( for about 30% of males past puberty there is also an inflammation of the testes)

The distal end of the gallbladder extends slightly below the _______, _________ margin of the liver and the rest lies along the _______ and _______ surface of the liver

anterior, inferior inferior and posterior

mastication

chewing, the mechanical part of digestion

What forms the most common type of gallstones?

cholesterol coming out of solution

hepatopancreatic sphincter (Sphincter of oddi)

circular muscle fiber near the terminal opening of the heaptopancreatic ampulla. It relaxes when CCK levels increase

cholelithiasis

condition of having gall stones

Function of saliva

dissolve foods so digestion can begin

During swallowing, the ________ is depressed to cover the laryngeal opening like a lid. The _____ ____ also come together to close off the epiglottis

epiglottis, focal folds/cords

what is the narrowest part of the alimentary canal

esophagus

Duodenal papilla (papilla of vater)

formed by hepatopancreatic sphincter. Its a protrusion into the lumen of the duodenum

Gastric canal

formed by rugae along the lesser curvature, funnels fluids directly from the body of the stomach to the pylorus

three main subdivisions of the stomach

fundus, body, and the pylorus

choleliths

gallstones

What may lead to a gangrenous gallbladder

gas producing bacteria

Oral Cholecystogram

in the past contrast was ingested orally to view the gallbladder.

cholecystitis

inflammation of the gallbladder

Caudate lobe

located posterior to the quadrate lobe, it extends superiorly to the diaphragmatic surface

Biliary stenosis

narrowing of one of the biliary ducts. May result in cholecystitis and jaundice

clinical indications for oral cholecystogram

nausea, heartburn, and vomiting

acute cholecystitis

often a blockage of the cystic duct restricts the flow of bile from the gallbladder into the common bile duct. The blockage is usually at the neck of the gallbladder.

list the organs of the alimentary canal

oral cavity (mouth), pharynx, esophagus, stomach, small intestine, large intestine, and anus

choledocholithiasis

presence of stones in the biliary duct

Cholangiogram

radiographic examination of the biliary ducts

cysto

sac or bladder

cholecystocholangiogram

study of the gallbladder and the biliary ducts

cholecystectomy

surgical removal of the gallbladder

Deglutition

the act of swallowing

Where is bile stored

the gallbladder

What is the largest organ in the human body?

the liver

Where is bile manufactured?

the liver

True or false: the gallbladder is anterior to the midcoronal plane and the duct system is about midway between the front and the back.

true