Liver and biliary duct anatomy

What are the 3 primary functions of the gallbladder?

1)store bile 2)concentrate bile 3)contract when stimulated

The neck (Narrow proximal end)of the gallbladder that Continues as the cystic duct. The cystic duct is ______ long And Contains folds called ______to prevent distention or collapse of the cystic duct

3-4 cm Spiral valve

Give the following information regarding the gallbladder: Length Normal Bile capacity Shape Parts

3-4" 30-40 mL Pear shaped Fundus, body, and neck

How many total lobes does the liver have?

4, 2 major and 2 minor lobes

Common Bile Duct: •About _____ long •Internal diameter about the size of ________

7.5 cm Drinking straw

What forms the most common type of gallstones?

Cholesterol coming out of solution

What Descends behind the superior portion of the duodenum and the head of the pancreas to enter the descending portion of the duodenum

Common bile duct

The liver extends from the _______to just below the _______

Diaphragm 10th rib

a common site for impaction of gallstones

Hepatopancreatic ampulla

What is the most applicable function of the liver to radiographic study?

It's production of bile

One of the primary functions of the gallbladder is to concentrate the bile through hydrolysis. What happens if too much water is absorbed or if the cholesterol becomes too concentrated?

May form gallstones (choleliths)

What causes cholesterol to crystallize and form into gallstones?

Not enough bile salts OR Too much cholesterol

The liver has 2 minor lobes on the medial aspect of the R major lobe called the Quadrate and the Caudate lobe. Where is the quadrate lobe located? Where is the caudate lobe located?

Quadrate: Between the GB and falciform ligament Caudate: posterior to Quadrate lobe

What is the largest vertical dimension of the liver? Describe it (length and R or L side)

Right border 6-7"

Older name for the hepatopancreatic sphincter

Sphincter of Oddi

What position drains the gallbladder into the duct system?

Supine

The liver has 2 minor lobes on the medial aspect of the R major lobe called the Quadrate and the Caudate lobe. What's in between these two minor lobes?

The hilum of the liver (porta hepatitis)

What is the major function of bile?

To break down fat

What modality is a Non-invasive means of studying the GB and biliary ducts? What are it's 4 advantages over OCG?

Ultrasound No ionizing radiation Can detect small calculi Doesn't use contrast medium Requires Less patient prep

What is the widest part of the liver? Describe it. (Length, concave or convex)

Upper border 8-9" long Convex

Bile is a liquid substance. What is it mainly composed of?

bile salts bile pigments cholesterol water

Another name for the pancreatic duct

duct of Wirsung

One of the primary functions of the gallbladder is to concentrate the bile. This is done through a process called ____________

hydrolysis (removal of water)

Located inferior to the diaphragm, the _______ is the largest solid organ in the body. How much does it weigh?

liver 3-4 lbs.

When gallstones grow in size and number it can cause:

minimal to complete obstruction of the flow of bile from the gallbladder into the duodenum.

What study (now obsolete) involved having the pt orally ingest contrast medium pills to view the gallbladder? What modality replaces this study?

oral cholecystogram (OCG) Ultrasound

Describe the movement of bile within the biliary system

1. Bile is produced by the liver 2. Bile drains from the liver into R and L hepatic ducts where they come together to form the common hepatic duct 3. From the common hepatic ducts the bile goes into the gallbladder through the cystic duct 4. The bile comes out of the gallbladder through the cystic duct again and travels to the common bile duct 5. The common bile duct unites with the pancreatic duct and that area is called the hepatopancreatic ampulla 6. The hepatopancreatic ampulla is guarded by the hepatopancreatic sphincter which pushes the bile into the duodenum

Sometimes the common bile duct and the Pancreatic duct don't unite to form the hepatopancreatic duct but remain separated This occurs in _______% of people They do unite in the remaining _____% of people

40% 60%

How much bile does the liver produce per day?

800-1000mL (around 1 quart)

Older name for the hepatopancreatic ampulla

Ampulla of vater

The lateral view Demonstrates the gallbladder _______ to the MCP

Anterior

Bile is a liquid substance composed mainly of bile salts, bile pigments, cholesterol and water. _________ is responsible for the yellow color. _________ facilitate the absorption of fats.

Bile pigments Bile salts

What position places the gallbladder closer to IR?

Prone

The liver has 2 major and 2 minor lobes. Give the names and location of the minor lobes

Quadrate lobe Caudate lobe Located on the medial aspect of the R. Major Lobe

The liver has 2 major and 2 minor lobes. Give the name of the two major lobes and what divides them

R and L lobes Falciform ligament

Describe how increased levels of cholecystokinin (CCK) stimulates the flow of bile and pancreatic juice to the duodenum

cause the GB to contract and the terminal opening of the common bile duct to relax AND Causes the pancreas to secrete pancreatic juice and the hepatopancreatic spincter to relax

The gallbladder normally contracts when what type of foods are in the duodenum? These foods stimulate the mucosa of the duodenum to secrete a hormone called _______

fats or fatty acids are in the duodenum. cholecystokinin (CCK)

The hepatopancreatic Ampulla is controlled by circular muscle called the ___________ This muscle causes a protrusion into the lumen of the duodenum known as the ___________

hepatopancreatic sphincter (sphincter of Oddi) duodenal papilla (papilla of Vater)

Where is bile stored when it's not needed for digestive purposes?

in the gallbladder