1100: UNIT 3 BILIARY SYSTEM: LIVER, PANCREAS, AND SPLEEN

The liver converts toxic secretions from the intestines into non-toxic substances. What does it also provide?

-Blood clotting mechanism -metabolizes carbohydrates -handles urea

Points of Connection of the Gallbladder?

-Common Bile Duct (CBD) -Cystic Duct -Hepatic Ducts: right, left, common

What are components of the Liver?

-Lobes: right and left, quadrate and caudate. -Capsule of Glisson

Components of the Gallbladder are?

-Neck -Corpus/Body -Fundus

What is the Liver's points of connection?

-hepatic diverticulum -common bile duct (CBD) -Septume transversum -Omental foramen

A Splenectomy is the removal of the spleen for ?

-hypersplenism -traumatic ruptures -accessory spleens, Staging procedure for Hodgkin's

___________ cholecystitis is usually caused by gallstones that won't pass through the cystic duct.

Acute

Cirrhosis of the liver is usually caused by what?

Alcoholism or other conditions such as Hepatitis C.

Liver, hepatic ducts, common hepatic duct, cystic duct, gallbladder, bile duct, ampulla of Vater, sphincter of Oddi.

Bile's Pathway

endoscopic retrograde cholangiopancreatography (ERCP) allows direct visualization of the ________________________, injection of radiographic contrast into ductal system, and biopsy when indicated.

Biliary Duct

A congenital absence/underdevelopment of 1+ of the biliary structures; can cause jaundice and liver damage.

Biliary atresia

Pathology of the Biliary tract consists of?

Biliary atresia and Biliary Cancer

Malignancy composed of epithelial cells in the gallbladder is known as?

Biliary cancer

Connected by the common bile duct (CBD), the gallbladder, liver, and pancreas assist in the digestive breakdown of food and conversion of toxic to non-toxic substances.

Billary System

________________ envelopes the entire liver in heavy connective tissue?

Capsule of Glisson

A diagnostic intra-operative x-ray is called a

Cholangiogram

_______________ is the removal of the gallbladder (open/lap) approach.

Cholecystectomy

What is the inflammation of the gallbladder, abnormal composition of bile called?

Cholecystitis

Pathology of the Gallbladder consists of?

Cholecystitis (acute and chronic), Cholelithiasis (gallstones and obstructions)

The visualization of the gallbladder (Oral or IV) is?

Cholecystography

The anastomosis between the CBD and jejunum (side to side or end to end) is called?

Choledochojejunostomy (Roux-Y)

What is the visualization of the common bile duct referred to as?

Choledochoscopy

Gallstones are composed of?

Cholesterol, bile salts and fatty acids.

What is the Expandable body of the gallbladder?

Corpus/Body of Gallbladder

What is the T-tube attached to?

Drainage bag, bile bag.

Liver tissue is __________________________, hemostatic substances are commonly used.

Extremely Friable

Rounded end terminates gallbladder. Describes what?

Fundus of the Gallbladder

Pear-shaped sac 3-4 inches long, stores and eventually concentrates the bile and releases it into the duodenum which is necessary for the breakdown of food and cholesterol and helps stimulate peristalsis in the small intestine during surgery.

Gallbladder

What is located under the liver, attached to its undersurface by connective tissue?

Gallbladder

What is the presence in or blockage of the bladder by crystalized stones?

Gallstones and obstruction

What is a mass of blood vessels in a benign tumor?

Hemangioma

What is the greatest intra-operative hazard w/splenic procedures.

Hemorrhaging.

Inflammation of the liver is called?

Hepatitis

Red pulp of the spleen is _________________?

Highly vascular

Pancreatitis is the ?

Inflammation of the pancreas

The injection of radiopaque solutions into the biliary duct to determine the presence and action of the stones or strictures to remove them. (Frequently done in combination w/chole)

Intraoperative Cholangiogram (IOC)

_______________________ permits x-ray identification of stones in the biliary system.

Intraoperative Cholangiogram (IOC)

What is the name of the procedure? Removal of the gallbladder through a laparoscopic approach.

Laparoscopic Cholecystectomy

Largest and most important mass of glandular tissue in the body (3-4lbs) produces bile and secretes cholesterol, proteins, and lipoproteins.

Liver

The hepatic artery, hepatic veins, and inferior vena cava makes up the blood supply of the ________?

Liver

What is located inferior to the lungs and diaphragm?

Liver

Removal of small piece of the liver to identify presence of metastatic carcinoma/ hep c.

Liver Biopsy

__________ is usually done in conjunction with other procedures in the or. (ex: tru-cut, biopsy needle, telfa)

Liver Biopsy

___________, either primary, original source of cancer, or metastatic, cancer that has spread from other parts of the body.

Liver Cancer

Removal of specific loves of the liver.

Lobectomy

What attaches organ to the common bile duct?

Neck of the gallbladder

What is the primary cause of stones due to high cholesterol?

Obesity

What is the name of the procedure? Removal of the gallbladder through a subcostal incision.

Open Cholecystectomy

A (6-9 in.) elongated glad, like a grape cluster on its side, composed of exocrine and endocrine glandular tissue that secretes digestive enzymes, alpha and beta cells w/in the pancreatic islets of Langerhaus secrete glucagon and insulin, respectively to assist in the digestion of carbohydrates.

Pancreas

The following are points of connection of the _______________________? -Pancreatic Duct -Accessory Pancreatic Duct -Common Bile Duct (CBD) -Hepao- pancreatic ampulla -Duodenal papilla, greater and lesser

Pancreas

The transfer of pancreatic organ from donor to recipient primarily for 4ths w/serious secondary diabetic complications and/or tumor.

Pancreatic Transplant

What are the growths characterized by fluid sacs in the pancreas?

Pancreatic cysts

Pancreas, pancreatic duct (wirsung), ampulla of Vater, sphincter of Oddi, duodenum.

Pancreatic enzymes' pathway

Anatomical resection of the liver. This procedure removes the segments that are divided by specific blood vessels and ducts.

Segmental

A lymphatic gland that supports the immune system.

Spleen

An oval shaped lymphatic organ, protected by the 10th-12th ribs, varies in size, vascular tissue supports the immune system and monitors and stores blood cells, filters microorganisms, is mesodermal.

Spleen

Red and White Pulp are components of the ?

Spleen

Splenic vein and Splenic artery makes up the blood supply of what?

Spleen

What is nestled against the stomach, pancreas, and liver?

Spleen

___________________ is the RBC deficiency within the spleen.

Splenic anemia

What is trauma to the spleen is referred to as?

Splenic lacerations

The enlargement of the spleen is called?

Splenomegaly

Narrowest portion of the Pancreas and the furthest from the duodenum is known as what?

Tail of the Pancreas

What is the primary portion of the Pancreas?

The Body

What is nestled against the duodenum where the CBD and pancreatic duct converge.

The head of the Pancreas

White pulp of the spleen is ______________?

Tissue of lymphocytes

What set should always be readily available when surgery is taking place with the spleen.

Vascular Set

A surgical removal of a small portion of the liver.

Wedge

Hepatic/Liver Resection

Wedge, segment, lobe, or biopsy of the liver for diseases diagnosis, laceration, tumor removal.

The radical removal of the head of the pancreas, entire duodenum, portion of the jejunum, distal third of the stomach, lower half of the CBD, w/re-establishment of continuity of the biliary, pancreatic, GI systems for carcinoma of the head of the pancreas or ampulla of water. This is known as a?

Whipple (Pacreaticoduodenectomy)

Isolate any instruments contacting _____ in a basin.

bile

Insertion to a T-tube may be possible to produce ___________________ __________ of the common bile duct.

continuous drainage

Cirrhosis of the liver is when connective tissue replaces _________________________________, tissue becomes hardened and its venous drainage becomes blocked.

damaged liver tissue

ERCP stands for ?

endoscopic retrograde cholangiopancreatography

Extracorporeal Shockwave Lithotripsy (ESWL) is used to shatter __________________________.

gallbladder or kidney stones

Cholelithiasis is known as

gallstones

Chronic cholecystitis begins with __________?

gradual onset

If ____________________ come in contact with bile it is to be considered dirty.

instruments

Hepatic intraductal assay (HIDA) is a scan that utilizes _______________________________.

nuclear imaging.

Bc bile is considered dirty it should not come in contact with the ____________________________________?

peritoneal cavity or skin.

Surgeons may use _________________ to anchor drains.

skin stitches

Label all syringes, those w/radiopaque contrast media are especially critical for __________________________________.

successful x-ray visualization

Liver Transplant

transfer of liver or partial liver from donor to recipient, for patients whose life is threatened or severely compromised by liver resection.

The ______________________________ goes to the common bile duct and the long through the outside of the skin up the RUQ.

two short ends of the T-tube