Biliary Tract & Upper GI System

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1

largest organ in the body

liver

2

how much does the liver weigh

3-4lbs

3

what is the widest portion of the liver & how wide

superior border

approx. 8-9in

4

which border of the liver is its greatest vertical dimension & how long

right border

approx. 6-7in

5

what protects the liver & why

lower right rib cage because liver is highly vascular & easily lacerated

6

where is the gallbladder located

centrally in posterior inferior region of the liver

7

how many lobes of the liver are there & what are they

4

major right & left lobes

minor quadrate & caudate lobes

8

what separates the right & left lobes

falciform ligament

9

where is the quadrate lobe located

inferior surface of right lobe between gallbladder & falciform ligament

10

where is the caudate lobe located

posterior to quadrate lobe & superior to diaphragmatic surface

11

function of the liver

production of bile

12

major functions of bile

aid in digestion of fats by emulsifying fat globules & absorption of fat following its digestion

13

bile is formed in __________ __________ of liver & travels by __________ ___________ to the larger ____________ or __________ __________ __________

small lobules

small ducts

right or left hepatic ducts

14

bile is carried to the _________ via the _________ for temporary __________, or it may be _________ directly into the _________ via the __________ ___________ ___________

gallbladder

cystic duct

storage

secreted

duodenum

commo bile duct

15

the common bile duct is joined by the __________ __________ at the __________ ___________, which empties into the __________ via the __________ __________

pancreatic duct

hepatopancreatic sphincter

duodenum

duodenal papilla

16

what are the 3 parts of the gallbladder

fundus

body

neck

17

describe the fundus of the gallbladder

distal end & broadest part

18

what is the main section of the gallbladder

body

19

what is the neck & what does it continue as

narrow proximal end

cystic duct

20

the cystic duct is __________ to __________ __________ long & contains several _________ _________ along its length

3-4cm

membranous folds

21

what is the spiral valve & its function

folds from cystic duct prevents distention or collapse of cystic duct

22

the normal gallbladder is __________ to __________ ___________ long & approx. ___________ __________ wide. It generally holds __________ to __________ __________ of bile

7-10cm

3cm

30-40mL

23

3 primary functions of the gallbladder

store bile

concentrate bile

contract when stimulated

24

why is bile concentrated in the gallbladder

result of hydrolysis (removal of water)

25

what is choleliths & how is it formed

gallstones

too much water is absorbed or cholesterol becomes too concentrated

26

what forms the most common type of gallstone

cholesterol

27

foods such as fats or fatty acids stimulate the __________ __________ to secrete the hormone __________

duodenal mucosa

cholecystokinin (CCK)

28

how long is the common bile duct

7.5cm

29

what is another name for pancreatic duct

duct of wirsung

30

in about 40% of individuals, the pancreatic duct pass into the __________ as __________ separate ducts with separate openings. In the remaining 60%, the CBD joins the __________ __________ to form __________ common passageway through the single __________ into the __________

duodenum

2

pancreatic duct

1

papilla

duodenum

31

common pancreatic duct passageway is a(n) __________, the __________ __________

ampulla

hepatopancreatic ampulla

32

older term for hepatopancreatic ampulla

ampulla of vater

33

what is the hepatopancreatic sphincter

circular muscle fiber near terminal opening of CBD passageway into duodenum

34

another name for hepatopancreatic sphincter

sphincter of oddi

35

what is duodenal papilla

protrusion into lumen of duodenum

36

another name for duodenal papilla

papilla of vater

37

accessory organs of digestion

salivary glands

pancreas

liver

gallbladder

38

what are the 3 primary functions of the digestive system

digest

absorb

eliminate

39

what are the 3 pairs of salivary glands

parotid

submandibular (submaxillary)

sublingual

40

the act of swallowing is termed __________

deglutition

41

pharynx

12.5cm long

part of digestive tube found posterior to nasal cavity mouth & larynx

42

3 parts of the pharynx

nasopharynx

oropharynx

laryngopharynx

43

nasopharynx

posterior to nasal septum nasal cavities & soft palate

not part of digestive system

44

oropharynx

posterior to oral cavity

extends from soft palate to epiglottis

45

laryngopharynx

extends from epiglottis to lower border of larynx (level of C6)

46

another name for laryngopharynx

hypopharynx

47

epiglottis

membrane covered cartilage that moves down to cover opening of larynx during swallowing

48

during swallowing, the __________ ___________ closes off the _________ to prevent swallowed substances from regurgitating into the nose

soft palate

nasopharynx

49

the __________ prevents material from reentering the mouth

tongue

50

during swallowing, the __________ is depressed to cover the __________ opening; prevents food & fluid from being __________

epiglottis

laryngeal

aspirated

51

esophagus

muscular canal

approx. 25cm long & 2cm in diameter

extends from laryngopharynx (cricoid cartilage - C5-C6) to stomach (T11)

52

the __________ is posterior to the __________ & just anterior to the cervical & thoracic vertebral bodies

esophagus

trachea

53

where are the 2 indentations of the esophagus

aortic arch

left primary bronchus

54

what is the abdominal segment of the esophagus called

cardiac antrum

55

the opening between the esophagus & the stomach is termed __________

esophagogastric junction or cardiac orifice

56

the esophagus contains well-developed __________ muscle layers in its upper third, __________ & __________ muscle in its middle third, & __________ muscle in its lower third

skeletal

skeletal & smooth

smooth

57

the esophagus is a __________ tube that opens only when swallowing

collapsible

58

what is peristalsis

wavelike series of involuntary muscular contractions that propel solid & semisolid materials through tubular alimentary canal

59

what is another name for esophagogastric junction

cardiac orifice

60

the esophagogastric junction is the __________, or __________ between the __________ & the __________

aperture

opening

esophagus

stomach

61

what is the cardiac sphincter

small circular muscle that allows food & fluid to pass through cardiac orifice

62

what is another term for cardiac notch

incisura cardiaca

63

where is the cardiac notch found

superior to cardiac orifice & distal abdominal portion of esophagus

64

what is the cardiac antrum

expanded portion of terminal esophagus

65

what is another term for pyloric orifice

pylorus

66

what is the pylorus

opening of distal stomach

67

the __________ __________ at the pylorus is a thickened muscular ring that __________ periodically during __________ to allow stomach or gastric contents to move into the first part of the __________ __________, the __________

pyloric sphincter

relaxes

digestion

small intestine

duodenum

68

the __________ __________, which is found along the medial border of the stomach, forms a __________ border as it extends between the __________ & __________ __________

lesser curvature

concave

cardiac

pyloric orifices

69

the __________ __________, which is found along the lateral border of the stomach. It is __________ to __________ times longer than the __________ __________. It extends from the __________ __________ & the __________

greater curvature

4-5

lesser curvature

cardiac notch

pylorus

70

3 main subdivisions of the stomach

fundus

body

pylorus

71

what & where is the fundus of the stomach

ballooned portion that lies lateral & superior to cardiac orifice

72

in the __________, or __________ position, the __________ is usually filled by a bubble of swallowed air; this is referred to as a __________ __________

upright

erect

fundus

gastric bubble

73

2 parts of the pyloric portion of the stomach

pyloric antrum

pyloric canal

74

when the stomach is empty, the internal lining is thrown into numerous longitudinal mucosal folds termed _________

rugae

75

what is the gastric canal

formed by rugae

funnels directly from body of stomach to pylorus

76

what is the most superior part of the stomach

fundus

77

air/gas barium distribution in the stomach in the supine position

barium posterior portion inside fundus

air gas in body & pylorus

78

air/gas barium distribution in the stomach in the prone position

air gas in highest position inside fundus

barium in anterior body & pylorus

79

air/gas barium distribution in the stomach in the erect position

air gas rises to fill fundus

barium descends to fill pylorus

80

the __________, which is the first portion of the small intestine, commonly called the __________ __________

duodenum

small bowel

81

the __________ is about __________ to __________cm long & is the __________, __________, & most __________ portion of the small intestine

duodenum

20-24

shortest

widest

fixed

82

most of the duodenum & the pancreas are __________ structures; that is, they are located __________ to the __________ __________

retroperitoneal

posterior

parietal peritoneum

83

what is the duodenum shaped like

letter C

84

4 parts of the duodenum

superior

descending

horizontal

ascending

85

the first part of the superior portion is termed the _________ __________, or __________

duodenal cap

cap

86

what is the most common site of ulcer disease

duodenal bulb

87

the duodenal bulb portion of the duodenum is __________; the remainder of the duodenum is __________

intraperitoneal

retroperitoneal

88

which portion is the longest segment in the duodenum

descending portion

89

the descending portion of the duodenum possesses the __________ __________, which is the opening for the __________ __________ & __________ ducts into the duodenum

duodenal papilla

common bile

pancreatic

90

the junction of the duodenum with the second portion of the small intestine, the __________ is termed the _________ __________. This portion is relatively fixed & is held in place by a fibrous band, the __________ __________ __________ (_________ __________ of the duodenum)

jejunum

duodenojejunal flexure

ligament of treitz

suspensory muscle

91

digestion can be divided into a __________ process & a __________ component

mechanical

chemical

92

__________ digestion includes all movements beginning in the __________ __________ (__________) with chewing, or __________, & continuing in the ___________ & __________ with swallowing, or __________

mechanical

oral cavity

mouth

mastication

pharynx

esophagus

deglutition

93

the passage of solid or semisolid food from the stomach takes __________ to __________sec, whereas liquids pass in about __________sec

4-8

1

94

the __________ acting as a reservoir for food & fluid also acts as a large mixing bowl

stomach

95

if pyloric valve is __________, the stomach contents are churned or mixed with stomach fluids into a semifluid mass termed _________

closed

chyme

96

when the pyloric valve __________, small amounts of __________ are passed into the duodenum by __________ __________

opens

chyme

stomach peristalsis

97

how long does the gastric emptying process take

2-6hrs

98

the small intestine (__________ __________) continues __________digestion with a churning or mixing activity termed __________ __________

small bowel

mechanical

rhythmic segmentation

99

function of rhythmic segmentation

mix food & digestive juices

100

how long does it take for chime to move through the small intestine

3-5hrs

101

6 classes of substances ingested

carbs

lipids or fats

vitamins

minerals

water

102

only __________, __________, & __________ must be chemically digested to be absorbed

carbs

proteins

lipids

103

chemical digestion is speeded up by various ___________, which are ___________ ___________

enzymes

biologic catalysts

104

4 classes of body habitus

hypersthenic

hyposthenic

asthenic

sthenic

105

for hypersthenic patients, the gallbladder is __________ & almost __________. The __________ is also very __________ & assumes a __________ position

high

transverse

stomach

high

transverse

106

for a hypersthenic patient, the level of the stomach extends from __________ to __________. The duodenal bulb is at the level of __________ or __________

T9-T10

T11

T12

107

why is the large intestine pushed down on a hyposthenic/asthenic patient

long narrow lungs with low diaphragm

108

in a hyposthenic/asthenic patient, the stomach is __________=shaped & __________ in the abdominal cavity, extending from __________ to __________. The duodenal bulb is at the level of __________ to __________. The gallbladder is at the level of __________ __________, approx. __________ to __________

J

low

T11-L5

L3-L4

iliac crest

L3-L4

109

in a sthenic patient, the stomach is __________-shaped; extends from __________ to _________; duodenal bulb is at the level of __________ to __________; gallbladder is less __________

J

T11-L2

L1-L2

transverse

110

_________ & __________ contrast media are used to render the GI tract visible radiographically

radiolucent

radiopaque

111

_________, or _________, contrast media include swallowed air, CO2 gas crystals & gas bubble

radiolucent

negative

112

what is the most common positive, or _________, contrast medium

radiopaque

barium sulfate

113

barium is relatively __________ because of its extreme __________ in water. Because it does not interact chemically with the body, it rarely produces an _________ reaction

inert

insolubility

allergic

114

a mixture of barium sulfate & water forms a _________ __________,not a _________

colloidal suspension

solution

115

modified true or false

barium sulfate dissolves in water

false

barium sulfate never dissolves in water

116

modified true or false

in a colloidal suspension, the particles suspended in water dissolves over time

false

particles settle over time when allowed to sit

117

all barium suspensions must be __________ well just before use

mixed

118

2 types of mixtures of barium sulfate

thick

thin

119

what does BaSO4 stand for

barium sulfate

120

the thin barium sulfate & water mixture contains __________ part BaSO4 to __________ part water; consistency of a thin __________

1

1

milkshake

121

thick barium contains __________ or __________ parts BaSO4 to _________ part water; consistency of _________ __________

3

4

1

cooked cereal

122

barium sulfate mixtures are contraindicated if there is any chance that the mixture might escape into the _________ _________; can lead to _________ __________ or __________

peritoneal cavity

intestinal infarcts

peritonitis

123

if barium sulfate contraindication is suspected, what should you use

water soluble iodinated contrast media

124

wha happens if any water-soluble material escapes into peritoneal cavity

body absorbs it

125

modified true or false

barium sulfate is not absorbed by the body

true

126

what is the one drawback to water-soluble materials

bitter taste

127

water-soluble iodinated contrast media should not be used if the patient is __________ to _________, or if the patient is experiencing severe _________; it often further _________ the patient

sensitive

iodine

dehydration

dehydrates

128

double-contrast procedures employing both __________ or _________ contrast media were developed in _________ where a high incidence of _________ __________ exists

radiolucent

radiopaque

japan

stomach carcinoma

129

the radiopaque contrast medium is _________ __________. High _________ barium is used to coat the _________ _________

barium sulfate

density

stomach mucosa

130

the radiolucent contrast medium is either _________ __________or _________ _________

room air

CO2 gas

131

2 common forms of gas crystals

calcium

magnesium citrate

132

how is CO2 gas created

patient ingests gas-producing crystals

133

on reaching the stomach, gas crystals form a _________ _________ _________

large gas bubble

134

what is one of the functions of the large intestine

absorbs water

135

what happen to remaining barium sulfate mixture in the large intestine

may become solidified

136

what does the buck slot shield do

significantly reduces scatter radiation

137

protective aprons contain _________mm lead equivalency

0.5

138

2 common radiographic procedures of the upper GI system involving contrast media

esophagram

upper GI series

139

other names for esophagram

esophagogram

barium swallow

140

esophagogram is the common radiographic procedure or exam of the _________ & _________ in which contrast medium is used; occasionally, a _________ or _________ contrast medium may be used

pharynx

esophagus

radiopaque

negative

rdiolucent

141

what is achalasia

aka cardiospasm

peristalsis is reduced along distal 2/3 of esophagus

inability of esophagogastric sphincter to relax during swallowing

142

what is the term used for difficulty swallowing

dysphagia

143

what is esophageal varices

dilation of veins in distal esophagus

144

what is esophageal reflux

aka GERD or gastroesophageal reflux disease

entry of gastric contents irritating lining of esophagus

reported as heartburn

145

what is zenker's diverticulum

large outpouching of esophagus just above upper esophageal sphincter caused by weakening of muscle wall

146

modified true or false

patients need no preparation for an esophagogram

true

147

esophagograms generally use both _________ & _________ barium

thin

thick

148

3 additional items useful for detection of a foreign body

cotton balls soaked in thin barium

barium pills or gelatin capsules filled with BaSO4

marshmallows