Chapter 11: The Gallbladder and the Biliary System

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1

adenomyomatosis

small polypoid projections from the gallbladder wall

2

ampulla of Vater

small opening in the duodenum in which the pancreatic and common bile duct enter to release secretions

3

bilirubin

yellow pigment in bile formed by the breakdown of red blood cells

4

cholangitis

inflammation of the bile duct

5

cholecystectomy

removal of the gallbladder

6

cholecystitis

inflammation of the gallbladder; may be acute or chronic

7

cholecystokinin

hormone secreted into the blood by the mucosa of the upper small intestine; stimulates contraction of the gallbladder and pancreatic secretion of enzymes

8

choledochal cyst

cystic growth of the common duct that may cause obstruction

9

choledocholithiasis

stones in the bile duct

10

cholelithiasis

gallstones in the gallbladder

11

cholesterolosis

variant of adenomyomatosis; cholesterol polyps; also called cholesterosis

12

common bile duct

extends from the point where the common hepatic duct meets the cystic duct; drains into the duodenum after it joins with the main pancreatic duct

13

common duct

refers to common bile or hepatic ducts when the cystic duct is not seen

14

common hepatic duct

bile duct system that drains the liver into the common bile duct

15

cystic duct

connects the gallbladder to the common hepatic duct

16

gallbladder (GB)

storage pouch for bile

17

Hartmann’s pouch

small part of the gallbladder that lies near the cystic duct where stones may collect

18

Heister’s valves

tiny valves found within the cystic duct

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hydrops

massive enlargement of the gallbladder

20

jaundice

excessive bilirubin accumulation that causes yellow pigmentation of the skin; first seen in the whites of the eyes

21

junctional fold

small septum within the gallbladder, usually arising from the posterior wall

22

Klatskin’s tumor

cancer at the bifurcation of the hepatic ducts; may cause asymmetric obstruction of the biliary tree

23

Murphy’s sign

positive sign implies exquisite tenderness over the area of the gallbladder upon palpation

24

pancreatic duct

travels horizontally through the pancreas to join the common bile duct at the ampulla of Vater

25

Phrygian cap

gallbladder variant in which part of the fundus is bent back on itself

26

polyps of the gallbladder

small, well-defined soft tissue projection from the gallbladder wall

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porcelain gallbladder

calcification of the gallbladder wall

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porta hepatis

central area of the liver where the portal vein, common duct, and hepatic artery enter

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sludge

low-level echoes found along the posterior margin of the gallbladder; move with change in position

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sphincter of Oddi

small muscle that guards the ampulla of Vater

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wall echo shadow (WES) sign

sonographic pattern found when the gallbladder is packed with stones

32

Name the layers of the GB

serosal

subserosal

muscular

mucosal

33

What is the least common variant of the gallbladder?

agenesis

34

What GB variant is associated with cystic fibrosis?

hypoplasia

35

What does bile consist of?

bile salt

cholesterol

amino acids

conjugated hormones

fat digestion

36

What is the most common GB variant?

Junctional fold

37

What causes bile to flow?

cholecystokinin causes contraction of GB

bile flows if ductal pressure is lower than hepatic secretory pressure

38

What does increased WBC indicate?

accute cholecystitis

chronic cholecystitis

injury to bile duct

39

What does increased bilirubin indicate?

sub accute cholecystitis

choledocholithiasis

injury to bile duct

GB carcinoma

internal biliary fistula

40

What does increased indirect bilirubin indicate?

pre or hepatic obstruction

41

What does increased direct bilirubin indicate?

post hepatic obstruction

42

What does increased alkaline phosphatase (ALP) indicate?

biliary obstruction

43

What does increased aspartate aminotansferase (AST) indicate?

injured liver

skeleton

heart

44

What does increased alanine aminotansferase (ALT) indicate?

injured liver

stays elevated long

45
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phrygian cap

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hartmann's pouch

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junctional fold

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septated