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Questions and Answers
What are the three sections of the gallbladder?
The three sections of the gallbladder are the fundus, body, and neck.
True or false: Biliary colic is caused by a gallstone temporarily blocking the pancreatic duct.
False
True or false: Gallstone formation is primarily due to the precipitation of cholesterol crystals.
True
True or false: Surgery to remove the gallbladder is the typical treatment for gallbladder attacks.
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True or false: Biliary colic occurs in 10 to 15% of adults in the developed world each year.
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Early surgery intervention for acute inflammation of the gallbladder within a few days of symptom debut does not increase the risk for complications compared to later surgery in an asymptomatic stage.
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Increasing acute phase surgeries for acute inflammation of the gallbladder could free multiple in-hospital days per patient and spare pain and suffering in wait of receiving an operation.
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According to the Cochrane review, those who waited on average 4 months for surgery had a higher rate of hospitalization for complications compared to those who received early intervention with surgery.
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The annual risk of developing biliary colic is 2 to 3%.
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About 30% of people experience further problems related to gallstones within a year following an attack
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15% of people with biliary colic eventually develop inflammation of the gallbladder if not treated
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Symptoms of gallstone disease include sharp, crampy, or severe right upper quadrant pain, nausea, vomiting, and pain induced by fatty meals
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Complications of gallstone disease include cholecystitis, cholangitis, acute pancreatitis, and gallstone ileus
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Biliary pain may be caused by obstruction of the common bile duct or the cystic duct by a gallstone
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Risk factors for cholesterol gallstone formation include age, female sex, obesity, hormonal birth control, and diabetes mellitus
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Diagnosis is guided by symptoms and laboratory findings, with ultrasound being the gold standard imaging modality for gallstones
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Initial management includes relieving symptoms, correcting electrolyte and fluid imbalance, and using antiemetics and pain medication
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Surgery, particularly laparoscopic cholecystectomy, is the definitive treatment for gallstone disease, with early removal potentially being better than delayed removal
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ERCP is used for diagnostic and therapeutic purposes if a gallstone in the bile duct is suspected
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Prophylactic cholecystectomy is rarely indicated unless specific risk factors are present
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Biliary pain without gallstones, known as postcholecystectomy syndrome, can severely affect a patient's quality of life
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Where does the common hepatic artery originate from?
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What regulates the opening of the hepatopancreatic ampulla into the duodenum?
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Where is the gallbladder located?
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Which vessels provide the gallbladder's blood supply?
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Where does bile drain into after leaving the canaliculi?
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Where do hepatic lymph nodes receive drainage from the liver?
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What provides the innervation to the gallbladder?
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What is the primary function of the gallbladder?
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Where does the common bile duct merge with to form the hepatopancreatic ampulla?
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What is the venous drainage for the liver?
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What is the source of sympathetic fibers for the liver's innervation?
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Where does the lymphatic drainage of the liver's posterior aspect occur?
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What is the primary role of the liver in digestion?
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How is the human liver divided?
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What creates grooves and impressions on the visceral surface of the liver?
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What is the primary source of blood supply to the liver?
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What is the function of the hepatic portal vein?
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What is the role of the hepatic artery proper in liver function?
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What are the potential spaces surrounding the liver called?
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How is the liver divided into right and left lobes?
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What is the function of the ligamentum teres hepatis?
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What is the main function of hepatocytes in the liver?
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Which vessels merge to form the hepatic portal vein?
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Study Notes
Anatomy and Function of the Gallbladder
- The gallbladder is divided into three sections: the fundus, body, and neck, with the fundus facing the abdominal wall.
- The gallbladder wall is composed of layers including a mucosa with microvilli, a muscular layer, and a serosa.
- Variations in size, shape, and position of the gallbladder are rare and generally asymptomatic.
- The gallbladder develops from an endodermal outpouching of the embryonic gut tube, as part of the biliary tree.
- The main functions of the gallbladder are to store and concentrate bile for the digestion of fats in food.
- Bile, produced by the liver, flows through the biliary tree into the gallbladder, where it is stored.
- Cholecystokinin stimulates the gallbladder to contract and release bile into the duodenum, assisting in fat absorption.
- Bile primarily consists of water and bile salts, and aids in eliminating bilirubin from the body.
- During gallbladder storage of bile, it is concentrated 3-10 fold by removing some water and electrolytes.
- The gallbladder may have variations including a Phrygian cap, multiple gallbladders, or abnormal positions.
- Anatomical variations can occur, such as left-lying liver, though they are very rare.
- The gallbladder's location and development are related to the embryonic gut tube and the formation of the biliary tree.
Gallstone Disease: Symptoms, Complications, Causes, and Management
- About 30% of people experience further problems related to gallstones within a year following an attack
- 15% of people with biliary colic eventually develop inflammation of the gallbladder if not treated
- Symptoms of gallstone disease include sharp, crampy, or severe right upper quadrant pain, nausea, vomiting, and pain induced by fatty meals
- Complications of gallstone disease include cholecystitis, cholangitis, acute pancreatitis, and gallstone ileus
- Biliary pain may be caused by obstruction of the common bile duct or the cystic duct by a gallstone
- Risk factors for cholesterol gallstone formation include age, female sex, obesity, hormonal birth control, and diabetes mellitus
- Diagnosis is guided by symptoms and laboratory findings, with ultrasound being the gold standard imaging modality for gallstones
- Initial management includes relieving symptoms, correcting electrolyte and fluid imbalance, and using antiemetics and pain medication
- Surgery, particularly laparoscopic cholecystectomy, is the definitive treatment for gallstone disease, with early removal potentially being better than delayed removal
- ERCP is used for diagnostic and therapeutic purposes if a gallstone in the bile duct is suspected
- Prophylactic cholecystectomy is rarely indicated unless specific risk factors are present
- Biliary pain without gallstones, known as postcholecystectomy syndrome, can severely affect a patient's quality of life
The Liver and Its Role in Digestion
- The liver can regenerate itself and plays a major role in digestion by producing bile, storing energy, detoxifying toxic substances, and producing proteins.
- The liver is a large intraperitoneal organ located mostly in the right hypochondriac and epigastric regions of the abdomen, with important functions including bile production, detoxification, and storage/release of carbohydrates and proteins.
- The human liver is divided into four parts referred to as lobes: the larger right lobe, the smaller left lobe, the caudate lobe, and the quadrate lobe.
- The liver is surrounded by potential spaces, including the right and left subphrenic recesses, the subhepatic space, and the hepatorenal recess.
- The liver has two main surfaces: the diaphragmatic surface, in direct contact with the diaphragm, and the visceral surface, an irregular surface molded by neighboring organs.
- The liver is divided into right and left lobes by the falsiform ligament, which contains the ligamentum teres hepatis, the remnant of the fetal umbilical vein.
- Grooves and impressions on the visceral surface of the liver are created by close contact with other organs, including the right and left sagittal fissures and the porta hepatis.
- The blood supply of the liver comes from two major sources: the hepatic portal vein and the hepatic artery proper, with the majority of blood entering the liver through the hepatic portal vein.
- The hepatic portal vein carries nutrient-rich blood from the gastrointestinal tract to the liver, while the hepatic artery proper supplies oxygen-rich arterial blood to the liver.
- The hepatic portal vein results from the merging of the splenic and superior mesenteric veins, while the hepatic artery proper stems from a branch of the celiac trunk called the common hepatic artery.
- The hepatic portal vein delivers blood straight to the hepatocytes, the liver cells that carry out tasks such as detoxification, while the hepatic artery proper mainly supplies the non-parenchymal part of the liver.
- The liver's blood supply plays a crucial role in its functions, including detoxification and nutrient processing.
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Description
Test your knowledge of the anatomy and function of the gallbladder with this quiz. Explore topics such as the structure of the gallbladder, its developmental origins, the storage and concentration of bile, and the role of bile in fat digestion and bilirubin elimination. Learn about rare variations and anomalies related to the gallbladder's position and structure.
