Gallbladder and Biliary System PDF

11 The Gallbladder and the Biliary System KEY TERMS Exercise 1 Match the following anatomy and physiology terms with their definitions. C _______   1. ampulla of Vater L _______   2. bilirubin M _______   3. cholecystectomy A _______   4. common bile duct _______   5. common duct F O _______  ...

11 The Gallbladder and the Biliary System KEY TERMS Exercise 1 Match the following anatomy and physiology terms with their definitions. C _______   1. ampulla of Vater L _______   2. bilirubin M _______   3. cholecystectomy A _______   4. common bile duct _______   5. common duct F O _______   6. common hepatic duct _______   7. cystic duct G _______   8. gallbladder B _______   9. Hartmann’s pouch I _______ E 10. Heister’s valve D 11. hydrops _______ J 12. pancreatic duct _______ _______ N 13. phrygian cap H 14. porta hepatis _______ _______ K 15. sphincter of Oddi A. 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 B. Storage pouch for bile C. Small opening in the duodenum in which the pancreatic and common bile duct enter to release secretions D. Massive enlargement of the gallbladder E. Tiny valves found within the cystic duct F. Refers to common bile and hepatic ducts when cystic duct is not seen G. Connects the gallbladder to the common hepatic duct H. Central area of the liver where the portal vein, common duct, and hepatic artery enter I. Small part of the gallbladder that lies near the cystic duct where stones may collect J. Travels horizontally through the pancreas to join the common bile duct at the ampulla of Vater K. Small muscle that guards the ampulla of Vater L. Yellow pigment in bile formed by the breakdown of red blood cells M. Removal of the gallbladder N. Gallbladder variant in which part of the fundus is bent back on itself O. Bile duct system that drains the liver into the common bile duct Exercise 2 Match the following sonographic evaluation and pathology terms with their definitions. 1. adenomyomatosis 2. cholangitis 3. cholecystitis 4. cholecystokinin 5. choledochal cyst 6. choledocholithiasis 7. cholelithiasis 8. cholesterolosis A. B. C. D. Gallstones in the gallbladder Calcification of the gallbladder wall Inflammation of the bile duct Excessive bilirubin accumulation causes yellow pigmentation of the skin; first seen in the whites of the eyes E. Small polypoid projections from the gallbladder wall F. Sonographic pattern found when the gallbladder is packed with stones G. Cancer at the bifurcation of the hepatic ducts; may cause asymmetrical obstruction of the biliary tree H. Low-level echoes found along the posterior margin of the gallbladder; move with change in position 85 Copyright © 2012, 2007 by Mosby, an imprint of Elsevier Inc. All rights reserved. Chapter 11   The Gallbladder and the Biliary System 9. jaundice 10. junctional fold 11. Klatskin’s tumor 12. Murphy’s sign 13. polyp 14. porcelain gallbladder 15. sludge 16. wall echo shadow (WES) sign I. Hormone secreted into the blood by the mucosa of the upper small intestine; stimulates contraction of the gallbladder and pancreatic secretion of enzymes J. Variant of adenomyomatosis; cholesterol polyps K. Inflammation of the gallbladder; may be acute or chronic L. Cystic growth on the common duct that may cause obstruction M. Small septum within the gallbladder, usually arising from the posterior wall N. Small, well-defined soft tissue projection from the gallbladder wall O. Stones in the bile duct P. Positive sign implies exquisite tenderness over the area of the gallbladder upon palpation ANATOMY AND PHYSIOLOGY Exercise 3 Label the following illustrations. 1. Gallbladder and biliary system. 12. Heister's valve 11. Neck of gallbladder 10. Hartmann's Pouch 1. Right hepatic duct 2. Left hepatic duct 3. Common hepatic duct 4. Cystic duct 9. Body of gallbladder 5. Common bile duct 8. Fundus of gallbladder 6. Pancreatic duct 7. Ampulla of Vater 86 Chapter 11   The Gallbladder and the Biliary System Copyright © 2012, 2007 by Mosby, an imprint of Elsevier Inc. All rights reserved. 2. Relationships within the porta hepatis. 1. Rt & Lt hepatic duct 13. Cystic artery 12. 2. Rt & Lt hepatic arteries Cystic duct 3. Common hepatic duct 11. Common bile duct 4. Proper hepatic artery 10. Liver 9. Gallbladder 8. Colon 5. Right gastric artery 6. Pancreas 7. Duodenum Exercise 4 Fill in the blank(s) with the word(s) that best completes the statements or provide a short answer about the anatomy and physiology of the gallbladder. 1. The gallbladder serves as a reservoir for ___________________ that is drained from the hepatic ducts in the liver. 2. The common hepatic duct is joined by the cystic duct to form the ___________________ duct. 3. The main pancreatic duct joins the common bile duct, and together they open through a small ampulla (the ampulla of ___________________) into the duodenal wall. 4. The end parts of the common bile duct and main pancreatic duct and the ampulla are surrounded by circular muscle fibers known as the ___________________. 5. The arterial supply of the gallbladder is from the ___________________ artery, which is a branch of the right hepatic artery. 6. List the two primary functions of the extrahepatic biliary tract. Exercise 5 Fill in the blank(s) with the word(s) that best completes the statements or provide a short answer about the anatomy and physiology of the gallbladder. 1. Describe the normal function of the gallbladder during digestion. 2. Bile is the principal medium for excretion of bilirubin ___________________. 3. The ___________________ from the small intestine stimulate the liver to make more bile. This activates intestinal and pancreatic enzymes. 87 Copyright © 2012, 2007 by Mosby, an imprint of Elsevier Inc. All rights reserved. Chapter 11   The Gallbladder and the Biliary System