Biliary

Question 1

chole

Answer 1

bile

Question 2

cysto

Answer 2

bag or sack

Question 3

cholecyst

Answer 3

gallbladder

Question 4

choledocho

Answer 4

common bile duct

Question 5

cholangio

Answer 5

bile vessel

Question 6

gall bladder location in hypersthenic

Answer 6

2” higher (T12) and lateral

Question 7

gallbladder location in sthenic patient

Answer 7

L2 or 1” above LCM and 2” to the right of MSP

Question 8

gallbladder location of Asthenic patient?

Answer 8

midline at L4

Question 9

functions of the gallbladder

Answer 9

1. storage of bile
2. concentration of bile
3. contraction when stimulated (cholecystokinin - CCK)

Question 10

cholecystography

Answer 10

study of gall bladder

Question 11

cholangiography

Answer 11

study of biliary ducts

Question 12

cholecystangiography

Answer 12

study of GB and ducts

Question 13

examinations of the gall bladder

Answer 13

1. percutaneous transhepatic cholangiography
2. T-Tube cholangiogram
3. endoscopic retrograde cholangiopancreatogram - ERCP

Question 14

patency of ducts would require what kind of examine

Answer 14

stenosis

Question 15

GB tumours requires what type of exam?

Answer 15

biliary neoplasia

Question 16

Gallstones requires which type of exam?

Answer 16

cholelithiasis

Question 17

cholelithiasis

Answer 17

cholesterol is radiolucent
- majority of gall stones are radiolucent
- see filling defect with contrast
- 20% contain enough calcium to be seen radiographically
- ultrasound is modality of choice for diagnosis

Question 18

PTC - percutaneous transhepatic cholangiography

Answer 18

in the OR
Diagnostic or therapeutic
- Insertion of needle through the skin into a bile duct
- Injection of dilute contrast
- May drain excessive fluid
- May remove stones or sludge causing obstruction
- May insert stents
- Often for palliative patients

Question 19

slide 11

Answer 19

PTC images

Question 20

T-Tube Cholangiogram

Answer 20

• Biliary tract examination that is performed via a T-shaped or pigtail-shaped catheter left in the common hepatic and common bile ducts for postoperative drainage (often after removal of the gallbladder)
• To show the caliber and patency of the ducts, or the presence of residual or previously undetected stones

Question 21

prep for T-tube cholangiogram?

Answer 21

• The drainage tube is clamped the day before
• The preceding meal is withheld
• May need cleansing enema 1 hour before

Question 22

why is a pigtail catheter required

Answer 22

• pigtail catheter is required for laparoscopic biliary procedures because it can be placed percutaneously. The T-tube catheter can be placed only during an open surgical procedure.

Question 23

density of contrast

Answer 23

• The density of the contrast medium used no greater than 25% to 30% because small stones may be obscured with a higher concentration

Question 24

slide 13

Answer 24

what position is this?

Question 25

slide 15

Answer 25

lateral projection

Question 26

what is lateral projection used to show?

Answer 26

anatomic branching of the hepatic ducts in the plane and to detect any abnormality that is not otherwise shown

Question 27

ERCP - endoscopic retrograde cholangiopancreatogram

Answer 27

- Endoscopic inspection, cannulation, and injection of the biliary ducts with the use of a duodenoscope (fiberoptic endoscope) by a Gastroenterologist - In the Endoscopy suite or Radiology Suite - Mostly CT used now

Question 28

what is ERCP used to treat?

Answer 28

ERCP remains a mainstay on the treatment of choledocholithiasis and malignant obstructive jaundice

Question 29

responsibilities of technologist

Answer 29

1. Prepare fluoroscopy suite 2. Set up examination tray 3. Select and prepare contrast media, - medications are prepared by RN - patient will receive anesthetic at back of throat 4. Take scout images 5. Provide protective aprons 6. Monitor the patient during the procedure 7. Take conventional radiographs or fluoro images as requested

Question 30

alternate imaging of gall bladder

Answer 30

ultrasound - most common CT - secondary study MRI - not as common

Question 31

choledocholithiasis

Answer 31

stones of the common bile duct

Question 31

cholecystitis

Answer 31

gall bladder inflammation

Question 32

slide 21 and 22

Answer 32

know procedure and anatomy