Biliary System

Question 1

What shape is the gallbladder?

Answer 1

Hollow, pear-like shape

Also referred to as piriform.

Question 2

Where is the gallbladder located?

Answer 2

Under the liver segments IVB and V

It is an intraperitoneal organ.

Question 3

What is the size range of the gallbladder’s length?

Answer 3

7–10 cm

Question 4

What is the width of the gallbladder at its widest point?

Answer 4

2.5 cm

Question 5

What is the normal volume of the gallbladder?

Answer 5

30–35 mL

Question 6

What volume can the gallbladder hold if the cystic duct is obstructed?

Answer 6

Up to 300 mL

Question 7

What are the main structural components of the gallbladder?

Answer 7

• Fundus
• Body
• Infundibulum
• Neck

Question 8

What is the infundibulum of the gallbladder?

Answer 8

The section that narrows from the body to the neck

Question 9

How is the neck of the gallbladder connected?

Answer 9

Connects to the cystic duct → common hepatic duct → common bile duct

Question 10

What is the Hartmann gallbladder pouch?

Answer 10

A dilation on the ventral aspect of the gallbladder, proximal to the gallbladder neck

Question 11

What is the most common site of gallstone impaction?

Answer 11

Hartmann gallbladder pouch

Question 12

Is the Hartmann pouch considered a pathologic finding?

Answer 12

False

Question 13

What is the cystic plate?

Answer 13

Fibroareolar tissue that attaches the gallbladder to the liver

Question 14

What anatomical variants have been inaccurately described in literature regarding the gallbladder?

Answer 14

Infundibulum and Hartmann Pouch

Question 15

What is the function of bile?

Answer 15

Storage of bile

Bile is produced by the liver and stored in the gallbladder.

Question 16

How does bile drain from the liver?

Answer 16

Bile drains from the liver via small bile ducts.

Question 17

What stimulates the gallbladder to contract?

Answer 17

Cholecystokinin (CCK) stimulates the gallbladder to contract.

Question 18

Where does bile get released after gallbladder contraction?

Answer 18

Bile is released through the cystic duct into the second part of the duodenum.

Question 19

How is bile concentrated?

Answer 19

By absorption of electrolytes and water.

Question 20

What is the arterial blood supply to the gallbladder?

Answer 20

Cystic artery (branch of the right hepatic artery).

Question 21

What is the venous drainage from the neck of the gallbladder?

Answer 21

Cystic veins → portal vein.

Question 22

What is the venous drainage from the body and fundus of the gallbladder?

Answer 22

Hepatic sinusoids.

Question 23

What type of innervation is provided by the sympathetic nervous system to the gallbladder?

Answer 23

Via the celiac plexus.

Question 24

What type of innervation is provided by the parasympathetic nervous system to the gallbladder?

Answer 24

Hepatic branch of the vagus nerve.

Question 25

Which nerve provides sensory fibers to the gallbladder?

Answer 25

Phrenic nerve.

Question 26

What is the referred pain location associated with cholecystitis?

Answer 26

Right shoulder region.

Question 27

What spinal nerves originate the phrenic nerve?

Answer 27

C3–C5.

Question 28

The phrenic nerve provides somatic sensation to which area?

Answer 28

Shoulder area.

Question 29

What are the layers of the gallbladder wall?

Answer 29

Serosa, adventitia, muscularis externa, lamina propria, mucosa ## Footnote The layers include serosa on the inferior peritoneal surface and adventitia on the superior hepatic surface.

Question 30

What type of epithelium is found in the mucosa of the gallbladder?

Answer 30

Simple columnar epithelium with microvilli ## Footnote This type of epithelium aids in absorption and secretion.

Question 31

What does the gallbladder mucosa secrete?

Answer 31

Mucin ## Footnote Mucin is a glycoprotein that contributes to the protective layer of the gallbladder.

Question 32

The serosa is located on which surface of the gallbladder?

Answer 32

Inferior peritoneal surface

Question 33

The adventitia is located on which surface of the gallbladder?

Answer 33

Superior hepatic surface

Question 34

What is the function of the muscularis externa in the gallbladder?

Answer 34

Facilitates contraction for bile release ## Footnote The muscularis externa is responsible for the motility of the gallbladder.

Question 35

What are the two divisions of the biliary tree?

Answer 35

Intrahepatic and extrahepatic bile ducts

Question 36

What are the components of the intrahepatic bile ducts?

Answer 36

Bile canaliculi, intrahepatic bile ductules (canals of Hering), segmental bile ducts, sectional ducts

Question 37

Which segments are drained by the right posterior duct (RPD)?

Answer 37

Segments VI and VII

Question 38

Which segments are drained by the right anterior duct (RAD)?

Answer 38

Segments V and VIII

Question 39

What forms the right hepatic duct (RHD)?

Answer 39

The connection of the right posterior and anterior ducts

Question 40

What forms the left hepatic duct (LHD)?

Answer 40

The connection of bile ducts from segments II–IV

Question 41

What is the common hepatic duct (CHD)?

Answer 41

Formed by the right and left hepatic ducts

Question 42

What is the common bile duct formed by?

Answer 42

The common hepatic duct and cystic duct

Question 43

Where does the common bile duct travel?

Answer 43

In the free edge of the lesser omentum, in the hepatoduodenal ligament

Question 44

What structures are located posterior to the common bile duct?

Answer 44

The duodenum and the pancreas

Question 45

What does the common bile duct connect with?

Answer 45

The main pancreatic duct

Question 46

Where does the common bile duct drain into?

Answer 46

The hepatopancreatic ampulla (ampulla of Vater)

Question 47

What is the hepatobiliary triangle?

Answer 47

An anatomical space formed by the common hepatic duct, the cystic duct, and the inferior border of the liver

Question 48

What does the hepatobiliary triangle contain?

Answer 48

* Cystic artery * Cystic lymph node (Lund's node)

Question 49

Why is the hepatobiliary triangle important during cholecystectomy?

Answer 49

To prevent damage to the cystic artery and extrahepatic biliary system

Question 50

What is the Calot triangle?

Answer 50

An anatomical space formed by the common hepatic duct, the cystic duct, and the cystic artery

Question 51

What does the portal triad consist of?

Answer 51

* Hepatic artery * Portal vein * Common bile duct

Question 53

What is the primary germ layer from which the embryonic liver is derived?

Answer 53

Endoderm

Question 54

During which week of embryonic development does the liver start to develop?

Answer 54

4th week

Question 55

What is the hepatic diverticulum also known as?

Answer 55

Hepatic bud

Question 56

From what structure does the bile duct arise?

Answer 56

Hepatic diverticulum

Question 57

What does the bile duct connect with?

Answer 57

Midgut

Question 58

From what does the gallbladder and cystic duct form?

Answer 58

Ventral outgrowth of the bile duct

Question 59

True or False: The gallbladder forms from the hepatic diverticulum.

Answer 59

False

Question 60

Fill in the blank: The gallbladder and cystic duct form from a _______ of the bile duct.

Answer 60

ventral outgrowth

Question 61

What are the components of the biliary duct system leading to the gallbladder?

Answer 61

Hepatocytes, Bile, Bile canaliculi, Herring's ducts, Interlobular Biliary ducts, Collecting Bile Ducts of interhepatic portal triads, R. and L. hepatic ducts, Common Hepatic duct, Cystic ducts, Common Bile Duct

Question 62

What is the length of the Common Bile Duct?

Answer 62

5-15 cm

Question 63

What forms the Hepatopancreatic Ampulla?

Answer 63

Common Bile Duct and Pancreatic main duct of Wirsung

Question 64

What is the function of the Sphincter of Oddi?

Answer 64

Guards the entrance of the Hepatopancreatic Ampulla into the duodenum

Question 65

What is the function of the Sphincter of Bayden?

Answer 65

Contracts to back up bile into the cystic duct for storage in the gallbladder

Question 66

What is the arterial supply for the gallbladder?

Answer 66

Cystic artery, Right hepatic artery, Posterior superior Pancreaticoduodenal artery, Gastroduodenal artery

Question 67

What is the venous drainage for the gallbladder?

Answer 67

Posterior superior Pancreaticoduodenal vein, Other parts directly from liver

Question 68

What is the average volume of bile stored in the gallbladder?

Answer 68

~50mL

Question 69

Describe the anatomical location of the gallbladder.

Answer 69

Lies in fossa for gallbladder on the visceral surface of the liver, at the junction of the left and right livers

Question 70

What are the three parts of the gallbladder?

Answer 70

* Fundus * Body * Neck

Question 71

What is the function of the Spiral valves (Heister's valves) in the cystic duct?

Answer 71

Helps keep cystic duct open and offers resistance to sudden dumping of bile

Question 72

What supplies blood to the gallbladder and cystic duct?

Answer 72

Cystic artery

Question 73

What drains the neck and cystic duct of the gallbladder?

Answer 73

Cystic veins

Question 74

What lymph nodes are involved in the lymphatic drainage of the gallbladder?

Answer 74

Hepatic lymph nodes, Cystic lymph nodes

Question 75

What is the sympathetic innervation for the gallbladder?

Answer 75

Celiac nerve plexus

Question 76

What is the parasympathetic innervation for the gallbladder?

Answer 76

Vagus nerve, right Phrenic nerve

Question 77

What is the role of Cholecystokinin (CCK) in gallbladder function?

Answer 77

Stimulates contraction of the gallbladder and relaxation of sphincters

Question 78

Fill in the blank: The gallbladder is a _______ shaped organ.

Answer 78

pear

Question 79

True or False: The fundus of the gallbladder is completely surrounded by peritoneum.

Answer 79

True

Question 80

What is Hartmann's pouch?

Answer 80

Dilation/pouch at the junction of the neck of the gallbladder and the cystic duct in diseased states