Biliary system test

Question 1

lithiasis

Answer 1

formation of stones

Question 2

function of galbladder

Answer 2

stores and recieves bile from liver

Question 3

body habitus and where galbladder is for each one

Answer 3

hypersthenic - high RUQ (very lateral)
sthenic - low RUQ (more medial)
hypo sthenic - (almost in line with MSP, low RUQ)
asthenic - in line with MSP, high RLQ

Question 4

when is the straification of stones seen

Answer 4

seen in upright and decubitus positions

Question 5

what mimics stones in an exam?

Answer 5

air bubbles

Question 6

where does the pancreas sit in body habitus

Answer 6

up and high the bigger the patient, goes down the smaller

Question 7

what quadrant does the pancreas lie in?

Answer 7

head lies in the RUQ/inline with MSP, tail lies in the LUQ

Question 8

what does the sphincter of oddi control?

Answer 8

muscular valves that regulates bile flow
also controls CBD and the hepatic duct

relaxes to allow bile flow into duodenum

made of smooth muscle

Question 9

choleangiography with a stent is done when?

Answer 9

after surgery for stent

pigtail done durign laproscopic
t-tube during open surgery

Question 10

stratification of stones in galbladder
what positions can you put them in to see them?

Answer 10

seen in upright and decubitus positions and RPO

Question 11

bile duct anatomy

Answer 11

common hepatic duct
-
cystic duct (connected to galbladder directly)
-
common bile duct

Question 12

ampulla of vater is formed by what two things

Answer 12

common bile and pancreatic duct

Question 13

which duct allows bile travel in two directions

Answer 13

cystic duct (in galbladder and out of it)

Question 14

what does bile do

where is it secreted

what vitamins does it help absorp?

Answer 14

surfactant that aids in absoprtion of fat soluble vitamins like A,D,E, and K

It’s secreted into the duodenum
Excretion of bilirubin

Question 15

cholecystokinen function hormone what what secretes that

Answer 15

contract galbladder and stimulates the relase of bile with a fatty meal

Question 16

T tube = what procedure
stent = what procedure
needle = what procedure
scope = what procedure

Answer 16

T tube = postoperative cholangiography where stent is placed to drain
stent = T tube/postoperative cholangiography
needle = percutaneous transhepatic cholangiography
scope = ERCP endoscopic retrograde cholangiopancreatography

Question 17

identify the strcutres of the biliary system

Answer 17

n

Question 18

contrast agent used for a GI series

Answer 18

radiopaque contrast agent

WITH SUSPECTED PERFORATION USE WATER SOLUBLE

Question 19

what is a portahepatis

Answer 19

portion of the liver in which the ducts and vascular structures enter and leave the liver.

Question 20

what does not indicate a moderate reaction of contrast?
(mild, moderate, severe)

Answer 20

mild: sensation of warmth, metallic, sneezing
moderate: nausea, vomit, itching, wheezing, hypertension
severe: anaphylactic reaction, cardiac event, respiratory crisis

Question 21

acute calculous cholecystitis
vs
acute acalculous cholecystitis

fever/stone and what it is

Answer 21

calculous - cystic duct blocked with stone causing inflammation/bacterial infection BUT NO FEVER
acalculous - inflammation without stone involvement but critically ill patients have a fever

Question 22

purpose of glucagon

Answer 22

Elevates the concentration of glucose and fat in the bloodstream

Question 23

ERCP - endoscope usage allows a catheter to be inserted into what anatomy?

Answer 23

the ampulla from the duodenum so that the contrast can be injected retrograde