ARDMS/Edelman Main Biliary Tract Anatomy & Pathology

The right and left hepatic ducts join to form
the common hepatic duct (CHD)

The gallbladder is located at the ________ end of the main lobar fissure

The gb neck tapers to form
the cystic duct

The cystic duct joins with the _________ to form the ______
common hepatic duct (CHD); CBD

What two ducts join to form the ampulla of Vater?
CBD and the main pancreatic duct (Duct of Wirsung)

What fold controls bile flow in the cystic duct?
Valve of Heister

Abnormal diverticulum of the neck of the gallbladder
Hartmann’s pouch

Fold between the body and neck of the gallbladder
Junctional fold

The CBD passes __________ to the ________ part of the duodenum.
posterior; first

The ampulla of Vater empties through the duodenal papilla, controlled by the __________
sphincter of Oddi

M/c cause of wall thickening?

Made up of calcium bilirubinate granules and cholesterol crystals

Non-shadowing, mobile, echogenic material in a non-contracted gallbladder

WES sign can also be referred to as
double arc

Wall inflammation of the gallbladder due to cystic duct obstruction by a gallstone
acute cholecystitis

Associated with cholelithiasis (90-95% of patients) and acalculosous
acute cholecystitis

Increased amylase in acute cholecystitis suggests obstruction at the level of the ________
ampulla of Vater

Acute cholecystitis due to gb wall ischemia and infection

Gb wall thickening that occurs commonly in diabetic men; high occurrence of gangrene

Gas is found in this type of gb wall thickening, causing a comet-tail sign

Purulent material in the gb due to bacteria-containing bile asso/w acute wall thickening

Presents with the same symptoms of acute cholecystitis. but with fever

Localized collection of fluid around the GB; caused by acute cholecystitis

Acute cholecystitis without the presence of gallstones. Typically a secondary event in hospitalized patients. Asso/w surgery, trauma, burns, sepsis, AIDS
acalculous cholecystitis

Sludge-like material with a high concentration of calcium
milk of calcium bile (limy bile)

Sludge that results in distal acoustic shadowing. Asso/w chronic cholecystitis and obstruction of the cystic duct.
milk of calcium bile (limy bile)

Calcification of the gb wall asso/w chronic cholecystitis
porcelain gb

Known as mucocele of the gallbladder

Overdistended gb filled with mucoid or clear, watery substances. Asymptomatic and palpable

Hydrops is suggested with a transverse diameter

Polyps greater than _______ are likely to be cancerous

Lipids are deposited in the gb wall that appear as polyps. Lacks reverberation artifact.
cholesterolosis (strawberry gallbladder)

Symptoms mimic cholecystitis. Associated findings include a porcelain gallbladder
gb carcinoma

Hyperechoic changes in the gb wall causing overgrowth of the mucosa. Creates diverticula. Asso/w comet tail artifact

In most situations, biliary obstruction is due to pathology in the _________
distal CBD

__________ and _______ are the two most common lesions of biliary obstruction.
gallstones; carcinoma of the head of the pancreas

Biliary obstruction presents with increased _____, _______, and ____.
ALP, direct bilirubin, GGT

“Parallel channel sign” or “Shotgun sign”
dilated intrahepatic ducts

Cholecystokinin causes the gb to ________

M/C location for an obstructive stone?
distal CBD

Obstruction where only the common hepatic duct and the intrahepatic duct will dilate.
common hepatic obstruction

Obstruction where only the intrahepatic ducts dilate. Asso/w Klatskin’s tumors
obstruction at the junction of the rt and lt hep ducts

Calculi in the bile ducts

Complications of choledocholithiasis include ______. ________, ______, and increased ______
cirrhosis, cholangitis, pancreatitis, ALP

Impacted stone in the cystic duct causing exstrinsic compression of the common hepatic duct
mirizzi syndrome

Primary sclerosing cholangitis is the most common predisposing condition of

Cholangiocarcinoma typically originates within the ____________
extrahepatic biliary ducts (CBD or CHD)

Bacterial infection superimposed on an obstruction of the biliary tree

Suspected when jaundice persists beyond 14 days of age
biliary atresia

Air in the biliary tract

Cyst of the intra or extrahepatic bile ducts that are most common in asia
choledochal cysts

Type V choledochal cyst characterized by multifocal segmental dilitation of the intrahepatic bile ducts
caroli’s disease

M/C cause of malignant neoplasm obstructing the biliary tree
pancreatic adenocarcinoma

Adenocarcinoma of the head of the pancreas typically causes
courvoisier gallbladder

Conjugated bilirubin + unconjugated bilirubin =
total bilirubin

______ increases in diseases that impair bile formation, specifically bile duct obstruction

Bile thickening occurs within the ducts of ______

Term Definition Promotion The positive communication a business has with its customers. Product Promotion Promotion of a store’s merchandise. Institutional Promotion Promotion meant to heighten a store’s image. Personal Selling A type of promotion that involves the use of paid …

Who was sentenced to death in a controversial criminal trial? c. Nicola Sacco The trial and execution of Nicola Sacco and Bartolomeo Vanzetti: d. demonstrated how the Red Scare extended into the 1920s. WE WILL WRITE A CUSTOM ESSAY SAMPLE …

Inexpensive tests for frequency urination patient? Checking hormones levels – problems with pituitary or adrenal gland Blood test to check for hormone levels Measure urination quantity Physical exam for hydration status, checking blood pressure Perform a prostate examination Giardia does …

Palpate bony landmarks of the pelvis a. Pubic symphysis b. Pubic crest – attachment for rectus abdominis c. Pubic tubercle – attachment for inguinal ligament d. ASIS e. PSIS – dimples f. Ischial tuberosity g. Crest of ilium h. Tubercle …

David from ajethno:

Hi there, would you like to get such a paper? How about receiving a customized one? Check it out