Biliary System/ Pancreas

What does the biliary system consist of

gallbladder, inter and intrahepatic bile ducts

What joins to form the common bile duct

Common hepatic duct joins cystic duct

Gallbladder is divided into

fundus, body, neck

Where is the gallbladder fossa

posteroinferior portion of the right lobe of liver

Where is the main lobar fissure

between the portal vein and gallbladder

What forms the common hepatic duct

right and left hepatic ducts join

Cystic duct contains mucosal folds called

spiral halves of Heister

What does the spiral halves of Heister do

help move bile in the correct direction

What does the cystic duct connect

connects gallbladder and common hepatic duct

A patient with gallbladder removed can have a CBD measuring 

1-10mm

Normal measurement of the CBD

1-7mm

Where does the common bile duct enter the duodenum

Ampulla of Vater

The sphincter of Oddi

regulates flow of bile into duodenum

What stimulates the GB to contract with fat and amino acid ingestion

cholecystokinin 

What makes up the Mickey Mouse sign

portal vein, common bile duct, and hepatic artery

What structures of the portal triad enter the liver

hepatic artery and portal veinW

What portal triad structure leaves the liver

CBD

Postive Murphys sign 

if patient reacts to pressure 

Why is sonography not the best imaging modality for pancreas

lies in the “C” loop of the duodenum

Most of pancreas is

retroperiteneal

How does the CBD run with the pancreas

posterolateral portion of the pancreas

How does the Gastroduodenal artery sit in regard to pancreas 

anterolaterally

Neck of pancreas is located

anterior to the SMV

Anterior to the portal splenic confluence

Body of pancreas lies

anterior to the aorta, SMA, and SV

Tail of pancreas is situated

between the stomach anteriorly and left kidney posteriorly

How does the SV run in regards to the tail of pancreas

posterosuperior 

Where is the uncinate process located

posterior to the SMV and anterior to the IVC

What percent of the pancreas is exocrine

90%

Amylase breaks down

carbs

Lipase breaks down 

fats

Trypsin breaks down

proteins

Beta cell correlates to what hormone

insulin

What action does beta cell have`

turns glucose to glycogen

What is the alpha cell hormone

Glucagon  

What is the action of the alpha cell

turns glycogen to glucose

What is the normal appearance of the pancreas

homogenous, hyperechoic compared to the liver

Annular pancreas

ring of pancreatic tissue surrounds 2nd portion of duodenum

Ectopic pancreas 

pancreatic tissue without vascular connection to pancreas