Hepatobiliary exam - GB normal/abnormal

GB is an ____ thin-walled saccular or pear shaped structure

intraperitoneal

GB is located in the ___ of abdomen in GB

RUQ

GB is on the ___/___ surface of the liver

visceral/posterior

Gb is between the ___ lobe and ___ lobe of liver

quadrate and right

GB lies ___ to the RK and trv colon and ____ to the right lobe of liver

anterior, inferior

Normal GB measures __-__ x __-__ x __-__cm

7-10, 2-3, 3-5

Normal GB has a bile capacity of ___-___ ml

30-60

Normal GB wall should not exceed mm in thickness (normally __-__mm)

3, 1-2

GB ___ can be used for evaluation of ___ function

volume

What are the 3 layers of the GB wall?

Serosa, subserosa, mucosa

Outermost layer of GB wall =

Middle layer =

Innermost layer of GB wall =

Serosa, subserosa, mucosa

Subserosa = (what is the other name for it)

muscularis

Pocket-like invaginations of the epithelium (mucosa) into the muscularis are called?

Rokitansky-Aschoff sinuses

Rokitansky-Aschoff sinuses communicated directly with the GB ____

lumen

What are the segments of the GB?

Neck, body, fundus

What is the most distal and inferolateral portion of the GB?

Fundus

GB fundus projects below the ___ margin of the liver and is usually close to hepatic flexure of ___ and ___

inferior, colon, duodenum

GB portion between the neck and fundus & is in contact with the visceral surface of liver =

body

Portion of GB that is continuous with the cystic duct, and is oriented posteromedially towards the porta hepatis =

Neck

Cystic duct is approx __ cm long, and has a somewhat s-shape

4

What duct connects the GB neck with CHD then joins the CHD to form the CBD?

cystic duct

Cystic duct has ___ folds and spiral valves of ___, that help it prevent kinking/collapsing

mucosal, Heister

Hartmann’s pouch = forms when the __ of the GB folds in on itelf

neck

Phrygian cap = forms when the ___ of the GB folds or kinks on itself

fundus

Junctional fold = forms when the GB folds on itself in the region where the ___ and ___ meet

neck, body

What is the most common normal GB variant?

Junctional fold

What is it called when the GB is completely embedded in hepatic tissue, mimicking a liver cyst?

Intrahepatic GB

Double GB is ___ and is more common in __

rare, women

Double GB is usually one ___ and one ___-functional

functional, non

What artery supplies the GB with blood?

cystic artery

the cystic artery is a branch of the ___ ___ artery

right hepatic

What vessel drains the GB?

cystic vein

cystic vein drains directly into the ___ vein

portal

The GB functions as a reservoir to ___ and ____ bile until needed

store, concentrate

Bile is continually formed by hepatocytes in the liver, ___-___ ml/day

500-1000

Bile contains a few products, what are they?

water, cholesterol, bile salts, bilitubin, lecithin, inorganic ions, mucoproteins

What transports bile from liver or GB to duodenum?

bile ducts

bile ducts are divided into ___ and ___ portions

intrahepatic, extrahepatic

Intrahepatic ducts contain ___ and ___ hepatic ducts

left, right

Extrahepatic ducts include ___ and ___

CHD, CBD

What gived bile ducts their echogenic appearance?

Connective tissue sheath surrounding them