The Bilary System
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Where is bile manufactdured in?
Manufactured in the liver.
Where is bile stored?
In the gall bladder?
What is the function of bile?
Aid in digestion fo fats by breaking down fat globules
Helps in the absoprtion of fat.
What si the largest organ in the body?
What quadrant is your liver located in?
Upper right quadrant
How much bile does the liver produce a day?
1 quart of bile a day
How does bile travel?
Travels by small ducts through the right or left hepatic duct
What does the right and left hepatic duct join as?
They become as the common hepatic duct
Describe the route of bile.
From the liver, bile goes through the right/left hepatic duct, then to common hepatic duct, then to common bile duct, and then to pancreatic duct, and then into the duodenum
What are the 3 parts of the gall bladder?
Fundus, body and neck
How much bile can the gall bladder hold?
What is the most distal and broadest portioin of the gall bladder?
What is the most proximal area of the gall bladder? Where does it continue?
The neck continues on and becomes the cystic duct
What is a spiral valve? What does it do?
Spiral valves are the folds inside the cystic ducts and helps prevent collapse of the cystic duct
What are the functions of the Gall bladder? What happens in each one?
: Stores biles for future use.
: Concnetrates bile due to hydrolysis.
: Contracts when food such as fats or fatty acids are in the duodenum.
Bile that is too concentrated can cause....
When is cholecystotokinin ( CCK ) secreted?
When fats or fatty acids are in the duodenum.
What does CCK's do?
They cause the gall bladder to contract and the terminal opening of the common bile duct to relax.
What is the patient prepartion for an Oral Cholecystogram?
1. Fat Free diet 1-2 days prior
2. Evening meal before exam should be LIGHT and should not contain fats or fried foods.
3. Patients should ingest 4 - 6 tablets of contrast after the evening meal.
4.. NPO after midnight
Whar are the routine projections for OCG? ( Oral Cholecystogram )
Right Lateral Decubitis
What are the 4 advantages of sonography over conventional OCG?
1. No ionizing radiation
2. Detection of small calculli
3. No contrast media
4. Less patient prepartion.
What is the purpose of operative cholangiograms?
1. If there are undetected choleltihs
2. Patency of bilar ducts.
3. Functional status of hepatopancreatic ampulla
4. If there are smal llesions or strictures of bilary ducts.
What is a laparoscopic cholangiogram?
Endoscope insereted through the umbuilicius to perform cholycystectomy and cholangiography.
What are the advantages of Laparscopic CHolangiogram
Less invasive, less hospital time, and less money
How is the T tube located?
Half of the common hepatic duct,
Other half in common bile duct
Extends out to where the gall bladder use to be.
The Bilary System