RAD-146 BILIARY SYSTEM

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anatomy12
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275179
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RAD-146 BILIARY SYSTEM
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2014-06-21 14:14:15
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  1. what is the best position to view the gall bladder in profile
    right lateral
  2. the biliary system is the study of _____
    the manufacture transport and storage of bile
  3. what is bile
    it is manufactured in the liver transported by the various ducts and stored in the gallbladder
  4. what is the major function of bile
    it aids in the digestion of fats by emulsifying or breaking down fat globules and absorption of fat following their digestion
  5. what is the largest organ in the body
    liver
  6. how is bile formed
    from small lobules of the liver and travels by small ducts into the right or left hepatic duct
  7. the right and left hepatic duct join together to form the _____
    common hepatic duct
  8. List the biliary route
    • right and left hepatic ducts
    • common hepatic duct
    • common bile duct
    • pancreatic duct
    • then into duodenum
  9. what are the three main parts of the gallbladder
    which portion is most distal and broader
    • fundus neck body
    • fundus
  10. how long and wide is the normal gall bladder
    how much bile can the gallbladder store
    • 7-10cm and 3cm wide
    • 30-40 cc's bile
  11. which duct is adjacent to the neck of the gallbladder
    cystic duct
  12. what are the membranous folds along the length of the cystic duct
    how long is the cystic duct
    what is the function of this structure
    • spiral valve
    • 3-4cm
    • functions to prevent distention or collapse of the cystic duct
  13. what are the three main functions of the gallbladder
    storage: if bile is not needed for digestive purposes it is stored for future use in the GB

    concentration: bile is concentrated in the GB due to hydrolysis

    contraction:the GB normally contracts when foods such as fats or fatty acids are in the duodenum
  14. too much concentration of bile results in what?
    bile that is too concentrated can result in gallstones/choleliths
  15. Fatty foods stimulate the duodenal mucosa to secrete the hormone ______
    cholecystokinin (CCK)
  16. which duct descends and enters into the descending portion of the duodenum
    common bile duct
  17. which ducts drain bile and form into the common bile duct
    how long is the common bile duct
    • common hepatic duct and cystic duct
    • 7.5cm long
  18. what are alternative names for gall stones
    • biliary calculi
    • choleliths
  19. what is the region at the distal end of the common bile duct and the junction at the distal end of the main pancreatic duct (2 names)
    hepatopancreatic ampulla (ampulla of vater)
  20. what is the valve or area the is after the hepatopancreatic ampulla (ampulla of vater)(2 names)?
    hepatopancreatic sphincter (sphincter of oddi)
  21. the region of duodenal papilla is located where
    in the first segment of the duodenum looks like a pimple
  22. where is the gallbladder on a hypersthenic patient
    deep under the liver hardley seen
  23. what are the four advantages of medical sonography over an conventional OCG (operative cholangiogram)
    • no ionizing radiation
    • no contrast media administered
    • detects small calculi
    • less pt prep (less time consuming)
  24. what is an operative (t-tube) cholangiogram used for
    • to find undetected choleliths
    • to see if biliary ducts are open and clear no blockage
    • function of the hepatopancreatic ampulla
    • locate small lesions or strictures in biliary ducts
  25. during an operative cholangiogram after how many cc's should you make an exposure after
    after injection of 6-8cc's of contrast
  26. what is a laparoscopic cholangiogram
    procedure that involves an endoscope inserted through the umbilicus to perform a cholecystectomy and cholangiography
  27. what is a PTC
    why would it be used
    • percutaneous transhepatic cholangiography
    • for people who cannot handle anesthesia
  28. why is a PTC used (2 common reasons)
    obstructed jaundice: if patient biliary ducts are suspected to be dilated  or obstruction to biliary ducts cause by a stone or stenosis

    stone extraction and biliary drainage
  29. is anesthesia used for a PTC
    • no because it is an outpatient test
    • it is less invasive and cost less
  30. what the risks of a PTC
    • liver hemorrhaging
    • possible pneumothorax
    • bile may escape into peritoneal cavity leading to inflammation of surrounding tissue
  31. what does ERCP stand for
    endoscopic retrograde cholangiopancreatography
  32. what is the purpose of an ERCP (3 reasons)
    • investigate patency of biliary/pancreatic duct
    • reveals any choleliths not previously detected
    • demonstrates small lesions structures or dilations within the biliary/pancreatic ducts
  33. administration of contrast media is delivered where in each of these exams:
    operative or laparoscopic cholangiogram
    T-tube cholangiogram
    PTC
    ERCP
    • operative or laparoscopic cholangiogram: direct injection through catheter during surgery
    • T-tube cholangiogram: direct injection though indwelling drainage tube
    • PTC: direct injection by needle puncture through liver into the biliary ducts
    • ERCP: direct injection though catheter placed during endoscopic procedure
  34. where is the CR for a general GB or Biliary Duct position PA (scout)
    If 14x17 was used where would u center
    breathing?
    • 10x12
    • CR perp to level of l2 (1'' above lower rib margin and 2'' to right of MSP
    • at crests like KUB
    • Suspend respiration on expiration
  35. for a PA scout of GB the CR would be where for a hypersthenic and asthenic patient
    • hypersthenic = 2'' higher
    • asthenic = 2'' lower
  36. what structure is best shown in a rt lateral decubitus
    • stratification of choleliths
    • GB below vertebral column
  37. what is the degree of obliquity for an LAO GB
    is there more or less for a hypersthenic and asthenic pt
    what os the breathing
    • 15-40
    • less for hypersthenic more for asthenic
    • expose on expiration
  38. what does an LAO visualize of the GB
    GB opacified and projected away from vertebral column
  39. what other position visualizes stratification lines of the choleliths
    where is the CR for this position
    for the pa erect position of the GB on an asthenic patient where is the CR and rotation of body
    • pa erect
    • same as prone pa
    • asthenic: 2'' lower and rotate 10-15 degrees
  40. where is the t -tube place during this procedure
    inside the common bile duct
  41. cholangiogram
    cholecystocholangiogram
    choleliths
    • radiographic examination of biliary ducts
    • study of both the gallbladder and the biliary ducts
    • gallstones
  42. cholelithiasis
    cholecystitis
    cholecystectomy
    • condition of having gallstones
    • inflammation of the galbladder
    • surgical removal of gallbladder
  43. how much barium is needed for a small bowel series
    what is the intervals for each radiograph, when does it start
    • 16oz barium
    • 30-1hr at time of ingestion by the patient
  44. what is the air or chemical agent used in a contrast enteroclysis procedure
    how much is needed
    • methylcellulose
    • 90 ml
  45. in a supine position the barium and air are where
    • barium in ascending and descending colon
    • air in recto sigmoid colon and transverse colon
  46. in the prone position where is the barium and air
    • air ascending and descending colon
    • barium in sigmoid and transverse
  47. how much bile is produced a day
    1qt
  48. a small bowel series is a study of the _______ only
    small intestines
  49. list the quadrants of the following
    Duodenum:
    Jejunum:
    Ileum:
    Ileocecal valve:
    • RUQ and LUQ
    • LUQ and LLQ
    • RUQ, RLQ, and LLQ
    • RLQ
  50. what is the shortest and wider portion of the SI
    which is the longest but smaller in diameter
    • duodenum 10in
    • ileum
  51. the transverse colon is _______
    the ascending descening and rectum are _______
    • intraperitoneal
    • retroperitoneal
  52. where is the CR for SBS pa projection for a 15-30min radiographs
    and hourly radiographs?
    • 2in above iliac crests
    • iliac crests
  53. Methylcellulose is introduced into the small
    intestine during
    enteroclysis
    to _____
    A.Dilate the loops of small intestine
    B.Reduce peristalsis
    C.Increase peristalsi
    D.Reduce bowel spasm
    A. Dilate the loops of SI
    (this multiple choice question has been scrambled)

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