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Gallbladder Jeopardy

Check out myAnatomy Can you findme? OUCH! I¶ve gotRUQ pain Look what I cando!

To dilate or not to dilate-that is the question«

(CBD that is!)

100 100 100 100 100

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Name the three parts of the GBand describe location«

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W hat is the most common variant of the GB and what is it sometimesmistaken for?

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W hat is CCK and what part of the GB contracts in response?

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T he CBD enters the 2 nd

portion of the duodenumalong with what? T hroughW hat?

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Describe the appearance andgive the measurements of thewall in a normally functioninggallbladder.

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W here is the GB located and whatare the normal measurements?

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If performing a scan and thegallbladder is not visualized, whatstructure would you use as alandmark to locate it?

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W hat joins the CHD 1-2 cm above theduodenum to form the CBD and issuperior to the GB neck?

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T he CBD travels inferior and posterior to what? In a groove, located in whatrelation to the pancreatic head?

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Name three compllications of chroniccholecystitis«

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Patient presented to the ER withsudden progressive RUQ pain,

leukocytosis and increased bilirubin..

Sonogram reveals GB wall thickening,pockets of non-gravity dependenthyperechoic foci, dirty shadowing andring down artifact. W hat would mostlikely be the diagnosis?

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T he patient presents with RUQpain, fever, chills and jaundice.T he sonogram reveals massivelydilated ducts. Stones could bevisualized in the ducts along withan enlarged gallbladder. T hiscondition is referred to as?

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emale patient presented to theER with RUQ pain extending tothe right shoulder, nausea andvomiting. Ultrasound could notdetect a distended gallbladder;however a large acoustic shadowwas seen in the GB region. W hatis the most likely diagnosis?

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A 65 year old patient with ahistory of ulcerative colitispresents to the ER with RUQpain, weight loss, and fatigue.Ultrasound reveals dilatedintrahepatic biliary radicals with aCBD that measures 0.45 cm.W hat is the most likelydiagnosis?

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Bile production occurs where?

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W hat are the three functions of the gallbladder?

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W hat¶s the role of theSpiral Valves of Heister?

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W hat are the threefunctions of CCK?

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Name the pathway of bile«

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Couvasier¶s Gallbladder

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Caroli¶s Disease

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M errizzi Syndrome

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P ancreatic Cancer

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Choledocholithiasis

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undus ± most distal

Body ± between the fundus and neck

Neck ± located to the right of the

porta hepitis

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J unctional fold

Septations

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P ancreatic duct (Duct of W irsung)

A mpulla of Vater

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T hin, echogenic smooth walls

Measuring <3 mm

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RUQ

7-10 cm long

5 cm transverse

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Cystic duct

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Common Hepatic Duct

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Bouveret¶s Syndrome

Mirizzi syndrome

P orcelain GB

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Emphysematous Cholecystitis

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Klatskin T umor

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Contraction of the GB

Relaxation of the sphincter of Oddi

Increasing bile flow from the liver

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Hepatocytes bile canaliculiintrahepatic ducts(biliary radicals)

R & L main hepatic duct CHDCystic Duct GB Cystic DuctCBD 2 nd portion of the duodenum

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Dilates

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Does Not Dilate

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