2.
This part of the gallbladder is the fullest most distal part of the gallbladder that usually projects below the inferior margin of the liver.
Explanation
The fundus is the correct answer because it refers to the part of the gallbladder that is the fullest and most distal, meaning it is located farthest away from the point of origin. It typically projects below the inferior margin of the liver.
3.
This part of the gallbladder is the narrowest portion located just to the right of the porta hepatis. It tapers to form the cystic duct.
Explanation
The correct answer is "neck". The explanation is that the neck of the gallbladder refers to the narrowest portion of the organ, which is located just to the right of the porta hepatis. It tapers to form the cystic duct.
4.
The gallbladder can also be _______hepatic
Explanation
The correct answer is "intra". The term "intrahepatic" refers to something that is located within or inside the liver. In this context, it means that the gallbladder can also be located within the liver.
5.
The right and left main hepatic ducts merge to form the _____________ _____________ duct.
Explanation
The right and left main hepatic ducts come together to create the common hepatic duct.
6.
The gallbladder contracts in response to what?
Explanation
Cholecystokinin (CCK) is a hormone released by the small intestine in response to the presence of fat and protein in the digestive system. It plays a crucial role in the digestion and absorption of these nutrients. When CCK is released, it stimulates the contraction of the gallbladder, causing it to release bile into the small intestine. Bile aids in the digestion and absorption of fats. Therefore, the gallbladder contracts in response to cholecystokinin (CCK).
7.
This layer of the gallbladder wall is the outermost layer of visceral peritoneum
Explanation
The outermost layer of the gallbladder wall is known as the serosa. The serosa is a thin layer of connective tissue that covers the outer surface of many organs in the abdominal cavity, including the gallbladder. It is composed of a single layer of cells called mesothelial cells, which secrete a lubricating fluid to reduce friction between organs. The serosa provides protection to the gallbladder and helps to keep it in place within the abdominal cavity.
8.
Sono AppearanceThe bile duct lumen normally appears _____________ with thin, echogenic walls. Gains may have to be _____________ slightly from those used during hepatic imaging to avoid artifactual filling (pseudo-sludge).
Explanation
The correct answer is "anechoic, decreased". In normal conditions, the bile duct lumen appears anechoic, meaning it appears black on ultrasound due to the absence of echoes. The walls of the bile duct are thin and echogenic, meaning they produce echoes and appear bright on ultrasound. However, during hepatic imaging, the gain settings may need to be decreased slightly to avoid artifactual filling or pseudo-sludge, which can create false echoes and make the bile duct appear filled with sludge.
9.
The gallbladder can also be ______ sided (situs inversus)
Explanation
The gallbladder can also be situated on the left side of the body, a condition known as situs inversus. In situs inversus, the organs of the body are mirror images of their normal positions. So, instead of being on the right side, the gallbladder is located on the left side. This is a rare condition that occurs during embryonic development and does not typically cause any health issues.
10.
Gallbladder ____________ means that a person was not born with a gallbladder.
Explanation
Agenesis refers to the absence or failure of development of a specific organ or body part. In this case, agenesis of the gallbladder means that a person was not born with a gallbladder.
11.
The ampulla of vater is controlled by the _______________ _______ _______________.
Explanation
The ampulla of Vater is a small muscular structure located at the junction of the common bile duct and the pancreatic duct. It acts as a gateway for the release of bile and pancreatic enzymes into the small intestine. The sphincter of Oddi, a circular muscle, surrounds the ampulla and controls its opening and closing. When the sphincter of Oddi relaxes, it allows the flow of bile and pancreatic enzymes into the intestine for digestion. Conversely, when it contracts, it prevents the backflow of intestinal contents into the ducts. Therefore, the sphincter of Oddi plays a crucial role in regulating the release of digestive fluids from the ampulla of Vater.
12.
The branches of the intrahepatic biliary tree converge to form a right and left __________ duct which joins to form the _______________ ______________ _____________.
Explanation
The branches of the intrahepatic biliary tree come together to create a right and left hepatic duct. These two ducts then merge to form the common hepatic duct.
13.
Using color flow doppler to follow the CBD, the CBD will or will not have color within?
Explanation
When using color flow Doppler to follow the CBD (common bile duct), the CBD will not have color within. This is because the color flow Doppler is used to visualize the direction and velocity of blood flow, not the flow within the CBD, which carries bile and not blood. Therefore, the CBD will appear without color when using color flow Doppler.
14.
The ____________ _______________ ______________ is an important landmark in locating the gallbladder especially when the gallbladder is contracted, contains no bile, or is completely filled with stones or sludge.
Explanation
The main lobar fissure is an important landmark in locating the gallbladder, particularly in cases where the gallbladder is contracted, contains no bile, or is completely filled with stones or sludge. The main lobar fissure is a prominent anatomical feature that can be used as a reference point to identify the gallbladder accurately, even in challenging situations.
15.
Name the three parts of the gallbladder, from the fullest part to the narrowest.
Explanation
The gallbladder is divided into three parts: the fundus, body, and neck. The fundus is the fullest part of the gallbladder, located at the top. It is often described as bulbous or rounded. The body is the middle part of the gallbladder, connecting the fundus and the neck. The neck is the narrowest part of the gallbladder, located at the bottom, and it connects to the cystic duct.
16.
Intrahepatic ducts are biliary _____________ that run _________________ within the portal triad. These radicals merge together to form the right and left main _____________ ducts.
Explanation
The correct answer is radicals, intrasegmentally, hepatic. Intrahepatic ducts are biliary radicals that run intrasegmentally within the portal triad. These radicals merge together to form the right and left main hepatic ducts.
17.
The gallbladder wall is measured on its ___________ surface, leading edge to leading edge.
Explanation
The gallbladder wall is measured on its anterior surface, from leading edge to leading edge. This means that the measurement is taken from the front side of the gallbladder wall, starting from one edge and ending at the opposite edge.
18.
The common hepatic duct runs anterior to the ______________ _____________ with the _____________ _________________ sandwiched between.
Explanation
The common hepatic duct runs anterior to the portal vein and hepatic artery with the hepatic artery sandwiched between.
19.
A ________________ ______________ is a fold in the fundal portion of the gallbladder causing the fundus to lie over the body.
Explanation
A phrygian cap is a fold in the fundal portion of the gallbladder that causes the fundus to lie over the body. This anatomical variation is characterized by a folding or bending of the gallbladder, resulting in the fundus being positioned over the body of the gallbladder. This can be seen on imaging studies such as ultrasound or CT scans. The term "phrygian cap" is used to describe this specific anatomical variant.
20.
An _______________ shaped gallbladder means that it has an "s" shape.
Explanation
An hourglass-shaped gallbladder refers to a gallbladder that has a distinctive "s" shape. This shape resembles an hourglass, with a narrow middle portion and wider upper and lower portions. It is important to note that the shape of the gallbladder can vary among individuals, and an hourglass shape may be considered abnormal or indicative of certain conditions. However, without further context, it is difficult to determine the exact significance or implications of an hourglass-shaped gallbladder.
21.
_____________ is a low-lying, dropping, or sagging gallbladder.
Explanation
Ptotic is the correct answer because it means a low-lying, dropping, or sagging gallbladder. This term is used to describe the abnormal position or displacement of the gallbladder, which can occur due to various factors such as weakened supporting structures or congenital abnormalities.
22.
The fat is not in the meal, the gallbladder empties ___________.
Explanation
When the fat is not present in the meal, the gallbladder does not release enough bile to aid in the digestion of fat. This results in the gallbladder emptying poorly, as it is not stimulated to contract and release bile effectively.
23.
The GDA is _______________ and _________________ to the pancreatic head.
Explanation
The GDA (gastroduodenal artery) is positioned in front of and to the side of the pancreatic head.
24.
Sono AppearanceThe CBD is an anechoic tubular structure with thin, echogenic walls. The CBD varies considerably in length and course. You may not be able to image completely in one image, however it should always be followed all the way to the _______________ _____________.
Explanation
The CBD (common bile duct) is a tubular structure with thin, echogenic (bright) walls that can be visualized using ultrasound. It is important to follow the CBD all the way to the pancreatic head, as this is its final destination. The pancreatic head is where the CBD joins with the pancreatic duct to form the ampulla of Vater, which then opens into the duodenum.
25.
The common hepatic duct joins with the _____________ duct to form the _____________ ___________ _____________.
Explanation
The common hepatic duct joins with the cystic duct to form the common bile duct.
26.
The intrahepatic ducts are not normally visualized, however should not exceed ____(#) mm near the convergence
Explanation
The intrahepatic ducts are not normally visible on imaging, but they should not exceed 2mm near the convergence. This suggests that if the diameter of the intrahepatic ducts exceeds 2mm, it may indicate a potential abnormality or obstruction in the ducts.
27.
This layer of the gallbladder wall is smooth muscle that contracts in response to cholecystokinin.
Explanation
The smooth muscle layer of the gallbladder wall is called the muscularis externa. This layer contracts in response to cholecystokinin, a hormone that is released when food enters the small intestine. The contraction of the muscularis externa helps to squeeze bile out of the gallbladder and into the small intestine, where it aids in the digestion and absorption of fats.
28.
Intrahepatic ducts are biliary _____________ that run _________________ within the portal triad. These radicals merge together to form the right and left main _____________ ducts.
Explanation
The correct answer is "radicals, intrasegmentally, hepatic". Intrahepatic ducts are biliary radicals that run intrasegmentally within the portal triad. These radicals merge together to form the right and left main hepatic ducts.
29.
Another name for the pancreatic duct is _____________ duct.
Explanation
The correct answer is "Wirsungs." The pancreatic duct is also known as the Wirsungs duct. This duct is responsible for carrying digestive enzymes from the pancreas to the small intestine, where they aid in the digestion and absorption of nutrients. The name "Wirsungs" refers to the German anatomist Johann Georg Wirsung, who first described this duct in the 17th century.
30.
An enlarged gallbladder is also called ______________.
Explanation
An enlarged gallbladder is also referred to as hydropic.
31.
_____________ _______________ is the most common variant of the gallbladder. It is a fold between the neck and body, and may appear as septations in the gallbladder.
Explanation
The most common variant of the gallbladder is the junctional fold. It is a fold located between the neck and body of the gallbladder. This fold may also appear as septations within the gallbladder.
32.
The gallbladder is located in the _________, and is pear shaped.
Explanation
The gallbladder is located in the right upper quadrant (RUQ) of the abdomen. It is a pear-shaped organ.
33.
Sono appearance
The common hepatic duct can be identified ______________ to the hepatic artery and portal vein near the porta hepatis.
Explanation
The correct answer is "anterior." The common hepatic duct can be identified anterior to the hepatic artery and portal vein near the porta hepatis. This means that it is located in front of or in front of these structures.
34.
A ______________ gallbladder is rare, and is a fold in the gallbladder that projects into the lumen.
Explanation
A septated gallbladder is rare because it refers to a condition where there is a fold in the gallbladder that projects into the lumen. This means that the gallbladder is divided into separate compartments or sections by a septum. This condition can cause complications such as increased risk of gallstones or inflammation.
35.
Ducts are measured _____________ to ______________ measuring the diameter of the lumen, not including the ___________.
Explanation
Ducts are measured from the inner to the inner walls, excluding the walls themselves, when determining the diameter of the lumen. This means that the measurement is taken from the innermost point of the duct to the innermost point on the opposite side, without including the thickness of the walls.
36.
Within the lumen of the cystic duct are the _____________ _____________ of _____________. These are not true valves, but are actual _____________ folds that function to prevent collapse or over distention of the ballbladder
Explanation
Within the lumen of the cystic duct are spiral valves, also known as Heister's valves, which are mucosal folds. These folds serve the purpose of preventing the collapse or over distention of the gallbladder.
37.
This layer of the gallbladder wall is the innermost wall made up of simple columnar epithelium
Explanation
The innermost layer of the gallbladder wall is called the mucosal layer. It is made up of simple columnar epithelium, which is a type of tissue that consists of a single layer of tall, narrow cells. This layer is responsible for producing and secreting mucus, which helps to protect the gallbladder wall from the acidic bile that is stored in the organ. Additionally, the mucosal layer also absorbs water and electrolytes from the bile, aiding in its concentration.
38.
_________________ is when there are two pear shaped parallel cystic structures.
Explanation
Duplication refers to the presence of two pear-shaped parallel cystic structures. This means that there is a duplication of a certain organ or structure in the body. It is characterized by the presence of two identical or similar structures that are positioned next to each other. This condition can occur in various parts of the body and can lead to different symptoms and complications depending on the specific organ or structure involved.
39.
Another function of the gallbladder is the disbursement of bile. High concentration of fats or partially digested proteins stimulates the intestinal mucosa to secrete the hormone ________________ or ________.
Explanation
The gallbladder has another function, which is to disburse bile. When there is a high concentration of fats or partially digested proteins in the intestines, the intestinal mucosa secretes the hormone cholecystokinin (CCK) or CCK. CCK is responsible for stimulating the gallbladder to contract and release bile into the small intestine, aiding in the digestion and absorption of fats.
40.
The CBD passes ________________ and ________________ to the pancreatic head where it joins the ______________ duct which together empty into the duodenum.
Explanation
The CBD passes posterior and lateral to the pancreatic head where it joins the pancreatic duct which together empty into the duodenum.
41.
Sono appearance-The cystic duct may occasionally be seen leaving the gallbladder ____________. Sometimes the valves of ____________ may also be seen. It is important not to confuse these echogenic mucal folds for pathology such as ___________.
Explanation
The correct answer is neck, heister, stones. In sono appearance, the cystic duct may occasionally be seen leaving the gallbladder at the neck. Sometimes the valves of Heister may also be seen. It is important not to confuse these echogenic mucal folds for pathology such as stones.
42.
The gallbladder concentrates bile. ________ and _______ ions are absorbed by mucosa.
Explanation
The gallbladder plays a crucial role in the digestion process by concentrating bile, a substance produced by the liver that aids in the breakdown of fats. In order to concentrate bile, the gallbladder absorbs water and salt ions from the bile through its mucosa. This absorption process helps to increase the concentration of bile in the gallbladder, making it more effective in digesting fats when it is released into the small intestine.
43.
The biliary system transports bile, which is continually produced by the _____________ _____________ ___________ (_______________) to the _______________ where it aids in digestion.
Explanation
The biliary system transports bile, which is continually produced by the hepatic parenchymal cells (hepatocytes) to the duodenum where it aids in digestion.
44.
The gallbladder is the storage site for bile that was produced by the _____________. The gallbladder has a storage of ____(#) - ____(#) ml.
Explanation
The gallbladder serves as a storage site for bile, which is produced by the liver. Bile is essential for the digestion and absorption of fats in the small intestine. The gallbladder has a capacity of 30 to 60 ml, allowing it to store and release bile as needed for the digestive process.
45.
CCK is responsible for...
Correct Answer(s)
A. Contraction of the gallbladder muscularis to force bile into the CBD
A. Relaxation of the sphincter of Oddi
A. Increasing bile flow from liver
Explanation
CCK, or cholecystokinin, is a hormone released by the small intestine in response to the presence of fatty acids and amino acids. It has several functions related to bile and digestion. One of its roles is to stimulate the contraction of the gallbladder muscularis, which helps to force bile into the common bile duct (CBD) and ultimately into the small intestine. Additionally, CCK relaxes the sphincter of Oddi, a muscle that controls the flow of bile and pancreatic enzymes into the small intestine. This relaxation allows for the release of bile into the CBD. Lastly, CCK also plays a role in increasing bile flow from the liver, promoting the production and secretion of bile.
46.
Sono Appearance-A normal functioning gallbladder will have _________, ___________, __________ walls, an _____________ lumen, and ___________ acoustic enhancement.
Correct Answer(s)
thin, echogenic, smooth, anechoic, posterior
Explanation
A normal functioning gallbladder will have thin walls, which means they are not thick or enlarged. It will also have echogenic walls, meaning they produce echoes when sound waves are directed towards them. The walls will be smooth, indicating there are no irregularities or abnormalities present. The lumen, or the inner space of the gallbladder, will be anechoic, meaning it does not produce echoes. Lastly, there will be posterior acoustic enhancement, which refers to increased brightness or enhancement of the tissue behind the gallbladder.
47.
This layer of the gallbladder wall is connective tissue.
Correct Answer(s)
laminar propria
Explanation
The correct answer is laminar propria. The laminar propria is a layer of connective tissue found in the gallbladder wall. It is responsible for supporting and providing structure to the gallbladder. This layer is composed of collagen fibers and blood vessels, which help to maintain the integrity of the gallbladder and facilitate its function in storing and releasing bile.
48.
The CBD should measure about _____(#) mm/decade. <___(#) mm is normal, _____(#) - _____(#) mm is prominent, and >____(#) mm is dilated. It is common to observe the CBD measurements up to ____(#) mm status post cholecystecomy.
Correct Answer(s)
1, 5, 6, 7, 8, 10
Explanation
The CBD should measure about 1 mm/decade. 5 mm is considered normal, 6-7 mm is considered prominent, and >8 mm is considered dilated. It is common to observe CBD measurements up to 10 mm status post cholecystectomy.
49.
The gallbladder is an ____________________ sac, measuring approximately _____(#) - _____(#) cm long and ____(#) cm transversely.
Correct Answer(s)
intraperitoneal, 7, 10, 5
Explanation
The gallbladder is a sac-like organ located in the abdominal cavity. It is intraperitoneal, meaning it is surrounded by the peritoneum, a membrane that lines the abdominal wall. The gallbladder measures approximately 7 to 10 centimeters in length and 5 centimeters transversely.