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what is the average weight of the adult human liver?
3-5 pounds
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which abdominal quadrant contains the gallbladder?
right upper quadrant (epigastrium)
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what is the name of the soft tissue structure that separates the right from the left lobe of the liver?
falciform ligament
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which lobe of the liver is larger, the right or left?
right
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list the other two lobes of the liver (in addition to right and left lobes):
- quadrate lobe
- caudate lobe
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how many functions does the liver perform?
over 100
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the average healthy adult liver produces _________ of bile per day.
- 1-3 pints per day
- 1/2 - 1 1/2 L per day
- 1 quart per day
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list the three primary functions of the gallbladder:
- store bile
- concentrate bile
- contract when stimulated
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what is the name of the hormone that causes the gallbladder to contract?
cholecystokinin (CCK)
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cholecystokinin (CCK) is secreted by the:
duodenal papilla
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what is something that typically may lead to gallstones?
concentrated levels of cholesterol in bile
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what is a common site for impaction, or lodging of gallstones?
duodenal papilla
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an older term for the main pancreatic duct is the:
duct of Wirsung
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the gallbladder is located more (posteriorly or anteriorly) within the abdomen?
anteriorly
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what is the liver's primary location within the abdomen?
to the right of the mid-sagittal plane
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on an asthenic patient, where is the gallbladder located within the abdomen?
near the mid sagittal plane
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on a hypersthenic patient, where is the gallbladder located within the abdomen?
to the right of the mid-sagittal plane
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on a hyposthenic patient, whereas the gallbladder located within the abdomen?
to the right of the midsagittal plane
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what position should the patient be placed in if the primary purpose is to drain the gallbladder into the duct system?
supine (especially RPO)
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which projection (AP or PA) would place the gallbladder closest to the image receptor for the best visualization?
PA
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which radiographic oblique position will project the gallbladder away from the spine?
LAO (20°-25°, ave)
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the prefix chole refers to:
relationship with bile (bile)
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the prefix cycsto refers to:
bag or sac (bladder)
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radiographic examination of the gallbladder is called:
cholecystogram
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radiographic examination of the biliary ducts is called:
cholangiogram
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radiographic examination of both the gallbladder and biliary ducts is called:
cholecystocholangiogram
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the acronym OCG refers to:
oral cholecystogram
-
oral types of contrast media designed to visualize the gallbladder are termed:
cholecystopagues (telepaque, most often)
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list the three biliary functions measured during an OCG:
- the functional ability of the liver to remove the contrast from the bloodstream and secrete it along with bile
- the patency and condition of the biliary ducts
- the concentrating and contracting ability of the gallbladder
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what are four contraindications for an OCG?
- advanced hepatorenal disease
- active GI disease
- pregnancy
- hypersensitivity to iodine-containing contrast agents
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true or false. most gallstones contain enough calcium to be at least minimally visualized on a plain abdomen radiograph.
-
chronic _____________ is usually associated with gallstones.
cholecystitis
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true or false. the evening meal before an OCG should contain a slight amount of fat.
- false
- slight fat in meals 1-2 days before, no fat the evening prior
-
how many hours before an OCG should the contrast tablets be taken?
10 to 12 hours
-
what is the purpose of the fatty meal or CCK study?
to cause the gallbladder to contract (by stimulating the release of CCK)
-
name a procedure that may be performed during a postoperative (T-tube) cholangiogram
removal of a biliary stone
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why is a chest x-ray commonly ordered following a PTC?
to check for a pneumothorax
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how is the contrast media introduced during a ERCP?
direct injection through a catheter placed during an endoscopic process
-
how is the contrast media introduced during a PTC?
direct injection by needle
-
how is the contrast media introduced during a T-tube cholangiogram?
direct injection through drainage tube puncture
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how is the contrast media introduced during an immediate cholangiogram?
direct injection through catheter during surgery
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how is the contrast media introduced during an OCG?
oral ingestion
-
how is the contrast media introduced during a cholecystosonography?
no contrast media required
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the gallbladder is usually found on the sthenic patient at the level of:
L2
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centering for a PA scout projection on a hypersthenic patient is usually _____________ as compared with a sthenic patient.
higher and more lateral
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which oblique position will project the gallbladder away from the spine?
LAO
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which two possible positions during an OCG will stratify any possible gallstones?
- PA erect
- right lateral decubitus
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the gallbladder is located in the _____________ -margin of the liver.
anterior inferior
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what is another name for the pancreatic duct?
Duct of Wirsung
-
what is the fundus of the gallbladder?
the broadest portion
-
what is the enlarged chamber in the distal aspect of the common bile duct?
hepatopancreatic ampulla
-
a series of mucosal folds in the cystic duct:
spiral valve
-
what type of tissue makes up the hepatopancreatic sphincter?
circular muscle
-
what makes up a protrusion into the duodenum?
duodenal papilla
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what is the duct connected directly to the gallbladder?
cystic duct
-
what part of the gallbladder makes up the neck?
the narrowest portion
-
what part of the gallbladder makes up the body?
the middle aspect
-
what type of needle is most often used for a PTC?
a skinny needle (chiba needle)
-
which of the following studies is considered an invasive procedure?
D. PTC
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