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24 Cards in this Set

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bile:
aka Gall
-made by the liver
-aid in lipid digestion
-bitter, alkaline, brownish-yellow or greenish-yellow fluid that is secreted by the liver, stored in the gallbladder, and discharged into the duodenum and aids in the emulsification, digestion, and absorption of fats
gallbladder:
-does NOT make bile, just stores it
-stimulation for release by cholecystokinin
-small, pear-shaped muscular sac, located under the right lobe of the liver, in which bile secreted by the liver is stored until needed by the body for digestion
Functional anatomy of the pancreas:
1. exocrine and endocrine gland
2. secretes amylase, lipase and trypsinogen
3. stimulated by cholecystokinin and seretin
pancreatitis:
inflammation of the pancreas caused by derangement of enzymes secreted into the gland
3 disorders of the gallbladder:
1. cholesterol gallstone formation
2. cholecystitis and cholelithiasis
3. acute cholecystitis
3 causes of cholesterol gallstone formation:
1. saturation of bile with cholesterol
2. nucleation (aggregation of crystals)
3. stone growth (stasis of bile in gallbladder)
pancreas:
-long, irregularly shaped gland in vertebrates, lying behind the stomach
-secretes pancreatic juice into the duodenum and insulin, glucagon, and somatostatin into the bloodstream
pancreatic duct:
aka Wirsung's canal
-excretory duct of the pancreas, extending through the gland from tail to head, where it empties into the duodenum
sphincter of Oddi:
-complex sphincter closing the duodenal orifice of the common bile duct
chronic pancreatitis:
-primarily in alcoholics
-caused by buildup of calcifications that destroy the parenchyma
-severe abdominal pain occurs
-Cystic fibrosis is most common cause of chronic pancreatitis in children
4 Common conditions caused by chronic pancreatitis:
1. Diabetes mellitus
2. malabsorption
3. weight loss
4. Vit K deficiency
Dx of chronic pancreatitis:
1. calcifications on xray
2. clinical picture and history
3. ERCP appearance "chain of lakes"
4. complications and symptoms similar to acute
Tx of chronic pancreatitis:
-pain control
-sphinterectomy
-stents
-surgery (fileting duct)
-pancreatic enzymes
-antacids, H2 antagonist
-management of diabetes
3 disorders of the pancreas:
1. actute pancreatitis
2. chronic pancreatitis
3. Cancers of pancreas and biliary tract
acute pancreatitis:
-rapid onset inflammation of the pancreas
-caused by biliary tract disease or alcohol (66%)
-overproduction of enzymes causing abdominal pain and tenderness
-can lead to circulatory collapse
ERCP =
Endoscopic Retrograde Cholangiopancreatography
-endoscopy of the biliary tree and the pancreatic duct
-by injection of contrast, an image of both structures can be formed on X-ray, facilitating the diagnosis of obstruction, Ex:gallstones
Dx of acute pancreatitis:
-abdominal pain and tenderness
-high levels of serum amylase and lipase
-"sentenial loop" on xray
-CT scan
-differential diagnosis
Tx for acute pancreatitis:
1. mild cases: NPO, suction, IV fluids
2. severe cases: necrosis, bacterial contamination, peritoneal lavage, laparotomy
Complications of acute pancreatitis:
1. edoscopic or surgical drainage of pseudocyst (from mass, infection, rupture, hemorrhage)
2. abscess
3. ascites caused by leakage into duct - removal by paracentesis or stent in duct
4. ERCP for radiologic evaluation, extraction of stones, sphincterectomy
cholecystitis:
-inflammation of the gall bladder, usually resulting from a gallstone obstructing the cystic duct
cholelithiasis:
-presence or formation of gallstones in the gallbladder or bile ducts
biliary colic:
-extreme cramping pain in the right upper abdomen, the area just below the chest. The pain is caused by gallstones in the gallbladder (an organ of the digestive system) or bile ducts (small tubes that drain bile from the liver into the gallbladder and small intestines)
chronic cholecystitis:
-long-standing inflammation of the gallbladder characterized by repeated attacks of pain (gallbladder attacks) over a prolonged period
-tx: avoid fatty foods
acute cholecystitis:
-sudden onset of inflammation of the gallbladder, resulting in severe, steady upper abdominal pain (biliary colic), which may occur repeatedly
-At least 95% of these pts have gallstones