34297154-extra-hepatic-biliary-apparatus.docx

Extra hepatic biliary apparatus It is an apparatus made up for collection of bile from liver stored in gall bladder & transmits to 2nd part of duodenum It consists of 1. 2. 3. 4. 5.

Hepatic ducts Common hepatic ducts Gall bladder Cystic duct Bile duct

Hepatic ducts - there are two hepatic ducts arising from Rt & Lt lobe of liver these hepatic ducts starts from porta hepatis of liver these two hepatic ducts joins to form common hepatic ducts Common hepatic duct - it is 3 cm long it receives cystic duct to form bile duct Gall bladder - it is situated in fossa for gall bladder on the inferior surface of liver Size - it is 7 cm long & 3 cm wide Parts of gall bladder - it has a) Fundus b) Body

c)

Neck

Fundus - it is present at the level of 9th costal cartilage on the RT side it anteriorly related with anterior abdominal wall & posteriorly with beginning of transverse colon Body - is related superiorly to the liver & inferiorly to 1st part of duodenum, head of pancreas, transverse colon Neck - is narrow & shows a small dilatation i.e. pouch is known as Hartman’s pouch Inside the neck there is a spiral valve (valve of hister) which controls the release of bile from gall bladder Functions of gall bladder – 1. 2. 3. 4.

It stores the bile It concentrates the bile It release bile whenever required Bile is secretion liver not the gall bladder it is only stored in gall bladder

Blood supply – Cystic artery - it is branch of hepatic artery (branch of coeliac trunk) Venous drainage - portal vein

Lympathetic drainage - in to cystic group Cystic duct - it is continuation of neck of gall bladder it is 1’’long & it joins the bile duct the spiral valve is continue in the cystic duct Function - transport of bile to bile duct Bile duct - it is formed by union of common hepatic duct & cystic duct Length - it is 8 cm long It goes downwards in the free margin of lesser Omentum & comes to 2nd part of duodenum Here it is joined by pancreatic duct to form hepatopancreatic ampulla or duct This ampulla shows a dilatation known as ampulla of vater it opens in 2nd part of duodenum The ampulla of vater is guarded by a sphincter known as sphincter of oddi This is the junction of foregut & mid gut Blood supply 1. 2.

Mainly by branches of cystic artery Superior pancreatico-duodenal artery

Venous drainage - portal vein

Lympathetic drainage 1. 2. 3.

Cystic group Hepatic group Pancreatico-splenic group & ultimately to coeliac group

Nerve supply - cystic plexus of nerves Applied anatomy 1. 2.

3.

4. 5. 6.

7.

Inflammation to gall bladder is known as cholecystitis Formation of gall stones takes place in gall bladder this happens more commonly in fat fertile females of age group 40 – 50 yrs The pain in gall bladder is felt at the 9th costal cartilage Rt side & is known as Murphy’s sign Hartman’s pouch is common site for gall bladder stones Removal of gall bladder is called as cholecystoectomy Humeral contraction of gall bladder - gall bladder contracts when food is rich in fat enters duodenum Cholecystography