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Biliary Sludge
A bile duct is any of a number of long tube-like structures that carry bile, and is present in most vertebrates. The bile duct is separated into three main parts: the fundus (superior), the body (middle), and the neck (inferior). Bile is required for the digestion of food and is secreted by the liver into passages that carry bile toward the hepatic duct. It joins the cystic duct (carrying bile to and from the gallbladder) to form the common bile duct which then opens into the intestine. Structure The top half of the common bile duct is associated with the liver, while the bottom half of the common bile duct is associated with the pancreas, through which it passes on its way to the intestine. It opens into the part of the intestine called the duodenum via the ampulla of Vater. Segments The biliary tree (see below) is the whole network of various sized ducts branching through the liver. The path is as follows: bile canaliculi → canals of Hering → interlobular bile ...
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Endoscopic Retrograde Cholangiopancreatography
Endoscopic retrograde cholangiopancreatography (ERCP) is a technique that combines the use of endoscopy An endoscopy is a procedure used in medicine to look inside the body. The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are insert ... and fluoroscopy to diagnose and treat certain problems of the bile duct, biliary or pancreatic ductal systems. It is primarily performed by highly skilled and specialty trained gastroenterologists. Through the endoscope, the physician can see the inside of the stomach and duodenum, and inject a contrast medium into the ducts in the biliary tree and/or pancreas so they can be seen on radiography, radiographs. ERCP is used primarily to diagnose and treat conditions of the bile ducts and main pancreatic duct, including gallstones, inflammatory strictures (scars), leaks (from trauma and surgery), and cancer. ERCP can be performed fo ...
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Hepatic Ducts
The common hepatic duct is the first part of the biliary tract. It joins the cystic duct coming from the gallbladder to form the common bile duct. Structure The common hepatic duct is the first part of the biliary tract. It is formed by the union of the right hepatic duct (which drains bile from the right functional lobe of the liver) and the left hepatic duct (which drains bile from the left functional lobe of the liver). The duct is about 3 cm long. The common hepatic duct is about 6 mm in diameter in adults, with some variation.Gray's Anatomy, 39th ed, p. 1228 Termination The common hepatic duct typically unites with the cystic duct some 1–2 cm superior to the duodenum and anterior to the right hepatic artery, with the cystic duct approaching the common hepatic duct from the right. Relations The right branch of the hepatic artery proper usually passes posterior to the duct, but may rarely pass anterior to it instead. Histology The inner surface is ...
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Cholangiocarcinoma
Cholangiocarcinoma, also known as bile duct cancer, is a type of cancer that forms in the bile ducts. Symptoms of cholangiocarcinoma may include abdominal pain, yellowish skin, weight loss, generalized itching, and fever. Light colored stool or dark urine may also occur. Other biliary tract cancers include gallbladder cancer and cancer of the ampulla of Vater. Risk factors for cholangiocarcinoma include primary sclerosing cholangitis (an inflammatory disease of the bile ducts), ulcerative colitis, cirrhosis, hepatitis C, hepatitis B, infection with certain liver flukes, and some congenital liver malformations. Most people have no identifiable risk factors. The diagnosis is suspected based on a combination of blood tests, medical imaging, endoscopy, and sometimes surgical exploration. The disease is confirmed by examination of cells from the tumor under a microscope. It is typically an adenocarcinoma (a cancer that forms glands or secretes mucin). Cholangiocarcinoma is ty ...
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Pancreatic Cancer
Pancreatic cancer arises when cell (biology), cells in the pancreas, a glandular organ behind the stomach, begin to multiply out of control and form a Neoplasm, mass. These cancerous cells have the malignant, ability to invade other parts of the body. A number of types of pancreatic cancer are known. The most common, pancreatic adenocarcinoma, accounts for about 90% of cases, and the term "pancreatic cancer" is sometimes used to refer only to that type. These adenocarcinomas start within the part of the pancreas that makes digestive enzymes. Several other types of cancer, which collectively represent the majority of the non-adenocarcinomas, can also arise from these cells. About 1–2% of cases of pancreatic cancer are neuroendocrine tumors, which arise from the hormone-producing neuroendocrine cell, cells of the pancreas. These are generally less aggressive than pancreatic adenocarcinoma. Signs and symptoms of the most-common form of pancreatic cancer may include jaundice, ...
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Jaundice
Jaundice, also known as icterus, is a yellowish or, less frequently, greenish pigmentation of the skin and sclera due to high bilirubin levels. Jaundice in adults is typically a sign indicating the presence of underlying diseases involving abnormal heme metabolism, liver dysfunction, or biliary-tract obstruction. The prevalence of jaundice in adults is rare, while jaundice in babies is common, with an estimated 80% affected during their first week of life. The most commonly associated symptoms of jaundice are itchiness, pale feces, and dark urine. Normal levels of bilirubin in blood are below 1.0  mg/ dl (17  μmol/ L), while levels over 2–3 mg/dl (34–51 μmol/L) typically result in jaundice. High blood bilirubin is divided into two types: unconjugated and conjugated bilirubin. Causes of jaundice vary from relatively benign to potentially fatal. High unconjugated bilirubin may be due to excess red blood cell breakdown, large bruises, gen ...
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Bilirubin
Bilirubin (BR) (adopted from German, originally bili—bile—plus ruber—red—from Latin) is a red-orange compound that occurs in the normcomponent of the straw-yellow color in urine. Another breakdown product, stercobilin, causes the brown color of feces. Although bilirubin is usually found in animals rather than plants, at least one plant species, '' Strelitzia nicolai'', is known to contain the pigment. Structure Bilirubin consists of an open-chain tetrapyrrole. It is formed by oxidative cleavage of a porphyrin in heme, which affords biliverdin. Biliverdin is reduced to bilirubin. After conjugation with glucuronic acid, bilirubin is water-soluble and can be excreted. Bilirubin is structurally similar to the pigment phycobilin used by certain algae to capture light energy, and to the pigment phytochrome used by plants to sense light. All of these contain an open chain of four pyrrolic rings. Like these other pigments, some of the double-bonds in bilirubin isomer ...
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Gallstone
A gallstone is a stone formed within the gallbladder from precipitated bile components. The term cholelithiasis may refer to the presence of gallstones or to any disease caused by gallstones, and choledocholithiasis refers to the presence of migrated gallstones within bile ducts. Most people with gallstones (about 80%) are asymptomatic. However, when a gallstone obstructs the bile duct and causes acute cholestasis, a reflexive smooth muscle spasm often occurs, resulting in an intense cramp-like visceral pain in the right upper part of the abdomen known as a biliary colic (or "gallbladder attack"). This happens in 1–4% of those with gallstones each year. Complications from gallstones may include inflammation of the gallbladder (cholecystitis), inflammation of the pancreas (pancreatitis), obstructive jaundice, and infection in bile ducts ( cholangitis). Symptoms of these complications may include pain that lasts longer than five hours, fever, yellowish skin, vomiting, da ...
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Somatosensory Cortex
The somatosensory system, or somatic sensory system is a subset of the sensory nervous system. The main functions of the somatosensory system are the perception of external stimuli, the perception of internal stimuli, and the regulation of body position and balance (proprioception). It is believed to act as a pathway between the different sensory modalities within the body. As of 2024 debate continued on the underlying mechanisms, correctness and validity of the somatosensory system model, and whether it impacts emotions in the body. The somatosensory system has been thought of as having two subdivisions; *one for the detection of mechanosensory information related to touch. Mechanosensory information includes that of light touch, vibration, pressure and tension in the skin. Much of this information belongs to the sense of touch which is a general somatic sense in contrast to the special senses of sight, smell, taste, hearing, and balance. * one for the nociception detect ...
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Prefrontal Cortex
In mammalian brain anatomy, the prefrontal cortex (PFC) covers the front part of the frontal lobe of the cerebral cortex. It is the association cortex in the frontal lobe. The PFC contains the Brodmann areas BA8, BA9, BA10, BA11, BA12, BA13, BA14, BA24, BA25, BA32, BA44, BA45, BA46, and BA47. This brain region is involved in a wide range of higher-order cognitive functions, including speech formation (Broca's area), gaze ( frontal eye fields), working memory ( dorsolateral prefrontal cortex), and risk processing (e.g. ventromedial prefrontal cortex). The basic activity of this brain region is considered to be orchestration of thoughts and actions in accordance with internal goals. Many authors have indicated an integral link between a person's will to live, personality, and the functions of the prefrontal cortex. This brain region has been implicated in executive functions, such as planning, decision making, working memory, personality expression, moderating ...
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Insular Cortex
The insular cortex (also insula and insular lobe) is a portion of the cerebral cortex folded deep within the lateral sulcus (the fissure separating the temporal lobe from the parietal lobe, parietal and frontal lobes) within each brain hemisphere, hemisphere of the mammalian brain. The insulae are believed to be involved in consciousness and play a role in diverse functions usually linked to emotion or the regulation of the body's homeostasis. These functions include compassion, empathy, taste, perception, motor control, self-awareness, cognitive functioning, interpersonal relationships, and awareness of homeostatic emotions such as Hunger (physiology), hunger, pain and fatigue. In relation to these, it is involved in psychopathology. The insular cortex is divided by the central sulcus of the insula, into two parts: the anterior insula and the posterior insula in which more than a dozen field areas have been identified. The cortical area overlying the insula toward the lateral su ...
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Brain Stem
The brainstem (or brain stem) is the posterior stalk-like part of the brain that connects the cerebrum with the spinal cord. In the human brain the brainstem is composed of the midbrain, the pons, and the medulla oblongata. The midbrain is continuous with the thalamus of the diencephalon through the tentorial notch, and sometimes the diencephalon is included in the brainstem. The brainstem is very small, making up around only 2.6 percent of the brain's total weight. It has the critical roles of regulating heart and respiratory function, helping to control heart rate and breathing rate. It also provides the main motor and sensory nerve supply to the face and neck via the cranial nerves. Ten pairs of cranial nerves come from the brainstem. Other roles include the regulation of the central nervous system and the body's sleep cycle. It is also of prime importance in the conveyance of motor and sensory pathways from the rest of the brain to the body, and from the body back ...
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Vagus Nerve
The vagus nerve, also known as the tenth cranial nerve (CN X), plays a crucial role in the autonomic nervous system, which is responsible for regulating involuntary functions within the human body. This nerve carries both sensory and motor fibers and serves as a major pathway that connects the brain to various organs, including the heart, lungs, and digestive tract. As a key part of the parasympathetic nervous system, the vagus nerve helps regulate essential involuntary functions like heart rate, breathing, and digestion. By controlling these processes, the vagus nerve contributes to the body's "rest and digest" response, helping to calm the body after stress, lower heart rate, improve digestion, and maintain homeostasis. The vagus nerve consists of two branches: the right and left vagus nerves. In the neck, the right vagus nerve contains approximately 105,000 fibers, while the left vagus nerve has about 87,000 fibers, according to one source. However, other sources report sl ...
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