Viscera (heart, lungs, liver, gastrointestinal tract)
Gallbladder
Vesica biliaris (Vesica fellea)
- Origin
- Lodged in the gallbladder fossa on the visceral surface of the right hepatic lobe (junction of the 9th costal cartilage and lateral border of the rectus abdominis)
- Insertion
- Tapers into the cystic duct to join the common hepatic duct forming the common bile duct
- Function
- Stores, concentrates (up to 10-fold), and expels bile into the duodenum in response to cholecystokinin (CCK) release triggered by dietary fatty acids
- Innervation
- Celiac plexus (sympathetic T7-T9, parasympathetic vagus; parietal peritoneal sensory innervation via right phrenic nerve C3-C5)
- Movement & chain
- Smooth muscle contraction and biliary evacuation postprandially
- Palpation
- Murphy's sign (arrest of inspiration upon deep palpation of RUQ in acute cholecystitis); Courvoisier's sign (painless palpable gallbladder in pancreatic head cancer)
- Clinical
- Cholelithiasis (gallstones), acute calculous cholecystitis, biliary colic, empyema of the gallbladder, gallbladder adenocarcinoma.
- Segmental innervation
- T7-T9 visceral segments (referred pain to epigastrium, right infrascapular region, and right shoulder via C3-C5)
- In clinical practice
- Eliciting Murphy's sign, dietary counseling regarding fat restriction, laparoscopic cholecystectomy perioperative nursing care
- Region in the model
- Viscera (heart, lungs, liver, gastrointestinal tract)