Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3 Gastrointestinal System > 14 Distal GI tract pathology > Flashcards

14 Distal GI tract pathology Flashcards

1
Q

Define diarrhoea.

A

Diarrhoea= a symptom

Loose/watery stools > 3 times a day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In general terms, how might diarrhoea be caused? (2) What are the two broad categories for diarrhoea ( relate to the causes)

A
  1. Unwanted substance- gut motility and secretions stimulated to get rid of it (primarily secretion)
  2. Colon overwhelemed- cannot receive quantity of water from ileum

Categories:

  1. Osmotic
  2. Secretory
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which types of diarrhoea (osmotic or secretory) stops when fasting? Explain why?

A

Osmotic - presence of electrolytes and nutrients in bowel lumne draws water in. If nothing there to pull water in diarrhoea will stop.

Secretory- diarrhoea will continue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Give some causes of secretory and osmotic diarrhoea.

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is constipation defined as?

A

One of the following:

  • Hard stools
  • Difficulty passing stools
  • Inability to pass stools
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some risk factors for constipation? (4)

A
  1. Medication eg codeine
  2. Female:male 3:1
  3. Increasing age/ children under 4 years
  4. Low level of physical activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How is material usually moved through the large intestine during fasting and during digestion?

A
  1. Fasting: shuttle contractions- facilitate absorptive process
  2. Digestion: mass peristalsis–> propulsive waves- mass movement towards rectum for defaecation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the 3 main classes of constipations (according to physiological cause)?

A

Normal transit constipation

eg harder stools

Slow transit constipation

decreased bowel movement

Defaecation problems: pelvic floor dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How is constipation treated?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe the structure of the appendix? (inc blood supply)

A

Appendix= diverticulum off caecum

Has complete longitudinal layer of muscle

Separate blood supply to caecum- coming up through mesentery from ileocolic branchc of SMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The appendix has potentially different locations which are important to consider when thinking about the presentation of acute appendicitis. Fill in the missing labels:

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the 3 broad categories for appendicitis? How is appendicitis caused?

A

Acute (mucosal oedema)

Gangrenous (transmural inflammation and necrosis)

Perforated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the symptoms of appendicitis? Why might pain experienced be different in someone who has a pelvic or a retrocaecal appendix?

A

Remember: altered anatomy in pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why is harder to diagnose children with appendicitis?

A

History is difficult

Symptoms more non-specific

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the signs of appendicitis? What is McBurney’s point?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is appendicitis diagnosed?

A
  • History/examination
  • Blood test- WBC
  • Pregnancy test/urine dip- rule out pregnancy/UTI
  • Possibly CT with contrast
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is appendicitis treated?

A

Antibiotics

Open appendicectomy

Laparoscopic appedicectomy

18
Q

What is diverticulosis, where do the majority occur and how is it caused?

Is it symptomatic?

A

Where?

Colon- 85% sigmoid colon

Where nutrient vessels penetrate bowel wall

Symptomatic?

Asymptomatic

19
Q

What is the difference between diverticular disease and acute diverticulitis?

A

Diverticular disease= patient experiences pain but there is no inflammation/infection

Diverticulitis= diverticula are inflammed/perforate +/- bleeding and abscess formation

20
Q

In what % of people with diverticulosis does diverticulitis occur? How does diverticulitis occur?

A

25%

21
Q

Differentiate between complicated and uncomplicated diverticulitis:

A

Uncomplicated- inflammation and small absecesses confined to colonic wall

Complicated- larger abscesses, fistulas, perforation

22
Q

What are the signs and symptoms of acute diverticulitis?

A
  • Symptoms
    • Abdominal pain at site of inflammation
      • usually left lower quadrant- sigmoid colon)
    • Fever
    • Bloating
    • Constipation (inflammation can block colonic lumen)
    • Haematochezia (fresh blood- not malaena)
  • Signs
    • Tachycardia
    • Abdominal distension
    • Localised abdominal tenderness
    • Reduced bowel sounds
    • Signs of peritonitis eg nausea/vomiting
23
Q

How is acute diverticulitis investigated?

A

Blood tests- raised WBCs

Pregnancy test- exclude ectopic

Ultrasound

CT scan

Colonoscopy (BUT be careful not to cause perforation)

24
Q

How is acute diverticulitis treated? (think uncomplicated and complicated)

A
  1. Antibiotics, fluids, analgesia (may be sufficient for uncomplicated)
  2. Surgery if perforation/large abscess (-needs to be drained)
    1. Partial colectomy required if other treatments failed
25
Q

Describe the structure of the rectum and its function. What stimulates the urge to defaecate?

A

Structure:

  • 12-15cm
  • Continuous band of outer longitudinal muscle (unlike teniae coli of rest of colon)
  • Curved shaped, anterior to sacrum
  • Parts= intraperitoneal and parts= extraperitoneal

Function:

  • Temporary storage of faeces prior to defecation
  • Stretching of rectum stimulates urge to defaecate
26
Q

The blood supply to the rectum is from 3 main arteries that form a plexus. Where do these 3 main arteries branch off?

  • Superior rectal artery
  • Middle rectal artery
  • Inferior rectal artery
A
  • Superior rectal artery- inferior mesenteric
  • Middle rectal artery- internal iliac
  • Inferior rectal artery- pudendal artery
27
Q

Describe the venous drainage of the rectum.

A
  • Portal drainage- superior rectal vein
  • Systemic drainage- internal iliac vein
    • Potential for porto-systemic anastamosis
28
Q

Where is the start of the anal canal? Does it point anteriorly or posteriorly?

A
29
Q

Fill in the missing labels:

A
30
Q

What makes up the anal sphincter complex? What type of muscle is it?

A
31
Q

Outline how defecation occurs. (defecation reflex, delay/defecation)

A
32
Q

The dentate (pectinate) line is the junction between which parts embryologically? What is it the division between (type of pain receptors and type of epithelium)?

A

Junction of hindgut and proctodaeum (ectoderm)

33
Q

What are haemorrhoids (not necessarily pathological)?

A

Anal cushions= venous plexus areas

Play role in anal continence

34
Q

Haemorrhoids can be pathological- they are either internal or external. How might internal haemorrhoids (above dentate line) be caused and how do they present?

A
  • How?
    • Loss of connective tissue support
  • Presentation?
    • Relatviely painless
    • Can enlarge and prolapse through anal canal
    • Can bleed bright red blood
    • Pruritis (skin itching)
35
Q

How are internal haemorrhoids treated?

A
  • Increased hydration/high fibre diet
  • Avoid straining
  • Rubber band ligation
  • Surgery
36
Q

What are the different grades of internal haemorrhoids?

A
37
Q

Are external haemorrhoids painful? How are they treated?

A

Very painful- contains blood clot

Surgery (to treat thrombosed external haemorrhoids)

38
Q

What is an anal fissure? How can is present?

A

Linear tear in anoderm

Usually posterior midline

After passing hard stool (but not necessarily)

  • Very painful defaecation
  • Haematochezia
39
Q

How are anal fissures caused (risk factors) (2)? How are anal fissures treated?

A

Causes/risk factors:

  • High internal anal sphincter tone
  • Reduced blood flow to anal mucosa

Treatment:

  • Hydration, dietary fibre, analgesia
  • Warm baths
  • Medication (try and relax anal sphincter)
40
Q

What are some causes of haematochezia?

A
  • Diverticulitis
  • Angiodysplasia (small vascular malformation in bowel wall)
  • Colitis (IBD, infective)
  • Colorectal cancer
  • Anorectal disease
41
Q

Give some causes of malaena:

(offensive smelling- haemoglobin altered by digestive enzymes and gut bacteria)

A

3 Gastrointestinal System (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions