ABD Board-Gastrointestinal Tract Flashcards
normal intestinal wall is between _ to _ thick depending on the distention of the bowel
3 to 5 mm
4 concentric bowel wall layers (layers of the gut wall)
mucosa
submucosa
muscularis externa (external muscle layer)
adventitia or serosa
intestical pathology creates a sonographic pattern called
gut signiature known as the target or pseudokidney sign
appearance of gut signature
hypoechic external rim corresponding to thickened intestinal wall and hyperehcoic center relating to a residual gut lumen or mucosal ulceration
the segment of esophagus between the diaphragm and the stomach
gastroesophageal junction
appearance of gastroesophageal junction
on long midline view the of the epigastrum this is seen as a target sign posterior to the left lobe of the liver
refers to the presence of air within the peritoneal cavity
pneumoperitoneum
most common cause of pneumoperitoneum
perforation of the ABD viscus, most commonly by a perforated ulcer
with the patient on the supine position free peritoneal air will float ____
anteriorly
placing the transducer on the anterior ABD will result in a ________ ______ or ____ ____ ______
reverberation artifact
total sound reflection (thus absence of an image)
most common cause of acutely painful ABD
acute appendicitis
patients present with what for acute appendicitis
periumbilical pain shifting to RLQ
anorexia (loss of appetite)
leukocytosis (increased WBC)
rebound tenderness
typical location for appendix
posterior to the terminal ileum
anterior to iliac vessels
RLQ location of the appendix between the umbilicus and the iliac crest
mcburneys point
appendicitis is caused by
the obstrucioin of the appendiceal lumen by a fecalith or hyperplasia of the submucosa.
mucosal secretions increase the intraluminal pressure and compromise venous and lymphatic drainage
bacterial infection leads to gangrenen and perforation
perforation leads to peritonitis
used to displace bowel gas and decrease the distance obetween the transducer and the appendix
graded compressioin ultrasound
sonographic criteria for diagnosing an inflammatory appendix includes
non compressible
> 6 mm diameter
appendicolith (fecalith)
can be observed with an inflammed appendix
color flow hyperiemia (lots of blood flow and color)
causes a functional gastric outlet obstruction as a result of hypertrophy and hyperplasia of the muscular layers of the pylorus
hypertrophic pyloric stenosis
neonatal patient 3-8 weeks old present with what for hypertrophic pyloric stenosis
vomiting (non bloody, non bilious)
palpable “olive shaped” pylorus
visible peristalsis (wavelike movements that push contents)
pyloric wall thickness, channel length, and cross section diameter will all _______ when pyloris is hypertrophic
increase
pylorus size criteria
no strong agreement on sizes threshold for diagnosis
muscle thickness > 3 mm (3 to 4 mm)
channel length > 17 mm (14 to 24 mm )
cross section diameter > 15 mm
most accurate measurement for hypertrophic pylous
muscle wall thickness
4 mm or more considered positive but between 3 and 4 mm may also be positive especially in premature or younger neonate
most common cause of gastric outlet obstruction in neonate 4 weeks or less or in premature babies
pylorospasm
unlike HPS it is treated conservatively
