Abdomen Ch 5 Pathology Flashcards by Bria Maples

The lining of the abdomen

Peritoneum

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Lining attached to abdominal organs

visceral peritoneum

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Churns gastric content and propels it toward pylorus

Peristalsis

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Appears as longitudinal lines within the stomach–Only can see when empty

Rugae

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How each section of the small bowel will appear radiographically?

Duodenum-transverse rigid appearance
jejunum-appears delicate and feathery
Ileum-folds look like those of the duodenum but not as large in diameter

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What are two things always present on an abdominal image of an un-prepped patient?

Gas patterns

- Fecal Matter

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Presence of air-fluid levels on an erect image of normal patients?

Few if any air fluid levels

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Where gas patterns are normally only seen at on an adult patient?

stomach

- colon

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What image is taken to show air-fluid levels when patient cannot stand?

left lateral decubitus

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What does endoscopy do?

Allows for the visualization of both ends of the internal surfaces of the GI system

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What does endoscopy use?

Lighted instruments with optics to visualize diseases of GI system

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When thick barium is used on the esophagus?

When esophagus is single object of study

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When is thin barium used on an esophagus?

When esophagus is studied as part of the GI system along with other parts

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What is difficult swallowing known as? It is also the most common chief complaint when performing esophagrams?

Dysphagia

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What does an UGI procedure evaluate>

Contour, position, rugae, and peristaltic changes

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When a stoma is surgically created in the abdominal wall to allow drainage of bowel contents in a pouch located on the outside of the body

Colostomy

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What is a common indication for ileostomy?

ulcerative colitis

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What 2 conditions CT of the colon is commonly done to evaluate?

Diverticulitis

- appendicitis

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Why endoscopic procedures are used on GI system?

Used to look inside GI tract and other hollow organs and cavities of the body

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What’s a contraindication for capsule endoscopy?

Bowel obstruction

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What gastric tubes are used for?

Aspiration of gastric contents
Decompression and removal of contents
Nutritional support
Medication Administration

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Congenital absence or closure of a normal body orifice or tubular organ?

Atresia

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When the esophagus fails to develop past some point?

Esophageal atresia

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Abnormal tube like passage?

Fistula

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What's the radiographic appearance of bowel atresia?

Double bubble sign- gaseous distension of the stomach creates one bubble and gas in proximal duodenum creates a second bubble

What is an imperforate anus?

COngenital disorder in where there is no anal opening to the outside

What's the common area of fistula in boys and girls?--Imperforate anus

Boys- between bowel and urethra | Girls-between bowel and vagina

What is hypertrophic pyloric stenosis?

Congenital anomaly of stomach where pyloric canal leading out of stomach is greatly narrowed

Is hypertrophic pyloric stenosis the most common indication for surgery in infants?

Yes

Who does hypertrophic pyloric stenosis most commonly effect?

first born males

What are the signs and symptoms of hypertrophic pyloric stenosis?

Projectile vomiting at 2-6 weeks. Infants often becomes dehydrated and fails to gain weight

With hypertrophic pyloric stenosis what does an UGI evaluates?

Demonstrates delayed gastric emptying accompanied by a classic string sign as the barium trickles through the narrowed elongated pyloric canal

The complete reversal of ALL the abdominal organs is called?

Situs Inversus

What is Hirschsprung's Disease?

Theabsence of neurons in bowel wall, typically sigmoid colon primarily affecting men

Hirschsprung's Disease also referred to as

Congenital megacolon

What is toxic megacolon?

Develops from bacterial overgrowth leading to fluid and electrolyte imbalances in the infant that could result in death

What is Meckel's Diverticulum?

Congenital diverticulum of distal ileum

What does Meckel's diverticulum symptoms mimic?

Appendicitis except for location of pain

What esophageal strictures are commonly secondary to?

Ingestion of caustic material

What is GERD?

Results from an incompetent cardiac sphincter allowing the backwards flow of gastric acid and contents into the esophagus

IS reflux always considered abnormal?

Not necessarily

What are the treatments for GERD?

Elevate the head o the bed, avoid drinks such as coffee and alcohol that stimulate acid secretions, avoid foods such as cholate that decrease sphincter competence, avoid smoking, anatacids was to gastric acids out of the esophagus for pain relief and medical therapy, surgery is used as a last result

What is a peptic ulcer?

an erosion of the mucous membrane of the lower end of the esophagus, stomach, or duodenum

Where are peptic ulcer is most commonly located?

The duodenal bulb and lesser curvature of stomach

What is the radiographic appearance of a peptic ulcer?

Radiating spike like wheels of mucosal folds that run to the edge of the crater

What is gastroenteritis?

Inflammation of the mucosal lining of the stomach and small bowel... General grouping of a number of inflammatory disorders

What is gastroenteritis radiographic appearance?

Slit like collection of barium surrounded by radiolucent holds of swollen elevated mucosa

What is Chron's Disease or Regional Enteritis?

Chronic inflammatory disease with unknown etiology

What is the Radiographic appearance Crohn's disease/regional enteritis?

Cobblestone appearance when there's ulcers. String sign seen when ileum is so diseased and stenotic that barium just trickles through opening

What is the most common abdominal surgery performed in the US?

Appendicitis- appendectomy

Inflammatory lesions of colon, mucosa, unknown etiology(thought to be autoimmune) 4xs more likely to occur in white Jewish people, typically affecting 15-25 year olds--develop excessive diarrhea with blood, pus, and mucous

Ulcerative Colitis

What are esophageal varices?

Abnormally dilated lengthened superficial veins of the esophagus

What is the radiographic appearance of esophageal varices?

Worm-like defects within the thin barium suspensory

When Esophageal varices are to be viewed is thick or thin barium used?

Thin because thick can cover the appearance of the varices

A protrusion of a loop of bowel thru a small opening usually the abdominal wall-- occurs because of the anatomic weakness

hernia

Common in men--occurs when a bowel loop protrudes through a weakness in the inguinal ring and may descend downward into the scrotum

Inguinal Hernia

When a herniated loop of bowel can be pushed back into the abdominal cavity

Reducible hernia

When the herniated loop becomes stuck and cannot be reduced

Strangulated hernia

What is a hiatal hernia?

It occurs in about 1/2 the population of people over the age of 50- happens when there's a weakness of esophageal hiatus that permits some portions of stomach to herniate into the thoracic cavity

When can hiatal hernias be reduced?

in early stages

What is the most common appearance of a mechanical bowel obstruction?

Gas confined to the small bowel with multiple air fluid levels visible on an upright abdomen indicates a mechanical bowel obstruction

In a mechanical bowel obstruction what does emesis containing bile indicate?

A mechanical obstruction

When a gallstone erodes from the gall bladder and creates a fistula to small bowel

gallstone ileus

Twisting of bowel loop about its mesenteric base (or on itself)

volvulus

When does intussusception occur?

When a segment of bowel, constricted by peristalsis telescopes into a distal segment and is driven further into the distal bowel by peristalsis

What is the radiographic appearance of intussusception?

Coiled spring--this is common in infants and children

Failure of normal peristalsis. Gas distributed throughout both the large and small bowel is indicative of a _____

paralytic ileus

When does a paralytic ileus occur?

After surgeries that require bowel manipulation

A pouch or sac of variable size that occurs normally or is created but herniation of a mucous membrane through a defect in its muscular coat

diverticula

A pulsion type found at pharyngoesophageal junction at the upper end of the esophagus

Zenker's Diverticulum

When is a colonic diverticulae seen in which portion of the colon?

sigmoid colon 95%

Colonic diverticulae is sometimes referred as?

left sided appendicitis

Where do esophageal tumors occur?

lower 1/3 of esophagus, but can occur anywhere

What is a leiomyoma?

benign smooth muscle tumors

What is the only successful treatment for stomach tumors?

surgical removal

What are colon polyps?

Small masses of tissue arising from bowel wall that project inward into the lumen

What two ways do colon polyps attach to the colon?

- sessile-attached directly to bowel wall with wide base | - pedunculated-attached by narrow stalk

What is the radiographic appearance if colon polyps?

Rounded filing defect or contour defect in the barium shadow

Predisposing factors of colon cancer

family history and ulcerative colitis

Radiographic appearance of colon cancer?

"apple core" commonly called apple core lesion