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MRT Year 1 Semester 2 > Anatomy and Pathology 2: Quiz 1 > Flashcards

Anatomy and Pathology 2: Quiz 1 Flashcards

1
Q

Accessory Digestive Organs

A
  • teeth
  • tongue
  • salivary glands
  • liver
  • gallbladder
  • pancreas
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2
Q

What moves food through the digestive system?

A

Peristalsis

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3
Q

What secures the tongue to the floor of the cavity?

A

Lingual frenulum

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4
Q

What does the tongue do?

A
  • helps form bolus (food and saliva ball)

- pushed bolus into pharynx

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5
Q

3 pairs of salivary glands

A
  • Parotid (around ear): largest, stensen’s duct opens to inner cheek
  • Submandibular (below the jaw): under tongue at angle of mandible, wharton’s duct opens onto floor of mouth on either side of frenulum
  • Sublingual (under tongue): floor of mouth anterior to submandibular glands
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6
Q

What are mumps?

A

Inflammation of parotid glands

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7
Q

3 parts of pharynx

A
  • nasopharynx
  • oropharynx
  • laryngeopharynx
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8
Q

Is the esophagus anterior or posterior to the trachea?

A

Posterior

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9
Q

What directs food into the esophagus?

A

Epiglottis

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10
Q

Soft fold of mucosa in the stomach?

A

Rugae

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11
Q

Layers of the stomach (inner to outer)

A
  • Mucosa
  • Submucosa
  • Muscularis
  • Serosa (visceral peritoneum)
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12
Q

KNOW PARTS OF THE STOMACH

A

.

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13
Q

Beginning and end of the small bowel?

A
  • pyloric sphincter

- ileocecal valve

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14
Q

What does the small bowel do?

A
  • mechanical digestion and propulsion
  • chemical digestion
  • absorption of nutrients
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15
Q

4 regions of the small bowel

A
  1. Superior
  2. Descending
  3. Horizontal
  4. Ascending
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16
Q

Which parts of the small bowel are attached to the abdominal wall by the mesentery?

A

Jejunum and Ileum

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17
Q

The ileum connects to the colon at the _______?

A

Ileocecal valve

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18
Q

Functions of the pancreas

A

Produces digestive enzymes and insulin

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19
Q

4 parts of the pancreas?

A
  • Head
  • Neck
  • Body
  • Tail
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20
Q

What does the pancreatic duct do?

A

Dumps juices into the duodenum for digestion

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21
Q

Functions of the large bowel?

A
  • Final absorption of water and formation of feces
  • Storage of feces until evacuation
  • secretion of mucous for safe passage
  • formation of some vitamins (B and K)
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22
Q

Muscular bands in the large intestine that form the haustra are called ______?

A

Teniae coli

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23
Q

Parts of the large intestine

A
  • Cecum
  • Ascending
  • Hepatic flexure
  • Transverse (most anterior)
  • Splenic flexure
  • Descending
  • Sigmoid
  • Rectum
  • Anus
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24
Q

What DI exam images the biliary tree?

A

Cholangiogram

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25
Q

What is the porta hepatis and what things are located in it?

A
  • the gateway to the liver

- contains the hepatic ducts, hepatic artery, and portal vein

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26
Q

Functions of the liver

A
  • forms bile
  • performs 200 metabolic functions including regulation of blood metabolism, cleaning up toxins, storing vitamins, ironm, and glycogen
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27
Q

Function of the gallbladder?

A

Store bile

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28
Q

What hormone signals the gallbladder to release bile?

A

Cholecystokinin (CKK)

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29
Q

What is an atresia?

A

An abnormal “blind” pouch or end where there should be an opening

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30
Q

What is a fistula?

A

An abnormal connection between 2 tubular parts of anatomy, abnormal passageway

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31
Q

What is an esophageal atresia and tracheoesophageal fistula? Symptoms/complications? Indications?

A

Esophageal atresia: Esophagus has formed with 2 blind ends, baby cannot swallow saliva
TE fistula: abnormal passage between the esophagus and the trachea
-both congenital, but can be acquired as an adult through trauma, infection, or cancer
-aspiration pneumonia, inability to swallow saliva, other congenital malformations of the skeletal, CVS, or GI systems
-CONTRAST ESOPHAGRAM IS CONTRAINDICATED
-Small radio-opaque feeding tube used to demonstrate atresia
-absence of air in the stomach for atresia
-non-contrast CT is safest

32
Q

What is Achalasia? Symptoms/complications? Indications?

A

The lower esophageal sphincter cannot relax due to compromised nervous control

  • patients complain of sternal pain and dysphagia
  • dilated proximal esophagus with absence of peristalsis leading to the “rat tail or beak like” sign on a barium esophagram
  • treated with dilatation, medication, botulinum toxin, or myotomy
33
Q

What is a foreign body? Symptoms/complication? Indications?

A

Foreign objects lodged, or food impacted in the esophagus or anywhere in GI tract

  • patient will not be able to swallow without regurgitation if object is in esophagus, obstructions lasting 12hrs + may result in perforation
  • radiopaque objects visualized with radiographs
  • poorly chewed food demonstrated after barium is swallowed
  • treated with meds, endoscopic retrieval or surgery
34
Q

What routine do we use for foreign bodies?

A

Soft tissue neck routine

  • include nasopharynx on lateral c-spin (bridge of nose), collimate out eyes
  • AP same as normal
35
Q

What is GERD? Symptoms/complications? Indications?

A

Gastroesophageal reflux disease. Any disease/condition that allows retrograde flow of stomach contents into distal esophagus causing esophagitis or structural changes to tissue
-can be caused by ingestion of caustic agents, chocolate, caffeine, alcohol, or fatty foods
-acute episodes cause esophagitis, chronic conditions can compromise peristalsis leading to scarring, ulceration, or stricture
-main symptoms are heart burn, or chest pain
-barium swallow or esophogram
Treatment involves lifestyle changes and reduction in acid-causing foods or surgery (in extreme cases)

36
Q

What is esophageal carcinoma? Symptoms/complications? Indications?

A

Cancer of the esophagus

  • progressive dysphagia in anyone over 40 may indicate this (adenocarcinoma)
  • symptoms appear late in the disease and prognosis is poor due to high chance of metastasis
  • strong correlation with excessive ETOH intake and smoking
  • chemotherapy, radiotherapy, or surgery, but mainly palliative care
  • ulceration, mucosal destruction, stenosis, and clear visual difference between healthy and not tissue
  • CT: wall thickening of esophagus
37
Q

What is the hiatus?

A

Where the esophagus passes through the diaphragm

38
Q

What is a sliding hiatal hernia? Symptoms/complications? Indications?

A

Some portion of the stomach and gastroesophageal junction moved into the chest temporarily when intra-abdominal pressure is increased

  • reflux or heartburn
  • upper GI will demonstrate the condition when the patient is placed in a trendelenberg position
39
Q

What is a rolling hiatal hernia, paraesophageal hernia? Symptoms/complications? Indications?

A

Part of all of the stomach pushing up into the thoracic cavity through a defect in then diaphragm. The gastro-esophageal sphincter stays below the diaphragm

  • volvulus, esophagitis, ulcers, strictures, but main symptoms are related to reflux
  • diagnosed with chest x-ray or upper GI
  • severe cases may need laparoscopic surgery to push stomach back into place, secure it, and repair any gap in the diaphragm
40
Q

What is a hypertrophic pyloric stenosis? Symptoms/Complications? Indications?

A

Hyperplasia (enlargement), hypertrophy, and elongation of the pylorus. The edematous thickened tissue can be palpated as a mobile, hard “olive”.

  • projectile vomiting leading to dehydration
  • best diagnosed with ultrasound, but upper GI with thin barium may confirm by demonstrating “string sign” and delayed stomach emptying
41
Q

What is gastritis? Causes? Symptoms? Indications?

A

Inflammation of the stomach caused by alcohol, corrosive agents, and infection, most common cause helicobacter pylori

  • erosions and ulcers may form
  • thickening of gastric folds, gas bubbles in the stomach wall
42
Q

What is a peptic ulcer? Causes, symptoms/complications, indications?

A

Inflammatory processes in the stomach and duodenum secondary to gastritis caused by pepsin and HCl wearing though the mucosal lining of the stomach

  • hemorrhage, gastric outlet obstruction, perforation leading to peritonitis
  • benign ulcers: smooth barium filled projections, smooth folds around it
  • malignant: not so nice
  • lifestyle changes, low acid foods, stress reduction, antibiotics
43
Q

What is a peptic ulcer aggravated by?

A

NSAIDs

44
Q

What is the most common cause of upper GI bleeding and pneumoperitoneum?

A

Peptic ulcers

45
Q

What is gastric CA? Symptoms/complications? Indications?

A

Tumor of the stomach, usually cancerous, less than 20% survival rate over 5yrs

  • symptoms aren’t usually noticeable until tumor is advanced
  • stomach doesn’t churn, appears “stuck”
  • CT is used for staging
  • surgery is treatment of choice
46
Q

What is another name for Crohn’s disease?

A

Regional enteritis

47
Q

What is crohn’s disease? Symptoms/complications? Indications?

A

Chronic inflammation of the GI tract, involves all layers

  • unknown cause, common in young adults, can have acute episodes
  • palpable masses, pain and fever, widespread inflammation, ulcerations, fistulas between other organs, atresias
  • thickening of the bowel wall “cobblestone appearance”, “pipe-like narrowing”, “string sign”
  • treated with meds or surgery
48
Q

What is a small bowel obstruction? Symptoms/complications? Indications?

A

Bowel blockage due to a variety of conditions such as hernia, tumors, inflammation, stones, previous surgery or peritonitis (most commong)

  • strangulation of the bowel from hernia or volvulus
  • No air seen in bowel/colon distal to blockage, step-ladder appearance, bowel becomes distended (gas/fluid levels)
  • surgery
49
Q

What is a large bowel obstruction? Symptoms/complications? Indications?

A

Blockage in the large bowel most commonly caused by bowel cancer, severity depends on how competent the ileocecal valve is

  • perforation most likely in the cecum
  • distended colon, little or no gas in small bowel if valve is competent
  • if not competent, gas will be seen in the large and small bowels
50
Q

What is intussusception? Symptoms/complications? Indications?

A

Acute telescoping of one part of the intestinal tract into another because of peristalsis, more common in children

  • severe abdominal pain, blood in stool, palpable mass in right side
  • ischemic necrosis, prognosis is good if treated within 48hrs
  • “coiled spring” appearance
  • therapeutic enema
51
Q

What is a volvulus? Symptoms/complications? Indications?

A

Bowel blockage caused by twisting of the bowel around its mesentery, most common in elderly in the sigmoid colon and cecum

  • necrosis and perforation of the bowl is life threatening
  • surgery required
52
Q

What is adynamic illeus? Symptoms/complications? indications?

A

Compromised motility in the small and large bowels (stop peristalsis) due to neural, hormonal, metabolic, or physical causes. Occurs after abdominal surgery (will clear within 36-48hrs)

  • may occur in bowel adjacent to inflamed tissue
  • air fluid levels in both the small and large bowel with no obvious obstruction indication
  • NG tube used to aspirate the stomach and decompress the bowel
53
Q

What is diverticulosis? Symptoms/complications? indications?

A

Colonic outpouchings caused by herniations of mucosa and submucosa through the muscularis at point of weakness is the bowel wall

  • most common in sigmoid colon
  • low fibre diet, older individuals
  • chronic or intermittent lower abdominal pain around meals
  • barium filled diverticula appear on contrast studies
  • no seeds, no nuts, popcorn, etc. Exercise to increase peristalsis
54
Q

What is toxic megacolon?

A

Acute non-obstructive dilation of the colon

55
Q

What is diverticulitis? Symptoms/complications? Indications?

A

Necrosing inflammation of the diverticula caused by abscessing of trapped fecal matter

  • fibrous adhesions
  • may lead to inflammation of the colon wall, fistulas, or narrowing of the lumen
  • no seeds, nuts etc, exercise and antibiotics
56
Q

What increases the chances of colon cancer?

A
  • Ulcerative colitis

- colonic polyps

57
Q

What is ulcerative colitis? Symptoms/complications? Indications?

A

Inflammatory lesions that only involve the mucosal layers of the colon (most often in rectosigmoid colon ) (small ulcers on inside lumen)

  • bloody diarrhea, abdominal pain, fever, weight loss, toxic megacolon
  • 10x more likely to develop cancer
  • mucosa appears bumpy, “collar-buttoned”
  • colon appears as “lead-pipe”
  • diet changes, anti-inflammatories, stress control, surgical resection
58
Q

What is a contraindication of barium enema?

A

Toxic megacolon

59
Q

What is a colonic polyp? Symptoms/complications? Indications?

A

Abnormal neoplasm projecting from a muscous membrane, benign, but may become malignant

  • most common in left colon and rectosigmoid
  • rectal bleeding, pain on rare occasions, diarrhea, constipation
  • removed during colonoscopy, double contrast barium enema shows filling defects
60
Q

What is colon cancer? Symptoms/complications? Indications?

A

Bowel cancer in the colon

  • most common between 50-70yrs
  • most arise form pre-existing polyps
  • family history of polyps or ulcerative colitis
  • sometimes obstruction or bleeding
  • may spread to lymph, liver, or lungs
  • napkin ring or apple core sign on DCE
  • surgery, chemo, radiotherapy
61
Q

What is cholelithiasis? Symptoms/complications? Indications?

A

FREELY-MOVING stones in the gallbladder formed from irregular emptying of the gallbladder or incorrect chemical balance of bile (bile crystallizes)

  • commonly caused by four f’s (female, fatty diet, ++++ body habitus, family history) or extreme rapid weight loss
  • pain in RUQ, jaundice if bile can’t reach duodenum, gray-white feces
  • stones roll to dependant side when patient is repositioned
  • broken up with lithotripsy, dissolved with meds, or removed (laparoscopically or with surgery)
62
Q

What is cholecystitis? Symptoms/complications? Indications?

A

Acute inflammation of the gallbladder most often caused by obstruction of the cystic duct by a gallstone

  • gallstones can damage mucosal layer and cause infection
  • edema in gallbladder wall and pain in RUQ
  • sonography
  • cholecystectomy is treatment (looks unhappy)
63
Q

How are the different types of hepatitis contracted?

A

A + E : “ate them” ingestion of fecal matter
B: blood and bodily fluids
C: blood (transfusions)

64
Q

What is hepatitis? Symptoms/complications? Indications?

A

Inflammatory disease of the liver

  • jaundice, pain, nausea, vomiting, tenderness over liver
  • without treatment: cirrhosis (C), portal hypertension, hepatocellular necrosis, increased risk for hepatocellular carcinoma
  • hepatomegally (chronic hepatitis)
  • decreased blood clotting ability (chronic hepatitis)
  • prevention is best medicine (vaccines for A and B) and standard precautions
  • antiviral drugs used to control it, but it stays with you forever
65
Q

Which type of hepatitis is the most common cause of chronic hepatitis, cirrhosis, and liver cancer?

A

C

66
Q

What is cirrhosis? Symptoms/complications? Indications?

A

Chronic destruction of the liver that cause parenchyma to be replaced by fibrotic scar tissue
-most often caused by alcohol abuse, hepatitis, toxins, or biliary disease

67
Q

Stages of liver cirrhosis

A
  • Fatty liver disease
  • Inflamed (hepatomegaly)
  • Nodules (localized swelling)
  • Liver can’t process alcohol and toxins build up
  • Fibrotic tissue replacing parenchyma
  • Significant symptoms (portal hypertension, ascites) = cirrhosis
68
Q

What is portal hypertension? Symptoms/Complications? Indications?

A

Increased resistance to antegrade flow in the portal veins

  • caused by liver cirrhosis, blood can’t move through liver back to IVC
  • retrograde flow causes splenomegaly, esophageal varicies, and caput medusa
  • treated for a splenorenal shunt, or TIPPS (palliative)
  • shunts threaded through IJV, right atrium, IVC, and portal vein
69
Q

What is ascites? Symptoms/complications? Indications?

A

Fluid in the peritoneal cavity

  • portal hypertension ad decreased albumin levels caused fluid to leak out of circulation into tissues
  • caused by cirrhosis, chronic hepatitis, kidney or heart failure, cancer
  • “dog-eared bladder” on abdominal x-rays, liver may be displaced
70
Q

What are esophageal varicies? Symptoms/complications? Indications?

A

Collateral veins that have formed in the esophagus

  • caused by cirrhosis and associated portal hypertension
  • rupture is fatal (1/3 of cirrhosis deaths)
  • thin barium done for upper GI will demonstrate “worm-like” filling defects
71
Q

How should images be done for esophageal varicies? Why?

A

Recumbent, for safety

72
Q

What is hepatocellular carcinoma? Symptoms/complications? Indications?

A

Primary liver cancer most commonly associated with alcoholism and cirrhosis

  • central liver mass that alters contour of liver
  • usually death by hemorrhage before it spreads
  • chemotherapy is palliative, need liver transplant
73
Q

What is metastatic liver disease? Symptoms/complications? Indications?

A

Most common malignancy of the liver

  • liver filters blood, common for cancers in other parts of the body to spread to liver
  • more common than primary liver cancer
  • jaundice, tenderness, hepatomegaly
74
Q

What is acute pancreatitis? Symptoms/complications? Indications?

A

Inflammation of the pancreas caused by digestive enzymes that have become activated and begin to digest the pancreas from the inside out

  • caused by alcohol abuse, gallstone blockage of ampula of vater leading to a reflux in bile into the pancreas
  • sudden onset of severe steady abdominal pain, nausea, and vomiting, jaundice
  • sometimes gas/fluid levels, adynamic ileus, or displacement of adjacent structures
  • treated with IV fluids, meds, and in some cases antibiotics
75
Q

What is chronic pancreatitis? Symptoms/complications? Indications?

A

Frequent intermittent damage to the pancreas causes scar tissue to form and the pancreas can no longer produce digestive enzymes, insulin, or glucagon

  • pain, malabsorption, weight loss, diabetes
  • presence of calcifications in the pancreas
  • no alcohol, change in diet (reduced fat and protein)
  • pancreatic enzyme supplements and pain meds
76
Q

What is pancreatic carcinoma? Symptoms/complications? Indications?

A

Most commonly an adenocarcinoma, which is often detected too late

  • pain, weight loss, jaundice, fatigue, nausea, vomiting, and diabetes
  • risk factors: smoking, alcoholism, chronic pancreatitis, diabetes mellitus, family history of adenocarcinoma
  • pancreatectomy removed the pancreas, duodenum, CBD, gallbladder, spleen, and surrounding lymph nodes

MRT Year 1 Semester 2 (11 decks)

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