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GI II Exam 1 > Bowel Path I > Flashcards

Bowel Path I Flashcards

1
Q

small intestine

A

duodenum
jejunum
ileum

digest/absorb protein, carb, lipid

absorb vits, minerals

protects against intruders

resorption of water

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2
Q

hepatic flexure

A

large bowel - right side

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3
Q

splenic flexure

A

large bowel - left side

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4
Q

paralytic lieus

A

intestine has no contractions - functional obstruction

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5
Q

big 4 causes GI obstruction

A

adhesions
hernia
volvulus
intussusception

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6
Q

pseudo obstruction

A

paralytic ileus - post op

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7
Q

GI obstruction sx

A

pain
distension
vomiting
constipation

usually requiring surgery
-not paralytic ileus

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8
Q

small bowel obstruction

A

pain is colicky - cramping and intermittent

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9
Q

large bowel obstruction

A

longer lasting spasms

constipation early and vomiting less prominent

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10
Q

CT of obstruction

A

full of fluid and see air level

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11
Q

intussusception

A

part of intestine invaginated into another section

telescoping

most frequent - ileum entering cecum

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12
Q

dances sign

A

intussusception

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13
Q

diagnosis of intussusception

A

ultrasound

target like mass - 3cm in diameter

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14
Q

target mass

A

ultrasound with intussusception

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15
Q

tx of intussusception

A

barium enema - confirms dx and reduces it

surgical reduction if this doesnt work

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16
Q

red currant jelly

A

with intussusception

-ischemic mucosa is sloughed off

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17
Q

inguinal hernia

A

majority right sided
-males

cannot be reduced = incarceration

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18
Q

direct inguinal hernia

A

medial to inferior epigastric vessels - transversalis fascia

indirect inguinal hernia - deep inguinal ring - lateral to inferior epigastric vessels - fail of closure of processus vaginalis

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19
Q

most common cause of intestinal obstruction worldwide

A

hernia

in US - adhesions

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20
Q

volvulus

A

malrotation of loop of blwel

infants or adults

commonly in the sigmoid colon

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21
Q

diagnosis of volvulus

A

abdominal x-ray

22
Q

coffee bean sign

A

x-ray of volvulus

or bent-inner tube

23
Q

birds beak

A

diagnosis of volvulus using barium enema

24
Q

adhesions

A

fibrous bands between tissues and organs
-internal scar tissue after surgery-injury

-most common cuase of obstruction in US

can lead to internal hernia

complete obstruction - surgical intervention

most improve conservative care within 2-5 days

25
Q

ischemic bowel disease etiology

A

often arterial embolism

or thrombosis - second most common - superior mesenteric artery

26
Q

cocaine

A

non-occlusive IBD

27
Q

transmural bowel infarct

A

bad - contents can leak out with perforation in 1-4 days

28
Q

rapid onset of periumbilical pain with nausea and vomiting

A

intestinal infarct

29
Q

mesenteric ischemia

A

inflammation and injury of small intestine result from inadequate blood supply

common in elderly

three phases:
1 hyperactive - abdominal pain and bloody stool
2 paralytic - loss motility
3 shock - fluid leak through colon lining

30
Q

superior mesenteric artery

A

ascending and transverse colon

31
Q

inferior mesenteric artery

A

descending colon, sigmoid, rectum

32
Q

watershed areas

A

weak points in blood flow to colon
-between SMA and IMA boundaries

splenic flexure and transverse colon

vulnerable to ischemia

33
Q

rectum

A

dual blood supply

34
Q

ischemic colititis diagnosis

A

scope

35
Q

tx ischemic colitis

A

supportive

surgery if severe

36
Q

angiodysplasia

A

non-neoplastic vascular lesion

cecum or prox right colon
path unknown

tortuous dilatation of malformed submucosa and mucosa blood vessels

60yo

significant bleeding can occur

resembles telangiectasia

37
Q

heydes syndrome

A

angiodysplasia with aortic valve stenosis

vWF - protelysed with high shear stress

38
Q

hemorrhoids

A

pregnancy
cirrosis

most commonly - straining of stool**

39
Q

internal hemorrhoids

A

painless bleeding

40
Q

external hemorrhoids

A

painful

41
Q

secretory diarrhea

A

> 500mL isotonic fluid stool daily

persist during fasting**

infectious

42
Q

osmotic diarrhea

A

> 500mL hypertonic fluid
abates with fasting**

lactase deficiency

43
Q

exudative diarrhea

A

mucosal damage
-purulent bloody stools

  • persists during fasting
  • bacterial or IBD
44
Q

deranged motility diarrhea

A

improper neuromuscular

variable during fasting**

45
Q

malabsorption diarrhea

A

improper absorption
-bulky stool - excess fat

abates with fasting**

celiac, giardia, pancreatitis, CF

46
Q

diarrhea

A

increase in stool mass, frequency or fluiditiy

47
Q

dysentery

A

low volume bloody diarrhea

48
Q

standard test for malabsorption

A

72 hour stool for fat

pt diet 100g fat day

more than 18-20g fat in stool - pt has malabsorption

49
Q

malabsorption

A

luminal phase - pancreatitis, CF

mucosal phase - celiac sprue

postabsorptive phase - lymph obstruction

50
Q

infectious enterocolitis

A

huge worldwide problem

viral - rotavirus

bacterial - 3 mechanisms

also parasitic

responsible for lots of death worldwide

GI II Exam 1 (29 decks)

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