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AB&SS 1 > C12: GI Tract > Flashcards

C12: GI Tract Flashcards

1
Q

What is the esophagus and where does it pass though the diaphragm

Where does it enter the stomach

A
  • muscular tube going from the pharynx to the GE junction

- passes through hiatus of diaphragm at T10 and enters the superomedial aspect of the stomach (cardia)

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2
Q

What is the hiatus of the diaphragm formed by

A

The R crus of the diaphragm

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3
Q

What’s the relationship of the esophagus to the AO

A

Anterior

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4
Q

The GE junction marks the juncture of what structures of the stomach

A

The greater and lesser curve

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5
Q

Where is the stomach located in the abdo

A

L hypochondrium and epigastric regions (lower aspect crosses midline and ends at the duodenum)

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6
Q

Where is the cardia of the stomach found?

What is the fundus of the stomach?
Body?
Pylorus?

A

Cardia: surrounds lower esophageal sphincter

Fundus: rounded most superior part of stomach (L of cardia)

Body: central portion

Pylorus: distal aspect of stomach

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7
Q

Where will the pylorus lie with an empty stomach?

Full?

A

Empty: just R of midline

Full: may shift even more to R of midline

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8
Q

Which part of the sm bowel is the widest and most fixed

A

Duodenum

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9
Q

What are the 4 parts of the duodenum and all of their different names

A
  1. First part/Superior/Bulb
  2. Second/ descending
  3. Third part/transverse
  4. Forth part/ascending
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10
Q

Describe the location of the 1st part of the duodenum.

A
  • intraperitoneal

- runs from neck of the pylorus up and backwards to the level of the GB

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11
Q

which structures empty into the 2nd part of the duodenum.

A

CBD and main panc duct

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12
Q

Which areas of the abdo are retroperitoneal

A

2nd to 4th part of the duodenum

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13
Q

The jejunum leaves the retro peritoneum and becomes intra peritoneum at which ligamentum

A

Suspensory ligament/ligament of Treitz

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14
Q

What’s the function of the ligamentum of Treitz

A

Attaches duodenum to the diaphragm

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15
Q

How’s the jejunum arranged and which regions of the body does it occupy

A

-arranged in multiple loops and occupies the umbilical and L iliac regions

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16
Q

Which part of the small bowel is the longest?

Where does it join the large intestine

A

Ileum

A the ileocecal sphincter (valve of the sm bowel/lg bowel junction)

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17
Q

Which regions of the abdo does the ileum occupy

A

Umbilical, hypogastric, R iliac and pelvic regions

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18
Q

What structure anchors the ileum and jejunum to the post. Abdo wall

A

Mesentary

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19
Q

Where in the abdo is the cecum located

A

In the retroperitoneum

  • in RLQ and/or R iliac region
  • sits below ileocecal sphincter at het origin of the ascending colon

(Pouch like portion)

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20
Q

Which structures extends from the inferior portion of the cecum

A

Appendix

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21
Q

What is the appendix

A

Blind ended tub that opens into the cecum

22
Q

What DI modalities are best to see the appendix in children and adults

A

Adults: CT

Children: US

23
Q

Which area of the body is the ascending colon and how does it run?

A

Retroperitoneum

-runs in a superior path along the R flank… from the R iliac fossa to the visceral surface of the R lobe of liver

24
Q

What does the hepatic flexure connect? Which structure does is get in the way of imaging

A
  • connects the ascending and transverse colon
  • 90 degree curse in the RUQ
  • makes it hard to image the R kidney
25
Q

Where’s the transverse colon located?

How does it travel w/ reference to the duodenum

A

Intraperitoneal

Anterior

26
Q

Which colon extends over the pelvic brim

A

Descending colon… it runs from the L side of the abdomen to the L iliac fossa

27
Q

Where does the sigmoid colon end?

It sits anterior to which structure

A
  • terminal end of the colon

- sits anterior to the sacrum and projects inwards towards the midline

28
Q

When does the rectum become the anal canal

A

When it penetrates the levator ani muscle

29
Q

What are the 4 histological layers of the GI wall

A

Mucosa
Submucosa
Muscularis
Serosa

30
Q

Describe the mucosal layer of the GI lining

A
  • inner most layer composed of epithelial lining, c-tissue and muscle
  • protects, absorbs and secretes
31
Q

Describe the submucosal layer of the GI lining

A
  • made of c-tissue, contains blood vessels and lymphatics

- nourishes surrounding tissue and transports absorbed nutrients

32
Q

Describe the muscularis layer of the GI lining

A
  • smooth muscle arranged in circular and longitudinal groups

- responsible for parastalsis

33
Q

Describe the serosal layer of the GI lining

A

-outer layer for protection

34
Q

the rugae of the stomach run along which axis of the stomach

do we see the rugae when stomach is distanded

A

parallel to the long axis.. they function to increase SA and allow for expansion

-no

35
Q

what are the characteristics fold that we see in the small bowel

do they disappear when distended?

how far apart are they

A

valvule conniventes (circular folds)

  • dont disappear when distended
  • 3-5 mm apart
36
Q

where are the valvule conniventes most prominent

A

in the duodenum and first half of the jejunum… not often seen the the ileum

37
Q

what are the characteristics fold that we see in the large bowel… what are they formed by

how far apart are they

A
  • haustral markings… due to 3 short muscle bands that cause the colon to pucker into sacculations
  • 3-5 cm apart
38
Q

what does the term ‘gut signature’ refer to?

A

the layers appearance of the gut (any area of the GI tract) on US due to the different acoustic properties of the histological layers o the GI tract.

39
Q

describe the echogenicity of the layers of the gut

A 
Lumen: hyper echoic
Mucosa: hypoechoic
Submucosa: hyper echoic
Muscularis: hypo echoic
Serosa: hypo echoic
40
Q

describe the appearance of the gut wall (not echogenicity)… including thickness

what are we assessing the bowel for?

A

-should be uniform and compressible

Avg sign wall thickness (measure from lumen to wall):

  • 3 mm distended
  • 5 mm (non distended)

+ movement, diameter and contents

41
Q

what is the keyboard sign?

what are haustral makings?

A
  1. valvular conniventes of the duodenum and jejunum

2. ascending and descending colon

42
Q

what are the primary functions of the GI tract

A
  • digestion and absorption of nutrients

- also the largest endocrine gland

43
Q

where are the endocrine cells of the GI tract located

A

in the mucosa

44
Q

what are the 3 hormones release by the GI tract?

what organ releases them and what are there functions?

A
  1. Gastrin:
    - released by the stomach
    - stimulates secretion of gastric acid
  2. Cholecystokinin:
    - related by the duodenum into the blood after fatty food and controls the contraction of the GB
  3. Secretin:
    - released by the duodenal mucosa and stimulates the secretion of bicarbonate from the panc
    - decreases acid content
45
Q

what are the arteries that supply the Sm and Lg bowel

how is blood drained from the Sm and Lg bowel

A
  • celiac artery, and superior and inferior mesenteric arteries
  • through the portal system
46
Q

the gastric artery and vein supply/drain which organ

A

stomach

47
Q

what does it indicate if theres symmetrical thickening of the GI lining?
asymmetrical?

w/ these conditions, will the bowel be compressible?

A
  • inflammation (wont be compressible)

- malignancy (wont be compressible)

48
Q

what can lead to excessive amount of fluid in the GI tract

A
  • hypersecretion
  • mechanical obstruction
  • paralytic ileus (paralysis of the bowl, usually temporary)
49
Q

when would activity of the bowl be increase of decreased

A

increased: early mechanical bowel obstruction or inflammation
decreased: paralytic ileus or end stage mechanical obstruction

50
Q

should bowel gas typically be displaceable?

A

yes

AB&SS 1 (13 decks)

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