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Penny abdomen > Ch. 10 GI Tract & Abd wall > Flashcards

Ch. 10 GI Tract & Abd wall Flashcards

1
Q

The gastrointestinal tract or alimentary canal consists of:

A

Mouth, pharynx, esophagus, stomach, the wall intestines, and colon

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2
Q

What organ is the most proximal portion of the gastrointestinal tract?

A

The mouth

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3
Q

This organ lies distal to the mouth and unites it to the esophagus

A

Pharynx

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4
Q

The ________ travels inferiorly within the thorax and through an opening in the diaphragm

A

Esophagus

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5
Q

The __________ _______ can be identified with sonography and will appear as a bulls-eye structure between the left lobe of the liver and abdominal aorta in the sagittal imaging plane

A

Gastroesophageal function

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6
Q

What are the three parts of the stomach?

A

fundus, body, pylorus

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7
Q

A muscle that controls the emptying of the contents of the stomach into the duodenum

A

pyloric sphincter

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8
Q

C-shaped or referred to as the C-loop of the duodenum

A

Proximal duodenum

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9
Q

Distal to the duodenum are:

A

Jejunum and ileum of the small intestines

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10
Q

The proximal colon is also called

A

Cecum

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11
Q

A blinded ended tube that is connected to the cecum of the colon

A

Vermiform appendix

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12
Q

Most gastrointestinal tract sonographic studies are performed using what probe?

A

A high frequency linear array transducer. Some may require a curved array transducer

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13
Q

the alternating echogenicities of the bowel wall layers should produce the classic _____/_____ appearance

A

target, bullseye

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14
Q

A sonographic examination of the gastrointestinal tract should include ________ ______ to differentiate normal from anomalous bowel

A

Graded compression or compression sonography

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15
Q

Specifically, normal bowel should be _______ and should have observable _________.

A

Compressible; peristalsis

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16
Q

Generally, the normal intestinal wall should measure less than ___ mm in thickness

A

5mm

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17
Q

True or false: a normal bowel wall segment produces little to bo color Doppler

A

True

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18
Q

When examining the gastrointestinal tract, color Doppler can be beneficial for what reasons?

A

Because of inflammatory changes and neoplasms within the gastrointestinal tract will often reveal hyperemia

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19
Q

Sonography utilizes _________ to analyze bowel.

A

Compression

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20
Q

When the bowel is compressible, what does it mean?

A

It means it’s normal bowel

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21
Q

When the bowel is noncompressible, what does it mean?

A

It means it’s abnormal bowel

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22
Q

The bend in the colon that marks the beginning of the transverse colon is called

A

hepatic flexure or right colic flexure

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23
Q

Another bend inferior to the spleen that marks the beginning of the descending colon is called

A

splenic flexure or left colic flexure

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24
Q

What is the termination point of the gastrointestinal tract?

A

anus, external opening of the rectum

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25
Q

Most GI tract parts are considered

A

intraperitoneal (exception of duodenum, ascending & descending colon)

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26
Q

The GI tract consists of how many layers?

A

five

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27
Q

The GI tract layers alternate echogenicity and hypoechoic segments, odd layers are ___, even layers are ____.

A

echogenic, hypoechoic

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28
Q

The alternating echogenicities of bowel wall layers should produce was sonographic sign

A

“target” or “bull’s-eye”

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29
Q
  1. Superficial mucosal layer (echogenic)
  2. Deep mucosal layer (hypoechoic)
  3. Submucosal layer (echogenic)
  4. Muscularis layer (hypoechoic)
  5. Serosa (echogenic)
A

Five GI layers

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30
Q

Normal small bowel wall thickness is between

A

1.5-3mm in thickness

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31
Q

Small bowel distention is defined as a

A

2.5mm or greater (outer-outer wall)

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32
Q

The colon should measure ___ in the nondistended state

A

4-9mm

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33
Q

Colon distention is the diameter of a segment that exceed

A

6mm

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34
Q

Bowel walls should appear ___ in a distended state.

A

thin

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35
Q

A long, narrow, blinded-ended tube that is commonly located within the right lower quadrant, at the level of cecum

A

Appendix

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36
Q

The most common cause of acute abdominal pain resulting in surgery

A

acute appendicitis

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37
Q

This condition may be the result of some form of obstructive process such as appendicolith, fecalith, lymph node, tumor, foreign body, seeds, or parasite.

A

Acute appendicits

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38
Q

________ ______ is used to sonographically investigate the abdomen for signs of appendicitis.

A

Graded compression

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39
Q

What will an inflamed appendix looks like in sonography?

A

Noncompressible, blind-ended tube that measures more than 6mm in diameter

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40
Q

An _________ will appear as an echogenic, shadowing structure within the lumen of the appendix

A

Appendicolith

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41
Q

Patients with appendicitis will suffer from rebound tenderness over Mcburney point in the RLQ is referred to as

A

McBurney sign

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42
Q

Patients with acute appendicitis that have pain in the RLQ when the LLQ is palpates is referred to as

A

Rovsing sign

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43
Q

The sonographic appearance of the hyperechoic edematous connective tissue that surrounds the inflamed appendix

A

thyroid in the belly sign

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44
Q

Clinical findings of______:
1. initial epigastric or general abd pain that with t ime, is confined to the RLQ
2. acute abd pain
3. rebound tenderness
4. nausea and vomiting
5. possible leukocytosis
6. high fever (with abscess formation)

A

Acute Appendicitis

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45
Q

Sonographic findings of ______:
1. noncompressible, blind-ended tube that measures morethan 6mm in diameter from outer wall to outer wall
2. echogenic structure within the lumen of appendix (appendicolith)
3. hyperemic flow within the wall of inflamed appendix
4. periappendiceal fluid collection

A

Acute Appendicitis

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46
Q

What is the distal region of the stomach?

A

pylorus

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47
Q

The _________ _______ controls gastric emptying and prevents undigested food products, or chyme, from refluxing back into the stomach from the duodenum

A

Pyloric sphincter

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48
Q

This condition is a defect in the relaxation of the pyloric sphincter.

A

Hypertrophic pyloric stenosis

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49
Q

_______ _______ ______ causes a gastric outlet obstruction

A

Hypertrophic pyloric stenosis

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50
Q

Hypertrophic pyloric stenosis is most commonly encountered in what age?

A

Infants between 2 and 6 weeks old

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51
Q

The clinical findings where the enlarged pyloric muscle can be palpated is referred to as

A

The olive sign

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52
Q

To examine the pyloric region of the stomach, the infant is placed in what position?

A

Right lateral decubitus position

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53
Q

What can be done to get a better visual of the pylorus?

A

A small amount of water or glucose solution is given to the patient

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54
Q

What does the pyloric sphincter do?

A

controls gastric emptying & prevents undigested food products/chyme from refluxing back into the stomach from the duodenum

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55
Q

What infants are most likely to suffer from HPS?

A

first born, white male infants

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56
Q

In longitudinal plane, what is the position of the pylorus?

A

It’s within the epigastrium, slightly right of the midline, near the gallbladder

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57
Q

The pylorus is normally positioned ___ in the abdomen.

A

transverse

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58
Q

Pyloric stenosis yields a ___ appearance when the transducer is placed transverse to the abdomen.

A

cervix

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59
Q

The abnormal pylorus in short axis appears what on sonography?

A

A target or doughnut sign

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60
Q

If pyloric stenosis is present, the wall of the pyloric muscle will measure ___mm or greater in thickness, while the length of the abnormal pyloric channel will measure ___mm or greater.

A

3mm or greater in thickness; 17mm or greater in length

61
Q

What are the three additional causes of nonbilious vomiting in the infant?

A

Pylorospasm
Gastroesophageal reflux
Malrotation of the midgut

62
Q

_________ is a common cause of delayed gastric opening in infants

A

Pylorospasm

63
Q

A temporary spasm & thickness of the pyloric sphincter that can replicate the sonographic appearance of pyloric stenosis

A

pylorospasm

64
Q

Another cause for nonbilious projectile vomiting other than HPS in an infant

A

gastroesophageal reflux (reflux out of stomach back into esophagus)

65
Q

Abnormal rotation of the bowel that leads to a proximal small bowel obstruction, small bowel rotates around the SMA

A

midgut malrotation

66
Q

Patients with a midgut malrotation most often suffer from

A

bilious vomiting

67
Q

The relationship with the SMA and SMV showing a whirlpool sign is indicative of what

A

midgut malrotation

68
Q

What can be observed in sonography in terms of gastroesophageal reflux?

A

Fluid mixed with gas bubbles can be observed traveling retrograde up the esophagus

69
Q

Clinical findings of ______:
1. first-born (white) male infant (most often)
2. nonbilious, projectile vomiting
3. weight loss
4. constipation
5. dehydration
6. insatiable appetite
7. palpable olive sign

A

Pyloric Stenosis

70
Q

Sonographic findings of ______:
1. abnormal pylorus appears as a target or doughnut sign in transverse view
2. abnormal pylorus appears as a cervic in the longitudinal view
3. wall will measure greater than or equal to 3mm in thickness
4. length of pyloric channel will measure greater than or equal to 17mm

A

Pyloric Stenosis

71
Q

The telescoping of one segment of bowel into another, most often the proximal segment of bowel inserts into the distal segment

A

intussusception

72
Q

The proximal portion of the bowel with intussusception

A

Intussuceptum

73
Q

What does invaginate mean?

A

To insert

74
Q

The distal segment of the bowel with intussusception

A

intussuscipiens

75
Q

With intussusception, the intussusceptum is allowed to _________ into the next part which is intussuscipiens.

A

Invaginate (to insert)

76
Q

What is the most common type of intussusception?

A

ileocolic intussusception

77
Q

_________ ________ occurs within the right lower quadrant at the level of the ileocecal valve.

A

Ileocolic intussusception

78
Q

This condition occurs more often in male and has been cited as the most common cause of intestinal obstructions in children less than 2 years old

A

Intussusception

79
Q

What is the key to finding intussusception?

A

Red currant jelly stool

80
Q

What should be used in sonography to evaluate the pediatric patient who has clinical findings suspicious for intussusception?

A

Graded compression sonography

81
Q

Clinical findings of _______:
1. intermittent severe abdominal pain
2. vomiting
3. palpable abdominal mass
4. red currant jelly stools
5. leukocytosis

A

Intussusception

82
Q

Sonographic findings of ______:
1. noncompressible, target-shaped or pseudokidney shaped mass that consists of alternating rings of echogenicity (cinnamon bun sign)
2. The diameter of the intussuscepted bowel will exceed 3 cm

A

Intussusception

83
Q

Most common cause of of intestinal obstruction in children less than 2 years of age, more common in male patients

A

intussusception

84
Q

In adults, intussusception can be caused by a

A

neoplasm

85
Q

Hallmark clinical finding of intussusception

A

red currant jelly stool (mixture of blood and mucus)

86
Q

Intussusception will appear as what sign sonographically in transverse

A

“target” (may also resemble “cinnamon-bun sign” because of alternating rings of echogencity representing the edematous layers of the bowel wall)

87
Q

Intussusception will appear as what sign sonographically in a longitudinal plane

A

“pseudokidney sign”

88
Q

Diameter of intussusception will exceed

A

3mm

89
Q

Intussusception can lead to

A

ischemia & gangrene of the bowel

90
Q

What are the two types of intestinal obstruction?

A

mechanical and nonmechanical

91
Q

This type of intestinal obstruction results from the bowel being physically blocked by something

A

Mechanical obstruction

92
Q

This type of intestinal obstruction is when the bowel lacks normal peristalsis

A

Nonmechanical obstruction

93
Q

When bowel lacks normal peristalsis

A

nonmechanical obstruction or paralytic ileus

94
Q

With obstruction small bowel diameter will measure ___ or greater from outer to outer wall

A

2.5mm

95
Q

The mucus membrane folds within the inner walls of the small bowel

A

plicae circulares

96
Q

Distended fluid filled loops of bowel with intestinal obstruction sonographically will show what sign

A

keyboard sign

97
Q

The colon diameter will exceed ___ with intestinal obstruction

A

6mm

98
Q

Clinical findings of an______:
1. abdominal distention
2. intermittent abdominal pain
3. constipation
4. nausea and vomiting

A

Intestinal Obstruction

99
Q

Sonographic findings of an ______:
1. distended fluid filled loops of bowel
2. an abrupt termination point of the distended bowel may be identified
3. increased peristaltic motion with to-and-fro motion of intraluminal contents (mechanical obstruction only)

A

Intestinal Obstruction

100
Q

masses of various ingested material that may cause an intestinal obstruction

A

Bezoars

101
Q

A type of bezoars that consists of ingested hair

A

Trichobezoars

102
Q

Bezoars that consists of powdered milk that has not been adequately mixed with water

A

Lactobezoars

103
Q

bezoars that consist of vegetable material are called ______ and are more often found in older patients.

A

phytobezoars

104
Q

An autoimmune disease characterized by periods of inflammation of the gastrointestinal tract

A

Crohn disease

105
Q

The most common inflammatory disease of the small intestine

A

Crohn disease

106
Q

Crohn’s disease usually involves the terminal ______ or proximal colon.

A

Ileum

107
Q

Crohn’s disease won’t be compressible and will show what kind of sign sonographically

A

“target sign”

108
Q

Bowel wall will measure greater than ___ with Crohn’s

A

3mm

109
Q

Clinical findings of ______:
1. Episodes of diarrhea
2. Abdominal pain
3. Weight loss
4. Rectal bleeding

A

Crohn Disease

110
Q

Sonographic findings of ______:
1. bowel wall thickening >5mm
2. affected bowel will be noncompressible and have a target appearance
3. hyperemic wall

A

Crohn Disease

111
Q

The development of small outpouchings termed diverticuli in the digestive tract, most often the sigmoid colon

A

diverticulosis

112
Q

Inflammation resulting from infection of the small outpouching of the sigmoid colon is termed

A

Diverticulitis

113
Q

Clinical findings of _____:
1. constipation or diarrhea
2. fever
3. nausea and vomiting
4. cramping, LLQ pain

A

Diverticulitis

114
Q

Sonographic findings of ______:
1. segmentally thickened bowel with evidence of an inflamed diverticula and inflamed perienteric fat
2. affected bowel segment will typically reveal hyperemia
3. inflamed diverticula may appear as echogenic projections from the bowel that produce shadowing or ring-down artifact

A

Diverticulitis

115
Q

Inflammation of the colon

A

colitis

116
Q

What are the several types of colitis?

A

Pseudomembranous
Ulcerative
Ischemic
Infectious

117
Q

More often associated with watery diarrhea can result from the use of antibiotic therapy that destroys the healthy flora of the intestine and leads to C. difficile

A

pseudomembranous colitis

118
Q

Clinical findings of _____:
1. bloody or watery diarrhea
2. fever
3. abdominal pain
4. previous use of antibiotic therapy

A

Colitis

119
Q

Sonographic findings of _____:
1. thickened, hypoechoic colon wall
2. hyperemia within the colon wall

A

Colitis

120
Q

Gastric cancer is most often in the form of

A

adenocarcinoma

121
Q

Clinical findings of _____:
1. Weight loss
2. Abdominal pain
3. Anorexia
4. Vomiting

A

Gastric Carcinoma

122
Q

Sonographic findings of ______:
1. Hypoechoic, irregular-shaped, bulky mass that can measure up to 10cm in size
2. Could appear as a target or have a pseudokidney appearance

A

Gastric Carcinoma

123
Q

Third leading cause of death in the western countries after lung and breast, typically found in the rectosigmoid colon

A

colon cancer

124
Q

Malignancy of the alimentary tract will appear hypoechoic, irregularly shaped, bulky mass that can measure up to 10cm in size and sonographically may show what kind of signs

A

“target” and “pseudokidney sign”

125
Q

An intraperitoneal extension of mucin secreting cells that result from the rupture of a malignant mucinous ovarian/appendix tumor

A

pseudomyxoma peritonei

126
Q

Most commonly encountered metastatic tumors of the bowel

A

malignant melanoma, primary tumors of lung & breast

127
Q

The rectus abdominis muscles are divided by a band of connective tissue called

A

linea alba

128
Q

A rupture in the rectus abdominus muscle or associated vasculature can lead to a

A

rectus sheath hematoma (discoloration in area of hematoma)

129
Q

Most common site for endometriosis outside the female pelvis region is the

A

anterior abdominal wall

130
Q

List some of the causes of rectus sheath ______:
Abdominal contractions from childbirth
Sneezing
Coughing
Defecation
Urination
Intercourse

A

hematoma

131
Q

Clinical findings of a Rectus Sheath ______:
1. Abdominal pain
2. Palpable abdominal mass
3. Discoloration of the skin in the area of the hematoma
4. Decreased hematocrit

A

Rectus Sheath Hematoma

132
Q

Sonographic findings of a Rectus Sheath ______:
1. blood can appear hypoechoic, hyperechoic, complex, and/or anechoic depending on the stage of development

A

Rectus Sheath Hematoma

133
Q

Clinical findings of ______ of the Abdominal Wall:
1. History of endometriosis
2. Prior cesarean section
3. Pain on the area of the cesarean section scar (possible pain that correlates with
the menstrual cycle)
4. Palpable mass

A

Endometriosis

134
Q

Sonographic findings of ______ of the Abdominal Wall:
1. well-defined, lobulated, or infiltrative mass
2. hypoechoic to the adjacent tissue

A

Endometriosis

135
Q

Most common type of ventral hernia, referred to as a paraumbilical hernia in adults

A

umbilical hernia

136
Q

What is the term that denotes twisting of the bowel?

A

volvulus

137
Q

Which of the following is true of a rectus sheath hematoma?

A

It may occur during defecation

138
Q

Which of the following is not a layer of gut identified with sonography?

A

visceral

139
Q

Pseudomyxoma peritonei can result from

A

appendix cancer

140
Q

Which of the following best describes the location of McBurneys point?

A

halfway between the anterior superior iliac spine and the umbilicus

141
Q

The most common location of the vermiform appendix is in the area of the

A

cecum

142
Q

Which of the following is the development of small outpouchings within the sigmoid colon?

A

diverticulosis

143
Q

Treatment for intussusception is by means of

A

therapeutic enema

144
Q

The most common cause of intestinal obstruction in children less than 2 years of age is

A

intussusception

145
Q

What are the several types of hernias in the abdominal wall?

A

Inguinal hernia
Incisional hernia
Linea alba hernia
Umbilical hernia
Spigelian hernia

146
Q

Performed by attempting to forcibly exhale while keeping the mouth and nose closed

A

Valsalva technique

147
Q

What technique can be utilized to show movement and change the size of the hernia?

A

Valsalva technique

148
Q

accquired inguinal hernia; result from the weakening of the transversalis fascia

A

direct groin hernia

149
Q
A

indirect groin hernia

Penny abdomen (8 decks)

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