CH.4 Abdomen and GI System Flashcards
1
Q
Name the 9 regions of the abdomen begining with the right upper side and moving transversely.
A
- Rt hypochondriac
- Epigastric
- Lt Hypochondrian
- Rt Lateral
- Umbilical
- Lt Lateral
- Inguinal
- Pubic
- Lt Inguinal
2
Q
What is the name of the line that break up the regions of the abdomen?
A
Addison Lines
3
Q
This is the largest membrane in the body and it lines the abdominal cavity.
A
Peritoneum
4
Q
This is a serous lining attached to the abdominal organs.
A
Visceral peritoneum
5
Q
This attaches directly to the abdominal wall
A
Parietal Peritoneum
6
Q
This is a double fold of parietal peritoneum projecting from the posterior abdominal wall in the lumbar region.
A
Mesentary
7
Q
This is a double fold of peritoneum that attaches to the duodenum, stomach and transverse colon and hangs loosely over the intestines.
A
Greater Omentum
8
Q
This is a fold of peritoneum that attaches to the liver and lesser curvature of the stomach and duodenum.
A
Lesser Omentum
9
Q
This tract digests and absorbs food. It extends from the mouth to the pharynx-esophagus-stomach-instestines-rectum and ends at the anus.
A
Alimentary Canal
10
Q
This movement churns gastric content and propels it toward the pylorus.
A
Peristalsis
11
Q
This consists of the transverse rigid duodenum, featherly jejunum, smallest portion ileum.
A
Small intestine
12
Q
This is a double layer of peritoneum where the hepatic flexure, transverse colon and splenic flexure attach to the posterior abdominal wall.
A
Mesocolon
13
Q
A small bowel study is complete once the contrast reaches where?
A
The ileocecal valve
14
Q
When performing a large bowel study, what is the purpose of negative air contrast?
A
To distend the lumen to see the mucosal lining
15
Q
This is a stoma created in the abdominal wall to allow drainage of bowels into a closed external pouch.
A
Colostomy
16
Q
This is a stoma placed in the ileum to drain the bowels.
A
Ileostomy
17
Q
This is a congenital anomaly in which the esophagus fails to develop resulting in a discontinuation of the esophagus.
A
Esophageal Atresia
18
Q
What are some symptoms of esophageal atresia?
A
- excessive salvation
- choking
- gagging
- dyspnea
- cyanosis
19
Q
This is a congenital discontinuation of the bowels with the most common type occuring at the ileum and the next common type occuring at the duodenum.
A
Bowel Atresia
20
Q
What are symptoms of bowel atresia?
A
- abdominal distention
- inability to pass stool
21
Q
What are radiographic indications of Bowl Atresia?
A
- “Double Bubble Sign”
- This is created by the gastric bubble and the bubble from the proximal duodenum
22
Q
This is a congental failure of the distal rectum and anus to develop. Often complicated by fistulas.
A
Colonic Atresia
23
Q
What is the prognosis for all 3 types of bowel atresia?
A
Excellent after surgical intervention.
24
Q
No anal opening to the exterior of the body is called what?
A
Imperforate Anus
25
What is another name for Imperforate Anus?
"Blind Pouch"
26
This is a congential anomaly of the stomach in which the pyloric canal leading out of the stomach is greatly narrowed because of hypertrophy of the pyloric sphincter.
Hypertrophic Pyloric Stenosis
27
This is the most common indication for surgery in infants and is 4 times more likely to occur in first born males.
Hypertrophic Pyloric Stenosis
28
What is another name for Hypertrophic Pyloric Stenosis?
"string sign" + Congenital Pyloric Stenosis
29
This is a recessive genetic disorder where the instestines are not in their normal postition.
Malrotation
30
What are the varying degrees of Malrotation?
- Failure of fixation of the cecum in the RLQ
| - Complete trasposition of the bowel (small intestines on the rt and colon on the lt)
31
This is complete reversal of all abdominal organs and is very rare.
Situe Inversus
32
This is the absence of neurons in the bowel wall, typically in the sigmoid colon, preventing the normal relaxation of the colon and peristalsis resulting in narrowing and constricting.
Hirschsprungs Disease
33
If Hirschsprungs Disease is left untreated it can turn into what, developing from a bacteria overgrowth?
Toxic Megacolon and Death
34
This is congenital diverticulum of the distal ileum containing a saclike anomoly located within the left ileocecal valve. It is the remnant of a duct connecting the small bowell to the umbilicus in the fetus.
Meckels Diverticulum
35
What are common symptoms of Meckels Diverticulum?`
Ulcers along with episodes of bleeding from the ulcer sites.
- Cramping
- Vomitting
- Bowel Obstruction
36
What other disease can Meckels mimic?
Appendicitis
37
What are some radiographic indications of Meckels?
Stalk-Like
38
This is secondary to ingestion of caustic materials such as acids or alkalines or from factors that inflame the mucosa and creates scarring of the esophagus.
Esophageal Strictures
39
This is an incompetence in the cardiac sphincter allowing the backward flow of gastric acid and contents into the esophagus.
Gastroesophageal Relux Disease (GERD)
40
What is the most effective treatment of GERD?
Lifestyle changes along with medication.
41
What study is done for diagnosis of GERD?
Endoscopic studies
Barium Swallows
Esophagoscopy
Esophageal Manometry
42
These usually appear as single small round cavities that penetrate through the mucosa and into the submucosa at the lower end of the esophagus, stomach or duodenum.
Peptic Ulcers
43
What are the primary sites for peptic ulcers?
Duodenal Bulb
Lesser curvature of the stomach
Pylorus
44
What are peptic ulcers in the stomach called?
Gastric Peptic Ulcers
45
What are peptic ulcers in the duodenum called?
Duodenal Peptic Ulcers
46
This bacteria has been considered the single most common cause of peptic ulcer disease.
H. pylori
47
95% of peptic ulcers are which type of ulcer?
Duodenal Peptic Ulcer
48
An imbalance between acid and pepsin production can be influenced by what factors?
hormonal and neural factors
49
Excessive vagal stimulation causes this type of ulcer.
Cushing Ulcers
50
These are mucous producing glands that if undeveloped no mucous can be produced.
Brunners Gland
51
This type of ulcer is caused by decreased blood flow or ischemia impairing mucus secretions. It is more common in blood group "O".
Curlings Ulcer
52
What are some signs and symptoms associated with ulcers?
- gnawing or burning epigastric pain
- similar to "hunger pangs"
- occurs 1- hrs after meals
53
What are signs and symptoms specific to gastric ulcers?
- Pain in lt upper gastric after eating large meals
- Nausea and vomiting
- concomitant weight loss
- GI bleeding
54
This type of ulcer often follows a chronic course of remission and exacerbation.
Duodenal Ulcer
55
What are the signs and symptoms specific for duodenal ulcers?
- Heartburn
- Mid epigastric pain
- weight gain
- hot water bubbling in the back of throat
56
This is a lucid line between the crater of the ulcer and the organ it is associated with?
Hamptons Line
57
An ulcer can be seen radiographically En face or En profile... What does this mean?
- En face- looking directly down into the well of the crater
| - En profile- viewed from the side
58
Clover leaf deformity is associated with what type of ulcer?
Duodenal Peptic Ulcer
59
This is inflammation of the stomachs mucosal lining that may occur in many forms typically mild to severe and transient with only vague signs or it may be chronic.
Gastroenteritis or Gastritis
60
With this type of gastritis the mucosa is inflamed and appears red and edematous it may be ulcerated and bleeding. It is short in duration and usually heals spontaneously.
Acute Gastritis
61
What are common causes of Gastritis?
- infection from microorganisms
- allergies to food (shellfish)
- drugs (aspirin)
- ingestion of spicy food
62
What are signs and symptoms of gastritis?
- epigastric discomfort
- nausea vomitting
- malaise, fever, headache
63
What does acute gastritis look like radiographically?
Demonstrates a thickened mucosal fold (rugae)
64
This form of gastritis is characterized by atrophy of the mucosa of the stomach with loos of the secretory glands.
Chornic Gastritis
65
Chronic Gastritis is usually associated with what?
Chronic peptic ulcers
66
What does Chronic Gastritis typically look like on a radiographic Image?
- The rugae become thin and atrophy
| - The funds may look "bald" Johns head
67
This is an idiopathic relapsing granulamatous inflammatory disorder which usually affects the terminal ileum or colon.
Crohns Disease
68
What are signs and symptoms of Crohns Disease? And what can it mimic?
- Mimics appendicitis
| - Right lower quadrant pain -cramping tenderness, flatulence, nausea, fever, and diarrhea
69
What is the bacteria may present with Chronic Gastritis? What is it usually associated with?
Helicobacter pylori, peptic ulcers
70
Chronic Gastritis is s precipitating factor for what?
Gastric Carcinoma
71
What is another name for Crohns Disease?
- Regional Enteritis
| - Granulomatous Colitis
72
Which area of the GI tract does Crohns disease generally occur?
Distal portion of the ilium at ileocecal valve.
73
Crohns disease can extend to what other areas of the GI system?
- Regional Lymph Nodes
| - Mesentary
74
What happens to the bowel wall over time in patients with Crohns Disease?
- Bowel wall thickens
- Lumen becomes narrowed
- Presents as an ileus (small Bowel obstruction)
75
What does Crohns Disease appear like radiographically in the bowel?
- "cobblestone" "skip lesions" lesions interspersed between normal segments.
76
This is inflammation of the appendix can be caused usually by a fecalith or rarely a neoplasm and is the most common abdominal surgical emergency in the U.S.
Appendicitis
77
Appendicitis can cause the appendix to become more susceptible to infection to this bacteria normally found in the intestinal tract.
Escherichia Coli
78
This is an inflammation often chronic disease that affects the mucosa and submucosa of the colon.
Ulcerative Colitis
79
Ulcerative Colitis usually begins at this portion of the colon and given time will travel upwards.
Rectum and Sigmoid
80
Ulcerative colitis mimics what disease?
Crohns Disease
81
What can develop from Ulcerative Colitis?
- abcesses
| - pseudopolyps
82
What are predisposing factors of Ulcerative Colitis?
- family history
- bacterial infection
- allergic reaction to foods
- over production of enzymes that break down the mucosal membrane
83
What is the main difference between Ulcerative Colitis and Crohns Disease?
Crohns disease affects all layers of the bowel wall
| UC- disease of the mucosa of the colon
84
What can Ulcerative Colitis lead to?
- Anemia
- Cirrhosis
- Arthritis
- Hemorrhoids
85
What does Ulcerative Colitis look like radiographically?
- lead pipe sign (loss of colon haustration and mucosal edema)
- Collar button on barium enema (looks like pt swallowed buttons)
86
This is an dilated and tortuous area of superficial or deep veins.
Varices
87
What is the most common location of varicose?
The legs
88
Varicosity's can be found where?
- Esophagus
| - Rectum
89
Why do varices occur in the esophagus?
Because of portal hypertension
90
What is the best pt position to demonstrate esophageal varicose?
recumbent because gravity causes poor visualization in erect position
91
What are radiographic features of esophageal varicose?
- Serpiginous thickened folds
- Rosary bead appearance
- Worm Tracings
92
What maneuver can accentuate esophageal varicose?
Valsalva maneuver- bear down like a bowel movement
93
What are major complications are associated with esophageal varicose?
- Veins are easily torn by food passing down
| - Hemorrhage is common
94
This is a protrusion of a portion of the stomach into the thoracic cavity through the esophageal hiatus in the diaphragm. typically around T11-12.
Hiatal Hernia
95
Hiatal Hernias are often associated with what?
GERDs
96
What are the 2 types of hiatal hernias?
1. Direct/ Sliding
| 3. Paraesophageal
97
This type of hiatal hernia consist of a mucosal ring that protrudes into the lumen.
Paraesophageal
98
This type of hernia is most common and represents 90% of all hernias. It occurs when a portion of the stomach and gastroesophageal junction move above the diaphragm.
Sliding or Direct
99
Sliding or Direct hernias can be secondary to what?
esophageal cancer, kyphoscoliosis
100
What procedure will detect most hernias?
UGI series
101
Hernias are populary referred to as what?
Rupture
102
If a herniated loop of bowel can be pushed back into the abdominal cavity it is said to be what?
Reducible
103
If the bowel becomes stuck and connot be reduced it is called what?
Incarcerated hernia
104
If constriction through which the bowel loop has passed is tight enough to cut off the blood supply to the bowel it is called?
Strangulation hernia
105
This portion of the fundus and greater curvature of the stomach slides through the hiatus covered by the complete peritoneal coating is which type of hernia?
paraesophageal
106
What is the normal position of paraesophageal hernias?
Gastroesophageal junction
107
This is anything that causes a lack of movement of the intestinal contents through the intestine.
Intestinal Obstructive Disease
108
Intestinal Obstructive Diseae develops more frequently in which area of intestines
- Small Intestines
| - 90%
109
What occurs during obstruction of the small bowel?
- Peristalsis ceases
- Distention of the intestines occur
- electrolytes accumulate
- Blocks flow of venous blood
110
What can small bowel obstruction result in?
Metabolic alkalosis from dehydration and loss of gastric HCL
111
What can large bowel obstruction result in?
Slower dehydration and loss of intestinal alkaline fluids resulting in metabolic acidosis.
112
This is a lack of propulsion in the intestine following abdominal surgery.
- Paralytic Ileus
- Ileus
- Adynamic
113
This is obstruction of the flow of intestinal contents due to a physical blockage distending the intestine.
Mechanical Bowel Obstruction
114
What can cause mechanical obstructions?
- adhesions
- hernias
- tumors
- foreign bodies
- intissisception
- volvulus
115
What are the auscultations the bowel makes called?
Broborygmi sounds
116
Mechanical Obstruction can lead to what type of shock?
Hypovolemic Shock
117
What is the radiographic appearance of Mechanical Obstruction?
"Step Ladder"
118
This is a mechanical type of obstruction consisting of telescoping of proximal part of the bowel into the distal part because of peristalsis cases bowel obstruction and compromises the vascular supply to the bowel wall.
Intussuseption
119
What is the most common site of intussuseption?
Cecum and ileum
120
What are the cardinal signs of intussuseption?
- Intermittent colicky pain
- vomitting
- mucus and blood stools, Jelly stool
- Sausage shaped abdominal mass
121
What does intussuseption look like radiographically?
BE shows "coiled spring sign", "slinky toy"
122
This is twisting of he intestine at least 180 degrees on its mesentery which results in blood vessel compression.
Volvulus
123
What can a volvulus result from?
- Adhesions
- ingested Foreign Body
- Rotational Abnormality
124
What are the most common areas for a volvulus?
Sigmoid colon
125
What does a volvulus look like radiographically?
As a collection of air conforming to the shape of the affected dilated bowel.
- "bean shape"
- "beak" sign
126
This is outpouchings of the esophageal wall.
Esophageal Diverticula
127
This esophageal diverticula involves all layers of the wall.
True or traction
128
This esophageal diverticula is composed of only mucosa and submucosa herniating through the muscular layer.
False or pulsion
129
This is herniation or outpouching of the mucosa through the muscle layers of the colon wall.
Diverticulosis
