Chapter 10: The Gastrointestinal Tract Flashcards
a disorder in which the immune system attacks normal tissue
autoimmune disorder
the proximal portion of the duodenum closest to the stomach
duodenal bulb
a defect in the relaxation of the pyloric sphincter that leads to the enlargement of the pyloric muscles and closure of the pyloric sphincter
hypertrophic pyloric stenosis
the proximal segment of the bowel with intussusception
intussusceptum
the distal segment of the bowel with intussusception
intussuscipiens
a situation in which the small bowel mesentery rotates around the superior mesenteric artery
malrotation of the midgut
a point halfway between the anterior superior iliac spine and the umbilicus; the area of pain and rebound tenderness in patients suffering from acute appendicitis
McBurney point
a common congenital outpouching of the wall of the small intestine
Meckel diverticulum
a situation in which bowel is blocked because of the lack of normal peristalsis of a bowel segment or segments; also referred to as a paralytic ileus
nonmechanical obstruction
when the pyloric sphincter muscle is enlarged and palpable on physical examination of the abdomen; often indicative of pyloric stenosis
olive sign
a temporary spasm and thickening of the pyloric sphincter that can replicate the sonographic appearance of pyloric stenosis
pylorospasm
a blind-ended tube that is connected to the cecum of the colon
vermiform appendix
a situation in which a loop of bowel twists upon itself
volvulus
normal bowel should be ____________
compressible
the normal intestinal wall should measure less than ____ in thickness
5 mm
the most common cause of acute abdominal pain resulting in surgery
appendicitis
the inflamed appendix will appear as a ____________, blind-ended tube that measures more than ____ in diameter
noncompressible
6 mm
Clinical findings: initial epigastric or general abdominal pain that, with time, is confined to the right lower quadrant acute abdominal pain rebound tenderness nausea and vomiting possible leukocytosis high fever (with abscess formation)
acute appendicitis
Sonographic findings:
noncompressible, blind-ended tube that measures more than 6 mm in diameter from outer wall to outer wall
echogenic structure within the lumen of the organ
hyperemic flow within the wall of the inflamed organ
periappendiceal fluid collection
acute appendicitis
if pyloric stenosis is present, the wall of the pyloric muscle will measure ____ or greater in thickness and the length of the abnormal pyloric channel will measure ____ or greater
3 mm
17 mm
the abnormal pylorus appears as a “target” or “doughnut” in the __________ scan plane and as a cervix in the __________ scan plane
longitudinal
transverse
3 additional causes of nonbilious vomiting in the infant
pylorospasm
gastroesophageal reflux
malrotation of the midgut
Clinical findings: first-born male infant nonbilious, projectile vomiting weight loss constipation dehydration insatiable appetite palpable olive sign
hypertrophic pyloric stenosis
Sonographic findings:
abnormal pylorus appears as a target or doughnut in the transverse view
abnormal pylorus appears as a cervix in the longitudinal view
wall of pylorus will measure greater than or equal to 3 mm in thickness
length of pyloric channel will measure greater than or equal to 17 mm
hypertrophic pyloric stenosis
the most common type of intussusception and where it occurs
ileocolic intussusception
occurs within the right lower quadrant at the level of the ileocecal valve
Clinical findings: intermittent, severe abdominal pain vomiting palpable abdominal mass red currant jelly stools leukocytosis
intussusception
Sonographic findings:
noncompressible, target-shaped or pseudokidney-shaped mass that consists of alternating rings of echogenicity
intussusception
2 types of intestinal obstruction
mechanical
nonmechanical
Sonographic findings:
distended fluid-filled loops of bowel
an abrupt termination point of the distended bowel may be identified
increased peristaltic motion with to-and-fro motion of intraluminal contents (mechanical only)
intestinal obstruction
Clinical findings: episodes of diarrhea abdominal pain weight loss rectal bleeding
Crohn disease
Sonographic findings:
bowel wall thickening
affected bowel will be noncompressible and have a target appearance
hyperemic wall
Crohn disease
gastric cancer is most often in the form of what?
adenocarcinoma
Clinical findings: weight loss abdominal pain anorexia vomiting
gastric carcinoma
Sonographic findings:
hypoechoic, irregular-shaped, bulky mass in the intestines
gastric carcinoma
a rupture in the muscle or associated vasculature of the rectus sheath
rectus sheath hematoma
Clinical findings: abdominal pain palpable abdominal mass discoloration of the skin in the area of concern decreased hematocrit
rectus sheath hematoma
Sonographic findings:
blood can appear hypoechoic, hyperechoic, complex, and/or anechoic depending on the stage of development
rectus sheath hematoma
Which of the following is not a layer of gut identified with sonography? A. visceral B. serosa C. submucosa D. mucosa
visceral
All of the following are true of normal intestinal findings with sonography except:
A. normal bowel does not compress
B. normal bowel should have observable peristalsis
C. intestinal wall should measure less than 5 mm
D. normal bowel has little to no color Doppler signals
normal bowel does not compress
All of the following are sonographic criteria in the diagnosis of pyloric stenosis except:
A. wall of the pylorus measures less than 8 mm
B. length of the pylorus measures more than 17 mm
C. doughnut appearance in transverse
D. cervix appearance in longitudinal
wall of the pylorus measures less than 8 mm
All of the following are sonographic findings of acute appendicitis except: A. appendicolith B. compressible, blind-ended tube C. periappendiceal fluid collection D. hyperemic flow
compressible, blind-ended tube
What gastrointestinal abnormality is sonographically diagnosed as an abnormal relationship between the superior mesenteric artery and superior mesenteric vein? A. pyloric stenosis B. intussusception C. Crohn disease D. midgut malrotation
midgut malrotation
The situation when bowel protrudes into the groin is referred to as a: A. inguinal hernia B. linea alba hernia C. umbilical hernia D. Spigelian hernia
inguinal hernia
The situation when bowel protrudes into a weakened area in the lower one-fourth of the rectus muscle is referred to as a: A. inguinal hernia B. linea alba hernia C. umbilical hernia D. Spigelian hernia
Spigelian hernia
The area of pain and rebound tenderness with acute appendicitis is most likely at: A. Meckel point B. McBurney point C. Murphy point D. olive point
McBurney point
Which of the following best describes the location of McBurney point?
A. left lateral to the umbilicus and medial to the left iliac crest
B. halfway between the anterior superior iliac spine and the umbilicus
C. midway between the umbilicus and symphysis pubis
D. medial to the superior iliac spine
halfway between the anterior superior iliac spine and the umbilicus
The most common location of the vermiform appendix is in the areal of the: A. jejunum B. descending colon C. cecum D. sigmoid colon
cecum
Which of the following is not a sonographic finding consistent with Crohn disease?
A. bowel wall thickening
B. noncompressible bowel that has a target appearance
C. increased peristalsis
D. hyperemic wall
increased peristalsis
All of the following are common clinical findings in infants that present with intussusception except: A. vomiting B. first-born male infant C. red currant jelly stools D. leukocytosis
first-born male infant
Traditionally, treatment for intussusception is by means of: A. surgery B. external manipulation C. compression sonography D. contrast enema
contrast enema
Hypertrophic pyloric stenosis is most often found in infants between: A. 1 and 10 days of age B. 2 and 8 weeks of age C. 10 and 24 weeks of age D. 2 and 4 years of age
2 and 8 weeks of age
For better sonographic visualization of the pyloric sphincter, the infant is often placed in what position? A. right lateral decubitus B. left lateral decubitus C. prone D. upright
right lateral decubitus
