Chapter 10: The Gastrointestinal Tract

Question 1

a disorder in which the immune system attacks normal tissue

Answer 1

autoimmune disorder

Question 2

the proximal portion of the duodenum closest to the stomach

Answer 2

duodenal bulb

Question 3

a defect in the relaxation of the pyloric sphincter that leads to the enlargement of the pyloric muscles and closure of the pyloric sphincter

Answer 3

hypertrophic pyloric stenosis

Question 4

the proximal segment of the bowel with intussusception

Answer 4

intussusceptum

Question 5

the distal segment of the bowel with intussusception

Answer 5

intussuscipiens

Question 6

a situation in which the small bowel mesentery rotates around the superior mesenteric artery

Answer 6

malrotation of the midgut

Question 7

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

Answer 7

McBurney point

Question 8

a common congenital outpouching of the wall of the small intestine

Answer 8

Meckel diverticulum

Question 9

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

Answer 9

nonmechanical obstruction

Question 10

when the pyloric sphincter muscle is enlarged and palpable on physical examination of the abdomen; often indicative of pyloric stenosis

Answer 10

olive sign

Question 11

a temporary spasm and thickening of the pyloric sphincter that can replicate the sonographic appearance of pyloric stenosis

Answer 11

pylorospasm

Question 12

a blind-ended tube that is connected to the cecum of the colon

Answer 12

vermiform appendix

Question 13

a situation in which a loop of bowel twists upon itself

Answer 13

volvulus

Question 14

normal bowel should be ____________

Answer 14

compressible

Question 15

the normal intestinal wall should measure less than ____ in thickness

Answer 15

5 mm

Question 16

the most common cause of acute abdominal pain resulting in surgery

Answer 16

appendicitis

Question 17

the inflamed appendix will appear as a ____________, blind-ended tube that measures more than ____ in diameter

Answer 17

noncompressible

6 mm

Question 18

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)

Answer 18

acute appendicitis

Question 19

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

Answer 19

acute appendicitis

Question 20

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

Answer 20

3 mm

17 mm

Question 21

the abnormal pylorus appears as a “target” or “doughnut” in the __________ scan plane and as a cervix in the __________ scan plane

Answer 21

longitudinal

transverse

Question 22

3 additional causes of nonbilious vomiting in the infant

Answer 22

pylorospasm
gastroesophageal reflux
malrotation of the midgut

Question 23

Clinical findings:
first-born male infant
nonbilious, projectile vomiting
weight loss
constipation
dehydration
insatiable appetite
palpable olive sign

Answer 23

hypertrophic pyloric stenosis

Question 24

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

Answer 24

hypertrophic pyloric stenosis

Question 25

the most common type of intussusception and where it occurs

Answer 25

ileocolic intussusception | occurs within the right lower quadrant at the level of the ileocecal valve

Question 26

``` Clinical findings: intermittent, severe abdominal pain vomiting palpable abdominal mass red currant jelly stools leukocytosis ```

Answer 26

intussusception

Question 27

Sonographic findings: | noncompressible, target-shaped or pseudokidney-shaped mass that consists of alternating rings of echogenicity

Answer 27

intussusception

Question 28

2 types of intestinal obstruction

Answer 28

mechanical | nonmechanical

Question 29

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)

Answer 29

intestinal obstruction

Question 30

``` Clinical findings: episodes of diarrhea abdominal pain weight loss rectal bleeding ```

Answer 30

Crohn disease

Question 31

Sonographic findings: bowel wall thickening affected bowel will be noncompressible and have a target appearance hyperemic wall

Answer 31

Crohn disease

Question 32

gastric cancer is most often in the form of what?

Answer 32

adenocarcinoma

Question 33

``` Clinical findings: weight loss abdominal pain anorexia vomiting ```

Answer 33

gastric carcinoma

Question 34

Sonographic findings: | hypoechoic, irregular-shaped, bulky mass in the intestines

Answer 34

gastric carcinoma

Question 35

a rupture in the muscle or associated vasculature of the rectus sheath

Answer 35

rectus sheath hematoma

Question 36

``` Clinical findings: abdominal pain palpable abdominal mass discoloration of the skin in the area of concern decreased hematocrit ```

Answer 36

rectus sheath hematoma

Question 37

Sonographic findings: | blood can appear hypoechoic, hyperechoic, complex, and/or anechoic depending on the stage of development

Answer 37

rectus sheath hematoma

Question 38

``` Which of the following is not a layer of gut identified with sonography? A. visceral B. serosa C. submucosa D. mucosa ```

Answer 38

visceral

Question 39

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

Answer 39

normal bowel does not compress

Question 40

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

Answer 40

wall of the pylorus measures less than 8 mm

Question 41

``` 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 ```

Answer 41

compressible, blind-ended tube

Question 42

``` 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 ```

Answer 42

midgut malrotation

Question 43

``` 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 ```

Answer 43

inguinal hernia

Question 44

``` 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 ```

Answer 44

Spigelian hernia

Question 45

``` 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 ```

Answer 45

McBurney point

Question 46

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

Answer 46

halfway between the anterior superior iliac spine and the umbilicus

Question 47

``` The most common location of the vermiform appendix is in the areal of the: A. jejunum B. descending colon C. cecum D. sigmoid colon ```

Answer 47

cecum

Question 48

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

Answer 48

increased peristalsis

Question 49

``` 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 ```

Answer 49

first-born male infant

Question 50

``` Traditionally, treatment for intussusception is by means of: A. surgery B. external manipulation C. compression sonography D. contrast enema ```

Answer 50

contrast enema

Question 51

``` 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 ```

Answer 51

2 and 8 weeks of age

Question 52

``` 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 ```

Answer 52

right lateral decubitus