Chapter 10 The Gastrointestinal Tract And Abdominal Wall Flashcards
What are the diagnostic criteria for pyloric stenosis?
3mm in thickness and 17mm in length
In what position is the infant often placed for better sonographic visualization of the pyloric sphincter?
Right lateral decubitus
HPS is most often found in infants between:
2 and 6 weeks of age
The most common cause of intestinal obstruction in children less than 2 years of age is:
Intussusception
Traditionally, treatment for intussusception is by means of:
Therapeutic enema
The sonographic finding of fluid-filled, distended loops of bowel is consistent with:
Intestinal obstruction
_____is the development of small outpouchings within the sigmoid colon?
Diverticulitis
The most common location of the vermiform appendix is in the area of the:
Cecum
Rebound tenderness is associated with:
Appendicitis
The olive sign is best described as :
Enlarged palpable pyloric sphincter
The location of McBurney point?
Between the anterior superior iliac spine and the umbilicus
What anatomic structure may be noted as a bullseye structure anterior to the abdominal aorta and posterior to the left lobe of liver in SAG plane?
Gastroesophageal junction
_______refers to the bowel being physically blocked by something
Mechanical
The area of pain and rebound tenderness with acute appendicitis is most likely at:
McBurney point
The situation when bowel protrudes into a weakened area in the lower one-fourth of the rectus muscle is referred to as:
Spigelian hernia
Diffused liver diseases are:
- Hemochromatosis
- Hepatitis
- Glycogen storage disease
- Steatosis
- Cirrhosis
- Fatty sparing
Gastric cancer is most often in the form of:
Adenocarcinoma
Other abnormalities that can present much like pyloric stenosis include:
- Midgut malrotation
- Pylorospasm
- Gastroesophageal reflux disease (GERD)
What abnormality associates red currant jelly stools?
Intussusception
The situation when bowel protrudes into the groin is referred to as:
Inguinal hernia
Clinical findings of acute appendicitis
- Epigastric or general abdominal pain
- Acute abdominal pain
- Rebound tenderness
- Nausea and vomiting
- Possible leukocytosis
- High fever (Abscess formation)
Layers of gut identified with sonography:
- Superficial mucosal
- Deep mucosal
- Submucosal
- Muscular
- Serosal
Pediatric patients could suffer from bowel obstructions that are caused by a buildup of ingested hair. The mass associated with this is:
Trichobezoar
Clinical findings of pyloric stenosis:
- First-born (white) male infant
- Nonbilious, projectile vomiting
- Weight loss
- Constipation
- Dehydration
- Insatiable appetite
- Palpable olive sign
Pseudomyxoma peritonei can result from:
Appendix cancer
An autoimmune disease characterized by periods of inflammation of the gastrointestinal tract describes:
Crohn disease
The normal intestinal wall should measure less than ______ in thickness
5mm
Within the distal stomach lies the ____, a muscle that controls the emptying of the stomach into the duodenum
Pyloric sphincter
The esophagus travels inferiorly within the thorax and through an opening in the diaphragm called the:
Esophageal hiatus
The ______consists of the mouth, pharynx, esophagus, stomach, the small intestines and colon
Gastrointestinal tract
_____has been cited as the most common cause of acute abdominal pain resulting in surgery
Appendicitis
There are two types of intestinal obstruction:
- Mechanical
- Nonmechanical
Blood accumulation within the muscle or under the sheath can be the result of:
*Abdominal trauma
*May occur spontaneously
The _____forms a covering for the paired rectus abdominis muscles
Rectus sheath
The most common site for endometriosis outside the female pelvis region is the:
Anterior abdominal wall
Complications of abdominal wall hernias include:
*Incarceration
*Strangulation
*Ischemia of the affected bowel
What transducer should be used for abdominal wall hernias?
A high frequency linear transducer and standoff pad
______ occurs within the RLQ at the level of the ileocecal valve
ileocolic intussusception
______is the telescoping of one segment of bowel into another
Intussusception
_____is a defect in the relaxation of the pyloric sphincter
Hypertrophic pyloric stenosis
An appendicolith will appear as an:
Echogenic, shadowing structure within the lumen of the appendix
_____can result from the use of antibiotic therapy that destroys the healthy flora of the intestines and leads to C.difficile
Pseudomembranous colitis
Different types of colitis include:
- Pseudomembranous
- Ulcerative
- Ischemic
- Infectious
_____is the development of small outpouching termed diverticuli in the digestive tract most often the sigmoid colon
Diverticulosis
_____is an autoimmune disorder characterized by periods of inflammation of the GI tract
Crohn disease
_____may resemble a cinnamon bun sign in the transverse plane as a result of the alternating echogenicity and the elliptical shape of mass
Intusscusception
_____are masses various ingested materials may cause intestinal obstructions
Bezoars
Bezoars that consist of vegetable material are called:
Phytobezoars (found in older patients)
______or paralytic ileus is when the bowel lacks normal peristalsis
Nonmechanical obstruction
Stool that contains a mixture of blood and mucus is referred to as _____and it is a hallmark clinical findings of intussusception
Jelly stool
_____results from the bowel being physically blocked by something
Mechanical obstruction
Clinical findings of Acute appendicities
- Initial epigastric or general abdominal pain
- Acute abdominal pain
- Rebound tenderness
- Nausea and vomiting
- Possible leukocytosis
- High fever (with abscess formation)
Clinical findings of pyloric stenosis
- First-born (white) infant male
- Nonbilious, projectile vomiting
- Weight loss
- Constipation
- Dehydration
- Insatiable appetite
- Palpable olive sign
Clinical findings of intussusception
- Intermittent. severe abdominal pain
- Vomiting
- Palpable abdominal mass
- Red currant jelly stools
- Leukocytosis
Clinical findings of an intestinal obstruction
- Abdominal distention
- Intermittent abdominal pain
- Constipation
- Nausea and vomiting
Clinical findings of Crohn disease
- Episodes of diarrhea
- Abdominal pain
- Weight loss
- Rectal bleeding
Clinical findings of diverticulitis
- Constipation or diarrhea
- Fever
- Nausea and vomiting
- Cramping and LLQ pain
Clinical findings of colitis
- Bloody or watery diarrhea
- Fever
- Abdominal pain
- Previous use of antibiotic therapy
Clinical findings of Gastric carcinoma
- Weight loss
- Abdominal pain
- Anorexia
- Vomiting
Clinical findings of Endometriosis of the abdominal wall
- History of endometriosis
- Prior cesarean section
- Pain on the area of the cesarean section scar (possible pain with menstrual cycle)
- Palpable mass
Clinical findings of a rectus sheath hematoma
- Abdominal pain
- Palpable abdominal mass
- Discoloration of the skin in the area of the hematoma
- Decreased hematocrit
Sonographic findings of Acute Appendicitis
- Noncompressible
- measures more than 6mm in diameter
- appendicolith
- Hyperemic flow
- Periappendiceal fluid collection
Sonographic findings of pyloric stenosis
- Abnormal pylorus appears as a target or doughnut in the short axis view
- Abnormal pylorus appears as a cervix in the long axis view
- Wall of pylorus will measure greater than or equal to 3mm in thickness
- Length of pyloric channel will measure greater than or equal to 17mm
Sonographic findings of intussusception
- Noncompressible, target-shaped or pseudokidney shaped mass that consists of alternating rings of echogenicity (Cinnamon bun sign)
- The diameter of the intussuscepted bowel will exceed 3cm
Sonographic findings of intestinal obstruction
- Distended fluid-fluid 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 obstruction only)
Sonographic findings of diverticulitis
- Segmentally thickened bowel with evidence of an inflamed diverticula and inflamed perienteric fat
- Affected bowel segment will typically reveal hyperemia
- Inflamed diverticula may appear as echogenic projections from the bowel that produce shadowing or ring-down artifact
Sonographic findings of gastric carcinoma
- Hypoechoic, irregular shaped bulky mass
Sonographic findings of a rectus sheath hematoma
- Blood can appear hypoechoic, hyperechoic, complex and/or anechoic depending on the stage of development
