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Endoscopy Nurses - GENCA > Chapter 16 - Large Intestine > Flashcards

Chapter 16 - Large Intestine Flashcards

1
Q

How long is the large intestine approximately in adults?

A

120-150 cm

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2
Q

What is the name of the valve that acts as a sphincter both to control the passage of intestinal contents from the ileum to the colon AND to prevent the reflux of bacteria from colon back into the small bowel?

A

Ileocecal valve

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3
Q

Name the four layers of large intestine wall

A

[s] serosa
[m] muscularis
[s] submucosa
[m] mucosa

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4
Q

The rectum does not have a _______ layer

A

serous layer

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5
Q

The rectum and anal canal receive arterial blood from

A

the hemorrhoidal artery

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6
Q

The mucosa is smooth surfaced and is arranged in folds called

A

plicae semilunares coli

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7
Q

The right half of the large intestine receive arterial blood from

A

the superior mesenteric artery

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8
Q

The left or lower portion of the large intestine receive arterial blood from

A

inferior mensenteric artery

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9
Q

Main functions of the large intestine are:
1.
2.
3. (to a minor extent)

A
  1. Storage and movement of intestinal content
  2. Absorption of water, electrolyte and bile acid
  3. Excretion of water, mucus, potassium and bicarbonate
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10
Q

What are the 3 basic patterns of movement of the large bowel?

A
  1. Periodic tonic contractions of the longitudinal and circular muscles
  2. Nonpropulsive contractions eg. peristalsis and retrograde peristalsis (back and forth)
  3. Spontaneous mass movements (urge to defecate when feces move into rectum)
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11
Q

What is hematochezia?

A

blood in stool

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12
Q

What is the name of the condition where hundreds of adenomatous polyps develop throughout the colon?

A

Familial adenomatous polyposis (FAP)

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13
Q

What is the name of a hereditary syndrome where multiple adenomatous polyps develop and osteomas appear on the mandible, skull and long bones?

A

Gardner syndrome

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14
Q

What are the names of 3 most common polyposis syndromes?

A
  1. Familial adenomatous polyposis (FAP)
  2. Gardner Syndrome
  3. Peutz-Jeghers Syndrome (PJS)
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15
Q

What is the name of the Syndrome characterized by multiple polyps and abnormal brown pigmentation of the lips, oral mucosa and skin?

A

Peutz-Jeghers Syndrome (PJS)

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16
Q

What are the two types of ischaemic colitis?

A
  1. Occlusive - mechanical obstruction eg. emboli
  2. Nonocclusive - severe derangement in Central circulation eg. congestive heart failure, MI, hemorrhage, Sepsis or cardiac arrhythmia

Treatment: Most patients recover spontaneously, although a minority develop bowel infarction and peritonitis. These pts require resection, primary anastomosis or temporary colostomy.

17
Q

What is the name of the disease that have ulceration in the small bowel and/ colon during the neonatal period?

A

Necrotizing enterocolitis (NEC)

Treatment: NBM, NG tube for suctioning, IV nutrition & antibiotic.

18
Q

What is the cardinal symptom occurring 70-90% of the time in UC associated usually with blood in stool?

A

Diarrhea

19
Q

What are some treatments for UC?

A
  1. In adults, avoidance of food that aggravate symptoms
  2. In children - nutritional therapy
  3. Fibre restriction for those with strictures and lactose avoidance for those with lactose intolerance
  4. Drug therapy 💊
  5. Bedrest for acute exacerbation
  6. Surgery - hemorrhage, perforation, carcinoma, severe colitis with or without toxic megacolon, unresponsive to medications
20
Q

What is toxic megacolon?

A

An acute dilatation of the diseased colon associated with systemic toxicity.

Note: Most severe, life threatening complication of UC

21
Q

Treatment of toxic megacolon includes:

A
  1. Nill by mouth
  2. NG suction
  3. IV fluids and electrolytes
  4. Steroids
  5. Broad spectrum antibiotics
  6. Surgery if no improvement within 24-48 hours
22
Q

What is the name of the condition where there is acute inflammation of the bowel mucosa with the formation of pseudomembranous plaques overlying area of superficial ulceration?

A

Pseudomembranous colitis

23
Q

What is the name of the spore-forming, gram-negative, anaerobic rod associated with pseudomembranous colitis that produces toxins?

A

Clostridium difficile (C. difficile)

24
Q

Treatment of pseudomembranous colitis inclues:

A
  1. Discontinue antibiotics
  2. Administrating an agent that binds the C. difficile toxin eg. cholestyramine or one that eradicates the organism altogether eg. metronidazole
25
Q

An infant up to 6 months of age manifests with vomiting, diarrhea, poor weight gain, hamatochezia and irritability to cow’s milk protein is called what condition?

A

Cow’s milk protein-induced enterocolitis

26
Q

Irritable bowel syndrome (IBS), the most frequent reason for outpatient visits is characterized by:

A

abdominal pain, altered bowel habit, distention, constipation and diarrhea

27
Q

Treatment for IBS includes:

A
  1. Sympathetic diagnosis and reassurance that organic causes have been ruled out
  2. High fibre diet
  3. Anticholinergic agents to decrease abdominal pain and diarrhea
  4. Psychological support and drug therapy (to reduce stress)
  5. Probiotics
  6. Laxative or stimulant
  7. Serotonin receptor agonists to decrease motility
  8. Rifaximin for bacterial overgrowth
  9. Peppermint oil relaxes smooth muscle
28
Q

Chron’s disease involves the ___ ____ of the bowel wall. It is often segmental. Complications include ___ & ___.

A

Full thickness

Complications: Stricture and fistula

29
Q

What is the name of the common disorder occuring in school-aged children where intermittent abdominal pain persists for more than 3 months?

A

Chronic recurrent abdominal pain syndrome

30
Q

Can you name 3 parasitic diseases that affect the large intestine?

A
  1. Amebiasis (caused by E.histoytica)
  2. Trypanosomiasis (caused by T.cruzi)
  3. Trichuriasis (whipworm)
31
Q

Colorectal cancer is the second most common cancer (apart from melanoma of the skin) in adults after prostate cancer in men and breast cancer in women. Approximately 95% of the intestinal cancer occur where?

A

mucous producing cells (adenocarcinoma)

32
Q

What are 3 types of intestinal obstruction?

A
  1. Mechanical eg. atresia, stenosis, hernia
  2. Neurogenic or Pseudo-obstruction (smooth muscle, endocrine, neurological or pharmalogical causes)
  3. Vascular obstruction (emboli or atherosclerosis)
33
Q

Anorectal disorders includes:

A
  1. Hemorrhoids
  2. Fecal impaction
  3. Encopresis
  4. Abscess
  5. Anal fistula
  6. Anal fissure (thin tear)
  7. Rectal prolapse
34
Q

What is the name of the condition when a newborn have difficulty passing stool because there is a congenital absence of part or all of the nerve cells in the colon?

A

Hirschsprung’s disease

35
Q

How is Hirschsprung’s disease diagnosed and treated?

A

Diagnosed by: barium enema, anorectal manometry, and biopsy of the rectum

Treatment: Surgery - stoma or pull-through surgery

Endoscopy Nurses - GENCA (7 decks)

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