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Lawrence > Colon > Flashcards

Colon Flashcards

1
Q

Ce se dezv din mezenteron si ce din metenteron

A

Mez: - cec, colon asc, col transv prox
Met: - colon transv distal (1/3), col desc, sigmoid, rect

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2
Q

Unde nu exista apendici epiploici

A

Cec
Apendice cecal
Rect

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3
Q

Care este cea mai mobila parte a colonului

A

Transv

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4
Q

Colonul asc si desc sunt retroperitoneale fixe. But how is sigmoidul?

A

Intraperitoneal, mobil

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5
Q

Din ce e formata vena porta

A

VMI -> V splenica + VMS

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6
Q

Inervatia psy a colonului

A

Vag - proximal, 1/2 transv
S2-S4 - 1/2 transv si distal

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7
Q

Lungime colon, rect, cAnal

A

Colon = 150 cm
Rect = 12-18 cm
cAnal = 2,5-5 cm

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8
Q

2/3 sup din rect sunt acoperite ANT de peritoneu si atasate POST de retroperitoneu. cum e 1/3 inf

A

Complex extraperitoneala

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9
Q

Vascularizatie rect

A
  1. A hemoroidala sup (rectala) <- AMI
  2. A hemoroidala mijl <- A iliaca interna
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10
Q

Inervatie sy + psy rect

A

SY
Sup: L1 - L3
Inf (1/3): nv presacali -> plex hipogastric -> 2 nv hipogastrici
PSY - S2 - S4 - nv erigenti

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11
Q

Vascularizatie anus

A

A hemoroidala inf <- A rusinoasa int <- A iliaca int

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12
Q

Cea mai frecventa localizare a diverticulozei

A

Colon sigmoid

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13
Q

Diverticulii adevarati

A
  • Congenitali
  • Hernierea tuturor straturilor
  • Colon drept
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14
Q

Diverticulii falsi

A
  • Dobanditi
  • Herniere mucoasa + submucoasa
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15
Q

Manif clinice in boala diverticulara simptomatica necomplicata

A
  1. Durere abd recurenta in abd inf stg
  2. Modif tranzit: constipatie, diaree, alternanta
  3. Uneori hdi

!!! Absente febra + leucocitoza
!!! Absenta inflamatia

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16
Q

Radiologie + trat in BDSN

A
  1. Spasm segmentar + stenoza luminala
  2. Fibre
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17
Q

Manif clinice in diverticulita necomplicata

A
  1. Durere inf stg subacuta
  2. Febra
  3. Tulb de tranzit
  4. Palpare formatiune
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18
Q

Manif diverticulitei complicate

A
  1. Abces
  2. Fistula
  3. Perforatie in peritoneu
  4. Obstructie totala / partiala
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19
Q

Cea mai frecv complicatie fistulara

A

Fistula colo-vezicala

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20
Q

Trat pt pacientii cu durere importanta in diverticulita acuta

A
  1. Spitalizare
  2. Hidratare parenterala
  3. Nimic po
  4. Atb iv -> B.fragilis 5-7 zile
  5. Examinare colonoscopica ulterioara
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21
Q

Indicatii trat chir in boala diverticulara

A
  1. Perforatie libera
  2. Obstructie
  3. Boala refractara
  4. Hemoragie
  5. Fistule
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22
Q

Trat abceselor ca si complicatie a diverticulitei

A

Abcese mici
- repaus intestinal
- atb iv

Abcese mari (>5 cm)
- drenaj percutan
- repaus + atb iv

23
Q

In cazul fistulelor se face rezectie sigmoidiana cu anastomoza. Care e dif dintre cele 2 fistule (vezicala si vaginala)

A

Colo-vezicala - sutura primara a vezicii
Colo-vaginala - orificiul vaginal se vindec per secundam

24
Q

Operatie Hartmann

A
  • pt perforatia libera si obstructia colonului
    1. Rezectie sigmoid afectat + colostomie terminala + bont rectal abandonat
    2. Desfiintarea colostomiei + repunere in tranzit a bontului
25
Q

Cea mai frecv cauza de hdi

A

Diverticuloza

26
Q

Simptome in hemoragia diverticulara

A

Sangerare rectala nedureroasa cu sange rosu aprins sau inchis

27
Q

Dg diferential in hemoragia diverticulara

A
  1. Angiodisplazia
  2. Neoplazii
  3. Colita ischemica
  4. BII
28
Q

Investigatii in hemoragie diverticulara

A
  1. Colonoscopia
  2. Angiografia (colonoscopia nu controleaza hemoragia)
  3. Arteriografia mezenterica -> hemoragii moderate sau severe (>0,5 ml/min)
  4. RMN (mai sensibil ca primele)
29
Q

Ce se injecteaza pe cateterul de arteriografie in hemoragia diverticulara

A

Vasopresina fix la locul hemoragiei

30
Q

De cine e data cel mai frecv ocluzia la adult

A
  1. Cancer de colon sau rect
  2. Boala diverticulara
  3. Volvulus
31
Q

Cum arata perforatia pe rx toracica

A

Aer liber subdiafragmatic

32
Q

Aspect rx volvulus sigmoidian

A

Boabe de cafea / tub indoit interior

33
Q

Cioc de pasare la clisma cu subst hidrosolubila inseamna

A

Volvulus colonic

34
Q

Simptome volvulus sigmoid si cec

A
  1. Crampe abd
  2. Durere
  3. Greata + varsaturi
  4. Constipatie severa
35
Q

Explorarea de electie pt volvulus

A

CT contrast

36
Q

Care colon se dilata in POAC

A

Ascendent si transv

37
Q

Ce trebuie evitat in POAC

A
  1. Laxative orale osmotice
  2. Stimulante ale peristalticii
38
Q

Ce polipi apar in BII

A

Inflamatori

39
Q

Ce apare in Peutz-Jeghers

A

Hamartoame

40
Q

Adenoame cu cel mai mare risc de malignizare

41
Q

Unde sunt localizate 80% din adenoamele viloase

42
Q

HNPPC - risc pt ce cancere

A
  1. Colon drept
  2. Endometrial
  3. Urotelial
43
Q

Metastazele cancerului de colon sunt in

A
  1. FIcat
  2. Plaman
44
Q

Din ce stadiu se recomanda chimio in cancerul de colon si rect

A

Colon - st 3
Rect - st 2 si 3

45
Q

Standardul terapiei adjuvante cancer colon

A

FOLFOX
5FU + Leucovorin + Oxaliplatin - 4-6 luni

46
Q

Agentii noi biologici promitatori

A
  1. Bevacizumab
  2. Irinotecan
  3. Cetuximab
47
Q

Tratamentul prolapsului rectal

A

Rezectie sigmoidiana + rectopexie

48
Q

Care hemoroizi nu sangereaza

49
Q

Hemoroizii interni

A

I - NU prolabeaza
II - Prolabeaza da revin la normal singuri
III - Si astia da ii bagi la loc cu mana
IV - Nu-i mai bagi la loc

50
Q

Fistulele - localizare si cauze

A
  1. Intersfincteriene - abces perianal
  2. Transsfincteriene - abces ischio-rectal
  3. Suprasfincteriene - abces supralevatorian
51
Q

Cauza cea mai frecvneta de durere anorectala

A

Fisuri anale

52
Q

Topicele in fisuri anale

A
  1. Ca blocanti (diltiazzem, nifedipina)
  2. Nitrati
53
Q

Tratam gonoreei

A
  1. Spectinomicina 2g doza unica im
  2. Cefalosporine
  3. Quinolone
    + Doxi pt Chlamydia
54
Q

Tratam sifilis

A

Penicilina G doza unica im
Doxi, tetra (alergie)

Lawrence (9 decks)

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