Exam III - Clinical Aspects Flashcards
Extravasation of Urine
- rupture of the spongy urethra allows accumulation of urine between Scarpa’s Fascia and Deep Fascia
- almost exclusive to males
Cryptorchidism
- Testes are undescended at birth (3% fullterm; 30% premature)
- Undescended testes are most commonly found in the inguinal canal (usually unilateral)
- Usually descend in the first few weeks or months
- Increases risk of testicular cancer due to compression
Peristalsis
Propulsive movement of the gut; contractile ring appears and moves distally
Reverse Peristalsis
Occurs in vomiting
Congenital Hypertrophic Pyloric Stenosis
- Tumor-like increase in the size of the pyloric sphincter, reducing the size of the pyloric canal
- Results in projectile vomiting
- May be present at birth
Pylorospasm
- Spasmodic contraction of pyloric sphincter
- Sometimes present in infants
- Food does not pass easily from stomach to duodenum
- Subluxations in T5-T9 may play a role
Gastric Ulcer
- A crater like depression in the mucosa of the stomach
- Inadequate covering of stomach wall by alkaline mucus
- Subluxations of T5-T9 may play a role
- Secretion of gastric acid is controlled by Vagus Nerve
What causes gastric ulcers?
Excess acid secretion (stress)
Inadequate Mucus Barrier (presence of bacteria)
Duodenal Ulcer
- Mucosa in duodenum is eroded to form a crater-like depression, most commonly found in duodenal cap
- May affect liver, pancreas, and gall bladder, as well as gastroduodenal artery
Outline the path fluid travels from a perforated duodenal ulcer.
Subhepatic recess -> right paracholic gutter -> Iliac fossa
Ileal (Meckel’s) Diverticulum
- Malformation of digestive tract
- Remnant of a portion of the embryonic vitelline duct
- Finger-like pouch which projects from distal ileum
- May become inflamed, mimicking appendicitis
Crohn’s Disease
- Inflammatory bowel disease which most commonly affects the distal ileum and adjacent colon
- Affects ALL layers of intestine
- Results in pain, diarrhea, and malabsorption
- Produces a “cobblestone” radiographic appearance
Appendicitis
- Inflammation of the appendix
- Symptoms usually begin as umbilical pain, localizing to the right lower quadrant
What is the most common intra-abdominal inflammatory condition?
Appendicitis
What causes appendicitis?
lymphoid hyperplasia
fecal compaction
Diverticulosis
- Herniations of the mucosa of the colon through the muscular layer
- MC in individuals over 40 yrs,
- Radiographically, characterized by numerous outpouchings along the colon
Where does divertulosis most commonly appear?
sigmoid colon
T/F) Diverticulosis contains inflammation.
False. (osis = no inflam)
Ulerative Colitis
- Sever inflammation and ulceration of the rectum and lower colon
- Restricted to mucosa
- Bowel perforation may occur
Irritable Bowel Syndrome
- Recurrent abdominal pain and diarrhea with no inflam or deterioration in health
What may be caused by chronic constipation?
Hiatal hernias, inguinal hernias, diverticulitis, colon cancer
What is the most common organ, outside of gut, for metastasis of colon cancer?
Liver
Cirrhosis of the Liver
- Destruction of hepatic cells and their replacement by fibrous tissues and fat
Compression of what leads to portal hypertension?
Porta Hepatis
What are some causes of liver cirrhosis?
Alcoholism, Hepatitis, Chronic obstruction of bile duct, CHF
Portal Hypertension
- Abnormal elevation of pressure within the portal system
- Blood backs up into the caval system where anastomoses appear
T/F) The portal system has no valves.
True
Gallstones
- Hard masses formed by the solidification of bile constituents, mainly cholesterol crystals
- Commonly block the hepatopancreatic ampulla, creating a backup of bile
What are some risk factors for gallstones?
Being female, Obesity, Pregnancy, high fat diet
Where will the gallbladder refer pain?
lower thoracic spinal cord segments (T8-T11)
right upper quadrant of the abdomen
Right subscapular region of back
Forceful compression of the abdomen can rupture what organ?
Pancreas
Where does the pancreas refer pain?
Lower thoracic segments (head - right vertebral column; body and tail - left vertebral column)
What is the most frequently injured abdominal organ?
Spleen
Rupture of the spleen often results in what?
severe hemorrhage and shock
The spleen becomes fragile in what conditions?
Mononucleosis (MC), Malaria, Sickle-cell anemia, Septocemia (blood poisoning)
