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Abdomin And Superficial Structures > Gastrointestinal Tract > Flashcards

Gastrointestinal Tract Flashcards

1
Q

What is the path of the alimentary canal?

A

Mouth, pharynx, esophagus, stomach, duodenum, small and large intestine

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2
Q

Describe the esophagus

A

Hollow muscular tube

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3
Q

The esophagus extends from what structures?

A

Pharynx to GE junction

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4
Q

At what level does the esophagus go through the diaphragm?

A

T10

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5
Q

What part of the diaphragm does the esophagus puncture?

A

RT crus

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6
Q

Is the esophagus anterior or posterior to the aorta?

A

Anterior

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7
Q

What portion of the stomach does the esophagus enter?

A

Cardia- superomedial aspect of stomach

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8
Q

What structure marks the junction of the greater and lesser curvature of the stomach?

A

GE junction

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9
Q

What regions does the stomach lie in?

A

Hypochondrium and epigastric region

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10
Q

What space does the stomach lie in?

A

Peritoneal

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11
Q

The lower aspect of the stomach crosses midline and terminates at what structure?

A

Duodenum

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12
Q

Identify the different aspects of the stomach (6)

A 
Cardia 
Fundus
Body
Lesser curvature 
Greater curvature 
Pylorus
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13
Q

What does the cardia surround?

A

Lower esophageal sphincter

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14
Q

What is the fundus of the stomach?

A

Rounded portion, superior and to the left of the cardia

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15
Q

Is the lesser curvature concave or convex shaped?

A

Concave

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16
Q

What aspect of the stomach is the pylorus?

A

Distal aspect

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17
Q

Describe the duodenum

A

Shortest, widest and most fixed part

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18
Q

When the stomach is empty where does the pylorus sit?

A

Right of midline

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19
Q

On a fully distended stomach where does the pylorus sit?

A

Shifts 5-8cm to the right of midline

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20
Q

How many parts are there of the duodenum?

A

4

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21
Q

What cavity does the first part of the duodenum sit in?

A

Intraperitoneal

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22
Q

What are the additional names of the first part of the duodenum?

A

Superior/bulb

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23
Q

Describe the route of the first part of the duodenum

A

From the pylorus running upward and backwards to the about the level of the GB neck

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24
Q

What is another name for the second part of the duodenum?

A

Descending part

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25
Q

The second part of the duodenum connects with what duct?

A

CBD and main pancreatic duct insertion

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26
Q

What is another name for the 3rd part of the duodenum?

A

Transverse or horizontal

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27
Q

Where is the IVC in comparison to the 3rd part of the duodenum?

A

Posterior

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28
Q

How is the 3rd part of the duodenum sitting compared to the pancreatic head?

A

Posterior

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29
Q

What is another name for the 4th part of the duodenum?

A

Ascending

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30
Q

What cavity is the 4th part of the duodenum sitting in?

A

Retroperitoneal cavity

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31
Q

How does the 4th part of the duodenum run?

A

Superior and to the left

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32
Q

Where does the jejunum become intraperitoneal?

A

At suspensory ligament (Ligament of Treitz)

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33
Q

What quadrants does the jejunum occupy?

A

Umbilical and left iliac regions

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34
Q

What is the longest portion of the small bowel?

A

Ileum

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35
Q

What regions does the ileum occupy?

A

Umbilical, hypogastric, right iliac and pelvic regions

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36
Q

How are the ileum and jejunum anchored to the posterior wall?

A

Mesentery

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37
Q

Where is the cecum located?

A

RLQ and/or right iliac region

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38
Q

Is US the modality of choice for adults or children when imaging the appendix?

A

Children

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39
Q

What cavity is the ascending colon located in?

A

Retroperitoneal cavity

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40
Q

What cavity is the transverse colon in?

A

Intraperitoneal cavity

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41
Q

What cavity is the descending colon in?

A

Retroperitoneal cavity

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42
Q

What is the path of the descending colon?

A

Descends from the left side of the abdomen to the left iliac fossa

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43
Q

Does the descending colon extend over the pelvic brim?

A

Yes

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44
Q

How does the sigmoid colon sit in comparison to the sacrum?

A

Anterior to the sacrum

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45
Q

Is the rectum located in the true pelvis or false pelvis?

A

True pelvis

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46
Q

What does the rectum penetrate to become the anal canal?

A

Levator ani muscle

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47
Q

How does the GE junction sit in comparison to the aorta?

A

Left and anterior

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48
Q

What is the anterior surface of the stomach in contact with?

A

Diaphragm, left lobe of liver and anterior abdominal wall

49
Q

What is the posterior portion of the stomach in contact with?

A

Diaphragm, gastric surface of spleen, left adrenal, superior portion of kidney, anterior surface of pancreas and splenic flexure

50
Q

What is the posterior/inferior stomach in contact with?

A

Lesser sac, pancreas, transverse colon and spleen

51
Q

Is the 1st part duodenum posterior or anterior to the left lobe of the liver?

A

Posterior

52
Q

Where is the 1st part duodenum compared to the GB?

A

Medial

53
Q

What structures is the 1st part of the duodenum anterior to?

A

CBD, GDA, PV and head of pancreas

54
Q

The 2nd part of the duodenum is lateral to what structure?

A

Pancreatic head

55
Q

The 2nd part of the duodenum is medial to what structure?

A

Hepatic flexure

56
Q

The 2nd part of the duodenum is posterior to what structure?

A

Transverse colon

57
Q

How does the 3rd part of the duodenum run?

A

Passes right to left and anterior to greater vessels and crura of diaphragm

58
Q

Is the 3rd part of the duodenum anterior or posterior to the mesenteric vessels?

A

Posterior

59
Q

How is the 4th part of the duodenum in relation to the aorta and crus of the diaphragm?

A

Lateral

60
Q

Is the transverse colon anterior or posterior to the duodenum?

A

Anterior

61
Q

How is the transverse colon in comparison to the pancreas?

A

Anterior and inferior

62
Q

What is the length of the esophagus?

A

25cm

63
Q

What is the length of the pylorus?

A

2-3cm in length

64
Q

How long is the small bowel?

A

5-6 m

65
Q

How wide is the small bowel?

A

3cm wide

66
Q

How long is the large bowel?

A

2m

67
Q

Describe the mucosa

A

Epithelial lining, loose connective tissue (lamina propria), muscularis mucosa

68
Q

What is the function of the mucosa?

A

Protects, absorbs and secretes

69
Q

Describe the submucosa

A

Connective tissue, blood vessels and lymphatics

70
Q

What is the function of the submucosa?

A

Nourishes surrounding tissue and transports absorbed nutrients

71
Q

Describe the muscularis

A

Smooth muscle in circular and longitudinal groups

72
Q

What is the muscularis responsible for?

A

Movement of tube and its content

73
Q

What is the job of the serosa?

A

Protection

74
Q

What are valvulae conniventes?

A

Characteristic circular folds in the small bowel; 3-5cm apart

75
Q

Where are valvulae conniventes most prominent?

A

In the duodenum and first half of jejunum

76
Q

Do valvulae conniventes disappear when the small bowel is distended?

A

No

77
Q

Are the valvulae conniventes prominent in the ileum?

A

Not apparent

78
Q

What is the keyboard sign?

A

valvulae conniventes

79
Q

What are haustral markings?

A

Projections into the large bowel

3-5cm apart

80
Q

What causes the large bowel to pucker into sacculations?

A

3 muscular bands (short bands)

81
Q

What is the term “gut signature” referring to?

A

Distinct layered appearance of gut due to different acoustic properties of the histologic layers of the GI tract

82
Q

How does the lumen appear when collapsed?

A

Hypoechoic

83
Q

How does the mucosal layer appear on US?

A

Hypoechoic

84
Q

How does the submucosa appear on US?

A

Hyperechoic

85
Q

How does the muscularis appear on US?

A

Hypoechoic

86
Q

How does the serosa appear on US?

A

Echogenic

87
Q

How should the gut wall appear?

A

Uniform and compressible

88
Q

What is the average thickness of the gut wall?

A

Distended- 3mm

Non-distended- 5mm

89
Q

What do we assess the gut for?

A

Motor activity, content and diameter

90
Q

Where are the haustral markings most prominently seen?

A

Ascending and descending colon

91
Q

What is the primary function of the gut?

A

Digestion and absorption of nutrients

92
Q

Is the GI an endocrine or exocrine organ?

A

Largest endocrine system

93
Q

Which layer of the GI tract stimulates the release of endocrine hormones?

A

Mucosa

94
Q

What do the hormones released by the GI tract stimulate?

A

Intestinal absorption and act on the secretion of water, enzymes and electrolytes

95
Q

What are the 3 GI hormones?

A
  1. Gastrin
  2. Cholecystokinin “CCK”
  3. Secretin
96
Q

What organ releases gastrin?

A

Stomach

97
Q

What does gastrin stimulate the secretion of?

A

Gastric acid

98
Q

What organ releases CCK and what does it control?

A

Released by duodenum into the blood upon ingestion of fats

Controls GB contraction

99
Q

What structure releases secretin?

A

Released by duodenal mucosa

100
Q

What does the secretion of secretin stimulate?

A

Secretion of bicarbonate by the pancreas, decreases acid content

101
Q

What is the relation of the COLLAPSED antrum to the pancreas?

A

Anterior to the pancreas

102
Q

Is the sigmoid colon anterior or posterior to the iliac vessels?

A

Anterior

103
Q

In females is the sigmoid colon anterior or posterior to the uterine surface?

A

Posterior

104
Q

In males is the sigmoid colon anterior or posterior to the bladder?

A

Posterior

105
Q

What arteries supply the small and large bowel?

A

Celiac, superior and inferior mesenteric arteries

106
Q

What does the venous return from the small and large bowel empty into?

A

Portal system

107
Q

What vessels supply and drain the stomach?

A

Gastric artery and vein

108
Q

What is symmetric thickening of the bowel associated with?

A

Inflammation- normally benign

109
Q

What is asymmetric thickening of the bowel associated with?

A

Malignancy

110
Q

What is paralytic ileus?

A

Failure of intestine to propel content- paralyzed bowel

111
Q

When does activity within the bowel increase?

A

Increases with mechanical bowel obstruction or inflammation in early stages

112
Q

When does activity within the bowel decrease?

A

Decreases with paralytic ileus/ end-stage mechanical obstruction

113
Q

What is pt prep for the GI tract?

A

Depends on area: no prep, fasting, drinking water

114
Q

How is the esophagus assessed?

A

Endoscopic procedure

115
Q

What frequency is used for examining the bowel?

A

3.5-5MHz linear transducer

116
Q

When should graded compression be used?

A

In suspicious areas

117
Q

What should normal gut do when compressed?

A

Should compress and displace bowel gas

118
Q

What do we look for when assessing paracolic gutters?

A

Free fluid and masses

Abdomin And Superficial Structures (12 decks)

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