Gastrointestinal Tract Flashcards
1
Q
What is the path of the alimentary canal?
A
Mouth, pharynx, esophagus, stomach, duodenum, small and large intestine
2
Q
Describe the esophagus
A
Hollow muscular tube
3
Q
The esophagus extends from what structures?
A
Pharynx to GE junction
4
Q
At what level does the esophagus go through the diaphragm?
A
T10
5
Q
What part of the diaphragm does the esophagus puncture?
A
RT crus
6
Q
Is the esophagus anterior or posterior to the aorta?
A
Anterior
7
Q
What portion of the stomach does the esophagus enter?
A
Cardia- superomedial aspect of stomach
8
Q
What structure marks the junction of the greater and lesser curvature of the stomach?
A
GE junction
9
Q
What regions does the stomach lie in?
A
Hypochondrium and epigastric region
10
Q
What space does the stomach lie in?
A
Peritoneal
11
Q
The lower aspect of the stomach crosses midline and terminates at what structure?
A
Duodenum
12
Q
Identify the different aspects of the stomach (6)
A
Cardia Fundus Body Lesser curvature Greater curvature Pylorus
13
Q
What does the cardia surround?
A
Lower esophageal sphincter
14
Q
What is the fundus of the stomach?
A
Rounded portion, superior and to the left of the cardia
15
Q
Is the lesser curvature concave or convex shaped?
A
Concave
16
Q
What aspect of the stomach is the pylorus?
A
Distal aspect
17
Q
Describe the duodenum
A
Shortest, widest and most fixed part
18
Q
When the stomach is empty where does the pylorus sit?
A
Right of midline
19
Q
On a fully distended stomach where does the pylorus sit?
A
Shifts 5-8cm to the right of midline
20
Q
How many parts are there of the duodenum?
A
4
21
Q
What cavity does the first part of the duodenum sit in?
A
Intraperitoneal
22
Q
What are the additional names of the first part of the duodenum?
A
Superior/bulb
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
24
Q
What is another name for the second part of the duodenum?
A
Descending part
25
The second part of the duodenum connects with what duct?
CBD and main pancreatic duct insertion
26
What is another name for the 3rd part of the duodenum?
Transverse or horizontal
27
Where is the IVC in comparison to the 3rd part of the duodenum?
Posterior
28
How is the 3rd part of the duodenum sitting compared to the pancreatic head?
Posterior
29
What is another name for the 4th part of the duodenum?
Ascending
30
What cavity is the 4th part of the duodenum sitting in?
Retroperitoneal cavity
31
How does the 4th part of the duodenum run?
Superior and to the left
32
Where does the jejunum become intraperitoneal?
At suspensory ligament (Ligament of Treitz)
33
What quadrants does the jejunum occupy?
Umbilical and left iliac regions
34
What is the longest portion of the small bowel?
Ileum
35
What regions does the ileum occupy?
Umbilical, hypogastric, right iliac and pelvic regions
36
How are the ileum and jejunum anchored to the posterior wall?
Mesentery
37
Where is the cecum located?
RLQ and/or right iliac region
38
Is US the modality of choice for adults or children when imaging the appendix?
Children
39
What cavity is the ascending colon located in?
Retroperitoneal cavity
40
What cavity is the transverse colon in?
Intraperitoneal cavity
41
What cavity is the descending colon in?
Retroperitoneal cavity
42
What is the path of the descending colon?
Descends from the left side of the abdomen to the left iliac fossa
43
Does the descending colon extend over the pelvic brim?
Yes
44
How does the sigmoid colon sit in comparison to the sacrum?
Anterior to the sacrum
45
Is the rectum located in the true pelvis or false pelvis?
True pelvis
46
What does the rectum penetrate to become the anal canal?
Levator ani muscle
47
How does the GE junction sit in comparison to the aorta?
Left and anterior
48
What is the anterior surface of the stomach in contact with?
Diaphragm, left lobe of liver and anterior abdominal wall
49
What is the posterior portion of the stomach in contact with?
Diaphragm, gastric surface of spleen, left adrenal, superior portion of kidney, anterior surface of pancreas and splenic flexure
50
What is the posterior/inferior stomach in contact with?
Lesser sac, pancreas, transverse colon and spleen
51
Is the 1st part duodenum posterior or anterior to the left lobe of the liver?
Posterior
52
Where is the 1st part duodenum compared to the GB?
Medial
53
What structures is the 1st part of the duodenum anterior to?
CBD, GDA, PV and head of pancreas
54
The 2nd part of the duodenum is lateral to what structure?
Pancreatic head
55
The 2nd part of the duodenum is medial to what structure?
Hepatic flexure
56
The 2nd part of the duodenum is posterior to what structure?
Transverse colon
57
How does the 3rd part of the duodenum run?
Passes right to left and anterior to greater vessels and crura of diaphragm
58
Is the 3rd part of the duodenum anterior or posterior to the mesenteric vessels?
Posterior
59
How is the 4th part of the duodenum in relation to the aorta and crus of the diaphragm?
Lateral
60
Is the transverse colon anterior or posterior to the duodenum?
Anterior
61
How is the transverse colon in comparison to the pancreas?
Anterior and inferior
62
What is the length of the esophagus?
25cm
63
What is the length of the pylorus?
2-3cm in length
64
How long is the small bowel?
5-6 m
65
How wide is the small bowel?
3cm wide
66
How long is the large bowel?
2m
67
Describe the mucosa
Epithelial lining, loose connective tissue (lamina propria), muscularis mucosa
68
What is the function of the mucosa?
Protects, absorbs and secretes
69
Describe the submucosa
Connective tissue, blood vessels and lymphatics
70
What is the function of the submucosa?
Nourishes surrounding tissue and transports absorbed nutrients
71
Describe the muscularis
Smooth muscle in circular and longitudinal groups
72
What is the muscularis responsible for?
Movement of tube and its content
73
What is the job of the serosa?
Protection
74
What are valvulae conniventes?
Characteristic circular folds in the small bowel; 3-5cm apart
75
Where are valvulae conniventes most prominent?
In the duodenum and first half of jejunum
76
Do valvulae conniventes disappear when the small bowel is distended?
No
77
Are the valvulae conniventes prominent in the ileum?
Not apparent
78
What is the keyboard sign?
valvulae conniventes
79
What are haustral markings?
Projections into the large bowel
| 3-5cm apart
80
What causes the large bowel to pucker into sacculations?
3 muscular bands (short bands)
81
What is the term "gut signature" referring to?
Distinct layered appearance of gut due to different acoustic properties of the histologic layers of the GI tract
82
How does the lumen appear when collapsed?
Hypoechoic
83
How does the mucosal layer appear on US?
Hypoechoic
84
How does the submucosa appear on US?
Hyperechoic
85
How does the muscularis appear on US?
Hypoechoic
86
How does the serosa appear on US?
Echogenic
87
How should the gut wall appear?
Uniform and compressible
88
What is the average thickness of the gut wall?
Distended- 3mm
| Non-distended- 5mm
89
What do we assess the gut for?
Motor activity, content and diameter
90
Where are the haustral markings most prominently seen?
Ascending and descending colon
91
What is the primary function of the gut?
Digestion and absorption of nutrients
92
Is the GI an endocrine or exocrine organ?
Largest endocrine system
93
Which layer of the GI tract stimulates the release of endocrine hormones?
Mucosa
94
What do the hormones released by the GI tract stimulate?
Intestinal absorption and act on the secretion of water, enzymes and electrolytes
95
What are the 3 GI hormones?
1. Gastrin
2. Cholecystokinin "CCK"
3. Secretin
96
What organ releases gastrin?
Stomach
97
What does gastrin stimulate the secretion of?
Gastric acid
98
What organ releases CCK and what does it control?
Released by duodenum into the blood upon ingestion of fats
| Controls GB contraction
99
What structure releases secretin?
Released by duodenal mucosa
100
What does the secretion of secretin stimulate?
Secretion of bicarbonate by the pancreas, decreases acid content
101
What is the relation of the COLLAPSED antrum to the pancreas?
Anterior to the pancreas
102
Is the sigmoid colon anterior or posterior to the iliac vessels?
Anterior
103
In females is the sigmoid colon anterior or posterior to the uterine surface?
Posterior
104
In males is the sigmoid colon anterior or posterior to the bladder?
Posterior
105
What arteries supply the small and large bowel?
Celiac, superior and inferior mesenteric arteries
106
What does the venous return from the small and large bowel empty into?
Portal system
107
What vessels supply and drain the stomach?
Gastric artery and vein
108
What is symmetric thickening of the bowel associated with?
Inflammation- normally benign
109
What is asymmetric thickening of the bowel associated with?
Malignancy
110
What is paralytic ileus?
Failure of intestine to propel content- paralyzed bowel
111
When does activity within the bowel increase?
Increases with mechanical bowel obstruction or inflammation in early stages
112
When does activity within the bowel decrease?
Decreases with paralytic ileus/ end-stage mechanical obstruction
113
What is pt prep for the GI tract?
Depends on area: no prep, fasting, drinking water
114
How is the esophagus assessed?
Endoscopic procedure
115
What frequency is used for examining the bowel?
3.5-5MHz linear transducer
116
When should graded compression be used?
In suspicious areas
117
What should normal gut do when compressed?
Should compress and displace bowel gas
118
What do we look for when assessing paracolic gutters?
Free fluid and masses
