GI Flashcards
Parietal Peritoneum
Attached to the abdominal wall
Visceral Peritoneum
Attached to the abdominal organs
How long is the Esophagus?
10-12 inches
Name the three parts of the small bowel
Duodenum, Jejunum, Ileum
How long is the small bowel?
Approximately 21 feet
How long is the large bowel
6 feet
What are the four parts of the large bowel?
Ascending, Transverse, Descending, Sigmoid
What is the AP Abdomen/KUB for?
Survey purposes
Rule out obstruction or perforation
Assess tube and catheter placements
Preliminary image for other procedures
Correct technique
No motion
Pertinent anatomy visualized
What does a barium swallow visualize?
Esophagus
What does an upper GI study visualize
Stomach
What does the small bowel study visualize
Small bowel
What does the barium enema study visualize
Large bowel
What is the function of a nasogastric(NG)/oralgastic(OG) tube?
Placed through nose
Aspiration of gastric contents
Control of nausea and vomiting
Bowel dysfunction or surgery
Nutritional support
Medication administration
How are G-tubes, J-tubes, and PEG placed?
Surgically placed through abdominal wall into area of interest
What is Esophageal Atresia
Esophagus fails to develop past some point
Inability to insert NG tube
Symptoms of esophageal atresia
Excessive salivation, choking, gagging, dyspnea, cyanosis
What is tracheoesophageal fistula
Failure of the esophageal lumen to develop separately from the trachea
Why is tracheoesophageal fistula a concern?
May coincide with atresia
Increased risk of aspiration
Incompatible with Life
Prognosis good if handled appropriately
Aspiration prevention
Surgical repair
What are the types of tracheoesophageal fistula are there?
Congenital and acquired
What is the congenital tracheoesophageal fistula
Result from failure of the esophageal lumen to develop completely separate from the trachea
Surgical repair
What is the acquired tracheoesophageal fistula?
Caused by cancer, infection, trauma, instrumentation perforation
Surgical repair if indicated
Stent
What is a hypertrophic pyloric stenosis (HPS)?
A congenital anomaly of the stomach where the
pyloric canal is greatly narrowed because of
hypertrophy and hyperplasia of the pyloric
sphincter
Most common surgery indication for infants
Is thought to be caused by genetic factors
What does hypertrophic pyloric stenosis cause to the patient? Why is it a complication?
Pyloric stenosis causes obstruction (incomplete
or complete), preventing food from entering into
the duodenum
Hypertrophic pyloric stenosis can often be palpated, how is it described when palpated?
It is often described as a mobile hard “olive.”
What are signs that a patient has hypertrophic pyloric stenosis during an Upper GI study
Delayed gastric emptying
* Barium-filled antrum
* Shoulder sign
* Filling of proximal pylorus
* Beak sign
* Elongated pylorus
* String sign
What is atresia?
When there is a closure of a normal opening or tubular organ
a tube that does not connect to anything
at level of the spine doe tracheoesophageal fistula usually happen?
T4
what is an esophageal stricture?
a narrowing of the esophagus
how does an esophageal stricture happen?
damage from alkaline or acidic corrosive agents or a radiation side effect
how is esophageal strictures treated?
pts go through endoscopy to assess damage
then they go through a treatment where there esophagus is dilated
what is reflux esophagitis?
where the lower esophageal sphincter fails to act as an effective barrier and allows gastric content to enter lower esophagus
what is the primary cause of reflux esophagitis?
GERD – gastroesophageal reflux disease
can also be caused by:
Herpes virus
Candida
What is nissen fundoplication?
Surgical procedure to treat GERD and hiatal hernia. In GERD it is usually performed when medical therapy has failed.
the fundus is wrapped around the esophageal sphincter to reinforce
what is the outcome of nissen fundoplication?
reinforcement of the lower esophageal sphinctor
What is barrett’s disease?
Condition where the lower esophagus becomes damaged by acid reflux and the tissue is replaced with similar stomach tissue
is barrett’s disease a concern relating to cancer?
yes, it is pre-cancerous
What is esophageal varicies?
dilated veins in the distal esophagus
varicose veins of distal esophagus and stomach
why does esophageal varices happen?
due to the increase blood flow caused by increased pressure in the portal venous system
what is a common cause of esophageal varices?
strenuous vomiting, people with alcohol issues
what are treatment options for esophageal varices
vasoconstrictor drugs
ballon tamponade - creates pressure to stop bleeding
surgery - tie off vessels
What are treatment options for esophageal perforation?
chest tube
antibiotics
surgery - stent
How many projections are needed for foreign bodies?
Two projections 90 degrees from each other
what is peptic ulcer disease? (PUD)
a group of inflammatory processes involving the distal esophagus, stomach and duodenum
Nonsteroidal antiinflammatory drugs and bacteria alter the mucosa
what are common locations of peptic ulcer disease(PUD)?
lesser curvature of the stomach
duodenal bulb
how is peptic ulcer disease diagnosed?
endoscopy
double contrast GI studies
How do acute ulcers look like?
shallow & show some signs of healing
how do chronic ulcers look like?
deeper and have sharp margins and no necrotic tissue due the acid keeping the bottom “clean”
what is gastritis?
inflammation of the stomach mucosa
what are causes of gastritis?
Nonsteroidal antiinflammatory drug
Alcohol
Steroids
Stress or trauma
Infection
H. pylori, Salmonella
What is appendicitis?
inflammation of the appendix
What does appendicitis usually result from?
an obstruction from a fecalith or rarely a neoplasm
what is the key symptom of appendicitis?
elevated WBC count and sudden onset of constipation
what is the treatment for appendicitis
immediate appendectomy before perforation and to prevent complications
A regimen of antibiotics if perforation has occurred to reduce risk of peritonitis and sepsis
What is Crohn’s disease?
A chronic inflammatory disease that affects any part of the digestive tract.
where does Crohn’s disease most often occur?
the terminal area of the ileum and/or proximal colon
Are fistulas common with Crohn’s disease?
Yes
