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Anna Burant IV > GI > Flashcards

GI Flashcards

1
Q

Large intestine consist of the:

A

Cecum, appendix, colon, rectum, and anal canal

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2
Q

Approx. length of the large intestine from the ileum to the anus

A

1.5 meters

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3
Q

The large intestine is characterized by the (3):

A

Taenia coli, haustra, sacculations

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4
Q

Where the fecal material is stored until defecation

A

Sigmoid colon

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5
Q

Absorb water from the highly liquid material received from the ileum

A

Cecum and ascending colon

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6
Q

Large blind pouch that extends below the level of the ileocecal valve

A

Cecum

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7
Q

The splenic flexure is anchored to the diaphragm by the _____

-serves as a boundary between disease processes of the left subphrenic space and the left paracolic gutter

A

Phrenicocolic ligament

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8
Q

EXTRAPERITONEAL (within the anterior pararenal space, and is covered by peritoneum only on its ventral surface)
colonic segments

A

Ascending and descending colon

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9
Q

INTRAPERITONEAL COLONIC SEGMENTS

A

Transverse and sigmoid colon

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10
Q

Average length of the anal canal

A

3-4 cm

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11
Q

The thickness of the wall of the normal colon does not exceed ____

A

5mm

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12
Q

The appendix arises from the ______ of the cecum at the junction of the taenia coli, approx _____ below the ileocecal valve

A

Posteromedial, 1 to 2 cm

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13
Q

Normal average diameter of the appendix

A

4 to 5 mm

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14
Q

Normal approx length of the appendix

A

8cm (although it may be up to 30cm long)

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15
Q

The appendix always arises from the cecum on the ____ side of the ileocecal valve

A

Same

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16
Q

On CT, US and MR, the normal appendix appears as a thin-walled tube less than ____mm in diameter

A

6

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17
Q

Arbitrarily defined as the proximal 2/5s of the mesentric intestine

A

Jejunum

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18
Q

The distal 3/5s of the mesenteric intestine

A

Ileum

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19
Q

Concave border of the small bowel loops

-where the mesenteric leaflet attaches

A

Mesenteric border

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20
Q

The convex border facing away from the mesentery

A

Antimesenteric border

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21
Q

Imaging characteristics of the jejunum(4)

A
  1. feathery mucosal pattern
  2. More prominent valvulae conniventes
  3. Wider lumen
  4. Thicker wall
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22
Q

Imaging characteristics of the ileum(4):

A
  1. Less feathered mucosal pattern
  2. Thinner,Less frequent folds
  3. Narrower lumen
  4. Thinner wall
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23
Q

Finger like projections that extend from the entire mucosal surface of the small bowel

A

Villi

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24
Q

Normal lymph nodes in the mesentery measure ______

A

Less than 4mm in diameter

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25
Q

4 GI TRACT layers

A

Mucosa, submucosa, muscularis propria, serosa or adventitia

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26
Q

Innermost GI tract layer exposed to the lumen

A

Mucosa

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27
Q

Provides connective tissue support for the mucosa

-contains the primary vascular and lymphatic channels, lymphoid follicles and autonomic nerve plexuses

A

Submucosa

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28
Q

Major muscular structure of the bowel wall, comprised of the inner circular and outer longitudinal layers

A

Muscularis propria

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29
Q

Outer covering of the bowel

A

Serosa or adventitia

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30
Q

Region of the GE junction (part of the stomach)

A

Cardia

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31
Q

That portion of the stomach above the level of the GE Junction

A

Fundus

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32
Q

Central 2/3s of the stomach from the Cardia to the incisura angularis

A

Body of the stomach

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33
Q

Acute angle formed on the lesser curvature that marks the boundary between body and the antrum of the stomach

A

Incisura angularis

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34
Q

Produce hydrochloric acid in the stomach

A

Parietal cells

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35
Q

Produce pepsin precursors in the stomach

A

Chief cells

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36
Q

The parietal cells and chief cells are located in which part of the stomach

A

Fundus and body

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37
Q

Distal one-third of the stomach than contains gastrin-producing cells but no acid secreting cells

A

Antrum

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38
Q

Junction of the stomach with the duodenum

A

Pylorus

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39
Q

Pyramidal first portion of the duodenum

A

Duodenal bulb or cap

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40
Q

Portion of the duodenum that is lateral to the head of the pancreas

A

Second or descending portion of the duodenum

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41
Q

Pierces the medial aspect of the descending duodenum at the ampulla of vater

A

Common bile duct and pancreatic duct

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42
Q

Portion of the duodenum that passes to the left between the superior mesenteric vessels and the inferior vena cava and aorta

A

Third or horizontal portion of the duodenum

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43
Q

Portion of the duodenum that ascends on the left side of the aorta to the level of L2 and the ligament of treitz

A

Fourth or the ascending portion of the duodenum

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44
Q

Detailed pattern of the gastric mucosa

A

Area gastricae

*normal area gastricae varies from a fine reticular pattern to a course nodular pattern

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45
Q

Refers to the gastric mucosal folds that produce distinct radiolucent ridges when the stomach is partially distended

A

Rugae

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46
Q

Rugal folds are most prominent in the ____ and _____ and are usually absent in the ____

A

Fundus; proximal gastric body;

Antrum

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47
Q

The ______ of the stomach is attached to the liver by the lesser omentum

A

Lesser curvature

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48
Q

The greater omentum attaches to the ____ of the stomach

A

Greater curvature

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49
Q

INTRAPERITONEAL space posterior to the stomach and anterior to the pancreas

A

Lesser sac

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50
Q

On CT, the normal gastric wall thickness when well distended:
A. In the antrum
B. In the body

A

A. 5 to 7mm

B. 2 to 3mm

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51
Q

Normal duodenal wall thickness

A

Less than 3mm

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52
Q

3 pharyngeal compartments

A
  1. nasopharynx
  2. oropharynx
  3. hypopharnyx(laryngopharynx)
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53
Q

Pharyngeal compartment that extends from the skull base to soft palate

A

Nasopharynx

54
Q

Pharyngeal compartment that is posterior to the oral cavity and extends from the soft palate to the hyoid bone

A

Oropharynx

55
Q

Pharyngeal compartment that extends from the hyoid bone to the cricopharyngeus muscle

A

Hypopharynx (laryngopharynx)

56
Q

Anterior boundary of the oropharynx

A

Base of the tongue

57
Q

Separate the larynx from the oropharynx and hypopharynx

A

Epiglottis and aryepiglottic folds

58
Q

2 symmetrical pouches formed in the recess between the base of the tongue and the epiglottis

A

Valleculae

*divided medially by the median glossoepiglottic fold and bounded laterally by the lateral glossoepiglottic folds

59
Q

Deep symmetrical lateral recesses formed by the protrusion of the larynx into the hypopharynx

A

Piriform sinuses

60
Q

The esophagus extends from the ______ muscle at the level of C5-C6 to the ______

A

Cricopharyngeus ; GEJ

61
Q

Esophagus is a muscular tube formed by an outer ____ muscle layer and inner _____ muscle layer lined by _______ epithelium

A

Longitudinal; circular; stratified squamous

62
Q

The esophagus lacks a _______ layer

A

Serosal

63
Q

A. Proximal 1/3 of esophagus muscle type

B. Distal 2/3 of esophagus muscle type

A

A. Striated muscle

B. Smooth muscle

64
Q

Normal extrinsic impression on the esophagus are made by the (3):

A

Aortic arch, left mainstem bronchus , left atrium

65
Q

Esophageal pattern with multiple regular transverse folds ,1mm thick, result from contraction of the longitudinal fibers in the muscularis mucosa

A

Feline esophagus

66
Q

Distension of the upper esophagus ______ OR

the lower esophagus ________ is abnormal

A

More than 10mm ; more than 20mm

67
Q

______ in the esophagus is always abnormal

A

Air-fluid levels

68
Q

The wall of the distended esophagus should not exceed ____ in thickness

A

3cm

69
Q

Demarcates the pharynx and the esophagus

A

Cricopharyngeus muscle(C5-C6 level)

70
Q

Saccular termination of the esophagus

A

Esophageal vestibule

71
Q

The tubulovestibular junction (in esophagogastric region) is formed by a symmetrical muscular ring called the ______

A

A ring

72
Q

An asymmetrical mucosal ring or notch that occurs at the junction of esophageal squamous epithelium with gastric columnar epithelium

A

B ring

73
Q

Seen best on double contrast study, this marks the junction of the squamous epithelium of the esophagus and the columnar epithelium of the stomach

A

Z line

74
Q

2 Radiographic markers of the GE junction

A

B ring and the Z line

75
Q

Normal process of swallowing can be divided into (3):

A

Oral, pharyngeal and esophageal stages

76
Q

Esophageal motility is evaluated by observing fluoroscopically at least ______ separate swallows of barium with the patient in a _____ position

A

5; prone-oblique

77
Q

Radiographically appears as a stripping wave that traverses the entire esophagus from top to bottom

A

Primary peristalsis

78
Q

Has the same radiographic appearance as primary waves except that they may start at the point of the retained barium bolus

A

Secondary peristalsis

79
Q

Nonperistaltic contractions that cause a corkscrew or beaded appearance of the esophageal barium column

A

Tertiary waves

80
Q

A tongue-shaped organ , approx 12 to 15 cm in length, that lies within the anterior pararenal compartment of the retroperitoneum

A

Pancreas

81
Q

Pancreas location:
_______ to the left of the liver, stomach and lesser sac;
_______ to the spine,IVC and aorta

A

Posterior ; anterior

82
Q

The splenic vein and pancreas are ______ to the superior mesenteric artery

A

Anterior

83
Q

Maximum dimensions for pancreatic size are (diameter):

A. Head B. Body C. Tail

A

A. 3.0 cm; B. 2.5 cm; C. 2.0 cm

84
Q

(In Brant) pancreatic duct normally measures ____ mm in diameter in the head and tapers smoothly toward the tail

A

3-4mm

85
Q

Body’s largest lymphoid organ

A

Spleen

  • sequesters abnormal and aged RBC and WBC
  • reservoir for RBCs
86
Q

Average spleen dimension in adults (in Brant)

A

12 x 7 x 3-4 cm (L x W x thickness)

87
Q

Term applied to a normal spleen positioned outside of its normal location in the LUQ

A

Wandering spleen

*caused by laxity of the splenic ligaments

88
Q

Refers to multiple implants of ectopic splenic tissue that may occur after traumatic splenic rupture

A

Splenosis

89
Q

During arterial phase the spleen exhibits alternating bands of hi and low density

A

Arciform enhancement pattern

90
Q

Congenital absence of the spleen

A

Asplenia(Ivemark syndrome)

91
Q

Splenules

A

Accessory spleen

92
Q

Maximum enhancement of the liver parenchyma occurs at _____ second

A

60 to 120 seconds following hepatic arterial enhancement

93
Q

Longitudinal plane thru the middle hepatic vein, IVC and gallbladder fossa divides the livers into ____

A

Right and left lobes

94
Q

Longitudinal plane thru the right hepatic vein divides the right lobe into _____

A

Anterior (VIII and V) and posterior (VII and VI) segments

95
Q

Longitudinal plane thru the left hepatic vein divides the left lobe into _____

A

Medial (IVa and IVb) and lateral (II and III) segments

96
Q

Transverse plane thru the left portal vein divides the left lobe into ______

A

Superior (IVa and II) and inferior (IVb and III) segments

97
Q

Oblique transverse plane thru the right portal vein divides the right lobe into _____

A

Superior (VIII and VII) and inferior (V and VI) segments

98
Q

Hepatic segment that extends between the fissure of the ligamentum venosum and the IVC

A

Segment I (caudate lobe)

99
Q

Transient enhancement differences(liver)

  • page 694
  • systemic venous blood drains into hepatic sinusoids altering normal intrahepatic blood results in focal areas of increased or decreased enhancement during the various phases of parenchymal enhancement
A

Transient hepatic attenuation differences (THADs) or Transient hepatic intensity differences (THIDs)

100
Q

(On CT), the normal liver parenchymal attenuation is ______ than the attenuation of normal spleen parenchyma on UNENHANCED images

A

=/>

*during arterial phase, spleen

101
Q

The ducts of the left hepatic lobe are more ______ than those of the right hepatic lobe

A

ANTERIOR

102
Q

Cystic duct + common hepatic duct

A

Common bile duct

103
Q

The CBD tapers distally as it ends in the _____

A

Sphincter of Oddi

*protrudes into the duodenum as the ampulla of vater

104
Q

Descriptive folding of the gallbladder Fundus, is a common normal variant

A

Phrygian cap

105
Q

Small folds in the cystic duct

A

Spiral valves of Heister

106
Q

A gallbladder greater than 5 cm in diameter is considered _____

A

Enlarged (hydropic)

107
Q

A gallbladder less than 2cm in diameter is considered _____

A

Contracted

108
Q

The normal gallbladder wall does not exceed __ mm in thickness, measured from the gallbladder lumen to liver parenchyma, when gallbladder is distended

A

3

109
Q

The peritoneal cavity is divided into the ____

A

Greater peritoneal cavity and the lesser peritoneal cavity(lesser sac)

110
Q

Space which communicates around the liver with the anterior subhepatic and posterior subhepatic space(Morison pouch)

A

Right subphrenic space

111
Q

Most dependent portion of the abdominal cavity in the supine position

A

Morison pouch (right hepatorenal fossa)

112
Q

Left subphrenic (perisplenic) space communicates freely with the left subhepatic space but is separated from the right subphrenic space by the ________ and from the left paracolic gutter by the _____

A

Falciform ligament; phrenicocolic ligament

113
Q

Space affected by diseases of the duodenal bulb, lesser curve of the stomach, gallbladder, and left lobe of the liver

A

Left subhepatic space (gastrohepatic recess)

114
Q

Most dependent portion of the peritoneal cavity in the upright patient

A

Pelvis

115
Q

Remnant of the obliterated umbilical vein

A

Ligamentum teres

*found in the caudal free end of the falciform ligament

116
Q

Part of the liver not covered by peritoneum

A

Bare area

117
Q

Composed of the gastrohepatic and hepatoduodenal ligaments, suspends the stomach and the duodenal bulb from the inferior surface of the liver

A

Lesser omentum

*separates the gastrohepatic recess of the left subphrenic space from the lesser sac

118
Q

Isolated peritoneal compartment between the stomach and the pancreas

A

Lesser sac

*communicates with the rest of the peritoneal cavity only through the small foramen of Winslow

119
Q

A double layer of peritoneum that hangs from the greater curvature of the stomach

A

Greater omentum

*serves as fertile ground for implantation of peritoneal mets

120
Q

3 divisions of the retroperitoneal space

A

Anterior pararenal, perirenal, posterior pararenal

121
Q

Space that Extends between the posterior parietal peritoneum and the anterior renal fascia

A

Anterior pararenal space

  • bounded laterally by the lateroconal fascia
  • contains the pancreas, duodenal loop, ascending and descending colon
122
Q

Anterior and posterior renal fasciae encompass the kidney, adrenal gland, and perirenal fat within the ______

A

Perirenal space

123
Q

A potential space filled only with fat

A

Posterior renal space

*continues into the flank as the properitoneal fat stripe

124
Q

3 major anatomic compartments of the pelvis

A
  1. Peritoneal cavity
  2. Extraperitoneal space
  3. Perineum
125
Q

Peritoneal cavity extends to the level of the vagina forming the _____, or to the level of the seminal vesicles forming the _______

A

Pouch of Douglas (cul-de-sac); rectovesical pouch

126
Q

Anterior boundary of the rectouterine pouch

A

Broad ligament

127
Q

Most dependent portion of the peritoneal cavity

A

Cul-de-sac

128
Q

Continuous with the retroperitoneal space of the abdomen

A

Extraperitoneal space of pelvis

129
Q

Anatomic landmark of the perineum

A

Ischiorectal fossa

130
Q

Lies below the pelvic diaphragm

A

Perineum

Anna Burant IV (7 decks)

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