GI cases CIS Flashcards
what organs are controlled by celiac ganglia sympathetically
esophagus, gallbladder, stomach, liver, spleen, and pancreas
what organs are controlled by superior mesenteric ganglia
small intestine
ascending and transverse colon
appendix
what organs are controlled by the inferior mesenteric ganglion
descending sigmoid colon, rectum
what is the facilitation level of appendix? sympathetic level?
facilitation- T12
sympathetic- T10
what commonly refers to the right neck trapezius area
liver, gallbladder, duodenum
from iritation of the diaphragm
where are trigger points for heartburn
external oblique
projectile vomiting and belching can be tirggerd how
palpation of points of the posterior abdominal wall bilaterally
where are the trigger points for diarrhea
lower abdominal muscles
where is chapmans for stomach hyperaciditiy and and post
Ant: 5th 6th intercostal space MCL to L of sternum
post: intertransverse space midway spinous and transveser processes between 5th and 6th on L
chapmans for liver/gallbladder ant/post
ant: 6th and 7th ICS MCL sternum to R
post: intertransverese space 6th and 7th vertebrae on R
chapmans point for appendix ant/post
ant: upper edge near tip 12th rib on R
post: 11th intertransverse space on R
describe chapmans points for colon anterior
1-2 “ wide on trochanter femur down to patella
R: cecum is upper 1/5
next 3/3 is ascending colon
last 1/5 is for the first 2/5 transverse of colon
L: lower 1/5 last 3/5 transverse colon
middle 3/5 is descending colon
upper 1/5 sigmoid colon
very tip trochanter on L is recto-sigmoid junction
colon TP on posterior side
TP of L2 and TP of L4 in triangular pattern reaching across iliac crest
what is post-operative ileus
failure to pass flatus or stool for 3/6 days after surgery
transient impairment of f(x) and motility
what is the arndt-schultz law
weak stimuli accelerate physiologic activity
medium stimuli inhibit physiologic activity
strong stimuli halt physiologic activity
What are the pacemakers of the gut
interstitial cells of Cajal
what is the concept visceral joint
held together by the suction between surfaces of peritoneum
the fold of peritoneum or pleura act like ligaments
the intracavity P holds viscera in place
the mesentery supports vessels
omental system join 2 elements of digestive tract together
what is visceral somatic dysfunction
any restriction. fixation, adhesion limits mobility and motility
even a small amount of restriction can have big consequences
causes of visceral somatic dysfunction
infection/inflammation trauma surgery pregnancy scoliosis/short leg syndrome craniosacral dysfunction
when palpating abdomen evaluate for what
painfulness
differences in tension
position of the organ
tone of the organ
74 y.o M crampy abdominal pain crescendo decrescendo for past week and getting worse
no bowel movement for 3 days, small hard stool.
similar episodes before
fiber worsens Sx, denies vomiting or blood in stool
PMH + HTN +HLD +CABG 4 yr ago, appendectomy, + smoking Hx
mild AV nicking on exam, soft to palpation, tenderness in LLQ no organomegaly, LLQ absent BS, + occult blood
ddx?
bowel obstruction/ileus IBD (crohn/UC) tumor ischemic bowel adhesions constipation fecal impaction diverticulitis hypothyroidism
What OMT for absent bowel movements
sympathetics T10-L2 (inferior mesenteric gangnion
PAN S2-4
sibsons, diaphragm and pelvic diaphragm
chapmans for atonic constipation
ant: b/l in muscle tissues between ASIS and greater trochanter
post: b/l along 11th rib at costovertebral junction
32 y.o F with diffuse abdominal pain during night and before meals. no spicy food and has food backup in throat, denies blood in stool. +smoking Hx, drinks lots of soda, DM2, HTN amenorrheic past 4-5 mo
obese - occult blood
ddx
GERD gastric ulcer duodenal ulcer cholycystitis cholylithiasis pregnancy
