GI Cases DSA/CIS Flashcards
stomach CP?
In the left 5th intercostal space between the mid-clavicular line and sternum
Midway between the spinous process and tip of the transverse process on the Left 5th and 6th thoracic vertebrae
Liver CP?
In the right 5th and 6th intercostal space between the mid-clavicular line and sternum
Midway between the spinous process and tip of the transverse process on the Right 5th, 6th and 7th thoracic vertebrae
gall bladder CP?
In the right 6th intercostal space between the mid-clavicular line and sternum
Midway between the spinous process and tip of the transverse process on the Right 6th and 7th thoracic vertebrae
pancreas CP?
Right 7th intercostal space close to the costochondral junction
Midway between the spinous process and tip of the transverse process on the Right 7th and 8th thoracic vertebrae
intestinal peristalsis CP? (constpiation)
Bilaterally in the muscle tissues between the ASIS and the Greater Trochanter
Costovertebral junction of the 11th rib on the Right
pyloris CP?
Anterior Midline of the Sternum (angle of Louis to xiphoid)
Right costovertebral junction of the 10th rib
appendix CP?
Tip of the right 12th rib, upper edge
Inter-transverse space between 11th and 12th thoracic vertebrae on the Right
Stomach hyperacidity CP
5th and 6th intercostal space from the mid-clavicular line to the sternum on the left
intertransverse space, midway between the spinous and transverse processes, between 5th and 6th vertebrae on the left
LIver/GB CP
th and 7th intercostal space from mid-clavicular line to the sternum on the right
intertransverse space, midway between the spinous and transverse processes, between 6th and 7th vertebrae on the right
appendix cp
upper edge near the tip of the 12th rib on the R
11th intertransverse space on the right
colon cp - spastic constipation/colitis
An area 1-2” anterolateral aspect of the thighs along the femur starting at the greater trochanter and extending to within an inch of the knees
right femur:
Upper fifth corresponds with the cecum
Middle 3/5’s corresponds with ascending colon
Last 1/5 represents hepatic flexure and first 2/5’s of transverse colon
left femur:
Upper fifth corresponds with the sigmoid
Middle 3/5’s corresponds with descending colon
Last 1/5 represents splenic flexure and last 3/5’s of transverse colon
– TP of L2 – TP of L4 a triangular area reaching across to the iliac crest
vagus n. exits where?
cranium via the jugular foramen
sympathetic control of GI tract?
Tends to inhibit GI function Frequently activated in pathological situations Inhibits smooth muscle Induces contraction of sphincters Regulates blood flow in the GI tract
PS control of GI tract?
Activates physiological processes in the gut wall
Allows filling of the stomach to occur without an increase in intraluminal pressure
Generally involved in relaxation of sphincters
Contraction of smooth muscle layers in the colon
Controls the caliber of the internal anal sphincter
sympathetically driven GI sx?
Constipation Bloating Pain Contraction of sphincters Increased vasomotor tone (may lead to decreased mucus production in stomach and intestines)
** increased vascular tone, decrased O2 and nutrients to tissues, decreased peristalsis
PS drive sx?
Nausea Vomiting Diarrhea Hypermotility Relaxation of sphincters Increased mucus secretion Increased acid production in the stomach
= increased in gastritis, ulcers, GERD
Post-Operative Ileus
Failure to pass flatus or stool for 3/6 days after surgery
Transient impairment of function and motility
Due to:
Mechanical irritation
Edema of tissues – mesentery and intestine
Inflammatory molecules which cause the
Activation of inhibitory neural reflexes
Medications, particularly opiates (which don’t inhibit motility, but increased uncoord. contractions w/ increased tone and decreased transit)
pathophy. of lymphatics?
Impaired flow increases tissue congestion
Impaired nutrient absorption from the intestines
Congestion increases the likelihood of fibrosis, and susceptibility to infection
arndt-Schultz law
Weak stimuli accelerate physiologic activity
Medium stimuli inhibit physiologic activity
Strong stimuli halt physiologic activity
how does visceral manipulation work?
sends stimuli to mechanical sensors –> enteric nervous system
helps with things that block it like adhesions, scars, inflammation
Visceral joints?
Double layer system - serous fluid creates suction between surfaces of the peritoneum, etc.
Ligamentous system – folds of peritoneum or pleura binding an organ to the wall of the cavity or to another organ
- Not present for structural stability like skeletal ligaments
Turgor and Intracavitary pressure – hold the viscera in place, remain constant in mass, yet stick together
Mesenteric system- folds of peritoneum that support the nerves, arteries, veins and lymphatics of the small and large intestines
Omental system – folds of peritoneum that join 2 elements of the digestive tract together and has a neurovascular role
chapmans small intestines
Anterior: Bilateral 8-9th, 9-10th, and 10-11th intercostal spaces close to the costochondral junctions
Posterior: Bilateral 8-9th, 9-10th, and 10-11th intertransverse spaces midway between the spinous process and the tip of the transverse process
chapmans for atonic constipation?
Anterior: Bilaterally in the muscle tissues between the ASIS and the Greater Trochanter
Posterior: Bilaterally along the 11th rib at the costovertebral junction.
colic
Crying and fussing more than
3 hours per day
3 days a week
For more than 3 weeks
Inconsolable, excessive crying associated with hypertonicity, perceived pain, borborygmus, wakefulness
Cyclic
Onset 2-6 weeks old and lasts typically 3 months
Pathophysiology? Dietary - mom's diet Psychological - maternal depression Gastrointestinal - H. pylori Hormonal Neurological immaturity
