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Year 2 > GI HARC 2 > Flashcards

GI HARC 2 Flashcards

1
Q

Primitive gut tube has __ parts which develop into GI tract & organs

A

3

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2
Q

What are the 3 parts of which delove into GI tract and organs

A

Foregut

Midgut

Hindgut

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3
Q

• Foregut develops into:

A
  • Oesophagus to 2nd part of duodenum
  • Accessory organs – liver, gallbladder, pancreas
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4
Q

• Midgut develops into:

A

• 2 nd part duodenum to ¾ transverse colo

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5
Q

• Hindgut develops into:

A

• ¾ transverse colon to superior rectum

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6
Q

Name the colours

A

Orange: Foregut

Purple: Midgut

Green: Hindgut

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7
Q

What does the Lower GI tract consist of?

A

• Jejunum to anus

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8
Q

Function of the small intestine

A
  • Mechanical and chemical digestion
  • Absorption of 90% of nutrients
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9
Q

Function of large intestine

A
  • Reabsorption of water & electrolytes
  • Convert indigestible food into faeces – store & expel
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10
Q

Histology of Small Intestine

What are the key microanatomical features of mucosa:

A
  • Circular folds
  • Villi & Microvilli
  • Intestinal glands
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11
Q

Properties of circular folds

A

• Increase surface area and slow chyme flow

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12
Q

Properties of Villi and Microvilli

A
  • Maximise surface area of intestinal wall
  • Most abundant in proximal 2/3 of S.I. – most absorption
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13
Q

Properties of Intestinal glands

A
  • Enterocytes, Goblet cells, Paneth cells, etc. and multipotent stem cells to replace eroded epithelia
  • Produce intestinal juices rich in digestive enzymes and hormones
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14
Q

Small Intestine

A
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15
Q

Small intestine

A
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16
Q

Histology of Small Intestine

A

Micrograph of circular folds

Micrograph of villi

Electron micrograph of microvilli

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17
Q

Histology of Large Intestine

What are the key microanatomical features:

A
  • No circular folds or villi (except anal canal)
  • Intestinal glands (many more, deeper crypts)
  • Enterocytes – absorptive cells with a microvilli border
  • Goblet cells – secrete mucous to facilitate faecal movement
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18
Q

Large Intestine

A
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19
Q

Histology of Large Intestine

What is this?

A

Section through wall of colon

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20
Q

Name a congential anomalies

A

Hirschsprung’s Disease.

Meckel’s diverticulum

Omphalocele- Abdominal Wall Defects

Gastroschisis-Abdominal Wall Defects

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21
Q

What is Hirschsprung’s Disease?

A

This disorder is characterized by the absence of particular nerve cells (ganglions) in a segment of the bowel in an infant. The absence of ganglion cells causes the muscles in the bowels to lose their ability to move stool through the intestine (peristalsis).

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22
Q

• Enteric nervous system has ______ and ________ plexuses

A

myenteric

submucosal

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23
Q

What does aganglionosis mean

A

The state of being without ganglia; for example, absence of ganglion cells from the myenteric plexus as a characteristic of congenital megacolon.

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24
Q

What does Hirschsprung’s Disease involve?

A

• HD involves agangliosis of both plexuses in distal colon & rectum

SO the absent/damage to the ganglia here means that the nerves are not funcitonal = muscle atrophy/wastage

  • Functional obstruction develops from spasms in denervated colon
  • Becomes apparent as severe constipation within first 2 months
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25
Q

How to identify Hirschsprung’s Disease?

A

• Biopsy to identify ‘transition zone’ between absent and present ganglionic cells. Surgery to remove affected segment

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26
Q

What is Meckel’s diverticulum?

A

A Meckel’s diverticulum, a true congenital diverticulum, is a slight bulge in the small intestine present at birth and a vestigial remnant of the omphalomesenteric duct (also called the vitelline duct or yolk stalk).

the vitellointestinal duct should seperate over time during development but sometimes the connection does perisist =.

27
Q

What is vitellointestinal duct

A

(embryonic connection between yolk sac and midgut lumen)

28
Q

In Meckel’s diverticulum can cause gastric mucosa which may cause bleeding from ‘gastric’ ulceration in its mucous membrane

What can this be mistaken for?

A

appendicitis

29
Q

Meckles’s Diverticulum usually comes in Rule of 2s?

What does this mean?

A

Rule of 2s:

  • 2% of population
  • Presents in first 2 years
  • 2 inches in length
  • Approx. 2ft from ileocaecal valve
30
Q

What is Omphalocele?

A

• Large herniation of intestines (and sometimes liver & other organs) out of umbilicus at birth (so more than usually comes out of umbilicus)

This leads to:

  • Failure to return to abdomen after natural protrusion during development
  • May be related to embryonic folding defect

IMPORTANT: herniation is covered by the peritoneal membrane and amnion

31
Q

What is Gastroshcisis?

A
  • Herniation of bowel loops (sometimes also stomach & liver) through para-umbilical defect in abdominal wall
  • No surrounding membrane
  • Cause unknown but genetic & environmental factors linked
  • Possibly by compromise in vasculature to abdominal wall

surgery to repair

IMPORTANT: not covered by membrane

32
Q

Out of Gastroschisis and Omphalocele which one is covered by y peritoneal membrane and amnion

A

Omphalocele

33
Q

What does Antenatal US show on Gastroschisis and Omphalocele?

A

Omphalocele- Antenatal US shows herniated loops (but not free-flowing because contained within peritoneum)

Gastroschisis- Antenatal US can show herniation to right of umbilicus, freefloating and small fetal abdominal circumference

34
Q

What imaging do we use to asses the GI tract?

A

X-ray

Ultrasound

Fluoroscopy

Cross section imaging (computed tomography) CT

MR- MAgnetic resonance imaging (MR)

35
Q

How do we use X ray in the GI tract?

A

Predominanty to look for perforation or bowel perfiration and to look at bowel patterns

  • abnormal/free gas
  • Bowel gas pattern (obstruction)
  • normal bowel gas,abnormal location
  • calcificaiton
  • tubes/lines/Fbs
36
Q

What do the two starts indicate?

A

Subdiaphragmatic free gas

37
Q

What are these X-rays showing?

A

Abdominal free gas

38
Q

What is this Xray showing?

A

Gas in the bowel wall- pneumotosis

39
Q

What is this Xray showing

A

Bowel gas pattern

40
Q

What does this Xray show?

A

Normal bowel gas, abnormal place

so this is a diaphragmatic hernia

41
Q

What can you see in this X-Ray

A

Calcification

42
Q

Why would you do an ultrasound in the GI tract?

A
  • Solid organs
  • Fluid filled structures
  • Free fluid/ collections
  • Masses Abnormal bowel
43
Q

What does this ultrasounds show

A
44
Q

What does this ultrasound show in children?

A
45
Q

What does this ultrasound show?

A

Crohn’s terminal ileitis

46
Q

What is a fluoroscopy?

A

Real time live xray where you use a dye that shows up on xray to fill a hallow structure.

47
Q

Why would you use a fluroscopy for GI

A
  • Bowel lumen
  • Transit/peristalsis
  • Abnormal communications
48
Q

What does this fluroscopy show?

A

Malrotation

49
Q

What do these show

A

Hirschprung’s disease

50
Q

Why do we do CT scans for GI

A

Free gas

Free fluid/ collections

Acute haemorrhage

Soft tissues

Vasculature

Calcifications

51
Q

What is wrong is this CT?

A

Free gas

52
Q

Why would you do MR in GI

A

Soft tissues

Free fluid/collections

Vasculature

53
Q

Why do we need to know the circulation of peritoneal fluid, the spaces and how they communicate

A

Because it helps us understand the spread of tumour and infection

also can localise pathology by identifying the space continuing abnormal fluid/gas/tissue

also can predict disease behaviour

54
Q

How many sacs do the peritoneum have?

A

2 greater and lesser

55
Q

Falciform ligament attaches liver to _________

A

abdominal wall

56
Q
A
57
Q

Right Subhepatic space is bounded superiorly by the ____ _____ ___ of the l____. Continues with right ______ space and right ___ space as well

A

bounded supreriorly by the inferior right lobe of the liver. Continues with right subphrenic space and right colic space as well

58
Q

Left Subhepatic space located between left lobe of _____ anteriorly and the ______ posteriorly.

A

located between left lobe of liver anteriorly and the stomach posteriorly.

59
Q

The top and bottom portion so the peritoneal cavity communicates through the ______ _______

A

The top and bottom portion so the peritoneal cavity communicates through the paracolic spaces.

60
Q

Between bladder and uterus we have______

A

vesicouterine pouch

61
Q

Between Rectum and uterus-

A

rectouterine pouch

62
Q

Where is the lesser sac located?

A

lies anterior to pancreas and posterior to the stomach.

63
Q
A

Year 2 (33 decks)

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