GI Tract Flashcards
What are aphtous ulcers?
- painful superficial ulceration of oral mucosa
- stress induced, resolves spontaneously, often recurrs
How can one ID an aphtous ulcer
grayish base surrounded by erythema. the gray base represents granulation tissue
what is behcet’s syndrome?
recurrent aphtous/genital ulcers, uveitis
- immune complex vasculitis : small vessels
- can be seen after viral infxn
What do oral herpes look like?
shallow, painful, red ulcers
- HSV 1 associated
When is the primary oral herpes infxn usually?
- childhood
Virus stays dormant in ganglia of trigeminal nerve - stress/ sunlight cause reactivation of virus
- vesicles often arise on lips (cold sores
What are the risk factors for SCC of mouth?
tobacco and EtOH
- floor of mouth is a common location
What are precursor lesions for SCC of mouth?
Leukoplakia or erythoplakia
What is leukoplakia?
white plaque
What is hairy leukoplakia due to?
EBV
hairy, shaggy on lateral tongue
- ICPs
only hyperplasia
What is erythroplakia
Red plaque due to angiogenesis
- more suggestive of squamous dysplasia
What is the primitive gut tube made up of?
- incorporates yolk sac during development
- endoderm: epithelial lining of mucosa
- mesdoerm - all other layers
What are the divisions of the GI tract?
- foregut = pharynx to duodenum
- Midgut - duodenum to transverse colon
- Hindgut = distal transverse colon to rectum
What are some development defects of anterior abdominal wall due to failure of…
a) rostral fold closure
b) lateral fold closure
c) caudal fold closure
a) sternal defects
b) omphalocele, gastroschisis
c) bladder exstrophy
What is gastroschisis?
extrusion of abdominal contents through lateral abdominal folds; not covered by peritoneum. hernia is right to umbilicus
What is omphalocele?
persistence of herniation of abdominal contents into umbilical cord, covered by peritoneum and amnion of umbilical cord
What are other things than an omphalocele associated w/?
Beckwith Wiedemann syndrome
Chromosomal abnormaliity
congenital heart dz
What are jejunal, ileal, and colonic atresia due to?
vascular accident (apple peel atresia) - bilious vomiting
What is seen on x-ray for the small and large bowel atresias?
- distended bowl proximal to atresia
2. absence of air distal to atresia
What are the steps for midgut development?
6th wk = midgut herniates thru umbilical range
10th wk = returns to abdominal cavity and rotates around SMA
What is the most common esophagus anomaly?
esophageal atresia w/ distal tracheoesophageal fistula due to malformation of trachesophageal septum
What is the clinical presentation of trachesophageal fistula?
drooling, choking, and vomiting w/ first feeding
- allows air to enter stomach (visible on CXR)
- cyanosis is secondary to larngospasm (to avoid reflux related aspiration)
- polyhydraminos b/c can’t digest amniotic fluid
What is the clinical test to dx trachesophageal fistula?
failure to pass NG tube into stomach
What is a H type esophagus anomaly?
fistula alone
What is seen on CXR of a pure esophageal atresia?
gasless abdomen