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MIDS 127 > GIT > Flashcards

GIT Flashcards

1
Q

What structures does the GIT include?

A

Lips
Mouth
Pharynx
Esophagus
Stomach
Sm intestine
Appendix
Colon
Anux

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2
Q

What is an advantage + disadvantage of imaging the GIT?

A

Pro: can evaluate peristalsis function with cine-clips
Con: hard to see due to gas

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3
Q

What are the bowel wall layers + SF’s?

A
  1. Mucosal surface/epithelium: innermost layer, echogenic
  2. Muscularis mucosa*: hypoechoic, thin + smooth
  3. Submucosa: echogenic, thickest, contains vessels + lymph channels
  4. Muscularis propria/externa*: hypoechoic, inner + outer layer of smooth muscle
  5. Serosa: outermost, thin layer on periphery, echogenic

(* if we can see on u/s)

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4
Q

What is the largest endocrine organ in the body?

A

GIT!

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5
Q

Functions of the GIT?

A

-Digestion (most in duodenum)
-Absorption

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6
Q

Measurements of bowel wall?

A

3-6mm when undistended
2-4mm when distended (often has shadows)

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7
Q

What is the easiest structure to see on u/s in the GIT?

A

Stomach (LUQ)

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8
Q

What are the parts of the stomach?

A

-Esophagus goes into top of stomach
-Fundus is top
-Body is middle
-Pylorus antrum is bottom (which moves chyme into duodenum)

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9
Q

What patient positions are best for imaging the stomach?

A

-LLD for fundus
-RLD for antrum + pylorus

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10
Q

Where do duplication cysts occur in stomach?

A

Greater curvature of stomach
(m/c women)

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11
Q

What do duplication cysts look like in stomach?

A

-Anechoic
-Inner echogenic rim
-Wide outer hypoechoic rim
-On greater curvature of stomach

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12
Q

What is the cause of gastric dilatation?

A

Obstruction

(affects gastric emptying)

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13
Q

What is gastritis + what causes it?

A

-Inflammation of gastric mucosa
-From infection, drugs, stress or autoimmune

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14
Q

What does chronic gastritis look like?

A

-Hyperplastic + inflammatory polyps

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15
Q

What does atrophic gastritis look like?

A

-Small mucosa (inner lining stomach)

(Precursor to gastric cancer)

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16
Q

What does emphysematous gastritis look like?

A

-Same as acute, but with small gas bubbles in wall

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17
Q

Does Crohn disease commonly affect the stomach?

A

No!

(m/c terminal ileum)

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18
Q

What is Crohn disease + who does it affect?

A

-Inflammation of all layers of bowel wall
-Unknown cause
-M/c in young adults

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19
Q

What does Crohn disease look like?

A

-Hypoechoic target lesion
-Very vascular walls

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20
Q

What is the m/c benign gastric tumour?

A

Leiomyomas

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21
Q

What do leiomyoma’s look like?

A

-Hypoechoic
-Oval/circular
-Possible necrosis

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22
Q

What does GIST’s stand for?

A

Gastrointestinal stromal tumours

(can be benign or malignant)

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23
Q

Where is the m/c place to have a GIST?

A

Stomach

(think stromal for stomach)

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24
Q

What do GIST’s look like?

A

-Hypoechoic
-Possibly hemorrhage or degeneration

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25
Q

What is the m/c type of gastric carcinoma?

A

Adenocarcinoma

(m/c males)

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26
Q

What does gastric carcinoma look like?

A

-Thick wall (target/pseudokidney sign)
-Mass with no peristalsis
-Can have ulcers

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27
Q

SF of lymphoma?

A

-Thick hypoechoic wall
-Rugal fold thickening

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28
Q

Most common site for primary lymphoma in the GIT?

A

Stomach

29
Q

What shape is the duodenum?

A

C shaped

30
Q

What are the 4 parts of the duodenum?

A

-Duodenal bulb (shortest part)
-Descending (inferior)
-Transverse (across)
-Ascending (superior)

31
Q

Where is the duodenum, jejunum + ileum in the body?

A

-Duodenum is 1st portion
-Jejunum is middle portion (thickest)
-Ileum is 3rd portion (longest)

32
Q

Measurement of wall thickness of small bowel?

A

Less than 5mm

(if collapsed + symmetric)

33
Q

Measurement of small bowel?

A

Less than 3cm

34
Q

Where/what is the appendix?

A

A tubular structure attached to the cecum with a blind end

35
Q

What are some characteristics of the appendix?

A

-Compressible
-Possibly tortuous
-No peristalsis

36
Q

Measurements of appendix?

A

-Less than 6mm AP (outer-outer)
-Less than 2mm wall thickness

37
Q

What is McBurney point?

A

-Imaginary line from iliac spine to umbilicus
-Midpoint of line is where the appendix is located

38
Q

What does blind end mean?

A

When you are scanning the appendix and all of a sudden it ends (is normal)

39
Q

Where is the colon located?

A

Laterally on R/L sides + superiorly along liver margin

40
Q

What are the 4 sections of the colon?

A

-Ascending
-Transverse
-Descending
-Sigmoid (end before rectum)

(colon is hardest to see on u/s)

41
Q

What does a fluid filled colon indicate?

A

-Diarrhea
-Obstruction

(is abnormal)

42
Q

What are the measurements of the colon wall?

A

Undistended: 4-9mm thick
Distended: 2-4mm thick

43
Q

How should you approach an appendicitis exam?

A

-Start with AOC
-Next start at cecum and try to find it inferiorly
-Lastly extend into pelvic/endovaginal exam if still can’t find it

44
Q

What is an ileus?

A

Pseudo obstruction from diminished mobility of bowel (no peristalsis anymore)

45
Q

What does an ileus look like on u/s?

A

Stitches

46
Q

What does obstruction of the small bowel look like?

A

-Bumpy
-Round
-Can see bowel folds

47
Q

Lightbulb for intussusception?

A

-Children
-Sandwich sign in SAG!
-Circles in TRV
(looks like a cinnamon bun)

48
Q

Cause of intussusception?

A

-Idiopathic in children
-Pathological mass in adults

49
Q

Cause of a small bowel hematoma?

A

Duodenum immobility

50
Q

Cause of edema in small bowel?

A

Swelling of valvulae conniventes (bowel folds)

51
Q

Lightbulb for Crohn disease for small bowel?

A

-M/c ileum
-Diarrhea
-Thick bowel wall (5-15mm)
-Target sign!

52
Q

Where does diverticulitis in small bowel m/c occur?

A

Distal ileum

53
Q

What is the m/c benign + malignant tumours?

A

B = leiomyomas
M = leiomyosarcomas

54
Q

How do GIST’s + lymphomas look different sonographically compared to the other malignant tumours?

A

GIST’s = exophytic
Lymphoma = affects the bowel wall

55
Q

Who is m/c to get appendicitis?

A

-Men
-Aged 5-45 (mean age 28)

56
Q

What is rebound tenderness?

A

When pain is greater at release of pressure, rather than when applying the pressure

57
Q

SF of appendicitis?

A

-Target sign
-Greater than 6mm + 2mm wall
-Possible appendicolith/fecalith (looks like calcification in lumen)
-Non compressible
-No peristalsis
-Fluid

58
Q

What are the 3 complications of appendicitis?

A

-Abscess
-Peritonitis (inflammation of lining of stomach)
-Rupture/perforation

59
Q

What is a mucocele?

A

Distension of appendix due to mucus

60
Q

SF of a mucocele?

A

-Similar to appendicitis but w/o signs + symptoms
-Anechoic lumen with some echoes present

61
Q

What is pseudomyxoma peritonei?

A

-Rupture of adenocarcinoma tumour that produces too much mucin
-Mucocele hangs off end of appendix

(m/c from appendix primary carcinoma)

62
Q

SF of NETS’s?

A

Hypoechoic mass with appendiceal TIP!

63
Q

What is mesenteric adenitis + its SF?

A

-Inflamed lymph nodes
-Round nodes (instead of normal oval)
-Greater than 4mm

64
Q

What affects the colon during obstruction?

A

Cystic fibrosis affects the bowel (ileum or prox colon)

65
Q

What is the main difference b/w Crohn disease inn the colon + ulcerative colitis?

A

Crohn = only affects certain areas
Colitis = is continuous

(otherwise they look SF the same)

66
Q

M/c location for diverticulosis in colon?

A

Retrosigmoid colon

67
Q

Lightbulb for diverticulosis in colon?

A

-Low bulk/fiber diet
-M/c over 50 years old

68
Q

Where is colorectal carcinoma m/c?

A

-Rectum is m/c
-Rectosigmoid colon is also common

MIDS 127 (14 decks)

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