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GI - Y2 > L1 - Introduction to GI > Flashcards

L1 - Introduction to GI Flashcards

1
Q

Summarise the GI tract intrinsic sensory pathways

A
  • submucosal and myenteric plexus

- enteric reflexes regulating motility, secretion and blood flow

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2
Q

Describe what stimuli will activate the extrinsic vagal afferents?

A

Low mechanical stimuli

  • thermal
  • chemical
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3
Q

Cell bodies of vagal afferents are situated

A

Nodose ganglion

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4
Q

Central terminal of vagal aferents is found in the…

A

Brainstem nucleus tractus solitarius

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5
Q

Stroking of gastric mucosa will trigger the release of…

A

Serotonin (5HT) into the lamina propia of the epithelium.

Small amount into lumen of the gut

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6
Q

What type of innervation is the visceral peritoneum

under

A
  • autonomic innervation
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7
Q

Describe pain felt in the visceral peritoneum

A

pain is deep, dull and poorly defined

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8
Q

What type of innervation is the parietal peritoneum under

A

Somatic innervation

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9
Q

Describe pain felt in the parietal peritoneum

A 
pain is sharp, well localised 
rebound tenderness
- pain felt even after hand is lifted 
guarding 
- board like rigidity
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10
Q

Explosive onset of pain indicative of…

A

Perforation of viscus (appendix or colon) or sudden ischaemia (e.g. mesenteric)

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11
Q

Rapid onset on pain may be indicative of…

A

Acute inflammatoin

e.g. appendicitis, cholecystitis

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12
Q

Gradual progress pain may be indicative of..

A

Peritonitis

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13
Q

Describe colic pain

A

Contraction of smooth muscle against an obstruction causes a cyclical on-off pain.

Intervals are severe.

Patient may roll around in pain

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14
Q

Descirbe biliary colic

A

Gradual onset, then constant.

So not true colic

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15
Q

Peritonitis

A
  • inflammation of peritoneum
  • general or localised
  • tenderness, guarding and rebound tenderness
  • caused by acid form perforated ulcer
  • caused by bile from biliary system
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16
Q

Compare and contrast somatic pain and visceral pain

A

Somatic

  • later onset
  • more specific location

Visceral

  • dull and / or cramping
  • intermittent
  • poorly localised
  • pain in organ
17
Q

Position of foregut

A

Pharynx to Ampulla of Vater

18
Q

Midgut

A

Ampulla of vater to first 1/3rd of the transverse colon.

19
Q

Hindgut

A

Mid transverse colon to dentate line in rectum.

20
Q

What would you look out for in an abdominal examination…

A

Scars, distension, discoloration, rashes, trauma, striae, caput medusa

21
Q

Caput medusae

A

Portal venous drainage back to liver impaired.
Channels through previously closed down periumbilical veins are opened.
Allowing portal blood going to the viscera to drain back into larger systemic circulation.

22
Q

Hesselbach’s triangle

A

Defined by edge of rectus abdominis muscle, inguinal ligament and inferior epigastric artery.

23
Q

Direct Hernia

A
  • can exit through superficial ring but cannot extend into scrotum
  • weakness in posterior fascia
  • medial to inferior epigastric muscles
24
Q

Indirect hernia

A
  • travels both deep and superficial ring
  • can extend into scrotum
  • most likely to occur as a result of deep inguinal ring not closing properly.
25
Q

Blumberg sign

A

Pain, rebound tenderness, guarding

- indicative peritonitis

26
Q

How to arrive at a diagnosis using tincanbeds?

A 
T - trauma 
I - infection 
N - neoplasm 
C - congential 
A - acquired 
N- nervous 
B - blood 
E - endocrine 
D - drugs 
S - syphillus
27
Q

Murphpy’s sign

A

Pressure applied to right upper quadrant during inspiration. Causes very large pain.

Indicates gall bladder inflammation.

28
Q

Kehr’s sign

A

left shoulder pain form diaphragm.

Suggestive of free intraperitoneal blood.

29
Q

McBurney’s sign

A

Tenderness with palpation of abdomen 2/3rd of the way between the umbilical and right iliac crest

30
Q

Psoas

A

Patient flexes right hip against resistance and experiences RLQ pain, suggestive of appendicitis

31
Q

Grey-turners sign

A
  • ecchymosis of left flank

- suggest haemorrhage pancreatitis

GI - Y2 (18 decks)

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