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Core radiotherapy practice > Lower GI system > Flashcards

Lower GI system Flashcards

1
Q

Where does the small intestine start and finish?

A

Starts at the pyloric sphincter and ends at the ileo-ceacal valve

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2
Q

How long and wide is the small intestine?

A

5-9m long
2.5cm wide

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3
Q

List the 3 sections of the small intestine

A
  1. Duodenum
  2. Jejunum
  3. Ileum
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4
Q

What epithelium lines the small intestine?

A

Simple columnar epithelium

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5
Q

Where are the brunner’s glands found and what is their function?

A

They are found in the submucosa of the small intestine
secrete alkaline juices to neutralise the stomach acid in the chyme

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6
Q

What is the superficial layer of the small and large intestine?

A

Serosa

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7
Q

List 4 cell types found in the epithelium of the small intestine and what do they produce?

A

Absorptive cells - posess microvilli
Goblet cells - secrete mucus
Paneth cells - secrete lysosyme
Enteroendocrine cells - secrete hormones into the gut

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8
Q

What are the circular folds called in the small intestine?

A

Plicae circulares

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9
Q

Give 3 ways in which the small intestine is adapted to have a larger surface area?

A

Villi

Microvilli (brush border )

Plicae circulares

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10
Q

What is the length and width of the large intestine?

A

1.5m

6cm wide

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11
Q

Explain the structure of the large intestinal wall

A

It has 3 bands of smooth muscle called the Taenia coli that run around the colon forming Haustrations in the colon.

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12
Q

List the 8 sections of the large bowel:

A

1.Caecum
2.Ascending colon
3. Hepatic flexure
4. Transverse colon
5. Splenic flexure
6. Descending colon
7. Sigmoid colon
8. Rectum

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13
Q

How long is the colon?

A

15cm

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14
Q

What is the function of the large intestine?

A
  1. absorption of water and electrolytes
  2. produce and absorb vitamins
  3. forming and storage of faeces
  4. bacteria present to break down food
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15
Q

What is the function of the appendix?

A

It contains lymphatic tissue, plays a role in the immune system .

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16
Q

What is the peritoneum and list the two types?

A

A serous membrane that lines the abdominal cavity and separates the abdo organs from organs in the pelvis.

Visceral peritoneum - covers organs in the abdo

Parietal peritoneum - binds organs to the abdo wall so they remain in position.

Fluid between layers to allow slight movement in the abdo cavity.

17
Q

Name 4 non-malignant bowel conditions:

A
  1. Diverticulitis
  2. IBS
  3. Haemorrhoids
  4. ulcerative/ischaemic colitis
18
Q

What is the 10 yr survival for colorectal cancer?

A

53%

19
Q

Give 5 causes/risk factors of colorectal cancer

A
  1. Old age
  2. Diet (too much red/processed meat, not enough fibre)
  3. Family history
  4. Polyps
  5. Bowel conditions
20
Q

What is the most common histology for colorectal cancer?

A

Adenocarcinoma

21
Q

Where does colorectal cancer most commonly metastasise to?

A

Lungs,

Liver,

Brain

22
Q

Name the nodes that commonly drain fluid from the colorectal region

A

Epicolic,paracolic nodes

23
Q

List 5 signs and symptoms of colorectal cancer:

A
  1. Abnormal bowel motions (diarrhoea, loose stools, constipation)
  2. rectal bleeding, blood in stools
  3. Pain in the abdomen
  4. lump in the abdominal region
  5. Bowel obstruction
24
Q

Give 3 ways in which colorectal cancer may be diagnosed

A
  1. Digital rectum examination
  2. Feacal immunochemical test
  3. Colonoscopy
  4. CT colonography
25
Q

What is the name of the procedure where the bowel opening is at the surface of the abdominal wall?

A

Colostomy

Stoma - is the opening at the abdominal wall

26
Q

How is colon cancer normally treated?

A

Surgery is primary treatment followed by chemotherapy

Chemotherapy can be given before.

Radiotherapy is never used unless treating palliative.

27
Q

How is rectum cancer normally treated

A

Surgery and radiotherapy (with or without chemo)

Radiotherapy is either given before or after (more common to be given before surgery)

28
Q

List 3 chemotherapy drugs used to treat colorectal cancer

A

5FU, capecitabine, cetuximab

29
Q

What is the name of the surgical procedure for colon cancer and rectum cancer?

A

Colon -
small - local resection (of the colon lining)
large - Colectomy - removal of all or part of colon

Rectum-
small - Total mesorectal excision (TME)
large - Transanal endoscopic microsurgery (TEM)

30
Q

What is the pre op long course, pre op short course and post op course of radiotherapy for rectum cancer?

A

Pre op short - 25Gy in 5#

Pre-op long 45-50 in 25-28#

Post op with chemo - 45-54Gyin 20-30#

Core radiotherapy practice (15 decks)

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