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Abd / SS > Module 13 : GI Tract > Flashcards

Module 13 : GI Tract Flashcards

1
Q

esophagus

A
  • muscular tub e
  • passes through hiatus of the diaphragm at T 10
  • anterior to aorta
  • enters superomedial aspect of the stomach (cardia)
  • GE junction marks juncture of the greater and lesser curvatures of the stomach
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2
Q

stomach

A
  • left hypochondirum
  • epigastric regions
  • peritoneal
  • lower aspect crosses midline and terminates at the duodenum
  • 6 parts
    + cardia
    + fundus
    + body
    + greater curve
    + ;esser curve
    + pylorus
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3
Q

cardia

A
  • surrounds lower esophageal sphincter
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4
Q

fundus

A
  • rounded portion

- superior and left of cardia

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5
Q

body

A
  • large central portion
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6
Q

lesser curve

A
  • concave medial portion
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7
Q

greater curve

A
  • convos lateral portion
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8
Q

pylorus

A
  • pyloric canal, pyloric antrum
  • disstal aspect of stomach
  • on an empty stomach lies on right of midline
  • fully distended shifts 5-8cm to the right off midline
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9
Q

small bowel

A
  • 3 parts
    + duodenum
    + jejunum
    + ileum
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10
Q

duodenum

A
  • shortest widest and most fixed
  • 4 parts
    + first part
    + second part
    + third part
    + fourth part
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11
Q

first part of duodenum

A
  • superior/ bulb
  • intraperitoneal
  • from pylorus running upward and backward to level of GB neck
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12
Q

second part od duodenum

A
  • descending
  • retroperitoneal
  • CBD and main pancreatic duct insertion
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13
Q

third part of duodenum

A
  • transverse/horisontal

- retroperitoneal

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14
Q

fourth part of duodenum

A
  • ascending
  • runs superior and to the peft
  • retroperitoneal
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15
Q

jejunum

A
  • intraperitoneal at ligament of treitz (connects bowel to diaphragm)
  • arranged in multiple loops
  • occupies the umbilical and left iliac regions
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16
Q

ileum

A
  • longest portion
  • umbilical hypogastric right iliac and pelvic regions
  • joins large bowel at ileocecal sphincter
  • ileum and jejunum anchored to posterior abdominal wall by mesentery
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17
Q

large bowel / colon

A
  • multiple division

- cecum ascending transverse descending sigmoid rectum and anal canal

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18
Q

cecum

A
  • pouch like portion at origin of ascending colon
  • right lower quadrant
  • appendix extends from inferior portion
  • retroperitoneal
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19
Q

appendix

A
  • blind ended tubular structure

- opens into cecum

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20
Q

ascending colon

A
  • retro peritoneal
  • superior path along right flank
  • from right iliac fossa to visceral surface of right lobe
  • hepatic flexure
    + connect ascending and transverse colon
    + 90 degree curve shadows kidney
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21
Q

transverse colon

A
  • intraperitoneal
  • travels horizontally across mid abdomen anterior to duodenum
  • splenic flexure
    + bends downward 90 degrees inferior to spleen connecting transverse to descending colon
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22
Q

descending colon

A
  • retroperitoneal
  • descends on left side of abdomen to left iliac fossa
  • extends over pelvic brim
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23
Q

sigmoid colon

A
  • terminal end of colon
  • projects inward toward midline e
  • sits anterior to sacrum
24
Q

rectum

A
  • descends into true pelvis

- ends at anal canal

25
Q

anal canal

A
  • rectum penetrates levator ani mussen to become anal canal
26
Q

GI anatomy

A 
- continuous tube with 4 concentric layers
   \+ mucosa
   \+ submucosa
   \+ muscularis
   \+ serosa
27
Q

mucosa

A
  • epithelial lining loose connective tissue
  • muscular mucosa
  • innermost layer
  • protects absorbs secretes
  • hypo echoic
28
Q

submucosa

A
  • connective tissue blood vessels lymphatic
  • nourishes surrounding tissue and transports absorbed nutrients
  • hyper echoic
29
Q

muscularis

A
  • smooth muscle in circular and longitudinal
  • responsible for movement of tube and its contents
  • hyopechoic
30
Q

serosa

A
  • outer layer
  • protection
  • hyperechoic
31
Q

stomach - anatomy

A
  • characteristic folds called rugae
    + increase expansion and surface area
  • parallel to long axis of stomach
  • disappear in distended state
32
Q

small bowel anatomy

A
  • folds called valvulae conniventes
  • do not disappear when intestine is distended
  • 3-5mm apart
  • most prominent in duodenum and first half jejunum
33
Q

large bowel anatomy

A
  • huastral markings

+ 3-5 cm apart

34
Q

gut signature

A
  • district layered appearance of gut on ultrasound do to different acoustic properties of histological layers of GI tract
35
Q

sonographic appearance

A
  • uniform and compressible
  • average thickness
    + 3mm (distended)
    + 5 mm (non distended)
  • assess bowel for motor activity
  • keyboard sign = valvulae conniventes
  • austral marking = ascending and descending colon
36
Q

physiology

A
  • primary function = digestion and absorption
  • largest endocrine organ
  • ingestion of flood stimulates release of hormones from endocrine cells in mucosa
37
Q

GI hormones

A
  • gastrin
  • cholecystokinin
  • secretin
38
Q

gastrin

A
  • released by stomach

- stimulates secretion of gastric acid

39
Q

cholecystokinin

A
  • CCK

- released by duodenum controls GB contraction

40
Q

secretin

A
  • released by duodenum to stimulate release of bicarbonate from panc to neutralize stomach acid
41
Q

ultrasound land mark - ge junction

A
  • anterior and left of aorta
42
Q

ultrasound landmark - stomach

A
  • antrum is anterior to panc
43
Q

ultrasound landmark - duodenum

A
  • lateral to panc head
44
Q

ultrasound landmark - jejunum

A
  • inferior to body and talk of pan

- anterior to left kidney

45
Q

ultrasound landmark - cecum

A
  • medial to ASIS and iliopsoas
46
Q

ultrasound landmark - appendix

A
  • posterior to cecum
47
Q

ultrasound landmark - ascending colon

A
  • anterior lateral to low pole of right kidney
48
Q

ultrasound landmark - transverse colon

A
  • inferior to pan and stomach
49
Q

ultrasound landmark - descending colon

A
  • adjacent to left flank over lw pole left kidney
50
Q

ultrasound land mark - sigmoid

A
  • anterior to external iliac
  • poster to uterues
  • posterior to bladder
51
Q

vasculature

A
  • celiac superior and inferior mesenteric arteries supply small and large bowel
  • venous return from small and large bowel into portal system
  • gastric artery and vein supply and drain stomach
52
Q

ultrasound assesemnt

A
  • asses diameter content and motor activity
53
Q

wall thickness

A 
- normal 
  \+ 3 mm distendne
   \+ 5 mm undistended
- if thickened
   \+ symmetric = inflammation 
   \+ asymmetric = malignancy
54
Q

content of lumen

A
  • excessive amounts of fluid
    + hyper secretion
    + mechanical obstruction
    + paralytic ileus
55
Q

activity

A 
- increases with
   \+ mechanical bowel obstruction 
   \+ or inflammation 
- decreases with 
   \+ paralytic ileum
   \+ end stage mechanical obstruction
56
Q

ultrasound prep and technique

A
  • no prep fasting drinking water
  • high frequency linear
  • slow graded compression
  • normal gut should compress and gas displaced
  • use caution where tender

Abd / SS (14 decks)

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