Pathology of the Small Intestines, Colon, and Appendix Flashcards
What is visceral pain?
Autonomic innervation and will be stimulated by distention, contraction
- Vague pain, dull
- Not sensing of cutting or more localized pain
What is somatic pain?
From the parietal peritoneum, will have more localized discomfort
- Sharp pain
- Associated with infection, inflammation
What is peritonitis?
Inflammation of the peritoneal cavity
- BAD
- Fluid within the peritoneum from underlying process
What is diverticulosis?
Uninflamed diverticula
- Common cause of acute lower GI bleed (bleeds more than diverticulitis)
What is diverticulitis?
Inflammation of the diverticulum
- Commonly associated with micro or gross perforations
What is the pathophysiology of diverticular disease?
- Associated with Western Diet, decreased fiber intake
Firm, small stools need stronger contractions for successful peristalsis –> increased intraluminal pressure leads to herniation of the mucosal and submucosal layers through area of vascular defect
What is Meckel’s Diverticulum?
Congenital diverticulum typically asymptomatic at the illiocecal valve
In ischemic bowel disease, vascular occlusion may be associated with:
- Atherosclerosis
- Aortic aneurysm
- Clot
In ischemic bowel disease, diminished blood flow is associated with:
- Hypotension
- Arrhythmia
- Sepsis
Where is the watershed area in the bowel?
Splenic flexture
The decreased blood flow in ischemic bowel disease leads to what?
- anaerobic metabolism, build up of cellular waste
- necrosis
- leaky gut
- translocation of gut bacteria
What is pneumatosis intestinalis?
- Sepsis, perforation, abscess
- Fatal if untreated
What genetic predisposition is associated with Inflammatory bowel disease?
HLA-B27
What two conditions fall under inflammatory bowel disease?
Ulcerative colitis
Crohn’s
What is the blood test for ulcerative colitis?
P-ANCA
What layer is effected by ulcerative colitis?
Mucosa layer
What layers of the bowel are effected by Crohn’s disease?
Entire thickness of the lumen
What is toxic megacolon associated with?
Infection (C. diff, E. coli, Salmonella)
What are the three flavors of constipation?
- Normal transit constipation
- Slow transit constipation
- Pelvic floor dysfunction
What is normal transit constipation associated with?
Low-fiber diet or low water intake
What causes slow transit constipation?
Decreased colonic motor activity, either idiopathic or secondary cause
What is pelvic floor dysfunction constipation associated with?
The pelvic floor is unable to tighten appropriately
May be associated with hemorrhoids or other anal pathology
What is the dentate line?
Dentate line seperates the anal canal in half, separates the vasculature and innervation
How are hemorrhoids classified?
Either internal or external based on location on dentate line
What type of hemorrhoid will be more sensitive?
External, has more innervation
What is torn in a an anal fissure?
Tear of the anoderm
