Small and Large Intestine

Question 1

duodenal/peptic ulcers

Answer 1

inflammatory erosions of the duodenal mucosa

Question 2

where do most duodenal ulcers occur?

Answer 2

posterior wall of the superior part of the duodenum w/i 3 cm of pylorus

Question 3

what is at risk during the repair of a paraduodenal hernia?

Answer 3

injury of the branches of the IMA/v or the ascending branches of the L colic a

Question 4

where does pain from foregut derivatives localize (esophagus, stomach, pancreas, duodenum, liver, biliary duct) ?

Answer 4

epigastric region

Question 5

where does pain from midgut derivatives localize (small instestine, bile duct, cecum, appendix, ascending colon, most of transverse colon)?

Answer 5

peri-umbilical region

Question 6

where does pain from the hindgut derivatives localize (distal part of transverse colon, descending colon, sigmoid colon, rectum)?

Answer 6

hypogastric region

Question 7

what results from malrotation of the midgut?

Answer 7

several congenital anomalies - volvulus of intestine

Question 8

orad

Answer 8

toward the mouth

Question 9

aborad

Answer 9

away from the mouth

Question 10

what does occlusion of vasa recta by emboli (blood clots) result in?

Answer 10

ischemia of the part of the intestine concerned - if bad enough, necrosis -> paralytic ileus

Question 11

ileus

Answer 11

obstruction of the intestine - severe colicky pain, abdominal distension, vomiting, fever, dehydration

Question 12

how do you diagnose ileus?

Answer 12

superior mesenteric arteriogram

Question 13

Meckel diverticulum

Answer 13

congenital anomaly - remnant of the proximal part of the embryonic omphaloenteric duct (yolk stalk) - appears as a finger-like pouch

Question 14

retrocecal appendix

Answer 14

extends superiorly toward the right colic flexure and is usually free

Question 15

what determines the symptoms and site of muscular spasm/tenderness when the appendix is inflamed?

Answer 15

anatomical position of the appendix

Question 16

what point is the base of the appendix deep to?

Answer 16

McBurney point

Question 17

appendicitis

Answer 17

acute inflammation of the appendix

Question 18

acute abdomen

Answer 18

severe abdominal pain arising suddenly

Question 19

what is a common cause of acute abdomen?

Answer 19

appendicitis

Question 20

where is maximum tenderness felt at in appendicitis?

Answer 20

McBurney’s point

Question 21

fecalith/ coprolith

Answer 21

concretion that forms around a center of fecal matter

Question 22

thrombosis

Answer 22

clotting of blood

Question 23

what can acute infection of the appendix result in?

Answer 23

thrombosis of the appendicular artery

Question 24

rupture of appendix results in what?

Answer 24

peritonitis, increased abdominal pain, nausea, vomiting, abdominal rigidity

Question 25

appendectomy

Answer 25

surgical removal of the appendix through transverse/gridiron incision centered at McBurney point

Question 26

laparascopic appendectomy

Answer 26

inflate peritoneal cavity with CO2 -> laparascope through small incision in anterolateral abdominal wall

Question 27

malrotation of the intestine

Answer 27

failure of descent of the cecum - appendix not in RLQ

Question 28

subhepatic cecum

Answer 28

when cecum is high, appendix in right hypochondriac region

Question 29

volvulus of the colon

Answer 29

obstruction of the intestine resulting from twisting

Question 30

cecopexy

Answer 30

fixation of the colon - may avoid volvulus and possible obstruction of the colon - anchoring procedure

Question 31

ulcerative colitis/Crohn’s disease

Answer 31

chronic inflammation of colon

Question 32

colectomy

Answer 32

sometimes performed with Crohn’s disease - removal of terminal ileum, colon, rectum and anal canal

Question 33

ileostomy

Answer 33

constructed to establish a stoma - artificial opening of the ileum through the skin of the anterolateral abdominal wall

Question 34

colostomy/sigmoidostomy

Answer 34

performed following a partial colectomy to create an artificial cutaneous opening for the terminal part of the colon

Question 35

colonoscopy

Answer 35

procedure to observe the interior of the colon -long, flexible fiberoptic endoscope inserted into colon through the anus and rectum

Question 36

sigmoidoscopy

Answer 36

shorter endoscope (sigmoidoscope) to observe interior of sigmoid colon

Question 37

where do most tumors of the large intestine occur?

Answer 37

sigmoid colon and rectum - often appear near the rectosigmoid junction

Question 38

diverticulosis

Answer 38

disorder in which multiple false diverticula develop along the intestine - commonly found in sigmoid colon

Question 39

what age group dose diverticulosis usually affect?

Answer 39

middle-aged and elderly

Question 40

diverticula

Answer 40

external evaginations or out-pocketings of the mucosa of the colon

Question 41

colonic diverticula

Answer 41

not true diverticula b/c formed from protrusions of mucous membrane only, evaginated through weak points developed b/w muscle fibers rather than involving the whole wall of the colon

Question 42

volvulus of the sigmoid colon

Answer 42

rotation and twisting of the mobile loop of the sigmoid colon and mesocolon - results in obstruction of the lumen of the descending colon and any part of the sigmoid colon proximal to the twisted segment

Question 43

constipation

Answer 43

inability of the stool to pass

Question 44

fecal impaction

Answer 44

an immovable collection of compressed or hardened feces