Small And Large Intestines Flashcards
Numerate the developmental anomalies of small intestine!
1) Atresia or stenosis
2) Duplication
3) Meckel diverticulum
4) Omphalocele
In case of atresia it involve many segments of small intestine True/False?
False .The correct is
Involve only one segment
Duplication ,takes the form of persistent blind ended tubular protrusion up to 5 to 6 cm long True/False?
False .The correct is
Meckel diverticulum
Duplication ,usually take form of tubular to saccular cystic structure ?
True
Meckel diverticulum is resultant of failure involution of omphalomesenteric duct ?
True
Define Omphalocele !
Is a congenital defect in periumbilical abdominal wall leaves behind a membranous sac ,into which the small intestine herniate
Major anomalies of large intestine include….&….
Malrotation and Hirschsprung disease
In malrotation , the developing bowel prevent the intestines from take their normal appearance ?
False .The correct is
Prevent them from assume their normal intra-abdominal position
Define Hirschsprung disease !
Leading to congenital megacolon
1) The caudate migrating of neural crest driving cell along the alimentary tract arrests at some point before reaching the anus
2) Leading to functional obstruction and aggressive distention of the colon proximal to the affected part
Numerate the vascular disorder of intestine !
1) Ischemic Bowel disease
2) Angiodysplasia
3) Haemorrhoids
Ischemic lesions affect the small intestine True/False?
True
Ischemic bowel disease affect the large intestine only True/False?
True
What is the main cause of Ischemic lesion?
Occlusion of one of the three major supply trunks of the intestine -celiac ,superior and inferior mesenteric arteries.
Why the loss of one vessels in Ischemic disease may be not affect?
Due to rich anastomotic interconnection between the vascular beds
Explain what happen if the lesions forming within end-arteries the penetrate the gut wall!
Producing small focal ischemic lesions ranges from transmural infarction ,affect all visceral layers of wall, to mural infarction ,affect mucosa and submucosa ,sparing the muscular layer of wall ,and
mucosal infarction ,if the lesions extend on deeper than the muscularis mucosa
The predisposing factor of ischemic lesions are ….. , …. , …. , non-occlusive ischemia and Miscellaneous
Arterial thrombosis ,Arterial embolism and Venous thrombosis
Describe the appearance of Ischemic lesions.
Whether the occlusions are arterial or venous ,the infarction always take appearance of dark red haemorrhagic appearance because of the reflow of blood into the damaged area
Transmural infarction , the onset of pian tends to be more sudden with…. than the ….
Mesenteric embolism ,arterial and venous thrombosis.
Why the diagnosis must be made promptly ?
Because this condition may progress to shock and vascular collapse
Why the mortality rate of Ischemic Bowel disease approach 90% ?
Because the time between the onset of symptoms and the perforation caused by gangrene is so small
What is the cause of angiodysplasia ?
This case is result from tortuous dilations of submucosal and mucosal blood vessels which is most often occur in cecum or right colon ,usually after sixth decade of life
In Angiodysplasia ,the haemorrhage may be acute and massive and only cause pernicious anaemia True/False?
False .The correct is
Ut may be chronic and intermittent and only cause severe anaemia
Give example about systemic disorders !
Hereditary Haemorrhagic Telangiectasia
Give example of variceal dilations !
1) Varices of Oesophagus
2) Haemorrhoids
What is the main cause of Haemorrhoids ?
Persistently elevated venous blood pressure within haemorrhoidal plexus
Numerate the predisposing factor of haemorrhoids !
1) Straining at stool in the setting of chronic constipation
2) Venous stasis of pregnancy in younger women
3) Resulting from cirrhosis of the liver
Haemorrhoids include ….&….
External haemorrhoids (dilations of the inferior haemorrhoidal plexus) Internal haemorrhoids (dilations of the superior and middle haemorrhoidal plexus)
Explain the complications of haemorrhoids !
1) Thin walled ,dilated vessels that commonly bleed, sometimes masking bleeding from far than serious proximal lesions
2) They may become thrombosed,particularly when subject to trauma from passage of stool
3) Internal haemorrhoids may prolapse during straining at stool and then become trapped by the compressive anal sphincter leading to sudden extremely painful ,oedematous haemorrhagic enlargement or strangulation
IBD include….&….
Crohn disease & Ulcerative colitis
Why IBD consider as individual disease ?
Because they have many difference
How IBD is initiated ?
By diverse genetic and immunologic pathways that are modified by environmental influences , including microbes and their products
Crohn’s disease affect the respiratory system from mouth to the lung True/False?
False .The correct is
The alimentary tract from mouth to the anus
Crohn’s disease is it including systemic disorders?
Yes such as iritis migratory polyarthritis, hepatic pericholangitis and obstructive uropathy with attendant nephrolithiasis
What is the features of CD ?
1) Sharply delimited and typically transmural involvement of bowel by an inflammatory process and mucosal damage
2) The presence of noncaseating granulomas in 40%-60% of cases
3) Fissuring by formation of fistulae
4) Making bowel wall rubbery and thick the result of oedema ,inflammation ,fibrosis , and hypertrophy of muscularis propria ,as a result the lumen is almost always narrowed
5) The classic feature of CD is (skippy lesions)
Early disease exhibit focal mucosal ulcers resembling Aphthus Ulcer ?
True
Describe the progressive disease !
Ulcers coalesce into long ,serpentine linear ulcers , which tend to be oriented along the axis of the bowel
Explain the dominant manifestations of CD?
1) Recurrent episodes of diarrhoea
2) Crampy abdominal pain
3) Fever lasting from days to months
How the manifestation of CD initiated ?
Begin insidiously , but in some instances , particularly in young persons ,the onset of pain so abrupt and the diarrhoea so mild that abdominal exploration is performed with a diagnosis of appendicitis
