Small Bowel II Flashcards

1
Q

What embryo layer is the epithelial lining of digestive tract, glands (liver/pancreas) derived from?

A

endoderm

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2
Q

What embryo layer is the muscular connective tissue and all other layers of the intestine, abdominal wall, peritoneum derived from?

A

Splanchnic Mesoderm

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3
Q

What is the gross anatomical difference between the Jejunum and the Ileum

A

Jejunum—long vasa rectae, large plicae circulares, thicker wall, fewer arcades

Ileum—shorter vasa rectae, smaller plicae circulares, thinner wall, multiple vascular arcades

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4
Q

What is the activity of the Migrating myoelectric complex and whe does it happen?

A

moves from stomach to ileocecal valve during INTERDIGESTIVE period - cleanse bowel of secretions and debris

cycles: 75-90 min

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5
Q

What is the hormone that affects small bowel motility the most? when is it found at peak levels

A

Motilin

peak levels during phase III of MMC

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6
Q

What are the 3 component of the mucosal layer?

A

epithelium
lamina propria
Muscularis mucosa

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7
Q

What are the 4 main subtypes of epithelial layer?

A
  1. Goblet cells—secret mucus
  2. Paneth cells—secrete lysozyme, TNF, and cryptidins
  3. Absorptive
  4. Enteroendocrine - produce GI hormones
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8
Q

What are two aspects of microvilli that gives it great absorption potential?

A
  1. high surface area

2. glycocalyx coating

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9
Q

What are most small bowel obstructions caused by in the US? what about the world?

A

US: postoperative adhesions
World: Hernias
tumors

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10
Q

What is the classic triad of strangulated bowels?

A

leukocytosis
fever
tachycardia
severe abdominal pain

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11
Q

What are classic Sx of obstructed small bowel?

A

nausea/vomiting
distended abdomen
colicky abdominal pain
alteration in flatus and stool passage

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12
Q

How does bowel strangulation happen?

A

gas, fluid, succus (bacteria) accumulate in lumen
intramural pressure causes microvascular perfusion
intestinal ischemia, necrosis = strangulation

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13
Q

What is a particularly dangerous form of strangulation? give an example?

A

Closed loop obstruction

Volvulus

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14
Q

What are Sx of Complete Bowel Obstruction? (FATAL) how urgent?

A
very urgent
Fever
Abdominal pain
Tachycardia
Acidosis
Leukocytosis
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15
Q

What is an Ileus?

A

Intestinal hypomotility WITHOUT obstruction

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16
Q

What are the abdominal and systemic causes of Ileus?

A
1. Abdominal:
Post-laparotomy
Intraabdominal inflammation/abscess
Intestinal ischemia
Retroperitoneal hemorrhage or inflammation
  1. Systemic
    Electrolytes (sodium, potassium, magnesium, phosphorus)
    Metabolic (uremia, diabetic coma, systemic sepsis)
    Drugs (opiates, psychotropic agents, anticholinergic agents)