Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Surgical Recall > SR 44 - Small Intestine > Flashcards

SR 44 - Small Intestine Flashcards

1
Q

How long is the duodenum?

A

12 inches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What marks the end of the duodenum and the start of the jejunum?

A

Ligament of Treitz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the length of the entire small bowel?

A

~6 meters (20 feet)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the blood supply for the small bowel?

A

Branches of the superior mesenteric artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does the small bowel do?

A

Major site of digestion and absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does the terminal ileum absorb?

A

B12
Fatty acids
Bile salts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the major difference between the jejunum and ileum?

A

Jejunum - long, large, thick
Ileum - short, small, thin

Vasa recta, plicae circulares, wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Signs and symptoms of a SBO?

A 
Abdominal discomfort
Cramping
Nausea
Abdominal distention
Emesis
High-pitched bowel sounds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What lab tests are performed with a SBO?

A

Electrolytes
CBC
Type and screen
Urinalysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the classic acid-base/electrolyte findings with proximal SBO?

A

Hypovolemic, hypochloremic, hypokalemic alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What must be ruled out on physical exam in patients with SBO?

A

Incarcerated hernia

Also look for surgical scars - increased risk of adhesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are major AXR findings are associated with SBO?

A

Distended loops of small bowel

Air-fluid levels on upright film

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Define a complete SBO

A

Complete obstruction of the lumen

Little to know colon gas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the danger of a complete SBO?

A

Closed loop strangulation of the bowel leading to bowel necrosis, and potential perforation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Define parial SBO

A

Incomplete SBO

Some colon gas (may still be passing gas)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the initial treatment of patients with SBO?

A

NPO
NGT
IVF
Foley

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What test can differentiate partial from complete bowel obstruction?

A

C with oral contrast and small bowel follow-through

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the causes of SBO?

A

The ABCs

  • Adhesions
  • Bulge (hernias)
  • Cancer and tumors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are lesser cause of SBO?

A

After adhesions, hernias and cancer:

  • Gallstone ileus
  • Intussusception
  • Volvulus
  • External compression
  • SMA syndrome
  • Bezoars, bowel wall hematoma
  • Abscesses
  • Diverticulitis
  • Crohn’s disease
  • Radiation enteritis
  • Annular pancreas
  • Meckel’s diverticulum
  • Peritoneal adhesions
  • Stricture

‘GIVES BAD CRAMPS’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the superior mesenteric artery (SMA) syndrome?

A

SMA compresses the duodenum causing obstruction

Seen with weight loss

21
Q

What is the treatment of complete SBO?

A

Laparotomy and lysis of adhesions

22
Q

What is the treatment of incomplete SBO?

A

Initially, conservative treatment with close observation plus NGT decompression

23
Q

How do you, intraoperatively, determin the level of obstruction in a SBO?

A

Transtion from dilated bowel proximal to the decompressed bowel distal to the obstruction

24
Q

What is the most common indication for abdominal surgeyr in patients iwth Crohn’s disease?

A

SBO

25
Q

Can a patient have a complete SBO and bowel movements/flatus?

A

Yes - the bowel distal to the obstruction can clear out gas and stool taht was there already

26
Q

After a small bowel resection, why should the mesenteric defect always be closed?

A

To prevent an internal hernia

27
Q

What ma cause SBO if patient is on coumadin?

A

Bowel wall hematoma

28
Q

What is the #1 cause of SBO in adults in industrialized nations?

A

Postoperative adhesions

29
Q

What is the #1 cause of SBO around the world?

A

Hernias

30
Q

What is the #1 cause of SBO in children?

A

Hernias

31
Q

What are the signs of strangulated bowel with SBO?

A

Fever, severe/continuous pain, hematemesis, shock, gas in teh bowel wall or portal vein, abdominal free air, peritoneal signs, acidosis (increased lactic acid)

32
Q

What are the clinical parameters that will lower the threshold to operate on a partial SBO?

A

Increasing WBC
Fever
Tachycardia/tachypnea
Abdominal pain

33
Q

What is an absolute indicateion for operation with partial SBO?

A

Peritoneal signs

Free air on AXR

34
Q

What condition commonly mimics SBO?

A

Paralytic ileus

AXR reveals gas distention throughout, including the colon

35
Q

What is the different diagnosis of paralytic ileus (nonobstructive)?

A

Postop ileus after abdominal surgery (resolves in 3-5 days)
Electrolyte abnormalities (hypokalemia)
Medications (anticholinergics, narcotics)
Inflammatory intra-abdominal process
Sepsis/shock
Spine injury
Retroperitoneal hemorrhage

36
Q

What tumor classically causes SBO due to ‘mesenteric fibrosis’?

A

Carcinoid tumor

37
Q

What are the different small bowel tumors?

A 
Leiomyoma
Lipma
Lymphangioma
Fibroma
Adenomas
Hemangiomas
38
Q

What are the signs and symptoms of small bowel tumors?

A

Abdominal pain
Weight loss
Obstruction
Perforation

39
Q

Most common benign small bowel tumor?

A

Leiomyoma

40
Q

Most common malignant small bowel tumor?

A

Adenocarcinoma

41
Q

What is the work up fof a small bowel tumor?

A

UGI with small bowel follow-through
Enteroclysis
CT scan
Enteroscopy

42
Q

What malignancy is classifcally associated with metastasis to small bowel?

A

Melanoma

43
Q

What is a Meckel’s diverticulum?

A

Remnant of the omphalomesenteric duct/vitelline duct, which connects the yolk sac the preimitive midgut in the embryo

44
Q

Where is a Meckel’s diverticulum located?

A

Within 2 feett of the ileocecal valve on the antimesenteric border of the bowel

45
Q

Possible complications of Meckel’s diverticulum?

A 
Intestinal hemorrhage (painless)
Intestinal obstruction
Inflammation+/- perforation
46
Q

What heterotopic tissue type is found in Meckel’s diverticulum?

A 
Gastric mucosa (60%)
Duodenal, pancreatic, colonic mucosa
47
Q

What is a Meckel’s scan?

A

Can for ectopic gastric mucosa in Meckel’s diverticulum
Uses technetium pertechnetate IV
Preferentially taken up by gastric mucosa

48
Q

What is the most common cause of small bowel bleeding?

A

Small bowel angiodysplasia

Surgical Recall (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions