The Gastrointestinal Tract Flashcards

1
Q

What is the esophagus? Where is it located in relation to the aorta? Where does it enter?

A
  1. Muscular tube
  2. Enters the superomedial aspect of stomach (cardia)
  3. Anterior to the aorta
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2
Q

What is the GE junction?

A

Juncture of the greater and lesser curvature s

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3
Q

Where does the esophagus pierce the diaphragm?

A

T10

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4
Q

Where is the stomach located? In what quadrants does the stomach lie? 3

A
  1. Left hypochondrium and epigastric region
  2. Peritoneal
  3. Lower aspect crosses midline and terminates at the duodenum
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5
Q

What does the cardia of the stomach surround?

A

Surrounds lower esophageal sphincter

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6
Q

What is the fundas of the stomach? 2

A
  1. Rounded portion
  2. Superior and left or cardia
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7
Q

What is the body of the stomach?

A

largest central poriton

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8
Q

What is the curvatures of the stomach

A
  1. lesser: concave and medial
  2. Greater: convex and lateral
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9
Q

What is the pylorus of the stomach? Where is it located if empty?

A
  1. Distal aspect
  2. Empty stomach: just right of ML
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10
Q

How long is the small bowel?

A

5-6 meters in length

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11
Q

What are the three parts of the small bowel?

A
  1. Duodenum
  2. Jejunum
  3. Ileum
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12
Q

What is the duodenum?

A

Shortest, widest and most fixed portion of the small bowel

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13
Q

How is the duodenum divided?

A

Into four parts

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14
Q

What is the first portion of the duodenum? Where is it located? 2

A

Superior/ bulb
1. Intraperitoneal
2. from pylorus runs up and back to about the level of the GB neck

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15
Q

What is the 2nd part of the duodenum? Where is it located? 2

A

Descending
1. Retroperitoneal
2. CBD and pancreatic duct insertion

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16
Q

What is the third part of the duodenum and where is it located?

A

Transverse
1. Horizontal
2. Retroperitoneal

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17
Q

What is the 4th part of the Duodenum? Where is it located?

A

Ascending
1. Retroperitoneal
2. Runs superior and to the left

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18
Q

What is the 4th part of the Duodenum? Where is it located?

A

Ascending
1. Retroperitoneal
2. Runs superior and to the left

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19
Q

What peritoneal cavity is the jejunum located? How is it arranged? What quadrants is it located? 3

A
  1. Intraperitoneal
  2. Arranged in multiple loops
  3. Mainly in umbilical and left iliac region
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20
Q

What is the ileum? Where is it located? 2

A
  1. Longest portion of the small bowel
  2. Located in umbilical, hypogastric, right iliac, and pelvic regions
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21
Q

Where does the ileum join?

A

Large intestines at the ileocecal sphincter

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22
Q

What is the ileum anchored by?

A

Mesentery

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23
Q

How long is the large bowel?

A

~2 meters in length

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24
Q

What are the multiple divisions of the large bowel? 5

A
  1. Cecum
  2. Colon
  3. Sigmoid
  4. Rectum
  5. Anal canal
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25
Q

What is the cecum? Where is it located?

A
  1. Pouch like portion at origin of ascending colon (below ileocecal sphincter)
  2. RLQ/ Right iliac region
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26
Q

Where does the appendix extend from?

A

Inferior portion of the cecum

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27
Q

What kind of structure is the appendix? What does it open into? Where is it located?

A
  1. blind ended tubular structure
  2. Opens into cecum
  3. RLQ
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28
Q

What is this an image of?

A

Appendix

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29
Q

What cavity is the ascending colon located in the peritonium? Where is it located? How does it run with peritonium?

A
  1. Retroperitoneal
  2. Superior path along the right flank
  3. Runs from right iliac fossa to visceral surface of right lobe
30
Q

What is the hepatic flexure?

A

Connects ascending and transverse colon with around a 90 degree curve in the RUQ

31
Q

What is the transverse colon? Where is it located? How does it travel?

A
  1. Intraperitoneal
  2. Travels horizontally across mid abdomen, anterior to duodenum
  3. Bends downward just inferior to the spleen (splenic flexure)
32
Q

What is the descending colon? Where is it located?

A
  1. Retroperitoneal
  2. Inferior path along left flank to the left iliac fossa
  3. Extends over pelvic brim
33
Q

What is the sigmoid colon? Where does it sit?

A
  1. Terminal end of colon
  2. Projects inward towards midline
  3. Sits anterior to sacrum
34
Q

Where does the rectum descend?

A

Into the true pelvis

35
Q

What does the anal canal penetrate?

A

The levator ani to become anal canal

36
Q

What is the mucosa layer? What does it do? What is it consist of?

A
  1. Inner most layer
  2. Protects, absorbs and secretes
  3. Epithelial lining, connective tissue and muscle
37
Q

What is the submucosa layer consist of? What does it do?

A
  1. Connective tissue, blood vessels and lymphatics
  2. Nourishes surrounding tissue; transports nutrients
38
Q

What is the muscularis? what does it do?

A
  1. Smooth muscle- circular and longitudinal
  2. Responsible for movement of tube and contents
39
Q

What is the serosa?

A

Outer protective layer

40
Q

What is the gut signature?

A

The distinct layer appearance of gut on ultrasound due to the different acoustic properties of the histologic layers of the GI tract

41
Q

What is the sonographic appearance of the lumen?

A

Hyperechoic

42
Q

What is the sonographic appearance of the mucosa?

A

Hypoechoic

43
Q

What is the sonographic appearance of the submucosa?

A

Hyperechoic

44
Q

What is the sonographic appearance of the muscularis?

A

Hypoechoic

45
Q

What is the sonographic appearance of the serosa?

A

Hyperechoic

46
Q

What are the folds in the stomach called? How do they run?

A
  1. They are called rugae
  2. They run parallel to long axis and disappear in a distended state
47
Q

How far apart is the vavlulae conniventes of the small bowels? Where is it the most most prominent? Is it visibile when the bowel is distended?

A
  1. 3-5 mm apart
  2. Most prominent in duodenum
  3. Visible even when bowel distended
48
Q

What is the distance of the haustral markings located?

A

3-5 cm apart

49
Q

What are these images of?

A

Small bowel

50
Q

What is this an image of?

A

Large bowel

51
Q

What is the sonographic appearance of the small and large bowels? 4

A
  1. Uniform and compressible
  2. Keyboard sign for small bowel
  3. Haustral markings for colon
  4. Peristalsis/ motor activity
52
Q

What is the wall thickness of the distended and the non distended bowel?

A

D: 3mm
ND: 5mm

53
Q

What is the primary function of the bowels?

A

Digestion/ absorption

54
Q

What is the endocrine functions of the bowel?

A

Ingestion of food stimulates release of hormones from the endocrine cells in the mucusa

55
Q

What are the GI hormones? 3

A
  1. Gastrin
  2. CCK
  3. Secretin
56
Q

What is Gastrin? What is it released by?

A
  1. Released by stomach
  2. Stimulates secretion of gastric acid
57
Q

What is CCK and what is it released by?

A
  1. Released by duodenum
  2. Controls GB contraction
58
Q

What is secretin? what is stimulates?

A
  1. Released by duodenum
  2. Stimulates secretion of bicarbonate
59
Q

What does the celiac, superior and inferior mesenteric arteries supply?

A

Small and large bowel

60
Q

What is the venous return for small and large bowels (what does it empty into)?

A

Empties into the portal venous system

61
Q

What does the gastric artery and vein supply and drain?

A

Stomach

62
Q

What is the sonographic assessment for GI?

A

Assess diameter, content and motor activity

63
Q

What is the wall thickness of the GI?

A

3mm distended/ 5mm nondistended

64
Q

What does symmetric thickening of the GI mean?

A

Inflammation

65
Q

What does the asymmetric thickening of the GI mean?

A

Malignancy

66
Q

What is the excessive amount of fluid in the lumen mean? 3

A
  1. Hypersecretion
  2. Mechanical obstruction
  3. Paralytic ileus
67
Q

If GI activity increases what does this mean?

A

Mechanical bowel obstruction/ inflammation

68
Q

If GI activity decreases what does this mean?

A

Paralytic ileus/ end stage mechanical obstruction

69
Q

What is the prep for a GI scan?

A

No prep, fasting, ingesting water

70
Q

What kind of probe do we use for a GI scan?

A

C6-2

71
Q

What kind of compression should use for a GI scan? Why? What should we do with tender areas?

A
  1. Slow graded compression
  2. Normal gut should compress
  3. Use caution where patients are tender