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GIGU Clinical > Week 1 > Flashcards

Week 1 Flashcards

1
Q
A
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2
Q

Describe longitudinal incisions

A

midline and paramedian incisions good exposure and access to the viscera

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3
Q

Describe median incisions

A

avoid cutting muscle, major blood vessels, and nerves made along the lines alba which means that there are only small vessels and nerves that are present

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4
Q

Describe paramedian incisions

A

lateral to the median plane; sagittal plane Open the anterior sheath, push the rectus muscles aside laterally and enter the peritoneum

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5
Q

Describe an oblique incision

A

Cut is related to the muscle fiber orientation

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6
Q

Describe Gridiron incisions

A

Used in appendectomy muscle splitting

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7
Q

Describe the oblique McBurney incision

A

Made at mcBurneys point, 2.5 cm superomedial to the ASIS careful to preserve the iliohypogastric nerve that runs deep to the internal oblique

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8
Q

Describe a suprapubic incision

A

made at the pubic hairline horizontal incisions gyn/OB surgeries linea alba and anterior layers of the rectus sheaths are transected and resected superiorly; rectus muscles are retracted iliohypogastric nerves and ilioinguinal nerves are identified and preserved

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9
Q

Describe subcostal incisions

A

provide access to the gallbladder and biliary ducts on the right side and spleen on the left 2.5 cm inferior to the costal margin to AVOID the 7th and 8th T spine nerves

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10
Q

What are the high risk incisions?

A

Pararectus and inguinal

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11
Q

Why are pararectus incisions high risk?

A

They are along the lateral border of the rectus sheath, can cut off the nerve supply to the rectus abdomens

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12
Q

Why are inguinal incisions high risk?

A

may injure the olio-inguinal nerve

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13
Q

If there is an infection or cancer that is ABOVE the umbilicus what lymph nodes will it travel to?

A

Axillary lymph nodes

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14
Q

If there is an infection or cancer that is BELOW The umbilicus, what lymph nodes will the infection and cancer mets to?

A

Superficial inguinal lymph nodes

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15
Q

If there is an infection in the deep veins or a cancer surrounding, what lymph nodes and veins will it travel to?

A

Deep lymph vessels External and internal iliac veins

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16
Q

What is the site for the direct inguinal hernia?

A

The medial inguinal fossa

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17
Q

What is the site of the indirect inguinal hernia?

A

Lateral inguinal fossa

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18
Q

If you have a patient come in with RLQ pain, fever, positive heel strike, and positive Rovsigns test, what incision would you expect to be made should the patient need surgery?

A

Gridiron

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19
Q

If you have a patient come in with a positive murphys sign, which incision would you expect to be used?

A

Subcostal

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20
Q

If you have a patient in which you need to have a good vantage point of the entire abdomen, which incision would you use?

A

Longitudinal

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21
Q

If there is cancer or infection in the scrotum, which lymph nodes does it spread to?

A

Scrotum drains into the superficial inguinal lymph then goes to the iliac and lumbar lymph nodes

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22
Q

If there is cancer or an infection in the testes, where will it spread?

A

Lumbar and pre-aortic lymph nodes

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23
Q

Describe a direct inguinal hernia

A

Medial to the inferior epigastric ligament occurs in the peritoneum alongside the spermatic cord

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24
Q

An _______ ________ ________ enters the deep ring and occurs within the sprematic cord and is able to go into the balls

A

indirect inguinal hernia

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25
Q

A direct inguinal hernia occurs medial to the ________ _______ _______

A

inferior epigastric artery

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26
Q

This type of hernia occurs below the inguinal ligament, is more common in women and is emergent

A

femoral hernia

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27
Q

Another term for undescended testicles is….

A

Cryptorchid testis

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28
Q

In cryptorchid testis, there is an increased risk of ________ _______

A

testicular cancer

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29
Q

A hydrocele is a peritoneal accumulation within the _______ _______

A

tunica vaginalis

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30
Q

A hydrocele is detected via ___________

A

transillumination

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31
Q

What is a hematocele?

A

Accumulation of blood in the tunica vaginalis

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32
Q

A ______ is when the pampiniform plexus of veins becomes dilated and tortuous

A

varicocele

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33
Q

An ______ ______ occurs through the linea alba between the diploid process and the umbilicus

A

epigastric hernia

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34
Q

Why do umbilical hernias typically occur in babies?

A

Because the anterior abdominal wall is weak especially in the umbilical ring

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35
Q

A _______ hernia occurs along the semilunar lines

A

Spigelian hernia

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36
Q

When the testis are cold, the ________ muscle draw the testis superiorly

A

cremaster muscle

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37
Q

What are the causes of peritonitis?

A

Bursed viscera Perforated viscera physical trauma

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38
Q

_______ is the collection of fluid in the peritoneal cavity

A

Ascites

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39
Q

______ is the top cause of ascites, and is commonly seen in alcoholic patients

A

cirrhosis

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40
Q

If a patient comes in with upper abdominal pain, fever, and increased pain after eating. If there was free fluid in the abdomen where would you expect it to be?

A

Fluid in the Omental Bursa

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41
Q

What are the causes for fluid in the omental bursa?

A
  1. Perforated posterior stomach wall 2. Pancreatitis 3. Trauma to the pancreas
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42
Q

You suspect that a patient has a small bowel obstruction in their descending colon, what subdivision of the peritoneal cavity would this be in?

A

Infracolic compartment

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43
Q

A patient comes in with severe abdominal pain, tenderness, N/V, fever, with an elevated white count. You suspect a bacterial infection. What is the diagnosis?

A

Peritonitis is typically caused by a bacterial infection/contamination

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44
Q

A subphrenic abscess is a frequent complication of _______

A

ascites

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45
Q

The flow of ascitic fluid and spread of intraperitoneal infections typically involves the ________ ________ (located immediately lateral to the ascending and descending colon).

A

paracolic gutters ***ascitic fluid passes inferiorly through these gutters into the pelvic cavity can ALSO travel to the pelvis this way

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46
Q

There is a knife wound to the anterior abdominal wall in the right upper quadrant, which ligament would you be worried about having damage to it?

A

Falciform ligament

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47
Q

There is an injury to the lesser omentum, which ligaments help to make up this structure?

A

Hepatogastric Hepatoduodenal

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48
Q

If somebody has epiglottitis, which phase of swallowing is likely affected?

A

Pharyngeal phase

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49
Q

Which portion of peristalsis will be damaged following a vagotomy?

A

Primary peristaltic wave

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50
Q

If there is an incomplete relaxation of the LES during swallowing, what is the diagnosis?

A

Achalasia: there is impaired peristalsis

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51
Q

What are the causes of achalasia?

A
  1. Decreased number of ganglion cells in the myenteric plexus (decreased movement of the longitudinal and circular muscles) 2. Degeneration produces NO and VIP (releases LES) 3. Damage to the nerves in the esophagus, so it doesn’t sense the food and push it down
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52
Q

What are the results of achalasia?

A

Backflow of food in the throat., difficulty swallowing, heartburn, chest pain

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53
Q

Describe GERD

A

Changes in the barrier between the esophagus and the stomach (histo) causing the LES to be weakened or abnormally relaxed

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54
Q

What are some reasons that GERD happens?

A

Motor abnormalities causing low pressures in the LES intragastric pressure increases after a large meal lifting pregnancy

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55
Q

If a person’s parasympathetic system is simulated, what happens to the GI system?

A

Increased motility, increased AP and force of contractions

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56
Q

Name that reflex: Negative feedback from duodenum will slow down the rate of gastric emptying

A

Entero-gastric reflex

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57
Q

If a patient comes in with decreased stomach motility and somehow you measure increased secretin released, what was present in the duodenum to cause this?

A

Acid

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58
Q

If a patient comes in with decreased stomach motility and you find fat present in the duodenum, what was released in order to inhibit the stomach motility?

A

Fats

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59
Q

A patient comes in with abdominal pain and on the CT scan, you notice that the duodenum is hypertonic, what is your main concern?

A

That the gastric emptying is inhibited…this seems bad lol

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60
Q

A patient comes in with a sensation of fullness, loss of appetite, nausea, and abdominal pain, upon CT it appears like there is scar tissue on the stomach, what is the diagnosis?

A

Gastric ulcer

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61
Q

If a patient comes in with a history of an eating disorder, how would you expect this to affect the gastric motility? a. increased because there is less stuff coming through so the system gets excited to see visitors b. Decreased because the system forgets what she’s doing c. It dont change

A

b.

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62
Q

How do you treat an issue with decreased gastric motility?

A

Pyloroplasty balloon dilation

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63
Q

________ is the slow emptying of the stomach or paralysis of the stomach in the absence of mechanical obstruction

A

Gastroparesis

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64
Q

_______ _______ is a common cause of gastroparesis

A

Diabetes mellitus

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65
Q

Injury to which nerve can also cause gastroparesis?

A

Vagus nerve

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66
Q

A patient comes in with a high blood glucose, n/v, early fullness when eating, weight loss, abdominal bloating, and abdominal discomfort What would you expect the diagnosis to be?

A

Gastroparesis

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67
Q

If there is an issue with the MMC in the stomach, what could occur in the patient physiologically?

A

SIBO-small intestinal bacterial overgrowth

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68
Q

Describe what happens in the event of vomiting

A

Reverse peristalsis in the small intestine Stomach and pylorus relaxation Forced inspiration to INCREASE abdominal pressure movement of the larynx Glottis closes Forceful expulsion of gastric contents

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69
Q

What does pressure or chemical irritation in the sphincter cause?

A

Inhibits peristalsis of the ileum and excites the sphincter

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70
Q

There is damage to the nerves that supply the external sphincter, which nerves are these?

A

Somatic pudendal nerves

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71
Q

Describe the rectosphincteric reflex

A

As it fills with feces, the SM wall of the rectum contracts and internal anal sphincter relaxes

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72
Q

IF there is a destruction of the pathway between the sensation of rectal distention and voluntary control of the external anal sphincter, what will occur?

A

Loss of voluntary control of defecation

73
Q

If a baby is born and they are unable to pass the meconium (first DOOKie) what is the cause of this disease? Also what is the disease

A

hirschsprung disease which is caused by absent ganglion cells from a segment of the colon

74
Q

What are some of the results physiologically of Hirschsprung disease

A

VIP levels are low smooth muscle constriction less coordinated movements accumulation of colon contents

75
Q

What is the treatment of Hirschsprung diseasE?

A

Surgical resection of colon segment lacking ganglia

76
Q

This reflex is a LONG reflex and is generally stimulatory. It increases motility, secretomotor and vasodilatory activities

A

Vagovagal reflex Vagus N. carries both afferents and efferents

77
Q

this reflex depends on extrinsic neural connections and is inhibitory If an area of the bowel is distended, the contractile portions of the rest of the bowel will decrease

A

intestino-intestinal reflex

78
Q

This reflex is negative feedback from the duodenum and will slow down the rate of gastric emptying

A

Enterogastric reflex

79
Q

This reflex is when gastric distention relaxes the ileocecal sphincter

A

Gastroileal reflex

80
Q

This reflex is the distention of the stomach or duodenum initiating mass movements via the ANS

A

Gastro and duodenal colic reflexes

81
Q

This reflex is when rectal distention initiates defecation; rectal distention causes the relaxation of the internal sphincter

A

Defecation reflex (rectosphincteric)

82
Q

A 29 y/o male with a long history of constipation participates in an investigational study. During part of the study a small intraluminal balloon is inserted through the anus to the rectum. Transducers are also inserted to measure the internal and external anal sphincter pressures. Inflation of the rectal balloon causes the external anal sphincter to contract. the internal anal sphincter, which shows normal tone, fails to relax and the urge to defecate is not sensed. Which of the following structures is most likely damaged in this patient? a. External anal sphincter b. Internal anal sphincter c. Pelvic splanchnic nerve d. Pudendal nerve e. rectum

A

c. pelvic splanchnic nerve

83
Q

A 5 y/o female is brought to the clinic because she has severe, chronic constipation. her mother has noticed that the bowel movements are sometimes of very large diameter. Physical examination reveals that the patients height and weight are below the 10 percentile. The most likely diagnosis is a. Achalasia b. Anger about potty training c. Depression about learning to read d. Diverticulitis e. Hirschsprungs disease

A

e. Hirschsprungs disease

84
Q

What are the 3 esophageal constrictions?

A

Cervical: upper esophageal constrictor (cricopharyngeus) Thoracic: where esophagus passes posterior to the left main bronchus and aorta Diaphragmatic: where the esophagus passes through the esophageal hiatus

85
Q

A ________ ______ _______ is where the cardia of the stomach is in a normal position, but the peritoneum and fundus of the stomach are anterior to the esophagus. No regurgitation occurs

A

Para-esophageal hiatal hernia

86
Q

A ______ ______ ______ is when the esophagus, cardia of the stomach, and fundus of the stomach protrude through the esophageal hiatus; worse when the patient lays down or bends over; regurgitations

A

sliding hiatal hernia

87
Q

Name and describe the parts of the pylorus

A

Pyloric antrum: wider portion of the pylorus Pyloric canal: narrow, distal portion of the pylorus Pyloric sphincter: normally closed; regulates the flow of food into the duodenum

88
Q

Which portion of the duodenum is intraperitoneal?

A

The first part which is the most mobile and associated with the hepatoduodenal ligament

89
Q

What are plicae circulares and where are they found?

A

In the mucosal folds of the jejunum; they diminish in size from proximal to distal

90
Q

There are 3 different components along the large intestine that store fat?

A
  1. longitudinal bands of smooth muscle- tennis coli 2. Sacculations-haustra 3. appendices epiplociae
91
Q

Describe the main pancreatic duct

A

begins in the tail and is joined by the accessory in the tail

92
Q

What is the purpose of the sphincter of the main pancreatic duct?

A

Prevents bile from entering the pancreas

93
Q

Which duct of the pancreas has an opening that is located at the minor papilla of the duodenum?

A

Accessory pancreatic duct

94
Q

The _______ _______ is formed by the union of the common bile duct and the main pancreatic duct. Is associated with the sphincter of Oddi and the major duodenal papilla

A

Hepatopancreatic ampulla

95
Q

What is the flow of the bile from the liver to the gallbladder?

A
  1. bile canaliculi 2. interlobular bile ducts 3. right and left hepatic ducts 4. common hepatic duct (+cystic duct) 5. common bile duct
96
Q

If there is a gallstone in the cystic duct, what would result?

A

cholecystitis

97
Q

Blockage of the hepatopancreatic ampulla will cause what?

A

It will block the common bile duct and the main pancreatic duct, causing bile to back up into the pancreas causing pancreatitis and jaundice

98
Q

What is the protective mucosal type?

A

Nonkeratinized stratified squamous

99
Q

What is the absorptive mucosal type?

A

Simple columnar epithelium

100
Q

What is the secretory mucosal type?

A

Simple columnar epithelium

101
Q

What is the absorptive AND protective mucosal type?

A

Simple columnar epithelium

102
Q

Describe GERD

A

causes chronic inflammation, ulceration, and difficulty in swallowing due to reflux of gastric contents

103
Q

Describe the histological changes that occur during Barrett’s esophagus

A

Changes from nonkeratinized stratified to columnar mucus secreting/glandular

104
Q

During swallowing the _____ area of the stomach relaxes

A

orad

105
Q

You have a patient come into the ER complaining of abdominal pain when ingesting a lot of protein. You notice that there is a problem in the cell that has abundant RER with apical secretory granules

A

Chief cells: secrete pepsinogen in response to protein to break it down (after it is turned into pepsin)

106
Q

These cells are large cells that are round or pyramidal shaped, contain one central round nucleus, and has an eosinophilic cytoplasm because there is increased mitochondria

A

Parietal cell

107
Q

What do parietal cells secrete

A

HCL and intrinsic factor

108
Q

A patient comes in with an atrophied pyloric sphincter which muscle is most likely affected?

A

The circular muscles that is within the muscularis layer

109
Q

A patient presents with a vitamin B12 deficiency, assuming that the problem is not dietary related, which cell of the GI tract would you suspect as the culprit of the deficiency?

A

Parietal cells because they secrete intrinsic factor

110
Q

______ _______ Secrete peptide hormones to control gut motility, regulate secretion of enzymes, HCl, bile & other components for digestion

A

Enteroendocrine cells

111
Q

These cells function in innate immunity by secreting antimicrobial substances

A

Paneth cells

112
Q

What is the shape of a paneth cell?

A

pyramidal shaped at the base of the intestinal glands

113
Q

These are located in a crypt base near the paneth cells that repopulate the epithelial lining

A

intestinal stem cells

114
Q

What is the function of M cells?

A

To transepithelially transport particles and microorganisms in the ileal mucosa

115
Q

Where are Brunners glands located and what do they do?

A

In the duodenum and help to neutralize the chyme by producing an alkaline secretion

116
Q

Hirschprungs disease is caused by mutations in the _____ gene that is required for differentiation of the _____ which leads to aganglionosis of the distal colon

A

RET NCC

117
Q

Describe short segment Hirschsprungs disease

A

confined to the rectosigmoid colon 85% of the cases

118
Q

Describe long segment disease

A

extends past the rectosigmoid cregion to the splenic flexure

119
Q

A patient comes in with a weird disease and you’re suspecting that there is an issue with the acidity of the stomach acid because it is not being alkalized. In which portion of the GI tract would you look for pathology during endoscopy?

A

In the duodenum, you’re looking for Brunners glands

120
Q

On your fourth year path rotation you receive a slide from a patient who has been having severe abdominal pain. this slide is supposedly going to be able to tell the location of the pathology. You notice that there are tubular intestinal glands present with well defined lacteals. You also notice an absence of submucosal glands and lymph nodules in the lamina propria. Whatcha thinking?

A

Jejunum bitch

121
Q

What is the function of the ileoceccal valve and why does it have thickened muscular mucosa?

A

To propel food from the ileum to the cecum; needs muscle to keep colonic contents from going into the ileum

122
Q

If you have cancer in your colorectal zone of the anal canal, what cell type will be present/

A

simple columnar epithelium that is identical to the rectum

123
Q

Differentiate between white rami and gray rami

A

both connect the spinal nerves to the sympathetic trunk White rami are pre-ganglionic; myelinated; entrance ramps Gray rami are postganglionic; unmyelinated; exit ramps on a highway

124
Q

List the sympathetic pathways

A

Spinal nerve pathway postganglionic sympathetic nerve pathway splanchnic nerve pathway adrenal medulla pathway

125
Q

Which cranial nerves are associated with the parasympathetics

A

3 7 9 10

126
Q

Pain will travel with the _______ nervous system

A

sympathetic

127
Q

A patient comes into the ER with abdominal pain that has been going on for about 10 days, how would you classify this pain?

A

Subacute abdominal pain

128
Q

What classifies as acute abdominal pain?

A

three days or less

129
Q

List pathologies that can cause pain

A

Inflammation Ischemia Stretching Obstruction Trauma Functional disease

130
Q

This type of pain is diffuse and poorly localized in the somatic regions

A

Visceral pain: damage to the internal organs and the tissues that support them

131
Q

This type of pain is well localized and caused by injury to skin, muscles, bone, joint and connective tissue

A

Somatic

132
Q

_______ pain can be localized to the dermatome superficial to the site of the painful stimulus

A

parietal pain

133
Q

Describe the “timeline” of abdominal pain in terms of visceral to localized pain

A

The pain starts out as visceral pain and eventually gives way to parietal pain which is localized to a dermatome and causes tenderness and guarding. When the localized peritonitis develops further, rigidity and rebound appear

134
Q

Visceral pain can be localized by the sensory cortex to an approximate spinal cord level determined by the _______ _____ of the organ involved.

A

embryological origin

135
Q

If there is pathology in the biliary tract, where would you expect the patient to have pain?

A

Epigastric area

136
Q

Which organs will cause periumbilical pain?

A

The midgut organs small bowel appendix cecum

137
Q

_______ ______ (most of colon, including half of sigmoid) as well as the intraperitoneal portions of the genitourinary tract cause pain initially in the suprapubic or hypogastric area.

A

Hindgut organs

138
Q

A patient comes in with pain in the right hypochondriac region of the abdomen, and increased white count and a fever. What is a possible diagnosis? (start with what organs are there)

A

A liver abscess The infection of the abscess would cause an increased white count and stuff.

139
Q

Why does referred pain occur?

A

It is caused by the network of interconnecting sensory nerves that supply different tissues

140
Q

_________ structures are the pancreas, kidney, and aorta

A

retroperitoneal pain

141
Q

______ pain is intermittent cramp like pain that is caused by an obstruction of a hollow muscular viscus

A

colicky pain

142
Q

Describe the pain that would occur with a gastric ulcer

A

Foregut visceral pain Worse on eating; patient tends to avoid meals

143
Q

Describe the pain that would occur with a perforated gastric ulcer

A

Foregut chronic visceral pain Sudden severe pain spreading all over abdomen Signs of generalized peritonitis

144
Q

What is the possible diagnosis based on the pain presentation? Foregut visceral pain Somatic pain in right upper quadrant Referred pain to right shoulder Nausea and vomiting Fever Tender right upper quadrant Positive Murphy’s sign

A

Acute cholecystitis

145
Q

A patient comes in with…. Midgut visceral pain Somatic pain in right lower quadrant Nausea and vomiting Fever Tender right lower quadrant who is she

A

Acute appendicitis

146
Q

How will a patient with a possible ruptured appendix present?

A

signs of localized peritonitis in the RLQ

147
Q

What are the pain patterns of an adhesive small bowel obstruction?

A

History of previous abdominal surgery e.g. appendectomy, hysterectomy Midgut visceral colicky pain Vomiting No flatus or bowel action Possible dehydration Distended soft abdomen; non‐tender Increased bowel sounds

148
Q

What is the possible diagnosis of a patient who presents with…. Sudden onset of very severe colicky pain from loin to groin; also severe back pain Patient writhing with pain and pacing about Possible hematuria Afebrile Soft abdomen Tender renal angle

A

passage of a kidney stone

149
Q

A 67 y/o male presents to the ED with progressive weight loss with hindgut visceral colicky pain. Pt is not able to pass stools or gas. Upon examination, the abdomen is distended with a possible mass felt in the left lower quadrant. Bowel sounds are increased in all 4 quadrants. What is the possible diagnosis?

A

Obstructing cancer of descending colon

150
Q

Patient is a 21 y/o female presenting to the ED c/o abdominal pain onset 3 hours ago that she describes as a sharp pain rated 9/10 in severity. She claims that the pain is located in the lower middle portion of her abdomen below her umbilicus with radiation into her sacrum. Upon exam patient is tender to palpation of the hypogastric area and rectouterine pouch on vaginal examination

A

Ruptured ectopic pregnancy

151
Q

An elderly male patient is in the clinic and you are suspecting a leaking aortic aneurysm. What are some possible symptoms in regards to the pain presentation?

A

Sudden onset of severe back pain Pale and shocked; hypotensive Tender epigastrium Palpable impulse from aneurysm in epigastrium

152
Q

________ ________ _______ is the narrowing of the pyloric lumen which obstructs food passage

A

Hypertrophic pyloric stenosis

153
Q

A baby comes in with projective non-bilious vomiting after feeding, nost as frequent stools, and failure to gain weight. You suspect that during fetal development there was an inability of the neural crest cells and the ganglion are poorly populated but not absent. What do you expect the diagnosis to be?

A

Hypertrophic pyloric stenosis

154
Q

Describe what happens to the muscularis externa in pyloric stenosis?

A

It hypertrophies and forms a palpable mass at the right costal margin

155
Q

List some of the pancreatic anomalies that could occur

A
  1. Accessory pancreatic duct
  2. Pancreas divisum: two separate ducts
  3. Annular pancreas
156
Q

What are some complications that can occur with an annular pancreas

A

Duodenal obstruction or stenosis

157
Q

What results from the obliteration of extrahepatic and intrahepatic ducts?

A

Biliary atresia

158
Q

In biliary atresia, the ducts are replaced by _______ _______ from inflammation

A

fibrotic tissues

159
Q

Shortly following birth, a baby shows signs of neonatal jaundice, white clay stools, and dark colored urine. What is the diagnosis. Given this diagnosis what is the necessary treatment?

A

Biliary atresia

Liver transplant

160
Q

An _______ is the hernation of the gut into the umbilicus that is covered by the peritoneum.

A

Omphalocele

161
Q

There is an increased risk of omphalocele with trisomy _____ and ____

A

13 and 18

162
Q

When omphalocele is seen, what are some of the possible etilogies?

A
  1. Herniated bowel does not fully retract
  2. Lateral body folding and fusion is abnormal which makes the anterior abdominal wall weak and the bowel can herniate
  3. The connective tissue of the skin and hypaxial musculature of the body wall do not form normally which makes it weak
163
Q

If the abdominal contents herniate through the abdominal wall and the exterior WITHOUT peritoneal covering, what is this called?

A

Gastrochisis

164
Q

If the yolk stalk is unable to connect to the midgut and remians connected to the umbilicus, what pathology is present?

A

Meckel’s diverticulum

165
Q

A 2 y/o male presents to the clinic with abdominal swelling and currant jelly stools present in his diaper. Upon radiology testing, there is an intestinal obstruction that is 2 feet proximal to the terminal ileum with an outpocketing that appears to be 2 inches long heading to the umbilicus. What is likely the diagnosis of this patient?

A

Meckel’s diverticulum

Rule of twos:

2% incidence

2x more common in males

2% have sx

2 feet proximal to the terminal ileum

2 inches long

2 years of age

166
Q
A
167
Q

A ______ is rolled up, twisted intestines. Patient will present with abdominal pain, vomiting, and GI bleeding

A

Volvulus

168
Q

A _______ ___ ______ ______ is when the gut completes the first 90 counterclockwise rotation but does not do the remaining 180 counterclockwise rotation

A

non-rotation of midgut loop

169
Q

Describe the organ positioning following a non-rotation of midgut loop.

A

Left sided colon and right sided small intestines

170
Q

A ______ _______ _______ occurs when the cut does the initial counterclockwise 90 degree rotation but does a 180 clockwise rotation.

A

reverse gut rotation

171
Q

Describe the organ positioning that occurs following a reverse gut rotation

A

The transverse colon is posterior to the duodenum

increased risks of ischemia and stenosis of the colon

172
Q

_______ _____ ___ _______ occurs during the 5-6th months. The lumen of the intestines is almost completely obliterated due to endodermal proliferation and villi formation.

A

Intestinal stenosis and atresia

173
Q

A person with down syndrome (trisomy 21) is most likely to have which GI pathology?

A

Intestinal stenosis and atresia

174
Q

_______ ______ is the partial occlusion due to ineffective recanalization

***horizontal and ascending parts

A

Duodenal stenosis

175
Q

______ _______ is the complete occlusion of the lumen

A

Duodenal atresia

176
Q

An ______ ______ is the persistant anal membrane

A

Imperforated anus

177
Q

Based on the following factors, what is the most appropraite associated pathology?

  • absence of ganglionic plexus
  • lack of peristalsis
  • hypertrophy in intestines
  • colonic dilation or distension
A

Hirschsprungs disease (congenital aganglionic megacolon)

178
Q
A

GIGU Clinical (5 decks)

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