GI Complications

Question 1

Parasympathetic innervation of colon

Answer 1

Vagus n. = proximal to mid-transverse colon

Splanchnic n. (Pelvic n.) = descending colon and rectal region

Question 2

Innervation of internal anal sphincter

Answer 2

Sympathetic T11-L2

Question 3

UMN vs LMN colonic dysfunction in SCI patient: which one has flaccid EAS and which has spastic EAS

Answer 3

UMN = spastic EAS
LMN = flaccid EAS

Question 4

Sympathetic innervation of colon

Answer 4

Hypogastric nerve via superior and inferior mesenteric ganglia and the celiac ganglia

Question 5

How long after SCI do you keep patient on stress ulcer prophylaxis?

Answer 5

4 weeks

Question 6

What are two things that make up the enteric nervous system?

Answer 6

Auerbach’ plexus

Meissner’s plexus

Question 7

How long after SCI do patients have hypercalcemia

Answer 7

4-8 weeks after SCI

Question 8

What is SMA syndrome

Answer 8

Third portion of duodenum is compressed by SMA resulting in GI obstruction

Question 9

1 treatment for hypercalcemia

Answer 9

IV fluids to increase urinary excretion of Calcium

Question 10

What is the nutcracker effect?

Answer 10

Anything that decreases distance between aorta and SMA can cause compression of the duodenum

Question 11

How do you stimulate the rectocolic reflex?

Answer 11

Suppositories or digital stimulation

Question 12

Main symptom of SMA syndrome

Answer 12

Post-prandial nausea and vomiting

Question 13

What acute gastric complication is seen during spinal shock

Answer 13

Adynamic ileus and gastric atony

Question 14

What SCI patient population is SMA more common in?

Answer 14

Tetraplegics

Question 15

Auerbach’s vs Meissner’s plexus

Answer 15

Auerbach’s plexus = primarily motor

Meissner’s plexus = primarily sensory

Question 16

2 medications that can be used to treat hypercalcemia

Answer 16

Pamidronate and furosemide

Question 17

Most common fractures in SCI

Answer 17

Supracondylar femur fractures

Question 18

In SCI osteoporosis, do you get more trabecular or cortical bone loss?

Answer 18

Trabecular

Question 19

UMN vs LMN colonic dysfunction in SCI patient: which one has fecal incontinence and which has fecal impaction

Answer 19

UMN = fecal impaction
LMN = fecal incontinence

Question 20

What structure does Senna act on?

Answer 20

Auerbach’s plexus

Question 21

Most common cause of emergency abdominal surgery in chronic SCI patients

Answer 21

Cholecystitis

Question 22

What diagnostic imaging do you do for SMA syndrome

Answer 22

UGI series to look for duodenal obstruction

Question 23

Innervation of external anal sphincter

Answer 23

Pudendal nerve

Question 24

UMN vs LMN colonic dysfunction in SCI patient: which one has intact reflexes?

Answer 24

UMN lesion has intact reflexes

Question 25

What kind of neurogenic bowel is manual disimpaction used?

Answer 25

Areflexic bowel - LMN lesion

Question 26

What kind of hypercalcemic SCI patients do you treat?

Answer 26

All of them, whether symptomatic or asymptomatic