What provides the efferent innervation of the abdominal viscera?
The sympathetic and parasympathetic (autonomic) nervous system.
What organs of the GI tract are retroperitoneal?
Most of the duodenum and the ascending and descending colon.
What artery supplies the following areas?
- The small intestine and the right half of the colon
- The left half of the colon and the superior rectum
- The upper abdominal structures
- Superior mesenteric artery
- Inferior mesenteric artery
- Celiac artery
What spinal level is the aortic hiatus of the diaphragm located at?
Does the following pain location get transmitted via the autonomic nervous system or somatic nervous system?
- Visceral pain
- Pain from the abdominal wall
- Pain experienced due to derangements of abdominal viscera
- Pain from the parietal peritoneum
What condition would we consider in an infant with projectile vomiting?
Some sort of GI obstruction or hypertrophic pyloric stenosis.
What occurs when patients ingest substances that are not well absorbed but have a high osmotic content?
Poor reabsorption of water in the GI tract which leads to diarrhea.
What is the difference in time period between acute and chronic diarrhea?
What is the difference in cause?
Acute diarrhea lasts for less than 7 days. Chronic diarrhea lasts for greater than 14 days.
Acute diarrhea is usually caused by toxins or bacteria whereas chronic diarrhea is usually caused by a chronic infection or a pathology of the GI system such as excess hormone secretion or celiac disease.
What might clay colored stool indicate?
How do you define constipation?
Where do most causes of constipation have their origin?
Inabilty to pass stool more frequently than three times per week.
In the colon, rectum, or anus.
What is the most common cause of constipation in the elderly?
Pediatric age group?
Imperforate anus and meconium ileus.
If a patient had a recent surgery and is presenting with jaundice, what may be causing the condition?
What if a patient presents with jaundice and inflammatory bowel disease?
Use of halogenated anesthesia
Primary sclerosing cholangitis (ie. Ulcerative colitis)
What three diseases should you think of when presented with an alcoholic?
Pancreatitis, hepatitis, and gastritis.
What GI condition causes leukonychia?
UC, GI lymphoma, liver cirrhosis, malabsorption conditions.
Palmar crease pigmentation?
Encephalopathy secondary to renal and liver failure.
What can cause parotid enlargement that is associated with the GI tract?
Primary biliary cirrhosis
Peutz Jegher’s syndrome
Vitamin B12 and iron deficiency
What are the 9 F’s which cause protuberance/distension?
Fat, fluid, full bladder, feces, flatus, fetus, false pregnancy, fibroid, fatal tumor.
When do paradoxical abdominal movements occur?
When the diaphragm is paralyzed.
What is Cullen’s sign and what does it indicate?
Bluish discoloration of the umbilicus indicating intraperitoneal bleeding.
What is Grey Turner’s sign and what does it indicate?
Bluish discoloration of the flanks indicating retroperitoneal bleeding such as seen in hemorrhagic pancreatitis.
What direction do superficial veins of the abdomen drain above the umbilicus and below the umbilicus?
Above - upwards
Beow - downwards
What causes reversal of this flow?
Inferior vena cava obstruction.
What do high pitched tinkling sounds indicate when listening to the bowel?
Fluid and air under tension in a dilated bowel.
What are the soft tissue layers of the abdomen?
Skin Subcutaneous tissue Muscle Fascia Parietal peritoneum