Anatomy and Pathology 2: Quiz 1 Flashcards
(76 cards)
1
Q
Accessory Digestive Organs
A
- teeth
- tongue
- salivary glands
- liver
- gallbladder
- pancreas
2
Q
What moves food through the digestive system?
A
Peristalsis
3
Q
What secures the tongue to the floor of the cavity?
A
Lingual frenulum
4
Q
What does the tongue do?
A
- helps form bolus (food and saliva ball)
- pushed bolus into pharynx
5
Q
3 pairs of salivary glands
A
- Parotid (around ear): largest, stensen’s duct opens to inner cheek
- Submandibular (below the jaw): under tongue at angle of mandible, wharton’s duct opens onto floor of mouth on either side of frenulum
- Sublingual (under tongue): floor of mouth anterior to submandibular glands
6
Q
What are mumps?
A
Inflammation of parotid glands
7
Q
3 parts of pharynx
A
- nasopharynx
- oropharynx
- laryngeopharynx
8
Q
Is the esophagus anterior or posterior to the trachea?
A
Posterior
9
Q
What directs food into the esophagus?
A
Epiglottis
10
Q
Soft fold of mucosa in the stomach?
A
Rugae
11
Q
Layers of the stomach (inner to outer)
A
- Mucosa
- Submucosa
- Muscularis
- Serosa (visceral peritoneum)
12
Q
KNOW PARTS OF THE STOMACH
A
.
13
Q
Beginning and end of the small bowel?
A
- pyloric sphincter
- ileocecal valve
14
Q
What does the small bowel do?
A
- mechanical digestion and propulsion
- chemical digestion
- absorption of nutrients
15
Q
4 regions of the small bowel
A
- Superior
- Descending
- Horizontal
- Ascending
16
Q
Which parts of the small bowel are attached to the abdominal wall by the mesentery?
A
Jejunum and Ileum
17
Q
The ileum connects to the colon at the _______?
A
Ileocecal valve
18
Q
Functions of the pancreas
A
Produces digestive enzymes and insulin
19
Q
4 parts of the pancreas?
A
- Head
- Neck
- Body
- Tail
20
Q
What does the pancreatic duct do?
A
Dumps juices into the duodenum for digestion
21
Q
Functions of the large bowel?
A
- Final absorption of water and formation of feces
- Storage of feces until evacuation
- secretion of mucous for safe passage
- formation of some vitamins (B and K)
22
Q
Muscular bands in the large intestine that form the haustra are called ______?
A
Teniae coli
23
Q
Parts of the large intestine
A
- Cecum
- Ascending
- Hepatic flexure
- Transverse (most anterior)
- Splenic flexure
- Descending
- Sigmoid
- Rectum
- Anus
24
Q
What DI exam images the biliary tree?
A
Cholangiogram
25
What is the porta hepatis and what things are located in it?
- the gateway to the liver
| - contains the hepatic ducts, hepatic artery, and portal vein
26
Functions of the liver
- forms bile
- performs 200 metabolic functions including regulation of blood metabolism, cleaning up toxins, storing vitamins, ironm, and glycogen
27
Function of the gallbladder?
Store bile
28
What hormone signals the gallbladder to release bile?
Cholecystokinin (CKK)
29
What is an atresia?
An abnormal "blind" pouch or end where there should be an opening
30
What is a fistula?
An abnormal connection between 2 tubular parts of anatomy, abnormal passageway
31
What is an esophageal atresia and tracheoesophageal fistula? Symptoms/complications? Indications?
Esophageal atresia: Esophagus has formed with 2 blind ends, baby cannot swallow saliva
TE fistula: abnormal passage between the esophagus and the trachea
-both congenital, but can be acquired as an adult through trauma, infection, or cancer
-aspiration pneumonia, inability to swallow saliva, other congenital malformations of the skeletal, CVS, or GI systems
-CONTRAST ESOPHAGRAM IS CONTRAINDICATED
-Small radio-opaque feeding tube used to demonstrate atresia
-absence of air in the stomach for atresia
-non-contrast CT is safest
32
What is Achalasia? Symptoms/complications? Indications?
The lower esophageal sphincter cannot relax due to compromised nervous control
- patients complain of sternal pain and dysphagia
- dilated proximal esophagus with absence of peristalsis leading to the "rat tail or beak like" sign on a barium esophagram
- treated with dilatation, medication, botulinum toxin, or myotomy
33
What is a foreign body? Symptoms/complication? Indications?
Foreign objects lodged, or food impacted in the esophagus or anywhere in GI tract
- patient will not be able to swallow without regurgitation if object is in esophagus, obstructions lasting 12hrs + may result in perforation
- radiopaque objects visualized with radiographs
- poorly chewed food demonstrated after barium is swallowed
- treated with meds, endoscopic retrieval or surgery
34
What routine do we use for foreign bodies?
Soft tissue neck routine
- include nasopharynx on lateral c-spin (bridge of nose), collimate out eyes
- AP same as normal
35
What is GERD? Symptoms/complications? Indications?
Gastroesophageal reflux disease. Any disease/condition that allows retrograde flow of stomach contents into distal esophagus causing esophagitis or structural changes to tissue
-can be caused by ingestion of caustic agents, chocolate, caffeine, alcohol, or fatty foods
-acute episodes cause esophagitis, chronic conditions can compromise peristalsis leading to scarring, ulceration, or stricture
-main symptoms are heart burn, or chest pain
-barium swallow or esophogram
Treatment involves lifestyle changes and reduction in acid-causing foods or surgery (in extreme cases)
36
What is esophageal carcinoma? Symptoms/complications? Indications?
Cancer of the esophagus
- progressive dysphagia in anyone over 40 may indicate this (adenocarcinoma)
- symptoms appear late in the disease and prognosis is poor due to high chance of metastasis
- strong correlation with excessive ETOH intake and smoking
- chemotherapy, radiotherapy, or surgery, but mainly palliative care
- ulceration, mucosal destruction, stenosis, and clear visual difference between healthy and not tissue
- CT: wall thickening of esophagus
37
What is the hiatus?
Where the esophagus passes through the diaphragm
38
What is a sliding hiatal hernia? Symptoms/complications? Indications?
Some portion of the stomach and gastroesophageal junction moved into the chest temporarily when intra-abdominal pressure is increased
- reflux or heartburn
- upper GI will demonstrate the condition when the patient is placed in a trendelenberg position
39
What is a rolling hiatal hernia, paraesophageal hernia? Symptoms/complications? Indications?
Part of all of the stomach pushing up into the thoracic cavity through a defect in then diaphragm. The gastro-esophageal sphincter stays below the diaphragm
- volvulus, esophagitis, ulcers, strictures, but main symptoms are related to reflux
- diagnosed with chest x-ray or upper GI
- severe cases may need laparoscopic surgery to push stomach back into place, secure it, and repair any gap in the diaphragm
40
What is a hypertrophic pyloric stenosis? Symptoms/Complications? Indications?
Hyperplasia (enlargement), hypertrophy, and elongation of the pylorus. The edematous thickened tissue can be palpated as a mobile, hard "olive".
- projectile vomiting leading to dehydration
- best diagnosed with ultrasound, but upper GI with thin barium may confirm by demonstrating "string sign" and delayed stomach emptying
41
What is gastritis? Causes? Symptoms? Indications?
Inflammation of the stomach caused by alcohol, corrosive agents, and infection, most common cause helicobacter pylori
- erosions and ulcers may form
- thickening of gastric folds, gas bubbles in the stomach wall
42
What is a peptic ulcer? Causes, symptoms/complications, indications?
Inflammatory processes in the stomach and duodenum secondary to gastritis caused by pepsin and HCl wearing though the mucosal lining of the stomach
- hemorrhage, gastric outlet obstruction, perforation leading to peritonitis
- benign ulcers: smooth barium filled projections, smooth folds around it
- malignant: not so nice
- lifestyle changes, low acid foods, stress reduction, antibiotics
43
What is a peptic ulcer aggravated by?
NSAIDs
44
What is the most common cause of upper GI bleeding and pneumoperitoneum?
Peptic ulcers
45
What is gastric CA? Symptoms/complications? Indications?
Tumor of the stomach, usually cancerous, less than 20% survival rate over 5yrs
- symptoms aren't usually noticeable until tumor is advanced
- stomach doesn't churn, appears "stuck"
- CT is used for staging
- surgery is treatment of choice
46
What is another name for Crohn's disease?
Regional enteritis
47
What is crohn's disease? Symptoms/complications? Indications?
Chronic inflammation of the GI tract, involves all layers
- unknown cause, common in young adults, can have acute episodes
- palpable masses, pain and fever, widespread inflammation, ulcerations, fistulas between other organs, atresias
- thickening of the bowel wall "cobblestone appearance", "pipe-like narrowing", "string sign"
- treated with meds or surgery
48
What is a small bowel obstruction? Symptoms/complications? Indications?
Bowel blockage due to a variety of conditions such as hernia, tumors, inflammation, stones, previous surgery or peritonitis (most commong)
- strangulation of the bowel from hernia or volvulus
- No air seen in bowel/colon distal to blockage, step-ladder appearance, bowel becomes distended (gas/fluid levels)
- surgery
49
What is a large bowel obstruction? Symptoms/complications? Indications?
Blockage in the large bowel most commonly caused by bowel cancer, severity depends on how competent the ileocecal valve is
- perforation most likely in the cecum
- distended colon, little or no gas in small bowel if valve is competent
- if not competent, gas will be seen in the large and small bowels
50
What is intussusception? Symptoms/complications? Indications?
Acute telescoping of one part of the intestinal tract into another because of peristalsis, more common in children
- severe abdominal pain, blood in stool, palpable mass in right side
- ischemic necrosis, prognosis is good if treated within 48hrs
- "coiled spring" appearance
- therapeutic enema
51
What is a volvulus? Symptoms/complications? Indications?
Bowel blockage caused by twisting of the bowel around its mesentery, most common in elderly in the sigmoid colon and cecum
- necrosis and perforation of the bowl is life threatening
- surgery required
52
What is adynamic illeus? Symptoms/complications? indications?
Compromised motility in the small and large bowels (stop peristalsis) due to neural, hormonal, metabolic, or physical causes. Occurs after abdominal surgery (will clear within 36-48hrs)
- may occur in bowel adjacent to inflamed tissue
- air fluid levels in both the small and large bowel with no obvious obstruction indication
- NG tube used to aspirate the stomach and decompress the bowel
53
What is diverticulosis? Symptoms/complications? indications?
Colonic outpouchings caused by herniations of mucosa and submucosa through the muscularis at point of weakness is the bowel wall
- most common in sigmoid colon
- low fibre diet, older individuals
- chronic or intermittent lower abdominal pain around meals
- barium filled diverticula appear on contrast studies
- no seeds, no nuts, popcorn, etc. Exercise to increase peristalsis
54
What is toxic megacolon?
Acute non-obstructive dilation of the colon
55
What is diverticulitis? Symptoms/complications? Indications?
Necrosing inflammation of the diverticula caused by abscessing of trapped fecal matter
- fibrous adhesions
- may lead to inflammation of the colon wall, fistulas, or narrowing of the lumen
- no seeds, nuts etc, exercise and antibiotics
56
What increases the chances of colon cancer?
- Ulcerative colitis
| - colonic polyps
57
What is ulcerative colitis? Symptoms/complications? Indications?
Inflammatory lesions that only involve the mucosal layers of the colon (most often in rectosigmoid colon ) (small ulcers on inside lumen)
- bloody diarrhea, abdominal pain, fever, weight loss, toxic megacolon
- 10x more likely to develop cancer
- mucosa appears bumpy, "collar-buttoned"
- colon appears as "lead-pipe"
- diet changes, anti-inflammatories, stress control, surgical resection
58
What is a contraindication of barium enema?
Toxic megacolon
59
What is a colonic polyp? Symptoms/complications? Indications?
Abnormal neoplasm projecting from a muscous membrane, benign, but may become malignant
- most common in left colon and rectosigmoid
- rectal bleeding, pain on rare occasions, diarrhea, constipation
- removed during colonoscopy, double contrast barium enema shows filling defects
60
What is colon cancer? Symptoms/complications? Indications?
Bowel cancer in the colon
- most common between 50-70yrs
- most arise form pre-existing polyps
- family history of polyps or ulcerative colitis
- sometimes obstruction or bleeding
- may spread to lymph, liver, or lungs
- napkin ring or apple core sign on DCE
- surgery, chemo, radiotherapy
61
What is cholelithiasis? Symptoms/complications? Indications?
FREELY-MOVING stones in the gallbladder formed from irregular emptying of the gallbladder or incorrect chemical balance of bile (bile crystallizes)
- commonly caused by four f's (female, fatty diet, ++++ body habitus, family history) or extreme rapid weight loss
- pain in RUQ, jaundice if bile can't reach duodenum, gray-white feces
- stones roll to dependant side when patient is repositioned
- broken up with lithotripsy, dissolved with meds, or removed (laparoscopically or with surgery)
62
What is cholecystitis? Symptoms/complications? Indications?
Acute inflammation of the gallbladder most often caused by obstruction of the cystic duct by a gallstone
- gallstones can damage mucosal layer and cause infection
- edema in gallbladder wall and pain in RUQ
- sonography
- cholecystectomy is treatment (looks unhappy)
63
How are the different types of hepatitis contracted?
A + E : "ate them" ingestion of fecal matter
B: blood and bodily fluids
C: blood (transfusions)
64
What is hepatitis? Symptoms/complications? Indications?
Inflammatory disease of the liver
- jaundice, pain, nausea, vomiting, tenderness over liver
- without treatment: cirrhosis (C), portal hypertension, hepatocellular necrosis, increased risk for hepatocellular carcinoma
- hepatomegally (chronic hepatitis)
- decreased blood clotting ability (chronic hepatitis)
- prevention is best medicine (vaccines for A and B) and standard precautions
- antiviral drugs used to control it, but it stays with you forever
65
Which type of hepatitis is the most common cause of chronic hepatitis, cirrhosis, and liver cancer?
C
66
What is cirrhosis? Symptoms/complications? Indications?
Chronic destruction of the liver that cause parenchyma to be replaced by fibrotic scar tissue
-most often caused by alcohol abuse, hepatitis, toxins, or biliary disease
67
Stages of liver cirrhosis
- Fatty liver disease
- Inflamed (hepatomegaly)
- Nodules (localized swelling)
- Liver can't process alcohol and toxins build up
- Fibrotic tissue replacing parenchyma
- Significant symptoms (portal hypertension, ascites) = cirrhosis
68
What is portal hypertension? Symptoms/Complications? Indications?
Increased resistance to antegrade flow in the portal veins
- caused by liver cirrhosis, blood can't move through liver back to IVC
- retrograde flow causes splenomegaly, esophageal varicies, and caput medusa
- treated for a splenorenal shunt, or TIPPS (palliative)
- shunts threaded through IJV, right atrium, IVC, and portal vein
69
What is ascites? Symptoms/complications? Indications?
Fluid in the peritoneal cavity
- portal hypertension ad decreased albumin levels caused fluid to leak out of circulation into tissues
- caused by cirrhosis, chronic hepatitis, kidney or heart failure, cancer
- "dog-eared bladder" on abdominal x-rays, liver may be displaced
70
What are esophageal varicies? Symptoms/complications? Indications?
Collateral veins that have formed in the esophagus
- caused by cirrhosis and associated portal hypertension
- rupture is fatal (1/3 of cirrhosis deaths)
- thin barium done for upper GI will demonstrate "worm-like" filling defects
71
How should images be done for esophageal varicies? Why?
Recumbent, for safety
72
What is hepatocellular carcinoma? Symptoms/complications? Indications?
Primary liver cancer most commonly associated with alcoholism and cirrhosis
- central liver mass that alters contour of liver
- usually death by hemorrhage before it spreads
- chemotherapy is palliative, need liver transplant
73
What is metastatic liver disease? Symptoms/complications? Indications?
Most common malignancy of the liver
- liver filters blood, common for cancers in other parts of the body to spread to liver
- more common than primary liver cancer
- jaundice, tenderness, hepatomegaly
74
What is acute pancreatitis? Symptoms/complications? Indications?
Inflammation of the pancreas caused by digestive enzymes that have become activated and begin to digest the pancreas from the inside out
- caused by alcohol abuse, gallstone blockage of ampula of vater leading to a reflux in bile into the pancreas
- sudden onset of severe steady abdominal pain, nausea, and vomiting, jaundice
- sometimes gas/fluid levels, adynamic ileus, or displacement of adjacent structures
- treated with IV fluids, meds, and in some cases antibiotics
75
What is chronic pancreatitis? Symptoms/complications? Indications?
Frequent intermittent damage to the pancreas causes scar tissue to form and the pancreas can no longer produce digestive enzymes, insulin, or glucagon
- pain, malabsorption, weight loss, diabetes
- presence of calcifications in the pancreas
- no alcohol, change in diet (reduced fat and protein)
- pancreatic enzyme supplements and pain meds
76
What is pancreatic carcinoma? Symptoms/complications? Indications?
Most commonly an adenocarcinoma, which is often detected too late
- pain, weight loss, jaundice, fatigue, nausea, vomiting, and diabetes
- risk factors: smoking, alcoholism, chronic pancreatitis, diabetes mellitus, family history of adenocarcinoma
- pancreatectomy removed the pancreas, duodenum, CBD, gallbladder, spleen, and surrounding lymph nodes
