Chapter 10 The Gastrointestinal Tract And Abdominal Wall

Question 1

What are the diagnostic criteria for pyloric stenosis?

Answer 1

3mm in thickness and 17mm in length

Question 2

In what position is the infant often placed for better sonographic visualization of the pyloric sphincter?

Answer 2

Right lateral decubitus

Question 3

HPS is most often found in infants between:

Answer 3

2 and 6 weeks of age

Question 4

The most common cause of intestinal obstruction in children less than 2 years of age is:

Answer 4

Intussusception

Question 5

Traditionally, treatment for intussusception is by means of:

Answer 5

Therapeutic enema

Question 6

The sonographic finding of fluid-filled, distended loops of bowel is consistent with:

Answer 6

Intestinal obstruction

Question 7

_____is the development of small outpouchings within the sigmoid colon?

Answer 7

Diverticulitis

Question 8

The most common location of the vermiform appendix is in the area of the:

Answer 8

Cecum

Question 9

Rebound tenderness is associated with:

Answer 9

Appendicitis

Question 10

The olive sign is best described as :

Answer 10

Enlarged palpable pyloric sphincter

Question 11

The location of McBurney point?

Answer 11

Between the anterior superior iliac spine and the umbilicus

Question 12

What anatomic structure may be noted as a bullseye structure anterior to the abdominal aorta and posterior to the left lobe of liver in SAG plane?

Answer 12

Gastroesophageal junction

Question 13

_______refers to the bowel being physically blocked by something

Answer 13

Mechanical

Question 14

The area of pain and rebound tenderness with acute appendicitis is most likely at:

Answer 14

McBurney point

Question 15

The situation when bowel protrudes into a weakened area in the lower one-fourth of the rectus muscle is referred to as:

Answer 15

Spigelian hernia

Question 16

Diffused liver diseases are:

Answer 16

• Hemochromatosis
• Hepatitis
• Glycogen storage disease
• Steatosis
• Cirrhosis
• Fatty sparing

Question 17

Gastric cancer is most often in the form of:

Answer 17

Adenocarcinoma

Question 18

Other abnormalities that can present much like pyloric stenosis include:

Answer 18

• Midgut malrotation
• Pylorospasm
• Gastroesophageal reflux disease (GERD)

Question 19

What abnormality associates red currant jelly stools?

Answer 19

Intussusception

Question 20

The situation when bowel protrudes into the groin is referred to as:

Answer 20

Inguinal hernia

Question 21

Clinical findings of acute appendicitis

Answer 21

1. Epigastric or general abdominal pain
2. Acute abdominal pain
3. Rebound tenderness
4. Nausea and vomiting
5. Possible leukocytosis
6. High fever (Abscess formation)

Question 22

Layers of gut identified with sonography:

Answer 22

1. Superficial mucosal
2. Deep mucosal
3. Submucosal
4. Muscular
5. Serosal

Question 23

Pediatric patients could suffer from bowel obstructions that are caused by a buildup of ingested hair. The mass associated with this is:

Answer 23

Trichobezoar

Question 24

Clinical findings of pyloric stenosis:

Answer 24

1. First-born (white) male infant
2. Nonbilious, projectile vomiting
3. Weight loss
4. Constipation
5. Dehydration
6. Insatiable appetite
7. Palpable olive sign

Question 25

Pseudomyxoma peritonei can result from:

Answer 25

Appendix cancer

Question 26

An **autoimmune disease** characterized by periods of **inflammation of the gastrointestinal tract** describes:

Answer 26

Crohn disease

Question 27

The normal intestinal wall should measure less than ______ in thickness

Answer 27

5mm

Question 28

Within the distal stomach lies the ____, a muscle that controls the emptying of the stomach into the duodenum

Answer 28

Pyloric sphincter

Question 29

The **esophagus travels** inferiorly within the thorax and through an **opening** in the diaphragm called the:

Answer 29

Esophageal hiatus

Question 30

The ______consists of the mouth, pharynx, esophagus, stomach, the small intestines and colon

Answer 30

Gastrointestinal tract

Question 31

_____has been cited as the most common cause of acute abdominal pain resulting in surgery

Answer 31

Appendicitis

Question 32

There are two types of intestinal obstruction:

Answer 32

* Mechanical * Nonmechanical

Question 33

Blood accumulation within the muscle or under the sheath can be the result of:

Answer 33

*Abdominal trauma *May occur spontaneously

Question 34

The _____forms a covering for the paired rectus abdominis muscles

Answer 34

Rectus sheath

Question 35

The most common site for endometriosis outside the female pelvis region is the:

Answer 35

Anterior abdominal wall

Question 36

Complications of abdominal wall hernias include:

Answer 36

*Incarceration *Strangulation *Ischemia of the affected bowel

Question 37

What transducer should be used for abdominal wall hernias?

Answer 37

A high frequency linear transducer and standoff pad

Question 38

______ occurs within the RLQ at the level of the ileocecal valve

Answer 38

ileocolic intussusception

Question 39

______is the telescoping of one segment of bowel into another

Answer 39

Intussusception

Question 40

_____is a defect in the relaxation of the pyloric sphincter

Answer 40

Hypertrophic pyloric stenosis

Question 41

An appendicolith will appear as an:

Answer 41

Echogenic, shadowing structure within the lumen of the appendix

Question 42

_____can result from the use of antibiotic therapy that destroys the healthy flora of the intestines and leads to C.difficile

Answer 42

Pseudomembranous colitis

Question 43

Different types of colitis include:

Answer 43

* Pseudomembranous * Ulcerative * Ischemic * Infectious

Question 44

_____is the development of small outpouching termed diverticuli in the digestive tract most often the sigmoid colon

Answer 44

Diverticulosis

Question 45

_____is an autoimmune disorder characterized by periods of inflammation of the GI tract

Answer 45

Crohn disease

Question 46

_____may resemble a cinnamon bun sign in the transverse plane as a result of the alternating echogenicity and the elliptical shape of mass

Answer 46

Intusscusception

Question 47

_____are masses various ingested materials may cause intestinal obstructions

Answer 47

Bezoars

Question 48

Bezoars that consist of vegetable material are called:

Answer 48

Phytobezoars (found in older patients)

Question 49

______or **paralytic ileus** is when the **bowel lacks normal peristalsis**

Answer 49

Nonmechanical obstruction

Question 50

Stool that contains a mixture of blood and mucus is referred to as _____and it is a hallmark clinical findings of intussusception

Answer 50

Jelly stool

Question 51

_____results from the bowel being physically blocked by something

Answer 51

Mechanical obstruction

Question 52

Clinical findings of Acute appendicities

Answer 52

1. Initial epigastric or general abdominal pain 2. Acute abdominal pain 3. Rebound tenderness 4. Nausea and vomiting 5. Possible leukocytosis 6. High fever (with abscess formation)

Question 53

Clinical findings of pyloric stenosis

Answer 53

1. First-born (white) infant male 2. Nonbilious, projectile vomiting 3. Weight loss 4. Constipation 5. Dehydration 6. Insatiable appetite 7. Palpable olive sign

Question 54

Clinical findings of intussusception

Answer 54

1. Intermittent. severe abdominal pain 2. Vomiting 3. Palpable abdominal mass 4. Red currant jelly stools 5. Leukocytosis

Question 55

Clinical findings of an intestinal obstruction

Answer 55

1. Abdominal distention 2. Intermittent abdominal pain 3. Constipation 4. Nausea and vomiting

Question 56

Clinical findings of Crohn disease

Answer 56

1. Episodes of diarrhea 2. Abdominal pain 3. Weight loss 4. Rectal bleeding

Question 57

Clinical findings of diverticulitis

Answer 57

1. Constipation or diarrhea 2. Fever 3. Nausea and vomiting 4. Cramping and LLQ pain

Question 58

Clinical findings of colitis

Answer 58

1. Bloody or watery diarrhea 2. Fever 3. Abdominal pain 4. Previous use of antibiotic therapy

Question 59

Clinical findings of Gastric carcinoma

Answer 59

1. Weight loss 2. Abdominal pain 3. Anorexia 5. Vomiting

Question 60

Clinical findings of Endometriosis of the abdominal wall

Answer 60

1. History of endometriosis 2. Prior cesarean section 3. Pain on the area of the cesarean section scar (possible pain with menstrual cycle) 4. Palpable mass

Question 61

Clinical findings of a rectus sheath hematoma

Answer 61

1. Abdominal pain 2. Palpable abdominal mass 3. Discoloration of the skin in the area of the hematoma 4. Decreased hematocrit

Question 62

Sonographic findings of Acute Appendicitis

Answer 62

1. Noncompressible 2. measures more than 6mm in diameter 3. appendicolith 4. Hyperemic flow 5. Periappendiceal fluid collection

Question 63

Sonographic findings of pyloric stenosis

Answer 63

1. Abnormal pylorus appears as a target or doughnut in the short axis view 2. Abnormal pylorus appears as a cervix in the long axis view 3. Wall of pylorus will measure greater than or equal to 3mm in thickness 4. Length of pyloric channel will measure greater than or equal to 17mm

Question 64

Sonographic findings of intussusception

Answer 64

1. Noncompressible, target-shaped or pseudokidney shaped mass that consists of alternating rings of echogenicity (Cinnamon bun sign) 2. The diameter of the intussuscepted bowel will exceed 3cm

Question 65

Sonographic findings of intestinal obstruction

Answer 65

1. Distended fluid-fluid loops of bowel 2. An abrupt termination point of the distended bowel may be identified 3. Increased peristaltic motion with to and fro motion of intraluminal contents (mechanical obstruction only)

Question 66

Sonographic findings of diverticulitis

Answer 66

1. Segmentally thickened bowel with evidence of an inflamed diverticula and inflamed perienteric fat 2. Affected bowel segment will typically reveal hyperemia 3. Inflamed diverticula may appear as echogenic projections from the bowel that produce shadowing or ring-down artifact

Question 67

Sonographic findings of gastric carcinoma

Answer 67

1. Hypoechoic, irregular shaped bulky mass

Question 68

Sonographic findings of a rectus sheath hematoma

Answer 68

1. Blood can appear hypoechoic, hyperechoic, complex and/or anechoic depending on the stage of development