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Lawrence > Colon > Flashcards

Colon Flashcards

(54 cards)

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1
Q

Ce se dezv din mezenteron si ce din metenteron

A

Mez: - cec, colon asc, col transv prox
Met: - colon transv distal (1/3), col desc, sigmoid, rect

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2
Q

Unde nu exista apendici epiploici

A

Cec
Apendice cecal
Rect

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3
Q

Care este cea mai mobila parte a colonului

A

Transv

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4
Q

Colonul asc si desc sunt retroperitoneale fixe. But how is sigmoidul?

A

Intraperitoneal, mobil

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5
Q

Din ce e formata vena porta

A

VMI -> V splenica + VMS

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6
Q

Inervatia psy a colonului

A

Vag - proximal, 1/2 transv
S2-S4 - 1/2 transv si distal

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7
Q

Lungime colon, rect, cAnal

A

Colon = 150 cm
Rect = 12-18 cm
cAnal = 2,5-5 cm

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8
Q

2/3 sup din rect sunt acoperite ANT de peritoneu si atasate POST de retroperitoneu. cum e 1/3 inf

A

Complex extraperitoneala

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9
Q

Vascularizatie rect

A
  1. A hemoroidala sup (rectala) <- AMI
  2. A hemoroidala mijl <- A iliaca interna
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10
Q

Inervatie sy + psy rect

A

SY
Sup: L1 - L3
Inf (1/3): nv presacali -> plex hipogastric -> 2 nv hipogastrici
PSY - S2 - S4 - nv erigenti

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11
Q

Vascularizatie anus

A

A hemoroidala inf <- A rusinoasa int <- A iliaca int

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12
Q

Cea mai frecventa localizare a diverticulozei

A

Colon sigmoid

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13
Q

Diverticulii adevarati

A
  • Congenitali
  • Hernierea tuturor straturilor
  • Colon drept
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14
Q

Diverticulii falsi

A
  • Dobanditi
  • Herniere mucoasa + submucoasa
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15
Q

Manif clinice in boala diverticulara simptomatica necomplicata

A
  1. Durere abd recurenta in abd inf stg
  2. Modif tranzit: constipatie, diaree, alternanta
  3. Uneori hdi

!!! Absente febra + leucocitoza
!!! Absenta inflamatia

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16
Q

Radiologie + trat in BDSN

A
  1. Spasm segmentar + stenoza luminala
  2. Fibre
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17
Q

Manif clinice in diverticulita necomplicata

A
  1. Durere inf stg subacuta
  2. Febra
  3. Tulb de tranzit
  4. Palpare formatiune
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18
Q

Manif diverticulitei complicate

A
  1. Abces
  2. Fistula
  3. Perforatie in peritoneu
  4. Obstructie totala / partiala
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19
Q

Cea mai frecv complicatie fistulara

A

Fistula colo-vezicala

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20
Q

Trat pt pacientii cu durere importanta in diverticulita acuta

A
  1. Spitalizare
  2. Hidratare parenterala
  3. Nimic po
  4. Atb iv -> B.fragilis 5-7 zile
  5. Examinare colonoscopica ulterioara
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21
Q

Indicatii trat chir in boala diverticulara

A
  1. Perforatie libera
  2. Obstructie
  3. Boala refractara
  4. Hemoragie
  5. Fistule
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22
Q

Trat abceselor ca si complicatie a diverticulitei

Study These Flashcards
A

Abcese mici
- repaus intestinal
- atb iv

Abcese mari (>5 cm)
- drenaj percutan
- repaus + atb iv

23
Q

In cazul fistulelor se face rezectie sigmoidiana cu anastomoza. Care e dif dintre cele 2 fistule (vezicala si vaginala)

Study These Flashcards
A

Colo-vezicala - sutura primara a vezicii
Colo-vaginala - orificiul vaginal se vindec per secundam

24
Q

Operatie Hartmann

Study These Flashcards
A
  • pt perforatia libera si obstructia colonului
    1. Rezectie sigmoid afectat + colostomie terminala + bont rectal abandonat
    2. Desfiintarea colostomiei + repunere in tranzit a bontului
25
Cea mai frecv cauza de hdi
Diverticuloza
26
Simptome in hemoragia diverticulara
Sangerare rectala nedureroasa cu sange rosu aprins sau inchis
27
Dg diferential in hemoragia diverticulara
1. Angiodisplazia 2. Neoplazii 3. Colita ischemica 4. BII
28
Investigatii in hemoragie diverticulara
1. Colonoscopia 2. Angiografia (colonoscopia nu controleaza hemoragia) 3. Arteriografia mezenterica -> hemoragii moderate sau severe (>0,5 ml/min) 4. RMN (mai sensibil ca primele)
29
Ce se injecteaza pe cateterul de arteriografie in hemoragia diverticulara
Vasopresina fix la locul hemoragiei
30
De cine e data cel mai frecv ocluzia la adult
1. Cancer de colon sau rect 2. Boala diverticulara 3. Volvulus
31
Cum arata perforatia pe rx toracica
Aer liber subdiafragmatic
32
Aspect rx volvulus sigmoidian
Boabe de cafea / tub indoit interior
33
Cioc de pasare la clisma cu subst hidrosolubila inseamna
Volvulus colonic
34
Simptome volvulus sigmoid si cec
1. Crampe abd 2. Durere 3. Greata + varsaturi 4. Constipatie severa
35
Explorarea de electie pt volvulus
CT contrast
36
Care colon se dilata in POAC
Ascendent si transv
37
Ce trebuie evitat in POAC
1. Laxative orale osmotice 2. Stimulante ale peristalticii
38
Ce polipi apar in BII
Inflamatori
39
Ce apare in Peutz-Jeghers
Hamartoame
40
Adenoame cu cel mai mare risc de malignizare
Viloase
41
Unde sunt localizate 80% din adenoamele viloase
Sigmoid
42
HNPPC - risc pt ce cancere
1. Colon drept 2. Endometrial 3. Urotelial
43
Metastazele cancerului de colon sunt in
1. FIcat 2. Plaman
44
Din ce stadiu se recomanda chimio in cancerul de colon si rect
Colon - st 3 Rect - st 2 si 3
45
Standardul terapiei adjuvante cancer colon
FOLFOX 5FU + Leucovorin + Oxaliplatin - 4-6 luni
46
Agentii noi biologici promitatori
1. Bevacizumab 2. Irinotecan 3. Cetuximab
47
Tratamentul prolapsului rectal
Rezectie sigmoidiana + rectopexie
48
Care hemoroizi nu sangereaza
Externi
49
Hemoroizii interni
I - NU prolabeaza II - Prolabeaza da revin la normal singuri III - Si astia da ii bagi la loc cu mana IV - Nu-i mai bagi la loc
50
Fistulele - localizare si cauze
1. Intersfincteriene - abces perianal 2. Transsfincteriene - abces ischio-rectal 3. Suprasfincteriene - abces supralevatorian
51
Cauza cea mai frecvneta de durere anorectala
Fisuri anale
52
Topicele in fisuri anale
1. Ca blocanti (diltiazzem, nifedipina) 2. Nitrati
53
Tratam gonoreei
1. Spectinomicina 2g doza unica im 2. Cefalosporine 3. Quinolone + Doxi pt Chlamydia
54
Tratam sifilis
Penicilina G doza unica im Doxi, tetra (alergie)

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