Exam III - Clinical Aspects

Question 1

Extravasation of Urine

Answer 1

• rupture of the spongy urethra allows accumulation of urine between Scarpa’s Fascia and Deep Fascia
• almost exclusive to males

Question 2

Cryptorchidism

Answer 2

• Testes are undescended at birth (3% fullterm; 30% premature)
• Undescended testes are most commonly found in the inguinal canal (usually unilateral)
• Usually descend in the first few weeks or months
• Increases risk of testicular cancer due to compression

Question 3

Peristalsis

Answer 3

Propulsive movement of the gut; contractile ring appears and moves distally

Question 4

Reverse Peristalsis

Answer 4

Occurs in vomiting

Question 5

Congenital Hypertrophic Pyloric Stenosis

Answer 5

• Tumor-like increase in the size of the pyloric sphincter, reducing the size of the pyloric canal
• Results in projectile vomiting
• May be present at birth

Question 6

Pylorospasm

Answer 6

• Spasmodic contraction of pyloric sphincter
• Sometimes present in infants
• Food does not pass easily from stomach to duodenum
• Subluxations in T5-T9 may play a role

Question 7

Gastric Ulcer

Answer 7

• A crater like depression in the mucosa of the stomach
• Inadequate covering of stomach wall by alkaline mucus
• Subluxations of T5-T9 may play a role
• Secretion of gastric acid is controlled by Vagus Nerve

Question 8

What causes gastric ulcers?

Answer 8

Excess acid secretion (stress)

Inadequate Mucus Barrier (presence of bacteria)

Question 9

Duodenal Ulcer

Answer 9

• Mucosa in duodenum is eroded to form a crater-like depression, most commonly found in duodenal cap
• May affect liver, pancreas, and gall bladder, as well as gastroduodenal artery

Question 10

Outline the path fluid travels from a perforated duodenal ulcer.

Answer 10

Subhepatic recess -> right paracholic gutter -> Iliac fossa

Question 11

Ileal (Meckel’s) Diverticulum

Answer 11

• Malformation of digestive tract
• Remnant of a portion of the embryonic vitelline duct
• Finger-like pouch which projects from distal ileum
• May become inflamed, mimicking appendicitis

Question 12

Crohn’s Disease

Answer 12

• Inflammatory bowel disease which most commonly affects the distal ileum and adjacent colon
• Affects ALL layers of intestine
• Results in pain, diarrhea, and malabsorption
• Produces a “cobblestone” radiographic appearance

Question 13

Appendicitis

Answer 13

• Inflammation of the appendix

- Symptoms usually begin as umbilical pain, localizing to the right lower quadrant

Question 14

What is the most common intra-abdominal inflammatory condition?

Answer 14

Appendicitis

Question 15

What causes appendicitis?

Answer 15

lymphoid hyperplasia

fecal compaction

Question 16

Diverticulosis

Answer 16

• Herniations of the mucosa of the colon through the muscular layer
• MC in individuals over 40 yrs,
• Radiographically, characterized by numerous outpouchings along the colon

Question 17

Where does divertulosis most commonly appear?

Answer 17

sigmoid colon

Question 18

T/F) Diverticulosis contains inflammation.

Answer 18

False. (osis = no inflam)

Question 19

Ulerative Colitis

Answer 19

• Sever inflammation and ulceration of the rectum and lower colon
• Restricted to mucosa
• Bowel perforation may occur

Question 20

Irritable Bowel Syndrome

Answer 20

• Recurrent abdominal pain and diarrhea with no inflam or deterioration in health

Question 21

What may be caused by chronic constipation?

Answer 21

Hiatal hernias, inguinal hernias, diverticulitis, colon cancer

Question 22

What is the most common organ, outside of gut, for metastasis of colon cancer?

Answer 22

Liver

Question 23

Cirrhosis of the Liver

Answer 23

• Destruction of hepatic cells and their replacement by fibrous tissues and fat

Question 24

Compression of what leads to portal hypertension?

Answer 24

Porta Hepatis

Question 25

What are some causes of liver cirrhosis?

Answer 25

Alcoholism, Hepatitis, Chronic obstruction of bile duct, CHF

Question 26

Portal Hypertension

Answer 26

- Abnormal elevation of pressure within the portal system | - Blood backs up into the caval system where anastomoses appear

Question 27

T/F) The portal system has no valves.

Answer 27

True

Question 28

Gallstones

Answer 28

- Hard masses formed by the solidification of bile constituents, mainly cholesterol crystals - Commonly block the hepatopancreatic ampulla, creating a backup of bile

Question 29

What are some risk factors for gallstones?

Answer 29

Being female, Obesity, Pregnancy, high fat diet

Question 30

Where will the gallbladder refer pain?

Answer 30

lower thoracic spinal cord segments (T8-T11) right upper quadrant of the abdomen Right subscapular region of back

Question 31

Forceful compression of the abdomen can rupture what organ?

Answer 31

Pancreas

Question 32

Where does the pancreas refer pain?

Answer 32

Lower thoracic segments (head - right vertebral column; body and tail - left vertebral column)

Question 33

What is the most frequently injured abdominal organ?

Answer 33

Spleen

Question 34

Rupture of the spleen often results in what?

Answer 34

severe hemorrhage and shock

Question 35

The spleen becomes fragile in what conditions?

Answer 35

Mononucleosis (MC), Malaria, Sickle-cell anemia, Septocemia (blood poisoning)