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Radiographic Pathology > Gastrointestinal System Part 2 - Large and Small Bowel > Flashcards

Gastrointestinal System Part 2 - Large and Small Bowel Flashcards

1
Q

Is Crohn’s disease a disease that affects the large, or small bowel?

A

Small bowel

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2
Q

This is the name of a chronic inflammatory small bowel disorder of unknown cause.

A

Crohn’s disease

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3
Q

Crohn’s disease is most common in geriatric patients.

A

False. Most common in young adults

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4
Q

Are ulcers and fistulas common in crohn’s disease?

A

Yes

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5
Q

When using barium to perform a study of the small bowels, how do the mucosal folds appear in crohn’s disease?

A

irregularly thickened and distorted.

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5
Q

On an x-ray of a patient with crohn’s disease, what is “string sign” exhibiting?

A

A narrow stretch of bowel with no mucosal pattern

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6
Q

What are skip lesions?

A

Diseased segments of bowel separated by healthy segments.

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7
Q

What is a small bowel obstruction?

A

A blockage of the small intestine

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8
Q

Adhesions from previous surgeries, peritonitis, hernias, intussusception, volvulus, tumors and vascular insufficiency may all result in what pathology?

A

small bowel obstruction

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9
Q

What is a possible complication of small bowel obstruction?

A

ischemia and necrosis of bowel segment, leading to sepsis and peritonitis

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10
Q

Which projections are best for visualizing small bowel obstructions?

A

upright or decubitus abdomen.

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11
Q

On an x-ray of a small bowel obstruction, bowel proximal to the obstruction will be ______ and bowel distal to the obstruction will be ______

A

distended, collapsed

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12
Q

What might small bowel obstruction be confused for, due to distension?

A

Small bowel may be confused for large bowel

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13
Q

What is adynamic (paralytic) ileus?

A

Failure of bowel contents to progress normally through a non-obstructed bowel

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14
Q

Adynamic (paralytic) ileus occurs because of what malfunction in the smooth muscle tissue?

A

Peristalsis

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15
Q

What is the difference between a localized ileus and a colonic ileus?

A

Localized is a small part of the small or large bowels, colonic is the large bowel

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16
Q

What treatments are used for adynamic (paralytic) ileus?

A

NG tube and IV fluids

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17
Q

How would localized ileus appear on an x-ray?

A

As one very distended loop

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18
Q

How would a colonic ileus appear on an x-ray?

A

Massive distension of bowels with no visible point of obstruction.

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19
Q

What might colonic ileus be confused for on an x-ray?

A

Mechanical obstruction.

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20
Q

What term is used to describe the telescoping of one part of the intestinal tract into another, because of peristalsis?

A

Intussusception

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21
Q

What demographic does intussusception most commonly occur in?

A

children

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22
Q

What is the major cause of bowel obstruction in children?

A

Intussusception

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23
Q

Is it possible for necrosis to occur due to intussusception?

A

Yes, vascular supply may become compromised

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24
Q

How might intussusception appear on an x-ray?

A

Coiled spring appearance on contrast enema

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25
Q

How might intussusception appear on a CT scan?

A

three concentric circles forming a soft tissue mass (target sign)

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26
Q

How might intussusception appear on ultrasound?

A

donut-shaped lesion

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27
Q

What is a hemangioma?

A

a benign vascular tumor

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28
Q

Where do most GI hemangioma occur?

A

small bowel, followed by large bowel and rectum

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29
Q

How might a GI hemangioma appear on an x-ray?

A

As a contrast displacing mass

30
Q

What modalities are used to diagnose inguinal hernia?

A

ultrasound or CT

31
Q

What is an inguinal hernia?

A

Abdominal contents protrude through weakened abdominal wall at the inguinal canals

32
Q

This condition is a series of herniations of the mucosa and submucosa through the muscular layers of the bowel wall

A

diverticulosis

33
Q

How might diverticulosis appear on an x-ray?

A

Multiple round outpouchings from the bowel

34
Q

This condition is a complication of diverticulosis, due to fecal matter being trapped in the diverticulum, leading to inflammation and perforation.

A

Diverticulitis

35
Q

What is a polyp?

A

A benign neoplasm, that projects into the lumen of the bowel

36
Q

Is it possible for polyps to be cancerous?

A

Most are asymptomatic, but certain types are cancerous

37
Q

What procedure is done to find and remove polyps?

A

Colonoscopy

38
Q

Where are most polyps found?

A

descending and sigmoid colon

39
Q

How do polyps appear radiographically?

A

As a filling defect on a barium enema.

40
Q

What is the difference in appearance between a sessile and a pedunculated polyp?

A

sessile are flat against the colon wall, and pedunculated have a thin stalk projecting them from the bowel wall into the lumen of the bowel

41
Q

Which type of polyp is most likely to be malignant?

A

Sessile polyp

42
Q

Sessile polyps are indicative of cancer if the diameter measures larger than _____

A

2 cm

43
Q

This inflammatory bowel disease rarely involves the small bowel.

A

Ulcerative colitis

44
Q

Ulcerative colitis often begins in what area of the bowel?

A

rectosigmoid area

45
Q

Bloody diarrhea, abdominal pain, fever and weight loss are all symptoms of what disease?

A

Ulcerative colitis

46
Q

How does Ulcerative colitis appear on an x-ray?

A

granula mucosa,

47
Q

As ulcerative colitis progresses, it’s appearance on an x-ray changes. It can exhibit a “lead pipe” appearance, due to what condition?

A

Loss of haustral markings due to muscular atrophy and spasm.

48
Q

“thumb printing” is a sign of what pathology?

A

Ulcerative colitis

49
Q

This is a complication of Ulcerative colitis involving extreme dilation of the large colon.

A

toxic megacolon

50
Q

Why is barium enema contraindicated for toxic megacolon?

A

Possibility of spontaneous bowel perforation due to extreme dilation of colon.

51
Q

How does toxic megacolon appear on an x-ray?

A

huge air-filled colon

52
Q

How does colorectal cancer appear on an x-ray?

A

narrowed lumen with irregular contours, rigid and tapered margins

53
Q

Colorectal cancer usually occurs in what sections of the bowel?

A

rectum and sigmoid colon

54
Q

What is the typical age demographic of colorectal cancer?

A

50-70 years old

55
Q

What is the most common type of bowel cancer?

A

annular colorectal carcinoma

56
Q

In annular colorectal carcinoma, are the lesions inside, our outside the bowel?

A

outside

57
Q

Why is early detection of annular colorectal carcinoma problematic?

A

Flat plaques of tumors are easily missed on exams.

58
Q

Annular colorectal carcinoma is usually found in what part of the bowel?

A

sigmoid colon

59
Q

How does colorectal carcinoma appear on an x-ray?

A

Barium enema will show an apple-core or napkin ring filling defect.

60
Q

What is the new gold standard for cancer detection of the large bowel?

A

CT Virtual Colonoscopy

61
Q

What is the usual cause of large bowel obstruction?

A

primary colon cancer

62
Q

Is it possible for diverticulitis or volvulus to cause large bowel obstruction?

A

Yes

63
Q

Is large bowel obstruction more, or less severe than small bowel obstruction?

A

Less

64
Q

Due to the increased pressure caused by large bowel obstruction, what area is especially at risk of perforation?

A

cecum

65
Q

On an x-ray, how would a large bowel obstruction change depending on whether or not the illeocecal valve was working?

A

Working valve: dilated colon with distended cecum and little small bowel gas.
Not working valve: distended gas loops in both small and large bowel.

66
Q

On an x-ray of a large bowel obstruction, is the gas filled sections of the colon continuous, or do they abruptly stop?

A

They abruptly stop.

67
Q

What is a volvulus?

A

The bowel twisting on itself, leading to abdominal obstruction.

68
Q

What are the 2 frequent locations of volvulus?

A

cecum and sigmoid colon

69
Q

birds-beak sign is attributed to volvulus in what area of the bowel?

A

sigmoid colon

70
Q

This condition is similar to volvulus, but occurs during fetal development.

A

Malrotation of bowel/colon

71
Q

This is a congenital defect leading to a lack of anal opening.

A

Imperforate anus (anal atresia)

72
Q

anal atresia is often associated with what other pathology.

A

Distended bowel.

73
Q
A

Radiographic Pathology (7 decks)

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