GI WB W/ IMAGES

Question 1

List the sequential parts of the digestive system.

Answer 1

Mouth, pharynx, esophagus, stomach, small intestine (duodenum, jejunum, and ileum), and large intestine (cecum;ascending, transverse, and descending colon; and rectum)

Question 2

The lower end of the esophagus is a circular muscle that acts as a sphincter, constricting the tube so that the entrance to the stomach, at the _______, is generally closed. This helps to prevent gastric acid from moving up into the esophagus.

Answer 2

Cardiac orifice

Question 3

The pylorus is further subdivided into the _____ , the _____canal, and the ______ sphincter.

Answer 3

antrum, pyloric, pyloric

Question 4

The duodenal bulb is peritoneal, supported by the hepatoduodenal, and passes ________ to the common bile duct, gastroduodenal artery, common hepatic artery, hepatic portal vein, and head of the pancreas.

Answer 4

anterior

Question 5

The common bile duct joins the pancreatic duct to enter the_______.

Answer 5

ampulla of vater

Question 6

The arteries that supply the esophagus include the inferior _____ branch of the ______ artery that supplies the upper esophagus; the descending _______ aorta that supplies the midesophagus; and the ______ branch of the celiac axis and the left inferior ______ artery of the abdominal aorta that supplies the lower end of the esophagus.

Answer 6

Thyroid, subclavian, thoracic, gastric, phrenic

Question 7

The ______ outlines the small intestine and contains the superior mesenteric vessels, nerves, lymphatic glands, and fat between its two layers.

Answer 7

mesentery

Question 8

The nutrients are transported to the liver after they are absorbed by the _____ ; the liver processes ans stores the nutrients.

Answer 8

blood

Question 9

The three layers of smooth muscle in the wall enable the stomach to mash and churn food and move it along with_____.

Answer 9

peristalsis

Question 10

Gastric glands secrete gastric juice containing________ acid and ______

Answer 10

hyrochloric, enzymes

Question 11

The hormone _____ , which is released by the stomach mucosa, stimulates gastric acid secretion.

Answer 11

gastrin

Question 12

Gastrointestinal hormones include ________ and ________.

Answer 12

choleystokinin, secretin

Question 13

______ within the large intestine devour the chyme and it turn produce vitamins that can be absorbed and used by the body.

Answer 13

bacteria

Question 14

The most common laboratory data the sonographer may come across in a patient with gastrointestinal disease relate to the presence of _____ in the stool.

Answer 14

blood

Question 15

As a result of chronic blood loss, ____ may be present.

Answer 15

anemia

Question 16

The _________ junction is seen on the sagittal scan to the left of the midline as a bull’s-eye or target-shaped structure anterior to the aorta, posterior to the left lobe of the liver, and inferior to the hemidiaphram.

Answer 16

gastroesophgeal

Question 17

The gastric _____ can be seen as a target shape at the midline.

Answer 17

antrum

Question 18

The sonographer usually cannot see the small bowel with ultrasound; the valvulae conniventes may be seen as linear echo densities spaced 3 to 5 mm apart. This is called the _______ and can be seen in the duodenum and jejunum.

Answer 18

“keyboard sign”

Question 19

The appendix is located on the abdominal wall under _________

Answer 19

McBurney’s point

Question 20

Localized collection of pus surrounded by inflamed tissue.

Answer 20

abscess

Question 21

process of nutrient molecules passing through wall of intestine into blood or lymph system.

Answer 21

absorption

Question 22

also known as the digestive tract; includes the mouth, pharynx, esophagus, stomach, duodenum, and small and large intestine.

Answer 22

alimentary tract

Question 23

a fecalith or calcification located in the appendix

Answer 23

appendicolith

Question 24

accumulation of serous fluid in the abdomen

Answer 24

ascites

Question 25

entrance of the esophagus into the stomach

Answer 25

cardiac orifice

Question 26

hormone secreted into the blood by the mucosa of the upper small intestine; stimulates contraction of the gallbladder and pancreatic secretion of enzymes

Answer 26

cholecystokinin

Question 27

inflammation of the bowl, accompanied by abscess and bowl wall thickining

Answer 27

Crohn's disease

Question 28

a pouchlike herniation through the muscular wall of a tubular organ that occurs in the stomach, the small intestine, or most commonly, the colon

Answer 28

diverticulum

Question 29

first part of the duodenum

Answer 29

duodenal bulb

Question 30

calcified deposit within the appendix; appendicitis can develop when the appendix becomes blocked by hard fecal matter

Answer 30

fecalith

Question 31

endocrine hormone released from the stomach (stimulates secretion of gastric acid)

Answer 31

gastrin

Question 32

helps support the lesser curvature of the stomach

Answer 32

gastrohepatic ligament

Question 33

helps support the greater curvature of the stomach

Answer 33

gastrophrenic, gastrosplenic & lienorenal ligaments

Question 34

ligament between the stomach and the spleen; helps support the stomach and spleen

Answer 34

gastrosplenic ligament

Question 35

double fold of the peritoneum attached to the duodenum, stomach, and large intestine; helps support the greater curve of the stomach; known as the fatty apron

Answer 35

greater omentum

Question 36

normal segmentation of the wall of the colon

Answer 36

haustra

Question 37

collection of blood

Answer 37

hemorrhage

Question 38

ascending colon rises from the right lower quadrant to bend at this point to form the transverse colon

Answer 38

hepatic flexure

Question 39

membranous extension of the peritoneum that suspends the stomach and duodenum from the liver; helps to support the lesser curvature of the stomach

Answer 39

lesser omentum

Question 40

ligament between the spleen and the kidney that helps support the greater curvature of the stomach

Answer 40

lienorenal ligament

Question 41

malignancy of the lymph nodes, spleen, or liver

Answer 41

lymphoma

Question 42

located by drawling a line from the right anterosuperior iliac spine to the umbilicus; at approximately the midpoint of this line lies the root of the appendix

Answer 42

McBurney's point

Question 43

site of maximum tenderness in the right lower quadrant; usually seen with appendicitis

Answer 43

McBurney's sign

Question 44

congenital sac or blind pouch found in the lower portion of the ileum

Answer 44

Meckel's diverticulum

Question 45

a fold from the parietal peritoneum that attaches to the small intestine, anchoring it to the posterior abdominal wall

Answer 45

mesentery

Question 46

fifth layer of bowel

Answer 46

mesothelium

Question 47

first layer of bowel

Answer 47

mucosa

Question 48

third layer of bowel

Answer 48

muscularis

Question 49

dilated fluid-filled bowel loops without peristalsis

Answer 49

paralytic ileus

Question 50

rhythmic dilation and contraction of the gastrointestinal tract as food is propelled through it

Answer 50

peristalsis

Question 51

a small tumor-like growth that projects from a mucous membrane surface

Answer 51

polyp

Question 52

muscle that connects the stomach to the proximal duodenum

Answer 52

pyloric canal

Question 53

inner folds of the stomach wall

Answer 53

rugae

Question 54

released from small bowel as antacid; stimulates secretion of bicarbonate

Answer 54

secretin

Question 55

forth layer of bowel; thin, loose layer of connective tissue, surrounded by mesothelium covering the intraperitoneal bowl loops

Answer 55

serosa

Question 56

the transverse colon travels horizontally across the abdomen and bends at this point to form the descending colon

Answer 56

splenic flexure

Question 57

one of the layers of the bowl, under the mucosal layer, contains blood vessels and lymph channels

Answer 57

submucosa

Question 58

characteristic of gastrointestinal wall thickening consisting of an echogenic center and a hypoechoic rim

Answer 58

target sign

Question 59

normal segmentation of the small bowel

Answer 59

valvulae conniventes

Question 60

inner folds of the small intestine

Answer 60

villi

Question 61

Describe the technique sonographers use to observe the upper GI tract

Answer 61

* drink 10-40 oz of H₂O through a straw after baseline study of the upper ABD (the straw helps reduce air ingestion) * Pt. is in upright position (causes air to rise to stomach fundus) * lower GI tract requires no prep * to image lower colon, pt may be given a H₂O enema

Question 62

describe the measures that should be taken if a patient presents with a "cystic" mass in the LUQ

Answer 62

several measurements can be taken to determine if the mass is the fluid-filled stomach or another mass arising from adjacent organs. 1. give pt. a carbonated drink to see bubbles in the stomach 2. ask the clinician to place a nasogastric tube for drainage 3. watch for "stomach" to change shape or size w/ ingestion of fluids 4. alter pt position - scan in upright or left or right lateral decubitus position 5. watch for peristalsis 6. ask the patient to drink water to see the swirling effect.

Question 63

Question 64

Answer 64

Question 65

Answer 65

Question 66

id the anatomic structure signified by the arrows ## Footnote **_duodenum, when filled w/ small amount of fluid (arrows)_** **_\*serves as excellent landmark for the pancreas head_**

Answer 66

id the anatomy that is demonstrated in these images of the small bowel. **_valvulae conniventes_**

Question 67

id the internal structures that are demonstrated in these images of the stomach **_A.) Sagital image: fluid filled stomach w/ rugae may be seen along the peripheral margins of the wall_** **_B.) Transverse image of stomach and rugae_**

Answer 67

This image represents what structure? ## Footnote **_collapsed stomach_**

Question 68

id the structures demonstrated in the images recorded over the RLQ ## Footnote **_fluid filled loops of bowel_**

Answer 68

Young patient presents with exquisite tenderness over the RUQ. What are the sonographic findings? **_Appendicitis_**