GIT Flashcards by Sarah Anderson

What structures does the GIT include?

Lips
Mouth
Pharynx
Esophagus
Stomach
Sm intestine
Appendix
Colon
Anux

How well did you know this?

Not at all

Perfectly

What is an advantage + disadvantage of imaging the GIT?

Pro: can evaluate peristalsis function with cine-clips
Con: hard to see due to gas

How well did you know this?

Not at all

Perfectly

What are the bowel wall layers + SF’s?

Mucosal surface/epithelium: innermost layer, echogenic
Muscularis mucosa*: hypoechoic, thin + smooth
Submucosa: echogenic, thickest, contains vessels + lymph channels
Muscularis propria/externa*: hypoechoic, inner + outer layer of smooth muscle
Serosa: outermost, thin layer on periphery, echogenic

(* if we can see on u/s)

How well did you know this?

Not at all

Perfectly

What is the largest endocrine organ in the body?

GIT!

How well did you know this?

Not at all

Perfectly

Functions of the GIT?

-Digestion (most in duodenum)
-Absorption

How well did you know this?

Not at all

Perfectly

Measurements of bowel wall?

3-6mm when undistended
2-4mm when distended (often has shadows)

How well did you know this?

Not at all

Perfectly

What is the easiest structure to see on u/s in the GIT?

Stomach (LUQ)

How well did you know this?

Not at all

Perfectly

What are the parts of the stomach?

-Esophagus goes into top of stomach
-Fundus is top
-Body is middle
-Pylorus antrum is bottom (which moves chyme into duodenum)

How well did you know this?

Not at all

Perfectly

What patient positions are best for imaging the stomach?

-LLD for fundus
-RLD for antrum + pylorus

How well did you know this?

Not at all

Perfectly

Where do duplication cysts occur in stomach?

Greater curvature of stomach
(m/c women)

How well did you know this?

Not at all

Perfectly

What do duplication cysts look like in stomach?

-Anechoic
-Inner echogenic rim
-Wide outer hypoechoic rim
-On greater curvature of stomach

How well did you know this?

Not at all

Perfectly

What is the cause of gastric dilatation?

Obstruction

(affects gastric emptying)

How well did you know this?

Not at all

Perfectly

What is gastritis + what causes it?

-Inflammation of gastric mucosa
-From infection, drugs, stress or autoimmune

How well did you know this?

Not at all

Perfectly

What does chronic gastritis look like?

-Hyperplastic + inflammatory polyps

How well did you know this?

Not at all

Perfectly

What does atrophic gastritis look like?

-Small mucosa (inner lining stomach)

(Precursor to gastric cancer)

How well did you know this?

Not at all

Perfectly

What does emphysematous gastritis look like?

-Same as acute, but with small gas bubbles in wall

How well did you know this?

Not at all

Perfectly

Does Crohn disease commonly affect the stomach?

No!

(m/c terminal ileum)

How well did you know this?

Not at all

Perfectly

What is Crohn disease + who does it affect?

-Inflammation of all layers of bowel wall
-Unknown cause
-M/c in young adults

How well did you know this?

Not at all

Perfectly

What does Crohn disease look like?

-Hypoechoic target lesion
-Very vascular walls

How well did you know this?

Not at all

Perfectly

What is the m/c benign gastric tumour?

Leiomyomas

How well did you know this?

Not at all

Perfectly

What do leiomyoma’s look like?

-Hypoechoic
-Oval/circular
-Possible necrosis

How well did you know this?

Not at all

Perfectly

What does GIST’s stand for?

Gastrointestinal stromal tumours

(can be benign or malignant)

How well did you know this?

Not at all

Perfectly

Where is the m/c place to have a GIST?

Stomach

(think stromal for stomach)

How well did you know this?

Not at all

Perfectly

What do GIST’s look like?

-Hypoechoic
-Possibly hemorrhage or degeneration

How well did you know this?

Not at all

Perfectly

What is the m/c type of gastric carcinoma?

Adenocarcinoma (m/c males)

What does gastric carcinoma look like?

-Thick wall (target/pseudokidney sign) -Mass with no peristalsis -Can have ulcers

SF of lymphoma?

-Thick hypoechoic wall -Rugal fold thickening

Most common site for primary lymphoma in the GIT?

Stomach

What shape is the duodenum?

C shaped

What are the 4 parts of the duodenum?

-Duodenal bulb (shortest part) -Descending (inferior) -Transverse (across) -Ascending (superior)

Where is the duodenum, jejunum + ileum in the body?

-Duodenum is 1st portion -Jejunum is middle portion (thickest) -Ileum is 3rd portion (longest)

Measurement of wall thickness of small bowel?

Less than 5mm (if collapsed + symmetric)

Measurement of small bowel?

Less than 3cm

Where/what is the appendix?

A tubular structure attached to the cecum with a blind end

What are some characteristics of the appendix?

-Compressible -Possibly tortuous -No peristalsis

Measurements of appendix?

-Less than 6mm AP (outer-outer) -Less than 2mm wall thickness

What is McBurney point?

-Imaginary line from iliac spine to umbilicus -Midpoint of line is where the appendix is located

What does blind end mean?

When you are scanning the appendix and all of a sudden it ends (is normal)

Where is the colon located?

Laterally on R/L sides + superiorly along liver margin

What are the 4 sections of the colon?

-Ascending -Transverse -Descending -Sigmoid (end before rectum) (colon is hardest to see on u/s)

What does a fluid filled colon indicate?

-Diarrhea -Obstruction (is abnormal)

What are the measurements of the colon wall?

Undistended: 4-9mm thick Distended: 2-4mm thick

How should you approach an appendicitis exam?

-Start with AOC -Next start at cecum and try to find it inferiorly -Lastly extend into pelvic/endovaginal exam if still can't find it

What is an ileus?

Pseudo obstruction from diminished mobility of bowel (no peristalsis anymore)

What does an ileus look like on u/s?

Stitches

What does obstruction of the small bowel look like?

-Bumpy -Round -Can see bowel folds

Lightbulb for intussusception?

-Children -Sandwich sign in SAG! -Circles in TRV (looks like a cinnamon bun)

Cause of intussusception?

-Idiopathic in children -Pathological mass in adults

Cause of a small bowel hematoma?

Duodenum immobility

Cause of edema in small bowel?

Swelling of valvulae conniventes (bowel folds)

Lightbulb for Crohn disease for small bowel?

-M/c ileum -Diarrhea -Thick bowel wall (5-15mm) -Target sign!

Where does diverticulitis in small bowel m/c occur?

Distal ileum

What is the m/c benign + malignant tumours?

B = leiomyomas M = leiomyosarcomas

How do GIST's + lymphomas look different sonographically compared to the other malignant tumours?

GIST's = exophytic Lymphoma = affects the bowel wall

Who is m/c to get appendicitis?

-Men -Aged 5-45 (mean age 28)

What is rebound tenderness?

When pain is greater at release of pressure, rather than when applying the pressure

SF of appendicitis?

-Target sign -Greater than 6mm + 2mm wall -Possible appendicolith/fecalith (looks like calcification in lumen) -Non compressible -No peristalsis -Fluid

What are the 3 complications of appendicitis?

-Abscess -Peritonitis (inflammation of lining of stomach) -Rupture/perforation

What is a mucocele?

Distension of appendix due to mucus

SF of a mucocele?

-Similar to appendicitis but w/o signs + symptoms -Anechoic lumen with some echoes present

What is pseudomyxoma peritonei?

-Rupture of adenocarcinoma tumour that produces too much mucin -Mucocele hangs off end of appendix (m/c from appendix primary carcinoma)

SF of NETS's?

Hypoechoic mass with appendiceal TIP!

What is mesenteric adenitis + its SF?

-Inflamed lymph nodes -Round nodes (instead of normal oval) -Greater than 4mm

What affects the colon during obstruction?

Cystic fibrosis affects the bowel (ileum or prox colon)

What is the main difference b/w Crohn disease inn the colon + ulcerative colitis?

Crohn = only affects certain areas Colitis = is continuous (otherwise they look SF the same)

M/c location for diverticulosis in colon?

Retrosigmoid colon

Lightbulb for diverticulosis in colon?

-Low bulk/fiber diet -M/c over 50 years old

Where is colorectal carcinoma m/c?

-Rectum is m/c -Rectosigmoid colon is also common