Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

test > Small Intestine > Flashcards

Small Intestine Flashcards

1
Q

What comprises the small bowel?

A

Duodenum, jejunum, and ileum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How long is the duodenum?

A

12 inches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What marks the end of the duodenum and the start of the jejunum?

A

Ligament of Treitz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the length of the small bowel?

A

6 meters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What provides blood supply to the small bowel?

A

Branches of the SMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the plicae circulares?

A

Circular folds of mucosa in small bowel lumen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the major structural differences between the jejunum and the ileum?

A

Jejunum: long vasa recta, large plicae circulares, thicker wall
Ileum: shorter vasa recta, smaller plicae circulares, thinner wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does the terminal ileum absorb?

A

B12, fatty acids, bile salts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is an SBO?

A

Small Bowel Obstruction.

Mechanical obstruction to the passage of intraluminal contents.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the signs and symptoms of SBO?

A

Abdominal discomfort, cramping, nausea, abdominal distention, emesis, high-pitched bowel sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What lab tests are performed with SBO?

A

Electrolytes, CBC, T&S, UA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the classic electrolyte findings with proximal obstruction?

A

Hypovolemic, hypochloremic, hypokalemic alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What must be ruled out on PE in patients with SBO?

A

Incarcerated hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What major AXR findings are associated with SBO?

A

Distended loops of small bowel air-fluid levels on upright film

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a complete SBO?

A

Complete obstruction of the lumen usually paucity or no colon gas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the danger of complete SBO?

A

Closed loop strangulation of the bowel leading to bowel necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a partial SBO?

A

Incomplete SBO; some colon gas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the initial management of all patients with SBO?

A

NPO, NGT, IVF, Foley

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What tests can differentiate partial from complete SBO?

A

CT with oral contrast, small bowel follow-through

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the ABCs of SBO?

A
  1. Adhesions
  2. Bulge (hernias)
  3. Cancer and tumors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are other causes (not ABCs) of SBO?

A

GIVES BAD CRAMPS:
Gallstone ileus, Intussusception, Volvulus, External compression, SMA syndrome, Bezoars, Bowel wall hematoma, Abscesses, Diverticulitis, Crohn’s disease, Radiation enteritis, Annular pancreas, Meckel’s diverticulum, Peritoneal adhesions, Stricture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is SMA syndrome?

A

SMA compresses duodenum, causing obstruction.

Seen with weight loss.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the treatment of complete SBO?

A

Laparotomy and lysis of adhesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is LOA?

A

Lysis Of Adhesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the treatment of partial SBO?

A

Initially, conservative treatment with close observation plus NGT decompression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Intra-operatively, how can the level of obstruction be determined in patients with SBO?

A

Transition from dilated bowel proximal to the decompressed bowel distal to the obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the most common indication for abdominal surgery in patients with Crohn’s disease?

A

SBO

28
Q

Can a patient have complete SBO and bowel movements and flatus?

A

Yes; the bowel distal to the obstruction can clear out gas and stool

29
Q

After a small bowel resection, why should the mesenteric defect always be closed?

A

To prevent an internal hernia

30
Q

What may cause SBO if a patient is on coumadin?

A

Bowel wall hematoma

31
Q

What is the most common cause of SBO in adults?

A

Post-operative adhesions

32
Q

What is the most common cause of SBO around the world?

A

Hernias

33
Q

What is the most common cause of SBO in children?

A

Hernias

34
Q

What are the signs of strangulated bowel with SBO?

A

Fever, severe/continuous pain, hematemesis, shock, gas in the bowel wall or portal vein, abdominal free air, peritoneal signs, acidosis (lactic acid)

35
Q

What are the clinical parameters that will lower the threshold to operate on a partial SBO?

A

Increasing WBC, fever, tachycardia, tachypnea, abdominal pain

36
Q

What is an absolute indication for operation with partial SBO?

A

Peritoneal signs, free air on AXR

37
Q

What classic saying is associated with complete SBO?

A

“Never let the sun set or rise on complete SBO”

38
Q

What condition commonly mimics SBO?

A

Paralytic ileus (AXR reveals gas distention throughout, including the colon)

39
Q

What is the differential diagnosis of paralytic ileus?

A

Post-operative ileus after abdominal surgery (usually resolves in 3-5 days); Electrolyte abnormalities (hypokalemia most common); Medications (anticholinergic, narcotics); Inflammatory intra-abdominal process; Sepsis or shock; Spine injury; Retroperitoneal hemorrhage

40
Q

What tumor classically causes SBO due to mesenteric fibrosis?

A

Carcinoid

41
Q

What is the differential diagnosis of benign tumors of the small intestine?

A

Leiomyoma, lipoma, lymphangioma, fibroma, adenoma, hemangioma

42
Q

What are the signs and symptoms of small bowel tumors?

A

Abdominal pain, weight loss, SBO, perforation

43
Q

What is the most common benign small bowel tumor?

A

Leiomyoma

44
Q

What is the most common malignant small bowel tumor?

A

Adenocarcinoma

45
Q

What is the differential diagnosis of malignant tumors of the small intestine?

A

Adenocarcinoma, carcinoid, lymphoma, sarcoma

46
Q

What is the workup of a small bowel tumor?

A

UGI with small bowel follow-through, enteroclysis, CT, enteroscopy

47
Q

What is the treatment for malignant small bowel tumor?

A

Resection and removal of mesenteric draining lymph nodes

48
Q

What malignancy is classically associated with metastasis to small bowel?

A

Melanoma

49
Q

What is Meckel’s diverticulum?

A

Remnant of the vitelline duct, which connects the yolk sac with the primitive midgut in the embryo

50
Q

What is the most common small bowel congenital abnormality?

A

Meckel’s diverticulum

51
Q

What is the usual location of Meckel’s diverticulum?

A

Within 2 feet of the ileocecal valve on the anti-mesenteric border of the bowel

52
Q

What is the major differential diagnosis for Meckel’s diverticulum?

A

Appendicitis

53
Q

Is Meckel’s diverticulum a true diverticulum?

A

Yes

54
Q

What is the incidence of Meckel’s diverticulum?

A

2%

55
Q

What is the gender ratio for Meckel’s diverticulum?

A

M:F = 2:1

56
Q

What is the average age at onset of symptoms of Meckel’s diverticulum?

A

Within the first 2 years of life, but can occur at any age

57
Q

What are the possible complications of Meckel’s diverticulum?

A

Intestinal hemorrhage (painless); intestinal obstruction; inflammation/perforation

58
Q

What are the signs and symptoms of Meckel’s diverticulum?

A

Lower GI bleeding, abdominal pain, SBO

59
Q

What is the most common complication of Meckel’s diverticulum in adults?

A

Intestinal obstruction

60
Q

What heterotopic tissue type is most often found in Meckel’s diverticulum?

A

Gastric mucosa, but duodenal, pancreatic, and colonic are also found

61
Q

What is the “rule of 2s” for Meckel’s diverticulum?

A 
2% of patients are symptomatic
Found 2 feet from the ileocecal valve
Found in 2% of the population
Most symptoms occur by 2 years
Ectopic tissue found in 1 of 2 patients
Most diverticula are 2 inches long
2:1 = M:F
62
Q

What is the role of incidental Meckel’s diverticulectomy?

A

Most experts would remove in children (controversial in adults)

63
Q

What is a Meckel’s scan?

A

Scan for ectopic gastric mucosa in Meckel’s diverticulum.

Uses technetium pertechnetate IV, which is preferentially taken up by gastric mucosa.

64
Q

What is the treatment of a Meckel’s diverticulum that is causing bleeding and obstruction?

A

Surgical resection with small bowel resection, as the actual ulcer is usually on the mesenteric wall opposite the diverticulum

65
Q

What is the name of the hernia associated with incarcerated Meckel’s diverticulum?

A

Littre’s hernia

66
Q

In patients with guaiac-positive stools and a negative upper and lower GI workup, what must be ruled out?

A

Small bowel tumor.

Evaluate with enteroclysis.

67
Q

What is the most common cause of small bowel bleeding?

A

Small bowel angiodysplasia

test (44 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions