Chapter 15: Lower Gastrointestinal System

Front 1

How long is the Duodenum?

Back 1

10 Inches (25cm)

Front 2

Which quadrant(s) is the Duodenum located in?

Back 2

RUQ and LUQ

Front 3

Which quadrant(s) is the Jejunum located in?

Back 3

LUQ and LLQ

Front 4

Which quadrant(s) is the Ileum located in?

Back 4

RUQ, RLQ, and LLQ

Front 5

Which quadrant is the Ilececal valve located in?

Back 5

RLQ

Front 6

What is the diameter of the small intestine at the proximal aspect to the distal end?

Back 6

1.5 inches (3.8cm) to about 1 inch (2.5cm)

Front 7

The large intestine (large bowel) begins in which quadrant?

Back 7

LRQ

Front 8

The large intestine extends around the periphery of the abdominal cavity to end at the ____.

Back 8

Anus

Front 9

How long is the large intestine?

Back 9

1.5 meters (5 feet)

Front 10

How wide in diameter is the large intestine?

Back 10

2.5 inches (6 cm)

Front 11

Radiographic examination specifically of the small intestine is called a....?

Back 11

Small bowel series or SBS

Front 12

How long is the average length of the large intestine?

Back 12

5 Feet or 1.5M

Front 13

How long is the average small bowel if removed and streched out during autopsy?

Back 13

23 Feet of 7M

Front 14

In a person with good muscle tone, the length of the entire small bowel would be …?

Back 14

15-18 Feet or 4.5-5.5M

Front 15

Which muscular bands mark the junction between the duodenum and jejunum?

Back 15

Suspensory muscle of the duodenum or ligament of Treitz

Front 16

Which two aspects of the large intestine are not considered part of the colon?

Back 16

Cecum & Rectum

Front 17

The colon consist of __ sections & __ flexures

Back 17

4 Secontions and 2 Flexures

Front 18

List two functions of the ileocecal valve.

Back 18

Prevents contents of the ileum from passing too quickly into the Cecum & Prevents reflux back into the ileum

Front 19

What is another term for the appendix?

Back 19

Valiform Appendix

Front 20

This is the longest aspect of the large intestine…

Back 20

Transverse Colon

Front 21

This is the widest portion of the large intestine…

Back 21

Cecum

Front 22

This is described as a blind pouch inferior to the ileocecal valve…

Back 22

Appendix (Valiform Appendix)

Front 23

This aspect of the small intestine is the smallest in diameter, but longest in length…

Back 23

Ileum

Front 24

This is the distal part; also called the iliac colon…

Back 24

Descending colon

Front 25

The shortest aspect of the small intestine is the…

Back 25

Duodenum

Front 26

This lies in the pelvis but possesses as wide freedom of motion…

Back 26

Sigmoid Colon

Front 27

This makes up 40% of the small intestine…

Back 27

Jejunum

Front 28

This is found between the Cecum and transverse colon…

Back 28

Asending Colon

Front 29

What is the term for the three bands of muscle that pull the large intestine into pouches?

Back 29

Taeniae Coli

Front 30

These pouches, or sacculations, seen along the large intestine wall are called _______?

Back 30

Haustra

Front 31

What is an older term for the mucosal folds found within the jejunum?

Back 31

Plicae Circulares

Front 32

True or false: A small bowel series is often combined with an Upper GI series.

Back 32

True

Front 33

What is it called when a small bowel series is combined with an Upper GI series?

Back 33

A small bowel follow-through

Front 34

Name the radiographic procedure designed to study the large intestine

Back 34

Barium Enema

Front 35

Barium Enemas are AKA?

Back 35

BE, BaE, and lower GI series

Front 36

A large bowel or colon filled with a combination of air and barium is referred to as a...?

Back 36

Double-contrast barium enema

Front 37

Abdominal and thoracic organs are reversed from their normal orientation of the body

Back 37

situs inversus

Front 38

Beginning at the pyloric valve of the stomach, name the three parts of the small intestine in order.

Back 38

duodenum, jejunum, and ileum

Front 39

Which part of the small intestine is labeled as the shortest and widest?

Back 39

The duodenum

Front 40

What is the name of the structure when the duodenum joins the jejunum?

Back 40

The duodenojejunal flexure

Front 41

The jejunum makes up about ___ of the small intestine, and is approximately how wide in diameter?

Back 41

2/3 and approximately 1 inch (2.5cm) in diameter

Front 42

The jejunum contains numerous mucosal folds (pilcae circulares), which does what?

Back 42

Increases the surface area to aid with absorption of nutrients.

Front 43

What appearance does the jejunum have on a radiographic exam?

Back 43

It has a feathery appearance due to the numerous mucosal folds

Front 44

The Jejunum begins where?

Back 44

At the site of the duodenojejunal flexure, slightly to the midline in the LUQ (Under the trans colon)

Front 45

The ileum makes up the distal ___ of the remaining aspect of the small intestine

Back 45

3/5th

Front 46

Which portion is the longest in the small intestines?

Back 46

Ilieum

Front 47

The terminal ileum joins the large intestine at the ______ ____ in the RLQ.

Back 47

ileocecal valve (sphincter or fold)

Front 48

True or false: The ileum possesses a thick wall and has many musocsal folds.

Back 48

False. The ileum posses a thinner wall and have fewer mucosal folds.

Front 49

True or false: At the point of the ileocecal valve (sphincter), the inner lumen of the ileum is nearly smooth

Back 49

True

Front 50

The large intestine begins in which quadrant?

Back 50

RLQ, just lateral to the ileocecal valve

Front 51

Name the four major parts of the large intestine.

Back 51

1. Cecum
2. Colon
3. Rectum
4. Anal canal

Front 52

What is the final segment of the large intestine called?

Back 52

The rectum

Front 53

The distal rectum contains the ____ _____, which ends at the ____.

Back 53

anal canal;
anus

Front 54

True or false: Large intestine and colon are not synonyms.

Back 54

True, the colon consists of 4 sections and 2 flexures and does NOT include the cecum and rectum

Front 55

Name the four sections of the colon.

Back 55

1. The ascending colon
2. The transverse colon
3. The descending colon
4. the sigmoid colon

Front 56

Name the two flexures included in the colon.

Back 56

1. The right (hepatic) flexure
2. the left (splenic) colic flexure

Front 57

What is located at the proximal end of the large intestine?

Back 57

Cecum

Front 58

What is the most distal part of the small intestine?

Back 58

The Ileum

Front 59

The small intestine and the cecum join togeather at the _________ ______.

Back 59

Ileocecal Valve

Front 60

The Ileocecal consists of __ lips that extend into the large bowel.

Back 60

Two Lips

Front 61

How long is the appendix?

Back 61

2-20cm

Front 62

Acute appendicitis accounts for about __% of all abdominal surgeries and is ___ times more common in men than women.

Back 62

50% & 1 1/2 times more common in men

Front 63

The rectum extends from the sigmoid colon into the ____.

Back 63

Anus

Front 64

What level does the rectum begin at?

Back 64

S3

Front 65

How long is the rectum?

Back 65

4 1/2'' Long

Front 66

How long is the anal canal?

Back 66

1 to 1 1/2'' Long

Front 67

The ____ _____ Is the dilated portion of the rectum loated anterior to the coccyx.

Back 67

Rectal ampula

Front 68

The rectum presents ___ anteroposterior curves.

Back 68

Two

Front 69

Which portion of the small intestine is located primarily to the left of the midline?

Back 69

Jejunum

Front 70

Which portion of the small intestine is located primarily in the RLQ?

Back 70

Ileum

Front 71

Which portion of the small intestine has the smoothest internal lining and does not present a feathery apperance when barium-filled?

Back 71

Ileum

Front 72

Which aspect of the small intestine is most fixed in position?

Back 72

Duodenojejunal Juction

Front 73

In which quardant does the terminal ileum connects with the large intestine?

Back 73

RLQ

Front 74

The widest portion of the large bowel is the _____?

Back 74

Cecum

Front 75

Which flexure of the large bowel usually extends more superiorly?

Back 75

Left Colic (Splenic) flexure

Front 76

Inflammation of the verriform appendix is called?

Back 76

Appendicitis

Front 77

What two structures would be filled on a double contrast barium enema with the patient supine?

Back 77

Transverse colon & Sigmoid colon

Front 78

Which aspect of the GI tract is responsible for the synthesis and absorption of vitamins B and K and Amino acids?

Back 78

Large Intestines

Front 79

What digestive movement is the large intestine also occurs in the small intestine?

Back 79

Peristalsis

Front 80

Is the cecum located retro, intra,or infra?

Back 80

Intraperitoneal

Front 81

Is the Ascending colon located retro, intra,or infra?

Back 81

Retro

Front 82

Is the transverse colon located retro, intra,or infra?

Back 82

Intra

Front 83

Is the descending colon located retro, intra,or infra?

Back 83

Retro

Front 84

Is the sigmoid colon located retro, intra,or infra?

Back 84

Intra

Front 85

Is the upper rectum located retro, intra,or infra?

Back 85

Retro

Front 86

Is the Lower rectum located retro, intra,or infra?

Back 86

Infra

Front 87

Is the C-loop of the duodenum located retro, intra,or infra?

Back 87

Retro

Front 88

Is the jejunum located retro, intra,or infra?

Back 88

Intra

Front 89

Is the Ileum located retro, intra,or infra?

Back 89

Intra

Front 90

What are the 3 charactersitics that differentiate the large intestine from the small intestine?

Back 90

1. Internal Diameter
2. Presence of multiple hustra
3. Relative positions of the 2 structues

Front 91

Inorganic salts are absorbed by which part of the intestine?

Back 91

The large intestine

Front 92

When a person is supine during a double contrast, which structures would be barium filled?

Back 92

Ascending & Descending & Sigmoid colon

Front 93

When a person is prone during a double contrast, which structures would be barium filled?

Back 93

Cecum, Transverse colon & Sigmoid colon

Front 94

List in order which structures must be seen on a small bowel radiograph.

Back 94

1. Duodenum, Suspensory muscle of the duodenum, Jejunum, Ileum, and area of the ileocecal vavle

Front 95

What structuers must be seen in a BE?

Back 95

1. Cecum
2. Ascending Colon
3. Right colic flexure
4. Transverse Colon
5. Left colic flexure
6. Descending colon
7. Sigmoid Colon
8. Rectum

Front 96

What is the promary function of the large intestine?

Back 96

Elimination of feces

Front 97

Feces consist normally of __% of water and __% of solid matter.

Back 97

65% Water
35% Solid matter

Front 98

The last stage of digestion occours in the large intestine through ______ action, which converts the remaining proteins into amino acids

Back 98

Bacterial Action

Front 99

_____ are gasses that help to break down remaining proteins into amino acids.

Back 99

Flatus

Front 100

What two types of movements happen in the small bowel?

Back 100

Peristalsis & Rythmic segmentations

Front 101

This function is described to have wave-like contractions that propel food from the stomach through the smalland large intestines.

Back 101

Peristalsis

Front 102

Barium Sulfate enters the stomach and reaches the ileocecal valve between _ and _ hours after ingestion.

Back 102

2-3 hours

Front 103

This function is described to localize cntractions in areas or regions that contain food.

Back 103

Rythmic Segmentations

Front 104

What four types of movements take place in the large intestine?

Back 104

Peristalsis, haustral, churning mass peristalsis, and defecation

Front 105

True or False: In the average adult, a large collection of gas in the small bowel is considered abnormal.

Back 105

True

Front 106

What is the purpouse of a SBS?

Back 106

To study the form and fuction of the three components of the small bowel and to detect any abnormal conditions

Front 107

Presurgical patients and patients suspeced of having a perforated hallow viscus should or shouldn't recicve BaSO4?

Back 107

NOT

Front 108

True of false: an obstructed large bowel should be ruled out first with an acute abdominal series and BE.

Back 108

True

Front 109

Name this Pathology: describes inflammation of the intestine.

Back 109

Enteritis

Front 110

Name this Pathology: A Common birth defect found in the ileum

Back 110

Meckel's Diverticulum

Front 111

Name this Pathology: A common parasitic infection of the small intestine

Back 111

Giardiasis

Front 112

Name this Pathology: A obstruction of the small intestine

Back 112

Ileus

Front 113

Name this Pathology: Patient with lactose or sucrose sensitivities

Back 113

Malabsorption Syndrome

Front 114

Name this Pathology: New growth

Back 114

Neoplasm

Front 115

Name this Pathology: A form of sprue

Back 115

Celiac Disease

Front 116

Name this Pathology: Inflammation of the intestine

Back 116

Enteritis

Front 117

Name this Pathology: Forms of inflammatory disease of the GI tract

Back 117

Regional Enterirtis

Front 118

Name this Pathology: Circular staircase or herringbone sign

Back 118

Ileus

Front 119

Name this Pathology: Cobblestone apperance

Back 119

Regional enteritis

Front 120

Name this Pathology: Apple core apperance

Back 120

Adenocarcinoma

Front 121

Name this Pathology: Dilation of the intestine with thickening of circular folds

Back 121

Giardiasis

Front 122

Name this Pathology: Large diverticulum of the ileum

Back 122

Meckel's Diver

Front 123

Name this Pathology: "Beak Sign"

Back 123

Volvulus

Front 124

How is Gardiasis acquired?

Back 124

Contaminated food, water, & person to person contact

Front 125

Meckle's Diverticulum is best diagnosed with with imaging modality?

Back 125

Nuc Med

Front 126

Whipples disease is a rare disorder of the...?

Back 126

Proximal small intestine

Front 127

List two conditions that may prevent the use of barium sulfate during a small bowel series.

Back 127

Possible perforated hollow viscus and or large bowel obstruction

Front 128

Name the four types of small bowel proceduers

Back 128

UGI & SBS togeather
SBS only
Enteroclysis
Intubation Method

Front 129

For the first two hours in the SBS radiographs are usually obtained at __ to __ mintue intervals

Back 129

15-30 min

Front 130

Go through the basic Upper GI-Small bowel cobo series

Back 130

1. Routine GI
2. Notation of time patient drinks first cup of BA
3. Drinking of 2nd cup of BA
4. 30 min PA image
5. Half and hour interval images until barium reaches large bowel
6. 1 hr interval images
7.Fluor of ileocecal valve and termminal ileum optional

Front 131

Describe the procedure summary for a small bowel series.

Back 131

1. abdomen scout
2.2 cups of BA ingested
3. 15-30 min images
4. half and hour interval images until BA in large bowel
5. 1 hr interval images
6. Optional fluro

Front 132

What type of patients should be given extra care when using water-soluible contrast media?

Back 132

Young and Dehydrated

Front 133

How much Barium Sulfate is given to to an adult patient for a SBS?

Back 133

2 cups or 16 oz

Front 134

When is a SBS deemed completed?

Back 134

Once barium has reached the ileocecal valve

Front 135

How long does it usually take to complete a small bowel series?

Back 135

2 hrs

Front 136

When is the 1st image generally taken during a SBS?

Back 136

15-30 mins

Front 137

True or false: Fluro is sometimes used during a small bowel series to visualize the ieocecal valve.

Back 137

True

Front 138

True or false: It takes about 12 hrs for Barium Sulfate in a healthy adult, given orally, to reach the rectum.

Back 138

False, 24 hrs

Front 139

The term enteroclysis describe swhat type of a small bowel study?

Back 139

Double Contrast

Front 140

Which two pathologic conditions are best evaluated through an enteroclysis procedure?

Back 140

Regional Enteritis (chrons disease) & malabsorption syndrom

Front 141

What two types of contrast media are used for an enteroclysis?

Back 141

High-Density Barium Sulfate and air or methlcellulose

Front 142

The tip of the catheter i advanced to the ______________________ during enteroclysis.

Back 142

Duojejunal flexure (suspensory ligament)

Front 143

What is the purpose of introducing methylcellulose during an enterclysis?

Back 143

It dilates the intestinal luman to produce a more diagnostic study

Front 144

A procedure to alleviate postoperative distention of a small intestine obstruction is called...?

Back 144

Therapeutic intubation

Front 145

What is the recommended patient prep before a SBS?

Back 145

NPO for 8 hrs and no gum or cigs

Front 146

Which position is recommended for SB images? WHy?

Back 146

Prone. Seperates the loops

Front 147

Name this condition: A twisiting of a portion of the intestine on its own mesentery

Back 147

Volvulus

Front 148

Name this condition: Outpouching of the mucosal wall

Back 148

Diverticulum

Front 149

Name this condition: Inflammatory condition of the large intestine

Back 149

Colitis

Front 150

Name this condition: Severe form of colitis

Back 150

Ulcerative colitis

Front 151

Name this condition: Telescoping of one part of the intestine into another

Back 151

Intussusception

Front 152

Name this condition: Inward growth extendinge from the lumen of the intestinal wall

Back 152

Polyp

Front 153

Which type of patient usually experiences intussusception?

Back 153

Infants

Front 154

A condition of numerous herniations of the mucosal wall of the large intestine is called...?

Back 154

Diverticulosis

Front 155

Name this condition: produces a tapered or corkscrew radiographic sign buring an BE.

Back 155

Volvulus

Front 156

Name this condition: Produces cobblestoen sign during an BE

Back 156

Ulcerative bcolitis

Front 157

What type of carcinoma is most commonly found in the large intestine?

Back 157

Annular Carcinoma

Front 158

True of false: Intestinal polyps and diverticula are very similar in structure

Back 158

False

Front 159

True or false: Volvulus occours ore in males than femals

Back 159

True

Front 160

True or false: The BE is commonly recomended for diagnosing possible acute appendicitis

Back 160

False

Front 161

Which four conditions would prevent the use of laxative cathartics before a BE?

Back 161

1. Gross bleeding
2. Severe Diarrhea
3. Obstruction
4. Inflammatory Lesion

Front 162

True or false: Any stool retained in he large intestine may require postponement of a BE study

Back 162

True

Front 163

True of false: and example of an irritant cathartic is magnesium cirate

Back 163

false, castor oil

Front 164

Name the 3 types of enema tips

Back 164

1. pastic disposable
2. rectal retention
3. air-contrast retention

Front 165

What temp should the water be for a BE mixture?

Back 165

85-90 F

Front 166

To minimize spasm during a BE ________ can be added to the contrast media mixture.

Back 166

Lidocaine