Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
20 Cards in this Set
- Front
- Back
|
What are the white lines of Toldt?
|
lateral and peritoneal reflections of the ascending and descending colon
|
|
|
What parts of GI tract do not have serosa?
|
esophagus, middle and distal rectum
|
|
|
What is the blood supply to the rectum?
|
proximal: superior hemorrhoidal from the IMA
middle: middle hemorrhoidal from the hypogastric (int. iliac) distal: inf. hemorrhoidal from the pudendals |
|
|
Waht is the venous drainage of the rectum?
|
proximal: via the IMV to the splenic vein, then to the portal vein
middle: via the iliac v. to the IVC distal: via the iliac to the IVC |
|
|
Main purpose of the colon?
|
H2O absorption and stool storage
|
|
|
What is colorectal CA?
|
adenocarcinoma of the colon or rectum
|
|
|
What is the incidence of Colorectal CA?
|
most common GI CA
second most common CA in the US increased incidenc with age starting at 40 and peaks at 70 to 80 years second most common cause of cancer deaths male:female ratio is 1:1 |
|
|
what are the risk factors for colon CA?
|
dietary: low-fiber, high fat diets INC rates
Genetic: fam hx is imp. risk factor; FAP, lynch syndrome IBD: UC>Chron's Age, previous colon CA |
|
|
What is Lynch's syndrome?
|
HNPCC: Hereditary NonPolyposis Colon Cancer - autosomal dominant inheritance of high risk for development of colon CA
|
|
|
What are current ACS recommendations for Colon Ca screening (without (+) family hx)?
|
annual digital rectal exam starting at age 40
annual fecal occult blood test starting at age 40 colonoscopies every ten years starting at age 50 |
|
|
What are the signs and symptoms associated with right sided Colon Ca?
|
microcytic anemia
occult melena > hematochezia PR postprandial discomfort fatigue Right sided colon has a large luminal diameter so CA may attain a large size before causing any problems |
|
|
What are the signs and symptoms associated with left sided Colon Ca?
|
change in bowel habits (small caliber stools)
colicky pain signs of obstruction - abdominal mass, heme+ stools or gross blood nausea, vomiting, constipation left sided colon has a smaller luminal diameter and semisolid contents |
|
|
From which sided colon ca is melena more common?
|
Right
|
|
|
from which sided colon Ca is hematochezia more common?
|
left
|
|
|
What are the signs and symptoms of rectal ca?
|
MC symptom is hematochezia (passage of red blood +/- stool) or mucus
tenesmus feelinf of incomplete evacuation of stool rectal mass |
|
|
what is the differential dx of colon tumor/mass?
|
adenoCa, carcinoid tumor, lipoma, leomyoma, lymphoma, UC, Chron's dz, benign polyps
|
|
|
Dx exams for colon ca?
|
H&P with rectal
heme occult CBC barium enema sigmoid/ colonoscopy |
|
|
How does colon Ca spread?
|
direct extension: circumferentially and then thru bowel wall to later involve other abdominoperineal organs
Hematogenous: portal circulation to liver; lumbar vertebral veins to lungs lymphogenous: regionally transperitoneal intraluminal |
|
|
What tests are useful to help find colon ca mets?
|
CXR
LFTs abdominal CT |
|
|
Hwat diagnostic test is useful for rectal Ca?
|
endorectal US - probe is placed transanally and depth of invasion and nodes are evaluated
|
