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;
48 Cards in this Set
- Front
- Back
|
What are 2 causes of congenital intestinal obstruction (atresias and stenoses)?
|
1. failure in development
2. intrauterine vascular accidents |
|
|
What is atresia?
|
Complete obstruction
|
|
|
What is stenosis?
|
Narrowing of intestine due to a diaphragm or web that partially obstructs
|
|
|
How does atresia present clinically?
|
vomiting, abdominal distention
|
|
|
What does esophageal atresia commonly present with?
|
Tracheo-esophageal fistula
|
|
|
What does esophageal atresia and fistula present with?
|
Aspiration, regurgitation, respiratory distress
|
|
|
Is duodenal stenosis more commonly proximal or distal?
|
Proximal
|
|
|
What is the major cause of duodenal stenosis?
|
Web- resulting from failure of recanalization
|
|
|
What is Annular Pancreas?
|
Another cause of duodenal stenosis due to surrounding of the duodenum by pancreas
|
|
|
What causes jejuno-ileal atresia?
|
Intrauterine vascular accidents
|
|
|
How are jejuno-ileal atresias classified?
|
1. Whether the blind ends are connected
2. Whether there is a corresponding defect in the mesentery |
|
|
How are anorectal atresias classified?
|
High (above levator sling) or Low
|
|
|
How do anorectal atresias present?
|
Abnormal perineum, imperforate anus, and often fistula to bladder, urethra, vagina
|
|
|
What is an omphalocele?
|
Defect of the abdominal wall where the umbilical cord inserts - sac containing intestinal loops, liver
|
|
|
What is gastroschisis?
|
Defect in abdominal wall to the right of the umbilical cord - evisceration of bowel, stomach, gonads but NO SAC
|
|
|
What is short bowel syndrome?
|
Massive loss of bowel
|
|
|
Most children with short bowel syndrome require what?
|
Total parenteral nutrition
Most eventually need transplantation |
|
|
What are duplications in the GI tract?
|
cystic or tubular outgrowths anywhere along GI tract
|
|
|
Do duplications communicate with the intestine?
|
NO! but may share wall
|
|
|
Where do neuroenteric remnants originate?
|
Dorsal midline GI
|
|
|
Where are neuroenteric remnants most common?
|
Cervical and lumbar regions
|
|
|
What are the clinical signs of neuroenteric remnants?
|
GI obstruction, respiratory distress, and CNS manifestations such as paralysis
|
|
|
What is a diverticulum?
|
remnant of the vitelline duct (most common- Meckel's)
Communication between yolk sac and endoderm in normal devo |
|
|
What is the most common GI congenital anomaly?
|
Meckel's diverticulum
|
|
|
Where is a Meckel's diverticulum located?
|
antimesenteric border of terminal ileum
|
|
|
What causes most symptoms of Meckel's?
|
Gastric mucosa - pain, rectal bleeding, perforation
|
|
|
How many degrees and to what direction does the gut rotate in development?
|
270 degrees CCW
|
|
|
What does malrotation cause?
|
abnormal fixation
Sometimes, volvulus and internal strangulation |
|
|
What is pseudobstruction?
|
Signs and Sx of obstruction without obstruction
|
|
|
What causes pseudobstruction?
|
Enteric neuropathy (Hirschsprung) (problem in nerves)
Visceral myopathy (problem in muscles) Secondary causes |
|
|
What gives rise to the enteric NS?
|
Vagal Neural crest cells
|
|
|
What does failure of migration of neural crest cells result in?
|
Aganglionosis (Hirschsprung)
|
|
|
Does aganglionosis result in loss of Meissner's plexus or Auerbach's?
|
Both.
|
|
|
What are 2 genetic susceptibilities to Hirschsprung?
|
1. Mutations in RET
2. Down's syndrome |
|
|
How is Hirschsprung diagnosed?
|
Absence of ganglion cells on biopsy
|
|
|
What is the most common GI emergency in newborns?
|
Necrotizing enterocolitis
|
|
|
What is a common finding in newborns with NEC?
|
Low birthweight
|
|
|
What are the signs of NEC?
|
abdominal distention, bloody stools, apnea, gas in bowel on radiology
|
|
|
What is pneumatosis intestinalis?
|
Gas in the bowel wall (found in NEC)
|
|
|
What are long term results of NEC?
|
Strictures, atresia, Short Bowel Syndrome
|
|
|
What is intussusception?
|
invagination of one intestinal segment into another
|
|
|
What is the most common cause of intestinal obstruction?
|
Intussusception
|
|
|
Compression of the mesentery in intussusception results in what?
|
Ischemia
|
|
|
What is the primary defect in cystic fibrosis?
|
abnormal chloride channel protein coded by CFTR gene
|
|
|
What are the 4 areas of the GI tract that CF affects?
|
1. Intestinal
2. Pancreatic 3. Hepatic 4. Nutritional |
|
|
What are CF's affects on the intestines?
|
Dense secretions
Meconium ileus (obstruction by viscid meconium) |
|
|
What are CF's affects on the pancreas?
|
Duct obstruction
Acinar destruction and loss Loss of exocrine function |
|
|
What are CF's affect on the liver?
|
Elevated liver enzymes (ASx)
Steatosis Cirrhosis Microgallbladder Gallstones |
