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36 Cards in this Set
- Front
- Back
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What is a diverticulum?
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Pouch created by herniation
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What is a true versus false diverticulum?
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True- All layers
Flase- Not all layers |
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What creates the weak points in the colon, making it susceptible to diverticula?
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The potential space created where the vessels penetrate through the gap formed by the tenia and underlying muscle
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Increased luminal pressure in the colon leads to what?
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Muscle hypertrophy
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Do you get diverticula in the rectum?
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NO! - no tenia so no haustral folds, potential spaces or diverticula
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How do diverticula lead to lower GI bleeding?
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The outpouching can hit the artery as it herniates.
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How do diverticula cause diverticulitis?
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Fecolith gets lodged in the opening leading to accumulation of mucus, etc in the pouch -> inflammation
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What layers are contained in a colonic diverticulum?
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Mucosa, submucosa, and fat
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Does this make a colonic diverticulum true or false?
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False
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Repetitive injury and inflammation lead to what?
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Strictures
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What are 2 types of diverticula of the small bowel?
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1. Acquired - scleroderma, myopathy
2. Congenital - Meckle's |
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What are the divericula of the esophagus?
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Zenker's
(pseudo-diverticulum) |
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How do scleroderma and myopathies cause diverticulum in the small bowel?
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Weaken the muscle allowing outpouchings
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Are the diverticula of the small bowel true or false?
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True
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What is the main complication of small bowel diverticula?
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Bacterial overgrowth in the region -> diarrhea
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What type of mucosa is present on Meckel's?
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Can be small bowel, gastric, or pancreatic
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What causes a Zenker's diverticulum?
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abnormal motility in the esophagus
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Zenker's diverticula leads to increased risk of what?
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squamous cell carcinoma
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What is a pseudo-diveritculum?
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DIlation of ducts of the minor salivary glands (NOT really diverticulum because NOT an outpouching)
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Where is the appendix located?
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Off the cecum
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What type of mucosa is the appendix composed of?
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Colonic w lots of lymphoid tissue
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Are diverticulum possible in the appendix?
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Yup - same as in colon so false diverticulum (because no muscularis propria layer).
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What causes acute appendicitis?
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Orifice obstruction
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At what ages is appendicitis most common?
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20-30s
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What is the pathway from obstruction to appendicitis?
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Obstruction -> venous outflow compromise -> edema -> arterial compromise -> mucosal death -> bacteria -> inflammation --> peritoneal signs
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What are 5 other etiologies of inflammation?
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1. Infection
2. IBD 3. Endometriosis 4. Drugs 5. Radiation |
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What are 2 common infectious agents of the appendix?
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1. Enterobius Vermicularis
2. Schistosomiasis |
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Parasites and crohn's sometimes cause what type of appendicitis?
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Granulomatous
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What drug causes ulcerations in the GI tract (and therefore can cause appendicitis)?
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Kayexalate - used in patients with renal failure
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What part of the mucosa does radiation affect?
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The crypts (stem cells)
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What are the 3 types of epithelial neoplasms seen in the appendix?
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1. Neuroendocrine
2. Mucinous cystic neoplasm 3. Adenocarcinoma |
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What is mucinous cystic neoplasm?
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dysplasia of mucin secreting cells with no invasion
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What are the 3 nuclear features of dysplasia?
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1. Increased size
2. hyperchromasia 3. increased N:C ratio |
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What is the treatment for adenocarcinoma?
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Right hemi-colectomy
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What is pseudomyxomatous peritonei?
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Mucin accumulation in the abdomen
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What is the primary tumor site in pseudomyxomatous peritonei?
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Appendix
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