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83 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Tumors and fibrotic strictures that narrow and obliterate the lumen
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Intramural
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i
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When the lumen is compressed and blocked
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extramural
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e
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neutralizes acid and initiates digestion, absorption of iron, calcium and folic acid
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deodenum
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d
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responsible for most of digestion and absorption of water and nutrients
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jejunum
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j
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completes digestion, takes up B12 and recovers bile salts
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ileum
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i
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prevents reflux of colonic contents into small intestine
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ileocecal valve
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i v
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Bacteria also make vitamin K here
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large intestine
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l
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lesions, stones, FB that block the lumen
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intraluminal
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i
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when a segment of the gut is twisted
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volvulus
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v
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when one part of the gut inverts and is pulled into the lumen by peristalsis
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intussusception
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i
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functional obstruction, a segment of the gut losses its propulsive function, gut is “sleeping”
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ileus
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i
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an acute opening where the gut contents spill freely and may lead to peritonitis from bacteria
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perforation
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p
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process invades an adjacent structure
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penetration
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p
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a walled off penetration may lead to this
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abscess
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a
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abnormal tubelike passage from one cavity to another, or from cavity to free surface; can be congenital or acquired
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fistula
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f
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ischemia of deeper muscle layers can cause scarring and this
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fibrosis
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f
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contraction of a scar can cause ____________ with luminal narrowing and obstruction
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strictures
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s
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Can lead to a breach in the mucosa exposing underlying tissue to luminal contents
Typically occurs in peptic ulcer disease May lead to fibrosis and scarring |
chronic inflammation
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c i
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Injured peritoneum (when apposed to healthy peritoneum) will resurface itself without scarring when inflammation resolves
However, if two injured peritoneal surfaces rub together, they will initially adhere to each other, seal by fibrin, and then scar Peritoneal scars are called _________ – a common cause of intestinal obstruction years later |
adhesions
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a
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outpouchings of a hollow organ
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diverticula
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d
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_______ diverticulum contain all the layers of the bowel wall
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true
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t
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_______ diverticulum consist of mucosa and submucosa herniated through the muscle layer
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false
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f
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pyrosis
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heartburn
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h
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"coffee ground" emesis(vomiting), BRB
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hematemesis
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h
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coughing up blood
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hemoptysis
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h
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BRB per rectum
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hematochezia
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h
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black, tarry stool
associated with gastrointestinal hemorrhage. The black color is caused by oxidation of the iron in hemoglobin during its passage through the ileum and colon. The most common cause is peptic ulcer disease |
melena
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m
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What else can turns stools black
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pepto bismal or iron supplements
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fluid in peritoneum
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ascites
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a
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refers to bruising of the flanks.
This sign takes 24-48 hours to appear and predicts a severe attack of acute pancreatitis, with mortality rising from 8-10% to 40%. |
Grey-Turner sign
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G-T
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is blue-black bruising of the area around the umbilicus.
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Cullen sign
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C
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Sharp pain when hand quickly removed from abdomen
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rebound tenderness
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r
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Flexible glass fibers carry image
Light source thru fibers Channels for insufflation of air, water, suction to remove secretions, instrument passage for biopsy, balloon dilation, injection, cautery Levers can manipulate tip and steer instrument |
endoscopy
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e
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Allows visual inspection of lumen of GI tract (esophagus, stomach and duodenum)
Used to discover reason for swallowing difficulties, nausea, vomiting, reflux, bleeding, indigestion, abdominal pain, or chest pain Local anesthetic, conscious sedation Swallow flexible endoscope Visualize all lining Biopsy, cautery NPO prior 6-8 hours, avoid anticoagulants, aspirin and NSAIDs for 3-5 d before test |
upper endoscopy (EGD) esophagogastroduodenoscopy
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u e
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Allows visual inspection of stomach, duodenum, and ducts in biliary tree and pancreas
Detect problems in the liver, gallbladder, bile ducts and pancreas Used to determine reason for jaundice, upper abdominal pain, unexplained weight loss |
endoscopic retrograde cholangiopancreastography (ERCP)
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e r
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Local anesthesia, conscious sedation
Swallow flexible endoscope Localize ducts and opening to duodenum Pass small tube through scope into ducts, inject a radiopaque contrast material Visualize pancreatic and common bile duct under fluoroscopy Biopsy, remove obstruction NPO prior 6-8 hours, avoid anticoagulants, aspirin and NSAIDs for 3-5 d before test Endocarditis antibiotic prophylaxis Dye (iodine) allergy |
endoscopic retrograde cholangiopancreastography (ERCP)
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e r
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Visualize the colon and distal ileum
Used to detect causes of unexplained bowel changes, cancer, abnormal growths, ulcers, bleeding |
colonoscopy
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c
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Conscious sedation
Flexible endoscope inserted into rectum Biopsy, cautery, inject medication or dyes Bowel prep prior to procedure NPO prior 6-8 hours, avoid anticoagulants, aspirin and NSAIDs for 3-5 d before test |
colonscopy
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c
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Visualize distal colon and rectum (65 mm)
Used to detect causes of diarrhea, abdominal pain, constipation, cancer, abnormal growths, ulcers, bleeding |
flexible sigmoidoscopy
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f s
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Can be performed by trained primary providers in office
Flexible tube inserted into rectum and sigmoid colon Biopsy, cautery Cleansing enema prior to procedure |
flexible sigmoidoscopy
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f s
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Anoscope for examination of anal canal
Proctoscope for examination of rectum |
rigid endoscopes
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r e
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Wide mediastinum or air-fluid level seen in obstructed esophagus
Pneumothorax or pneumomediastinum in perforated esophagus Free air under diaphragm in perforated bowel |
CXR
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C
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Abdominal series (3-way)
KUB (kidneys, ureter, bladder) Air-fluid levels indicate obstruction or ileus |
abdominal Xray
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a
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Detect problems in the esophagus, stomach and small intestine
Used to look for ulcers, scar tissue, abnormal growths, hernias or areas of blockage Drink barium contrast medium – coats esophagus, stomach and small intestine Fluoroscope allows visualization of digestive system Less accurate than endoscopy NPO for 8 hours prior to procedure radiography |
upper GI series
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u
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Detect problems in the large intestine (colon and rectum)
Used to look for abnormal growths, polyps and diverticuli Barium enema: infused via rectum – coats colon and rectum Bowel prep prior to procedure radiography/"barium enema" |
lower GI series
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l
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Localizes site of bleeding or occlusion of vessel
Inject contrast dye into the blood vessels that supply the organs of the abdomen |
angiography
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a
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By filling the vessels with dye, they can be identified and abnormalities can be detected.
Diagnose diseases of the blood vessels in the small and large intestines such as a narrowing or tumors. Identify the site of bleeding in the abdomen and possibly stop the bleeding by injecting a plug or chemical. Clear liquids 6-8 hours prior to procedure |
angiography
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a
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Good for gallbladder and measuring bile duct size
Less expensive than CT Liver, gallbladder, pancreas and digestive tract NPO for 6-8 hours prior to procedure Stomach, duodenum, small bowel Increased water intake immediately before test |
ultrasound
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u
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Good for solid organs, not for bowel wall
Better than US for liver and pancreas CT-guided aspiration and biopsy of lesions NPO 2-4 hours prior to procedure Elderly and diabetics need serum creatinine prior to testing with contrast dye |
computed tomography
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c t
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Useful in diagnosis of intra-abdominal masses
Provides detailed pictures of soft tissues clearly shows lymph nodes and blood vessels, and can evaluate blood flow may be used in diagnosing abnormal growths can provide information for the staging of abdominal tumors NPO 4-6 hours prior to procedure |
MRI
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m
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digital geometry processing is used to generate a three-dimensional image
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computed tomography
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c
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Used to determine if cystic duct is blocked by a stone or inflammation
Isotope is picked up and excreted by the liver in normal instances, gallbladder will fill with radionuclide if cystic duct is blocked, gallbladder with not receive any isotope if common bile duct is not blocked, isotope should pass through duct and end up in GI tract NPO 6 hours prior to procedure |
HIDA scan
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h
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short-lived, acute painful peristalsis
usually due to acute gastroenteritis |
intestinal colic
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i c
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short-lived, acute painful peristalsis
low in the abdomen, below the umbilicus relieved by defecation |
colon colic
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cc
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repeated or persistent painful peristalsis
sharp pain that causes patient to double-over distension, high-pitched “tinkling” bowel sounds, nausea failure to pass feces or flatus |
intestinal obstruction
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i o
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localized pain over inflamed organ
worse with movement or prodding |
peritoneal inflammation
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p i
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Severe RUQ pain, radiating to the back
Pain comes in waves Lasts for several hours Associated with nausea and vomiting Roam around to find comfortable position |
biliary colic
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b c
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RUQ pain that radiates to the shoulder
Excessive belching Nausea |
inflammed gallbladder
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i g
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Chronic inflammation with:
Severe pain in the back just below the shoulder blades Induced by eating or alcohol Mildly relieved by sitting forward Pancreatic cancer may be painless but extension retroperitoneally initiates unremitting central back pain |
pancreatic pain
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p p
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Pain that has been present for 6 months or longer
This pain may be an emotional expression |
chronic abdominal pain
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c a
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An urgent situation in which abdominal symptoms onset suddenly and are sufficiently severe to suggest a potentially lethal condition.
Pain is usu the predominant feature. Steady, severe pain is more ominous than colicky pain In addition to classic diagnoses consider: acute MI or angina aortic disease – dissection or aneurysm intestinal ischemia metabolic disorders |
severe acute abdominal pain
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s a a
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Difficulty in starting to swallow
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dysphagia
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d
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Relates to neurological or muscular disease
Assoc with drooling due to difficulty swallowing saliva Aspiration of saliva with assoc aspiration pneumonia difficulty with liquids more likely a problem with neurological or muscular control of swallowing |
dysphagia
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d
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Dysphagia of solids more likely a problem with __________ lesion
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structural
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s
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difficulty swallowing solids first then liquids is “BAD”, sign of cancer of esophagus but can be from strictures
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progressive dysphagia
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p d
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this type of dysphagia may suggest a benign structural lesion
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non-progressive
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n-p
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Intermittent sticking affecting solids and liquids suggest ________ disorder
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motility
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m
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“Lump in throat”
Usually in highly anxious people Increased during stress Temporary inability to swallow |
globus sensation
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g s
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Highly nonspecific symptom
May be associated with anxiety or depression If assoc with weight loss may suggest an organic disorder Initial hunger with rapid feeling of fullness may reflect poorly distensible stomach or motility disorder |
loss of appetite
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l o a
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food returning to mouth from esophagus without reverse peristalsis
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regurgitation
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r
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mouth filled with excess saliva, possibly symptom of peptic ulcers
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water brash
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w b
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Retrosternal, raw, burning sensation – starts at epigastrium and travels up to the throat
Precipitated by large meals, alcohol, stooping, or lying flat in bed Rapidly relieved by milk/alkali Persistent heartburn suggests esophagitis and repeated reflux Dysphagia may result |
pyrosis (heartburn)
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p
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Painful digestion
Often meal-related epigastric discomfort, pain or fullness Classic symptoms of peptic ulceration: Pain relieved by food and initiated with hunger Pain is epigastric and radiates to the back Antacids relieve symptoms within minutes Pain awakes patient in early hours Symptoms come in bouts |
dyspepsia
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d
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Increased serum bilirubin levels with yellow appearance of skin and mucous membranes
Usually noticed first in the sclera May be preceded by several days of pale stools and dark urine |
jaundice
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j
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Accumulation of serous fluid in the peritoneal cavity
Increased abdominal girth assoc with feeling of distention nausea and vomiting, SOB |
ascites
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a
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Gas production by bacteria in colon
Normal elimination is approx 1 liter per day (50-500 ml 13.5 times a day) |
flatulence
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f
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(air swallowing)
Belch after a large meal is a physiologic venting of air from the stomach |
aerophagia (belching)
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a
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“distended beyond normal size”
Unknown mechanism - Often assoc with IBS In hypersensitive gut – abdominal muscles relax to accommodate perceived distention Intestinal gas production does not cause bloating |
bloating
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b
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feeling of rectal fullness (even if bowel movement was recent), reflects rectal inflammation
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tenesmus
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t
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suggests abscess or thrombosed hemorrhoid
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constant anal pain
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c a p
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Tearing pain on defecation
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anal fissure
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a f
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intense intermittent anal pain attributed to spasm
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proctalgia fugax
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p f
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anal itch, idiopathic or pinworm infection
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pruritis ani
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p a
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