abd

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Author:
rbeacr
ID:
122311
Filename:
abd
Updated:
2011-12-09 21:24:45
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13 GI tract
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Description:
The gastrointestinal tract
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  1. alimentary tract
    • digestive tract
    • long tube 8m long
    • mouth to anus
  2. GI tract
    • digestive tract below diaphragm
    • largest endocrine structure in the body
    • digestion and reabsorption
  3. parts of digestive system
    • mouth
    • ppharnyx
    • esophagus
    • stomach
    • small intestine (duodenum, jejunum, ileum)
    • large intestine (cecum, ascending colon, rectum)
  4. acessory digestive glands
    • salivary
    • liver
    • pancreas
  5. esophagus
    from pharynx through thoracic cavity, through diaphragm into stomach
  6. cardiac orfice
    • entrance to stomach that has circular sphincter to keep it closed
    • prevent gastric acid from coming up
  7. stomach
    • large smooth muscular organ with the lesser curvature and greater curvature
    • has rugae- folds of mucosa and submucosa
    • 3 layers
  8. 3 parts of stomach
    • fundus
    • body
    • pylorus
  9. pyloric canal
    connects the stomach to prox duod.
  10. small intestine
    • long coiled tube
    • 5m long by 4cm wide
    • innerwall mucosal folds called -villi
    • wall 3-5mm (distended 3, nondistended 5)
    • 5 layers seen on ultrasound
  11. duodenum
    • 22 cm
    • curved like c
    • 4 parts- superior, descending, transverse, and asceding
    • most digestion takes place here
  12. large intestine
    • larger diameter and shorter legnth than small intestine
    • appendix, cecum, ascending, transverse, and descending colon, rectum, and anus
    • divided into segments called haustra
    • wall 5-7cm
  13. rectum
    12 cm long- terminates at anus
  14. gastrin
    horomone released by stomach mucosa stimulated gastric glands
  15. cholecystokinin and secretin
    • choley- gallbladder contraction and gastric emptying
    • secretin- released by small bowel to stimulate bicaronate to decrese acid in intestines
  16. gastroesophogeal junction
    bulls eye or target shape anterior to ao, post to LL liver
  17. appendix
    • long tubular structure extending from the cecum - may be several directions.
    • in abdominal wall under "mcburneys point"
    • 8-10 cm long, averaging 3 inches
    • <6mm- thin
    • rebound tenderness
  18. duplication cysts
    • upper GI
    • embryologic mistakes
    • lined with digestive tract epithelium
    • well developed muscular wall
    • cyst is continuous with the stomach
    • usually greater curvature of stomach in females
  19. gastric bezoar
    • psychosis- eatting things they shouldnt
    • trichobezoar- hair
    • phytobezoar-vegetable matter-unripe
    • concretions- inorganic- sand shellac asphalt

    immobile intraluminal masses
  20. polyps
    • small tumor like growth projection from mucous membrane
    • benign
  21. leiomyoma
    • most common tumor of the stomach
    • benign, asymptomatic
    • muscle tumor
  22. gastric caricinoma
    • malignant
    • 90-95% malig stomach tumors
    • 6th leading cause of death
    • older males
    • 50% in pylorus, 25% in body and fundus
    • target or pseudo kidney sign
    • gastric wall thickening
  23. lymphoma
    • can occur as primary tumor of GI
    • multifocal lesions
    • enlarged thickened mucosal folds
    • submucosal nodules
    • ulceration
    • weightloss nausea vomiting
    • hypoechoic mass- spoke wheel pattern
    • children younger than 10
  24. leiomyoscarcoma
    • second most common malignant GI tumor
    • 50-60s
    • may be big and outstrip blood supply-necrosis
    • target shaped lesion
  25. metastatic disease
    • rare
    • melanoma or lung cancer or breast cancer
    • submucosa, nodules, plaque
    • target pattern with thickening of stomach walls - cannot see the layers
  26. obstruction and dilitation of lower GI
    • dilitation of bowel prox to obstruct.
    • tubular or round echo free appearance
    • sonog should demonstrate compression of bowel
  27. acute appendicitis
    • luminal obstruction and inflammation
    • necrosis, abcess, perforation

    • pain rebound tenderness
    • nausea, vomit, diarrhea
    • leukocytosis
    • more rapid in young children 6-12 hrs
    • wall greater than 2mm thick
    • normal whole thing up to 6mm thick
    • cant compress
  28. appendocolith
    fecaliths or calculi in appendix
  29. mucocele
    • gross enlargement of appendix and mucous substance in lumen
    • scarring or fecalith after appendectomy are most common causes
    • encapsulated and not malignant but potential- pseudomyoxoma pertonei
  30. meckels diverticulitis
    pouchlike herniation through muscular wall of ileum
  31. crohns disease
    • recurrent inflammatory disease of terminal iliem and or colon
    • thickening of bowel wall
    • ansent peristalsis
    • ridgidity

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