The GI System Powerpoint First 1/2

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Digestive System

Digestive Glands

Normal GI Anatomy:

Sequential parts of the ___ ___ include the mouth, pharynx, esophagus, stomach, small intestine, and large intestine

Three types of accessory ___ ___ - the salivary glands, liver and pancreas - secrete digestive juices into the digestive system

2

Digestive; 8

Gastrointestinal tract

Normal GI Anatomy: The ____ or alimentary tract is a tube, __m long, extending from the ___ to the anus

The ___ ___ is the part of the digestive system that is below the diaphragm

3

Pharynx

Sphincter

Normal Anatomy - Esophagus:

Extends from the ____ through the thoracic cavity and diaphragm and empties into the ____

Lower end acts as a ____; the entrance to the stomach is generally closed

4

Muscular

Lesser and greater

Fundus, body and pylorus

Normal Anatomy - Stomach:

Large, smooth, ____ organ

Two surfaces: the ____ and _____ curvatures

Three parts: ____, _____ and _____

5

5; 4

Duodenum, jejunum, and ileum

Large intestine

Normal Anatomy - Small Intestine:

Long, coiled tube that measures approx. ___m long and ___cm in diameter

Three parts: ____, ____, and ____

Ileocecal orifice marks the entry into the ___ ____

6

Larger; smaller

Vermiform appendix, cecum, rectum and anus

Normal Anatomy - Large Intestine:

____ in diameter and ___ in length than the small intestine

Five parts: ___ ___, ____; ascending transverse and descending colon; ____ and ____

7

Gastric; phrenic

Varices

Vascular Anatomy - Esophagus:

___ branch of the celiac axis and the left inferior ____ artery of the abdominal aorta supply the lower end of the esophagus

___ may be seen to rise from the gastroesophageal arteries

8

Subclavian

Thoracic aorta

Vascular Anatomy - Esophagus:

Inferior thyroid branch of the ____ artery supplies the upper esophagus

Decending ___ ___ supplies the midesophagus

9

Gastric; pyloric; hepatic; splenic; gastric

Venous

Vascular Anatomy - Stomach:

Vascular supply is provided by the right ___ arterial branch, ____ and right gastropiploic branches of the ____ artery, left gastroepiploic branch and vasa brevia of the ____ artery, and left ____ artery

_____ system parallels the arterial system and empties into the portal venous system

10

Celiac axis; gastric; pancreaticoduodenal

Superior mesenteric; pancreaticoduodenal; ileal

Vascular Anatomy - Small Intestine:

The ___ ___ supplies the duodenum through its right ____, gastroduodenal, and superior _____ branches

The ___ ____ artery has multiple branches to the small bowel, which include the inferior _____, jejunal and ____ arteries

11

Mesentery; vessels, nerves, and lymphatic

Vascular Anatomy - Small Intestine:

The ____ outlines the small intestine and contains the superior mesenteric _____, ____, and ____ glands and fat between its two layers

12

Celiac, superior mesenteric, and inferior mesenteric

Ileocolic

Right Colic

Middle Colic

Vascular Anatomy: Large Intestine

The ____, ___ ___ and ___ ___ arteries supply both the small & large intestine

The SMA branches:

  • ____ artery
  • ___ ____ artery
  • ____ ____ artery
13

Inferior mesenteric; rectum; retroperitoneally

Left colic

Sigmoid

Superior rectal

Vascular Anatomy - Large Intestine: The ___ ___ artery supplies the intestine from the left border of the transverse colon to the ____, rising from the anterior surface of the abdominal aorta at the level of the 3rd lumbar vertebra and descending _____.

Branches of the IMA:

  • ___ ___ artery
  • ___ artery
  • ___ ___ artery
14

Wall; absorption

Liver; liver

Physiology of the GI Tract:

When the food particles are small enough, the nutrient molecules pass through the ___ if the intestine into the blood or lymph system by ____

The nutrients are transported to the ____ after being absorbed by the blood; the ___ processes and stores these nutrients

15

Gastrointestinal tract

Digestion; absorption

Physiology of the GI Tract: The ___ ___ is the largest endocrine organ in the body

____ and ____ are its main functions

16

Cells

Defecation

Rugae

Physiology & Labs of the GI Tract: The remaining nutrients in the blood are transported to ___ throughout the body

The undigested and unabsorbed food is eliminated from the digestive tract by the process of _____

When food enters the stomach, the ____ gradually smooth out; caused the stomach to stretch and increase its capacity for food intake

17

Three; peristalsis

Mucus

Gastric; hydrochloric acid

Physiology & Labs of the GI Tract:

____ layers of smooth muscle in the stomach wall enable it to mash and churn food and move it along with ____

Large amounts of ____ are secreted in the stomach

___ glands secrete gastric juice, which contains ___ ___ and enzymes

18

Chyme

Pylorus

Villi; villi; quickly

Physiology & Labs of the GI Tract: Food is converted into ___

This soupy mixture is moved toward the ____ and into the small intestine

The ____ within the small intestine increase its surface area for digestion and absorption of nutrients; without ____, food would move too ____ through the intestine for absorption

19

Intestinal; villi

Gastrin

Duodenum; bile; chyme

Physiology & Labs of the GI Tract: The ____ glands are found between the ___ and secrete large amounts of fluid that serve as a medium for digestion and absorption of nutrients.

The hormone, ____, which is released by the stomach mucosa, stimulates the gastric glands to secrete

Most of the digestions occurs within the _____. ___ and enzymes from the liver and pancreas are secreted into the duodenum to act on the ____ and break down the food particles for absorption

20

Cholecystokinin; gallbladder

Secretin

Physiology & Labs of the GI Tract:

____ is released by the presence of fat in the intestine and regulates ____ contraction and gastric emptying

____ is released from the small bowel to stimulate the secretion of bicarbonate to decrease the acid content of the intestine

21

Blood in the stools

Anemia

White blood

Carcinoembryonic antigen

Physiology & Labs of the GI Tract: Most common lab: ____ in the ____

____ may also be present as a result of chronic blood loss

Infection would show elevation in ___ ___ count

Increase in the ____ ____is found in patients with inflammatory bowel disease

22

Nausea, vomiting and diarrhea

Bowel abscess, diverticulitis, and appendicitis

Physiology & Labs of the GI Tract: Signs and Symptoms - ____, ____ & ____

Abdominal pain and fever may also be present with gastrointestinal conditions such as colitis, ____ ___, acute ____ and _____

23

Mucosa

Submucosa

Muscularis

Serosa

Mesothelium

Bowel Layers: ____: directly contacts the intraluminal contents; is lined with epithelial folds; is echogenic

____: contains blood vessels and lymph channels

____: contains circular and longitudinal bands of fiber

____: is a thin, loose layer of connective tissue

_____: covers intraperitoneal bowel loops

24

Echogenic

Gas; incomplete

Rim of lucency; echogenic

Sonographic Findings of the GI Tract: Intraluminal air produces an ____ shadow which prevents the sound bean from penetrating structures posteriorly

The scattering and reflection effect of ____ in the GI tract often produces an ___ or mottled distal acoustic shadow

The ___ of ____ represents the wall, and its periserosal fat produces the outer ____ border of the tract wall

25

Five

Odd

Even; 3; 5

Sonographic Findings of the GI Tract:

The bowel wall has ___ layers

The ___-numbered layers are echogenic

The ___-numbered layers are hypoechoic, with an average total thickness of __mm (distended) or __mm (nondistended)

26

Gastroesophageal junction; aorta; liver; hemidiaphragm

Liver; gastroesophageal junction

Sonographic Findings of the GI Tract: Stomach -

The ____ ____ is seen on the sagittal scan to the left of midline as a bull's eye or target-shaped structure anterior to the ___, posterior to the left lobe of the ___ and inferior to the ____

The left lobe of the patient's ____ must be large enough to be able to image the ____ ____

27

Stomach

Cystic Mass in the LUQ: If the patient has a cystic mass in the LUQ, determine whether the mass is the fluid filled ___ or another mass arising from adjacent organs

  • Give carbonated drink to see bubbles in the stomach
  • Have nasogastric tube placed for drainage
  • Watch for change in the shape or size of the "stomach" mass with ingestion of fluid
  • Alter the patient's position
  • Watch for peristalsis
  • Ask the patient to drink water to see the swirling effect
28

4; Superior; pylorus; neck

Descending

Transverse

Ascending; jejunum

Duodenum: ___ parts ___ portion courses anteroposteriorly from the ____ to the level of the ___ of the gallbladder

A sharp bend in the duodenum into the ____ portion that runs along the IVC at the level of L4

___ portion passes right to left with a sligh inclination upward in front of the great vessels and crura

___ portion rises to the right of the aorta and reaches the upper border at L4, where at the duodenojejunal flexure it turns forward to become the ____

29

Ileum; 3

Peristalsis

Small Bowel:

The ___ is smooth-walled; the small bowel is under ___mm thick

When fluid is in the bowel loops, look for ____, air movement, or movement of intraluminal fluid contents to rule out obstruction

30

Valvulae conniventes; 3-5

Keyboard

Small Bowel: Cannot usually be seen with sonography

The ___ ___ may be seen as linear echo densities spaced __ to __ mm apart

This is called the ____ sign and can be seen in the duodenum & jejunum