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


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




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



Lesser and greater

Fundus, body and pylorus

Normal Anatomy - Stomach:

Large, smooth, ____ organ

Two surfaces: the ____ and _____ curvatures

Three parts: ____, _____ and _____


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 ___ ____


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 ____


Gastric; phrenic


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



Thoracic aorta

Vascular Anatomy - Esophagus:

Inferior thyroid branch of the ____ artery supplies the upper esophagus

Decending ___ ___ supplies the midesophagus


Gastric; pyloric; hepatic; splenic; gastric


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


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


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


Celiac, superior mesenteric, and inferior mesenteric


Right Colic

Middle Colic

Vascular Anatomy: Large Intestine

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

The SMA branches:

  • ____ artery
  • ___ ____ artery
  • ____ ____ artery

Inferior mesenteric; rectum; retroperitoneally

Left colic


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

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


Gastrointestinal tract

Digestion; absorption

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

____ and ____ are its main functions





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


Three; peristalsis


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




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


Intestinal; villi


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


Cholecystokinin; gallbladder


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


Blood in the stools


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


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 _____







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



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




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)


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 ____ ____



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

4; Superior; pylorus; neck



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 ____


Ileum; 3


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


Valvulae conniventes; 3-5


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