-
alimentary tract
- digestive tract
- long tube 8m long
- mouth to anus
-
GI tract
- digestive tract below diaphragm
- largest endocrine structure in the bodydigestion and reabsorption
-
parts of digestive system
- mouth
- ppharnyx
- esophagus
- stomach
- small intestine (duodenum, jejunum, ileum)
- large intestine (cecum, ascending colon, rectum)
-
acessory digestive glands
-
esophagus
from pharynx through thoracic cavity, through diaphragm into stomach
-
cardiac orfice
- entrance to stomach that has circular sphincter to keep it closed
- prevent gastric acid from coming up
-
stomach
- large smooth muscular organ with the lesser curvature and greater curvature
- has rugae- folds of mucosa and submucosa
- 3 layers
-
-
pyloric canal
connects the stomach to prox duod.
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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
-
duodenum
- 22 cm
- curved like c
- 4 parts- superior, descending, transverse, and asceding
- most digestion takes place here
-
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
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rectum
12 cm long- terminates at anus
-
gastrin
horomone released by stomach mucosa stimulated gastric glands
-
cholecystokinin and secretin
- choley- gallbladder contraction and gastric emptying
- secretin- released by small bowel to stimulate bicaronate to decrese acid in intestines
-
gastroesophogeal junction
bulls eye or target shape anterior to ao, post to LL liver
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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
-
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
-
gastric bezoar
- psychosis- eatting things they shouldnt
- trichobezoar- hair
- phytobezoar-vegetable matter-unripe
- concretions- inorganic- sand shellac asphalt
immobile intraluminal masses
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polyps
- small tumor like growth projection from mucous membrane
- benign
-
leiomyoma
- most common tumor of the stomachbenign, asymptomatic
- muscle tumor
-
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
-
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
-
leiomyoscarcoma
- second most common malignant GI tumor
- 50-60s
- may be big and outstrip blood supply-necrosis
- target shaped lesion
-
metastatic disease
- rare
- melanoma or lung cancer or breast cancer
- submucosa, nodules, plaque
- target pattern with thickening of stomach walls - cannot see the layers
-
obstruction and dilitation of lower GI
- dilitation of bowel prox to obstruct.
- tubular or round echo free appearance
- sonog should demonstrate compression of bowel
-
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
-
appendocolith
fecaliths or calculi in appendix
-
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
-
meckels diverticulitis
pouchlike herniation through muscular wall of ileum
-
crohns disease
- recurrent inflammatory disease of terminal iliem and or colon
- thickening of bowel wall
- ansent peristalsis
- ridgidity
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