1. The stomach is a J-shaped pouch-like organ that lies under the ____ in the upper _____ portion of the abdominal cavity
    • diaphragm
    • left
  2. The stomach functions to receive food from the ____, mix it with ____, initiate the digestion of proteins, carry on a limited amt of absorption and move food to the ____
    • esophagus
    • gastric juices
    • small intestine
  3. The stomach is divided up into what 4 regions?
    • Cardiac
    • Fundic
    • Body
    • Pyloric
  4. What region of the stomach is a small area near the esophageal opening?
    Cardiac Region
  5. Which region of the stomach balloons above the cardiac portion, acts as a temporary storage area, and sometimes filled with swallowed air?
    Fundic region
  6. Which region of the stomach is the main part and is located between the fundic and the pylori regions?
    the body
  7. Which region of the stomach narrows and becomes the _____ canal as it approaches the junction with the small intestine?
    • pyloric canal
    • pyloric region
  8. What in the stomach is at the end of the pyloric canal, the muscular wall is thickened forming a powerful circular muscle
    pyloric sphincter or pylorus
  9. What stomach muscle serves as a valve that prevents regurgitation of food from the intestine back into the stomach
    pyloric sphincter or pylorus
  10. Which part of the stomach is located on the short, right curved border that extends from the cardiac to the pyloric openings
    lesser curvature
  11. What lines the stomach
    rugae or gastric folds
  12. What disappears when the stomach is filled with fluids or food?
    rugae or gastric folds
  13. Although gastric juices contain several digestive enzymes, which is the most important?
  14. Following a meal, the mixing of movements of the stomach wall aid in producing a semi fluid paste of food particales and gastric juices called
  15. What pushes the chyme toward the pyloric sphincter
    peristaltic waves
  16. Which muscle relaxes allowing the chyme to move a little at a time inot the small intestine
    pyloric sphincter
  17. what begins the digestive process?
    gastric juices
  18. Once the stomach emptys into the ____, accessory organs add their secretions to the chyme
  19. Which organs add their secreations to the chyme?
    • Pancreas
    • Liver
    • Gallbladder
  20. Is stomach ca more common in men or women?
    men (2:1)
  21. What is the peak age for stomach ca
  22. What is the pathology for stomach ca?
    90% adenocarcinoma
  23. Where are 50% of the lesions found with stomach ca
    distal/pyloric region
  24. Where are 25% of the regions found with stomach ca
    Cardiac Region
  25. Where are 5% of lesions with stomach ca
    greater curvature
  26. What % of lesions are found within the entire stomach
    10-15% and this is called lymphoma
  27. What is the etiology risk factors for stomach ca
    • diet (redmeat)
    • coal mining
    • type A blood
    • rubber working
    • asbestos
    • ulcers.polyps
    • alcohol/tobacco
    • poor nutrition
    • H pylori
  28. What are symptoms of stomach ca
    • persistent indigestion
    • epigastric distress or pain
    • loss of appetite
    • weight loss
    • N&V
    • dysphagia
    • jaundice
  29. How are stomach tumors diagnosed>
    • physical
    • upper GI
    • CT
    • endoscopy
  30. What is included in a work up for stomach ca
    • CBC (most have anemia)
    • Guaiac stool test (check for blood)
    • upper GIendoscopy with biopsy
    • CT scan chest and abdomen
    • laparoscopy
  31. What is the staging for stomach ca
  32. How many have distant mets already from stomach ca
    30% or 1/3
  33. which lymphnodes are involved with stomach ca
    • greater and lesser curvature
    • splenic
    • celiac
    • hepatic
  34. What is the direct spread of stomach ca
    • bowel
    • omenta
    • pancreas
    • colon
    • regional nodes
  35. Where in the blood does stomach ca spread to
    • # 1 LIVER
    • lung
  36. What is the 5 year survival rate for stomach ca
  37. When is surgery a good option for stomach ca and what are the complications
    • When no mets are present
    • complications
    • infection
    • hemorrhage
    • anemia
    • anastomis
    • PE
  38. What are treatment options for stomach ca
    • all modalities
    • surgery
    • radiation
    • chemo
  39. what field do you use to treat stomach ca and where
    Field extends from diaphragm to L3 including duodenal loop and regional lymph nodes
  40. what is the curative dose for stomach ca
    5000-5500 cGy
  41. What is the palliative dose for stomach ca
    3500-4000 cGy
  42. What is the curative dose for gastric lymphoma
    4000 cGy
  43. How do you postition a patient with treating stomach ca
    Supine with arms overhead
  44. What are the side effects for radiation in stomach ca
    • ulcers
    • fistula
    • decreased blood counts
    • bowel obstruction
    • transverse myelitis
  45. What are the critical structures to watch out for with stomach ca
    • kidneys
    • liver
    • bowel
    • cord
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