Chapter 5
the filling of the proximal pylorus "__________________"
"beak sign"
When diverticulosis becomes inflamed, it will take on a ________________ characteristic and be referred to as diverticulitis
"saw-tooth"
Infiltrating tumors aka ______________________
(linitis plastica)
The mesentery is a double fold of parietal peritoneum projecting from the posterior ___________________________ in the lumbar region in which most of the _________________ bowel is attached
-Abdominal wall -Small Bowel
There are transverse folds located within the rectum known as __________________________ as well as vertical folds called _______________________________
-Houston Valves -Rectal Columns
Esophageal strictures is linked mostly to __________________________, __________________________________, and ______________________________.
-Poor eating habits -Excessive alcohol intake -Smoking
A biopsy is small measuring about ______________________
1/2 centimeter or 1/4 in
Esophageal carcinomas give a poor prognosis with an overall 5-year survival rate of less than _________%
10%
Appendicitis can cause WBC count to elevate above ______________________
11,500
Ulcerative colitis typically affects ___________________ year olds.
15-25
The small bowel consists of three portions: the duodenum, the jejunum, and the ileum which altogether measures approximately ___________________feet in length
21 - 22
The large Bowel averages _________________ feet in length. It extends from the terminal ileum to the anus.
5 - 6 feet
Esophageal carcinomas account for _______% of the cancers of the GI system
7%
______________________ is a neuromuscular abnormality of the esophagus that results in the failure of the lower esophageal sphincter of the distal esophagus to relax, leading to dysphagia.
Achalasia
___________________________ is the most common type of colorectal cancer and is derived from the glandular epithelium of the colon
Adenocarcinoma
The esophagus lies ____________________ to the spine and descending aorta
Anterior
________________________ of the stomach are uncommon and account for only 10% of all stomach tumors
Benign tumors
________________________is useful in evaluating retroperitoneal and omental metastases from carcinoma of the digestive tract
CT imaging
On an UGI, the scarring from peptic ulcers produces the classic radiographic appearance of a "_________________" or "___________________" deformity
Clover leaf or trefoil cap
Chrons disease (Regional Enteritis) may take on a _________________________________ appearance
Cobblestone
________________________ is a congenital failure of the development of the distal rectum and anus, which may occur to a variable extent
Colonic atresia
___________________________ are associated with hypertrophy of the muscular layer of the bowel
Colonic diverticula
_________________________ are small masses of tissue arising from the bowel wall to project inward into the lumen
Colonic polyps
Regional enteritis aka __________________________or _________________________________
Crohn's disease or granulomatous colitis
____________________ is the condition of having diverticula without inflammation. It can be seen in all parts of the colon, but most often in the sigmoid colon by 95%.
Diverticulosis
Peptic ulcers that develop in the duodenal bulb or near the pylorus are called _______________________________
Duodenal Ulcers
They display spike-like wheels of mucosal folds that run to the edge of the crater
Duodenal Ulcers
_____________________________ are more common than gastric ulcers and are almost never cancerous.
Duodenal Ulcers
A KUB will demonstrate the "double-bubble" sign where the gas-filled stomach and the duodenum are completely separated. This is indicative of ______________________________
Duodenal atresia
________________________ is a condition involving the absence of the lumen between the stomach and duodenum resulting in a complete obstruction
Duodenal atresia
______________________________ generally form just above the diaphragm.
Epiphrenic diverticula
_________________________ is a congenital absence or closure of a normal body orifice or tubular organ
Esophageal atresia
the incomplete development of the esophagus at any given point is ____________________________
Esophageal atresia
Devices, such as a Hurst and Maloney dilators and pneumatic balloon dilators, are used to expand the structure to fix ____________________________________
Esophageal strictures
A frequent complication for Colonic Atresia is __________________formation to the genitourinary system, which often can be repaired surgically
FIstula
A ________________________ is a useful nuclear medicine exam to demonstrate GI bleeding and help direct angiographers to the site of bleeding if therapeutic intervention is to be performed
GI bleed scan
air in the biliary tree
Gallstone ileus
_____________________ is the inflammation of the mucosa of the stomach
Gastritis
Chronic alcoholism and the excessive intake of analgesics, along with excessive smoking and malnutrition cause __________________________
Gastroenteritis
___________________________ represents a number of inflammatory disorders of the stomach and intestine
Gastroenteritis
________________________can also be given to relax the stomach musculature.
Glucagon
The esophagus, or ______________, is a vertical tube, which extends from C-6 to T-11 (25 cm or 10 to 12 inches).
Gullet
The pouches that are formed by the puckering of the teniae coli are called ____________________
Haustra
Urea breath tests are performed on patients with gastric ulcers to identify the presence of _______________________
Helicobacter pylori
___________________________ is the protrusion of the stomach through an incompetent cardiac sphincter in the left hemi-diaphragm.
Hiatal hernia
_______________________________ is a congenital disease caused by the congenital absence of neurons in the bowel wall that prevent peristalsis causing an impaired evacuation of stools.
Hirschsprung's disease (aka congenital aganglionic megacolon)
_______________________________________ occurs four times more often in male children; most often in first -born male children.
Hypertrophic Pyloric Stenosis (HPS)
________________________________________ is a narrowing of the pyloric canal caused by hypertrophy (thickening) and hyperplasia of the pyloric sphincter
Hypertrophic Pyloric Stenosis (HPS)
_________________________ is a congenital discontinuation of the ileum
Ileal atresia
__________________________ is the most frequent type of bowel atresia.
Ileal atresia
The esophagus lies ______________________ to the pharynx
Inferior
____________________________________ spread within the walls of the stomach causing thickening of the walls and fibrous tissue production
Infiltrating tumors (linitis plastica)
Radiographs will show a coiled spring appearance
Intussusception
Benign tumors are almost always _________________________, which are smooth-walled muscle tumors of the esophagus
Leiomyomas
___________________________ are marked ragged in appearance as opposed to the smooth margins of a benign stricture
Malignant Esophageal strictures
________________________exists when the intestines are not in their normal position.
Malrotation
This type of lesion contains all of the muscular layers of the bowel wall. __________________________________
Meckel's Diverticulum
______________________________ is characteristic of having a congenital diverticulum found in the distal ileum
Meckel's Diverticulum
giant hypertrophic gastritis, otherwise known as ______________________________
Menetrier's disease
Appendicitis is an inflammation of the vermiform appendix resulting from an obstruction caused usually by a fecalith (arrows) or _______________________
Neoplasm
Routine views taken after fluoroscopy would include a _____________ and _________________
PA RAO
A ________________________will demonstrate the entire stomach and the duodenal bulb.
PA stomach
_________ has been proven to demonstrate approximately 20% of all the esophageal cancerous lesions undetected by CT
PET
_________________________ are the least malignant of the three types of stomach tumors
Papillary (fungating) tumors
_______________________________ are polypoid masses projecting into the stomach lumen
Papillary (fungating) tumors
Radiographically, gas is visible in the colon revealing a "step ladder" appearance.
Paralytic ileus
Drugs, aspirin, steroids, and smoking can cause ___________________________ to develop.
Peptic ulcers
___________________________ are erosions of the mucous membrane of the lower end of the esophagus, stomach, or duodenum
Peptic ulcers
The esophagus lies _____________________ to the trachea and heart
Posterior
Taeniae cause a ________________________ effect of the walls of the cecum and colon
Puckering
The two primary types of esophageal diverticula are __________________ and ___________________.
Pulsion and Traction
It appears radiographically as a rounded projection with a narrow neck and occurs more frequently in the upper and lower thirds of the esophagus.
Pulsion diverticula
____________________________ involves only the mucosa and results from a motility disorder of the esophagus that allows the mucosa to herniate outward
Pulsion diverticula
An ___________________ to highlight the pyloric canal and duodenal bulb
RAO Stomach
The patient will complain of RLQ cramping, nausea, and diarrhea
Regional enteritis (aka Crohn's disease or granulomatous colitis)
Varices appear as lucent, tortuous wave-like filling defects or "____________________" on radiographic images when demonstrated in the recumbent position
Rosary beads
hypertrophied pyloric muscle on the barium-filled antrum "_____________________" sign
Shoulder Sign
Regional enteritis (aka Crohn's disease or granulomatous colitis) affects all layers of the ___________________________.
Small bowel
______________________________ represent fewer than 5% of all benign and malignant GI neoplasms
Small-bowel tumors
Strictures caused by Regional enteritis may take on a "____________________" appearance.
String Sign
A _____________________________diverticulum occurs more frequently in the middle third of the esophagus at the carina and appears radiographically as a triangle whose apex points toward the disease.
Traction diverticula
They are triangular in shape with the apex pointing towards the diseased area.
Traction diverticula
____________________________ occur from scarring from an adjacent inflammatory disease such as TB
Traction diverticula
Regional enteritis (aka Crohn's disease or granulomatous colitis) affects males more often than females. True or False?
True
An ____________________________ is performed to evaluate the stomach for its contour, position, rugae, and peristaltic changes as it fills and empties
UGI (upper gastrointestinal series)
_________________________ show ragged edges very similar to benign ulcers
Ulcerating tumors
____________________________have a predilection for areas of the stomach near the greater curvature and the pylorus
Ulcerating tumors
___________________________ is an inflammatory lesion of the colonic mucosa
Ulcerative colitis
_________________________________ Radiographs will reveal the large bowel to have pseudopolyps, "lead pipe," or "stove pipe" appearance
Ulcerative colitis
_____________________ tests are performed on patients with gastric ulcers to identify the presence of Helicobacter pylori
Urea breath
_________________ are dilated tortuous (varicosed) veins occurring more frequently in alcoholics with portal venous hypertension and secondary to cirrhosis of the liver
Varices
The colon will take on the "beak sign" or "bean-shaped" sign.
Volvulus
__________________________ patterns are also common to esophageal varices.
Worm tracing
___________________ diverticulum results from increased intraluminal pressure caused by cricopharyngeal muscle spasm, which has been linked to gastroesophageal reflux
Zenker
Regurgitation of partially digested food should alert the clinician to the possibility of a ____________________________
Zenker diverticulum
The visceral peritoneum is attached to the __________________________________
abdominal organs
the parietal peritoneum is attached to the ________________________________
abdominal wall
radiographically, the esophagus appears to be smooth and dilated with a narrowing of the distal end producing the classic "beaked" appearance
achalasia
Esophageal carcinomas at the gastroesophageal junction are typically _________________________
adenocarcinomas
Radiographically, __________________________ will appear as infiltrating lesions with irregular narrowing of the lumen with abrupt, asymmetric borders.
adenocarcinomas
Stomach cancers or malignancies are mostly _______________________________
adenocarcinomas
___________________polyps pose a greater risk of malignancy
adenomatous polyps
The ________________________________ polyp is a tumor of benign neoplastic epithelium that can undergo dysplastic changes to become malignant
adenomatous-type
Volvulus is most common in ____________, where it occurs with equal frequency in small intestine and colon.
adults
Treatment of Intussusception can be the administration of a ________________________________.
barium enema
Squamous cell carcinomas most commonly arise in the _____________ of the esophagus
body
The ___________________________ is the opening of the esophagus into the medial superior aspect of the stomach.
cardiac orifice
A __________________ can be used for the removal of polyps in the GI lab but must be monitored closely after the procedure.
colonoscopy
Hirschsprung's disease aka _______________________________________
congenital aganglionic megacolon
Polyps are more commonly found in the ________________________________ mostly in the rectal-sigmoid area.
descending colon
Both the stomach and gastroesophageal junction will bulge through the hiatus causing the patient to have chest and abdominal pain, which will mimic a heart attack. This is an example of a _____________________________ hernia.
direct or sliding hiatal
The _____________________________hernia represents the majority of the hiatal hernias
direct or sliding hiatal
A _____________________________ study is essential for diagnosing Papillary (fungating) tumors at the earliest possible stage.
double contrast
The ___________________________ is indicated by its transverse rigid appearance
duodenal mucosa
Most small-bowel cancers occur in the _________________________ and ______________________.
duodenum and proximal jejunum
The chief complaint from most patients undergoing a traditional esophagram is _____________________
dysphagia
The _______________________ is the opening where the esophagus pierces the diaphragm in the thoracic cavity.
esophageal hiatus
Diverticulosis is more common in persons living in developed nations in which the usual diet has less ______________
fiber
Mechanical type bowel obstruction is usually caused by _______________________
fibrous adhesions
The stomach has a ___________________ which is to the left and above the opening from the esophagus
fundus
Peptic ulcers that develop in the lesser curvature of the stomach are known as __________________________
gastric ulcers
Esophageal adenocarcinomas usually occur in the lower esophagus around the __________________________________ in which a history of Barrett's esophagus precedes development in many cases
gastroesophageal junction
The __________________________is a double fold of the peritoneum that attaches to the duodenum, stomach, and transverse colon
greater omentum
Hernias usually occur at the _____________ and ___________________
groin and umbilicus
Rectal columns can eventually enlarge and dilate to become ___________________________
hemorrhoids
A _____________ is a loop of bowel that pushes its way through a weak spot in the abdominal wall
hernia
The ileum or third portion of the small bowel terminates at the __________________________ of the cecum
ileocecal valve
If the herniation becomes stuck and cannot be reduced, it is an __________________________________ which can result in a bowel obstruction
incarcerated hernia
The ______________________ is the angular notch along the lesser curvature of the stomach.
incisura angularis
An _________________________, which is common in men, occurs when a bowel loop protrudes through a weakness in the inguinal ring and descend downward into the scrotum.
inguinal hernia
The ___________________________appears delicate and feathery.
jejunal mucosa
Infiltrating tumors (linitis plastica) is associated with a ______________________ appearance
leather bottle
The _______________________________ is a fold of peritoneum that attaches the liver to the lesser curvature of the stomach and the duodenum.
lesser omentum
The terminal end of the duodenum is suspended by the ______________________
ligament of Treitz
gas confined to the small bowel with multiple air and fluid levels visible on an erect abdominal radiograph indicates a __________________________________
mechanical obstruction
When the classic "_________________" sign of hypertrophied pyloric muscle is palpated, the diagnosis of HPS can be made clinically, and the patient can be sent to surgery without the need for imaging examinations.
olive
The three types of stomach tumors are : ____________________________, ___________________________, ___________________________,
papillary (fungating) tumors, ulcerating tumors, and infiltrating tumors
The __________________________ hernia is life threatening because of the risk of volvulus, incarceration, or strangulation of the hernia
paraesophageal
The ______________________________________ is less common and has only a portion of the stomach sliding above the diaphragm leaving the gastroesophageal junction in place
paraesophageal or rolling hiatal hernia
gas distributed throughout both the large bowel and the small bowel is indicative a ____________________________
paralytic ileus
a _______________________ image is taken to visualize colon contraction and demonstrate mucosa
post evacuation
A Zenker diverticulum is a ___________________ type found at the pharyngoesophageal junction at the upper end of the esophagus
pulsion
Epiphrenic diverticula are a ____________-type diverticulum
pulsion
Infiltrating tumors (linitis plastica) begin growth near the _____________ and continue upward into the fundus
pylorus
Seventy-five percent of the cases diagnosed with ulcerative colitis are usually found in the _______________________ area causing a rigid bowel wall
rectosigmoid
Hernias are also known as ______________
ruptures
Malignant Esophageal strictures will usually show a sharply outlined "_______________" of tissue at the point where normal tissue meets diseased tissue.
shelf
Having diverticulosis in the _____________ bowel is less common
small
The _________________________________ is performed in timed intervals to determine GI motility and any other abnormalities involving the small bowel
small bowel follow through
In very young children, volvulus almost always happens in the _____________________________.
small intestine
The ____________________ initiates the digestion process
stomach
the entire elongated pylorus ("_______________________") as barium trickles through the narrowed pyloric canal.
string-sign
The large bowel has three bands of muscle running its length called ______________________________________
teniae coli (taeniae)
Most cases of Regional enteritis occur in the _________________________
terminal ileum
the rectum is extraperitoneal, beginning at the __________________ sacral segment and following the sacrococcygeal curve to the anus.
third
If Hirschsprung's is left untreated, it can progress to ___________________________
toxic megacolon
Usually, a ______________________________ is coincident with atresia
tracheoesophageal fistula
Shunts such as ___________________________________ can be applied to help redirect liver blood flow reducing portal hypertension and easing venous pressure in the esophageal and gastric collateral circulation.
transjugular intrahepatic portosystemic shunts (TIPS)
Patients with Meckel's Diverticulum are usually asymptomatic however they can result in abdominal pain near the _______________________
umbilicus
Multidetector CT (MDCT) units, in combination with oral contrast and gas distention of the colon, have the capability to perform a noninvasive endoscopic procedure called _______________________________
virtual colonoscopy
