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