DMS 102 - Unit 4 - Part 2

Slides 16-35

What are the layers of bowel inner to outer

• Mucosa ​

  • inner layer​

• Submucosa​

• Muscularis Propia​

• Serosa​

• Mesothelium ​

  • Outerlayer/peritoneum

Most inner layer of bowel

mucosa

most outerlayer of bowel

mesothelium

What layers of bowel are echogenic

1,3,5

what layers of bowel are hypoechoic

2 and 4

If you fill GI with water

it is easier to see the walls

Wall of GI tract measurment

< 5 mm

Wall of GI tract measurement if distended

< 3 mm

How to measure wall if GI

echogenic core to outer border of anechoic halo

Antrum can look like

pseudo kidney

Fluid filled stomach:

• thin uniform wall

• Peristalsis

Peristalsis meaning

contents are moving

If it is mass it wont

move

If you find a cystic mass in the LUQ what should you do

• Determine if stomach or other mass​

  • Watch for changes in shape, size, peristalsis​

  • Change positions – decubitus, upright​

  • Watch for peristalsis

Gas or fluid filled duodenal cap can

make the pancreas head look like is has a mass

the duodenum is to the right of the

pancreatic head

The duodenum may be outlined…

• with water​

• Change in position - RLD​

• Look for peristalsis

Small bowel has

valvulae conniventes and Ileum

What are valvulae conniventes

• Divets in small bowel ​

• Linear echo densities​

• Spaced 3 to 5 mm apart​

• “Keyboard” sign

Ileum has

smooth walls

Terminal Ileum is identified by

medial location to cecum​

• tubular appearance​

• small caliber​

• Smooth, thin, hypoechoic muscular wall​ that is 1-2 cm

The veriform appendix is

A remnant of what was originally the apex of the cecum

What is a good starting point for visualizing the appendix

McBurney's Point

Where do you find McBurney's Point

half way between hip and umbalicus

Measurements of vermiform appendix

length: 2-20 cm

Diameter: < or equal to 6 mm

Wall: < or equal to 2mm

Colon is identified by

Haustra Markings

Haustra markings are normally _____ apart

3-5 cm

Normal wall thickness of colon

4mm

Layers of Colon and appendix

1&2 - mucosa

3 - submucosa

4 - muscularis propria

5 - subserosal fatty tissue (outside)

If the colon is dilated

measure from fluid to outside wall

Distention considered adequate in the stomach if

diameter > 8 cm

Distention considered adequate in the small bowel is

> 5 cm

Distention considered adequate in the colon if

> 5 cm

Entire halo of colon should measure

< 2 cm

Most of the digestion & absorption of food takes place where in the GI tract?

Small bowel

Markings in the colon that distinguish them from small bowel are called

haustra