Digestive System Exam Questions

From Powerpoint

What is included in the digestive system?

Entire alimentary canal and several accessory organs

What are the primary functions of the digestive system?

• intake and digestion (breaks the food down)

• absorption (gives nutrition)

• elimination (any unused material in the form of waste)

What does the alimentary canal consist of?

• oral cavity

• pharynx

• esophagus

• stomach

• small intestine

• large intestine

• anus

Salivary glands

Secretes saliva to aid in digestion

What are the three salivary glands?

• parotid

• submandibular (submaxillary)

• sublingual

What is the largest salivary gland?

Parotid

What is the smallest salivary gland?

Sublingual

How much saliva is produced per day?

1000-1500 mL

Pancreas

Produces large amounts of digestive juices- endocrine (glucagon) and exocrine (secretes digestive enzymes)

Liver

Produces bile which assists in the digestion of fats

How much bile does the liver produce and what does it do?

1 qt for the digestion of fats

Gallbladder

Stores and concentrates bile

What is mastication?

Chewing

Mouth

Beginning of the alimentary canal and connects posteriorly with the pharynx

What are the structures of the mouth?

• upper and lower teeth

• hard and soft palates

• uvula

• tongue

Where is the pharynx located?

Posterior to the nasal cavity, mouth, and larynx, connects with the esophagus

What are the three parts of the pharynx?

• nasopharynx

• oropharynx

• laryngopharynx

Where is the nasopharynx located?

Behind the nasal cavity

Where is the oropharynx located?

Behind the oral cavity

Where is the laryngopharynx located?

Behind the larynx

When swallowing, in order for the food to enter the esophagus, what two things must occur?

• the soft palate closes off the nasopharynx to prevent food from regurgitating into the nose

• the epiglottis is depressed to cover the laryngeal opening (like a lid)

How big is the esophagus?

10 inches in length and ¾ of an inch in diameter

Where is the esophagus located?

Extends from the laryngopharynx to the stomach, located posterior to the larynx and the trachea

What are the two indentations on the esophagus?

Where it passes by the aortic arch and left primary bronchus

The esophagus passes through the diaphragm slightly to which direction?

Left

Cardiac antrum

After the esophagus passes through the diaphragm, this is the short segment of esophagus before it connects with the stomach

Esophagogastric junction or cardiac orifice

Opening between the esophagus and the stomach

Stomach

Located between the esophagus and the small intestine and serves as a reservoir for swallowed food

What are the three main divisions of the stomach?

• fundus

• body

• pyloric portion

Fundus

Superior portion of the stomach, in the erect position it is usually filled with air

Body of the stomach

Mid section, has folds call rugae

Pyloric portion of the stomach

Distal portion, has two parts: pyloric antrum, and pyloric canal

What is the area immediately surrounding the esophageal opening?

Cardia of the stomach

What is the muscle that controls the opening of the stomach

Cardiac sphincter

Pyloric orifice

Connects the stomach to the small intestine (opening)

Small intestine

Extends from the pyloric orifice of the stomach to the ileocecal valve where it joins with the large intestine

What section of the digestive system is where digestion and absorption occur?

Small intestine

What contains a series of finger-like projections called villi?

Small intestine

Villi

Help facilitate the process of digestion and absorption

What are the three sections of the small intestine?

• duodenum

• jejunum

• ileum

Ileocecal valve

End of the ileum and goes to the large intestine

What is the first part of the small intestine?

Duodenum

Duodenum

Shortest, widest, and most fixed portion of the small bowel

What organ is the duodenum closely related to?

Head of the pancreas

What are the four sections of the duodenum?

• First (superior)

• Second (descending)

• Third (horizontal)

• Fourth (ascending)

First (superior) portion of the duodenum

Duodenal bulb (or cap), common site of ulcer disease

Second (descending) portion of the duodenum

Longest segment, receives common bile and pancreatic ducts

Fourth (ascending) portion of the duodenum

Meets with the jejunum, termed duodenojejunal flexure

Where is the jejunum located?

Primarily to the left of midline in the LUQ and LLQs

What makes up 2/5ths of the small bowel?

Jejunum

Where is the ileum located?

Primarily in the RUQ, RLQ, and LLQ

What makes up approximately 3/5ths of the small bowel?

Ileum

The terminal ileum joins with the large intestine where?

Ileocecal valve in the RLQ

Does the diameter get smaller or larger from the duodenum to ileum?

Smaller

What is deglutition?

Swallowing

What is peristalsis?

Waves of muscular contraction

Chyme

Stomach contents mixed with stomach fluids

What are the radiographic procedures used for the alimentary canal?

• All use contrast medium

• All use fluoroscopy

• All take images after the fluoroscopic procedure is completed

What should be done to prep patients for upper GI exams?

• NPO 8 hours prior to study

• no gum chewing

• no smoking

• pregnancy?

What types of contrast medial are used to render the GI tract radiographically?

Radiolucent and radiopaque

What is included in radiolucent (or negative) contrast media?

Swallowed air, CO2 gas crystals, and the normally present gas bubble in the stomach

What is included in radiopaque (positive) contrast media?

Barium sulfate, and a water-soluble iodinated type called gastroview or gastrograffin

When should barium sulfate not be used?

If there is any chance that the mixture might escape into the peritoneal cavity (can harden and cause issues)

What type of contrast technique is typically used?

Double contrast

Barium Sulfate

• postive or radiopaque

• chalk-like substance

• absorbs more x-rays

• BaSO4

What is the ratio used for thick barium?

3 or 4:1 ratio of BaSO4 to water

What is the ratio used for thin barium?

1:1 ratio of BaSO4 to water

What are the four main procedures that are done to visualize the upper GI tract?

• esophagram (barium swallow)

• modified barium swallow (video swallow)- all you do is record exam

• upper GI

• UGI with a small bowel follow through

What is the purpose of the esophagram study?

Study the form and function of the pharynx and esophagus

What is the purpose of the upper GI study?

Study the form and function of the distal esophagus, stomach and duodenum

If your patient is tall and thin where are their organs?

Down and in

If your patient is short and stout where are their organs?

Up and out

Where are the stomach and large intestines located on a hypersthenic patient?

• stomach: high and transverse

• duodena; bulb/GB: T11-12

• large intestine: widely distributed

Where are the stomach and large intestines located on a sthenic patient?

• stomach: J-shaped

• duodenal bulb/GB: L1-2

• large intestine: L colic flexure high

Where are the stomach and large intestine located on a hyposthenic/asthenic patient?

• stomach: J-shaped and low

• duodenal bumb/GB: L3-4

• large intestine: low near pelvis

What should your kVp be set at for the UGI and esophagram studies?

110-125

Where is the barium located when your patient is prone?

Fundus is in the highest position causing the air to go to the fundus

Where is the barium located when your patient is supine?

The funds is at its lowest point, so this is where the barium settles

Where is the barium located when your patient is erect?

Air rises into the fungus, the air-barium line tends to be in a straight line

Where is the large bowel located?

Starts in the RLQ and it extends around the abdominal cavity and sends at the anus

What are the four parts of the large intestine?

• cecum

• colon

• rectum

• anal canal

Cecum

Located at the proximal end of the large bowl, it is a large pouch located inferior to the ileocecal valve, widest portion of the large bowel

What does the appendix attach to?

Cecum

What are the parts of the colon?

• ascending colon

• right colic (hepatic flexure)

• transverse colon

• left colic (splenic flexure)

• descending colon

• sigmoid colon

Rectum

Extends from the end of the sigmoid colon to the anal canal

Where does the anal canal end?

As an opening to the outside, the anus

Rectal ampulla

Dilated portion of the rectum located anterior to the coccyx

What does the direction of the rectum closely follow?

The sacrococcygeal curve then bends sharply anteriorly and inferiorly into the anal canal

What are the three differences between the small and large intestine?

• large intestine is bigger

• small has villi

• relative location

Where will the barium go in the colon if your patient is supine?

Transverse colon and sigmoid colon are more anterior to the air will go to these spots

Where will the barium go in the colon if your patient is prone?

Into the transverse and sigmoid colon

What are the four primary digestive functions by small and large bowels:

• digestion- most occurs in small

• absorption- most occurs in small

• reabsorption- 95% small

• elimination- large

Enteroclysis

Double contrast small bowel series- catheter placed through nose and into the duodenum

Intubation method

Single contrast for small bowl study (small bowel enema)- trying to relieve a small bowel obstruction

Barium enema

Single or double contrast

Defecogram

Watching someone poop

What are some contraindications to BaSO4?

• presurgical patients

• perforated hallow viscus

• large intestine obstruction

What are some contraindications to water-soluble iodinated contrast media?

• young or dehydrated patients

• sensitivity to iodine

How would you do a small bowel only series?

• scout radiograph

• pt drinks 16 oz (2 cups) of BaSO4 (note time)

• 15-30 minute radiograph

• 30 minutes interval radiographs

• spot ileocecal valve (optional)

Where is your CR for a small bowel series for the 0, 15, and 30 minute mark?

2 inches above the crest