Digestive System
Digestive Glands

Normal GI Anatomy:
Sequential parts of the ___ ___ include the mouth, pharynx,
esophagus, stomach, small intestine, and large intestine
Three types of accessory ___ ___ - the salivary glands, liver
and pancreas - secrete digestive juices into the digestive system

Digestive; 8
Gastrointestinal tract

Normal GI Anatomy: The ____ or alimentary tract is a tube, __m long,
extending from the ___ to the anus
The ___ ___ is the part of the digestive system that is below
the diaphragm

Pharynx
Sphincter

Normal Anatomy - Esophagus:
Extends from the ____ through the thoracic cavity and diaphragm
and empties into the ____
Lower end acts as a ____; the entrance to the stomach is
generally closed

Muscular
Lesser and greater
Fundus, body and pylorus

Normal Anatomy - Stomach:
Large, smooth, ____ organ
Two surfaces: the ____ and _____ curvatures
Three parts: ____, _____ and _____

5; 4
Duodenum, jejunum, and ileum
Large intestine

Normal Anatomy - Small Intestine:
Long, coiled tube that measures approx. ___m long and ___cm in diameter
Three parts: ____, ____, and ____
Ileocecal orifice marks the entry into the ___ ____

Larger; smaller
Vermiform appendix, cecum, rectum and anus

Normal Anatomy - Large Intestine:
____ in diameter and ___ in length than the small intestine
Five parts: ___ ___, ____; ascending transverse and descending
colon; ____ and ____

Gastric; phrenic
Varices

Vascular Anatomy - Esophagus:
___ branch of the celiac axis and the left inferior ____ artery
of the abdominal aorta supply the lower end of the esophagus
___ may be seen to rise from the gastroesophageal arteries

Subclavian
Thoracic aorta

Vascular Anatomy - Esophagus:
Inferior thyroid branch of the ____ artery supplies the upper esophagus
Decending ___ ___ supplies the midesophagus

Gastric; pyloric; hepatic; splenic; gastric
Venous

Vascular Anatomy - Stomach:
Vascular supply is provided by the right ___ arterial branch,
____ and right gastropiploic branches of the ____ artery, left
gastroepiploic branch and vasa brevia of the ____ artery, and left
____ artery
_____ system parallels the arterial system and empties into the
portal venous system

Celiac axis; gastric; pancreaticoduodenal
Superior mesenteric; pancreaticoduodenal; ileal

Vascular Anatomy - Small Intestine:
The ___ ___ supplies the duodenum through its right ____,
gastroduodenal, and superior _____ branches
The ___ ____ artery has multiple branches to the small bowel,
which include the inferior _____, jejunal and ____ arteries

Mesentery; vessels, nerves, and lymphatic

Vascular Anatomy - Small Intestine:
The ____ outlines the small intestine and contains the superior
mesenteric _____, ____, and ____ glands and fat between its two layers

Celiac, superior mesenteric, and inferior mesenteric
Ileocolic
Right Colic
Middle Colic

Vascular Anatomy: Large Intestine
The ____, ___ ___ and ___ ___ arteries supply both the small
& large intestine
The SMA branches:
____ artery ___ ____ artery ____ ____
artery

Inferior mesenteric; rectum; retroperitoneally
Left colic
Sigmoid
Superior rectal

Vascular Anatomy - Large Intestine: The ___ ___ artery supplies the
intestine from the left border of the transverse colon to the ____,
rising from the anterior surface of the abdominal aorta at the level
of the 3rd lumbar vertebra and descending _____.
Branches of the IMA:
___ ___ artery ___ artery ___ ___
artery

Wall; absorption
Liver; liver

Physiology of the GI Tract:
When the food particles are small enough, the nutrient molecules
pass through the ___ if the intestine into the blood or lymph system
by ____
The nutrients are transported to the ____ after being absorbed by
the blood; the ___ processes and stores these nutrients

Gastrointestinal tract
Digestion; absorption

Physiology of the GI Tract: The ___ ___ is the largest endocrine
organ in the body
____ and ____ are its main functions

Cells
Defecation
Rugae

Physiology & Labs of the GI Tract: The remaining nutrients in the
blood are transported to ___ throughout the body
The undigested and unabsorbed food is eliminated from the
digestive tract by the process of _____
When food enters the stomach, the ____ gradually smooth out;
caused the stomach to stretch and increase its capacity for food intake

Three; peristalsis
Mucus
Gastric; hydrochloric acid

Physiology & Labs of the GI Tract:
____ layers of smooth muscle in the stomach wall enable it to
mash and churn food and move it along with ____
Large amounts of ____ are secreted in the stomach
___ glands secrete gastric juice, which contains ___ ___ and enzymes

Chyme
Pylorus
Villi; villi; quickly

Physiology & Labs of the GI Tract: Food is converted into ___
This soupy mixture is moved toward the ____ and into the small intestine
The ____ within the small intestine increase its surface area
for digestion and absorption of nutrients; without ____, food would
move too ____ through the intestine for absorption

Intestinal; villi
Gastrin
Duodenum; bile; chyme

Physiology & Labs of the GI Tract: The ____ glands are found
between the ___ and secrete large amounts of fluid that serve as a
medium for digestion and absorption of nutrients.
The hormone, ____, which is released by the stomach mucosa,
stimulates the gastric glands to secrete
Most of the digestions occurs within the _____. ___ and enzymes
from the liver and pancreas are secreted into the duodenum to act on
the ____ and break down the food particles for absorption

Cholecystokinin; gallbladder
Secretin

Physiology & Labs of the GI Tract:
____ is released by the presence of fat in the intestine and
regulates ____ contraction and gastric emptying
____ is released from the small bowel to stimulate the
secretion of bicarbonate to decrease the acid content of the intestine

Blood in the stools
Anemia
White blood
Carcinoembryonic antigen

Physiology & Labs of the GI Tract: Most common lab: ____ in the ____
____ may also be present as a result of chronic blood loss
Infection would show elevation in ___ ___ count
Increase in the ____ ____is found in patients with inflammatory
bowel disease

Nausea, vomiting and diarrhea
Bowel abscess, diverticulitis, and appendicitis

Physiology & Labs of the GI Tract: Signs and Symptoms - ____,
____ & ____
Abdominal pain and fever may also be present with
gastrointestinal conditions such as colitis, ____ ___, acute ____ and _____

Mucosa
Submucosa
Muscularis
Serosa
Mesothelium

Bowel Layers: ____: directly contacts the intraluminal contents; is
lined with epithelial folds; is echogenic
____: contains blood vessels and lymph channels
____: contains circular and longitudinal bands of fiber
____: is a thin, loose layer of connective tissue
_____: covers intraperitoneal bowel loops

Echogenic
Gas; incomplete
Rim of lucency; echogenic

Sonographic Findings of the GI Tract: Intraluminal air produces an
____ shadow which prevents the sound bean from penetrating structures posteriorly
The scattering and reflection effect of ____ in the GI tract
often produces an ___ or mottled distal acoustic shadow
The ___ of ____ represents the wall, and its periserosal fat
produces the outer ____ border of the tract wall

Five
Odd
Even; 3; 5

Sonographic Findings of the GI Tract:
The bowel wall has ___ layers
The ___-numbered layers are echogenic
The ___-numbered layers are hypoechoic, with an average total
thickness of __mm (distended) or __mm (nondistended)

Gastroesophageal junction; aorta; liver; hemidiaphragm
Liver; gastroesophageal junction

Sonographic Findings of the GI Tract: Stomach -
The ____ ____ is seen on the sagittal scan to the left of
midline as a bull's eye or target-shaped structure anterior to the
___, posterior to the left lobe of the ___ and inferior to the ____
The left lobe of the patient's ____ must be large enough to be
able to image the ____ ____

Stomach

Cystic Mass in the LUQ: If the patient has a cystic mass in the LUQ,
determine whether the mass is the fluid filled ___ or another mass
arising from adjacent organs
Give carbonated drink to see bubbles in the stomach
Have nasogastric tube placed for drainage Watch for
change in the shape or size of the "stomach" mass with
ingestion of fluid Alter the patient's position
Watch for peristalsis Ask the patient to drink water to
see the swirling effect

4; Superior; pylorus; neck
Descending
Transverse
Ascending; jejunum

Duodenum: ___ parts ___ portion courses anteroposteriorly from the
____ to the level of the ___ of the gallbladder
A sharp bend in the duodenum into the ____ portion that runs
along the IVC at the level of L4
___ portion passes right to left with a sligh inclination
upward in front of the great vessels and crura
___ portion rises to the right of the aorta and reaches the
upper border at L4, where at the duodenojejunal flexure it turns
forward to become the ____

Ileum; 3
Peristalsis

Small Bowel:
The ___ is smooth-walled; the small bowel is under ___mm thick
When fluid is in the bowel loops, look for ____, air movement, or
movement of intraluminal fluid contents to rule out obstruction

Valvulae conniventes; 3-5
Keyboard

Small Bowel: Cannot usually be seen with sonography
The ___ ___ may be seen as linear echo densities spaced __ to __ mm apart
This is called the ____ sign and can be seen in the duodenum & jejunum