The document provides an overview of the radiologic anatomy of the mesenteric small bowel. It discusses the embryology and development of the small bowel. The anatomy of the small bowel is then described, including its length, attachments, blood supply, and lymphatic drainage. Various imaging modalities for evaluating the small bowel are reviewed, such as plain films, ultrasound, barium studies, CT, MRI, and nuclear medicine scans. Specific techniques for barium studies, enteroclysis, CT enterography, and MRI enterography are outlined.
Radiology ----Classical Signs in GIT Dr. Muhammad Bin Zulfiqar.
It is very difficult to learn much in the sea of radiology.
This presentation is the way to memorize classical signs in radiology.
Radiology ----Classical Signs in GIT Dr. Muhammad Bin Zulfiqar.
It is very difficult to learn much in the sea of radiology.
This presentation is the way to memorize classical signs in radiology.
Learn Barium Meal & Follow Through for the beginners from a Radiology Resident.For some image description please go through the text book "David Sutton" because i have described these image during my presentation Verbally..There are many animations used inside this presentation so to see all the pictures which are placed layer by layer with the help of animations you simple need to download this presentation first.... Thanx.
Anatomy of the stomach
Brief history of gastric surgery
Indications of Gastrectomy
The different types of gastrectomies.
The various reconstructions following a gastrectomy
Post Gastrectomy syndromes
1. Obstructive ileus is a condition characterized by a blockage in the intestines. 2. Ileus obstructive refers to a situation where there is a hindrance in the normal flow of the intestines. 3. The term obstructive ileus is used to describe a condition where there is an obstruction in the intestines, causing a disruption in the normal movement of food and fluids. Ileus refers to the intolerance of oral intake due to inhibition of the gastrointestinal propulsion without signs of mechanical obstruction. The diagnosis is often associated with surgery, medications, trauma, peritonitis, or severe illness. Mechanical obstruction has to be ruled out, and the diagnosis of ileus is dependent on radiographic evidence, usually on a CT scan or small bowel series. This activity reviews the evaluation and management of an Ileus and highlights the role of the interprofessional team in improving care for patients with this condition.
Objectives:
Identify the etiology of ileus.
Outline the typical presentation of a patient with ileus.
Review the management options available for ileus.
Identify interprofessional team strategies for improving care coordination and outcomes in patients with ileus.
Access free multiple choice questions on this topic.
Go to:
Introduction
Ileus, also known as paralytic ileus or functional ileus, occurs when there is a non-mechanical decrease or stoppage of the flow of intestinal contents.[1][2] Bowel obstruction is a mechanical blockage of intestinal contents by a mass, adhesion, hernia, or some other physical blockage. These two diseases may present similarly, but treatment can be very different depending on the underlying pathology.
Ileus is an often unavoidable consequence of abdominal or retroperitoneal surgery, but can also be found in severely ill patients with septic shock or mechanical ventilation. Due to the delayed refeeding syndrome seen after an ileus, postoperative ileus has a large economic impact in the United States alone.[3] An ileus usually manifests itself from the third to the fifth day after surgery and usually lasts 2 to 3 days with the small bowel being the quickest to return to function (0 to 24 hours), followed by the stomach (24 to 48 hours), and lastly the colon (48 to 72 hours).[2][4][5] A prolonged ileus is diagnosed if the ileus exceeds 2 to 3 days with the continued absence of obstruction signs.[6]
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Etiology
The cause of ileus has yet to be clearly defined. There are, however, several risk factors that have been shown to increase the likelihood and endurance of an ileus.[7]
Prolonged abdominal/pelvic surgery
Lower gastrointestinal (GI) surgery
Open surgery
Retroperitoneal spinal surgery
Opioid use
Intra-abdominal inflammation (sepsis/peritonitis)
Peritoneal carcinomatosis
Perioperative complications (pneumonia, abscess)
Bleeding (intraoperative or postoperative)
Hypokalemia
Delayed enteral nutrition or nasogastric (NG) tube placement
The risk for an ileus is influenced by a variety of fx
Small intestine/Intestinal obstruction/crohns disease/ileostomy/viscous organ...RajeevPandit10
all about small intestine, anatomy, physiology, intestinal obstruction, crohns disease/ileostomy/viscous organ perforation, meckels diverticulum, mysenteric ischemia, short bowel syndrome, celiac disease
various congenital gastrointestinal diseases manifesting in childhood or even in adults, their radiographic findings on various imaging modalities such as radiograph, barium, ultrasound etc.
Barium meal ppt presentation is very important for radiology resident , radiologist and radiographers. this slide contents lots of barium image and technique, position, indication and modification and lots of information. this presentation help alot thanks .
congenital anomalies of intestine ppt.pptxNoorHashmee
this ppt consist four congenital anomalies of intestine
duodenal atresia
Meckel's diverticulum
jejunal atresia
midgut malrotation
may be helpful for nursing students
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
3. Development of the small bowel
• Development of the midgut is
characterized by rapid elongation of the
gut and its mesentery, resulting in
formation of the primary intestinal loop
• physiological umbilical herniation
starting at sixth week
3
5. • Coincident with growth in length,the primary intestinal loop
rotates around an axis formed by the SMA
• Rotation occurs during herniation (about 90◦) as well as during
return of the intestinal loops into the abdominal cavity
(remaining 180◦)
• During the 10th week, herniated intestinal loops begin to return
to the abdominal cavity
5
8. Anatomy of mesenteric small
intestine
• Begins at duodenojejunal flexure & ends at ileocaecal junction
• 3-10m in length , average ~6.5 m
• jejunum comprising the proximal 2/5 & ileum distal 3/5
• attached to the posterior abdominal wall by its own fan shaped
mesentery extending obliquely from the ligament of Treitz, just
left of the L-2 vertebra, to the cecum, near the right sacroiliac
joint
• root of the small bowel mesentery allows the passage of
vessels ,lymphatic's & nerves
8
15. Imaging modalities
• Plain film
• Ultrasound
• Barium study
• CTscan
• MRI
• Nuclear medicine studies
• Angiography
15
16. Plain Abdominal film
•Are routinely performed ,widely available & cheap
•Indications are
perforation
small bowl obstruction
radiopaque foreign body
bowl infarction
mid gut volvulus
intussuption
16
21. Ultrasound
•Gas content within the gut lumen can make visibility difficult
• allows assessement of content , diameter & motility of GIT
•Ultrasound is superior to both CT & MRI for resolution of the gut wall
layers
•Normal gut is compressible and gas pockets displaced away
from the region of interest
• thickened abnormal bowel loops are non compressible &
remain unchanged
•The normal gut wall is uniform with an average thickness of
3mm if distended & 5mm if not distended
21
25. Barium study
• Barium studies remain the cornerstone of small bowel
imaging
• And still provide the best radiological assessment
when subtle alterations of mucosal morphology are
being sought
• Provide information about small bowel caliber , its
disposition , the wall thickness , and distribution of the
valvulae conniventes. 25
26. SMALL BOWEL FOLLOW-THROUGH
single contrast examination of the esophagus,
stomach, and small intestine
Indications
ü strictures
ü Partial obstruction
ü diverticula
ü masses
ü extraluminal tethering
ü Malabsorption 26
27. Contraindications
1.Complete or high-grade obstruction.
üThis is usually better evaluated by CT
examination (without oral contrast) using the
intraluminal fluid caused by the obstruction as
a natural contrast agent.
2.Suspected perforation (unless a water-
soluble contrast medium is used).
27
28. preparation
• Patient preparation
üfasting after midnight the day before the
examination.
• Equipment
ü500–1000 ml of low-density barium (28–42%
w/v) designed for the small intestine
üMetoclopramide 20 mg oral or IV
üpalpation pad with leaded glove
28
29. Technique
First, a single contrast upper GI is performed.
After this, the patient drinks an additional 1-2 cups and
waits outside the fluoroscopy suite.
After 15-30 minutes, a spot radiograph of the abdomen
is obtained and the patient is re-evaluated with
fluoroscopy.
A spot radiograph with fluoroscopic re-evaluation is
continued every 15-45 minutes until the enteric contrast
reaches the terminal ileum and enters the ascending
colon.
29
30. • prone position is used because the pressure
on the abdomen helps to spread out bowel
loops.
• paddle palpation
• Normal small bowel transit ranges between
30-120 minutes.
30
32. Per-oral pneumocolon
• technique that can be used during SBFT
to better visualize the ascending colon and
terminal ileum
• gas (ideally CO2) is insufflated into the
colon through the rectum in the majority of
patients(85-90%), the gas refluxes through
the ileocecal valve into the terminal ileum
• to create a double contrast
32
33. Limitations of the SBFT
• overlap of bowel loops,
• poor distension,
• flocculation of barium,
• intermittent barium filling, and
• unpredictable transit time
– little control over the degree of small bowel
filling and distention
– less severe strictures and small masses may
be difficult to see 33
34. Small bowel enema (enteroclysis )
• The study is performed by passing a specially
designed 12 to 14 French enteroclysis catheter
through the mouth or nose and into the distal
duodenum or proximal jejunum
• performed in one of three main ways:
1.single-contrast enteroclysis: low density barium (20-
40% w/v),volume of 600-1200 mL at an initial rate of
75 mL/min
2.air-contrast enteroclysis: medium density barium
(40-80% w/v),volume of 300-600 mL
ü Room air or CO2 is introduced via a pump when the barium
column reaches the distal small bowel
34
35. 3. methylcellulose enteroclysis: high density
barium (80% w/v),
ü volume of 220-300 mL of barium infused at 60-80
mL through a syringe until half of the expected
intestinal loops are visualized.
ü 1000 mL of Methylcellulose is instilled through an
electric pump
ü Enteric contrast coats the bowel wall and
methylcellulose distends the small bowel
35
36. enteroclysis cont..
Advantage
– Is more sensitive study for detail small bowel examination
– provides more uniform distension of the bowel, even
distribution of barium, superior anatomic detail, and shorter
overall examination time
Disadvantage
– substantial discomfort associated with tube placement
– Patients preparation is extensive, requires jejunal
intubation, laxative,???sedation
– Need skilled radiologist for intubation 36
38. CT and MRI enterography
• Improves up on barium study by demonstrating extra luminal
compartment, mesentery, solid organs, peritoneum &
retroperitonium
• MRE is used mostly in the initial diagnosis and follow-up of
inflammatory bowel disease; CTE is used for small bowel
lesions
• Contrast administration can be performed perorally (i.e., CT /
MR enterography) or by infusion via nasoenteric intubation
(i.e., CT/MR enteroclysis)
• Neutral or positive oral contrast can be used
38
39. CT enterography cont..
• Patients drink approximately 1.5–2 L of oral contrast over
45–60 min
• 150 ml of Iohexol (Omnipaque 300) administered intravenously
• Neutral or low-density oral contrast media are a prerequisite
for good-quality CT enterography
ü Water–methylcellulose solution,
ü lactulose solution,
ü polyethylene glycol,
ü low-density barium, 0.1% w/v Volumen and
ü milk
39
42. Nuclear medicine studies
• are useful alternative and adjunctive methods in
the investigation of small bowel pathology
üinflammatory bowel disease
ülocalisation of intestinal bleeding
üMeckel’s diverticulum
üCarcinoid tumours of the small bowel 42