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LSS Alimentary System > 1 Introduction to the Gastrointestinal Tract > Flashcards

1 Introduction to the Gastrointestinal Tract Flashcards

1
Q

XQ: What are signs? Symptoms?

A

A: externally visible- detectable by someone other than the patient

internally experiences by the patient and impossible to detect by others

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2
Q

Q: Recall common signs and symptoms of general gastrointestinal disease. (4)

A

A: -malaise

  • rapid weight loss
  • anorexia
  • anaemia
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3
Q

Q: What is malaise? (2) Sign of?

A

A: sensation is non specific

feeling of being generally unwell from an indeterminable cause

general GI disease

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4
Q

Q: What can lead to rapid weightloss? (2) Describe it. Sign of?

A

A: -reduced energy intake secondary to infection or increased bowel motility
-usually unintentional and uncontrollable

general GI disease

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5
Q

Q: What is anorexia? characterised by? (2) Associated with? (4) Sign of?

A

A: eating disorder characterised by low BMI and malnutrition

  • distorted self image
  • regimented weightloss strategies
  • restricted energy intake
  • increased energy expenditure

general GI disease

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6
Q

Q: What is anaemia? characterised by? (3) Common causes? (4) Sign of?

A

A: blood disorder

  • characterised by reduced ability to carry oxygen
  • lower than normal number of normal sized erythrocytes
  • normal number of smaller sized erythrocytes
  • blood loss
  • pregnancy
  • nutrient deficiences
  • blood poisoning

general GI disease

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7
Q

XQ: What is the common wall structure of the gut? (5)

A

A: -gut lumen: hollow tube that food and fluid pass through

  • mucosa:
  • submucosa:
  • smooth muscle layers:
  • serosa:
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8
Q

Q: Recall common signs and symptoms of upper gastrointestinal disease. (10)

A

A: -haemoptysis

  • nausea
  • vomiting
  • belching
  • malaena
  • haematemesis
  • dysphagia
  • odynophagia
  • heartburn/acid regurgitation= form of chest pain
  • epigastric pain
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9
Q

Q: Recall common signs and symptoms of hepatobiliary disorders. (6) What is it?

A

A: -right upper quadrant pain

  • biliary colic
  • jaundice
  • dark urine
  • pale stool
  • ascites

Having to do with the liver plus the gallbladder, bile ducts, or bile

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10
Q

Q: What is haemoptysis? Sign of? (2)

A

A: coughing up blood

upper GI disease/respiratory

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11
Q

Q: What is melaena? Due to? How?

A

A: black tarry stool

usually due to upper GI bleeding that travels through GI tract

during transit the pigment is altered by gut flora, digestive enzymes and secretions which significantly changes its colour

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12
Q

Q: What is nausea? Sign of?

A

A: general sensation of queeziness with or without inclination to vomit

upper GI tract disease

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13
Q

Q: What is vomiting? AKA? In the form of blood? Usually associated with? Sign of?

A

A: rapid ejection of stomach contents (voluntary or involuntary) AKA emesis

haematemesis (specifically referring to vomiting blood)

nausea

upper GI disease

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14
Q

Q: What is dysphagia? Odynophagia? Sign of?

A

A: difficulty swallowing food/fluid

sensation of pain associated with swallowing food/fluid

upper GI disease

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15
Q

Q: What is heartburn? Cause? Sign of?

A

A: central burning sensation (form of chest pain)

acid regurgitation- stomach entering oesophagus-> mucosa there is not built to withstand this -> causes pain and damage

upper GI disease

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16
Q

Q: What is belching? cause? Can be a sign of?

A

A: excess air in stomach escaping through mouth due to gas and pressure building up in stomach

upper GI disease

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17
Q

Q: Where is epigastric pain? (2)

A

A: discomfort in central upper abdomen below where chest pain is usually perceived

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18
Q

Q: Where is most of the liver and gall bladder located? Pain here can be a sign of?

A

A: right upper quadrant pain

hepatobiliary disorders

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19
Q

Q: What is biliary colic? Cause? (2) Sign of?

A

A: type of collicky pain

gall bladder contraction against downstream obstruction eg gall stones / tumour

hepatobiliary disorders

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20
Q

Q: What is jaundice? (2) Cause? Sign of? (2)

A

A: yellowing of skin, sclera and mucous membranes
-increase in circulating bilirubin

  • liver failure
  • hepatobiliary disorders , upper GI disorder
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21
Q

Q: What can cause dark urine? Associated with? (2)

A

A: elevated conjugated bilirubin in urine

liver disease/hepatobiliary disorders

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22
Q

Q: What are pale stools a sign of? What causes the normal colour? How do you get pale stools? Sign of?

A

A: liver disease

presence of stercobilin in it- pigment arises from bilirubin that enters gut through bile secretion

if B doesn’t make it into the gut eg blockage then stercobilin concentration will down down and stool will become pale

hepatobiliary disorders

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23
Q

Q: What is ascites? Causes? (3) Sign of?

A

A: generalised fluid accumulation (oedema) (over 30mL) in the abdominal cavity

  • cancer
  • malnutrition
  • liver failure

hepatobiliary disorders

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24
Q

Q: Recall common signs and symptoms of mid GI tract disorders. (4)

A

A: -abdominal pain

  • steatorrhoea
  • diarrhoea
  • abdominal distention
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25
Q

Q: How is abdominal pain distinguished from chest pain?

A

A: chest pain is more superficial than abdo pain

26
Q

Q: What is steatorrhoea? Cause? Sign of? (4)

A

A: sloppy, oily faeces

excess fat in stool

usually sign of digestive failure- either from reduced lipase activity or reduced bile activity

mid GI tract disorder

27
Q

Q: What is diarrhoea? Sign of?

A

A: watery faeces

mid and lower GI tract disorder

28
Q

Q: What is abdominal distention? Causes? (3) Sign of?

A

A: larger abdomen

  • harmful excess gas in colon
  • ascites
  • abdominal tumour

mid GI tract disease

29
Q

Q: Recall common signs and symptoms of lower GI tract disorders. (5)

A

A: -abdominal pain

  • rectal bleeding
  • constipation
  • Diarrhoea
  • incontinence
  • Flatulence
30
Q

Q: Give 2 alternative names for the digestive system. What are the 2 main roles?

A

A: gastrointestinal, alimentary

  • digestion= process of breaking down macromolecules to allow absorption
  • absorption= process of moving nutrients and water across a membrane into blood and then into body
31
Q

Q: What are the components of the GI tract? (15)

A

A: parotid gland

  • sublingual gland
  • sub mandibular gland
  • oesophagus
  • stomach
  • liver
  • gal bladder
  • pancreas
  • jejenum
  • duodenum
  • ileum
  • appendix
  • colon
  • rectum
  • anus
32
Q

Q: Why is the GI tract considered an external environment?

A

A: it can all be accessed through sphincters, without crossing a membrane. For example, it is feasible (albeit impractical and ridiculous) to pass a single piece of string from the mouth to the anus

33
Q

Q: What does the mucosa include? (3) What can it also include? Result?

A

A: -lining epithelium= varies depending on part of gut

  • loose connective tissue = lamina propria, which provides vascular support for the epithelium, and often contains mucosal glands.
  • muscalaris mucosae

Products of digestion pass into these capillaries

34
Q

Q: What is the submucosa? What can it include? (4) What is the role of the final component? Regulates? (3)

A

A: loose connective tissue layer

  • larger blood vessels
  • lymphatics
  • can contain mucous secreting glands
  • Includes a rich network of nerves called the submucosal plexus, which regulates secretion, absorption and local perfusion

secretion, absorption and local perfusion

35
Q

Q: Describe the muscle in gut walls. Made of? (2) Role?

A

A: usually two layers; the inner layer is circular, and the outer layer is longitudinal

layers of smooth muscle are used for peristalsis (rhythmic waves of contraction), to move food down through the gut

36
Q

Q: What is the serosa? AKA? difference? What covers it? What does it contain? (3)

A

A: Outermost layer of loose connective tissue
-adventitia
=> s = found around gut elements that are loose and not attached to anything. a = tends to line things that are fixed to gut wall

covered by the visceral peritoneum

  • blood vessels
  • lymphatic vessels
  • nerves
37
Q

Q: How is lower GI bleeding distinguishable from upper GI bleeding?

A

A: lower= bright red colour, indicating that it hasn’t been in the GI system long enough to lose its oxygen and have its gas-carrying proteins broken down.

38
Q

Q: What is constipation? How does stool differ when passed? (2) Sign of?

A

A: reduced gut motility (which allows longer for water absorption (and dehydration of the faeces).

firmer and dryer than normal

lower GI tract disease

39
Q

Q: What is incontinence? What can cause it? (3) Sign of?

A

A: loss of voluntary control over the excretion of human waste, and can involve the bladder, the rectum, or both.

  • neural damage to the anal sphincters
  • mechanical damage to the sphincters themselves
  • associated diarrhoea that is too watery to retain

lower GI tract disease

40
Q

Q: What is flatulence? Sign of?

A

A: loudness, frequency or severity of smell and can often cause embarrassment.

lower GI tract disorder

41
Q

Q: Recall whole body common signs and symptoms of GI tract disorders. (4)

A

A: -Cachexia

  • obesity
  • Lymphadenopathy
  • jaundice
42
Q

Q: What is cachexia? Cause? (2) Common in? Precedes?

A

A: medical term for muscle wasting, and can be caused by under nutrition or GI disease.

This type of wasting is common in older adults and often precedes a decline in physical functioning.

43
Q

Q: What is obesity an overt sign of? Process.

A

A: nutritional imbalance, most often over nutrition

extended period of positive energy balance (more energy coming in than being expended) can lead to storage in subcutaneous white adipose tissue.

44
Q

Q: What is lymphadenopathy? Variation? (2)

A

A: palpable (and sometimes observable) enlargement of lymphoid tissue, usually most obvious in the neck.

The lymph node enlargement may be unilateral (on one side) or bilateral (both sides).

45
Q

Q: What are hand related symptoms/signs of GI disease? (6)

A

A: -Koilonychia

  • Leuconychia
  • nail clubbing
  • Dupytren’s contracture
  • Tachycardia (radial pulse)
  • tremor
46
Q

Q: What is koilonychia? Common sign of?

A

A: spooning of the nails of the fingers (concaving). Usually, the nails have a convex shape

iron-definicient anaemia.

47
Q

Q: What is leuconychia? Reflects?

A

A: partial or complete whitening of the nails, which are usually pink

dietary nutrient deficiency

48
Q

Q: What is nail clubbing? Opposite of? Sign of? (3) Identification?

A

A: nails of the fingers taking an enlarged concave appearance // opposite of koilonychia

malabsorption, Crohn’s or cirrhosis.

assessing the angle of the nail bed with the distal phalange

49
Q

Q: What is dupytren’s contracture? Cause? Associated with? (2)

A

A: deformity of the hand that usually develops over years-> one or more fingers is in a bent position (usually the ring and/or little finger)

layer of tissue that lies under the skin of your palm in which thickened cords of tissue develop that can pull fingers

persistent uncontrolled diabetes and excess alcohol consumption

50
Q

Q: What is tremor? When are they considered a clinical sign? (2)

A

A: inability to keep the hand completely still.

if it has worsened over time, or is interfering with normal activities.

51
Q

Q: Name 3 common abdominal signs of a GI tract disorder.

A

A: -Palpable organ enlargement

  • Abdominal tenderness (Usually, there are no regions of the abdomen that are tender or painful to moderate pressure)
  • Distension
52
Q

Q: Name 4 symptoms of anal/rectal diseases. (GI)

A

A: -Haemorrhoids

  • fistula
  • fissure
  • Proctitis
53
Q

Q: What are haemorrhoids? Variation? (2) Sign of?

A

A: swollen superficial blood vessels that are prone to bleeding.

Internal haemorrhoids are usually painless, but external haemorrhoids can cause significant discomfort. They can feel very itchy.

anal/rectal disease

54
Q

Q: What is an anal fistula? Sign of?

A

A: generic term for ‘alternative pathway’. For anal fistulae, this is any pathway from the anus/rectum to the outside environment that is not directly through the entire anal canal

55
Q

Q: What’s an anal fissure? Prone to? Sensations?

A

A: tear or ulceration of the mucosal lining of the peri-anal tissue. It is prone to infection and can become rather painful during bowel movements.

56
Q

Q: What is Proctitis? Identification? (2)

A

A: inflammation of the inside of the rectum. It can be identified using a finger (digital rectal exam) or during a sigmoidoscopy

57
Q

XQ: When describing (and interpreting descriptions of) pain you should consider? (2)

A

A: Subjectivity - what is considered pain by one person may be considered as discomfort or painless to another. Similarly, the location of the pain may not be described correctly or perceived typically

Interpretability - pain and the sensation of pain is complex. Sometimes, just because the pain is perceived in one place doesn’t mean that it originates from there

58
Q

Q: Name the 9 regions of the abdomen and give an example of a cause of pain for each.

A

A: Right hypochondriac pain
- Gall stones, gall bladder infection, pulled muscles, hepatitis, kidney stone, pneumonia

Epigastric pain
-Acid reflux, heartburn, heart attack, gastritis, stomach ulcer, duodenal ulcer, pancreatitis, epigastric hernia

Left hypochondriac pain
-Pneumonia, spleen infection, splenomegaly, hepatitis, kidney stone, constipation, trapped wind

Right lumbar (flank) pain
-Kidney stone, kidney infection, trapped wind, constipation, pulled muscle, appendicitis

Umbillical pain
-Stomach ulcer, bowel obstruction, constipation, worms, Crohns, food poisoning, trapped wind, umbilical hernia

Left lumbar (flank) pain
-Constipation, trapped wind, diverticulitis, IBS, kidney stone, kidney infection, Crohns, ulcerative colitis
Right iliac (inguinal) pain 
-Appendicitis, urine infection, constipation, ectopic pregnancy, menstrual pain, pelvic infection, endometriosis, ovarian cyst, trapped wind, hernia

Hypogastric (suprapubic) pain
-Trapped wind, constipation, blaster infection, urinary retention, menstrual cramps, endometriosis, pelvic infection, fibroids, miscarriage

Left iliac (inguinal) pain
-IBS, Crohns, ulcerative colitis, diverticulitis, constipation, trapped wind, menstrual pain, endometriosis, pelvic infection, ovarian cyst, ectopic pregnancy, hernia
59
Q

Q: What is involved in the diagnostic approach to abdominal pain? (3-2,4,1)

A

A -History - talk to your patient, find out what is wrong and how long it has been a problem. Find out about their personal and family history by asking the right questions.

  • Examination - undertake an examination of your patient, using visual (look at them), auditory (ausculation), smell (perhaps a pungent external infection?) and tactile (is their skin cold, clammy, rough?) inputs
  • Investigations - to confirm or exclude diagnoses, you may need laboratory and/or imaging investigations to generate a clearer picture
60
Q

Q: Investigating and reporting pain. (8)

A

A: S - site

O - onset

C - character
How does the pain feel? Sharp?

R - radiation
Does the pain radiate elsewhere?

A - associated symptoms

T - timing
Has the pain changed over time?

E - exacerbating/relieving factors
Does anything affect the pain?

S - severity
Describe the pain as a rating between 1 (no pain at all) and 10 (excruciating pain)

LSS Alimentary System (17 decks)

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