1. Introduction to the GI Flashcards
What separate the GI tract into segments?
Sphincters
Describe the gut wall structure (5 parts)
- Gut lumen
- Mucosa - epithelial lining, glandular tissue, underlying loose connective tissue (lamina propria for vascular support)
- Submucosa - loos connective tissue, larger blood vessels and lymphatics, mucous secreting glands
- Smooth muscle - circular layer (innermost), longitudinal layer (outermost)
- Serosa - outermost connective tissue layer, covered by visceral peritoneum, contains blood vessels, lymphatics and nerves
What are overall symptoms of GI tract disorders?
- Malaise
- Rapid weight loss
- Anorexia
- Anaemia
What are the general signs of GI tract disorders?
- Cachexia - muscle wasting
- Obesity
- Lymphadenopathy - most obvious in neck
- Jaundice
What are symptoms of Upper GI tract disorders?
- Haematemesis - vomiting/coughing up blood
- Malena - black tarry stool due to upper GI bleeding
- Nausea (and vomiting)
- Dysphagia - difficulty swallowing
- Odynophagia - pain when swallowing
- Heartburn - from acid reflux
- Acid regurgitation
- Belching - excess air escaping
- Epigastric pain - central upper abdomen, where chest pain is perceived
What are the symptoms of hepatobiliary disorders?
- Right-upper quadrant pain
- Biliary colic - pain from gall bladder contraction against obstruction
- Jaundice - increase in circulating bilirubin
- Dark urine - from elevated bilirubin in urine
- Pale stool - no bilirubin => no stercobilin
- Ascites - generalised oedema in abdominal cavity (from cancer, malnutrition, liver failure)
What are the symptoms of mid-GI tract disorders?
- Abdominal pain
- Steatorrhea - from reduced lipase/bile activity
- Diarrhoea
- Abdominal distension
What are the symptoms of Lower GI tract disorders
- Abdominal pain
- Rectal bleeding (bright red)
- Constipation - reduced gut motility
- Diarrhoea
- Incontinence - loss of voluntary control (bladder or rectume) due to neural or mechanical damage to sphincters
- Flatulence - accumulation of gas
What are the hand signs of a GI tract disorders?
- Koilonychias - nail spooning (iron-deficient anaemia)
- Leukonychia - whitening of the nails
- Nail clubbing - >180 degrees nail - malabsorption, Crohn’s, cirrhosis
- Dupytrens contracture - hand deformity (finger pulled in) - thickening of the chords - persistent uncontrolled diabetes, excess alcohol consumption
- Tachycardia - experienced in hands
- Tremor
What are the abdominal signs of a GI tract disorder?
- Palpable organ enlargement
- Tender abdomen
- Distension
What are the signs of a GI tract disorder in the anus and rectum?
- Haemorrhoids - piles (swollen, superficial blood vessels, prone to bleeding)
- Fistula - abnormal pathway from anus/rectum to outside environment (not through main canal)
- Fissure - tear/ulceration of mucosal lining of peri-anal tissue
- Proctitis - inflammation, identified via digital rectal exam or sigmoidoscopy
What should be considered when interpreting descriptions of abdominal pain?
- Subjectivity - can differ from person to person
* Interpretability - pain received from one place doesn’t mean it originates there
What are the 9 abdominal regions?
- Right hypochondriac region
- Epigastric region
- Left hypochondriac region
- Right lumbar region
- Umbilical region
- Left lumbar region
- Right iliac region
- Hypogastric region
- Left iliac region
What can cause right hypochondrial pain?
- Stones
- Gall bladder infection
- Kidney stones
- Hepatitis
- Pneumonia
What can cause epigastric pain?
- Acid reflux/heartburn
- Heart attack
- Gastritis/stomach ulcer
- Duodenal ulcer
- Pancreatitis
- Epigastric hernia
