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Med Surg > 38 - Assessment: GI System > Flashcards

38 - Assessment: GI System Flashcards

1
Q

paraSNS -cholinergic effect on GI

A

mainly excitatorry effects on GI

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2
Q

sns - adrenergic effect on GI

A

inhibitory effect

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3
Q

GI tract nervous system is called…

A

enteric NS or intrinsic NS

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4
Q

Entreric NS [ENS]

A

regulates motility + secretin of GI

2 networks:

  • -1 Messner plexus (in submucosa)
  • -2 Auerbach/Myenteric plexus (bw muscle layers)
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5
Q

Messner plexus

A

submucosal plexus controls secretion + many sensory fux

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6
Q

Auerbach/Myenteric plexus

A

major nerve supply to GI tract

-controls mvmt

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7
Q

the ENS receives innervation from ANS, but it ____

A

functions INDEPENDENTLY of brain + spinal cord

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8
Q

veous blood draining the GI organs empties into ___

A

the PORTAL VEIN

  • then perfuses the liver
  • liver cleans the blood of bacteria + toxins
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9
Q

GI tract receives ___% of CO at rest, and

_____% after eating

A

25-30% of CO at rest
35% or more after eating

bc such a large % of CO perfuses these organs, the GI tract is a major source from which to divert blood flow during exercise, stress, or injury**

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10
Q

appetite center is found in the

A

hypothalamus

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11
Q

ghrelin

A

hormone release fr stomach mucosa

-plays role in appetite STIMULATION

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12
Q

leptin

A

hormone involved in appetite SUPPRESSION

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13
Q

deglutition

A

swallowing

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14
Q

bw swallows, the esophagus is ______ and the upper esophageal sphincter is _____

A

esophagus is COLLAPSED,

ues is CLOSED

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15
Q

LES

A

lower esophageal sphincter

  • controls opening of esophagus to stomach
  • *important barrier that normally prevents refluc of gastric contents into esophagus
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16
Q

stomach functions

A
  • store food
  • mix food w gastric secretions
  • empty contents in small boluses into sm.intstns
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17
Q

fundus glands

A

1 chief cells> secretes pepsinogen

2 parietal cells> secretes HCl, H2O, intrinsic factor

18
Q

intrinsic factor

A

promotes B12 (cobalamin) absorption

19
Q

sm. intstn functions

A

digestion + absorption

20
Q

mouth secretions

A

salivary amylase (starts starch digestn)

21
Q

stomach secretions

A 
1 HCl (activates pepsinogen to PEPSIN)
2 intrinsic factor (cobalamin absorptn)
3 lipase ( fat diegestn)
4 pepsinogen (protein digestn)
22
Q

small intestine secretions

A 
1 aminopeptidate + peptidase
(protein digestn)
2 amylase (carb digestn)
3 lactase (lactose>glucose+galactose)
4 lipase (fat digestn)
5 maltase (maltose>glucose)
6 sucrase (sucrose>glucose/fructose)
7 enterokinase (trypsinogen to trypsin)
23
Q

pancreas secretion

A 
1 amylase (starch to disaccharides)
2 chymotrypsin (protein digestn)
3 lipase (fat digestn)
4 trypsinogen (protein digestn)
24
Q

bile

A

emulsifies fats

-aids in absorption of fatty acids + fat solbl vitamins

25
Q

protein digestion begins w ___

A

release of pepsinogen fr chief cells

  • low pH activates pepsinogen into pepsin
  • pepsin breaks down protein
26
Q

lrg intestine functions

A
  • water + electrolyte absorption

- feces

27
Q

microbes in the _____ contribute to digestion by ____________

A

microbes in the COLON contribute to digestion by PRODUCING VITAMINS K + B, BREAKING DOWN PROTEINS THAT ARE NOT DIGESTED OR ABSORBED IN SMALL INTESTINES INTO AMINO ACIDS

28
Q

Valsalva maneuver

A

“bearing down”

-inspire deeply + hold breath + close airway + contract ab muscles

29
Q

Valsalva maneuver effect on oxygenation

A
  • reduce venous hrt return
  • decr hrt rate
  • decr CO
  • —–transient drop in BP
30
Q

Valsalva maneuver

CI

A
  • head injury
  • eye surgery
  • hrt problems
  • hemorrhoids
  • ab surgery
  • liver cirrhosis w portal hypertension
31
Q

sinusoids

A

capillaries bw rows of hepatocytes

-lined w kupferr vells which carry out phagocytic activity (removes bacteria + toxins in blood)

32
Q

presence of fat in upper duodenum triggers the release of _____

A

cholecystokinin (CCK)

–causes gallbladder to contract + release bile

33
Q

pancreas exocrine function

A

contributes to digestion by production + release of enzymes

34
Q

pancreas endocrine function

A 
occurs in islet of langerhans
B cells> insulin + amylin
A cells> glucagon
Gamma cells> somatostatin
F cells> pancreatic polypeptide
35
Q

age-related changes

A
  • delayed emptying
  • sm. muscle weakness
  • redues UES opetning
  • incompeten LES
  • decr GI motility

***secretion + absorption are less affecrted

36
Q

aging + constipation

A
  • slower peristalsis
  • anorectal dysfunction
  • inactivity
  • decr dietary fiber
  • inadequate fluid intake
  • constipating meds
  • neurologic, cognitive, metab problems
37
Q

upper GI series

A

to ID esophageal stricture, polyps, tumors, hiatal hernias, foreign bodies, + ulcers

38
Q

lower GI series or barium enema

A

ID polyps, tumors, lesions

39
Q

pyrosis

A

heartburn, burning in epigastric or substernal area

-may be due to incompetent LES

40
Q

melena

A

abnormal black tarry stool

-may be due to ulcers

41
Q

tenesmus

A

painful + ineffective straining at stiil
-sense of incomplete evacuation

-may be due to IBS, diarrhea second to infection

Med Surg (18 decks)

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