4C-THA LAAAGE Intestine Flashcards
The fibers of the L.I.’s external muscular layer are collected into longitudinal bands called ______.
teniae coli
The colon wall forms outpouchings (_______) between the teniae.
haustra
What are the 4 cells of the LI? HINT they have the same names as the SI!!
1.Absroptive cells 2.Goblet Cells 3.Endocrine cells 4.Regenerative Cells
What are the 4 functions of the LI?
1.Storage 2.Bacterial Housing 3.Some Absorption 4.Defecation
What is the main difference between the SI and LI luminal surfaces??
LI is a FLAT luminal surface… SI is VERY full of villi
How many different species of bacteria call the LI home?
500!!
The intestinal flora do fermentation of undigestible dietary fiber to generate _______, which are a major nutritional source for the colon and have trophic effects to promote normal mucosal growth and development.
fatty acids…
What pH range is the stool?
Slightly Acidic! 5.0-7.0
What are three main functions of the intestinal flora?
1.Take up space! 2.Metabolize things 3.Make 3 vitamins!
What are the three vitamins synthesized by the intestinal flora? What are the roles of these three vitamins?
Vit K-clotting factors, B12-RBC formation, and Folic Acid(B9)-RBC formation
What are the 4 mechanisms causing DIARRHEA?
1.increased OSMOTIC load 2.Increased SCRETION 3.inflammation(EXUDATIVE) 4.decreased absorption TIME
_______ diarrhea occurs when unabsorbable, water-soluble solutes remain in the bowel, where they retain water. What is an example?
Osmotic diarrhea…ex: lactose intolerance
_______ diarrhea occurs when the small and large bowel secrete more electrolytes and water than they absorb. What is an example?
Secretory diarrhea…EXAMPLE-INFECTIONS!!! Secretagogues include bacterial toxins (e.g. – in cholera), enteropathogenic viruses, bile acids & unabsorbed dietary fat.
________ diarrhea occurs with several mucosal diseases (e.g. – regional enteritis, ulcerative colitis, lymphoma, cancer) that cause mucosal inflammation, ulceration, or tumefaction. The resultant outpouring of plasma, serum proteins, blood, and mucus increases fecal bulk and fluid content. Involvement of the rectal mucosa may cause urgency and increased stool frequency because the inflamed rectum is more sensitive to distention.
Exudative
___________ occurs when chyme is not in contact with an adequate absorptive surface of the GI tract for a long enough time so that too much water remains in the feces. Factors include small- or large-bowel resection, gastric resection, vagotomy, surgical bypass of intestinal segments, and drugs that speed transit by stimulating intestinal smooth muscle (as a side effect).
Decreased absorption time
What is tough about diagnosing constipation?
It is infrequent pooping, which is different for everyone
What can all of these lead to? failure to respond to the urge to defecate inadequate fiber in the diet, inadequate fluid intake, weakness of the abdominal muscles, inactivity and bed rest, pregnancy, hemorrhoids
Constipation!
Disorders associated with chronic constipation include ________ diseases such as spinal cord injury, Parkinson’s disease, multiple sclerosis; endocrine disorders such as hypothyroidism or diabetic neuropathy; and obstructive lesions in the GI tract. Drugs such as _______, anti-cholinergic agents, calcium channel blockers, diuretics, iron supplements and aluminum antacids tend to cause constipation.
neurologic….opiates
The term _______ _______ _______ (___) is used to describe a functional GI disorder characterized by a variable combination of chronic and recurrent intestinal symptoms not explained by structural or biochemical abnormalities. There is evidence to suggest that 10-20% of people in Western countries have the disorder, although most do not seek medical attention.
irritable bowel syndrome (IBS)
What is the HALLMARK of IBS? What is believed to be the cause?
Pain is relieved with defecation….Caused CNS malfunction (stress!)
Who is affected more by IBS, women or men?
Women, also related to hormones(menses)
Because ________ lacks anatomic or physiologic markers, diagnosis is usually based on signs and symptoms of abdominal pain or discomfort, bloating, constipation, diarrhea, or an alteration between both.
IBS
What are the two inflammatory intestinal disorders that make up Inflammatory Bowel DISEASE (not syndrome!!)
1.Crohn’s Disease 2.Ulcerative Colitis (UC)
WHAT IS THE HALLMARK OF CROHN’S DISEASE?
COBBLESTONE
Which IBDisease has skip lesions instead of one common area of inflammation?
Crohns has the skip lesions. UC tends to be in one place
Which IBDisease has oral manifestations?
Crohn’s!
Which IBDisease ALWAYS involves the rectum and is therefore “down the line” more often then not?
Ulcerative Colitis
What is a condition in which the mucosal layer of the colon herniates through the muscular is layer?
DiverTicUlosis
Which part of the LI is most common to have Diverticulosis? Therefore where is a Pt going to feel pain if inflammation arises?
The sigmoid…Pain in Lower Left Quad!
What is the name of the disease when diverticula become inflamed?
Diverticulitis
Which condition is signaled by Lower Right Quadrant REBOUND tenderness?
Acute Appendicitis
What are the 4 examples of intestinal obstruction?
1.Hernia 2.Adhesion 3.Volvus(twist) 4.Intussuscepion
Pooping is a spinal cord- mediated __________ reflex that causes the walls of the sigmoid colon and the rectum to contract and the internal anal sphincter (smooth muscle) to relax. WHICH nerves are involved here?
parasympathetic…S2,S3,S4 keep the poo off the floor!!
What is the only sphincter we can control during pooping?
External Anal Sphincter
__________ refers to blood in the vomitus. It may be bright red or have a “coffee-ground” appearance because of the action of the digestive enzymes. WHY?
Hematemesis…Red=from up high in the GI tract vs Coffee=down low in the GI tract
Blood that appears in the stool may range in color from bright red to tarry black. Bright red blood usually indicates that the bleeding is from the _____ bowel. When it coats the stool, it often is the result of _______ ________.
lower…bleeding hemorrhoids
Where do MELENA stools indicate bleeding?
Above the ILEOCECAL VALVE!
Occult, or hidden, blood can only be detected by chemical means. It can be caused by ______, ________, or ______ of the intestine.
gastritis, peptic ulcer, or lesions of the intestine.
What is “one of the most common cancers in the Western World?
AdenoCarcinoma of the Colon & Rectum
What are the 4 progressions to AdenoCarcinoma of the colon/rectum?
Normal Mucosa–>Polyp—->Cancer—->Metastatic tumor
When is the most common age for adenocarcinoma of the colon/rectum to occur?
60-70 yrs
What are the 4 predisposing factors for adenocarcinoma of the colon/rectum?
- Polyps 2. Long standing UC 3.Genetic 4.High animal fat diet
