Alimentary + Hepatic Conditions

Question 1

What is the alimentary system and what is its function?

Answer 1

The alimentary system refers to the organs and tissues of the
body that are involved in digestion and the extraction of nutrients,
absorption of energy and also the expulsion of waste

Question 2

What organs and anatomical structures comprise the alimentary system?

Answer 2

Mouth
Pharynx
Oesophagus
Stomach
Liver
Gallbladder
Pancreas
Small intestine
Large intestine
Rectum
Anus

Question 3

Name 4 common conditions of the pancreas

Answer 3

Acute pancreatitis

Chronic pancreatitis

Pancreatic cancer

Diabetes

Question 4

What is acute pancreatitis and what are its symptoms?

Answer 4

Defined as swelling and pain from the pancreas with a sudden onset

Gradual or sudden pain in upper abdomen

Mild at first but worse after eating

Pain becomes severe and constant

Patients require hospitalisation for fluids and monitoring

Question 5

What are the main triggers of acute pancreatitis?

Answer 5

Alcohol abuse and gallstones

Question 6

What is chronic pancreatitis and what are some of it’s symptoms?

Answer 6

Chronic inflammation of the pancreas, impairs the ability of the pancreas to produce hormones and the bodies ability to digest food

Symptoms:
Upper abdominal pain
Nausea
Vomiting
Weight loss
Diarrhoea
Oily fatty stools

Question 7

What is thought to contribute to the development of chronic pancreatitis?

Answer 7

Heavy alcohol use
Autoimmune conditions
Genetic conditions
Family history
Blocked pancreatic duct or common bile duc

Question 8

What is pancreatic cancer?

Answer 8

Abnormal cell growth in the pancreas

Can occur anywhere in the pancreas:
Head of pancreas (60-70% of cases)
Body of pancreas
Tail of pancrea

Question 9

What is a luminal disease in relation to the digestive tract?

Answer 9

The digestive system is essentially a hollow tube which starts at the
mouth and goes all the way through the body to the rectum.

The inside of this tube is the “lumen”

Disorders affecting the inside of this tube are luminal disorders.

Question 10

Name some common luminal disorders

Answer 10

Oesophageal inflammation linked to acid reflux

Peptic ulceration

Infection

Uncommon but serious - Cancer of oesophagus, stomach or colon

Question 11

What is the prevalence of peptic ulceration?

Answer 11

4% of the population - 2% stomach + 2% duodenal

Incidence increases with age

Question 12

What are the 2 major causes of peptic ulceration?

Answer 12

Helicobacter pylori infection - a bacteria that can be found in the lining of the stomach (40% of UK’s population may host this bacteria)

NSAID use

Question 13

How do NSAIDs damage the GI system?

Answer 13

The mechanisms are not fully understood.

NSAIDs, in part, cause topical injury to the mucosa.

NSAIDs also cause platelet inhibition which may be linked to bleeding

Additional systemic effects of NSAIDs also play a role which is why
enteric coated NSAIDs have not been successful in preventing GI
damage.

Question 14

What can be used to diagnose peptic ulceration?

Answer 14

Endoscopy - a scope (fibre optic camera attached to a long tube) inserted into the mouth to examine the upper GI system

Colonoscopy- a scope inserted into the anus to examine the lower GI system

Question 15

Define Crohn’s disease

Answer 15

A chronic inflammatory disease of the intestines,
especially the colon and ileum, associated with ulcers and fistulae.

Question 16

What is Coeliac disease

Answer 16

A disease in which the small intestine is
hypersensitive to gluten, leading to difficulty in digesting food

Question 17

Define IBS

Answer 17

Irritable Bowel Syndrome

A common and chronic disorder that
affects the large intestine. Signs and symptoms include cramping,
abdominal pain, bloating, gas, and diarrhoea or constipation, or both.

Question 18

What are some common hepatic diseases?

Answer 18

Hepatitis

Cirrhosis

Non-Alcoholic Fatty Liver Disease

Alcoholic Liver Disease

Liver Cancer

Question 19

Name some common symptoms of hepatic disease

Answer 19

Jaundice

Abdominal pain or swelling

Fatigue

Nausea

Vomiting

Dark urine

Pale stools

Itching

Unexplained weight loss

Question 20

What are the main podiatric implications of hepatic disease?

Answer 20

Oral antimycotic therapies such as terbinafine (lamisil), used in the treatment of onychomycosis can cause damage to the liver

So caution is advised when treating patients with hepatic insufficiency for mycotic infections

Question 21

What is peristalsis?

Answer 21

Peristalsis is a series of wave-like muscle contractions that moves food to
different processing stations in the digestive tract. The process of peristalsis
begins in the oesophagus when a bolus of food is swallowed

Question 22

How does the stomach physically and chemically break down food?

Answer 22

The movement of the stomach helps to break down food but is also aided by
acid from the stomach lining and various digestive enzymes.

Question 23

What two organs are connected by the cardio-oesophageal sphincter?

Answer 23

Oesophagus + Stomach

Question 24

What two organs are connected by the pyloric sphincter?

Answer 24

Stomach + Small intestine

Question 25

What are the three regions of the small intestine?

Ordered from closest to the stomach - furthest from the stomach

Answer 25

Duodenum
Jejunum
Ileum

Question 26

What is the major function of the large intestine?

Answer 26

To absorb water from the remaining indigestible food matter and transmit
the useless waste material from the body

Question 27

What are the divisions of the large intestine?

Answer 27

Caecum
Asending colon
Transverse colon
Descending colon
Sigmoid colon
Rectum

Question 28

Where is bile produced and stored?

Answer 28

Produced in the liver

Stored in the gallbladder

Question 29

What is the function of bile?

Answer 29

Bile contains bile acids, which are critical for digestion and absorption of fats
and fat-soluble vitamins in the small intestine. Many waste products,
including bilirubin, are eliminated from the body by secretion into bile and
elimination in feces