ASSESSMENT OF DIGESTIVE AND GI FUNCTION Flashcards
phase of the digestive process that occurs when small molecules, vitamins, and minerals pass through the walls of the small and large intestine and into the bloodstream
Absorption
an enzyme that alds in the digestion of starch
amylase
last section of the gastrointestinal (GI) tract, outlet for waste products from the Gl system
anus
mixture of food with saliva, salivary enzymes, and gastric secretions that is produced as food passes through the mouth, esophagus, and stomach
chyme
phase of the digestive process that occurs when digestive enzymes and secretions mix with ingested food and when proteins, fats, and sugars are broken down into their component smaller molecules
digestion
upper abdominal discomfort asso- ciated with eating
dyspepsia: indigestion
phase of the digestive process that occurs after digestion and absorption, when waste products are evacuated from the body
elimination
collapsible tube connecting the mouth to the stomach, through which food passes as it is ingested
esophagus
acid secreted by the glands in the stomach; mixes with chyme to break it down into absorbable molecules and to aid in the destruction of bacteria
hydrochloric acid
phase of the digestive process that occurs when food is taken into the Gl tract via the mouth and esophagus
ingestion
a gastric secretion that combines with vita. min B, so that the vitamin can be absorbed
intrinsic factor
the portion of the Gl tract into which waste material from the small intestine passes as absorption continues and elimination begins; consists of sev- eral parts-ascending segment, transverse segment, descending segment, sigmoid colon, and rectum (syn- onym: colon)
large intestine
an enzyme that aids in the digestion of fats
lipase
the collective gertome of all microbes in a microbiota
microbiome
the complement of microbes in a given environment
microbiota
a gastric enzyme that is important in protein digestion
pepsin
longest portion of the Gl tract, consisting of three parts-duodenum, jejunum, and ileum-through which food mixed with all secretions and enzymes passes as it continues to be digested and begins to be absorbed into the bloodstream
small intestine
distensible pouch into which the food bolus passes to be digested by gastric enzymes
stomach
enzyme that aids in the digestion of protein
trypsin
delineates the entire GI tract after the introduction Of contrast agent
radiopaque liquid______ is commonly used
Upper GI fluoroscopy
Barium Sulfate
Very detailed double contrast, study of the entire small intestine that involves the continous infusion of 500 to 1000 mL of a thin barium sulfate suspension after this methylcellulose is infused through a tube
Enteroclysis
Most effective bowel cleansing preparatory agent
Polyethylene Glycol (PEG)
Visualization of the lower GI tract is obtained after
Installation of barium /barium enema 15-30mins
If active inflammatory disease fistulas or perforation of the colon is suspected a ______ can be used
water soluble iodinated contrast agent (diatrizoic acid)
Provides cross sectional images of abdominal organs and structures
Valuable tool for detecting and localizing many inflammatory conditions in the colon
Computed Tomography
common risk for IV contrast agents include
Allergic reaction and contrast induced nephropathy
Patient allergic to the contrast agent may be premeditated with a
Corticosteroid and antihistamine
Use in gastroenterology to supplement ultrasonography and CT
noninvasive tech uses magnetic fields and radio waves to produces images of the area being studied. Ang_____ can be attarcted to the magnet and cause injury.
Magnetic Resonance Imaging
Ferromagnetic objects
Produce images of the body by detecting the radiation imitated from radioactive substances
Positron emission tomography (PET)
Relies on the use of radioactive isotopes to reveal displaced anatomic structures changes in organ size and the presence of neoplasms or other focal lessons such as cysts or abscesses
Scintigraphy
Useful in determining the source of internal bleeding when all other studies have returned a negative result
Tagged red cell studies
also use to assess gastric emptying and colonic transit time.
this is useful in diagnosing disorders of gastric motility, diabetic gastroparesis and dumping syndrome
Radionuclide Testing
Use to evaluate colonic motility and obstructive defication syndromes
Patient given a capsule containing 20 radionuclide markers
process usually takes 4-5 days
Colonic Transit Studies
Also be used to evaluate esophageal and gastric motility and to collect secretions and tissue specimens for further analysis
allows direct visualization of the esopageal, gastric, and duodenal mucosa through a lighted endoscope
Upper gastrointestinal fibroscopy/EGD esophagogastroduedenoscopy
Diagnostic options for patients with esophageal diseases who can not tolerate an EGD
philcam eso/ capsule endoscopy
Flexible scope is passed through the recrum and sigmoid colon into descending, transverse, and ascending colon.
Colonoscopy
reduce secretion
atropine
to relax amooth muscle
glucagon
Sedative that provide moderate sedation with loss of the gag reflex and relieve anxiety during the procedure
midazolam
An enzyme that AIDS in the digestion of carbohydrates.Or starch
An enzyme that aids in the digestion of fats
protein
amylase
lipase
trypsin
Gastric enzyme that is important in protein digestion and product of the conversion of pepsinogen from the chief cell
pepsin
gi tract is a pathway ___
7-7.9 m (22-26 ft)
mouth
esophagus
stomach
small
large
rectum
anus
Hollow muscular tube
25 cm (10inch)
passes through at an diaphragm called the
diaphragmatic hiatus
The remaining portion of the GI tract is located within
peritoneal cavity
hollow muscular organ w/ a capacity of approximately 1500ml
stomach
in the inlet to the stomach
the place where the esophagus is connected to the stomach
gastroesophageal junction
4 anatomic regions of the stomach
cardia
fundus
body
pylorus
2/3 of the total length
longest segment of the GI tract
70 m(230 ft)
surface area for secretion and absorption
small In
small intestine 3 sections
duodenum
jejunum
ileum
large intestine consist of
ascending segment
transverse
descending
sigmoid
rectum
anus
portal venous system is composed of five large veins?
superior mesentric
inferior mesentric
gastric splenic
splenic
cystic veins
o2 and nutrients are supplied to the stomach by?
to the intestines?
gastric artery
mesentric arteries
bloood flow to the GI tract is about ___ of the total cardiac output and increases significantly after eating
20%
inhibitory effect on the GI tract
decrease gastric secretion and motility
causing the sphincter and blood vessels to constrict
sympathetic nerves
stimulation causes peristalsis
increase secretory activities
parasympathetic nerves
sphincter relax under the influence of the______ except of the sphincter of the upper esophagus adn tge external anal sphincter
parasympathetic stimulation
______ saliva is secreted daily from the____
1.5 L
parotid
submaxillary/submandibular gland
sublingual
voluntary act that is regulated by the swallowing center in the medulla oblongata of the cns
swallowing
in the absence of intrinsic factor, vit b12 cannot be absorbed and ______ results
pernicious anemia
duodenal secretions come from the accessory digestive organs..
pancreas
liver
gallbladder
duodenum secretions contains digestive enzymes?
amylase
lipase
bile
digestive enzymes secreted by the pancreas
trypsin
lipase
amylase
2 types of contractions in small intestine
segmentation contractions
intestinal peristalsis
produce mixing waves that move the intestinal content back and forth in a churning motion
segmentation contraction
propels the contents of the small intestine towards the colon
intestinal peristalsis
fats, proteins, carbs, na and chloride are absorbed in
jejunum
absorbed in some areas of small intestine and duodenum
nutrients
vit. b12 and bile salts are absorbed in
ileum
mg, phosphate, k are absorbed in
small intestine
major component of the large intestine, assist in completing the breakdown of waste material, especially of undigested or unabsorbed proteins and bile slats
gut microbes
chiefly a bicarbonate solution that acts to neutralize the end product formed by the colonic bacterial action
electrolyte solution
protects the colonic mucosa from the intraluminal contains and provides adherence for a fecal mass
mucus
gas formed contain
methane
hydrogen
sulfide & ammonia
normal gut microbiota is established by
2 years of age
1st line of defense against pathogenic microbes and microbial agents
intestinal epithelium
pqrst means
old cart
provocation
quality
region
severity
timing
onset
location
duration
characteristics
aggravating factors
relieving factor
timing
most common symptoms of pt w/ GI dysfunction
dyspepsia (indigestion)
cause the most discomfort because they remain in the stomach for digestion longer than proteins or carbohydrates
fatty foods
accumulation of gas in the GI tract may result in
belching
flatulence
expulsion of gas in the GI tract may result in
belching
expulsion of gaz from the rectum
flatulence
usually, gases in the small intestine pass into the colon and are released as
flatus
patients often complain of bloating, distention or feeling “full of gas” w/ excessive flatulence as a symptom of
food intolerance
gallbladder disease
uncomfortable sensation of sickness or “queasiness” that may or may not be followed by vomiting
nausea
forceful emptying of the stomach and intestinal contents through the mouth
vomiting
an acute onset of emesis that appears bright red or as coffee grounds is characteristics of a
mallory weiss tear
an abnormal increase in the frequency and liquidity of the stool or in daily stool weight or volume
diarrhea
a decrease in the frequency of stool or stools or stools that are hard, dry and of smaller volume than typical may be associated w/ anal discomfort and rectal bleeding
constipation
physical assessment
inspection
palpation
percussion
auscultation
abdominal assessment
inspection
auscultation
percussion
palpation
9 regions
epigastric
umbilical
hypogastric or suprapubic
right hypochondriac
left hypochondriac
right lumbar
left lumbar
right inguinal
left inguinal
bowel sounds are assessed using the diaphragm of the stheth for
soft clicks and gurgling sounds range from 5 to 30mins
used to determine the characteristics, location and frequency of bowel sounds and to identify vascular sounds
auscultation
used to assess the size and density of abdominal organs and to detect the presence of air filled fluid filled or solid masses
percussion
protein that us normally not detected in the blood of a healthy person; when detected in the blood it indicates thatt cancer is present
CEA - Carcinoembryonic Antigen
one of the most commonly performed stool tests
can be useful in initial screening for several disorders, although it is used most frequently in early cancer detection programs
guaiae based fecal occult blood testing
was developed to evaluate carbohydrate absorption
aiding in the diagnosis of bacterial overgrowth in the intestine and short bowel syndrome
hydrogen breath test
detects the presence of helicobacter pylori the bacteria that can live in the mucosal lining of the stomach and causes peptic ulcer
urea breath test
noninvasive diagnostic technique in which high frequency sound waves are passed into internal body structure and the ultrasonic echoes are recorded on an oseilloscope as they strike tissues of different densities
ultrasonography
specialized enteroscopic procedure that aids in the diagnosis of GI disorders by providing direct imaging of a target area
endoscopic ultrasonography (eus)
pt should eat a fat free meat the evening before the test
gallbladder studies
inherited in an autosomal dominant manner and is associated w/ colonic and extracolonic cancers
lynch syndrome
endoscopic examination of the anus, rectum, sigmoid
anoscopy
proctoscopy
sigmoidoscopy
useful for visualizing a segment of the small or large intestine and may be indicated to evaluate the anastomosis for recurrent disease or to visualize and treat bleeding in a segment of the bowel
endoscopy through an ostomoy stoma
measures changes in intraluminal pressures and the coordination of muscle activity in the GI tract w the pressures transmitted to a computer analyzer
manometry test
used to detect motility disorders of the upper and lower esophageal sphincter
esophageal manometry
very helpful in the diagnosis of achalasia (absence of peristalsis)
esophageal motility studies
measures the resting tone of the internal anal sphincter
anorectal manometry
an electrophysiologic study, performed to assess gastric motility disturbances and can be useful in detecting motor or nerve dysfunction
electrogastrography
measures anorectal function and is performed with very thick barium paste instilled into the rectum
defecography
used to assess the function of the rectum and anal sphincter while the patient attempts to expel the barium
fluoroscopy
pt with this disease secrete no acid under basal conditions or after stimulation
pernicious anemia
pt with these diseases secrete little or no acid
gastric ca
pt with this disease secrete some acid
gastric ulcer
pt with this disease usually secrete an excess amount of acid
duodenal ulcers
given Subcutaneously to stimulate gastric secretion
inform the pt that this injection may produce a flushed feeling
histamine or pentagastrin
offers the advantage of pH monitoring of the esophagus without the transnasal catheter
bravo pH monitoring system
peemits direct visualization of the organs and structures within the abdomen permitting visualization and identification of any growths, anomalies and inflammatory processes
laparoscopy
