CH 17 & 18: digestive and urinary systems Flashcards

1
Q

Carbohydrate metabolism generates

A

ATP

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2
Q

lipid metabolism provides

A

energy storage and release

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3
Q

protein metabolism provides

A

amino acids

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4
Q

Adequate nutrition relies on

A

optimal intake
digestion
absorption
transportation of nutrients,
excretion of waste products.

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5
Q

Once the food goes through the process of digestion, the extracted nutrients are made suitable for

A

absorption and transportation.

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6
Q

process of ingesting and utilizing nutrients for energy.

A

Nutrition

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7
Q

Metabolism allows chemical
reactions that do three things

A

(1) produce heat to maintain body temperature
(2) conduct neural impulses
(3) contract muscles.

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8
Q

Nutrition also provides the substances needed for the

A

growth, repair, and
maintenance of cells.

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9
Q

Water functions to:

A
  • Serve as a solvent promoting the availability of solutes to the cell
  • Promote and maintain fluid balance
  • Provide a transport medium for nutrients and wastes
  • Serve as a lubricant
  • Contribute to the regulation of body temperature
  • Provide the foundation for metabolic reactions
  • Contribute to the structure of cells and the circulatory system
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10
Q

The major macronutrients that are converted to usable sources of energy are:

A

proteins, lipids, and
carbohydrates.

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11
Q

proteins are broken down into :

A

amino acids and absorbed into circulation

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12
Q

how many amino acids are essential and required in the diet

A

9

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13
Q

dietary fats:
support -
stimulate -

A

supports digestion by decreasing gastric motility and secretions
stimulates pancreatic enzymes and bile secretion to facilitate digestion, absorption, and transportation of fat-soluble vitamins.

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14
Q

Essential fatty acids influence:

A

plasma membrane fluidity
receptor function
enzyme activity
cytokine production.

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15
Q

considered an essential fatty acid and has been demonstrated to reduce many disease states, including heart disease.

A

Linoleic acid

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16
Q

digested and converted into glucose

A

carbohydrates

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17
Q

what are two actions of glucose after digested

A
  1. where about 50% is used for oxidation or stored as glycogen
  2. exits the liver and is circulated throughout the body to be used by cells for energy.
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18
Q

major role of carbohydrates

A

provide energy

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19
Q

organic substances that the body is unable to manufacture (for the most part) and,
therefore, must be consumed. (

A

Vitamins

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20
Q

fat soluble vitamins

A

ADEK

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21
Q

Vitamin K function

A

coagulation of the blood

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22
Q

Thiamin B1 function

A

regulation of neural function

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23
Q

Folate functions

A

DNA RNA synthesis
red blood cells and white blood cells in bone marrow

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24
Q

Cobalamin functions

A

metabolism of all cells, GI tract, bone marrow, nervous tissue

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25
major roles of vitamins are to help develop
genetic materials, red blood cells, hormones, collagen, and nervous system tissue.
26
Minerals constitute
bone, hemoglobin, enzymes, hormones, and chemical mediators.
27
macrominerals include
sodium, potassium, calcium, phosphorus, magnesium, and sulfur.
28
microminerals include
iron, zinc, fluoride, and copper.
29
Hunger and satiety are regulated in the brain by the
hypothalamus, based on feedback from the gastrointestinal tract on the quantity and quality of food in the stomach and intestines
30
digestion is essential for what 3 functions
(1) digesting and extracting macronutrients (2) absorbing nutrients (3) forming a physiologic and chemical barrier against microorganisms and other foreign materials introduced during food ingestion.
31
stomach acids are a part of which line of defense
first by destroying many types of microorganisms and other harmful substances on contact
32
Four major secretory cells are found in the stomach:
 Mucous cells, which secrete alkaline mucus and protect the epithelium from stress and acid contact (protection from stomach acid)  Parietal cells, secrete both hydrochloric acid, a strong acid needed to activate pepsinogen and destroy pathogens, and intrinsic factor, a glycoprotein needed for intestinal absorption of vitamin B12 -INTRINSIC FACTOR  Chief cells, which secrete pepsin, a proteolytic enzyme critical to protein digestion  G cells, which secrete gastrin, a hormone responsible for controlling acid secretion and stimulating gastric motility
33
complex process of taking in nutrients and moving these to the circulation to be used by cells.
Absorption
34
Small intestine contains:
 duodenum contains the openings for the bile and pancreatic ducts  Jejunum is 8 ft long  Ileum is 12 ft long  Ends in the cecum
35
Large Intestine includes:
 5 feet long  Absorbs water and eliminate waste  Intestinal bacteria vital role in the synthesis of some B and K vitamins  Colon includes the ascending, transverse, descending sigmoid and rectum
36
altered nutrition possible causes
 Genetic defects that impact metabolism or absorption of nutrients  Malformation or damage to the gastrointestinal mucosa  Inadequate or excessive dietary intake of required nutrients  Excessive nutrient losses, such as through vomiting, diarrhea, or laxative use  Hypermetabolic states that exert excessive demands, such as with hyperthyroidism, cancer, burns, fever, or severe infection  Malabsorptive syndromes  Ingestion of unsafe food and water
37
lack of nutrient intake most often related to inadequate calorie consumption, inadequate intake of essential vitamins and minerals, or problems with digestion, absorption, or distribution of nutrients in the body.
Undernutrition
38
most common nutrients that are inadequately consumed or in great demand in those presenting with undernutrition.
Protein, iron, and vitamins
39
Protein malnutrition related to:
Marasmus deprivation of all food, a condition of starvation Kwashiorkor persons consuming adequate carbohydrates
40
dietary glucose is unavailable for glucose-dependent tissues, such as the brain and muscle tissue
in marasmus
41
lack of movement of specific nutrients across the gastrointestinal mucosa.
Malabsorption
42
Carbohydrate malabsorption is often the result of
pancreatic enzyme deficiencies absence or reduction of brush border disaccharidases congenital deficiency of the glucose–galactose transporter bacterial flora overgrowth in the intestine.
43
clinical manifestations of altered immunity
weight loss muscle weakness muscle wasting dehydration fatigue vitamin and mineral deficiencies
44
digestive system labs
a complete blood count with red blood cell indices peripheral smear sedimentation rate (to detect inflammation) serum electrolytes urinalysis urine culture. protein status, including serum albumin, transferrin, creatinine, and blood urea nitrogen (BUN) levels.
45
reduction in the number of circulating blood cells and subsequently reduced hemoglobin levels
anemia
46
represents a problem of iron demand on red blood cell development that cannot be met with current iron stores.
Iron-deficiency anemia
47
clinical manifestations of IDA
manifestations include pallor of the skin and mucous membranes fatigue weakness lightheadedness breathlessness palpitations headache tachycardia syncope brittle hair nails and mouth sores.
48
craving to chew or eat substances of non-nutritive value, such as chalk, soil, clay, or paper
Pica.
49
form of pica in which the person chews ice.
Pagophagia
50
Excessive body fat Major contributor to morbidity and mortality Health crisis
Obesity
51
the primary cell involved in obesity, are highly active metabolic, endocrine, and inflammatory cells.
Adipocytes
52
clinical manifestations of obesity
excess weight and body fat
53
comorbidities of obesity
diabetes heart disease hypertension hyperlipidemia stroke osteoarthritis liver disease gallstones poor wound healing sleep apnea certain cancers
54
functional units of the kidneys, forming urine through filtration, reabsorption, and secretion.
Nephrons.
55
2 primary roles of the kidneys
Regulation of body fluid and the balance between acids and bases
56
waste product produced by the kidneys, stored in the bladder, and excreted via the urethra through a complex interplay between neural, motor, and hormonal mechanisms
urine
57
basic processes of the renal system
- Regulation of body fluid volume and composition - Elimination of metabolic wastes - Synthesis, release, or activation of hormones - Erythropoietin - Renin - Vitamin D - Regulation of blood pressure
58
functions of nephrons
 Filter water-soluble substances from the blood  Reabsorb filtered nutrients, water, and electrolytes  Secrete waste
59
functions of the kidneys
 Maintain acid-base  Excrete the end products of body metabolism  Control fluid and electrolytes  Excrete bacterial toxins, water-soluble medications, and the metabolites of medications  Secrete renin to regulate blood pressure RAAS  Synthesize Vitamin D so calcium can be absorbed  Secrete erythropoietin to stimulate the bone marrow to make RBCs
60
homeostasis of water
 ADH reabsorption of water stimulated by dehydration, sodium concentration, or decrease in blood volume  Lack of ADH = Diabetes insipidus
61
homeostasis of sodium
 When sodium increases extra water is retained  This increases blood volume and increases BP  BP increases gfr increases  RAAS controls the reabsorption of sodium and stimulates the release of aldosterone  Aldosterone also increases the amoung of K in the blood
62
ureters composed of: Bladder composed of:
 Ureters composed of smooth muscle  Bladder composed of detrusor muscle and sphincters
63
urinalysis components
 pH  Specific gravity  Protein  Glucose  Ketones  Nitrite  Leukocyte esterase  Microscopic analysis includes crystals, casts squamous cells, WBCs and RBCs
64
should not be found in urine:
o Glucose o Ketones o Nitrite o Bacteria o Leukocyte esterase o Crystals o Stones o protein
65
possible motility issues of urine
 Results in stasis of urine in the bladder and the kidney  Can cause precipitation (solid substances to form from fluid  Blockage  Pyelonephritis and acute tubular necrosis
66
Inadequate arterial blood supply
ischemia or infarction
67
The consequences of obstruction are influenced by the:
o Degree of the obstruction (complete or partial) o Duration of the obstruction o Acuity or chronicity of the condition
68
possible complication of a patency issues
 Can lead to structural damage impaired function  Can lead to ischemia and necrosis  Can lead to obstruction of urine flow  Can lead to dilation injuries – hydronephrosis – decreased GFR and decreased function  Can developed within 24 hours  Can also lead to infection, sepsis and loss of function
69
stasis of urine behind the obstruction of renal structures, ureters, or urethra
urinary obstruction
70
collection of gas and fluid behind the obstruction
intestinal obstruction
71
signs and symptoms of obstructive disease
 Altered volume of urine  Altered urine characteristics  Bleeding  Pain  Distension  Anorexia  Nausea  Vomiting  Fever
72
patho indications for altered urinary elimination
proteinuria glucosuria ketonuria hematuria pyuria bacteriuria
73
Laboratory analysis of stool may include:.
microscopic examination or chemical evaluation. Color, consistency, volume, shape, and odor should be consistent with characteristics described previously.
74
Increased motility may impair:
nutrition may enhance loss of water and electrolytes.
75
Decreased motility prolongs storage time in the large intestine, increasing:
fluid loss from fecal matter, forming hard stools, and potentially promoting the return of waste products to circulation.
76
factors altering bowel elimination
analgesics emotional stress reduced activity
77
possible causes of bowel obstruction
 tumors, polyps, and impacted feces  fluid and gas accumulation, bowel obstruction is manifested by abdominal distension and pain  if obstruction impairs venous return, o edema develops in the large intestine, leading to reduced absorption. o Edema promotes continued fluid and gas accumulation because water and gas move into the bowel lumen. o Hydrostatic forces may increase so that fluid is forced through the bowel wall into the peritoneum. Further, bacteria may gain access to the circulation, promoting the development of sepsis. o Perforation may result from the pressure that exceeds the ability of the tissue to retain its structure.
78
assessment for bowel obstruction
 Inspection  Auscultation  Palpation  Characteristics of stool color consistency presence of fat or blood  Watery, hard, stringy, fatty, foul odor  Hemorrhoids  Blood  Pain
79
alterations in texture of stool that can give cause
watery hard stringy fatty foul odor
80
Watery diarrhea can mean:
o Acute onset caused by gastroenteritis or anxiety o Chronic pattern linked to inflammatory conditions or a high-fiber diet. Also caused by intolerance to particular foods or the effects of certain medications
81
hard diarrhea can mean
o Water content low, resulting in a dry stool that is difficult to pass o May contribute to the development of hemorrhoids. Linked to low-fiber diet, side effects of certain medications, or voluntary avoidance of stool evacuation
82
stringy diarrhea can mean
o May be caused by parasitic infections
83
fatty diarrhea can mean
o Caused by malabsorption of fat o Likely to float
84
foul odor in diarrhea can mean
o May be caused by steatorrhea, parasitic infection, or malabsorption syndromes
85
 Characterized as diffuse, radiating and generalized; difficult to determine precise location  Caused by stretching, distension, or inflammation, inducing edema and vascular congestion
Visercal
86
 Described as sharp, intense, and localized to a specific site  Caused by injury to the abdominal wall or parietal peritoneum
Somatic (also known as parietal)
87
 Felt at a location different from origin of pain  Caused by the sharing of a common afferent pathway between origin of pain and referred location
Referred
88
Individuals at risk for development of kidney stones include those with:
- Obstructive renal calculi (kidney stones) is an emergecy - Genetic predisposition - Urinary tract infection - Cystic kidney disease - Diabetes - Obesity - Gout - Hyperparathyroidism - Gastric bypass
89
fluid-filled cysts in kidney tissue bilaterally, leading to progressive loss of nephrons may be inherited or acquired.
polycystic kidney disease
90
Progressive decline in GFR is characteristic of decline in kidney function as follows:
Mild disease, GFR 60 to 89 mL per minute Moderate disease, GFR 30 to 59 mL per minute Severe disease, GFR 15 to 29 mL per minute Renal failure, GFR < 15 mL per minute
91
 rapid loss of kidney function  leads to cell hypoperfusion, cell death, decreased renal function  normal function can return if the cause removed  prerenal, intrarenal and postrenal causes
Acute Kidney Injury AKI
92
AKI: blood loss, dehydration, shock, infection (outside the kidney)
prerenal
93
AKI: tubular necrosis, prolonged ischemia, obstruction or nephrotoxicity
intrarenal
94
AKI: between the kidney and the outside: bladder neck obstruction or infection
postrenal
95
kidney disease that has Slow progressive and irreversible - Occurs in stages
chronic kidney disease
96
% loss of function nephrons before patient becomes symptomatic
75%
97
characteristic of GFR for CKD
GFR <60 ml per min for 3 months or longer
98
causes of CKD
o Can follow AKI o DM or other metabolic disorders o Hypertension o Urinary obstruction o Recurrent infections o Renal artery occlusion o Autoimmune disorders
99
labs for kidney disease
GFR best estimate for kidney function CMP contains electrolytes BUN Creatinine BUN elevated Creatinine elevated Urinalysis abnormal: RBCs, WBCs, casts, proteinuria, bacteria, nitrite, leukocyte esterase if infection CBC: anemia, leukocyutosis, thrombocytopenia Renal ultrasound
100
prevents reflux of gastric contents into the esophagus
lower esophageal sphincter
101
are critical in producing and secreting digestive enzymes and bile into the gastrointestinal tract. Ex:
Enyzmes salivary glands, pancreas, and liver,
102
secrete alkaline mucus and protect the epithelium from stress and acid contact
mucous cells
103
secrete both hydrochloric acid, a strong acid needed to activate pepsinogen and destroy pathogens, and intrinsic factor, a glycoprotein needed for intestinal absorption of vitamin B12 -INTRINSIC FACTOR
parietal cells
104
secrete pepsin, a proteolytic enzyme critical to protein digestion
chief cells
105
secrete gastrin, a hormone responsible for controlling acid secretion and stimulating gastric motility
G cells
106
deprivation of all food, a condition of starvation
Marasmus
107
persons consuming inadequate proteins
Kwashiorkor
108
Problems with processing or digesting nutrients:
pancreatic dysfunction enzyme deficiencies inadequate bile secretion
109
Problems with moving substances across the mucosa:
inflammatory conditions gastrointestinal atrophy excessive ingestion of a nutrient use of certain medications protein deficiencies
110
inhibits transport of nutrients once they have been absorbed across the mucosa and may occur with neoplasms or infectious processes
Lymphatic obstruction
111
how many exposures to food for allergy to occur
at least two
112
classes of BMI
*Class 1: BMI of 30 to less than 35 *Class 2: BMI of 35 to less than 40 *Class 3 (extreme or severe obesity): BMI of 40 or higher
113
diagnosis of obesity
comprehensive evaluation for comorbidities, such as hypertension, hypercholesterolemia, diabetes, hypothyroidism, venous varicosities, osteoarthritis, sleep apnea, depression, reproductive alterations, and infection
114
kidneys processing of cardiac out
20-25% 1000mL of blood per minute
115
neuromuscular function alterations of urine
*may involve the neurons of the peripheral and central nervous systems, neurotransmitter production, and availability or coordination of neural impulses from initiation to action *Result in retention or incontinence
116
perfusion issues of urine
*Inadequate arterial blood supply – ischemia or infarction *Damage to the renal structures *Decrease perfusion due to excessive constriction of arterioles, inadequate vascular volume, or obstructed patency of the arterial supply, as occurs with an embolism
117
infection causing bowel patentcy issues and patho
appendicitis – inflammatory response – if not treated and ruptures – infection of the peritonial cavity – septic shock – reduced perfusion to all organs
118
diagnostics of bowel obstruction
* Guaiac Test occult blood * Xray * Barium enema * Sigmoidoscopy * colonoscopy
119
types of urinary incontinence
*involving muscular contraction, neural transmission, hormonal stimulation, or mechanical factors *stress, *urge, *nocturia *overflow, *functional – inabilit to get to the toilet
120
GFR < 60 indicates:
CKD
121
proteinuria possible etiologies
renal failure nephrotic syndrome preeclampsia renal artery/vein thrombosis glomerular disease tubulopathy
122
glucosuria possible etiologies
diabetes mellitus
123
ketonuria possible etiologies
DM ketoacidosis starvation
124
hematuria possible etiologies
glomerular damage tumors kidney trauma UTI acute tubular infection urinary tract obstruction
125
pyuria possible etiologies
upper and lower UTI acute glomerulonephritis renal calculi