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Medical Surg > Ch 32 GI and pancreatic systems > Flashcards

Ch 32 GI and pancreatic systems Flashcards

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USMLE® Step 1 flashcards
1
Q

GI consists of

A 
Oral cavity
Pharynx
Esophagus
Stomach
Sm and lg intestine (colon)
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2
Q

Most absorption of nutrients take place

A

Sm intestine

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3
Q

Most water reabsorption takes place

A

Lg intestine

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4
Q

Indigestible material (cellulose) eliminated from

A

Lg intestine

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5
Q

3 parts of the salivary gland

A

Parotid
Submandibular
Sublingual glands

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6
Q

Salivary glands ducts

A

Carry saliva to the oral cavity

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7
Q

Amylase

A

Digestive enzyme in the saliva

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8
Q

Function of amylase

A

Digests starch to maltose

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9
Q

Lingual lipase

A

Activated by acidic pH in the stomach

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10
Q

Tongue made of skeletal muscle inner acted by

A

Cranial nerve XII

Hypoglossal

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11
Q

Taste buds inner acted by

A

7,9th cranial nerves

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12
Q

Function of uvula

A

Closes nasopharynx while the epiglottis closes the opening of the larynx

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13
Q

Stomach location

A

Upper left quadrant, left of liver, front of spleen

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14
Q

Parts of the stomach

A

Fundus
Pylorus
Pyloric sphincter

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15
Q

Gastric juice

A 
Water
Mucus
Pepsinogen
Hydrochloric acid
Gastric lipase
Intrinsic factor
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16
Q

Mucus forms what

A

Bolus

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17
Q

Pepsinogen

A

Enzyme that activates to pepsin by hydrochloride acid.
Begins the digestion of proteins to polypeptides
Hydrochloride acid creates the pH of 1-2 that is necessary to kill most microorganisms that enter the stomach.
Breaks down proteins

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18
Q

Gastric juices are secreted at…

A

Site or smell of food

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19
Q

Presence of food in the stomach

A

Stimulates the secretion of gastrin

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20
Q

Gastrin increases

A

Secretion of gastric juices

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21
Q

Stomach has 3 layers of the smooth muscle

A

Circular
Longitudinal
Oblique

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22
Q

Changes food to

A

Chyme

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23
Q

How long is the small intestine?

A

1 inch in diameter

20 ft long

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24
Q

Sm intestines extend from

A

Stomach to the cecum to the colon

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25
Q

Duodenum

A

10inches

Hepatopancreatic ampulla–entrance of the common bile duct and pancreatic duct and pancreatic bile duct

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26
Q

Jejunum

A

8ft long

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27
Q

Ilium

A

11 ft long

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28
Q

Digestion is completed…

A

Sm intestine
End products absorbed into blood and lymph
Bile and enzymes function in the sm intestines
Chyme enters the duodenum, intestinal mucosa produces enzymes: sucrase, maltase, lactase (disaccharides) to monosaccharides

Peptidases complete the digestion of proteins to amino acids
Nucleosidases and phosphatases completing nucleotide digestion

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29
Q

Lg intestine

A

5 ft long
Ilium of sm intestine to the anus
Stores and eliminates indigestible material
Absorbs water, minerals, and vitamins

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30
Q

Elimination

A

Defecation reflux

Spinal cord reflex

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31
Q

Liver, bladder, pancreas

A

Accessory organs

Produce or store digestive secretions

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32
Q

Liver location

A

Right side
Center of the abdominal cavity just below the diaphragm
Right lobe larger than left

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33
Q

Blood supply to the liver

A

Oxygenated blood

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34
Q

Hepatic portal circulation

A

Regulates blood levels of nutrients or to remove toxic substances from the blood.

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35
Q

Functions of the liver

A

Production of bile and hepatocytes

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36
Q

Liver functions

A

Synthesis of specific enzymes

37
Q

Carbohydrate metabolism

A

Regulates blood glucose levels by storing glucose as glycogen and changing glycogen back to glucose when glucose level is too low.

Also changes other monosaccharides fructose and galactose to
Glucose

38
Q

Amino acid metabolism

A

Regulates blood levels of amino acids based on tissue needs for protein synthesis
12 amino acids–nonessential amino acids
8amino acids which liver can’t synthesize are essential amino acids
Amino groups convert to urea and excreted through urine

39
Q

Lipid metabolism

A

Forms lipo proteins in the blood

40
Q

Synthesis of plasma proteins

A

Synthesizes albumin, clotting factors, globulins

41
Q

Albumin

A

Most abundant plasma protein
Helps maintain. Blood volume
ProThrombin fibrinogen circulate the blood until needed for clotting

42
Q

Amino acid undergo a process in the liver

A

Amino group is removed and the remaining carbon chain is converted to urea

43
Q

Synthesis of plasma proteins

A

Synthesizes albumin, clotting factors and globulins

44
Q

Synthesis of plasma protein

A

Albumin maintains blood volume by pulling tissue fluid into capillaries

45
Q

Clotting factors during plasma protein synthesi

A

Clotting factors produced by the liver include thrombin and fibrinogen.
Circulates in blood until needed for chemical clotting

46
Q

Globulin during plasma protein synthesis

A

Carriers for other molecules in the blood

47
Q

Phagocytosis of the Kupffer cells

A

Phagotyze worn erythrocytes, leukocytes, and some bacteria that circulate through the liver.
Many bacteria enter through the colon after being absorbed through the water

48
Q

Portal circulation

A

Brings blood to the liver before entering circulation through the body

49
Q

Bilirubin

A

Hepatocytes form bilirubin from the heme portion of the hemoglobin removed from worn erythrocytes.

Liver removes bilirubin from the blood collected from the speen and red bone marrow and excretes it into bile to be eliminated in feces

50
Q

Liver storage

A

Liver stores minerals iron and copper
Vitamins A D E K
Water soluble B12

51
Q

Detoxification

A

Synthesizes enzymes that alter harmful substances to less harmful ones

Converts ammonia from protein metabolism to urea

52
Q

Gall bladder

A

Under surface of the liver

53
Q

Bile in the common hepatic duct

A

Flows through the cystic duct and into the gallbladder until it is needed in the sm intestine

Concentrates bile by absorbing water

54
Q

Fatty foods enter the duodenum

A

Duodenal mucosa cholecystokinin

55
Q

Cholecystokinin

A

Stimulates contraction in the smooth muscle wall of the gallbladder
Contractions forces bile into the cystic duct, into the common bile duct, empties into the duodenum.

56
Q

Pancrease

A

Posterior to the greater curvature of he stomach.

Digestive secretions are produced by the exocrine glands called acini

57
Q

Acini

A

Digestive secretions produced by exocrine glands

58
Q

Pancreatic digestive enzymes are involved in the digestion of the four organic molecule categories

A

Amylase
Pancreatic lipase
Monoglycerides
Trypsinogen

59
Q

Trypsinogen

A

Inactive enzyme changed to active trypsin in the duodenum

Digests polypeptides to shorter chains of amino acids

60
Q

Pancreatic juice contains the following protolytic enzymes

A

Chymotrypsin
Carboxypeptides
Elastase

Ribonuclease & deoxyribonuclease for digestion of RNA and DNA

61
Q

Pancreas also has bicarbonate juice which contains

A

Alkaline

62
Q

Function of bicarbonate juice

A

Neutralize hydrochloride acid in gastric juice

63
Q

C. Diff

A

Risk factor with hospitalization or use of antibiotics

Use of probiotics can reduce the risk of C. Diff

64
Q

BMI

A

Calculated by height in inches x height
Divide by eight in lbs. by step 1 answer
Multiply step 2 answer by 703

18.5-24.9 is normal

65
Q

Inspection of the abdomen

A

Supine position
Arms to side
Asculate URQ then clock wise
Clicks or gurgles heard (bowel sounds)

66
Q

Hyperactive bowel sounds

A

High pitched
Rapid
Loud

67
Q

Hypoactive bowel sounds

A

Infrequent

Paralytic ileus or following abdominal bowel surgery

68
Q

Absent bowel sounds

A

Nothing heard in all quadrants for 2-5 minutes

69
Q

Bowel obstruction sounds

A

High pitched tinkling that is proximal to obstruction
Abnormal or absent distal to the obstruction
Report abnormal or absent sounds to physician

70
Q

Vascular sounds or Brits

A

Swooshing sounds
Heard over the aorta
Pts with chronic liver failure have a humming sound over the liver

71
Q

Percussion

A

Performed by advanced nurse or physician

72
Q

Palpating

A

Depress abdomin 0.5-1.0 inch

Use finger pads

73
Q

Ascites

A

Accumulation of fluid in the peritoneal cavity.

74
Q

Carcinoembryonic antigen (CEA) and carbohydrate antigen

A

Monitor GI cancer treatments
Found in patients with cirrhosis
Hepatic disease
Alcoholic pancreatitis

75
Q

Enzymes released by damaged liver cells

A

ALT–alanine aminotransferase
AST–asparate aminotransfase
LDH–lactic dehydrogenase

Elevations in these blood levels in absence of unknown trauma or heart attack indicate liver damage.

76
Q

Occult blood stool test

A

Blood not seen by naked eye

77
Q

UGI

A

Uppergastrointestinal series

78
Q

Angiography

A

Symptoms of arterial occlusive disease of the hepatic, biliary and pancreatic vessels

Used to evaluate neoplasms in the organs

79
Q

Liver scan

A

Inject a radioactive medium that is taken up by the liver

Instruments passes over liver that records the amt of material taken up from the liver

80
Q

Endoscopy

A

Tube and fiber optic system or a tiny capsule for observing the inside of hollow organ or cavity

81
Q

Esophagogastroduodenoscopy (EGD)

A

Visualizes the esophagus, stomach, and duodenum

82
Q

Retrograde cholangiopancreatography (ERCP)

A

Liver, gallbladder and pancreas

83
Q

Proctosigmoidoscopy

A

Distal sigmoid colon, rectum, anal canal

84
Q

Colonoscopy

A

Lining of the lg intestine

85
Q

Gastric analysis

A

Measures the secretions of the stomach

Diagnosis of duodenal ulcer
Gastric carcinoma
Pyloric or duodenal obstruction

86
Q

Gastric acid stimulation test

Basal cell test

A

Presence of cancer cells

87
Q

Orgastric tube

A

GI tube inserted orally into the stomach

88
Q

Gastrointestinal decompression

A

Necessary if stomach or sm intestine is filled with air or fluid
Distention
Feeling of fullness
Pain in abdomin

Prevention:turning pt or ambulation

Medical Surg (3 decks)

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