Ch 32 GI and pancreatic systems Flashcards
GI consists of
Oral cavity Pharynx Esophagus Stomach Sm and lg intestine (colon)
Most absorption of nutrients take place
Sm intestine
Most water reabsorption takes place
Lg intestine
Indigestible material (cellulose) eliminated from
Lg intestine
3 parts of the salivary gland
Parotid
Submandibular
Sublingual glands
Salivary glands ducts
Carry saliva to the oral cavity
Amylase
Digestive enzyme in the saliva
Function of amylase
Digests starch to maltose
Lingual lipase
Activated by acidic pH in the stomach
Tongue made of skeletal muscle inner acted by
Cranial nerve XII
Hypoglossal
Taste buds inner acted by
7,9th cranial nerves
Function of uvula
Closes nasopharynx while the epiglottis closes the opening of the larynx
Stomach location
Upper left quadrant, left of liver, front of spleen
Parts of the stomach
Fundus
Pylorus
Pyloric sphincter
Gastric juice
Water Mucus Pepsinogen Hydrochloric acid Gastric lipase Intrinsic factor
Mucus forms what
Bolus
Pepsinogen
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
Gastric juices are secreted at…
Site or smell of food
Presence of food in the stomach
Stimulates the secretion of gastrin
Gastrin increases
Secretion of gastric juices
Stomach has 3 layers of the smooth muscle
Circular
Longitudinal
Oblique
Changes food to
Chyme
How long is the small intestine?
1 inch in diameter
20 ft long
Sm intestines extend from
Stomach to the cecum to the colon
Duodenum
10inches
Hepatopancreatic ampulla–entrance of the common bile duct and pancreatic duct and pancreatic bile duct
Jejunum
8ft long
Ilium
11 ft long
Digestion is completed…
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
Lg intestine
5 ft long
Ilium of sm intestine to the anus
Stores and eliminates indigestible material
Absorbs water, minerals, and vitamins
Elimination
Defecation reflux
Spinal cord reflex
Liver, bladder, pancreas
Accessory organs
Produce or store digestive secretions
Liver location
Right side
Center of the abdominal cavity just below the diaphragm
Right lobe larger than left
Blood supply to the liver
Oxygenated blood
Hepatic portal circulation
Regulates blood levels of nutrients or to remove toxic substances from the blood.
Functions of the liver
Production of bile and hepatocytes
Liver functions
Synthesis of specific enzymes
Carbohydrate metabolism
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
Amino acid metabolism
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
Lipid metabolism
Forms lipo proteins in the blood
Synthesis of plasma proteins
Synthesizes albumin, clotting factors, globulins
Albumin
Most abundant plasma protein
Helps maintain. Blood volume
ProThrombin fibrinogen circulate the blood until needed for clotting
Amino acid undergo a process in the liver
Amino group is removed and the remaining carbon chain is converted to urea
Synthesis of plasma proteins
Synthesizes albumin, clotting factors and globulins
Synthesis of plasma protein
Albumin maintains blood volume by pulling tissue fluid into capillaries
Clotting factors during plasma protein synthesi
Clotting factors produced by the liver include thrombin and fibrinogen.
Circulates in blood until needed for chemical clotting
Globulin during plasma protein synthesis
Carriers for other molecules in the blood
Phagocytosis of the Kupffer cells
Phagotyze worn erythrocytes, leukocytes, and some bacteria that circulate through the liver.
Many bacteria enter through the colon after being absorbed through the water
Portal circulation
Brings blood to the liver before entering circulation through the body
Bilirubin
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
Liver storage
Liver stores minerals iron and copper
Vitamins A D E K
Water soluble B12
Detoxification
Synthesizes enzymes that alter harmful substances to less harmful ones
Converts ammonia from protein metabolism to urea
Gall bladder
Under surface of the liver
Bile in the common hepatic duct
Flows through the cystic duct and into the gallbladder until it is needed in the sm intestine
Concentrates bile by absorbing water
Fatty foods enter the duodenum
Duodenal mucosa cholecystokinin
Cholecystokinin
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.
Pancrease
Posterior to the greater curvature of he stomach.
Digestive secretions are produced by the exocrine glands called acini
Acini
Digestive secretions produced by exocrine glands
Pancreatic digestive enzymes are involved in the digestion of the four organic molecule categories
Amylase
Pancreatic lipase
Monoglycerides
Trypsinogen
Trypsinogen
Inactive enzyme changed to active trypsin in the duodenum
Digests polypeptides to shorter chains of amino acids
Pancreatic juice contains the following protolytic enzymes
Chymotrypsin
Carboxypeptides
Elastase
Ribonuclease & deoxyribonuclease for digestion of RNA and DNA
Pancreas also has bicarbonate juice which contains
Alkaline
Function of bicarbonate juice
Neutralize hydrochloride acid in gastric juice
C. Diff
Risk factor with hospitalization or use of antibiotics
Use of probiotics can reduce the risk of C. Diff
BMI
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
Inspection of the abdomen
Supine position
Arms to side
Asculate URQ then clock wise
Clicks or gurgles heard (bowel sounds)
Hyperactive bowel sounds
High pitched
Rapid
Loud
Hypoactive bowel sounds
Infrequent
Paralytic ileus or following abdominal bowel surgery
Absent bowel sounds
Nothing heard in all quadrants for 2-5 minutes
Bowel obstruction sounds
High pitched tinkling that is proximal to obstruction
Abnormal or absent distal to the obstruction
Report abnormal or absent sounds to physician
Vascular sounds or Brits
Swooshing sounds
Heard over the aorta
Pts with chronic liver failure have a humming sound over the liver
Percussion
Performed by advanced nurse or physician
Palpating
Depress abdomin 0.5-1.0 inch
Use finger pads
Ascites
Accumulation of fluid in the peritoneal cavity.
Carcinoembryonic antigen (CEA) and carbohydrate antigen
Monitor GI cancer treatments
Found in patients with cirrhosis
Hepatic disease
Alcoholic pancreatitis
Enzymes released by damaged liver cells
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.
Occult blood stool test
Blood not seen by naked eye
UGI
Uppergastrointestinal series
Angiography
Symptoms of arterial occlusive disease of the hepatic, biliary and pancreatic vessels
Used to evaluate neoplasms in the organs
Liver scan
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
Endoscopy
Tube and fiber optic system or a tiny capsule for observing the inside of hollow organ or cavity
Esophagogastroduodenoscopy (EGD)
Visualizes the esophagus, stomach, and duodenum
Retrograde cholangiopancreatography (ERCP)
Liver, gallbladder and pancreas
Proctosigmoidoscopy
Distal sigmoid colon, rectum, anal canal
Colonoscopy
Lining of the lg intestine
Gastric analysis
Measures the secretions of the stomach
Diagnosis of duodenal ulcer
Gastric carcinoma
Pyloric or duodenal obstruction
Gastric acid stimulation test
Basal cell test
Presence of cancer cells
Orgastric tube
GI tube inserted orally into the stomach
Gastrointestinal decompression
Necessary if stomach or sm intestine is filled with air or fluid
Distention
Feeling of fullness
Pain in abdomin
Prevention:turning pt or ambulation
