ch36: alterations of GI functioning Flashcards
what is anorexia?
body is undernourished
what is cachexia?
weakness and wasting of body due to severe chronic illness
what is vomiting?
productive release of stomach contents
what is retching?
nonproductive attempt to release stomach contents
what is diarrhea?
can’t stop releasing feces
what is small volume diarrhea?
type of diarrhea; due to metabolic, chronic disorders
what is large volume diarrhea?
type of diarrhea due to acute, identified obvious cause
what is osmotic diarrhea?
type of diarrhea; some sort of ion imbalance outside intestinal walls
what is secretory diarrhea
type of diarrhea; cellular level impairment (usually associated with small volume diarrhea)
what are the two types of abdominal pain?
- mechanical abdominal pain
2. ischemic abdominal pain
what is hematochezia?
bloody stool
types of GI bleeding?
- lower GI bleeding
- upper GI bleeding
- occult bleeding
mechanical abdominal pain?
inflammatory –> usually associated with crohn’s, IBS, ulcerative colitis
ischemic abdominal pain
interruption of blood flow to the abdomen –> pain
why does blood turn black when in the system for longer?
intestinal flora love the iron in blood –> blood becomes black
steatorrhea (what is it a sign of?)
fat in stool
could be a sign of liver damage
magnesium citrate
drink before a colonoscopy, brings water into the intestine
dysphagia
difficulty swallowing
achalasia
impaired esophageal peristalsis
gastroesophageal reflux (GERD)
stomach acid starts working its way up to esophagus
reflux esophagitis
chronic inflammation of esophagus because of GERD
what causes stomach acid to work its way up to the esophagus?
lower esophageal sphincter impairment
hiatal hernia (HH)
protrusion of an organ into another structure due to weakening
what are two types of hiatal hernia?
- sliding hiatal hernia
2. paraesophageal hiatal hernia
sliding hiatal hernia
stomach slides or moves into the thoracic cavity through the esophageal hiatus
paraesophageal hiatal hernia
the esophagus stays where it is and a portion of the stomach pushes up beside the esophagus
gastroparesis
impairment of stomach contents going into the duodenum of small intestine; affects the normal spontaneous movement of muscles in stomach
what are two types of GI obstruction?
- pyloric obstruction
2. intestinal obstruction
pyloric obstruction
narrowing/blocking of the opening between the stomach + duodenum
what are two types of intestinal obstruction?
- simple obstruction
2. functional obstruction
intestinal obstruction
caused by any condition that prevents normal flow of chyme through the intestinal lumen
simple obstruction
mechanical blockage of lumen by lesion or feces (most common)
functional obstruction
something impaired the ability of smooth muscle to move through intestine; failure of motility
gastritis
inflammation of the lining of the stomach.
acute gastritis
chronic gastritis
peptic ulcer disease
often caused by helicobacter pylori
- can be acute or chronic
- NSAIDs can also cause (prostaglandin inhibitors keep prostaglandins from maintaining the mucosal lining)
duodenal ulcers
ulcers in or near the duodenum
gastric ulcers
ulcers that affect the stomach itself; open sores that develop on the lining of the stomach
stress ulcers
ulcers that can be indirectly caused by shock, sepsis, and trauma
what are three types of stress ulcers?
- ischemic ulcers
- curling ulcers
- cushing ulcers
ischemic ulcers
ulceration happens because of interruption of blood flow to the stomach
curling ulcers
ulcerations after burn injuries (what degree of burns usually typically applies to this)
cushing ulcers
ulcerations caused by head or brain trauma –> interruption of impulses of nervous system innervates the stomach
gastrectomy
partial removal of stomach
maldigestion disease
impaired ability to break down food eaten for nutrition
malabsorption disease
impaired ability to absorb nutrients from food eaten
where is vitamin B12 mostly absorbed in the body?
in the stomach to aid in production of RBCs
what is the purpose of the pancreas and what happens with pancreatic insufficiency?
pancreas releases pancreatic juice into duodenum to neutralize pH of the chyme
- insufficiency: can’t neutralize chyme
what happens when a patient has lactase deficiency what what occurs?
lactose intolerance (abdominal intestinal pain → lactose accumulation → intestinal flora tries to break it down → makes different byproduct → GASSY)
bile salt deficiency
can lead to steatorrhea
- bile helps with fat breakdown and digestive problems post stomach
what are some inflammatory bowel diseases?
- appendicitis
- ulcerative colitis/crohn’s disease
- IBS
- diverticular disease
appendicitis
inflammation of the appendix
what is a possible function of the appendix?
repopulate normal flora
ulcerative colitis
affect the large intestine
crohn’s disease
can affect any part of the GI tract
irritable bowel syndrome (IBS)
what can be used to treat it?
abnormal colon contractions
can use benign, non pathogenic worms to treat –> trigger eosniophils and IgE to lesson symptoms
what are 2 diverticular diseases?
- diverticulosis
2. diverticulitis
diverticulosis
affect the diverticula of the intestine (out pouching without inflammation)
what should a patient avoid if they have diverticulosis?
seeds (it can get stuck in the diverticula –> growth –> inflammation)
diverticulitis
out pouching of the diverticula with infection or inflammation
obesity
having a BMI over 30
what are two types of obesity?
- central obesity
2. peripheral obesity
what is leptin?
hormone that is an appetite suppressor
what happens during leptin resistance?
body isn’t as sensitive to leptin anymore → ability to respond to leptin is lowered bc body is saturated with it all the time (constantly eating sugar → insulin resistance)
do fat cells increase in number or size when gaining weight?
fat cells get bigger (not necessarily increase in number)
what is ghrelin?
a hormone that is an appetite promoter
what happens during ghrelin resistance?
body isn’t as sensitive to ghrelin anymore –> ability to respond to it is lowered
anorexia nervosa
PSYCHOLOGICAL condition where individual is deliberately starving themself (to look thinner)
bulimia nervosa
PSYCHOLOGICAL condition where individual eats a lot (binge) and throws it up (purge)
what physiological changes are associated with bulimia nervosa?
- electrolyte imbalance
- esophagitis (stomach acid deteriorates esophagus)
- tooth decay
malnutrition
not bringing enough nutrients in to maintain homeostasis
starvation
deliberately preventing self from getting nutrients
what are two types of starvation?
- short term starvation
2. long term starvation
what are benefits of short term starvation?
gives body a break from high concentrations of leptin and insulin (decreases chance of desensitization); reset hormone concentrations
long term starvation
why does the liver have a lot of rough ER?
rough ER specializes in lipid metabolism
portal hypertension
elevated pressure in portal venous system –> can cause stuff to pass through the liver too quickly
ascities
fluid build up in peritoneal cavity (sign of LIVER DYSFUNCTION)
hepatic encephalopathy
liver can’t do its job –> starts affecting the brain
what type of headaches are associated with hepatic encephalopathy?
chronic tension headaches
jaundice (icterus)
yellowing of sclera, skin, nails
hyperbilirubinemia
bilirubin back up in bloodstream bc liver cannot convert into bile
what is bilirubin
byproduct of broken down RBCs
what are three types of jaundice?
- obstructive jaundice
- hemolytic jaundice
- hepatocellular jaundice
obstructive jaundice
actual blockage in the common bile duct
gall stones
hemolytic jaundice
rupture of too many RBCs (smth causing too many RBCs to break down)
hepatocellular jaundice
defect in the actual hepatocytes and the ability to make bile
(cirrhosis of the liver)
hepatorenal syndrome
kidney and liver relationship
Liver disease = imparied ability of kidney to do their job
what can cause acute liver failure?
- drug associated: can be triggered by acetaminophen (tylenol)
- infectious disease: hepatitis
viral hepatitis
hep B and C
non alcoholic fatty liver (NAFL)
fat infiltration into the liver
- can also lead to cirrhosis
cirrhosis
massive scar tissue infiltration in the liver
what are two types of cirrhosis
- alcoholic cirrhosis
2. billiary cirrhosis
alcoholic cirrhosis
caused by chronic alcohol abuse
biliary cirrhosis
scar infiltration of the biliary ductwork
primary biliary cirrhosis
autoimmune, idiopathic biliary cirrhosis
secondary biliary cirrhosis
defined cause of cirrhosis, usually happens similarly bc of alcoholic cirrhosis
what are 2 gallbladder disorders?
- cholelithiasis
2. cholecystitis
cholelithiasis
gallstones
what are gall stones mostly made out of?
fat and cholesterol
cholecystitis
inflammation of the gallbladder
what are two types of cholecystitis
- acute cholecystitis
2. chronic cholecystitis
acute cholecystitis
infectious disease related
chronic cholecystitis
slower development, can happen in absence of mitigating factors
- can start to affect the integrity of the bladder
- may lead to removal of gallbladder
is the pancreas an endocrine and exocrine gland?
both
what do true exocrine glands have?
ducts
how do endocrine glands that don’t have ducts secrete into the body?
secrete into the bloodstream
what are some pancreatic disorders?
pancreatitis, acute and chronic
pancreatitis
inflammation of the pancreas
acute pancreatitis
can be due to infectious disease or a reaction to drug
chronic pancreatitis
similar to liver cirrhosis; affects how pancreas acts a an endo/exocrine gland
- scar tissue infiltration
what is affected when secretion by the pancreas is impaired?
no pancreatic juice to neutralize chyme
no insulin/glucagon for sugar storage and absorption
what are the cancers of the GI tract?
- esophageal cancer
- stomach cancer
- colorectal cancer
- liver cancer
- pancreatic cancer
- gallbladder cancer
esophageal cancer
- what is it?
- what causes it?
- prognosis?
- cancer of the esophagus
- caused by smoking, GERD, alcohol abuse
- prognosis: tough to treat because patient still has to get nutrients and may exhibit cachexia –> usually successful just difficult
why does GERD lead to esophageal cancer?
chronic inflammation when stomach acid eats away at esophageal lining
stomach cancer
- what is it?
- what causes it?
- prognosis?
- cancer of the stomach (if prone to stomach ulcers = link to stomach cancer)
- caused by smoking, GERD, alcohol abuse
- prognosis: tough to treat because patient still has to get nutrients and may exhibit cachexia –> usually successful just difficult
colorectal cancer
- what is it?
- what causes it?
- prognosis?
- cancer of the colon (formation of polyps = risk factor of colorectal cancer)
- caused by diet, xenobiotic compounds, alcohol, smoking, chronic inflammation due to an infectious disease. GENETICS
- prognosis: all depends if you catch it in time
what is the biggest contributing factor towards colon cancer?
genetics
t/f: almost half of all colorectal cancers occur at the rectum
true
liver cancer
- what is it?
- what causes it?
- prognosis?
- cancer of the liver (hepatocellular and cholangiocellular carcinoma)
- infectious diseases HEP B and C, cirrhosis, smoking, liver damage
- prognosis: depends if you can catch it in time?
why does metastasis get stuck and grow in the liver?
narrow capillaries causes things to get stuck
what are the three most common places for metastasis?
lungs, liver, lymph
hepatocellular carcinoma
carcinoma that affects liver themselves (origin in the liver)
cholangiocellular carcinoma
carcinoma that affects the duct work (common bile duct, hepatic duct, cystic duct)
pancreatic cancer
- prognosis?
worse prognosis; even after treatment it can develop quickly
- by the time you realize it; it might be too late
gallbladder cancer
- prognosis?
better prognosis; can always have the gallbladder removed and pray it didn’t metastasize
