Chapter 13 Flashcards
oropharynx
mouth, salivary glands, pharynx
alimentary tract
esophagus, stomach, small/large intestines, anus
pancreaticobiliary tract
liver, gallbladder, bile duct, pancreas, accessory organs
function of the GI tract
- digestion
- motility
- secretion
- absorption
- storage/elimination
components of the GI tract
- primary organs are where we find food
- accessory organs is where we find bile
mucosa
inner layer of GI tract, epithelial cells
submucosa
basement membrane, right above mucosa, where blood vessels are found
muscularis propria
muscular layer, above basement memebrane
serosa
connective tissue on the outside of the GI tract
bacteria in the GI tract is found..
in the gut/large intestine
bacteria in the GI tract helps with..
- digestion of certain carbohydrates
- produce nutrients such as folate and vitamin K
- influence development and responsiveness of GI immune system
- metabolize certain drugs to active metabolites
most frequent and serious problems of the GI tract
- constipation: infrequent and/or difficult to pass stool
- diarrhea: abnormally frequent and liquid stools
- viral enteritis: intestinal flu or stomach flu
- diverticulosis
- gastroesophageal reflux disease (GERD)
signs and symptoms of GI disorder
- anorexia (don’t feel like eating)
- altered motility (vomiting, diarrhea, constipation)
- nausea
- retching
- bleeding
- lack of movement
bleeding in the upper GI tract
- hematemesis: vomiting blood
- melena: black tarry stool
bleeding in lower GI tract
hematochezie
gastric analysis
measurement of stomach acid
tests on gastrointestinal contents, blood and urine evaluate..
absorption from GI tract
endoscopy
tube down stomach
siigmoidscopy
sticking probe up to look at sigmoid colon
colonoscopy
tube up to look at large intestine
radiologic techniques for GI tract
- upper GI series
- barium enema (rectum and colon)
- CT scan
congenital pyloric stenosis
narrowing of outlet of distal stomach resulting from hypertrophy of pyloric muscle (opening between stomach and small intestine)
what is the cause of congenital pyloric stenosis?
unknown
what happens with congenital pyloric stenosis?
projectile vomiting after feeding begins 2-4 weeks after birth
treatment for pyloric stenosis?
surgically open up sphincter (almost exclusively in boys)
hirschsprung disease
lack of ganglion cells (neurons in PNS) in rectum results in defective bowel movement and megacolon
what population does hirschsprung disease affect?
infants with chronic constipation and distended abdomen
treatment of hirschsprung disease
requires surgical removal of aganglioniic segment and reattachment of normal bowel
hernia
bulging of organ or tissue through an abdominal opening
what happens if the hernia gets trapped?
may get ischemic and infarct
types of hernias
- inguinal
- hiatal
- epigastric (above stomach - infants)
- umbilical (infants)
inguinal hernia
outpouching of abdominal content into groin
what is a danger of an inguinal hernia?
danger of bowel strangulation
treatment for inguinal hernia
surgical repair (most common in men)
esophagus dysfunction can present with..
- dysphagia (difficulty swallowing)
- pain
- bleeding
- regurgitation of food into trachea
- choking and coughing
reflux esophagitis
reflux of gastric acid
types of reflux esophagitis
- gastroesophageal reflux disease (GERD)
- laryngopharyngeal reflux (LPR)
predisposing factors for reflux esophagitis
- medicine
- acidic food
- alcohol
- age
- women who are pregnant
- obesity
- lying down after eating
persistent severe reflux can lead to..
- barrets esophagus (acid irritates esophagus, need scope to diagnose)
- esophageal cancer
how is GERD different from heartburn?
GERD is reflux more than 2 times a week
treatment for reflux esophagitis
- avoid foods that increase acidic reflux
- medications that reduce acid production (proton pump inhibitors - OTC, pump hydrogen in to decrease acidity)
- avoiding lying down after eating
gastritis
acute injury to gastric mucosa caused by agents that compromise the protective mucous barrier lying over the epithelial cells (may be associated with bleeding)
symptoms of acute gastritis
- nausea
- vomiting
- epigastric pain
acute gastritis main causes
- non-steroidal anti-inflammatories (NSAIDS)
- alcohol
chronic gastritis causes
- autoimmune (parietal cells)
- heliobacter pylori
heliobacter pylori
most prevalent infective agent worldwide
heliobacter pylori is more frequent with..
age (adapts to low pH of stomach)
tests for h pylori
- antibodies detected in blood
- breath test - breathe into machine
- stomach biopsy
h pylori is a risk factor for..
- ulcer
- stomach cancer
- leads to gastritis
peptic ulcer disease
a break or ulceration in the protective mucosal lining oof the lower esophagus, stomach, or duodenum
what is the leading cause of peptic ulcer disease
heliobacter pylori
symptoms of peptic ulcer disease
- nausea
- vomiting
- gnawing or burning upper abdominal pain
- weight loss with decreased caloric intake
complications of peptic ulcer disease
- internal bleeding (anemia - iron deficiency)
- penetration into the pancreas
- perforation leading to infection (peritonitis)
treatment of peptic ulcer disease
- antibiotics
- decreasing acid secretion
- eliminating cofactors that led to development of ulcers
malabsorption
- failure to digest and/or absorb food
- caused by disease processes that impair enzyme activity and absorption of nutrients across the gastrointestinal epithelium
potential causes of malabsorption
- lactase deficiency
- inflammatory bowel disease
- pancreatic insufficiency (enzymes)
- bile salt deficiency
- celiac disease
lactose intolerance
deficiency of lactase
symptoms of lactose intolerance
- bloating
- diarrhea
- gas
- stomach ache
treatment of lactose intolerance
pill to breakdown lactose
celiac disease
autoimmune, allergy to gluten, damages small intestine (villus)
symptoms of celiac disease
- abdominal pain, bloating, gas
- fat in stool
- weight loss
- malnutrition
- constipation
treatment for celiac disease
avoid gluten
entercolitis
inflammation of the colon/intestines
causes of entercolitis
- virus (more common)
- rotavirus = children
- noravirus = adults
- bacteria (less common, more severe)
- E. coli
- salmonella
- capylobacter
entercolitis leads to..
diarrhea (3x/day)
entercolitis is the ______ leading cause of death in children under 5 in developing countries
2nd (dehydration)
appendix
beginning of large intestine
appendicitis
inflammation of the appendix (medical emergency)
appendicitis is more common in..
teenagers and young adults
possible causes for appendicitis
infection or obstruction
typical presentation of appendicitis
- right lower quadrant pain
- nausea
- vomiting
- fever
most serious complication of appendicitis is..
peritonitis (inflammation of lining of peritoneal cavity)
what are the two types of inflammatory bowel disease?
crohns and ulcerative colitis
characteristics of inflammatory bowel disease
- episodic bloody diarrhea
- crampy abdominal pain
- inappropriate immune response
- family history
- peak age 15-30
- involvement of extraintestinal tissues
treatment of inflammatory bowel disease
- anti-inflammatories
- decrease activity of immune system
- resection
crohns disease
- patchy (anywhere in GI tract)
- transmural (inflammation is across entire wall of GI tract)
risk factors for crohns disease
- white
- female
- smokers
ulcerative colitis
- large intestine only
- mucosa only
diverticulosis
small pouches that push out in weak spots in colon wall (found almost exclusively in sigmoid colon)
if diverticula become inflamed..
form diverticulosis (pushing out from lumen)
complications of diverticulitis
- pain
- bleeding
- abscess
- perforation
peritonitis
inflammation of the peritoneum (lining of the abdominal cavity)
types of peritonitis
- infectious
- usually due to bacteria from bowel due to perforation
- sterile (no bacteria present, just inflamed)
once peritonitis is healed..
may produce adhesions (difficulty of movement between large/small intestine)
esophageal carcinoma
arise from epithelial
risk factors for esophageal cancer
- tobacco use
- alcohol use
why does esophageal cancer have poor prognosis?
- tends to invade and metastasize early
- no screening tests
- presents as dysplasia (difficulty swallowing)
gastric carcinoma
worldwide as deadly as lung cancer
risk factors for gastric carcinoma
- h pylori and chronic gastritis
- diet high in smoked, pickled, or salt preserved food (high in Japan)
gastric carcinoma is usually..
asymptomatic until advanced, don’t catch until stages 3/4
colon cancer
begins with polyps on the lining of the colon
treatment of colon cancer
radiation, chemo or surgery
risk factors for colon cancer
- age
- family history
- history of polyps
- high intake red meat
- IBD
manifestations of colon cancer
- blood in stool
- altered bowel habits
- iron deficiency anemia
diagnosis of colon cancer
biopsy
screening for colon cancer
- occult blood test (not very sensitive but used over long periods of time has proven to be beneficial)
- colonoscopy
- cologuard test
organ failure
failure of absorption processes can be tolerated for a number of days
