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Endoscopy Nurses - GENCA > Chapter 14 - Stomach > Flashcards

Chapter 14 - Stomach Flashcards

1
Q

Which arteries supply blood to the stomach?

A

The celiac artery, give rise to three major branches including the left gastric, splenic and common hepatic arteries.

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2
Q

Blood is drained from the stomach via the ____ vein.

A

portal

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3
Q

What are the primary functions of the stomach?

A
  1. Digestion of food (by mixing and breakdown of food by contraction and relaxation of the muscle layers in the stomach as well as secretion of stomach enzymes and acids)
  2. Temporary storage for food and regulation of entry into duodenum
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4
Q

The mucosa contains 3 types of glands which differ from one region of the stomach to another. Can you name all three?

A
  1. Cardiac gland (distal to GOJ)
  2. Oxyntic gland (proximal 2/3 of the stomach)
  3. Pyloric gland (antrum and pylorus)
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5
Q

What does the cardiac gland secrete?

A

mucus and pepsinogen

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6
Q

What does the cells of oxyntic gland secrete?

A

Chief cells secrete pepsinogen
Parietal cells secrete hydrochloric acid (HCL) and intrinsic factors necessary for absorption of vitamin B12

Enterochromaffin cells secrete serotonin

Gland also secrete bicarbonate and hormonal products eg. somatostatin and glucagon

Note: HCL converts pepsinogen to pepsin

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7
Q

What does the pyloric glands secrete?

A

Mucus cells secrete mucus and pepsinogen
G cells secrete gastrin

Enterochromaffin cells secrete serotonin

Gland also secrete bicarbonate and hormonal products eg. somatostatin and glucagon

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8
Q

When the normal balance between factors that promote mucosa injury (eg. gastric acid, pepsin) and those that protect (eg. mucus, bicarbonate) is upset 😡 this gives rise to ___ or ___.

A

inflammation or ulcers

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9
Q

What are some risk factors for peptic ulcers?

A
  1. H. pylori infection 🧫
  2. Chronic use of NSAIDs
  3. Family history
  4. Cigarette smoking 🚬
  5. Excessive acid production seen in Zollinger-Ellison syndrome
  6. Prolong use of corticosteroids
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10
Q

What is dyspepsia?

A

Epigastric discomfort, burning or pain

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11
Q

Can inflammation and edema of the ulcer in the antrum or scarring at the gastroduodenal junction cause gastric outlet obstruction?

A

Yes, because of impaired antral motility.

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12
Q

Can gastric ulcer be malignant?

A

Yes

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13
Q

What are some drug therapy for ulcer without H.pylori?

A
  1. PPI (decrease acid production)
  2. H2 blockers (decrease acid production)
  3. Sucralfate (forms a protective cover)
  4. Antacids (neutralizes gastric acid)
  5. Prostaglandins (antisecretory effects)
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14
Q

If peptic ulcers are left untreated this may cause

A

hemorrhage, perforation, penetration and obstruction

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15
Q

When there is uncontrolled hemorrhage from a gastric ulcer, what emergency surgery can be performed?

A
  1. Vagotomy with pyloroplasty
  2. Billroth I
  3. Billroth II
  4. Total gastrectomy
  5. Gastric resection
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16
Q

The preferred treatment for H. pylori includes:
1.
2.
3.

A
  1. PPI
  2. Amoxicillin
  3. Clarithromycin
17
Q

What is achlorhydria syndrome?

A

Stomach does not produce HCL

18
Q

What is Curling’s ulcer?

A

An acute gastric erosion resulting as a complication from significant burns.

19
Q

What is Cushing’s ulcer?

A

Stress ulcers associated with brain trauma.

20
Q

A sliding hiatal hernia is often associated with

A

weakening of the lower esophageal sphincter (LES) and resultant esophageal reflux.

21
Q

What is dumping syndrome?

A

When your stomach empties its contents to the duodenum faster than normal. This is usually associated with patients who had gastric surgery.

22
Q

Patients with gastric outlet obstruction may vomit partially digested gastric content and complain of pain. Two-thirds of these pts become anorexic. What treatment is available?

A
  1. Restoration of food and electrolyte
  2. Decompression of the stomach
  3. Correction of nutritional deficiencies
  4. Endoscopic dilation of the pylorus
23
Q

Gastric varices is often a result of portal hypertension from alcoholic cirrhosis. What are 3 objectives to managing esophagogastric varices?

A
  1. To heamodynamically stabilize pt
  2. To stop acute variceal bleeding by:
    a. Endoscopic schlerotherapy
    b. Endoscopic variceal ligation (banding kit)
  3. To reduce portal pressure by radiological intervention:
    a. percutaneous transhepatic embolization (PTE)
    b. transjugular intrahepatic portosystemic shunt (TIPS)
24
Q

What is a bezoar?

A

Concretion of foreign material found in the stomach.

Phytobezoar - vegetable & plant material
Lactobezoar - milk curd
Pharmacobezoar - ingested medications
Trichobezoar - Hair that has been chewed

25
Q

How are bezoars treated?

A
  1. Endoscopic fragmentation with eg. forceps
  2. Enzymatic agents
  3. Gastrotomy

Endoscopy Nurses - GENCA (7 decks)

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