Chapter 18

Question 1

What does the liver do?

Answer 1

The liver:
Assists in digestion by secreting bile, which aids in the digestion of fats
Filters toxic substances produced by digestion
Creates glucose stores
Produces substances necessary for blood clotting and immune function

Question 2

What is the gallbladder?

Answer 2

The gallbladder is a hollow pouch located beneath the liver that acts as a reservoir for bile.

Question 3

What is the small intestine?

Answer 3

The small intestine consists of:
Duodenum

where digestive juices from the pancreas and liver mix together
Jejunum
Plays a major role in the absorption of digestive products
Comprises a large amount of the surface area of the small intestine and does much of the work
Ileum
Absorbs nutrients that were not absorbed earlier
Absorbs bile acids so they can be returned to the liver for future use and vitamin B12 for making nerve cells and red blood cells

Question 4

What does the pancreas do?

Answer 4

Secretes juice containing enzymes such as amylase that help break down starches, fats, and proteins

Produces bicarbonate and insulin

Bicarbonate neutralizes the stomach acid in the duodenum.

Insulin helps regulate the levels of glucose in the bloodstream.

Question 5

What is Peristalsis?

Answer 5

Peristalsis moves the waste matter through the intestines.

Question 6

What is the spleen?

Answer 6

Is located in the abdomen but has no digestive system function

Is part of the lymphatic system

Plays a significant role in relation to red blood cells and the immune system

Assists in the filtration of blood

Aids in the development of red blood cells

Serves as a blood reservoir

Produces antibodies to help the body fight off disease and infection

Question 7

What do the kidneys do?

Answer 7

The kidneys play an important role in the regulation of acid–base balance and blood pressure.

Blood pressure regulation is associated with the kidneys’ ability to remove sodium chloride from the body.

Kidney disease is a common cause of hypertension.

Nearly 20% of the output of blood from the heart passes through the kidneys each minute.

Question 8

What is the peritoneum ?

Answer 8

The peritoneum consists of:

The parietal peritoneum, which lines the walls of the abdominal cavity

The visceral peritoneum, which covers the organs themselves

Question 9

What is ileus?

Answer 9

Ileus is the paralysis of the muscular contractions that normally propel material through the intestine.

Distention usually begins after the muscular contractions cease.

The only way the stomach can empty itself if ileus occurs is by emesis.

Question 10

what is cholecystitis?

Answer 10

Inflammation of the gallbladder

Question 11

Common abdominal pains

Answer 11

Question 12

What are causes of acute abdomen?

Answer 12

causes of acute abdomen include:

Ulcers

Gallstones

Pancreatitis

Appendicitis

Gastrointestinal hemorrhage

Esophagitis

Esophageal varices

Question 13

What are ulcers?

Answer 13

In peptic ulcer disease (PUD), the protective layer of mucus lining the stomach and duodenum is eroded, allowing acid to eat into the organ itself over the course of weeks, months, or years.

Most peptic ulcers are the result of infection of the stomach with Helicobacter pylori (H pylori).

Other causes include:

Chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs)

Alcohol

Smoking

PUD affects both men and women equally, but tends to occur more often in the older population.

Patients with peptic ulcers experience a classic sequence of burning or gnawing pain in the stomach that subsides or diminishes immediately after eating and then reemerges 2 to 3 hours later.

The pain usually presents in the upper abdomen, but sometimes may be found below the sternum.

Nausea, vomiting, belching, and heartburn are common symptoms.

If the erosion is severe, gastric bleeding can occur, resulting in hematemesis and melena.

Some ulcers will heal without medical intervention, but often complications can occur from bleeding or perforation.

More serious ulcerative conditions can cause severe peritonitis and an acute abdomen.

Question 14

What are gallstones?

Answer 14

The gallbladder is a storage pouch for digestive juices and waste from the liver.

Gallstones can form and block the outlet from the gallbladder, causing pain.

If the blockage does not pass, it can lead to severe inflammation of the gallbladder, called cholecystitis.

The wall of the gallbladder becomes inflamed.

In severe cases, the gallbladder may rupture, causing inflammation to spread and irritate surrounding structures such as the diaphragm and bowel.

This condition presents as a constant, severe pain in the right upper or midabdominal region and may refer to the right upper back, shoulder area, or flank.

The pain may steadily increase for hours or may come and go.

Cholecystitis commonly produces symptoms about 30 minutes after a particularly fatty meal and usually at night.

Other symptoms include general gastrointestinal distress such as nausea and vomiting, indigestion, bloating, gas, and belching.

People at a higher risk for developing cholecystitis include women; older adults; obese people; and people of Scandinavian, Native American, and Hispanic descent.

Question 15

What is pancreatitis?

Answer 15

The pancreas forms digestive juices and is also the source of insulin.

Inflammation of the pancreas is called pancreatitis.

Can be caused by an obstructing gallstone, alcohol abuse, and other diseases

Severe pain may present in the upper left and right quadrants and may often radiate to the back.

The patient may report that the pain is worse after eating.

Other signs and symptoms include nausea and vomiting, abdominal distention, and tenderness.

Complications like sepsis or hemorrhage can occur, in which case assessment may also reveal fever or tachycardia.

Question 16

what is appendicitis?

Answer 16

The appendix is a small recess in the large intestine.

Appendicitis is an inflammation or infection in the appendix.

This inflammation can eventually cause the tissues to die and/or rupture, causing an abscess, peritonitis, or shock.

Initially, the pain caused by appendicitis is generalized, dull, and diffuse and may center in the umbilical area.

The pain later localizes to the right lower quadrant of the abdomen.

Appendicitis can also cause referred pain.

The patient may also report nausea and vomiting, lack of appetite, fever, and chills.

A classic symptom of appendicitis is rebound tenderness.This can be assessed by pressing down gently and firmly on the abdomen.

The patient will feel pain when the pressure is released. Women who are pregnant may not exhibit this symptom

Question 17

what is Gastrointestinal hemorrhage?

Answer 17

Bleeding within the gastrointestinal tract is a symptom of another disease, not a disease itself.

Gastrointestinal hemorrhage can be:

Acute, which may be shorter term and more severe

Chronic, which may be of longer duration and less severe

All complaints of bleeding should be considered serious.

A gastrointestinal hemorrhage can occur in the upper or lower gastrointestinal tract.

Bleeding in the upper gastrointestinal tract occurs from the esophagus to the upper small intestine.

In the esophagus, problems might include esophagitis, esophageal varices secondary to liver failure, or a Mallory-Weiss tear, which results from excessive retching or vomiting.

Hematemesis is frequently seen in patients with upper GI bleeding.

The blood is either bright red or has the appearance of coffee grounds, depending on where in the GI tract it originated and how briskly it is occurring.

Lower gastrointestinal bleeding occurs between the upper part of the small intestine and the anus.

Bowel inflammation, diverticulosis, diverticulitis, cancer, and hemorrhoids are common causes of bleeding in the lower gastrointestinal tract.

In lower gastrointestinal bleeding, the bleeding often manifests as melena, or dark tarry stools, as a result of partial digestion of the blood.

Question 18

what are Esophageal varices?

Answer 18

Occur when the amount of pressure within the blood vessels surrounding the esophagus increases, frequently as a result of liver failure

If the liver becomes damaged, blood begins to back up into portal vessels, dilating the vessels and causing the capillary network of the esophagus to begin leaking.

If pressure continues to build, the vessel walls may fail, causing massive upper gastrointestinal bleeding and, quickly afterward, hematemesis.

In industrialized countries, alcohol is the main cause of portal hypertension.

In developing countries, viral hepatitis is the main cause of liver damage.

Presentation of esophageal varices takes two forms.Initially, the patient shows signs of liver disease—fatigue, weight loss, jaundice, anorexia, edema in the abdomen, abdominal pain, nausea, and vomiting.

This gradual disease process takes months to years before the patient reaches a state of extreme discomfort.

The rupture of the varices is far more sudden.

The patient may report sudden-onset discomfort in the epigastric region or sternum.

He or she may have severe difficulty swallowing, vomiting of bright-red blood, hypotension, and signs of shock.

If the bleeding is less dramatic, hematemesis and melena are likely.

Spontaneous rupture is often life threatening and significant blood loss at the scene may be evident.

Major ruptures can lead to death in a matter of minutes.

Question 19

what are Mallory-Weiss tears?

Answer 19

A tear in the junction between the esophagus and the stomach, causing severe bleeding and potentially death

Primary risk factors include alcoholism and eating disorders.

Mallory-Weiss tears affect both men and women equally, but are more prevalent in older adults and older children.

Vomiting is the principal symptom.

In women, this syndrome may be associated with severe vomiting related to pregnancy.

In extreme cases, patients may experience signs and symptoms of shock, upper abdominal pain, hematemesis, and melena.

Question 20

symptoms of gastroenteritis?

Answer 20

Diarrhea is the principal symptom in both infectious and noninfectious gastroenteritis.

The diarrhea may contain blood and/or pus, and it may have a foul odor or be odorless.

Other signs and symptoms include:.

Abdominal cramping

Nausea, vomiting

Fever

Anorexia