Chapter 37 Flashcards
what is the job of the bowel?
to digest food (involves a corrosive solution and potentially pathogenic bacteria). to absorb the food into the blood while keeping the corrosive substances and the bacteria inside the gut. to keep the solution moving down the bowel at the right rate for digestion and absorption.
difficulty swallowing is also called
dysphagia
dysphagia has to do with weakness of ________ and problems with _______.
weakness of muscles that propel and problems with lower esophegal sphinter
GERD occurs when
weak or incompetent sphincter
manifestations of GERD
- heartburn/pain in epigastric that may radiate to throat, shoulder or back.
- regurgitation of chyme
- mid -epigastric pain within 1 hour of eating
mucosal injury of GERD
edema, inflammation and erosion of mucosal esophagus
major causes of irriation and ulcer formation
- aspirin and NSAIDS
2. infection with H. pylori
why do aspirin and NSAIDS cause gastric and ulcer formation?
irritate the gastric mucosa and inhibit prostaglandin synthesis.
H. pylori thrives in
an acid enviornment of the stomach
H. pylori disrupts
the mucosal barrier that protects the stomach from harmful effects of its digestive enzymes.
inflammation and sometimes hemmorhage of the stomach
acute gastritis
the common causes of acute gastritis are
- NSAIDS
- alcohol
- bacterial toxins
- cortioscsteriods
- chemo drugs
related to inflammtory changes. no gross erioson (spotty erosion r/t inflammation)
chronic gastritis
a big cause of chronic gastritis is
h. pylori bacteria
toxins and enzymes that promote inflammation and ulceration by interfering with gastric mucosa allowing acid to damage and may cause gastric atrophy and cancers
h. pylori bacteria
major cause of ulcers is
h. pylori
most common place peptic ulcer disease is found
duodenum
peptic ulcer disease is the
damage/erosion to the gastric mucosa
what are the contributors to peptic ulcer disease?
- h. pylori
- aspirin/NSAIDS
- family history
- age
- cigarette smoking
- warfarin
list the complications of PUD
scar tissue
repeated episodes of PUD cause
- hemmorhage, perfortation, pentretation, gastric outlet obstruction, edema and spasms
a peptic ulcer that is related to severe illness, neural injury, or systemic trauma
stress ulcer
ulcer within hours of a trauma, burns or sepsis
ischemic ulcers
ulcers that develop as a result of head/brain injury
cushing ulcers
risk factors for developmental of stress ulcers
large surface area burns, trauma, sepsis, acute respiratory distress syndrome, severe liver failure, major surgical procedures, zollinger-ellison syndrome.
chronic, relapsing inflammatory bowel disorders of unknown origin
inflammatory bowel diseases
inflammatory bowel diseases are caused by
- genetics
- alterations of epithelial barrier functions
- immune reactions to intestinal flora
- abnormal T cell responses
two types of inflammatory bowel diseases
crohn’s and ulceritiave colitis
idiopathic inflammatory disorder. causes skip lesions anywhere in GI tract. difficult to differeniate from ulceratitive collitis
crohn’s disease
chronic nonspecific inflammatory disease that cause ulceration of the colonic mucosa.
ulcerative colitis
symptoms of ulcerative colitis
diarrhea, bloody stools and cramping
outpouchings of the mucous membranes. lower left quadrant pain. fever and elevated WBC. unknown cause
diverticular disease
simple obstruction =
no alteration in blood flow
strangulated obstruction =
impaired blood flow… necrosis of tissue
impairment of peristalsis. common after abdominal surgrey, vascular insufficenies and electrolyte imbalances
paralytic obstruction
what would both types of mechanical and paralytic obstruction look like?
abdominal distention. loss of fluids and electrolytes and accumulation of gases and fluids
lactase deficiency means
unable to break down lactose into monosacchrides —> no lactose digestion and no monosacchride absorption
fermentation of lactose by bacteria causes
gas and osmotic diarrhea
with aging, we see a
decrease in gastric juice secretion, atrophy, loss of hepatic regeneration and may not metabolize drugs well.
