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BMS13 > Clinical Intro to GI Tract > Flashcards

Clinical Intro to GI Tract Flashcards

1
Q

What does the GI tract do?

A

Takes in food

Digests to extract and absorb energy and nutrients

Expels remaining waste

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2
Q

What is formed at the end of mastication?

A

Bolus

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3
Q

What are the three main salivary glands involved with eating?

A

Parotid

Sublingual

Submandibular

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4
Q

What type of saliva is produced by the parotid?

A

Serous

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5
Q

What type of saliva is produced by the submandibular?

A

Mixed

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6
Q

What type of saliva is produced by the sublingual?

A

Mucous

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7
Q

Which salivary gland is most active during eating/chewing?

A

Parotid

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8
Q

What are the digestive functions of saliva?

A

Form bolus

Amylase and lipase

Taste

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9
Q

What are the protective functions of saliva?

A

Dilution

Buffering

Lubrication

Remineralisation

Antimicrobial/antifungal/healing

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10
Q

What are the three regions of the pharynx?

A

Nasopharynx

Oropharynx

Hypopharynx

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11
Q

What prevents aspiration when you swallow?

A

Epiglottis

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12
Q

How long is the oesophagus on average?

A

25cm

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13
Q

How is food moved along the oesophagus?

A

Peristalsis

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14
Q

What are the four layers of the oesophagus?

A

Mucosa

Submucosa

Muscle layer

Adventitia

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15
Q

Describe the muscle arrangement of the oesophagus.

A

Upper third - voluntary

Middle third - mixed

Lower third - smooth

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16
Q

Describe the epithelium of the oesophagus.

A

Non-keratinised, stratified, squamous epithelium

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17
Q

At what level does the oesophagus pass through the diaphragm?

A

T10

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18
Q

At what level does the inferior vena cava pass through the diaphragm?

A

T8

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19
Q

At what level does the aorta pass through the diaphragm?

A

T12

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20
Q

What increases the secretion of saliva?

A

Parasympathetic and sympathetic stimulation

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21
Q

What decreases the secretion of saliva?

A

Sleep

Dehydration

Atropine

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22
Q

What are the characteristics of saliva?

A

Hypotonic

High HCO3- and K+

Contains α-amylase and lingual lipase

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23
Q

What increases the secretion of gastric acid?

A

Gastrin

Acetylcholine

Histamine

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24
Q

What decreases the secretion of gastric acid?

A

Chyme in duodenum

Somatostatin

Atropine

Cimetidine

Omeprazole

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25
Q

What increases the secretion of bile?

A

Cholecystokinin

Parasympathetic stimulation

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26
Q

What decreases the secretion of bile?

A

Ileal resection

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27
Q

What are the characteristic substances found in bile?

A

Bile salts

Bilirubin

Phospholipids

Cholesterol

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28
Q

What increases pancreatic secretion?

A

Parasympathetic stimulation

Secretin

Cholecystokinin

29
Q

What are the characteristics of pancreatic secretions?

A

Isotonic

High HCO3-

May contain pancreatic amylase, lipase, protease or pepsinogen or intrinsic factor

30
Q

Which amylase is stronger?

A

Pancreatic

31
Q

What does the stomach secrete?

A

Acid

Enzymes

32
Q

What are rugae?

A

Ridges of muscle tissue lining stomach

33
Q

How many muscle layers are there in the stomach’s muscularis externa?

A

Three

34
Q

What opens to allow chyme to move into the duodenum?

A

Pyloric sphincter

35
Q

How many lobes are in a human liver?

A

4

36
Q

What are the functions of the liver?

A

Drug metabolism

Produce clotting factors

Produce bile

37
Q

What are the cells of the liver called?

A

Hepatocytes

38
Q

What is the function of the bladder?

A

Stores and concentrates bile

39
Q

What is the common risk group for gall stones?

A

Females

40+

Fatty diet

40
Q

What is the endocrine function of the pancreas?

A

Regulate blood glucose by producing glucagon or insulin from islets of Langerhans

41
Q

What is the exocrine function of the pancreas?

A

Produce digestive enzymes

42
Q

What separates the small and large intestines?

A

Ileo-caecal valve

43
Q

What occurs in the large intestine?

A

Absorption of water

Absorption of vitamins made by bacteria

Reduction in acidity

Infection defence

44
Q

How does defence against infections occur in the large intestine?

A

Antibodies produced - especially by appendix

Confluence of several lymphoid tissues for surveillance

45
Q

What is an example of a direct dental defect?

A

Acid erosion by intrinsic acid reflux or extrinsic dietary acids

46
Q

What is an example of an indirect dental defect?

A

Malabsorption (medical conditions, drugs)

47
Q

What may result in enamel not forming or being translucent?

A

Hypercalcificaiton

Fluorosis

48
Q

What are two inflammatory bowel diseases?

A

Ulcerative colitis

Crohn’s disease

49
Q

What part of the GI tract does ulcerative colitis affect?

A

Part/whole of large intestine

50
Q

What is ulcerative colitis?

A

Inflammation, ulcers and pseudopolyps

Bacteria can leave GI tract into blood

51
Q

What are the oral manifestations of ulcerative colitis?

A

Oral ulceration

Blood blisters

Pyogenic granulosum

Erythema

52
Q

What is the characteristic timeline of Crohn’s disease?

A

Starts in teens/early twenties

Second peak in old age - 50-60yo

53
Q

What symptom might indicate Crohn’s disease?

A

Recurrent oral ulcers

54
Q

What are the symptoms of Crohn’s disease?

A

Intermittent abdominal pain, diarrhoea, abdominal distention

Fever

Anaemia and weight loss

Melaena

Fistulae and perianal sepsis

Finger clubbing

Uveitis, arthritis, skin rashes/erythemanodosum

55
Q

What is orofacial granulamatosis?

A

Group of non-infectious, idiopathic disorders

Histologically associated with non-caseating epitheloid granulomas and multinucleated Langhan’s giant cells within oral mucosa

56
Q

What does orofacial granulamatosis respond well to?

A

Injection steroids

57
Q

What is orofacial granulamatosis associated with?

A

Preservatives in diet

58
Q

What are some symptoms of orofacial granulamatosis?

A

Cracking

Oral ulcerations

Lip/soft tissue swelling

Staghorning

59
Q

What are the possible oral manifestations of inflammatory bowel diseases?

A

Ulcers

Swelling (facial or labial)

Mucosal tags

“Cobblestone” proliferation of mucosa (buccal)

Smoothing of tongue

Angular cheilitis

Gingival enlargement (secondary to drugs)

Staghorning

60
Q

What drugs may patients with IBD be taking?

A

Immunosuppressants

Corticosteroids

61
Q

What should you be aware of in patients with IBD?

A

Treat bacterial infections more aggressively

Gingival swelling

Hypertension, MI, hypotensive crises, cerebrovascular accidents

HPA-axis suppression, impaired glucose tolerance, diabetes, osteoporosis, growth retardation

Peptic ulceration

Delayed wound healing and poor quality tissues

62
Q

What is Coeliac disease?

A

Genetic hypersensitivity of small intestine mucosa to gliadin (in gluten) characterised by villous atrophy

63
Q

What are the two tests for Coeliac disease and which is more reliable?

A

Blood tests to see if you produce gluten antibodies

Small intestine biopsy - more reliable

64
Q

What is the dental relevance of Coeliac disease?

A

Malabsorption of vit. B12, folate - beefier tongue

Anaemia, iron-deficient

Glossitis, burning mouth, angular stomatitis, recurrent oral ulceration

65
Q

Why is malabsorption of vit. K important?

A

Patient will be prone to bleeding

66
Q

Why is malabsorption of vit. D important?

A

Osteomalacia (adults)

Rickets (children)

67
Q

What does angular stomatits indicate?

A

Iron deficiency or fungal infection

68
Q

What type fo ulcers do Coeliac disease patients tend to have?

A

Herpetiform (clusters)

BMS13 (7 decks)

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