Digestive Flashcards by Yuko Porter

Liver location

Under the right diaphragm and is divided int o right and left

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hepatic portal vein?

Delivering a__________ blood from the b________ containing nutrients After liver, the blood drain to c______________ and to heart

a) deoxygenated
b) small intestine
c) inferior vena cava

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Hepatic artery

Delivers a_________ blood from the b________

Oxygen-rich blood
Heart

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Fat Emulsifying agents? 3

Bile salts
Phospholipids
Pancreatic lipase

Absorbed in the Small Intestine

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Fat absorption

Phase 1?
Phase 2?
Phase 3?
Phase 4?

1
Emulsification & Lipolysis
2
Micelle Formation
3
Fat absorption
4
Triglyceride resynthesis
Adipose tissue(storage)

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Salivary amylase?

The primary enzyme in saliva
Breaks down carbohydrates into smaller molecules, like sugars

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Carbs digesting

a) in the mouth process
b) in the small intestine
c) Absorbed where?

a) Salivary amylase

b) Pancreatic amylase
Brush Border enzymes
(Lactase, maltase)

c) Small Intestine

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Pepsin?

A stomach enzyme that serves to digest proteins found in ingested food

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Protein
Digesting Agents

a) Stomach?
b) Pancreas

a) Pepsin
-actively digests
HCL
-creates pH
environment for pepsin to work

b) Pancreatic enzymes (in the SA)
* *Trypsin**
* *Chymotrypsin**
* *Carboxypeptidase**

2nd Brush border Enzymes
Aminopeptidase
Dipeptidase
90-95% absorbed

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obesity?

BMI?

Caloric intake>exceeds caloric expenditure

Fat storage = obesity
BMI >30

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Adiponectin?

*Protein-based hormone**
*Secret weight-loss weapon!!**

Boosts metabolism
Enhances the muscle to use Carbs for energy
Increases the rate at which the body breaks down fat

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Peptide YY?

Hormone made in the small intestine
Helps to reduce appetite and limit food intake

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Insulin resistance?

Increasing blood sugar

Insulin
- A hormone your pancreas makes to lower blood glucose, or sugar

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Obesity
Complications

Decreased levels of what hormone?

Adiponectin & Peptide YY
= Increased insulin resistance

Diabetes type 2
HTN
CAD (Hormonal issue)

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a) Resistin?
b) Leptin?

a) insulin resistance and links obesity to diabetes

b) Supposed to tell your brain that
You have enough fat stored!
You don’t need to eat anymore!

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Obesity
Complications

Increase what hormones?

Increased plasma levels
ghrelin
Resistin & leptin
= increased appetite

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Obesity
Complications

Increase what neurons activity?

Hypothalamic neurons activity

Orexigenic and Anorexigenic activity
= increased consumption
= increased fat storage (brain issue)　

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Orexigenic hormone?
Anorexigenic hormone?

neurons stimulate eating

suppress the appetite 抑制　

Cholecystitis

inflammation of the gallbladder

Cholelithiasis?

= Gallstone formation

Pain

a) parietal
b) visceral
c) referred

a) Acute, sharp and localized
b) Blunt, dull, generalized
c) Felt in a different location to the cause of pain

What does insulin do in the body?

Keep the glucose in the blood within a normal range
taking glucose out of the bloodstream and moving it into cells

helps blood sugar enter the body’s cells so it can be used for energy

Insulin is the key that moves glucose inside the cells

So the body has the energy to live

Insulin how to work?

Glycolysis

Irreversible
ATP
E to be used anywhere in the body

one glucose molecule is broken down to form two molecules of pyruvic acid

Insulin how to work? Glycogenesis

reversible Glycogen E to be stored in short term in liver or muscle

Insulin how to work? Lipogenesis

Irreversible E to be stored long term in adipose tissue

Pancreas Exocrine function/3 enzymes

Exo=GI tract ENZYMES 1. Protease(Typsin + Chymotrypsin) 2. Lipase(Fat) 3. Amylase (carb) Breakdown starch then smaller carbs

Pancreas Endocrine function/ 2hormons

Insulin -Lower blood sugar Glucagon -Raise blood sugar

Acute pancreatitis Causes 2

**Reversable** Drinking episode ETOH(alcohol) Gallstone Block built duct-back up enzyme to pancreas

1. Inside the pancreas are special cells that secrete digestive enzymes and hormones. The cells that secrete digestive enzymes are known as ______________ cells. A. Islet of Langerhans B. Protease C. Acinar D. Amylase

C. Acinar

Select-ALL-that-apply: In the pancreas, the acinar cells release: A. Amylase B. Somatostatin C. Lipase D. Protease

A,C, D

As the nurse, you know the two most common causes of acute pancreatitis are: A. High cholesterol and alcohol abuse B. History of diabetes and smoking C. Pancreatic cancer and obesity D. Gallstones and alcohol abuse

Which patient below is at MOST risk for CHRONIC pancreatitis? A. A 25 year old female with a family history of gallstones. B. A 35 year old male who reports social drinking of alcohol. C. A 15 year old female with cystic fibrosis. D. A 66 year old female with stomach cancer. C

Diabetes 1 a) onset? b) SS c) Treatment

* *Genetic** * *“Don't have a key(insulin) for the lock (cells)** a) Early onset (0-40 y/o) b) Fruity breath (medical emergency) Weakness/weight loss Blurry vision c) Insulin treatment Diet/exercise

Diabetes 2 a) onset? b) SS c) Treatment

**“Used the key(insulin) so much that it doesn't work anymore”** a) Later onset (40+) b) Increased thirst/urination Slow-healing wounds Obesity c) Healthy eating Physical activity Oral meds (metformin)

Lab tests Hemoglobin A1c? Normal range?

HbA1c 3 months history -Red blood cells live for abt 3 months \<42 mg/dl (\<5.7%) = non diabetic 42-47 mg/dl (5.7-6.4) = prediabetic \>48 mg/dl (\>6.4) = diabetic

Lab tests **Serum glucose**

Blood sugar check-Snapshot \<140 mg/dl = Non diabetes ii. 140-199 mg/dl = Prediabetes iii. \>200 mg/dl 2 hrs after eating = Diabetes

Cirrhosis a) Definition b) Causes

a ) Scarring of the liver tissue due to long term inflammation b) Injury Fibrosis (scarring tissue) Fibrosis leads to “shunting” of the blood in the liver leading to jaundice, portal HTN and toxin accumulation

Portal hypertension (Hydrostatic pressure) Causes?

Impaired blood flow in the portal venous system Causes an increase of 10 mmHg at the portal vein

Ascites (Oncotic pressure—albumin) a) Definition a) causes

a) Accumulation of ascetic fluid =abdominal distention, increased abdominal girth weight gain b) Caused by a drop in albumin plasma protein = Capillary hydrostatic pressure to exceed capillary oncotic pressure This leads to peripheral edema and beer belly

Hepatic encephalopathy a) causes? b) S/S

Encephalo (brain/head) / Pathy (disorder) a) The toxins(ammonia) that the liver is normal able to remove from the blood are now let loose, when they get to the brain they cause inflammation in the brain b) Impared congitive, motor and behavioral functions Due to \*Biochemical Imbalance\* - more ammonia than normal

Jaundice a) Causes? b) Result?

a) oversecretion of bile or an Intrahepatic obstruction of the bile duct (Cholelithiasis) b) Greenish-yellow color to the patients skin but to too much bilirubin in the blood (Hyperbilirubinemia)

Hepato-renal syndrome a) causes? b) where blood go?

a) Kidneys begin to shut down due to low BP leads to Renal Failure b) It’s in the liver due to Portal HTN

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Digestive Flashcards

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