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Digestive funx Flashcards

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1
Q

normally in __, the __ __ responds to __ glucose. The __ or __ center responds to __ glucose levels.

A

hypothalamus, hunger center, low, satiety, satisfaction, increased

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2
Q

4 facts about Anorexia

  1. seen in
  2. affected by
  3. related to
  4. precursor of
A
  1. seen in other d/o’s (cancer <3 dz renal dz)
  2. affected by smell emotions drugs
  3. can be related to psychosocial stress
  4. often precursor of nausea, pain diarrhea
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3
Q

3 facts about nausea

  1. what type of experience
  2. associated with
  3. specific…
A
  1. subjective experience
  2. associated w/ variety of conditions
  3. no specific neural pathways identified
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4
Q

major s/s of nausea

A

hypersalivation
tachy <3
diaphoresis

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5
Q

what roles do the SNS & PNS play in N/V & retching

A
  1. diffuse sympathetic discharge causes
    - increase <3 rate
    - increase resp.
    - diaphoresis
  2. PNS mediates:
    - increase salivation
    - increase motility (& relaxation of both sphincters)
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6
Q

what is the CTZ, location, funx

A
  1. chemoreceptor trigger zone
  2. 4th ventricle of brain
  3. receive stimuli from GI tract, vestibular apparatus, drugs, toxins, and hypoxia
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7
Q

location & funx of the vomiting center

A

-medulla just above spinal cord & below pons
sensory
-receives sensory impulses (odor, smell, taste, gastric irritation, or ACh (hi dose of Rx ACh directly causes vomiting)

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8
Q

what causes projectile vomiting

A
  1. direct stimulation of vomiting center
    - neurologic lesions (tumors, aneurysms) of brain stem
    - may be a symptom of GI obstruction
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9
Q

metabolic consequences of vomiting

A
  1. fluid imbalance
  2. electrolyte imbalance (hypoCl-, hypoCa+, hypoK+)
  3. acid-base disturbances (alkalotic)
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10
Q

causes of constipation

A

(constipation is a symptom not dz)

  1. mechanical
  2. physiological
  3. functional
  4. pharmacological
  5. psychological
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11
Q

s/s of diarrhea

A
  1. 3 or more days of loose unformed stools
  2. pain, cramping, urgency
  3. hyper active BS borbygamous
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12
Q

5 types of diarrhea

A
  1. large volume: r/t increase of h2o, secretions, or both
  2. small-volume: r/t increase in intestinal motility
  3. acute
  4. chronic
  5. steatorrhea
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13
Q

describe acute diarrhea

A

sudden onset
2 wks or more duration
r/t increase of h2o secretions or both
-can be microorganism

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14
Q

describe chronic diarrhea

A 
3-4 wks
recurring
inflammatory bowel dz
-fever bloody stools
-crohns ulcerative collitis
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15
Q

steatorrhea

A

fat in stools

related malabsorption syndrome (will float)

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16
Q

3 mechanisms that cause diarrhea

A
  1. osmotic
  2. secretory
  3. motility
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17
Q

describe osmotic diarrhea & it’s cause

A
  • presence of nonabsorbable substance in intestines which draws excess water into intestine which increases stool weight/volume
  • lactase & pancreatic enzyme deficiency
  • excessive ingestion of synthetic, nonabsorbable sugars (sorbital)
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18
Q

secretory diarrhea description & cause

A

excessive mucosal secretion of fluid & electrolytes which produces large volume diarrhea

  • bacterial enterotoxins (e coli c-diff ATB therapy)
  • small-volume secretory diarrhea caused by inflammatory disorder of intestine
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19
Q

motility diarrhea description & cause

A

food not mixed properly which impairs digestion increases motility

  • small bowel resection
  • surgical bypass of section of intestine
  • fistula formation btw loops of intestines
  • gi bleeding
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20
Q

Ab pain

A
  1. mechanical (ab organs are sensitive to stretching but not cutting tearing or crushing)
  2. inflammatory biochemical mediators stimulate nerve endings producing pain (histamine, bradykinin serotonin)
  3. infx/inflammation ->edema & vascular congestion
  4. ischemic d/t blood flow obsctruction
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21
Q

define adhesion & when they occur

A

bands of tissue that form btw tissues & organs, occur after surgery

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22
Q

3 types of pain

A

parietal
visceral
referred pain

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23
Q

3 types of GI bleeds

A
  1. upper gi
  2. lower
  3. acute
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24
Q

3 causes of upper GI bleeding

A
  1. esophageal varices
  2. peptic ulcers
  3. tearing (mallory-weiss tear) from weakness or retching
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25
Q

what is frank and occult blood

A

occult is hidden blood

frank is obvious blood

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26
Q

lower GI bleed causes

A
  • polyps
  • inflammatory dz
  • tumors
  • hemorrhoids
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27
Q

consequence of acute GI bleed

A

life threatening medical emergency with sudden blood loss and is at high risk for decreased tissue perfusion and can affect all organ systems

28
Q

define hematochezia & melena

A

hematochezia: bright red stools
melena: black or tarry stool, sticky, foul odor, increased BUN levels as a result of digestion of blood proteins

29
Q

describe GERD

A

loss of muscle tone at the lower esophageal sphincter, reflux of chyme (along w/acid and pepsin) from stomach through LES esophagus

30
Q

GERD clinical manifestations

A 
<3 burn
acid regurgitation
dysphasia, hoarseness
maybe tirgger for asthma or chronic cough
upper ab pain within 1 hr of eating
31
Q

What are inflammatory response in esophageal wall caused by GERD

A 
hyperemia
increased capillary permeability
edema 
tissue fragility
erosion
fibrosis and thickening
32
Q

define hiatal hernia & major symptoms

A
  • protrusion of upper part of stomach through diaphragm

- heartburn after eating and swallowing

33
Q

What are two types of hiatal hernia

A
  1. sliding, related to congenitally short esophagus, trauma, or weakening of diaphragm muscles
  2. paraesophageal: stomach slides up alongside esophagus
34
Q

when does a sliding hiatal hernia worsen

A

coughing, bending, tight clothes, obesity, pregnancy

35
Q

what s/s associated with paraesophageal hiatal hernia, what 2 things does it lead to, and what is the most serious complication

A

congestion of mucosal blood flow, leads to gastritis & ulcer formation, strangulation is the most serious/major complication

36
Q

what is pyloris obstruction, 2 types

A

narrowing of blocking of opening btw stomach and duodenum

  1. congenital (pyloric stenosis neonates)
  2. acquired (inflammation) caused by peptic ulcer dz (usually duodenal) or nearby carcinoma
37
Q

clinical signs of pyloric obstruct (View Pangs)

A

1 epigastic fullness after eating & late in day
2 nausea/epigastric pain (b/c of muscles contrax in attempt to force chyme past obstruction)
3 anorexia weight loss
4 gastric distention
5 succussion splash (sloshing)
6 copious vomiting- undigested food w/ no bile (projectile)
7 infrequent small stools

38
Q

what is intestinal obstruction & 2 types

A 
-any condition preventing normal flow of chyme through intestiene
1 simple (mechanical block)
2 functional: motility failure (paralytic ileus) can happen in post-op or in electrolyte imbalance
39
Q

describe hernia protrusion & intussusception

A
  1. d/t weakness in ab muscles or through inguinal ring

2. intussusception: telescoping of 1 part of intestine into another

40
Q

what does intussusception cause and who is it more common in

A

usually causes strangulation of blood supply

more common in infants

41
Q

define torsion & constriction adhesions

A
  1. torsion is intestinal twisting on its mesenteric pedicle

2 formation of fibrin and adhesions that attach to intestine, omentum, or peritoneum post-op most

42
Q

what is associated with torsion and what does it create

where are constriction adhesions most common

A
  • torsion associated with fibrous adhesions & -creates blood supply occlusion
  • most common in small bowel
43
Q

where do diverticula usually form

A

(L) descending & sigmoid colon

44
Q

s/s of diverticulitis

A

cramping
diarrhea
constipation
distention/flatulence

45
Q

what is the most common surgical emergency of ab & what are 2 risks

A
  • appendicitis

- gangrene & perforation

46
Q

clinical s/s of appendicitis

  1. location of pain
  2. 4 pieces of data used to diagnose give lab value
  3. symptoms
A
  1. RLQ
  2. clinic. manifestations, WBC (10-16K w/ hi neutrophil #), ultrasound, CT
  3. N/V anorexia low grade fever diarrhea (esp. in children)
47
Q

pathophysiology of portal HTN, & what 4 conditions can it cause

A
  • caused by blocked blood flow through portal venous sys or vena cava
    1. varicies (esophageal, stomach, ab wall, or rectum (hemorrhoids)
    2. ascites
    3. splenomegaly
    4. hepatic encephalopathy
48
Q

clinical manifestations (4) of portal HTN

A
  1. varices rupture and cause hemorrhage
  2. hematemesis
  3. melena
  4. hi mortality rate
49
Q

what is ascites, 3 causes in relation to

  1. albumin
  2. pressure
  3. weeping
A

fluid accumulation in peritoneal cavity

  1. lo albumin synthesis, decreasing capilary osmotic pressure
  2. hi capillary hydrostatic pressure
  3. hepatic lymph weeps into peritoneum carrying bacteria->peritonitis
50
Q

define jaundice (aka) cause/related pathology

A
  1. yellow or greenish skin pigmentation
  2. icterus
  3. hyperbilirubinemia
51
Q

what causes jaundice in neonates

adults

A
  1. newborns impaired bilirubin uptake and conjugation

2, adults: 2 hepatobiliary (liver/gallbladder) causes & 1 hematologic cause

52
Q

clinical manifestations of jaundice

A

fever, chills, liver pain d/t hepatitis

anorexia, malaise, pruritis

53
Q

2 types of hepatobiliary bilirubin increase, and what type of hyperbilirubinemia it causes

A
  1. extrahepatic- bile ducts blocked (cholestasis)
    - conjugated hyperbilirubinemia
  2. intrahepatic (conjugated & unconjugated)
    * liver pathology (cirrhosis & hepatitis)
    * inherited problem w/bilirubin processing
54
Q

cause of hemolytic jaundice & associated d/o’s & type of hyperbilirubinemia

A
  1. making too much bilirubin d/t increase RBC breakdown
  2. d/t sickle cell anemia, hemolytic anemia, GI bleeding
  3. (unconjugated)
55
Q

5 characteristics of hepatic encephalopathy

  1. complex…
  2. …funx
  3. changes
  4. result from
A
  1. complex neurological syndrome associated with liver failure
  2. impaired cerebral funx
  3. EEG changes
  4. primarily the result of protein related impaired ammonia metab.
56
Q

give complication of advanced liver failure, 2 characterizations what does it accompany, and prognosis

A
  1. hepatorenal syndrome
  2. portal HTN & circulatory related Renal failure
  3. accompanies sudden drop in circulatory volume
  4. poor prognosis
57
Q

2 main components of liver panel and give subcomponents of each

A
  1. liver enzymes (ALT alanin transminase/AST asparate transminase)
  2. Liver funx test (Bilirubin [direct, indirect], albumin, protein, ALP [alkaline phosphatase], PT [prothrombin time]
58
Q

hep A characteristics, lab results transmission

A
  1. self limiting, no carrier status
  2. labs: *Anti-HAV IgM contagious infx *anti-HAV IgG earlier infx
  3. fecal-oral
59
Q

Hep B lab results transmission

A
  1. HBsAG : surface protein of virus, acute chronic infx
  2. HBeAG: protein indicative of acute contagiousness
  3. HBcAb-IgM 1st antibody produced, detects acute infx
  4. HBsAb-IgG: earlier infx or immunity
  5. HBeAb: Recovery antibody

Transmission: parenteral, sexual, perinatal/vertical

60
Q

Hep C characteristics, manifestations, labs, transmision

A
  1. most common in many countries
  2. fluctuating ALT, 25% jaundice, asymptomatic
  3. Anti-HCV (previous infx, or chronic)
  4. parenteral, sexual, vertical
61
Q

Hep D characteristics, lab transmission

A
  1. superinfx associated with Hep b
  2. AntiHDV
  3. parenteral sexual vertical
62
Q

Hep E characteristics, lab, transmission

A
  1. resembles Hep A, mainly in developing countries
    • antiHEV IgM contagious infx * antiHEV IgG earlier infx
  3. fecal oral
63
Q

2 other organisms that cause Hep

A

Epstein Barr Virus, cytomegalovirus

64
Q

describe cirrhosis (3)

  1. what happens
  2. type of dz
  3. disrupts…
A
  1. scarring, fibrosis, resistance to blood flow
  2. irreversible inflamm dz
  3. disrupts liver structure & funx
65
Q

4 types of biliary cirrhosis

A

primary, secondary, postnecrotic, metabolic

66
Q

describe primary and 2ndary biliary cirrhosis

A
  1. primary: unknown etiology, inflamm & scarred bile ducts

2. 2ndary; obstruction (gallstones or neoplasms), inflamm and scarred bile ducts

67
Q

describe cause & effect postnecrotic & metabolic biliary cirrhosis

A

postnecrotic
1. post viral hep, drugs, toxins, autoimmune dz
2. necrotic tissue replaced with cirrhotic tissue
metabolic
1. metab defects
2. inflamm scarring

nursing (15 decks)

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