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Pathophysiology > Digestive System Disorders > Flashcards

Digestive System Disorders Flashcards

1
Q

Functions Of Digestive System

A

Processes ingested food and fluids
Breaks them down into their units
Controlled by enzymes

Absorbs necessary components
Membrane transport mechanisms
Mostly in small intestine

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2
Q

Gut wall(4 layers)

A

Mucosa
Epithelium, including mucus-producing cells

Submucosa
Connective tissue—including blood vessels, nerves, lymphatics, secretory glands within connective tissue

Circular smooth muscle layer
Longitudinal smooth muscle layer
(in place to allow peristalsis to move along the path of the digestive track)

Serosa
Visceral peritoneum(Inner lining)

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3
Q

Upper Gastrointestinal Tract

A

Oral Cavity
Esophagus
Stomach

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4
Q

Oral cavity

A

Initial phase of mechanical breakdown of food
Mastication by teeth

Initial chemical digestion
Salivary amylase—starts chemical breakdown of carbohydrates

Formation of bolus

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5
Q

Salivary amylase

A

starts chemical breakdown of carbohydrates

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6
Q

Pharynx

A

Swallowing (deglutition)

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7
Q

Esophagus Function

A

Closed except during swallowing, skeletal muscle at superior end—followed by smooth muscle

Swallowing:
The soft palate is pulled upward
The vocal cords are approximated
The epiglottis covers the larynx
Respiration ceases
The bolus is seized by the constricted pharynx
Bolus of food moves into the esophagus

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8
Q

Stomach

A

Expansible muscular sac—acts as reservoir for food and fluid

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9
Q

The Stomach contains how many smooth layer muscle?

A

Three smooth muscle layers

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10
Q

Stomach Full Description

A

Expansible muscular sac—acts as reservoir for food and fluid

Three smooth muscle layers

Constant mixing and churning of food
Initial digestion of proteins
By pepsin
Formed by combination of pepsinogen and HCl
Production of intrinsic factor
Essential for absorption of vitamin B12 in the ileum
Formation of chyme
Absorption of small and lipid-soluble molecules

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11
Q

Production of intrinsic factor is Essential for absorption of vitamin B12 in the ileum

A

B12 in the ileum

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12
Q

Pepsin

A

Causes Initial digestion of proteins
Formed by combination of pepsinogen and HCl

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13
Q

Where is chyme produced

A

Stomach

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14
Q

What organ receives blood from hepatic portal vein

A

Liver

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15
Q

Liver Function

A

“Metabolic factory” of the body

Receives blood from hepatic portal vein
Transport of nutrients from intestine to liver

Hepatocytes store nutrients
Play role in carbohydrate, protein, fat metabolism

Production of plasma proteins and clotting factors

Breakdown of old and damaged erythrocytes

Bile production

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16
Q

Hepatocytes

A

primary cells in the liver

store nutrients

Play role in carbohydrate, protein, fat metabolism

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17
Q

Pancreas

A

Exocrine pancreas arranged in lobules
Secretes digestive enzymes, electrolytes
Trypsin
Chymotrypsin
Carboxypeptidase
Ribonuclease
Pancreatic amylase
Bicarbonate ions

Pancreatic duct joins bile duct to enter duodenum

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18
Q

Small intestine

A

Major site for absorption of nutrients

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19
Q

Lacteal—lymphatic vessel

A

specialized lymphatic capillaries in the small intestine that absorb dietary fats and transport them to the bloodstream

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20
Q

Peyer patches

A

They are considered the gut’s immune system, helping to identify antigens and produce antibodies.

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21
Q

Small intestine Structure

A

Duodenum, jejunum, ileum
Villi (folds of the mucosa) and microvilli(On top of villi)(folds of cell membranes)
Increase surface area for absorption

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22
Q

Site of production of:
Mucus
Enterokinase, peptidases, nucleosidases, lipase, sucrase, maltase, lactase, cholecystokinin (hormone)

A

Small intestine

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23
Q

Malnutrition issues occur with problems with

A

Villi

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24
Q

Lower Gastrointestinal Tract

A

Large intestine
Small Intestine

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25
Q

Large intestine

A

Resident normal flora
Breakdown of certain food materials
Vitamin K synthesis by bacteria

Fluid and electrolyte reabsorption

Formation of solid feces
Mass movements

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26
Q

Parasympathetic nervous system (PNS) involves what vagus nerve

A

Vagus nerve (cranial nerve
[CN] X)

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27
Q

Parasympathetic nervous system (PNS)

A

Primarily through vagus nerve (cranial nerve
[CN] X)
Increased motility
Increased secretions

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28
Q

Sympathetic nervous system (SNS)
(Fight Or Flight)

A

Stimulated by factors such as fear, anger
Inhibits gastrointestinal activity
Causes vasoconstriction
Reduced secretions and regeneration of epithelial cells

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29
Q

A nerve that maintain continuous flow of saliva in mouth

A

Facial (CN VII) and glossopharyngeal (CN IX) nerves

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30
Q

Neural and Hormonal Controls
(2 of 2)

A

Facial (CN VII) and glossopharyngeal (CN IX) nerves
Maintain continuous flow of saliva in mouth
Distention and stretching of stomach
PNS activation
↑ Peristalsis and gastric secretions
Stomach empties within 2 to 6 hours after meal.
Food in intestine
Stimulation of intestinal activity
Enterogastric reflex
Inhibition of gastric emptying

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31
Q

Gastrin

A

Secreted by mucosal cells (stomach) in response to distention of stomach or partially digested substances
Increases gastric motility, relaxes pyloric and ileocecal sphincters—promotes stomach emptying

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32
Q

Histamine

A

Increased secretion of hydrochloric acid

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33
Q

Secretin

A

Decreases gastric secretions

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34
Q

Cholecystokinin

A

Inhibits gastric emptying; stimulates contraction of gallbladder

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35
Q

Carbohydrates digestion occurs in

A

Digestion starts in mouth
Followed by digestion in the small intestine

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36
Q

Proteins digestion occurs in

A

Digestion starts in stomach, continues in small intestine

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37
Q

Lipids

A

Emulsified by bile prior to chemical breakdown
Action of enzymes form monoglycerides and free fatty acids
Formation of chylomicrons

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38
Q

Fat-soluble vitamins

A

Vitamins A, D, E, K
Absorbed with fats

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39
Q

Water-soluble vitamins

A

Vitamins B and C—diffuse into blood

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40
Q

Electrolytes are absorbed by

A

active transport or diffusion

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41
Q

Drugs are primarily absorbed in the

A

intestine
Various transport mechanisms
Some (e.g., aspirin) absorbed in the stomach

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42
Q

Common Manifestations of Digestive System Disorders

A

Anorexia, Nausea, Vomiting, and Bulimia
Diarrhea
Constipation
Fluid and Electrolyte Imbalaces
Pain
Malnutrition

43
Q

Anorexia, Nausea, Vomiting,
and Bulimia may be signs of

A

May be signs of digestive disorder or other condition elsewhere in the body
Systemic infection

Uremia
(a serious condition that occurs when the kidneys are unable to filter waste from the blood, resulting in a buildup of toxins like urea and creatinine)

Emotional responses

Motion sickness

Pressure in the brain

Overindulgence of food, drugs

Pain

44
Q

Anorexia and vomiting
Can cause serious complications
such as

A

Dehydration, acidosis, malnutrition

45
Q

Anorexia
Often precedes

A

nausea and vomiting

46
Q

Nausea

A

Unpleasant subjective feeling
Simulated by distention, irritation, inflammation of digestive tract
Also stimulated by smells, visual images, pain, and chemical toxins and/or drugs

47
Q

Vomiting (emesis)
center located in the

A

medulla

48
Q

Vomiting (emesis)

A

Vomiting center located in the medulla
Coordinates activities involved in vomiting
Protects airway during vomiting
Forceful expulsion of chyme from stomach
Sometimes includes bile from intestine

49
Q

Bulimia—eating disorder

A

Damage to structures of the GI tract caused by recurrent vomiting
Oral mucosa
Teeth
Esophagus

50
Q

Vomiting Center Activation

A

Distention or irritation in digestive tract
Stimuli from various parts of the brain
Response to unpleasant sights or smells, ischemia
Pain or stress
Vestibular apparatus of inner ear (motion)
Increased intracranial pressure
Sudden projectile vomiting without previous nausea
Stimulation of chemoreceptor trigger zone
By drugs, toxins, chemicals

51
Q

Vomiting Reflex Activities

A

Deep inspiration
Closing the glottis, raising the soft palate

Ceasing respiration
Minimizes risk of aspiration of vomitus into lungs

Relaxing the gastroesophageal sphincter

Contracting the abdominal muscles
Forces gastric contents upward

Reversing peristaltic waves
Promotes expulsion of stomach contents

52
Q

Hematemesis

A

Presence of blood in emesis

53
Q

Coffee ground vomitus(Characteristics of Vomitus)

A

brown granular material indicates action of HCl on hemoglobin
(Hydrochloric acid)

54
Q

Hemorrhage(Characteristics of Vomitus)

A

red blood may be in vomitus

55
Q

Yellow- or green-stained vomitus(Characteristics of Vomitus)

A

Bile from the duodenum

56
Q

Deeper brown color(Characteristics of Vomitus)

A

May indicate content from lower intestine

57
Q

Recurrent vomiting of undigested food(Characteristics of Vomitus)

A

Problem with gastric emptying or infection

58
Q

Diarrhea

A

Excessive frequency of stools
Usually of loose or watery consistency
May be acute or chronic
Frequently with nausea and vomiting when infection or inflammation develops
May be accompanied by cramping pain
Prolonged diarrhea may lead to dehydration, electrolyte imbalance, acidosis, malnutrition

59
Q

Prolonged diarrhea may lead to

A

dehydration, electrolyte imbalance, acidosis, malnutrition

60
Q

Large-volume diarrhea (secretory or osmotic)

A

Watery stool resulting from increased secretions into intestine from the plasma
Often related to infection
Limited reabsorption because of reversal of normal carriers for sodium and/or glucose

61
Q

Small-volume diarrhea

A

Often caused by inflammatory bowel disease
Stool may contain blood, mucus, pus
May be accompanied by abdominal cramps and tenesmus

62
Q

Steatorrhea—“fatty diarrhea”

A

Frequent bulky, greasy, loose stools
Foul odor

Characteristic of malabsorption syndromes
Celiac disease, cystic fibrosis

Fat usually the first dietary component affected

Presence interferes with digestion of other nutrients.

Abdomen often distended

63
Q

Steatorrhea—“fatty diarrhea” is a characteristic of malabsorption syndromes such as

A

Celiac disease, cystic fibrosis

64
Q

Blood may occur in normal stools with

A

diarrhea, constipation, tumors, or an inflammatory condition.

65
Q

Frank blood

A

Red blood—usually from lesions in rectum or anal canal

66
Q

Occult blood

A

Small hidden amounts, detectable with stool test
May be caused by small bleeding ulcers

67
Q

Melena

A

Dark-colored, tarry stool
May result from significant bleeding in upper digestive tract

68
Q

Significant bleeding in upper digestive tract may cause which type of blood in stool

A

Melena

69
Q

Gas

A

From swallowed air, such as drinking from a straw
Bacterial action on food
Foods or alterations in motility

Excessive gas causes:
Eructation(belch)

Borborygmus(a rumbling or gurgling noise made by the movement of fluid and gas in the intestines.)

Abdominal distention and pain

Flatus(passing gas)

70
Q

Constipation

A

Less frequent bowel movements than normal
Small hard stools
Acute or chronic problem
May be caused by decreased peristalsis
Increased time for reabsorption of fluid
Periods of constipation may alter with periods of diarrhea.

Chronic constipation may cause hemorrhoids, anal fissures, or diverticulitis.

71
Q

Chronic constipation may cause

A

hemorrhoids, anal fissures, or diverticulitis.

72
Q

Causes of Constipation

A

Weakness of smooth muscle because of age or illness
Inadequate dietary fiber
Inadequate fluid intake
Failure to respond to defecation reflex
Immobility
Neurological disorders
Drugs (i.e., opiates)
Some antacids, iron medications
Obstructions caused by tumors or strictures

73
Q

Fluid and Electrolyte Imbalances

A

Dehydration and hypovolemia are common complications of digestive tract disorders.

Electrolytes
Lost in vomiting and diarrhea

Acid-base imbalances
Metabolic alkalosis
Results from loss of hydrochloric acid with vomiting

Metabolic acidosis
Severe vomiting causes a change to metabolic acidosis because of the loss of bicarbonate of duodenal secretions.
Diarrhea causes loss of bicarbonate.

74
Q

Pain: Visceral Pain

A

Burning sensation
Inflammation and ulceration in upper digestive tract

Dull, aching pain
Typical result of stretching of liver capsule

Cramping or diffuse pain
Inflammation, distention, stretching of intestines

Colicky, often severe pain
Recurrent sooth muscle spasms or contraction
Response to severe inflammation or obstruction

75
Q

Pain: Somatic Pain

A

Somatic pain receptors directly linked to spinal nerves
May cause reflex spasm of overlying abdominal muscles
Steady, intense, often well-localized abdominal pain
Involvement or inflammation of parietal peritoneum
Rebound tenderness—identified over area of inflammation when pressure is released

76
Q

Pain: Referred Pain (1 of 2)

A

Common phenomenon
Pain is perceived at a site different from origin.
Results when visceral and somatic nerves converge at one spinal cord level
Source of visceral pain is perceived as the same as that of the somatic nerve.
May assist or delay diagnosis, depending on problem

77
Q

Source of visceral pain is perceived as the same as that of the

A

somatic nerve

78
Q

Malnutrition

A

May be limited to a specific nutrient or general
Causes of limited malnutrition—specific problem
Vitamin B12 deficiency
Iron deficiency
Causes of generalized malnutrition
Chronic anorexia, vomiting, diarrhea
Other systemic causes
Chronic inflammatory bowel disorders
Cancer treatments
Wasting syndrome
Lack of available nutrients

79
Q

Causes of limited malnutrition—specific problem

A

Vitamin B12 deficiency
Iron deficiency

80
Q

Causes of generalized malnutrition

A

Chronic anorexia, vomiting, diarrhea

81
Q

Basic Diagnostic Tests

A

Radiography
Contrast medium may be used.

Ultrasound
May show unusual masses

Computed tomography (CT)

Magnetic resonance imaging (MRI)

CT and MRI may use radioactive tracers.
Can be used for liver and pancreatic abnormalities

82
Q

Basic Diagnostic Tests (2 of 2

A

Fiberoptic endoscopy used in upper GI tract
Biopsy may be done during procedures.

Sigmoidoscopy and colonoscopy
Biopsy and removal of polyps may be done

Laboratory analysis of stool specimens
Check for infection, parasites and ova, bleeding, tumors, malabsorption

Blood tests
Liver function, pancreatic function, cancer markers

83
Q

Common Therapies and Prevention
(Malnutrition)

A

Dietary modifications
Example—gluten-free diet (celiac disease)
Reduced intake of alcohol and coffee
Increased fiber and fluid intake
Stress reduction techniques
Stress impairs immune function and tissue healing.
Drugs
Variety of medications are available.

84
Q

Antacids

A

To relieve pyrosis(heartburn)

85
Q

Antiemetics

A

To relieve vomiting

86
Q

Laxatives or enemas

A

Treatment of acute constipation

87
Q

Antidiarrheals

A

Reduction of peristalsis
Relieve cramps

88
Q

Sulfasalazine

A

Anti-inflammatory and antibacterial
Used for acute episodes of inflammatory bowel disease

89
Q

Clarithromycin or azithromycin

A

Effective against Helicobacter pylori infection
Usually combined with a proton pump inhibitor

90
Q

Sucralfate

A

Coating agent
Enhance gastric mucosal barrier against irritants such as nonsteroidal anti-inflammatory drugs (NSAIDs)

91
Q

Anticholinergic drugs

A

Reduce PNS activity
Reduce secretions and motility

92
Q

Histamine 2 antagonists

A

Useful for gastric reflux

93
Q

Proton pump inhibitors

A

Reduce gastric secretion

94
Q

Upper Gastrointestinal Tract Disorders

A

Disorders of the Oral Cavity
Dysphagia
Esophgeal Cancer
Hiatal Hernia
Gastroesophageal Reflux Disease
Gastritis
Peptic Ulcer
Gastric Cancer
Dumping Syndrome
Pyloric Stenosis

95
Q

Cleft lip and cleft palate
(Disorders of the Oral Cavity)
(Congenital abnormalities)

A

Arise in sixth to seventh week of gestation

Most likely of multifactorial origin

Feeding problems of the infant

High risk of aspirating fluid into respiratory passages

Speech development impaired

(Treatment)
Surgical repair done as soon as possible
Therapy with speech-language pathologist and orthodontist

96
Q

Inflammatory lesions—aphthous ulcers

A

Streptococcus sanguis may be involved.
Part of the oral resident flora

Small painful lesions on:
Movable mucosa
Buccal mucosa
Floor of the mouth
Soft palate
Lateral borders of the tongue
Usually heal spontaneously

97
Q

Candidiasis

A

Candida albicans—causative agent

Often part of the resident flora

Opportunistic organism

Oral candidiasis (thrush)
People receiving broad-spectrum antibiotics
During and after cancer therapy
Immunocompromised individuals or those with diabetes

May appear as red, swollen areas

May be irregular patches of a white curdlike material

98
Q

Herpes simplex type 1 infection

A

Herpes simplex virus type 1 (HSV-1)
Transmitted by kissing or close contact
Virus remains dormant in sensory ganglion
Activated by stress, trauma, other infection
Formation of blister, ulcers, clear fluid release—contains virus; can be autoinoculated to other areas
Lesions heal spontaneously in 7 to 10 days.
Acute stage may be alleviated by antiviral medication.

May spread to eyes
Conjunctivitis and keratitis

99
Q

Complications of Herpes Type 1 if spread to eyes

A

Conjunctivitis and keratitis

100
Q

Herpetic Whitlow

A

a painful infection of the finger or thumb caused by the herpes simplex virus (HSV

101
Q

Syphilis is caused by

A

Treponema pallidum

102
Q

Primary stage Of Syphilis

A

Chancre, a painless ulcer on tongue, lip, palate
Heals spontaneously (1 or 2 weeks)

May cause oral lesions
Highly contagious during first and second stages

Both stages treated with long-acting penicillin

103
Q

Secondary stage Of Syphilis

A

Red macules or papules on palate—highly infectious
Heals spontaneously

May cause oral lesions
Highly contagious during first and second stages

Both stages treated with long-acting penicillin

104
Q
A

Pathophysiology (7 decks)

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