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Patho Chapter 37 Disorders Of Gastrointestinal FunCtion > Disorders Of Gastrointestinal Function > Flashcards

Disorders Of Gastrointestinal Function Flashcards

1
Q

Signs and symptoms common to gastrointestinal disorders

A
  • Anorexia
  • Nausea
  • Vomiting
  • Gastrointestinal bleeding
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2
Q

Anorexia, Nausea, Retching, and vomiting

A
  • Anorexia, nausea and vomiting are physiologic responses that are common to many GI disorders
  • Retching consists of the rhythmic spasmodic movements of the diaphragm, chest wall, and abdominal muscles
  • These responses are protective to the extent that they signal the presence of disease and in the case of vomiting, remove noxious agents from the GI tract
  • They can also contribute to impaired intake or loss of fluids and nutrients.
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3
Q

Vomiting and neural structures

A
  • Vomiting involved two functionally distinct medullary centers-the vomiting center and the chemoreceptors trigger zone.
  • The act of vomiting is thought to be a reflex that is integrated in the vomiting center, which is located in the dorsal portion of the reticular formation of the medulla near the sensory nuclei of the vagus
  • The chemoreceptors trigger zone is located in a small area on the floor of the fourth ventricle, where it is exposed to both blood and cerebrospinal fluid. It is thought to mediate the emetic effects of blood-borne drugs and toxins.
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4
Q

Swallowing

A

.Mechanism

  • Depends on the coordinated action of the tongue and pharynx
  • These structures are innervated by cranial nerves V, IX, X and XII.

. Alterations

  • Dysphagia: Difficulty in swallowing
  • Odynophagia: Paunful swallowing
  • Achalasia: Failure of the esophageal sphincter to relax
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5
Q

Gastroesophageal Reflux

A 
. Heartburn
- 30 to 60 minutes after meal
- Evening onset
-Pain in the epigastric that radiates to the throat, shoulder, or back
. Avoid large meals
. Avoiding alcohol use and smoking 
. Eating meals and sitting up
. Avoiding recumbent position several hours after a meal
. Avoiding bending for long periods 
. Sleeping with the head elevated 
. Losing weight if overweight
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6
Q

Complaints Accompanying Esophageal Diverticulum

A 
. The food stops before it reaches the stomach 
. Gurgling
. Belching 
. Coughing 
. Foul-smelling breath
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7
Q

Esophageal cancer

A 
. Squamous cell carcinoma 
-Alcohol and tobacco use
. Adenocarcinoma
- Barrett Esophagus 
. Dysphagia
. Weight loss
. Anorexia
. Fatigue
. Painful swallowing 
. Not easily caught
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8
Q

Factors Contributing to the Protection of the Gastric Muscosa

A

. Gastric Mucosal Barrier
. An impermeable epithelial cell surface covering
- Mechanisms for the selective transport of hydrogen and bicarbonate ions
-The characteristics of gastric mucus

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9
Q

Types of Mucus Protecting the Gastric Mucosa # 1

A

. Water-Insoluble Mucus

  • Forms a thin, stable gel that adheres to the gastric mucosal surface
  • Provides protection from the proteolytic actions of pepsin
  • Forms an unstirred layer that traps bicarbonate, forming an alkaline interface between the luminal contents to the stomach and its mucosal surface
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10
Q

Types of Mucus Protecting the Gastric Mucosa # 2

A

. Water -Soluble Mucus

  • Washed from the mucosal surface
  • Mixes with the luminal contents
  • Its viscid nature makes it a lubricant that prevents mechanical damage to the mucosal surface
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11
Q

Types of Mucus Protecting the Gastric Mucosa#2

A

. Water -soluble Mucus

  • Washes from the Mucosal surface
  • Mixes with the luminal contents
  • It’s viscid nature makes it a lubricant that prevents mechanical damage to the mucosal surface
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12
Q

Major Causes of Gastric Irritation and Ulcer Formation

A

. Aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs)
-Irritate the gastric mucosa and inhibit prostaglandin synthesis
. Infection with H. Pyloric
- Thieves in an acid environment of the stomach
-Disrupts the mucosal barrier that protects the stomach from harmful effects of its digestive enzymes

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13
Q

Types of Gastritis

A

. Acute Gastritis

  • A transient inflammation of the gastric muscosa
  • Most commonly associated with local irritants such as bacterial endotoxins, alcohol, and aspirin

. Chronic Gastritis

  • characterized by the absence of grossly visible erosions and the presence of chronic inflammatory changes
  • Leads eventually to atrophy of the glandular epithelium of the stomach
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14
Q

Major types of chronic Gastritis

A

. Helicobacter pyloric gastritis
. Autoimmune gastritis
. Multi focal atrophic gastritis
. Chemical gastropathy

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15
Q

Helicobacter pylori

A

. Colonized the mucus-secreting epithelial cells of the stomach
. Produce enzymes and toxins that have the capacity to interfere with the local protection of the gastric mucosa against acid
. Produce intense inflammation
. Elicit an immune response

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16
Q

Method for establishing presence of H. pyloric Infection

A

. C urea breath test using a radioactive carbon isotope
. Stool antigen test
. Endoscopic biopsy for unrease testing
. Blood tests to obtain serologic titers of H. Pylori antibodies

17
Q

Peptic Ulcer

A 
. Ulcerative disorders that occur in areas of the upper gastrointestinal tract that are exposed to acid -pepsin secretions
. Spontaneous remissions and exacerbation dare common
. Causes 
- H. Pyloric 
-Aspirin
-Age
-Warfarin
-Smoking
18
Q

Complications of peptic Ulcer# 1

A

. Hemorrhage
- causes by bleeding from the granulation tissue or from erosion of an ulcer into an artery or vein
. Obstruction
- Caused by edema, spasm, or contraction of scar tissue and interference with the free passage of gastric contents through the pylorus or adjacent areas

19
Q

Complications of Peptic Ulcer # 2

A

. Perforation

- Occurs when an ulcer erodes through all the layers of the stomach or duodenum wall

20
Q

Gastrointestinal Tract Bleeding

A

. Hematemesis

  • Blood in the vomitus
  • May be bright red or have coffee ground appearance

. Melena
- Blood in the stool
_ Ranged in color from bright red tarry black
- May be occult (hidden)

21
Q

Treatment of Peptic Ulcer

A

. Eradicate the cause and promote a permanent cure for the disease
- Eradicating H. Pyloric
-Relieving ulcers symptoms
-Healing the ulcer crater
. Acid -neutralizing, acid-inhibiting drugs, and mucosal protective
. Antacids
. Proton pump inhibitors

22
Q

Risk factors for development of stress ulcers

A 
. Large surface area burns
. Trauma
. Sepsis
. Acute respiratory distress syndrome 
. Severe liver failure 
. Major surgical procedures 
. Zollinger- Ellison syndrome
23
Q

Risk Factors for Development of Gastric Cancer

A

. Genetic predisposition
. Carcinogenic factors in the diet
. Autoimmune gastritis
. Gastric adenomas or polyps

24
Q

Conditions causing Altered Intestinal Function

A 
. Irritable bowel disease 
. Inflammatory bowel disease 
. Diverticulitis 
. Appendicitis 
. Alterations in bowel motility 
. Malabsorption syndrome 
. Cancer of the colon and rectum
25
Q

Infection of the intestine

A 
. Viral Infection 
- rotavirus 
. Bacterial Infection 
- Clostridium difficile colitis
- Escherichia Coli Infection

. Protozoan Infection
- E. Histolytica

26
Q

Characteristics of Irritable Bowel Disease

A

. Persistent or recurrent symptoms of abdominal pain
. Altered bowel function
. Varying complaints of flatulence, bloated ness
. Nausea and anorexia
. Constipation or diarrhea
. Anxiety or depression

27
Q

Inflammatory Bowel Disease

A

. Crohn Disease
- A recurrent, granulomatous type of inflammatory response that can affect any area of the gastrointestinal tract from the mouth to the anus

. Ulcerative Colitis
- A nonspecific inflammatory condition of the colon

28
Q

Symptoms of Diverticulitis

A 
. Pain in the lower left quadrant 
. Nausea and vomiting 
. Tenderness in the lower left quadrant 
. A slight fever
. An elevated white blood cell count
29
Q

Appendicitis

A

. The appendix becomes inflamed, swollen, and gangrenous, and if eventually perforated if not treated
. Appendicitis is related to intraluminal obstruction with a fecalith ( ie is hard piece of stool), gallstones, tumors, parasites, or lymphatic tissue

30
Q

Types of Diarrhea

A

. Large Volume

  • Osmotic
  • Secretory

. Small Volume

  • inflammatory bowel disease
  • Infections disease
  • irritable colon
31
Q

Manifestations of classic form of Celiac Disease

A

. Presents in infancy

. Manifest as

  • failure to thrive
  • Diarrhea
  • Abdominal distention
  • occasionally, severe malnutrition
32
Q

Common causes of Constipation

A 
. Failure to respond to the urge to defecate
. Inadequate fiber in the diet
. Inadequate fluid intake
. Weakeness of the abdominal muscles
. Inactivity and bed rest
. Pregnancy 
. Hemorrhoids
33
Q

Fecal Impaction

A 
. Painful anorectal disease
. Tumors
. Neurologenic disease 
. Use of constipating antacids or bulk laxatives 
. A low residue diet
. Drug induced colonic stasis
. Prolonged bed rest and debility
34
Q

Insteatinal Obstruction

A

. Mechanical obstruction can result from post operative causes such as external hernia and postoperative adhesions
. Paralytic, or adynamic, obstruction results from neurogenic or muscular impairment of peristalsis

35
Q

Instestinal Obstruction

A

. Mechanical

. Paralytic

. Abdominal distebtion

. Loss of fluids and electrolytes

36
Q

Peritoneal Cavity and Peritonitis

A 
. Permits rapid absorption of bacterial toxins 
. Favors the dissemination of contaminants 
. Great inflammatory response 
- Thick, fibrinous protective substance 
. Performed peptic ulcer
. Ruptured appendix 
. Performed diverticulum
. Gangrenous bowel 
. Abdominal trauma and wounds
37
Q

Intestinal Malabsorption

A 
. Failure to transport dietary constitutes from lumen of the instestine to the extracellular fluid
. Causes
- Celiac disease
. Inflammatory reaction
. Colorectal cancer

. Symptoms

  • Diarrhea
  • Steatorrhea
  • Flatulence
  • Bloating
  • Abdominal pain
  • Cramps
  • weakness , muscle, wasting
  • Weight loss and abdominal distention
38
Q

Colorectal Cancerd

A 
. Age
. Family history 
. Crohn disease 
. Ulcerative colitis
. Familial Adenomatous polyposis
. Diet
. Stool Occult blood tests
. Digital rectal using barium
. Flexible sigmoidoscopy and colonoscopy

Patho Chapter 37 Disorders Of Gastrointestinal FunCtion (3 decks)

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