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MS > DISORDERS OF THE DIGESTIVE SYSTEM > Flashcards

DISORDERS OF THE DIGESTIVE SYSTEM Flashcards

1
Q

Motor dysfunction of smooth muscle of the individual parts of the digestive system -

A

Aperistalsis refers to a lack of propulsion

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2
Q

Indigestion of food and absorption of nutrients -

A

malabsorption syndrome

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3
Q

hemorrhoids, peptic ulcers, tears or
inflammation in the esophagus, diverticulosis and diverticulitis, ulcerative colitis and Crohn’s
disease, colonic polyps, or cancer in the colon, stomach or esophagus.

A

Bleeding into the individual parts of the digestive tract –

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4
Q

Perforation of the wall of the digestive system with subsequent leakage of the contents to the
peritoneal cavity

A
  • appendicitis and diverticulitis
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5
Q

Obstruction in moving of the contents of one part of the digestive system to the next section

A
  • hernias; colon cancer; diverticulitis, Crohn’s disease
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6
Q
  • is the forceful emptying of stomach and intestinal contents through the mouth
A

Vomiting

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7
Q

the vomiting center lies in the ___ and includes the reticular formation and
tractus solitarius nucleus

A

medulla oblongata

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8
Q

stimulation of the vomiting center occurs

A

directly by irritants or indirectly.

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9
Q

the sudden expansion of the stomach and duodenum in the sudden accumulation of contents

A

VOMITING

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10
Q

irritation of the stomach mucosa by toxic substances

A
  • Direct -
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11
Q

reflex response to intense pain - trauma of ovary, testis, uterus, bladder and kidneys or stimulating the vomiting center, for example. metabolic acidosis or brain lesions

A
  • Indirect -
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12
Q

(malfunction of digestion)

A

. Dyspepsia

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13
Q
  • frequently it is ___ dyspepsia
A

functional (non-ulcer)

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14
Q
  • dyspepsia similar to ulcer symptomatology:
A

pain predominates

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15
Q
  • dyspepsia similar to dysmotility symptomatology:
A

nausea, vomiting, bloating

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16
Q

non-absorbable substance in the intestine draws water into the lumen by osmosis

A

osmotic diarrhea

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17
Q

DISEASES IN DYSPEPSIA: (2)

A

peptic ulcer
long-lasting reflux of stomach contents into the esophagus
gastritis

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18
Q

an increase in the frequency of defecation and the fluid content, volume, and weight of feces.

A

DIARRHEA

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19
Q

(fat in the stools)

A

Steatorrhea

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20
Q

− caused by an inflammatory disorder of the intestine, such as ulcerative colitis, Crohn disease, or
microscopic colitis

A

Small-volume diarrhea

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21
Q

lactose, milk sugar, is not digested by the intestine => high osmotic activity => binds water => increase
in the intestine volume content

A

lactase deficiency

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22
Q

− caused by resection of the small intestine (short bowel syndrome), surgical bypass of an area of
the intestine

A

Motility diarrhea

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23
Q

(large-volume diarrhea)

A

Osmotic diarrhea and secretory diarrhea

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24
Q

− caused by excessive mucosal secretion of chloride- or bicarbonate-rich fluid or inhibition of net
sodium absorption

A

Secretory diarrhea (large-volume diarrhea)

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25
Q
  • difficult or infrequent defecation
  • it is associated with difficulty emptying of solid stool, which is usually painful
A

Constipation

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26
Q

Bleeding in the upper GIT parts

A

(esophagus, stomach, duodenum

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27
Q

Bleeding in the lower GIT

A

(jejunum, ileum, colon, rectum)

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28
Q

sudden and intense bleeding in the GIT is ___ and manifests the presence of blood in the
stool or vomit

A

life threatening

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29
Q

presence of blood in vomit, in the form of fresh blood or blood precipitates

A

Hematemesis

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30
Q

blood in vomit in the form of

A

“coffee grounds”

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31
Q

blood flows more slowly in the stomach - it’s time for him to digest it - hemoglobin converts to

A

acidic hematin (black)

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32
Q

dark stool caused by digested blood

A

Melena

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33
Q

chronically recurrent losses of small amounts of blood that usually results in anemia due to iron losses

A

Occult bleeding

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34
Q

interfere with nutrient absorption

A

malabsorption syndromes

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35
Q

-failure of the chemical processes of digestion (intestinal lumen)

-caused by deficiencies of enzymes (__, __)

inadequate secretion of __ and inadequate reabsorption of __ in the __

A

maldigestion

pancreatic lipase, intestinal lactase

bile salts
bile in the ileum

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36
Q

-failure of the intestinal mucosa to absorb (transport) the digested nutrients

-result of ___

A

malabsorption

mucosal disruption

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37
Q

– malabsorption of proteins

A

Celiac

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38
Q

excretes certain digestive enzymes and is also the most important area for the absorption of nutrients

A

Small intestine

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39
Q

___ area depends on the construction of normal mucosa, which is shaped into the ___

A

Resorption
villi

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40
Q

malabsorption of sugar

A

Lactase Deficiency

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41
Q

__ and __ are considered to be primary diseases of malabsorption in our geographical area.

A
  • celiac and lactose intolerance
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42
Q
  • caused by the the allergic response in the small intestine to gluten
A

celiac

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43
Q
  • lack of activity - enzyme which degrades lactose (milk sugar)
A
  • Lactase
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44
Q

lactose is decomposed by

results in

A

intestinal bacteria to gas

abdominal cramps, bloating and diarrhea often

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45
Q

is characterized as ___ disorders, which may be due to __, or __ that impairs esophageal motility

A

Dysphagia
swallowing

mechanical obstruction of the esophagus
functional disorder

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46
Q

_____

  • intrinsic -
  • extrinsic -

The most common cause of extrinsic mechanical obstruction is ____

A
  • Mechanical obstruction

tumor, strictures

originate outside the esophageal lumen and narrow the esophagus by pressing inward on
the esophageal wall.

tumor

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47
Q
  • caused by neural or muscular disorders that interfere with ___ or ___.
  • typical causes of functional dysphagia in the ___
  • __ (a muscle disease) and neurologic impairments caused by stroke, MS, PD, ALS
A

Functional dysphagia
swallowing or peristalsis

upper esophagus

dermatomyositis

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48
Q

___ is a primary esophageal motility disorder characterized by an inability of the ____ to relax and is constantly ___

A

Achalasia
lower esophageal sphincter
contracted

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49
Q

MANAGEMENT of dysphagia

A
  • Esophageal dilation
  • Surgery
  • Medications (antacids, antibiotics)
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50
Q

Management of achalasia

A
  1. eat slowly, drink with fluids with meals
  2. Calcium channel blockers and nitrates
  3. botulinum toxins (botox)
  4. pneumatic dilation
  5. surgical myotomy
51
Q

__ & __ are taken by mouth ___ a meal.

For people with achalasia, these medications relax the muscles of the ___, allowing food and liquid to pass more easily into the stomach.

A

Calcium channel blockers and nitrates
10 to 30 minutes before

lower esophageal sphincter

52
Q

__ administration of botulinum toxin acts at the neuromuscular junction to cause __

A

botulinum toxin (Botox)
muscle paralysis

53
Q

___ is an endoscopic therapy for achalasia.

An ____ disrupts the muscle fibers of the lower esophageal sphincter, which is __in patients with achalasia.

A

Pneumatic dilation

air-filled cylinder-shaped balloon
too tight

54
Q
  • __ This procedure ___ the muscles at the ___, allowing the __ between the ___ and ___ to remain open.
A

Surgical myotomy
destroys
gastroesophageal junction
valve
esophagus and stomach

55
Q

__ is the opening in the ___ through which the esophagus passes becomes enlarged, part of
the upper stomach moves up into the lower portion of the thorax

A

HIATAL HERNIA
diaphragm

56
Q

There are two main types of hiatal hernias:

A

sliding and paraesophageal.

57
Q

__ occurs when all or part of the stomach pushes through the diaphragm beside the esophagus.

  • IT IS further classified as types __ __ __ , depending on the extent of herniation.
  • Large hiatal hernias may lead to __ ,__ , __
  • __, __ ,__ can occur with any type of hernia.
A

A paraesophageal hernia

II, III, or IV

intolerance to food, nausea, and vomiting.

Hemorrhage, obstruction, and strangulation

58
Q

occurs when the upper stomach and the gastroesophageal junction are displaced upward and slide in and out of the thorax.

The patient with a sliding hernia may have __ ,__ ,__

A

Sliding, or type I, hiatal hernia

pyrosis, regurgitation, and dysphagia.

59
Q

Diverticula may occur in one of the three areas of the esophagus—

A
  • pharyngoesophageal (upper),
  • midesophageal (middle), or
  • epiphrenic (lower)
60
Q

__ is an out-pouching of mucosa and submucosa that protrudes through a weak portion of the musculature of the esophagus.

A

An esophageal diverticulum

61
Q

Getting rid of excess air. ___ is commonly known as burping.

A

Belching

62
Q

when the patient assumes a recumbent position, undigested food is regurgitated

A
  • Coughing
63
Q

ESOPHAGEAL DIVERTICULUM

ASSESSMENT AND DIAGNOSTIC FINDINGS
* Barium swallow
* Manometric studies
___ senses the pressure and constriction of muscles in the esophagus as you swallow.
* ___ is contraindicated
* ___ of an NG tube should be avoided

A

The manometry test

Esophagoscopy

Blind insertion

64
Q

MANAGEMENT OF ESOPHAGEAL DIVERTICULUM

  • ___ of the cricopharyngeal muscle
  • Postoperative: evidence of leakage from the esophagus, developing ___.
  • Food and fluids are withheld until ___ show ____ at the surgical site
A
  • Diverticulectomy
    Myotomy

fistula

x-ray studies
no leakage

65
Q

___ a surgical emergency may result from iatrogenic causes (endoscopy or intraoperative injury, forceful vomiting or severe straining, foreign-body ingestion, trauma, and malignancy)

A

ESOPHAGEAL PERFORATION

66
Q

Perforation can occur at the __, __ , ___ of the esophagus

A

cervical, thoracic, or abdominal portion

67
Q
  • ___ means you have a high white blood cell count.
A

Leukocytosis

68
Q
  • The esophagus is located in the center of your chest in an area called the ____.
A

mediastinum

69
Q

ASSESSMENT AND DIAGNOSTIC FINDINGS FOR ESOPHAGEAL PERFORATION

(3)

A
  • X-ray studies
  • Fluoroscopy by either a barium swallow or esophagram (a noninvasive test)
  • Chest CT scan
70
Q

MANAGEMENT

  • Postoperative nutritional status is a major concern
    (__, __)
A

NPO 7 days, parenteral nutrition

71
Q

___ is the reflux of acid and pepsin from the stomach to the esophagus that causes esophagitis.

A

GERD

72
Q

___ - induce mucosal inflammation, erosion and ulceration

A

HCl, pepsin and bile

73
Q

____ is a burning feeling in the chest caused by stomach acid travelling up towards the throat (acid reflux).

− symptoms may worsen if the individual ____, or in the case of increasing intra-abdominal pressure (as a result of coughing, vomiting, or of hard stool)

− heartburn can be seen as ___, which requires the exclusion of cardiac ischemia

− alcohol or foods that contain acid (___) can cause discomfort and worsen the symptoms

A

Heartburn

lies down

chest pain

citrus fruits

74
Q

is used to evaluate the degree of acid reflux

A

Ambulatory 12- to 36-hour esophageal pH monitoring

75
Q

(inflammation of the gastric or stomach mucosa) is a common GI problem.

It may be __ or __

A

Gastritis

acute, lasting several hours to a few days, or chronic, resulting from repeated exposure
to irritating agents or recurring episodes of acute gastritis

76
Q

_____

  • _____—a person eats food that is irritating, too highly seasoned, or contaminated with disease-causing microorganisms.
  • Pharmacologic - overuse of ___ or ____
A

Acute gastritis

dietary indiscretion

aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), excessive alcohol intake,

77
Q

_____

  • benign or malignant ulcers
  • bacteria ___
  • Autoimmune diseases such as pernicious anemia;
  • dietary factors such as caffeine;
  • the use of medications such as NSAIDs or bisphosphonates (eg, alendronate [Fosamax],
    risedronate [Actonel], ibandronate [Boniva]);
  • alcohol;
  • smoking; or
  • chronic reflux of pancreatic secretions and bile into the stomach
A

Chronic gastritis

Helicobacter pylori

78
Q

is defined as a feeling of lethargy or a lack of mental or physical energy.

A

Lassitude

79
Q

are involuntary contractions of the diaphragm. (which can last from a few hours to a few days)

A

Hiccups

80
Q

Patients with ____ gastritis from vitamin deficiency usually have evidence of malabsorption of
vitamin ____ caused by the production of antibodies that interfere with the binding of vitamin __ to
___ factor.

A

chronic

B12
B12
intrinsic

81
Q
  1. Acute gastritis
  • refrain from ___ and food until symptoms subside.
  • a ___ diet is recommended.
  • If the symptoms persist, ___ fluids may need to be administered.
  • is caused by ingestion of strong acids or alkalis,

To neutralize acids, commo ____ (eg, aluminum hydroxide) are used;

to neutralize an alkali, ___ or ___ is used.

  • If corrosion is extensive or severe, ___ or ___ are avoided because of the danger of perforation and damage to the esophagus.
A

alcohol

nonirritating

intravenous (IV)

antacids

diluted lemon juice or diluted vinegar

emetics and lavage

82
Q
  1. Chronic gastritis
  • modifying the patient’s ___,
  • promoting __,
  • reducing ,
  • recommending avoidance of __ or __, and
  • initiating pharmacotherapy
A

diet

rest

stress

alcohol and NSAIDs

83
Q

is a result of imbalance between the mucosal defense mechanisms in the esophagus, stomach and
duodenum, and gastric mucosa-damaging mechanisms
relates to digestion of mucous membrane and lower parts of the stomach, duodenum, and lower
esophagus by ___ and ___

A

PEPTIC ULCER

HCl and pepsin

84
Q

Type of Peptic Ulcers:

  • quickly heal by the mucosa regeneration
A

acute

85
Q
  • traumatic origin, or after surgery CNS (irritation of n. Vagus -> hypersecretion HCl)
A

Cushing

86
Q
  • penetrate deeper into the tissue, healing takes several weeks or months
A

chronic

87
Q
  • traumatic origin, after burns (↑ levels of histamine -> hypersecretion HCl)
A

Curling

88
Q
  • Ellison Syndrome - ↑ production of gastrin -> stimulates the secretion of HCl)
A

Zollinger

89
Q
  • mucosal perfusion defect
A

Stress ulcers

90
Q

a burning sensation in the midepigastrium or the back.

  • Pain is usually relieved by __ , because food neutralizes the ___, or by taking __; however, once the stomach has emptied or the ___’s effect has decreased, the pain returns.
  • Sharply localized tenderness can be elicited by applying gentle pressure to the ___ at or slightly to the ___ of the midline.
A

eating
acid
alkali
alkali

epigastrium
right

91
Q

Serologic testing for antibodies against the __

A

H. pylori antigen,

92
Q

surgery to remove part of your vagus nerve.

A
  • Vagotomy
93
Q
  • lower part of the stomach (pylorus) surgery
A
  • Pyloroplasty
94
Q
  • more than two times their ideal body weight or
  • BMI exceeds 40kg/m2
  • more than 100 pounds greater than ideal body weight
A

Morbid Obesity

95
Q
  • main nerves of your parasympathetic nervous system. This system controls specific body functions such as your digestion
A

VAGUS NERVE

96
Q

is the resection, or surgery, of the main stomach referred to as antrum.

A

An antrectomy

97
Q

A prosthetic device is used to restrict oral intake by creating a small pouch of 10 to 15 mL that empties through the narrow outlet into the remainder of the stomach.

A

Gastric banding.

98
Q

A vertical row of staples along the lesser
curvature of the stomach creates a new, smaller stomach pouch of 10 to 15 mL.

A

gastroplasty

99
Q

A horizontal row of staples across the fundus of the stomach creates a pouch with a capacity of 20 to 30 mL. The jejunum is divided distal to the ligament of Treitz and the distal end is anastomosed to the new pouch. The proximal segment is anastomosed to the jejunum.

A

Roux-en-Y gastric bypass.

100
Q

Half of the stomach is removed, leaving a small area that holds about 60 mL. The entire jejunum is excluded from the rest of the gastrointestinal tract. The duodenum is disconnected and sealed off. The ileum is divided above the ileocecal junction and the distal end of the jejunum is anastomosed to the first portion of the duodenum. The distal end of the biliopancreatic limb is anastomosed to the ileum.

A

Biliopancreatic diversion with duodenal switch.

101
Q
  • is an inflammation of the vermiform appendix, which is a projection from the apex of the cecum
A

APPENDICITIS

102
Q

Clinical manifestation:

  • pain is initially diffuse and poorly localizable (___), later when the inflammation transit to the parietal peritoneum, patients localize the pain in the right hypogastrium (____)
  • the pain may be vague at ___, increasing in intensity over ___
  • ______ is associated with extension of the inflammation to the surrounding tissues
A

visceral pain

somatization visceral pain

first
3 to 4 hours

right lower quadrant pain

103
Q

sign – referred pain

A
  • Rovsing sign
104
Q
  • elicited by having the patient lie on his or her left side while the right thigh is flexed backward
A
  • Psoas sign
105
Q

The exact cause of appendicitis is ___

  • ___ obstruction of the lumen with stool, tumors, or foreign bodies with consequent increased intraluminal pressure, ischemia, bacterial infection, and inflammation is a common theory
A

controversial.

  • Fecalit
106
Q

in appendicitis, complete blood cell count - elevated ___

A

white blood cell count with an elevation of the neutrophils.

107
Q

Appendicitis with perforation management??

A

(Laparotomy)

108
Q

___ & ___ are chronic, relapsing inflammatory bowel diseases (IBDs) of unknown origin both diseases are associated with ____, alterations in epithelial cell barrier functions, immunopathology related to abnormal ___ reactions to microflora and other luminal antigens,
and varying phenotypes

A

Ulcerative colitis and Crohn disease

genetic factors

T-cell

109
Q

Crohn’s disease

  • any part of the ____
  • the most common - terminal part of the ___
  • inflammatory process affects all layers of the wall of the digestive tract -> ____ in the wall, the formation of ___ and ___
A

digestive tract

ileum

ulcerations

fistulas and abscesses

110
Q

Ulcerative colitis

  • affects __ and __
  • the process of fibrosis is not __
A

colon and rectum

intensified

111
Q

Transmural thickening
Deep, penetrating granulomas

A

Crohn’s disease

112
Q
  • Mucosal ulceration
  • Minute, mucosal ulcerations
A

Ulcerative colitis

113
Q
  • is a serious condition that can have many causes
  • __ disorders, ___ diseases, spinal cord injury
  • this happens very ___
A

ILEUS -

metabolic
parathyroid

rarely

114
Q
  1. ___ - obstruction in the lumen of the intestine and leads to compression of the wall
  • intussusception,
  • polypoid tumors and neoplasms,
  • adhesions,
  • hernias,
A

mechanical obstruction

115
Q
  1. ___ - due to the “paralysis” of the intestinal muscles
A

functional obstruction

116
Q
  • ____ - strangulation of blood vessel due to thrombosis or embolism
A

vascular obstruction

117
Q
  • in paralysis, intestinal immobility, intestine vasculature failure, CNS disorders
A
  • Paralytic ileus
118
Q
  • there is a long spasm of various segments of the intestine
A
  • Spastic ileus
119
Q

ileus management

A

Management
* Decompression of the bowel through a nasogastric tube

120
Q

CLINICAL MANIFESTATIONS

  • constipation may be the only symptom for months.
  • the stool is altered as it passes the obstruction that is gradually increasing in size.
  • Blood loss in the stool may result in iron deficiency anemia. (___)
  • The patient may experience weakness (____)
  • weight loss, and
  • anorexia
  • the abdomen becomes markedly distended,
  • crampy lower abdominal pain.
  • fecal vomiting develops (____)
  • Symptoms of shock may occur.
A

(Large Bowel Obstruction)

hematochezia

Asthenia

copremesis

121
Q

CLINICAL MANIFESTATIONS
* may be colic pain (obstruction of the lumen)
* vomiting and
* abdominal distension

A

(Small Bowel Obstruction)

122
Q

__ may be performed if removal of the entire large bowel is necessary (_)

A
  • An ileoanal anastomosis

proctocolectomy

123
Q

in which a surgical opening is made into the cecum,

  • A temporary or permanent ___ may be necessary.
A

A cecostomy,

colostomy

MS (8 decks)

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