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Pathophysiology > Exam 3 - Alterations Of Digestive Function > Flashcards

Exam 3 - Alterations Of Digestive Function Flashcards

1
Q

Anorexia definition

A

A lack of desire to eat despite physiologic stimuli that would normally produce hunger

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2
Q

Vomiting definition

A

The forceful emptying of the stomach and intestinal contents through the mouth

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3
Q

What do we document when a pt vomits?

A 
What time
How much
How often
Precipitating factors
Associated factors
Alleviating factors
What it looked like
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4
Q

Most common GI issue

A

Nausea

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5
Q

Definition of nausea

A

A subjective experience that is associated with a number of conditions

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6
Q

Common symptoms of nausea

A

Hypersalivation
Tachycardia
Aversion to food

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7
Q

What is retching?

A

Nonproductive vomiting

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8
Q

“Addictive” medication given for nausea

A

Phenergan

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9
Q

Definition of projectile vomiting

A

Spontaneous, forceful vomiting that does not follow nausea or retching

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10
Q

What causes projectile vomiting?

A
  • Direct stimulation of vomiting center by neurologic lesions of brain stem
  • Or gastrointestinal obstruction (more common)
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11
Q

Constipation definition

A

Infrequent or difficult defecation

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12
Q

What causes constipation?

A 
Neurogenic disorders
Functional or mechanical conditions
Low-residue diet
Sedentary lifestyle
Excessive use of antacids
Changes in bowel habits
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13
Q

Usual causes of constipation for older adults and adults

A

Older adults: GI tract slows down and becomes weaker

Adults: dehydration or *pain meds

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14
Q

Definition of diarrhea

A

Increased frequency of bowel movements

Increased volume, fluidity, weight of the poo

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15
Q

Definition of abdominal pain

A

AKA abdominal cramping

Symptom of a number of gastrointestinal disorders

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16
Q

Major causes of diarrhea

A

Osmotic diarrhea - fluid & electrolyte imbalance
Secretory diarrhea - trying to get rid of something
Motility diarrhea - issue in GI tract (most common)

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17
Q

What is referred pain?

A

Rebound tenderness after palpating

Used to test for appendicitis

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18
Q

Two types of gastrointestinal bleeding

A

Upper and lower

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19
Q

Color of blood from upper respiratory tract

A

Bright red

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20
Q

Where does upper gastrointestinal bleeding occur?

A

Esophagus
Stomach
Duodenum

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21
Q

Where does lower gastrointestinal bleeding occur?

A 
Below the ligament of Treitz
Jejunum
Ileum
Colon
Rectum
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22
Q

What does blood look like with lower gastrointestinal bleeding

A

Coffee grounds, dark burgundy

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23
Q

What does GI bleeding cause?

A

Low blood volume symptoms

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24
Q

Low blood volume symptoms

A 
Increased pulse
Increased respirations (from anxiety)
Decreased BP
Pallor
Increased turgor
Decreased urine output
Decreased SpO2 (later symptom depending on level of blood loss)
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25
How can someone bleed from their esophagus?
Tear that gets worse from eating but resolves | Esophageal varices
26
Term and spelling: | Bloody vomitus
Hematemesis
27
Term and definition: | Black tarry stools
Melena
28
Term and spelling: | bright red blood passed from the rectum
Hematochezia
29
Definition of hematemesis
Bloody vomitus, either bright red or digested blood
30
Definition of melena
Black, sticky, tarry, foul-smelling stools caused by digestion of blood in the gastrointestinal tract
31
Definition of hematochezia
Fresh, bright red blood passed from the rectum
32
What is occult bleeding
Trace amounts of blood in normal-appearing stools or gastric secretions
33
How is occult bleeding detected?
Only with a guaiac (or occult) test
34
Term and spelling: | Difficulty swallowing
Dysphagia
35
Definition of achalasia
Enervation of smooth muscle in esophagus and lower esophageal sphincter relaxation Loss of esophageal peristalsis and failure of lower esophageal sphincter to relax So gastric acid goes back and forth Pt would have constant heart burn
36
Side effects of achalasia
Pt would have constant heart burn | Can lead to upper GI bleeding which is very dangerous
37
Definition of GERD
Reflux of chyme (gastric acid) from the stomach to the esophagus
38
Causes of GERD
Conditions that increase abdominal pressure can contribute to GER
39
Risk factors for GERD
Obesity Hiatal hernia Drugs or chemicals that relax the LES
40
Clinical manifestations of GERD
Heartburn Regurgitation of chyme Upper abdominal pain within one hour of eating (because parietal cells are making more acid to digest)
41
Types of hiatal hernias
Sliding hiatal hernia | Paraesophageal hiatal hernia
42
Definition of hiatal hernia
Protrusion of the upper part of stomach through diaphragm into thorax
43
Definition of a sliding hiatal hernia
Moves in and out of diaphragm
44
Definition of paraesophageal hiatal hernia
Strangulated hernia that’s bigger on the thorax side
45
Clinical manifestations of sliding hiatal hernias
Asymptomatic
46
Clinical manifestations of paraesophageal hiatal hernias
GER Dysphagia Heartburn Epigastric pain
47
What is a pyloric obstruction?
Blocking or narrowing of the opening between the stomach and the duodenum
48
Clinical manifestations of pyloric obstruction
``` Vague epigastric fullness Nausea Epigastric pain Anorexia & weight loss *Vomiting (cardinal sign) *Infrequent, small stools (b/c of obstruction) ```
49
Clinical manifestations of prolonged pyloric obstruction
Malnutrition Dehydration Debilitation (Eventually death)
50
Definition of intestinal obstruction & ileus
Ileus = obstruction of the intestines - Any obstruction that prevents the flow of chyme through the intestinal lumen - Failure of normal intestinal motility in the absence of an obstructing lesion
51
Clinical manifestations of intestinal obstruction & ileus
Vomiting: classic sign (may turn malodorous with fecal smell), tarry -Loss of electrolytes -Hypovolemia Abdominal distention Constipation with failure to pass flatus Increased bowel sounds (high pitched at first, then silent)
52
Types of intestinal obstruction & ileus
Simple obstruction | Functional obstruction
53
What is a simple intestinal obstruction and ileus
Mechanical blockage of lumen by lesion
54
What is a functional intestinal obstruction and ileus?
Failure of motility (paralytic ileus)
55
Causes of intestinal obstruction and ileus
``` Hernia Intussusception Torsion (volvulus) Diverticulitis Tumor Paralytic ileus Fibrous adhesions ```
56
What is a hernia?
Protrusion of intestine through a weakness in the abdominal muscles or through the inguinal ring
57
Intussusception definition
Telescoping of one part of the intestine into another Usually causes strangulation Infants
58
Torsion definition
(Volvulus) Twisting of the intestine, with occlusion of the blood supply Usually associated with fibrous adhesions Older adults
59
Diverticula
Herniations of mucosa through the muscle layers of the colon wall, especially the sigmoid colon
60
Paralytic ileus
Loss of peristaltic motor activity in the intestine
61
Adhesions
Peritoneal irritation from surgery or trauma, causes adhesions that attach to intestine Cause traction and obstruction
62
What is diverticulosis?
Asymptomatic diverticular disease (chronic)
63
What is diverticulitis?
Inflammatory stage of diverticulosis (acute)
64
Gastritis definition
Inflammatory disorder of the gastric mucosa
65
Acute gastritis
Erodes surface epithelium | More worrisome - can cause ulcers
66
Chronic gastritis
Thinning and degeneration of stomach wall | Occurs in elderly
67
Clinical manifestations of gastritis
``` (Do not correlate with severity) Vague Anorexia Fullness Nausea Vomiting Epigastric pain Gastric bleeding (specific to gastritis b/c of irritation of lining of gut) ```
68
PUD definition
A break or ulceration in the protective mucosal lining of the lower esophagus, stomach, or duodenum
69
What causes acute PUD?
Temporary | Due to hypovolemia
70
PUD risk factors
``` Smoking Advanced age Habitual use of NSAIDS *Alcohol (biggest cause) Chronic diseases Infection of the gastric and duodenal mucosa with H. Pylori overgrowth ```
71
Chronic diseases that can cause peptic ulcers
Emphysema Rheumatoid arthritis Cirrhosis Diabetes
72
Kk
73
Types of PUD
Duodenal ulcers Gastric ulcers Stress ulcer
74
Most common of the peptic ulcers
Duodenal ulcers
75
Who does duodenal ulcers usually occur in
Younger people
76
Major cause of duodenal ulcers
Helicobacter pylori and NSAIDS
77
Patho of duodenal ulcers
Hypersecretion of stomach acid and pepsin
78
Causes of duodenal ulcers
Hypersecretion of stomach acid and pepsin Inadequate bicarbonate secretion (to balance acid) High gastric levels Acid production by cigarette smoking
79
Clinical manifestations of duodenal ulcer
Chronic intermittent epigastric pain | 2-3 hours after eating (comes and goes)
80
Ulcer that develops in the natural region of the stomach
Gastric ulcer
81
Who does gastric ulcers typically occur in
Males or females 55 to 65 years old
82
Pathophysiology of gastric ulcers
- The primary defect is an increased mucosal permeability to hydrogen ions
83
Clinical manifestations of gastric ulcers
Pain-food-relief; pain is often present after eating | Anorexia, vomiting, weight loss
84
Acute peptic ulcer that is related to severe illness, neural injury, or systemic trauma
Stress ulcer
85
Clinical manifestations of stress ulcers
Bleeding (seldom become chronic)
86
Types of stress ulcers
Ischemic ulcers Curling ulcers Cushing ulcers
87
Cause of ischemic ulcers
Multisystem trauma
88
Cause of curling ulcers
Burn injury
89
Cause of Cushing ulcers
Severe head trauma (vagus nerve)
90
Ulcerative colitis definition
Chronic inflammatory disease that causes ulceration of the colonic mucosa
91
Ulcerative colitis risk factors
Familial history Jewish descent Caucasians
92
Ulcerative colitis clinical manifestations
``` Intermittent remission and exacerbation (comes and goes) Diarrhea Bloody stools Continuous cramping Urgency ``` Dehydration Weight loss Anemia Fever
93
How much diarrhea for ulcerative colitis
10-20 stools/day
94
Chron disease definition
Inflammatory disease of large and small intestine | Idiopathic inflammatory disorder
95
What part of the digestive tract does crowns disease affect
Idiopathic inflammatory disorder; affects any part of the digestive tract; from mouth to anus
96
Clinical manifestations of Crohn disease
Diarrhea Occasional colonic bleeding Weight loss Lower abdominal pain

Pathophysiology (14 decks)

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