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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
Q

How can someone bleed from their esophagus?

A

Tear that gets worse from eating but resolves

Esophageal varices

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26
Q

Term and spelling:

Bloody vomitus

A

Hematemesis

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27
Q

Term and definition:

Black tarry stools

A

Melena

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28
Q

Term and spelling:

bright red blood passed from the rectum

A

Hematochezia

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29
Q

Definition of hematemesis

A

Bloody vomitus, either bright red or digested blood

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30
Q

Definition of melena

A

Black, sticky, tarry, foul-smelling stools caused by digestion of blood in the gastrointestinal tract

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31
Q

Definition of hematochezia

A

Fresh, bright red blood passed from the rectum

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32
Q

What is occult bleeding

A

Trace amounts of blood in normal-appearing stools or gastric secretions

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33
Q

How is occult bleeding detected?

A

Only with a guaiac (or occult) test

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34
Q

Term and spelling:

Difficulty swallowing

A

Dysphagia

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35
Q

Definition of achalasia

A

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

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36
Q

Side effects of achalasia

A

Pt would have constant heart burn

Can lead to upper GI bleeding which is very dangerous

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37
Q

Definition of GERD

A

Reflux of chyme (gastric acid) from the stomach to the esophagus

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38
Q

Causes of GERD

A

Conditions that increase abdominal pressure can contribute to GER

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39
Q

Risk factors for GERD

A

Obesity
Hiatal hernia
Drugs or chemicals that relax the LES

40
Q

Clinical manifestations of GERD

A

Heartburn
Regurgitation of chyme
Upper abdominal pain within one hour of eating (because parietal cells are making more acid to digest)

41
Q

Types of hiatal hernias

A

Sliding hiatal hernia

Paraesophageal hiatal hernia

42
Q

Definition of hiatal hernia

A

Protrusion of the upper part of stomach through diaphragm into thorax

43
Q

Definition of a sliding hiatal hernia

A

Moves in and out of diaphragm

44
Q

Definition of paraesophageal hiatal hernia

A

Strangulated hernia that’s bigger on the thorax side

45
Q

Clinical manifestations of sliding hiatal hernias

A

Asymptomatic

46
Q

Clinical manifestations of paraesophageal hiatal hernias

A

GER
Dysphagia
Heartburn
Epigastric pain

47
Q

What is a pyloric obstruction?

A

Blocking or narrowing of the opening between the stomach and the duodenum

48
Q

Clinical manifestations of pyloric obstruction

A 
Vague epigastric fullness
Nausea
Epigastric pain
Anorexia & weight loss
*Vomiting (cardinal sign)
*Infrequent, small stools (b/c of obstruction)
49
Q

Clinical manifestations of prolonged pyloric obstruction

A

Malnutrition
Dehydration
Debilitation
(Eventually death)

50
Q

Definition of intestinal obstruction & ileus

A

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
Q

Clinical manifestations of intestinal obstruction & ileus

A

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
Q

Types of intestinal obstruction & ileus

A

Simple obstruction

Functional obstruction

53
Q

What is a simple intestinal obstruction and ileus

A

Mechanical blockage of lumen by lesion

54
Q

What is a functional intestinal obstruction and ileus?

A

Failure of motility (paralytic ileus)

55
Q

Causes of intestinal obstruction and ileus

A 
Hernia
Intussusception
Torsion (volvulus)
Diverticulitis
Tumor
Paralytic ileus
Fibrous adhesions
56
Q

What is a hernia?

A

Protrusion of intestine through a weakness in the abdominal muscles or through the inguinal ring

57
Q

Intussusception definition

A

Telescoping of one part of the intestine into another
Usually causes strangulation
Infants

58
Q

Torsion definition

A

(Volvulus)
Twisting of the intestine, with occlusion of the blood supply
Usually associated with fibrous adhesions
Older adults

59
Q

Diverticula

A

Herniations of mucosa through the muscle layers of the colon wall, especially the sigmoid colon

60
Q

Paralytic ileus

A

Loss of peristaltic motor activity in the intestine

61
Q

Adhesions

A

Peritoneal irritation from surgery or trauma, causes adhesions that attach to intestine

Cause traction and obstruction

62
Q

What is diverticulosis?

A

Asymptomatic diverticular disease (chronic)

63
Q

What is diverticulitis?

A

Inflammatory stage of diverticulosis (acute)

64
Q

Gastritis definition

A

Inflammatory disorder of the gastric mucosa

65
Q

Acute gastritis

A

Erodes surface epithelium

More worrisome - can cause ulcers

66
Q

Chronic gastritis

A

Thinning and degeneration of stomach wall

Occurs in elderly

67
Q

Clinical manifestations of gastritis

A 
(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
Q

PUD definition

A

A break or ulceration in the protective mucosal lining of the lower esophagus, stomach, or duodenum

69
Q

What causes acute PUD?

A

Temporary

Due to hypovolemia

70
Q

PUD risk factors

A 
Smoking
Advanced age
Habitual use of NSAIDS
*Alcohol (biggest cause)
Chronic diseases
Infection of the gastric and duodenal mucosa with H. Pylori overgrowth
71
Q

Chronic diseases that can cause peptic ulcers

A

Emphysema
Rheumatoid arthritis
Cirrhosis
Diabetes

72
Q

Kk

A
73
Q

Types of PUD

A

Duodenal ulcers
Gastric ulcers
Stress ulcer

74
Q

Most common of the peptic ulcers

A

Duodenal ulcers

75
Q

Who does duodenal ulcers usually occur in

A

Younger people

76
Q

Major cause of duodenal ulcers

A

Helicobacter pylori and NSAIDS

77
Q

Patho of duodenal ulcers

A

Hypersecretion of stomach acid and pepsin

78
Q

Causes of duodenal ulcers

A

Hypersecretion of stomach acid and pepsin
Inadequate bicarbonate secretion (to balance acid)
High gastric levels
Acid production by cigarette smoking

79
Q

Clinical manifestations of duodenal ulcer

A

Chronic intermittent epigastric pain

2-3 hours after eating (comes and goes)

80
Q

Ulcer that develops in the natural region of the stomach

A

Gastric ulcer

81
Q

Who does gastric ulcers typically occur in

A

Males or females 55 to 65 years old

82
Q

Pathophysiology of gastric ulcers

A
  • The primary defect is an increased mucosal permeability to hydrogen ions
83
Q

Clinical manifestations of gastric ulcers

A

Pain-food-relief; pain is often present after eating

Anorexia, vomiting, weight loss

84
Q

Acute peptic ulcer that is related to severe illness, neural injury, or systemic trauma

A

Stress ulcer

85
Q

Clinical manifestations of stress ulcers

A

Bleeding (seldom become chronic)

86
Q

Types of stress ulcers

A

Ischemic ulcers
Curling ulcers
Cushing ulcers

87
Q

Cause of ischemic ulcers

A

Multisystem trauma

88
Q

Cause of curling ulcers

A

Burn injury

89
Q

Cause of Cushing ulcers

A

Severe head trauma (vagus nerve)

90
Q

Ulcerative colitis definition

A

Chronic inflammatory disease that causes ulceration of the colonic mucosa

91
Q

Ulcerative colitis risk factors

A

Familial history
Jewish descent
Caucasians

92
Q

Ulcerative colitis clinical manifestations

A 
Intermittent remission and exacerbation (comes and goes)
Diarrhea
Bloody stools
Continuous cramping
Urgency

Dehydration
Weight loss
Anemia
Fever

93
Q

How much diarrhea for ulcerative colitis

A

10-20 stools/day

94
Q

Chron disease definition

A

Inflammatory disease of large and small intestine

Idiopathic inflammatory disorder

95
Q

What part of the digestive tract does crowns disease affect

A

Idiopathic inflammatory disorder; affects any part of the digestive tract; from mouth to anus

96
Q

Clinical manifestations of Crohn disease

A

Diarrhea
Occasional colonic bleeding
Weight loss
Lower abdominal pain

Pathophysiology (14 decks)

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