Final/Last exam Flashcards
Vaginitis
Inflammation of vaginal wall
BV
Shift from normal flora. Gray white discharge, malodorous
Fungal
Yeast infection, cadida albicans, itching white and thick discharge
Trichomoniasis
STI (non symptomatic in men)
Protozoan parasite
Green/yellow frothy discharge
Vaginitis symptoms
Change in color/odor/ discharge
pain during intercourse
painful urination
light spoting
PID
Acute inflammation due to infection. can involve any URT organs
Salpingitis
inflammation of the fallopian tubes
Oophoritis
Inflammation of the ovaries
Risk factors of PID
<25, multiple sex partners, unprotected sex, douching
Symptoms of PID
Can be asymptomatic
Abdominal pain, cervical motion tenderness, adnexal pain, fever, pain/difficult urination, changes in discharge
Bartholin Cyst (Bartholintis)
Inflammation of one or both Bartholin gland ducts it is an accumulation of fluid due to injury or bacteria
managed by warm bath and NSAIDs
Pelvic organ prolapse
Muscular and fascia tissue loses tone and strength and organs that are found on pelvic floor desend
Clinical manifestation of prolapse
Sitting on a ball, backache , heaviness that worsens with standing , dysuria, etc treated with keigels
Follicular cysts
Benign ovarian cysts/functional cysts. LH fails to stimulate egg release or follicle never transforms and becomes fluid filled
Normal follical development
Normal: Luteinizing hormone (LH) stimulates oocyte (egg) release from follicle ->follicle transforms into corpus luteum->CL transforms into corpus albicans if no fertilization-> shrinks and goes away
What seperates the upper GI tract
Ligament of Trietz comes in a 1/3 of way down duodenum
Hematemesis
In the upper GI, if vomit is frank blood then there is an active bleed, if there are coffee grounds it was mixed with gastrin
Melena
Can be a bleed of upper and lower GI track stool is black or maroon and tary
Hematochezia
Bright red blood per rectum can be lower GI or a massive upper GI
Occult
typically asymptomatic
Mallory weiss tear
Linear lacerations at gastro esophageal junction that is caused by prolonged vomiting
S/S Hematemesis, ab pain, melena, retching
80-90 resolve on their own
Esophageal Varices
Dilated submucosal veins in the lower third of the esophagus (varicose veins in esophagus)
Liver disease/portal hypertension (pressure from liver backs up into GI vasulature)
S/S asymptomatic massive hematemesis when varices are ruptured
Diverticula
Small pouches formed of weakened lower intestingal wall
Risk 40+, smoking obesity, diet
S/S” LLQ pain, fever, tenderness, constipation diabetes, diarrhea
Hemorrhoids
Varices of the veins in the anus and rectum
Common in preg, obesity low fat diet,
BRB for bleeding
Esophageal obsturction dysphagia
Difficulty swallowing
Strop
Intrinsic blockage
Anything that is causing blockage from inside body– tumor, scar, GERD etc
Extrinsic Blockage
Foreign body obstruction
Symptoms
Retrosternal pain (breast bone), regurgitation of undigested food, weight loss, vomiting
Upper Esophageal Obstruction occurs
2-4 seconds after swallowing
Lower esophageal obstruction
Discomfort occuring 10-15 seconds after swallowing
Achalasia
Cardiac sphincter it doesnt open and allow food into the stomach and sits in esophages
Dysphagia complications
Aspiration pneumonia, malnutrtion, dehydration, choking
Esophageal cancer
S/S Difficulty & pain with swallowing, choking on food, hoarseness, coughing
endoscopy is diagnostic tool
Squamous cell carcinoma for esophageal cancer
upper 2/3s of esophagus in the epithelial lining
Risk: male over 50, betel nuts, hot drinks, etc
S/S: asymptomatic until advanced, dysphagia is 1st symptom, weight loss, hoarseness
Poor prognosis
Adenocarcinoma of the esophagus
lower 1/3 of esophagus glandular cells transform into intestinal cells
Gerd-> Barretts esophagus–> cancer
HB, indigestion, dysphagia etc
ileus
stop moving bowels (post op, drugs, etc)
Herniation
Weakened part of abdominal cavity
Adhesion
Scar tissue that forms between two loops of bowl
Intussusception
Telescoping of the bowel, bowel slips into itself and obstructs.
Intussusception
Telescoping of the bowel, bowel slips into itself and obstructs.
Vomitus
Can indicate the location of obstruction
Pyloris
Early, profuse vomiting of clear gastic fluid
proximate Small intestine
Mild distention, bile stained fluid
Lower in small intesting
More pronounced distention , vomitting may not occue or occur later and have fecal material
PUD
Chronic mucosal ulceration in stomach or duodenum
Imbalance between mucosal defense systems and damaging forces of gastric acid and pepsin,
PUD causes
NSAIDS, H. Pylor infection, cancer of stomach, Crohns disease, stress, burns, Zollinger-Ellison syndrome
Gastric vs Duodenal Ulcers
Pain
Weight
Male/Female
G pain is worse after eating D: relieved with eating (2-5 hours pain starts)
G: weight loss
D:weight gain
G: Women
D: Men
Hemorrhage
BV damage as ulcer erodes into the muscle of stomach or duodenal wall
Perforation
Ulcer erodes completely through the wall, peritonitis
GI accessory organs
Salivary glands, gallbladder, liver, pancreas
main GI organs
Mouth Esophagus Stomach Small Intestine Large Intestine Rectum Anus
Mechanical digestion
Chewing swallowing
Chemical digestion
Salivary amylase
inactivated by gastric acid, it breaks down carbs from poly to disaccharides
Esophagus –upper esophageal sphincter
voluntary control, prevents food from entering trachea
Esophagus –lower esophageal sphincter aka cardiac sphincter
Prevents stomach acid contents from refluxing into esophagus
4 parts of the stomach
Fundus
cardia
corpus/body
pylorus
pyloric sphincter
regulates gastric emptying into the duodenum
Capacity of the stomach
1.5 L
Functions of stomach
storage, mixing emptying
Secretory
exocrine: gastric acid, mucus intrinsic factor, pepsinogen
endocrine: gastrin
digests proteins/lipids and absorption of water and ions
Pepsinogen
Secreted by cheif cells
converted to pepsin my gastric acid and breaks down proteins
Intrinsic factors
secreted by parietal cells
glycoprotein that is necessary to absorb vitamin B
Gastric acid
produced by autonotmuc NS
and hormones largely contains HCL
Gastrin
Stimulates release of gastric acid (juice) aids in gastric motility.
induces pancreatic secretions and gallbladder emptying.
Small intestine
primary role is to absorb nutrients and minerals
Small intestine
primary role is to absorb nutrients and minerals
Parts of the small intesting
duodenum
Duodenum
ampulla of vater opens to it to supply exocrine enzymes from pancreas,
common bile duct supplys bile from gallbladder and liver
what does duodenum do
- Chemical breakdown of chyme by enzymes • Regulation of stomach emptying
- Mucus secretion
Jejunum
absorption of sugars, amino acid, fatty acids
Ileium
Absorption of nutrient left from jejunum
Absorption of B12 and bile salts
Connects to the cecum of the large intestine
Small intestine secretions
Mucus, aminopeptidase, enterokinase, amylase
Purpose of large intestines
Is approx. 5 ft. long
Reabsorb water and minerals
Formation and store feces Maintain microbiome Bacterial fermentation
Bacterial synthesis of Vitamin K
Liver
Largest internal organ, RUQ, two lobes ducts of each join with the cystic duct =common bile duct
Functions of liver
Produces bile, immunity, clotting, protein production, detox, metabolizes nutrients
Galbladder
store and concentrate bile that isnt being used.
Biles main function is to break down fats
contracts to secret bile in response to cholecystokinin
Pancreas exocrine function
Secretion of digestive enzymes • Carbohydrates – pancreatic amylase • Fats – pancreatic lipase (steapsin) • Proteins – trypsin Secretion of bicarbonate • Neutralizes chime in duodenum • Stimulated by secretin
causes of stomach obstructions
tumors, inflammation from duodenal ulcer , foreign bodies.
causes of intestinal obstruction
ileus from post operative bowl changes, foreign bodies, mechanical obstruction
zollinger ellison syndrome
gastrin producing tumor of the pancreas leading to chronic acid production, gastritis and ulcers
Sensory neurons:
transmit impulses from peripheral sensory receptors to the CNS
Association neurons
transmit impulses between neurons and only exist in CNS
How are impulses transmitted across the synapse
chemically or electrically
EPSPs
excited- depolarized post synaptic potentials
IPSPs
Hyperpolarized inhibitory post synaptic potentials
Types of neuroglia
Oligodendrocytes
astrocytes
microglia
ependymal
Forebrain includes
two cerebral hemispheres, (frontal parietal, temporal, occipital lobes basal ganglia
Midbrain
Corpora quadrigemina, tegmentum, cerebral peduncles
Hind brain
cerebellum pons and medulla
Forebrain
Sulci spaces and Gyri rides
Made up of grey matter which integrates, stores, and transmits info
white matter is made up of myelinated neurons
controls thoughts behaviors memory motor
Basal ganglia
lay deep inside cortex and are responsible for control of voluntary movements, cognitive and emotional functions
Thalamus, hypothalamus
control many functions including hormone synthesis, temperature regulation
Midbrain
connects forebrain and hindbrain
involved in controlling eye movements, makes dopamine
Cerebral aqueduct passes through
Pons
transmits info from cerebellum to brain stem
Medulla
controls reflexes such as HR, resp, BP, sneezing coughing, swallowing etc
Reticular activating system
essential for wakefulness and attention, control vital functions
Spaces
need to review
Epidural
b/w dura and skull
subdural
b/w dura and arachnoid mater
subarachnoid
contains csf; located bw arachnoid and pia mater
CSF
is produced by the choroid plexuses in the lat 3, 4, ventricles
prevents the brain from tugging on the meninges nerves and BV
Spinal cord
protected by the verterbral column, transmits long motor and sensory impulses that orginate in brain
PNS structures
Cranial nerves, spinal nerves, PNS have ascending, afferent pathways to carry sensory info to CNS and efferent pathway that goes to organs
Somatic nervous system
motor and sensory pathways regulate voluntary motor control of skeletal muscle
Autonomic NS
Motor and sensory pathyways that reg the bodies internal environment through the involuntary control of organs
Testicular torsion
Rotation of the testes the spermatic cord is twisted
Prostatis
Inflammation of the prostate due to uti or infection, can be cloudy urine, flu like symptoms
Balaritis
When the skin on the glans penis is inflamed, due to smegma build up or hygiene practices
Phimosis
When the foreskin of the penis is tight and cannot be retracted over the glans penis. This is normal up to 6 months
infection can happen
Paraphimosis
the skin is too tight and retracts behind the glans penis
is medical emergency.
Urethritis
Caused by inflammation of the urethra likely do to infection or STI, mucus discharge/cloudy urine
Varacocele
When the spermatic cord veins get varicosities and the valves don’t work as well. Can feel like a bag of worms and can cause sterility
priaprism
an unwanted erection for more than 4 hours
medical emergency
Chalymidia
Invades/destroys the host cells and causes beefy red mucousa
Gonorhea
A STI the causes damage as the body fights infection, wbc and dead cells come out as puss.
Syphilis
Infection that is 4 stages
- primary- painless chancres
- full body rash and very contagious
- latent phase- dormant
- Tertiary phase where psychological/neuro issues occur
Chancroid
Pain full, pull thickness loss of the genital skin can be spread through lymph nodes.
