Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ESA 3 steven > Gastro-Intestinal > Flashcards

Gastro-Intestinal Flashcards

0
Q

What are the main functions of the stomach?

A

Store food
Mix and disrupt
Secrete acid and enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

What are the 4 main processes of the digestive tract?

A

Secretion, digestion, motility and absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 4 parts of the stomach?

A

Cardiac, fundus, body, pyloric antrum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How is reflux prevented?

A

Acute angle
Lower oesophageal sphincter
Positive intra abdominal pressure compresses the walls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the cell layers that make up the alimentary canal?

A

Mucosa - epithelium, connective tissue and smooth muscle
Sub mucosa
Muscularis external
Serosa/adventitia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the muscle and nerve supply for mastication?

A

Masseter

Trigeminal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the functions of saliva?

A

Lubricate
Start digesting carbohydrates
Protection - moist, wash teeth and alkaline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the components of saliva?

A

Water, alkali, electrolytes, enzymes, mucus, bacteriostats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is xerostomia and the consequences of it?

A

Low saliva production

Can only eat moist food and teeth/mucosa degrades very quickly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 3 salivary glands and the type of saliva they produce?

A

Parotid - serous - high enzymes low mucus
Sub-lingual - mucous - high mucus no enzymes
Submandibular - mixed - produce 70% of saliva

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What do the acinar cells and ductal cells do?

A

Acinar secretes saliva and ductal cells modify the composition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the effect of increased saliva production?

A

More produced = less modified so
Higher volume, alkalinity and enzyme levels
Less hypotonic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Outline the process of swallowing

A

Voluntary phase - bolus formed and moved to pharynx
Reflex - pressure receptors stimulated causing: respiration inhibited, raise larynx, close glottis, open upper oesophageal sphincter, rapid peristaltic wave and opening of lower oesophageal sphincter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some potential causes of dysphagia

A

Motility problems - achalasia

Obstruction - tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does lateral folding and craniocaudal folding accomplish?

A

Lateral - ventral body wall and tubular primitive gut

Craniocaudal - creates pockets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the derivatives of the foregut? What is its blood supply?

A

Oesophagus, stomach, pancreas, liver, gall bladder and duodenum
Celiac trunk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the derivatives of the midgut? What is its blood and nerve supply?

A

Duodenum, jejunum, ileum, cecum, ascending colon and transverse colon
Superior mesenteric artery/vein
Vagus nerve/superior mesenteric ganglion and plexus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the derivatives of the hind gut? What is its blood and nerve supply?

A

Transverse colon, descending colon, sigmoid colon, rectum, upper anal canal, lining of bladder and urethra
Inferior mesenteric artery/vein
Pelvic nerve/inferior mesenteric ganglion and plexus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What does the splanchnic and somatic mesoderm become?

A

Somatic - muscle and fasciae of the abdominal wall

Splanchnic - smooth muscle of the gut wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe the muscle and fascia of the abdominal wall

A

Lateral folding creates linea alba in the middle
External oblique, internal oblique and transversus abdominis. Rectus abdominis anteriorly.
Deep is transversalis fascia. Superficial is superficial fascia and skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What do the dorsal and ventral mesenteries do?

A

Dorsal - attach entire gut to roof of abdominal cavity

Ventral - attach foregut to the floor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What do the left and right sac become?

A

Greater peritoneal sac

Lesser peritoneal sac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the greater omentum derived from? And the lesser omentum? And what do they connect?

A

Greater - dorsal mesentery. Greater curve to transverse colon
Lesser - ventral mesentery. Lesser curve to liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What does retroperitoneal mean and give an example of some organs which are

A

Never in the peritoneal cavity and never had a mesentery. Aorta, vena cava and kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What does secondary retroperitoneal mean and give an example of organs which are

A

Began development in the peritoneum but lost mesentery. Ascending and descending colon and duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the three vertical muscles of the abdominal wall?

A

External oblique, internal oblique, transversalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the two flat muscles of the abdominal wall?

A

Rectus abdominis and pyramidalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the rectus sheath?

A

The aponeurosis of the vertical muscles combine at the linea alba and enclose the flat muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the layers of the abdominal wall from superficial to deep?

A

Skin
Superficial fascia
Muscles and their associated fascia
Peritoneum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the arcuate line?

A

The point where posterior wall of the rectus sheath disappears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the 3 main types of incision?

A

Midline - through linea alba
Transverse - through the oblique muscles
Grid iron - split the muscle fibres

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is a Meckel’s diverticulum?

A

Remnant of the vitelline duct

2% of the population, 2” in length, 2:1 male/female ratio, found in under 2’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the following conditions: vitelline fistula, omphalocoele, gastroschisis?

A

Direct communication between umbilicus and GI resulting in faecal matter out of the umbilicus
Persistence of physiological herniation
Gut tube outside body with no covering

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is a hernia?

A

Abnormal protrusion of an organ or fascia through the walls of the cavity that contain it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the 3 main types of herniation?

A

Inguinal
Femoral
Umbilical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are the borders of the inguinal canal and what does it normally contain?

A

Lateral - deep inguinal ring
Medial - superficial inguinal ring
Anterior and superior - aponeurosis of external oblique
Posterior - transversalis fascia
Inferior - inguinal ligament
Males - spermatic cord and ilioinguinal nerve
Females - round ligament and ilioinguinal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the difference between a direct and indirect inguinal hernia

A

Direct goes through Hesselbachs triangle. Indirect goes through the deep ring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What are some complications of hernias?

A

Strangulation - poor blood supply

Incarceration - not easily reversed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are the functions of the stomach?

A

Store food
Digest food
Break food down into chyme

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are the “attack” and “defence” secretions by the stomach?

A

HCl and proteolytic enzymes

Mucus and HCO3-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are the 4 cells in gastric pits and what do they produce?

A

Parietal - acid
Chief - enzymes
Endocrine - gastrin
Neck - mucus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Outline the method of acid production and secretion

A

The mitochondria produces H+ and OH- ions from water in the mitochondria. OH- becomes HCO3- and is secreted into the blood. H+ enters the stomach via a proton pump using ATP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What effects acid secretion?

A

Gastrin - increased by peptides, ACh. Decreased by acid
Histamine - increased by gastrin and ACh
ACh - increased by CNS and distention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Outline the 3 phases of control

A

Cephalic - detect and ingest food. Autonomic
Gastric - food reaches stomach and via pH rising, stomach distending and peptides being released more acid is produced
Intestinal - as stomach empties gastrin antagonists and pH lowering reduces acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

How are the stomachs defences promoted?

A

Prostaglandins which are stimulated by the same mechanisms stimulating acid secretion thus matching attack and defence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What are some problems with stomach defences and what is the result?

A

Alcohol - dissolve mucus
H. pylori
NSAIDS - inhibit prostaglandins
Leads to peptic ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

How can you reduce acid secretion?

A

Proton pump inhibitors - omeprazole

Histamine antagonists - cimetidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What inhibits stomach emptying?

A

Fat, hypertonicity and low pH in the duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Explain the primary intestinal loop and it’s function

A

The midgut herniated into the umbilical cord to accommodate the growing liver and undergoes 3x 90 degree anticlockwise rotations around the SMA resulting in the final positions of the midgut.

49
Q

What are some malformation problems?

A

Incomplete - left sided colon
Reverse - transverse colon posterior to duodenum
Volvulus - abnormally twisted bowel = blockage, strangulation and ischaemia

50
Q

What is the purpose of recanalisation and what can its failure result in?

A

Gut cell growth is so rapid in the oesophagus, bile duct and small intestine the lumen can become obliterated
If it fails you can get atresia or stenosis

51
Q

What is the difference between an umbilical hernia and omphalocoele?

A

Umbilical hernia has a skin covering

52
Q

How is the anal canal and urogenital canal separated?

A

Urorectal septum separates them

53
Q

What are the differences above and below the pectineal line?

A

Above - IMA, columnar epithelium, parasympathetic, internal inguinal nodes, stretch sensation only
Below - pudendal a, stratified squamous, sympathetic, superficial inguinal nodes, pain/touch/temperature sensation

54
Q

Where is visceral foregut, midgut and hind gut pain felt?

A

Epigastric, peri umbilical, suprapubically

55
Q

How is gastric reflux normally prevented?

A

Lower oesophageal sphincter
Abdominal pressure>thoracic pressure
Right crus of diaphragm
Oblique entrance angle

56
Q

What are the symptoms of acid reflux and when are they worse?

A

Dyspepsia - heart burn

Lying down and hot drinks

57
Q

How do is reflux managed?

A

Lifestyle - stop smoking, weight loss, reduce alcohol

Medicate - antacids, PPIs, H2 antagonist

58
Q

What is an ulcer?

A

Break in the superficial epithelial cells down to muscularis mucosa

59
Q

Where are stomach ulcers and duodenal ulcers most likely to be found?

A

Lesser curve

Duodenal cap

60
Q

What can cause peptic ulcers and why?

A

NSAID - inhibit prostaglandins which produce the defences

61
Q

What are the symptoms of peptic ulcers?

A

Recurrent burn in epigastric pain worse at night and when hungry
Nausea
Weight loss

62
Q

How are ulcers managed?

A

PPI - omeprazole
H2 antagonist - cimetidine
Antibiotics - clarithromycin H. Pylori
Stop using NSAIDS

63
Q

What type of bacteria is H. pylori? How is it able to survive in the stomach?

A

Gram negative aerobic

It has urease which produces ammonia to neutralise the acid

64
Q

How is H. pylori diagnosed?

A

IgG
Urea breath test
Biopsy

65
Q

In what state does Chyme leave the stomach and how is that corrected?

A

Acidic - HCO3- added
Hypertonic - H2O added
Partly digested - enzymes and bile acids added

66
Q

What do the exocrine glands of the pancreas produce? Which part produces which?

A

Alkaline juice - ducts

Enzymes - acinar

67
Q

What stimulates the release of enzymes and alkaline juice respectively?

A

CCK

Secretin

68
Q

What are the four main functions of the liver?

A

Energy metabolism, detoxification, plasma proteins and bile

69
Q

Describe the blood and bile flow in the liver

A

Blood enters from the hepatic portal vein into sinusoids lined with hepatocytes into the central vein. Bile enter canaliculi and flows to the bile duct

70
Q

What are the two components of bile?

A

Bile acid dependent - bile acids and pigments

Bile acid independent - alkaline juice

71
Q

What do bile acids do?

A

Help with fat digestion by emulsifying them to increase surface area

72
Q

What does the gall bladder do?

A

Store recycled bile and concentrate it. When CCK is their the muscle contracts emptying it

73
Q

What are the defences the GI has to toxins?

A

Innate - physical and cellular

Adaptive

74
Q

List the physical defences

A

Sight, smell, memory, saliva, gastric acid, mucus, anaerobic, small intestinal secretions, peristalsis/segmentation

75
Q

What conditions can arise due to salivary problems?

A

Xerostomia - mucus and teeth degradation

Parotitis - staph aureus

76
Q

What can cause achlohydria and what conditions can then develop?

A

PPI, pernicious anaemia

Shigellosis, cholera, salmonella, clostridium difficile

77
Q

How is the small intestine protected?

A

Bile, enzymes, anaerobic environment, epithelial shedding and segmentation

78
Q

What can survive gastric acid?

A

TB - resist acid
H. Pylori - protective ammonia
Hep A
Polio

79
Q

What are the cellular defences?

A

Neutrophils, macrophages, natural killer cells, mast cells, eosinophils

80
Q

What can cause liver failure?

A 
Viral hepatitis
Alcohol
Drugs
Solvent
Mushrooms
81
Q

What are the GIs adaptive defences?

A

B lymphocytes
T lymphocytes
Lymphatics - MALT/GALT

82
Q

Explain mesenteric adenitis

A

Right iliac fossa pain - adenovirus

Mistaken for appendicitis

83
Q

Explain appendicitis

A

Obstruction of appendix leads to stasis and infection

Usually due to lymphoid hyperplasia (chickenpox) or facecloth

84
Q

What would you see in the blood for: hepatocellular damage, cholestasis, reduced synthetic function?

A

ALT, AST, gamma glutamyl transpeptidase
Bilirubin, alkaline phosphatase
Reduced albumin and increased clotting time (prothrombin)

85
Q

What are the 3 classifications of jaundice?

A

Pre hepatic - haemolytic
Hepatic - parenchymal
Post hepatic - cholestatic

86
Q

Explain pre hepatic causes of jaundice

A

Excess haemolysis - membrane defects, infections, Gilbert’s syndrome

87
Q

Explain hepatic jaundice

A

Decreased function - drugs, viruses, cirrhosis

88
Q

Explain post hepatic jaundice

A

Obstruction - intrahepatic - hepatitis, cirrhosis, drugs

Extra hepatic - gallstones, cancer

89
Q

What would you see in the blood for acute and chronic hepatitis?

A

Raised AST/ALT and jaundice

Reduced clotting and albumin

90
Q

What are risk factors for gallstones?

A

Female
Old
Obese

91
Q

What can gallstones be made of?

A

Cholesterol, calcium and bile

92
Q

Explain pancreatitis

A

Inflammation of the pancreas due to released enzymes. A duct obstruction causes acinar damage and release of proteases, lipase sand elastase

93
Q

What are some causes and clinical features of pancreatitis?

A

Gall stones, ethanol, trauma
Acute - Increased amylase, ALP, pain, vomiting, SIRS
Chronic - pain, steatorrhea, reduced albumin and jaundice

94
Q

What is the structure of the small intestine?

A 
Mucosa folded into villi separated by crypts. Cells multiply and then migrate and mature on the way to villi tips
Micro villi (brush border) to increase surface area
95
Q

In broad terms how is absorption done in the small intestine?

A

Villi cells secrete enzymes forming an unstirred layer. Nutrients diffuse into it and the enzymes digest them

96
Q

What enzymes does the body have to digest carbohydrates?

A

Alpha amylase in saliva and pancreas

Isomaltase, maltase, sucrose and lactase in the unstirred layer

97
Q

Explain how glucose is absorbed

A

Sodium pumps generate a sodium gradient and then glucose enters from the lumen along with sodium using SGLT1. Glucose then diffuses into the ECF via GLUT2

98
Q

What is oral rehydration therapy?

A

Consuming glucose and salt allows for greater Na+ intake and therefore a greater osmotic gradient

99
Q

How are amino acids absorbed?

A

Protein –> oligopeptide via pepsin from the stomachs chief cells and peptidases from the pancreas
Oligopeptide –> amino acids using enzymes in the brush border
Up taken in same manner as glucose

100
Q

Explain pernicious anaemia

A

Vit B12 is absorbed in the terminal ileum using intrinsic factor produced in the stomach
Vit B12 deficiency due to stomach damage or ileum removal

101
Q

Explain segmentation

A

The intestine is divided into segments which mixes the contents. The pacemakers fire more rapidly at the cephalic end (12–>8) so the gradient moves contents down

102
Q

What movement mechanisms are in the large intestine?

A

Haustral shuttling - same as segmentation

Mass movement - once or twice a day a peristaltic propulsion

103
Q

What factors control defaecation?

A

Internal anal sphincter - smooth muscle - parasympathetic - relax
External anal sphincter - striated - voluntary - relax

104
Q

What are the types of inflammatory bowel disease?

A

Ulcerative colitis - mucosal ulceration in rectum and colon
Crohn’s disease - transmutation inflammation of entire GIT
Microscopic, diversion, diverticular colitis

105
Q

Contrast Crohn’s disease and ulcerative colitis

A

Crohn’s - small bowl and colon, skip lesions, peri anal disease, fistulas, granulomas and fibrosis
Ulcerative - only in colon, continuous lesions, rectal involvement and bleeding

106
Q

What are the roles of normal microbiological flora?

A 
Synthesise vitamins - K, B12
Prevent colonisation by pathogens
Kill non-indigenous bacteria
Stimulate GALT development
Stimulate antibody production
107
Q

What are the types of bacteria (oxygen) and give an example of each?

A

Obligate aerobes - need O2 - TB
Obligate anaerobes - die in O2 presence - clostridium (produce spores for protection)
Facultative anaerobes - prefer O2 - E. Coli, staphylococcus

108
Q

Where are the anaerobic areas of the body?

A

Mouth, small bowel, colon

109
Q

Name some microbes found in the mouth and a condition it can cause

A

Staph aureus - parotitis

Candida albicans - oral thrush

110
Q

Name some microbes in the throat

A

Strep viridans/pyogenes/pneumoniae
Staphylococci
Neiserria meningitidis
Haemophilus influenza

111
Q

Why is abdominal surgery risky? What conditions can occur? And what is done to reduce the risk?

A

Lots of bacteria in the colon so high risk of wound infection
Faecal peritonitis and perianal abscessw
Prophylactic metronidazole and gentamicin

112
Q

What microbes are normally in the vagina and what is their physiological function?

A

Lactobacillus (gram positive)

Produce lactic acid to stop other bacteria colonising

113
Q

What is the difference between bacteraemia and septicaemia?

A

Bacteraemia - bacteria are cleared rapidly

Septicaemia - bacteria aren’t cleared and multiply. Cause sepsis

114
Q

What are the symptoms of oesophageal carcinoma? What is the 5 year survival rate? What investigations are done?

A

Dysphagia and weight loss

5%

Endoscopy, biopsy, barium

115
Q

What are the symptoms of gastric cancer? What is the 5 year survival rate? What investigations are done?

A

Epigastric pain, vomiting, weight loss

20%

Endoscope, biopsy, barium

116
Q

What are some ways of imaging the GI tract?

A 
X ray
Barium swallow/enema/meal follow through
Ultrasound
CT
MRI
Angiography
117
Q

What could cause a small bowel obstruction and what would the symptoms be?

A

Hernia, adhesion, tumour, inflammation

Vomit, mild distension, absolute constipation, colick pain

118
Q

What can cause large bowel obstruction and what would the symptoms be?

A

Colorectal carcinoma, diverticular stricture, hernia, volvulas, pseudobstruction

Pain, distention, constipation, colick pain

119
Q

Why might an erect chest x ray have to be done for an abdominal problem?

A

See if diaphragm is elevated due to

Perforated bowl - ulcer, tumour, obstruction, trauma, iatrogenic, diverticular disease

ESA 3 steven (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions