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Human Health and Disease > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

Functions of the GI tract

A
  • mechanical and chemical breakdown of food
  • passage of food by peristalsis
  • immunological protection
  • absorption of water and minerals
  • excretion of waste
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2
Q

Oral Cavity

A
  • salivary and mucus glands
  • teeth
  • tongue
  • soft and hart palate=Uvula
  • tonsil Immunological function)
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3
Q

what does salivary and mucus glands do in the mouth

A
  • soften food
  • lubricate food
  • formation of bolus
  • lipase and amylase begin digestion
  • antibodies
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4
Q

pharynx

A
  • connects the nasal/oral cavity to the esophagus

- passage of food and air

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5
Q

epiglottis

A
  • cartilaginous flap at the entrance of the larynx

- this covers over the larynx during swallowing protecting the airways

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6
Q

esophagus

A
  • muscular tube with mucus membrane
  • this is passage by peristalsis
  • has an upper and lower sphincter (upper is always active)
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7
Q

stomach

A
  • has a churning and grinding motility
  • releases gastric acid
  • releases different enzymes
  • intrinsic factor is released
  • has a protective mucus layer and bicarbonate section
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8
Q

what does gastric acid do?

A
  • activates digestive enzymes (pepsinogen and gastric lipase)
  • immunological function
  • contains HCL
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9
Q

Small Intestine

A
  • mixes and moves chyme
  • enzymatic breakdown using different enzymes
  • lots of absorption occurs here
  • large surface area due to Villi and microvilli
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10
Q

what are the three sections of the small intestine?

A
  • duodenum (where bile and pancreatic juices enter)
  • jejunum
  • ileum (vit B12 and bile acids are reabsorbed)
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11
Q

Large Intestine (colon)

A
  • important in the absorption of water
  • storage of waste
  • has about 3 peristaltic waves per day
  • bacterial breakdown
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12
Q

What is absorbed in the large intestine?

A
  • water
  • vitamin K
  • other nutrients
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13
Q

what is the purpose of the anus?

A

storage of feces

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14
Q

rectum

A
  • has two sphincters (one is voluntary control and one Is not)
  • allows for the removal of waste
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15
Q

what are the accessory organs of the digestive tract?

A
  • liver
  • pancreas
  • appendix
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16
Q

what does the liver do?

A
  • recieves nutrient rich blood from the GI track (first pass of metabolism)
  • produces bile
  • detoxifys blood
  • makes red blood cells in babies
  • makes clotting factors
  • carb, protein, and lipid metabolism
  • breakdown of ammonia
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17
Q

describe the importance of bile production?

A
  • bile is released into the duodenum
  • it allows for the absorption of fat soluble vitamins
  • bile salts emulsify fat droplets for better absorption
  • without you will have fatty feces (will look white)
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18
Q

endocrine functions of the pancreas

A

-release of insulin and glucagon

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19
Q

Exocrine functions of the pancreas

A
  • releases pancreatic juices into the duodenum
  • releases enzymes that assist in digestion (precursor enzymes)
  • peptidase and lipase and amylase
  • high bicarb content to neutralize pH of the Chyme from stomach
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20
Q

what does it mean to be a precursor enzyme?

A

this means that it is released in an inactive form and then gets activated by cleavage or a specific environmental conditions (ex. pH)

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21
Q

Peritoneum

A

the lining of the abdominal cavity

  • serous membrane
  • lining of the abdominal cavity
  • support of abdominal organs
  • nerves, blood, and lymphatic vessels pass through
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22
Q

describe the layers of the lining of the small intestine

A

outer most layer: serosa

  • tunica muscularis
  • submucosa
  • mucosa (touches the lumen of the small intestine)
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23
Q

describe the importance of the mucosa

A
  • this is what allows for motility
  • this is the layer that has villi and microvilli
  • white spots are goblet cells (release mucus for lubrication)
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24
Q

the top left of the patients abdomen is:

A

left hypochondriac region

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25
Q

the middle left of the patients abdomen is:

A

left lumbar region

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26
Q

the bottom left of the patients abdomen is:

A

left iliac region

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27
Q

the top right of the patients abdomen is:

A

right hypochondriac region

28
Q

the middle right of the patients abdomen is:

A

right lumbar region

29
Q

the bottom right of the patients abdomen is:

A

right iliac region

30
Q

the top middle of the patients abdomen is:

A

epigastric region

31
Q

the middle middle of the patients abdomen is:

A

umbilical region

32
Q

the bottom middle of the patients abdomen is:

A

hypogastric region

33
Q

Abdominal examination

A
  • inspection
  • auscultation
  • palpation
  • percussion
  • DRE
  • gynecological examination
34
Q

What does inspection refer to when doing an abdominal examination?

A
  • general condition (color, can they stand, cleanliness?)
  • vital parameters
  • look for scars or herniation
  • check if it is a moving or still patient (could be peritonitis)
35
Q

why Is it important to check for auscultation?

A

you want to listen to the intestinal sounds

  • you can hear normal sounds of stomach rumbling
  • you can hear metallic/high pitched tinkling sounds
  • you might hear no sound
36
Q

when would you hear metallic/high-pitched tinkling sounds

A
  • mechanical Ilius
  • this is when something is trapped in the intestine and it is something that is holding down the intestine that wants to move
37
Q

when would you not hear any sound coming from the abdomen?

A
  • this could be a paralytic ilius
  • this means the blood supply of the intestine is compromised and then the pain will go away because the tissue tied
  • *should hear movement at least once a minute otherwise something is wrong
38
Q

what are you looking for when you palpate the abdomen?

A
  • pain (diet pain, indirect pain,[always begin away from pain])
  • increased size of liver or spleen or pain in these
  • masses
  • hernias or defects in abdominal wall
  • Psoas sign
  • torsio testes
39
Q

what is Psoas sign?

A

when you pull up on the leg and try to activate the poses muscle and it hurts

40
Q

what is torso testes

A

twisting of the testicles that cause pain in the abdomen

  • this is common in young men
  • the testicle could be twisted and lose blood flow
    • if you cannot untwist you need to have surgery
41
Q

what are different types of sounds you could hear with percussion

A
  • tympanitic sounds: air in hollow viscera
  • dull: organ or mass or fluid (bladder)
  • painful: peritoneal reaction (gallstones/cholecystitis/kidney stones)
42
Q

what is DRE

A

digital rectal excitation

  • looking for painful areas, masses, and blood on your glove
  • *should always be preformed on patients with abdominal pain
43
Q

what is acute abdomen

A
  • pain in the abdomen for less than a week

- can have nausea, vomiting, and changes in stool consistency and color

44
Q

How common is acute abdomen

A
  • very common
  • about 10% of all visits to hospitals
  • one in three are admitted
  • most between the ages of 19-29 years old
  • half are discharged with unspecific abdominal pain
45
Q

what is RARELY done to the abdomen?

A

CAT scans because it causes so much radiation and the tissues of the abdomen absorb it

46
Q

anamnesis

A

the is the patients account of their medical history

47
Q

what could lack of bowel movements mean for acute abdomen?

A

this could mean they have an ilius

48
Q

What is important to ask about if there is blood or melena in feces?

A

ask about I they take iron supplements because they could look similar

49
Q

what are some preclinical tests performed for acute abdomen?

A

-blood test
-blood type
-hemoculture
-arterial blood gas
-imaging
ECG
Urinestix

50
Q

Gastroenteritis

A

inflammation of the gastrointestinal tract

  • abdominal pain
  • diarrea
  • nausa
  • vomiting
  • fever
51
Q

treatment for gastroenteritis

A
  • no antibiotic!!!
  • sometimes hospitalization (if they are extremely dehydrated or old and fragile)
  • treatment with fluids and electrolytes
  • if severe stool and blood samples for microorganisms.
52
Q

why don’t we want antibiotics for gastroenteritis

A
  • because we don’t know if it is bacteria or virus
  • this will also kill our natural flora which is there to help the issue
  • only give antibiotics to those who absolutely need it!!
53
Q

appendicitis Acuta

A
  • most often for 10-30 years of age
  • sick for less than two days
  • slight or moderate fever
  • localized peritoneal pain
    treatment: surgical or antibiotics
54
Q

Gallstones

A

-fat
-female
-forty
might be more common in females due to metabolism?

55
Q

describe gallstone attack episodes:

A
  • episodes with constant pain: can last a few hours
  • intense pain episodes: duration a few minutes
  • often localized under the right curvature
  • few symptoms between episodes
  • diagnosed via ultrasound
56
Q

differences in simple vs. complicated gallstones:

A

Simple: pain management until the episode is over

Complicated: Infection in the gall bladder, long duration of pain, many episodes, obstruction of duct into the small intestine, liver infections
treatment: surgical removal of gallbladder/removal of stone from bile duct

57
Q

Constipation

A

Deficating 2 or fewer times a week

  • incomplete emptying
  • pain
  • hard stools
  • most often women and elderly
  • predisposing Factors:
    • bad toilet habits
    • inactivity
    • fiber poor diet
    • low fluid intake
58
Q

why is it important to be weary of Diarrhea for constipation?

A

the large intestine is so full that the water and material moves through without being about to be absorbed at all and they have constant diarrhea

59
Q

Treatment for diarrhea:

A
  • laxatives and lavament
  • change of habits
  • prophylactic daily
60
Q

describe and uncomplicated gastric ulcer:

A
  • usually greater than 40 year old
  • dyspepsia/upper GI pain/area tender with palpation
  • alleviated by food or antacids
  • often sparse clinical findings
  • caused by a bacteria and use an NSAID (anti-inflammatory drug)
61
Q

what is the urea breath test?

A
  • this is used because the bacteria is able to convert urea into ammonia and CO2
  • if positive, eradicate with AB and proton pump inhibitor
  • always stop treatment with NSAID
  • referral to gastroscopy + biopsy at a later time
62
Q

what does it mean for perforation with a gastric ulcer?

A
  • sudden onset of intense pain and peritoneal reaction
  • laparoscopy and surgical closure
  • must be treated in a hospital
63
Q

pancreatitis acuta

A
  • alcohol abuse
  • pain in the umbilical and hypogastric area
  • sometimes radiation to the left shoulder
  • patient are most often leaning forward
  • very painful
  • increased enzymes that are spilling into the bloodstream and the surrounding area causing necrosis
64
Q

treatment for pancreatitis acuta

A
  • hospitalization +CT+ultrasound to exclude gallstone

- pain management

65
Q

Ileus

A

this means obstruction

66
Q

Name some common things that can be signs of an Ileus

A

-hernia (issues with the lining of the stomach
-often previous abdominal surgery
-episodes of intense pain
-fecal vomiting
-no intestinal sounds if paralytic ileum
metallic high pitched tingling sounds in mechanical ileum

67
Q

treatment for Ileus

A
  • emergency surgery with resection of necrotic tissues and removal of obstruction/strangulation
  • antibiotics

Human Health and Disease (11 decks)

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