Gastrointestinal Disorders Flashcards
describe the neural structures involved with vomiting
the vomiting center is located in the medulla and gets signals from the GI tract, the cerebral cortex, vestibular apparatus, and the chemoreceptor trigger zone.
the chemorecpetor trigger zone is located in the medulla also and is activated by many drugs and endogenous/exogenous toxins.
list possible factors in the development of GERD
transient relaxations of the weak or incompetent lower esophageal sphincter.
esophageal mucosal injury
delayed gastric emptying
TED
list common symptoms associated with GERD and it’s complications
symptoms: heartburn, regurgitation.
complications: strictures—caused by a combination of scar tissue, spasm, and edema. they produce narrowing of the esophagus and cause dysphagia when the lumen becomes sufficiently constricted.
Barrett esophagus—abnormal metaplasia in the cells of the lower portion of the esophagus. associated with a increased risk for development of esophageal adenocarcinoma.
describe the role of H. Pylori in the development of gastritis, gastroenteritis, and PUD.
H. Pylori for gastritis: H. Pylori infection is the most common cause of chronic gastritis. Transmission is largely by person to person, additional transmission routes such as water can happen in developing countries.
gastroenteritis: H. Plyori is a cause of gastroenteritis (need more here).
PUD: H. Plyori is a cause of PUD. The exact way it causes PUD is not known.
list clinical signs of PUD and duodenal ulcers
describe the pain in particular
pain: usually described as burning, gnawing, or cramp like. Usually is rhythmic and frequently occurs when the stomach is empty. pain is usually located over a small area near the middle in the epigastrium near the xiphoid and and may radiated below. The pain tends to recur at intervals of weeks or months. tenderness may occur with more extensive lesions. During an exacerbation, it occurs daily for a period of several weeks and them remits.
list factors in the development of gastric cancer and esophageal cancer
gastric cancer: genetics, carcinogens in the diet, autoimmune gastritis, and gastric adenomas or polyps. Also for some carcinomas chronic infection with H. Pylori.
esophageal cancer:
squamous cell: alcohol and tobacco use
adenocarcinoma: Barrett esophagus and GERD
compare the characteristics of Chron’s disease and ulcerative colitis.
Chron’s disease: recurrent inflammatory response that can affect anywhere in the GI tract. Characteristically, demarcated, granulomatous lesions are present surrounded by normal-appearing mucosal tissue (skip lesions if multiple). All of the layers of the bowel are involved, submucosal affected the most. Inflamed bowel looks like cobblestones. Bowel wall will become thickened and inflexible. peak incidence is with people in their 20s or 30s, women a little more than men.
ulcerative colitis: nonspecific inflammatory condition of the colon. inflammatory response largely limited to the mucosa and submucosa and also only confined to the rectum and colon. this makes colectomy curative. peak incidence between 15-25 years of age. begins in the rectum and spreads proximally.
differentiate bacterial from viral enterocolitis
bacterial infections will produce more severe effects than viral infections. Viral infections are Rotaviruses. Bacterial infections are those such as E Coli and C Diff.
viral infections will affect people 3-24 months of age.
bacteria infections will affect older people.
describe clinical signs of appendicitis and diverticulitis.
appendicitis: abrupt onset of pain, can be referred to the epigastric or periumbilical area. Also one to two episodes of nausea initially. Pain subsides for awhile. Pain will eventually become localized to the RLQ. palpation reveals deep tenderness and rebound tenderness.
diverticulitis: Pain, which may be constant and persist for several days, nausea and vomiting, fever, abdominal tenderness, constipation or, less commonly, diarrhea.
define diarreha and constipation
diarreha: a condition in which feces are discharged from the bowels frequently and in a liquid form.
constipation: a condition in which there is difficulty in emptying the bowels, usually associated with hardened feces.
contrast colon polyp with colon cancer
colon polyp: a mass that protrudes into the lumen of the gut. benign polyps will arise from the mucosal epithelium of the intestine. They are composed of cells that have proliferated in excess of what is needed to replace healthy epithelium.
colon cancer: most polyps begin as benign polyps. the frequency of polyps increases with age. on imaging, they can be distinguished by
list risk factors for colon cancer and treatment
risk increases with age, family history of cancer, people with Chron’s disease or ulcerative colitis, high level of fat in the diet, and those with familial adenomatous polyposis of the colon
treatment: surgical removal. can use preoperative radiation therapy. postoperative adjuvant chemotherapy may be used. radiation and chemo are used as palliative treatment methods.
Define intestinal obstruction, ileus, adhesions, strangulation and volvulus; how do these develop?
obstruction and ileus
intestinal obstruction: impairment of movements of intestinal components in a cephalocaudal direction. develops by volvus of the sigmoid colon, intussusception (shortening of the bowel), inguinal hernia.
ileus: a painful obstruction of the ileum or other part of the intestine. develops by cacteria or viruses that cause intestinal infections (gastroenteritis), chemical, electrolyte, or mineral imbalances (such as decreased potassium level), abdominal surgery, decreased blood supply to the intestines, infections inside the abdomen, such as appendicitis, kidney or lung disease
use of certain medicines, especially narcotics
Define intestinal obstruction, ileus, adhesions, strangulation and volvulus; how do these develop?
adhesions, strangulation and volvulus
adhesions: Abdominal adhesions are bands of scar-like tissue that form inside your abdomen.
develops by Crohn’s disease, diverticular disease, endometriosis link, pelvic inflammatory disease link, and peritonitis.
strangulation: If an obstruction cuts off the blood supply to the intestine, the condition is called strangulation. Strangulation occurs in nearly 25% of people with obstruction of the small intestine. develops by (adhesions) in the abdomen that form after surgery; hernias; colon cancer; certain medications; or strictures from an inflamed intestine caused by certain conditions, such as Crohn's disease or diverticulitis.
volvulus: an obstruction caused by twisting of the stomach or intestine
develops by: chronic constipation, infections, neuropsychiatric disorders, and electrolyte abnormalities, also adhesions.
Relate the signs of blood in the stool and other signs with colon cancer.
Sings and Symptoms of colon cancer
Pain areas: in the abdomen (because of the degradation in bowel function)
Gastrointestinal: blood in stool, change in bowel habits, constipation, narrow stools, or passing excessive amounts of gas
Whole body: anemia or fatigue
Also common: abdominal discomfort or weight loss
