Gastrointestinal System Flashcards
What is the Peritoneum/what does it do?
A membrane that forms the lining of the abdominal cavity and covers most of the intra-abdominal organs
What are the greater and lesser omentum?
Omenta are fused peritoneal folds that connect the stomach and duodenum with other abdominal organs
Can you list the Retriperitoneal organs?
Hint: SADPUCKER
S = Supra (adrenal) glands A = Aorta/IVC D = Duodenum P = Pancreas U = Ureters C = Colon K = Kidneys E = Oesophagus R = Rectum
What does Vitamin A help with?
What are the effects of deficiency?
What are the effects of excess intake?
Helps with Vision - forms light absorbing pigment rhodopsin
Maintains healthy skin and body immunity
Deficiency = Night blindness, dry mucous membrane, Infection
Excess = Fat soluble vitamins retained over time resulting in liver problems, hair loss, bone and joint pain, loss of appetite
What does Vitamin D help with?
What are the effects of deficiency?
What are the effects of excess intake?
Helps with absorption of calcium, bone formation and teeth strengthening
Deficiency = Rickets (Children), Brittle bones (adults)
Excess = Widespread calcification of soft tissues, adverse effects to muscles and heart tissue
What does Vitamin E help with?
What are the effects of deficiency?
What are the effects of excess intake?
Helps with antioxidants, formation of RBC, preserve healthy muscular + nervous system, maintains function of reproductive system
Deficiency = Fatigue, slow wound healing, premature ageing, low fertility
Excess = Fat soluble vitamin overdose - toxic
What does Vitamin E help with?
What are the effects of deficiency?
What are the effects of excess intake?
Helps with antioxidants, formation of RBC, preserve healthy muscular + nervous system, maintains function of reproductive system
Deficiency = Fatigue, slow wound healing, premature ageing, low fertility
Excess = Fat soluble vitamin overdose - toxic
What does Vitamin K help with?
What are the effects of deficiency?
What are the effects of excess intake?
Helps with blood clotting
Deficiency = slow blood clotting
Excess = Problems to red blood cells, baby’s brain damage
What does Vitamin B help with?
What are the effects of deficiency?
What are the effects of excess intake?
Vitamin B helps with oxidising carbohydrates, metabolism of carbs, proteins and fatty acids, formation of RBC’s, tissue formation and DNA/RNA synthesis
Deficiency = Anaemia, irritability, fatigue, pernicious anaemia, dry/cracked skin, mouth sores, poor growth, pellagra.
Excess = Nerve problems, they are water soluble so excess is normally excreted via urine
What does Vitamin C help with?
What are the effects of deficiency?
What are the effects of excess intake?
Helps with forming collagen
Deficiency = Poor collagen formation, scurvy
Excess = N/A
What does Calcium help with?
What are the effects of deficiency?
What are the effects of excess intake?
Helps with formation of bones and teeth, blood clotting
Deficiency = Rickets, Osteoporosis
Excess = kidney disease, calcification of soft tissues, disruption to the heart
What does Iron help with?
What are the effects of deficiency?
What are the effects of excess intake?
Helps with making haemoglobin
Deficiency = Anaemia
Excess = N/A
What does Phosphorus help with?
What are the effects of deficiency?
What are the effects of excess intake?
Helps with formation of bones/teeth, nucleic acid formation, energy (ATP) release in cells
Deficiency = Bone and teeth formation affected, cell respiration and muscle contractions effected
Excess = N/A
What does Sodium help with?
What are the effects of deficiency?
What are the effects of excess intake?
Helps with regulating body fluid balance and nerve impulse transmission
Deficiency = Muscular cramps
Excess = Hypertension, heart disease, stroke, kidney damage
What does SOCRATES stand for and what is it used to assess?
S = Site O = Onset C = Characteristics R = Radiaton A = Associated symptoms T = Timing E = Exacerbating/relieving factors S = Severity /10
Is a sudden or gradual onset of pain more concerning? Why?
Sudden onset pain is more concerning due to it being caused by a potential rupture/tear or torsion e.g. ruptured aneurysm, ectopic pregnancy, torsion of testis/ovarye
What is Gastroenteritis?
Symptoms?
Treatment?
A viral or bacterial infection of the stomach and bowel
Symptoms = Sudden, watery diarrhoea, feeling sick, mild fever, vomiting
Treatment = Drinking plenty of fluids, rest and paracetamol
Why can NSAID’s cause stomach cramps?
NSAID’s reduce an enzyme that preserves mucosal lining in the stomach
What is appendicitis?
Appendicitis is inflammation of the appendix, it becomes full of fluid and can compress surrounding vessels, compromising blood flow and causing ischaemia and necrosis.
This pressure can escalate forcing bacteria and toxins out, abscesses and peritonitis develop and eventually the appendix will rupture.
Rupture can accelerate peritonitis which can be life threatening
What are the symptoms of appendicitis?
Typically starts with central abdominal pain that may come and go. A burst appendix will cause sudden, severe pain
Within hours, pain travels to lower-right abdomen, becoming constant and severe
Positive McBurneys point/Rovsing’s sign
Palpation/coughing/walking can all make pain worse
Other symptoms include nausea, vomiting, lack of appetite, diarrhoea, high temp, flushed face, tachycardia
Check if they have had their appendix removed!!
Why does Positive Rovsings sign indicate appendicitis
It occurs due to irritation of overlying peritoneum, this pulls on the peritoneum that overlaps the appendix causing referred pain
What is pancreatitis?
Pancreatitis is inflammation of the pancreas, it can be acute or chronic
Causes include gall stones, alcohol, idiopathic cause
Gall stones can become stuck at the entrance to the duodenum, blocking the pancreatic duct and triggering pancreatitis
With this, enzymes that digest food are inactive in pancreas but can become active and auto-digest pancreas
It is a medical emergency, mortality increases with age
What are the associated complications of Pancreatitis?
Acute respiratory distress
Diabetes can develop
Infection
Shock
Renal failure
Malnutrition
What is Diverticulitis?
Bulging pouches in the intestinal wall called diverticula can become inflamed and infected. This often occurs due to faecal matter becoming stuck in the pouches
What are the symptoms of Diverticulitis?
Symptoms include abdominal pain, bloating and a change in normal bowel habits
Pain associated with diverticulitis is constant and severe. Can normally start below umbilicus before moving to lower left quadrant
Other symptoms include high temp <38, lethargic, nausea and vomiting.
What is Cholecystitis?
Acute inflammation of the gallbladder
It happens when bile becomes trapped and builds up in the gallbladder. In most cases this happens when solid lumps (gallstones) block the tube that drains bile from the gallbladder.
It is a potentially serious condition that usually needs to be treated in hospital
What are the symptoms of Cholecystitis?
Main symptom is sudden, sharp pain in the upper right quadrant of the abdomen and can spread to the right shoulder
Positive Murphys sign, also seen in acute cholecystitis.
To examine, pressure on upper right quadrant, deep breath, during exhalation will catch on edge of fingers and cause pain.
Symptoms include: High temp, nausea and vomiting, sweating, loss of appetite, jaundice, bulge in the abdomen, clay coloured stools due to lack of bile
More common in fair skinned women, advancing age, obesity, rapid weight loss or pregnancy/hormone replacement therapy
What are kidney stones?
Kidney stones are lumps that can develop in one or both kidneys causing severe pain known as renal colic.
These lumps are crystals formed by waste products in the blood
What are the symptoms of kidney stones?
Symptoms include persistent ache in lower back, sometimes felt in the groin - men many have pain in testicles/scrotum
Periods of intense pain in back or side of abdomen, may last for minute or hours
Feeling restless and unable to lie still
Other symptoms include: Nausea, increased urination, blood in the urine and pain during urination
What is peritonitis?
Peritonitis is a life threatening condition caused by the peritoneum becoming infected.
It can also damage the internal organs that the peritoneum covers.
What are the symptoms of peritonitis?
Extreme thirst, vomiting, fatigue, bloating, constipation, fever, diarrhoea, low urine output, nausea, inability to pass gas.
Likely to be tachycardia, increased RR and have a rigid abdomen, will need pre-alerting to ED.
The rigid abdomen will feel solid due to bacterial fluid pooling, hard to palpate and any movement that adds pressure will result in significant pain
If the pain eases and comes back suddenly this is a red flag!
The Pt will be dehydrated, low BP, look very unwell, low temp, reduced GCS, could be hypoxic,
What is intussusception?
Intussusception is a serious condition in which part of the intestine slides into an adjacent part of the intestine. This telescoping action often blocks food or fluid from passing through.
What is intussusception?
Intussusception is a serious condition in which part of the intestine slides into an adjacent part of the intestine. This telescoping action often blocks food or fluid from passing through.
What are the symptoms of Intussusception?
Very painful, sudden onset of symptoms within 1 day, severe abdominal pain, vomiting (sometimes green), blood stools with mucus in them (like red jelly), abdominal swelling, diarrhoea, signs of dehydration (Reduced urine output, dark urine, dry mouth, not tears when crying)
Can be fatal
Most common in babies under 1 and up to 5 - will cry consistently and nothing will relieve symptoms. Can be due to severe abdominal trauma
Sepsis and shock can occur
What is a stomach ulcer?
Ulcers in the stomach which can be caused by an infection
What are the symptoms of a stomach ulcer?
Symptoms include a burning/gnawing pain that develops in your abdomen.
Pain can also travel up the neck and down to the naval or through your back
Pain associated with stomach ulcer is caused by the ulcer itself and stomach acid that comes into contact and irritates the ulcer.
The pain can last from minutes to hours
What is an triple A?
A triple A is an Abdominal Aortic Aneurysm
It is a bulge or swelling in the aorta, the main blood vessel that runs from the heart down through the chest and tummy.
What are the symptoms of a Triple A?
Un-ruptured: Pulsating feeling in abdomen, usually near the umbilicus, persistent back pain, persistent abdominal pain. Complete blood pressures on different arms, may be different/abnormal
Ruptured: Sudden and severe pain in middle or side of abdomen. If laid flat, will see bulge (get down to eye level), In men, pain can radiate down to scrotum, will lose femoral pulse, become mottled and pale in legs very quickly
Other symptoms include: Dizziness, sweaty and clammy, tachycardic, shortness of breath, feeling faint, LOC, Cardiac arrest.
This would need a pre-alert.
What is G.O.R.D?
G.O.R.D is Gastroesophogeal Reflux Disease
It is a general term to describe the range of situations - acid reflux, with or without oesophagitis
It is caused by acid refluxing back into the oesophagus through a poorly functioning sphincter
Pressure changes causing gastric secretions to irritate the oesophagus - certain foods, alcohol, nicotine, existing hiatus hernia, obesity and pregnancy
What are the symptoms of G.O.R.D?
Epigastric pain, heartburn, intermittent and worse after a meal
Acidic taste in mouth, bloating and belching
Made worse by bending, stooping, tight belts, overweight
What is pyelonephritis?
Pyelonephritis is an infection in the kidney.
It can develop as a complication from cystitis - bacteria travel up from bladder to infect kidney and requires antibiotics
Most common with recurrent UTI’S
Kidneys can become oedemas and swell, resulting in renal damage from compression of renal artery
What are the symptoms of Pyelonephritis?
Symptoms include a gradual onset of pain (loin to groin, back to front), Patient appears ill, maybe systemically unwell with pyrexia, vomiting and rigors
What is Cystitis?
Cystitis is a UTI, an infection of the urethra or bladder, common in the elderly.
Symptoms of Cystitis/UTI
Change in frequency and dysuria, can cause onset of confusion in elderly and could be confused with a stroke
What is a bowel obstruction?
A bowel obstruction is where the intestine has a blockage and can cause a back-up of bowel contents.
Can cause bowel ischaemia leading to toxins entering circulation
Can cause dehydration due to unabsorbed water remaining in bowel and vomiting
What are the symptoms of a bowel obstruction?
Central abdominal pain of a colicky nature
May have distended abdomen
Vomiting/faecal vomiting in high obstruction
Absolute constipation in low obstruction with lack of flatulence
Reduce bowel sounds/movement
Distended abdomen
Normally hear about 15 bowel sounds in 1 minute, can be either hyperactive or underactive
What is Chrohns Disease ?
A type of inflammatory bowel disease (IBD). It causes swelling of the tissues (inflammation) in your digestive tract.
It is a chronic, relapsing condition.
Can occur anywhere along the GU tract
What are the symptoms of Chrohns disease?
Bloody diarrhoea, anaemia, malnutrition, intestinal obstruction, fluid, electrolyte and pH imbalances
Abdominal pain, weight loss
