gastrointestinal system Flashcards
Upper GI tract?
Lower GI tract?
Upper GI tract- mouth, esophagus, and stomach and aids in the ingestion and digestion of food
Lower GI tract- small intestine does digestion and absorption of nutrients
- large intestine absorbs water and electrolytes, storing waste products of digestion until elimination
neurogenic causes of Diarrhea vs Constipation
Diarrhea- diabetic enteropathy and hyperthyroidism
Constipation- irritable bowel syndrome, central nervous system lesion, dementia, spinal cord tumor, atomy
muscular causes of Diarrhea vs Constipation
Diarrhea- electrolyte imbalance and endocrine disorder
Constipation- muscular dystrophy, severe malnutrition, inactivity, obstructed defection, overactive pelvic floor muscles
mechanical causes of Diarrhea vs Consitpation
Diarrhea- Incomplete obstruction, postoperative effect
Constipation- bowel obstruction, pregnancy
What is hiatal hernia?
What type is most common?
In how many people? Men or Women?
Esophageal hiatus of the diaphragm becomes enlarged, allowing the stomach to pass through the diaphragm into the thoracic cavity
Sliding hernia (90-95%)
5 per 1000 people and women>men
What are some symptoms of the Hiatal Hernia?
Contributes to incompetence of the?
Heartburn
- 30-60 minutes after a meal
-lower esophageal sphincter allowing acid into the esophagus
Reflux
- contributes to GERD
Which of the following exercises is contraindicated for an individual with a known hiatal hernia?
Avoiding flat supine positions and any exercises requiring the Valsalva maneuver ( increasing intrabdominal pressure)
What is GERD?
The consequences from the reflux of gastric contents into the esophagus accompanied by a failure of anatomic and physiologic mechanisms to protect the esophagus
In healthy people, 3 factors to remain healthy esophagus…
In people with GERD….
- anatomic barriers between the stomach and the esophagus
- mechanisms to clear the esophagus of stomach acid
- maintaining stomach acidity and acid volume
-have consistently low pressure of the LES
What are the three extra esophageal manifestations?
Asthma, cough, and laryngitis
Cardiac chest pain should _______ is assumed to be related to GERD
distinguished and evaluated before chest pain
What is peptic ulcer disease?
A break in the lining of the stomach or duodenum of 5 mm or more owing to a number of different causes
What are some PUD complications?
Bleeding
Perforation- sudden severe pain in T spine with radiation to right upper quadrant
Penetration- ulcer erodes into adjacent organs
Gastric outlet obstruction
What is Crohn disease?
Most commonly affects where?
A chronic lifelong inflammatory disorder that can affect anu segment of the Intestinal tract
Ileum and colon
What is ulcerative colitis?
Typically found where?
A chronic inflammatory disorder of the mucosa of the colon, typically found in the rectum, which can then advance proximally to affect the entire colon
Crohn Disease vs Ulcerative Colitis
Age at Onset
Fam history
Gender
Cancer risk
Location of lesions
Bloody stools
Abdominal mass
Growth retardation
Cancer Complications
Age- Crohns: any age 10-30 years most common; Colitis: any age 10-40 years most common
Fam History- Crohns: 20-2%; colitis: 20%
Gender- Both equal in men and women
Cancer risk- Crohns: increased with early detection; colitis: increased and preventable with bowel resection
Location of Lesions- Crohns: any segment usually L or S Intestine; Colitis: rectum and left colon
Bloody stools typical for Colitis
Abdominal mass common in the right lower quadrant for Crohns
Growth retardation often marked in Crohns
Complications cancer is often in colitis
What is the most common extraintestinal finding in inflammatory bowel disease?
Arthritis
Proton Pump Inhibitor Suffix and Desired Effect
-prazole, gastric ulcers
Histamine H2 receptor blockers Suffix and Desired Effect
-idine, Gastric Ulcers
Oral antidiabetics
-amide, antidiabetic
Biphosphates
-dronate, osteoporosis
Diverticulosis vs Diverticulitis
Losis- the Prescence of outpouchings in the wall of the colon or small intestine
Litis- inflammation/infection of the diverticula with possible complications such as perforation abscess formation, obstruction, fistula formation, and bleeding
Where is there a higher incidence for Diverticular diseases?
What are risk factors for diverticular disease?
Western countries
Constipation, eating red meat, obesity, NSAIDS
Pathogenesis of Diverticular disease?
Diet, structural changes in the colonic wall, and functional changes in the bowels
Asymptomatic in what % of people?
Complicated vs uncomplicated?
80% of people
Uncomplicated: when diverticula becomes blocked, bacteria trapped inside proliferates
Complicated: a fistula may develop with the bladder, pneumaturia (air in the urine), fecaluria (urine in the stool), recurrent UTI
PT implications for Diverticular disease
Where may pain be reffered?
Physical activity has protective effect. careful to avoid activities that increase intraabdominal pressure
Back pain or pain in hip or thigh
What is appendicitis?
Peak incidence between what ages and males or females?
an inflammation of the vermiform appendix that often results in necrosis and perforation with subsequent localized or generalized peritonitis
15-19 years old and males
Etiologic factors of appedicitis?
1/3 are caused by???
Primarily from obstruction of the lumen and secondarily from bacterial infection
Obstruction that prevents normal drainage
Symptoms of appendicitis?
Pain is ____ and may shift within ____ hours of symptom onset to the _____ quadrant with point tenderness over what site???
WBC>
Ab pain with anorexia, nausea, vomiting and low grade fever
Constant, 12 hours, right lower, McBurney Point
20,000/mm^3
How many cases of appendicitis are atypical? Why?
40% to 50% of cases are atypical because of the position of the tip of the appendix
PT implications of appendicitis?
If appendicitis is suspected?
Symptoms of right thigh pain, groin pain, pelvic pain, referred pain in the hip
Medical attention must be immediate
What is a rectal fissure?
Result of?
Heals within how many months?
tear of the lining of the anal canal
excessive tissue stretching or tearing, childbirth or passage of a large hard bowel fissure
1-2 months
What is hemorrhoid?
It is associated with?
pillow like cluster of veins beneath the mucous membranes lining the lowest part of the rectum and anus
Increases intraabdominal pressure
Internal hemorrhoids vs External hemorrhoids?
Internal- occur in the lower rectum and noticed first when small bleeding occurs when pooping
External- located under the skin of the anus, painful because they form in nerve rich tissue outside the anal canal
