gastrointestinal system

Question 1

Upper GI tract?

Lower GI tract?

Answer 1

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

Question 2

neurogenic causes of Diarrhea vs Constipation

Answer 2

Diarrhea- diabetic enteropathy and hyperthyroidism
Constipation- irritable bowel syndrome, central nervous system lesion, dementia, spinal cord tumor, atomy

Question 3

muscular causes of Diarrhea vs Constipation

Answer 3

Diarrhea- electrolyte imbalance and endocrine disorder
Constipation- muscular dystrophy, severe malnutrition, inactivity, obstructed defection, overactive pelvic floor muscles

Question 4

mechanical causes of Diarrhea vs Consitpation

Answer 4

Diarrhea- Incomplete obstruction, postoperative effect
Constipation- bowel obstruction, pregnancy

Question 5

What is hiatal hernia?

What type is most common?

In how many people? Men or Women?

Answer 5

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

Question 6

What are some symptoms of the Hiatal Hernia?
Contributes to incompetence of the?

Answer 6

Heartburn
- 30-60 minutes after a meal
-lower esophageal sphincter allowing acid into the esophagus

Reflux
- contributes to GERD

Question 7

Which of the following exercises is contraindicated for an individual with a known hiatal hernia?

Answer 7

Avoiding flat supine positions and any exercises requiring the Valsalva maneuver ( increasing intrabdominal pressure)

Question 8

What is GERD?

Answer 8

The consequences from the reflux of gastric contents into the esophagus accompanied by a failure of anatomic and physiologic mechanisms to protect the esophagus

Question 9

In healthy people, 3 factors to remain healthy esophagus…

In people with GERD….

Answer 9

• 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

Question 10

What are the three extra esophageal manifestations?

Answer 10

Asthma, cough, and laryngitis

Question 11

Cardiac chest pain should _______ is assumed to be related to GERD

Answer 11

distinguished and evaluated before chest pain

Question 12

What is peptic ulcer disease?

Answer 12

A break in the lining of the stomach or duodenum of 5 mm or more owing to a number of different causes

Question 13

What are some PUD complications?

Answer 13

Bleeding
Perforation- sudden severe pain in T spine with radiation to right upper quadrant
Penetration- ulcer erodes into adjacent organs
Gastric outlet obstruction

Question 14

What is Crohn disease?
Most commonly affects where?

Answer 14

A chronic lifelong inflammatory disorder that can affect anu segment of the Intestinal tract
Ileum and colon

Question 15

What is ulcerative colitis?
Typically found where?

Answer 15

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

Question 16

Crohn Disease vs Ulcerative Colitis
Age at Onset
Fam history
Gender
Cancer risk
Location of lesions

Bloody stools
Abdominal mass
Growth retardation
Cancer Complications

Answer 16

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

Question 17

What is the most common extraintestinal finding in inflammatory bowel disease?

Answer 17

Arthritis

Question 18

Proton Pump Inhibitor Suffix and Desired Effect

Answer 18

-prazole, gastric ulcers

Question 19

Histamine H2 receptor blockers Suffix and Desired Effect

Answer 19

-idine, Gastric Ulcers

Question 20

Oral antidiabetics

Answer 20

-amide, antidiabetic

Question 21

Biphosphates

Answer 21

-dronate, osteoporosis

Question 22

Diverticulosis vs Diverticulitis

Answer 22

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

Question 23

Where is there a higher incidence for Diverticular diseases?

What are risk factors for diverticular disease?

Answer 23

Western countries

Constipation, eating red meat, obesity, NSAIDS

Question 24

Pathogenesis of Diverticular disease?

Answer 24

Diet, structural changes in the colonic wall, and functional changes in the bowels

Question 25

Asymptomatic in what % of people?

Complicated vs uncomplicated?

Answer 25

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

Question 26

PT implications for Diverticular disease

Where may pain be reffered?

Answer 26

Physical activity has protective effect. careful to avoid activities that increase intraabdominal pressure

Back pain or pain in hip or thigh

Question 27

What is appendicitis?

Peak incidence between what ages and males or females?

Answer 27

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

Question 28

Etiologic factors of appedicitis?

1/3 are caused by???

Answer 28

Primarily from obstruction of the lumen and secondarily from bacterial infection

Obstruction that prevents normal drainage

Question 29

Symptoms of appendicitis?

Pain is ____ and may shift within ____ hours of symptom onset to the _____ quadrant with point tenderness over what site???

WBC>

Answer 29

Ab pain with anorexia, nausea, vomiting and low grade fever

Constant, 12 hours, right lower, McBurney Point

20,000/mm^3

Question 30

How many cases of appendicitis are atypical? Why?

Answer 30

40% to 50% of cases are atypical because of the position of the tip of the appendix

Question 31

PT implications of appendicitis?

If appendicitis is suspected?

Answer 31

Symptoms of right thigh pain, groin pain, pelvic pain, referred pain in the hip

Medical attention must be immediate

Question 32

What is a rectal fissure?

Result of?

Heals within how many months?

Answer 32

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

Question 33

What is hemorrhoid?

It is associated with?

Answer 33

pillow like cluster of veins beneath the mucous membranes lining the lowest part of the rectum and anus

Increases intraabdominal pressure

Question 34

Internal hemorrhoids vs External hemorrhoids?

Answer 34

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