Gastrointestinal System (Exam One) Flashcards
Where does the absorption of nutrients and digestion take place?
Small intestine
Where does the absorption of water and minerals take place?
Large intestine
What does the oral cavity consist of?
- Teeth
- Tongue
- Salivary glands
Where does digestion begin?
In the oral cavity
What is the tongue made of? What nerve does it contain?
- Skeletal muscle
- Hypoglossal nerve
What is the first step in swallowing?
Elevation of the tongue
What are the only two digestive enzymes produced in the mouth?
- Amylase
- Linguinal Lipase
Saliva is mostly made up of what?
Water
What are the three pairs of salivary glands?
- Parotid
- Submandibular
- Sublingual
What is the purpose of the esophagus? How is this done?
- Carries ingested items to the stomach
- Peristalsis propels food to the stomach
What is the purpose of the lower esophageal sphincter (LES)?
- Allows food to enter the stomach
- Prevents backflow of food
The lower esophageal sphincter is also known as what?
Cardiac sphincter
List the parts of the stomach.
HINT: the CAR is FUN ‘til the BODY PILES
- Cardia
- Fundus
- Body
- Pylorus
What is the main purpose of the stomach?
To store food for digestion
Which cells secrete hydrochloric acid in the stomach?
Parietal cells
What does the hydrochloric acid do within the stomach?
- Kills microorganisms
- Breaks down food
- Facilitates gastric enzyme activation
When is gastric juice release?
At the sight or smell of food
What are rugae?
- Folds on internal surface of stomach
- Provide extra surface area
- Allows stomach to stretch
The stomach changes ingested food into what?
Chyme
What is the pyloric sphincter responsible for?
Regulates the rate of stomach emptying into the small intestine
What are the three portions of the small intestine?
- Duodenum
- Jejunum
- Ileum
What ducts are in the duodenum?
- Common bile duct
- Pancreatic duct
What is released by the pancreas release when chyme moves into the small intestine?
Bicarbonate
What does bicarbonate do?
Protects the small intestine from the acidity of gastric contents
What are villi? What are villi responsible for? Where are they located?
- Small fingerlike projections
- Located in the small intestine
- Increase surface area and absorb nutrients
The large intestine is also known as what?
Colon
What is the purpose of the large intestine?
Forms and stores feces
What does the ileocecal valve do?
Prevents backup of fecal matter from the large intestine into the small intestine
What is the liver’s role in digestion?
Produces bile
What is bile made of?
- Water
- Bile salts
Bile flows out of the liver through which ducts?
Left and right hepatic ducts
What ducts form the common hepatic duct?
Left and right hepatic ducts
Which duct is connected to the gallbladder?
Cystic duct
Which two ducts form the common bile duct?
- Cystic duct
- Common hepatic duct
What do bile salts do?
Break down fats in the small intestine
Explain hepatic portal circulation and how the liver detoxifies blood.
- Liver receives oxygenated blood from the hepatic artery
- Liver receives blood (high in nutrients, low in oxygen) from the abdominal organs and spleen via the hepatic portal vein
- Liver filters out by-products from abdominal organs and spleen
- By-products are excreted into the bile or the blood
- Bile by-products enter the intestine and exit the body via the feces
- Blood by-products are filtered out by the kidneys and exit the body via the urine
All blood enters the liver via the what?
Hepatic artery
All blood exits the liver via the what?
Hepatic portal vein
List the functions of the liver.
- Regulates the blood glucose level
- Regulates blood levels of non-essential amino acids
- Forms lipoproteins and cholesterol
- Produces albumin, clotting factors, and globulins
- Removes bacteria and foreign substances from the portal blood
- Forms bilirubin
- Storage for several vitamins and minerals
- Detoxification of harmful substances
- Coverts ammonia to urea
- Provides the body with active Vitamin D
Which organ is responsible for storing and concentrating bile until it is needed for digestion?
Gallbladder
Which hormone secreted when fatty foods need to be digested?
Cholecystokinin hormone
What does the hormone cholecystokinin do?
- Signals the gallbladder to contract
- Forces bile into the duodenum
What happens to the GI system of older adults?
- Sense of taste decreases
- Teeth loss causes difficulty chewing
- Secretions of GI tract are decreased
- Peristalsis may decrease causing constipation
- Frequent indigestion
- Risk of colon and oral cancer increase
- Peridontal disease is more common
- Diverticula may form
- Hemorrhoids are more common
What is included in the physical exam for a patient with GI issues?
- BMI
- Dry, cracked lips
- Foul breath
- Color of gums
- Ill fitting dentures
- Abdomen inspection, auscultation and palpation
A BMI of 30 or higher is considered what?
Obese
A BMI of 40 or higher is considered what?
Morbidly obese
What will the nurse hear with normal bowel sounds?
- Soft clicks
- Gurgles
What will the nurse hear with abnormal bowel sounds?
High-pitched tinkling sounds
What are hyperactive bowel sounds? What causes them?
- Rapid or increased sounds
- <5 seconds apart
- Caused by hunger or gastroenteritis
What are absent bowel sounds? What causes them? The nurse knows they should do what if the patients bowel sounds are absent?
- No sound at all for 5 minutes in each quadrant
- May indicate bowel disease or obstruction
- Can occur after anesthesia
- Report to provider!
What are hypoactive bowel sounds? What causes them?
- Infrequent sounds
- > 15 seconds apart
- Can occur after abdominal surgery
What is jaundice? What causes jaundice? If a patient is jaundice, what color will their urine and stool be?
- Yellowing of skin and sclera
- Caused by excess bilirubin
- Urine will be dark colored
- Stools may be gray in color
What labs should be assessed in a patient with suspected liver problems?
- CBC
- Bilirubin
- Occult blood
- ALT, AST, ALP
- Albumin
- Ammonia
- Potassium
- Amylase
- Lipase
What is a normal bilirubin level?
< 1.0 mg/dL
What is the upper GI series (barium swallow) test?
- X-ray of the esophagus, stomach, duodenum, and jejunum
- Patient drinks oral liquid contrast medium (barium) and x-rays are taken at timed intervals
What does the upper GI series detect?
- Strictures
- Ulcers
- Tumors
- Polyps
- Hiatal hernias
- Motility issues
What should the nurse monitor the patient for if they have had an upper GI series?
- Ensure patients clears the barium
- Constipation
- Chalky white stools
- Encourage plenty of foods
What education should the nurse provide to the patient before an upper GI series?
- Patient must be NPO for six hours prior to procedure
- No smoking prior to procedure
- Encourage plenty of foods
- Laxatives may be given
What is the a lower GI series (barium enema) test?
- Colon is filled with barium
- X-rays are taken
What does the lower GI series detect?
- Tumors
- Diverticula
- Stenosis
- Obstructions
- Inflammation
- Ulcerative colitis
- Polyps
What education should the nurse provide to the patient before a lower GI series?
- Patient placed on low residue or clear liquid diet several days prior to the procedure
- Clear liquids 24 hours prior
- NPO 8 hours before the test
- Laxatives will be given prior to clear the bowel
- Encourage liquids
- Failure to clear the bowel will result in cancellation of test
What patient education should be provided to a patient who has an esophagogastroduodenoscopy ?
- NPO for 8 hours prior to test
- Patient may have a sore throat for a few days
What should the nurse assess and monitor with an esophagogastroduodenoscopy?
- Dentures (think safety!)
- Assess for gag reflex
- NPO until gag reflex returns
- Monitor for perforation
- Monitor for pain, fever, abnormal vital signs, bleeding
What does the esophagogastroduodenoscopy assess?
- Visualizes the esophagus, stomach, duodenum
- Used to diagnose ulcers, cancer, bleeding
- Can obtain specimens via a biopsy
What should the nurse monitor the patient for if they have had an ERCP?
- Gag reflex
- NPO until gag reflex returns
- Vital signs
- Signs of reaction to contrast
- Assess for contrast dye allergy
What education must be provided for a patient undergoing a colonoscopy?
- Clear liquid diet evening prior to procedure
- Patient is NPO midnight prior to procedure
- Bowel must be clear for successful procedure!!
- Patient may experience gas and abdominal cramping afterwards
What should the nurse monitor for after a colonoscopy?
Rectal bleeding
When would a liver biopsy be needed?
When other diagnostic tests have not been successful in diagnosing a liver disease
What patient education should be provided prior to a liver biopsy?
- Patient will be on bedrest after procedure
- Avoid coughing and straining for 1 week
- Avoid exercise for 1 week
What should the nurse monitor after a liver biopsy?
- Vital signs
- Bleeding