GI Flashcards
What is another name for Gastrointestinal tract
alimentary canal
What does the GI tract consist of
Mouth, pharynx, esophagus, stomach, small intestine, large intestine
Name the accessory digestive organs
Teeth, tongue, salivary glands, liver, gallbladder, pancreas
What are the three regions that the abdomen is divided into
Intrathoracic, true abdomen, the retroperitoneal abdomen
What is the intrathoracic region enclosed by and what does it contain
Enclosed by lower ribs and is distal to the diaphragm
Contains the liver, gallbladder, spleen, stomach and transverse colon
What does the true abdomen contain
Small intestine, large intestine, lower portion of liver, bladder
Females: Uterus, Fallopian tubes, and ovaries
Where is the retroperitoneal abdomen located and what does it contain
Lies behind the thoracic and true portions
Contains the kidneys, urters, pancreas, posterior duodenum, ascending and descending colon and inferior vena cava
What are the six basic functions of digestion
Ingestion, secretion, mixing and propulsion, digestion, absorption, defecation
What does the process of absorption in the GI tract
Done by the villi and microvilli
The GI tract has linings of the walls that are made up of what distinct layers of tissue
Mucosa, submucosa, muscularis, and serosa
What is the mucosa
The innermost lining of the GI tract
What does the muscularis contain
Skeletal (voluntary) muscles and smooth (involuntary) muscles
What are the 2 sub layers of the serosa
Visceral and parietal peritoneum
What contains a “fatty apron” that drapes over the transverse colon and small intestine
The great omentum
What binds the small intestine to the posterior abdominal wall
The mesentery
What are the three salivary glands
The parotid, submandibular and sublingual
What do lysozomes do
Kill bacteria and protect the mouth from tooth decay
What does salivary amylase do
Begins the digestion of starches
What is the frenulum
It is the fold of mucous membrane in the middle underneath the tongue
What role do the teeth play of the GI tract
They perform mechanical digestion by chewing and breaking down food into small pieces
What are the sections of the pharynx
Nasopharynx, oropharynx, laryngopharynx
What are the phases of swallowing
Voluntary, pharyngeal, esophageal
What is the significance of the pharyngeal stage of swallowing
When the bolts is in the pharynx, the epiglottis seals off the larynx and the upper esophageal sphincter relaxes and the bolts moves into the esophagus
What is the j-shaped organ of the GI tract
The stomach
The stomach is acidic with a pH of what
2
What is the most elastic part of the GI tract
The stomach
The stomach can be stretched to accommodate up to how much food
6.4 liters
What are the main regions of the stomach
The cardia, fundus, body and pylorus
Gastric gland cells are exocrine cells that secrete what types of contents that combine to create gastric juice
Mucous neck cells - secrete mucous
Chief cells - secrete pepsinogen
Parietal cells
G cell
What do parietal cells secrete
Secrete Hydrochloric acid (HC1) - helps convert pepsinogen into pepsin
Secrete Intrinsic factor - necessary for the absorption of Vitamin B12 in the small intestines
What is chyme
A thick liquid in the stomach that is made of gastric juices, and macerated food particles
What functions are part of the pancreas
Endocrine and exocrine functions
What is the Islets of Langerhans
A specialized area within the pancreas that is made of different types of cells that make hormones
What is the most common cell in the pancreas that produces insulin
Beta cells
What is glucagon
A hormone that is produced by alpha cells (found in the Islets of Langerhans)
What is a clear, colorless liquid made of enzymes that consist mostly of water, some salts and sodium bicarbonate
Pancreatic juice
Pancreatic juices contain what
Trypsin and chymotrypsin, pancreatic amylase, pancreatic lipase, ribonuclease
What does trypsin and chymotrypsin do/breakdown
Protein digesting
Proteins: broken down by enzymes into amino acids, dipeptides and tripeptides
What is the second largest organ in the body
The liver
Skin is the first largest
Bile and waste created in the liver are passed into what hepatic ducts
Left and right hepatic ducts
Bile produced in the gallbladder in secreted through what
The cystic duct
The left and right hepatic duct form with the cystic duct to create what
Common bile duct
The common bile duct forms with the pancreatic duct to form what
Hepatopancreatic duct
The muscular valve that controls the passage of contents from the hepatopancreatic duct into the duodenum
Sphincter of Oddi
How long is the small intestine in a living person and in a cadaver
Living person - 3m (10 ft)
Cadaver - 6.5m (21 ft)
What are the three segments of the small intestine
Duodenum, jejunum, ileum
What part of the small intestine has the most absorption properties
The ileum
Most of the digestion and absorption events occur where
Small intestines
90% of water is absorbed where
Jejunum
What is the last part of the GI tract
The large intestine
What is broken down into ascending, transverse, descending and sigmoid portions
The colon
What connects the sigmoid colon to the anus
Rectum
What suggests intra-abdominal bleeding
Bluish periumbilical discoloration (Cullen sign)
What suggest retroperitoneal or intra-abdominal bleeding
Bluish flank discoloration (Gray-Turner sign)
Bowel sounds are heard as clicks and gurgles that occur irregularly and range from what to what
5-35 per minute
What is the biggest difference between inflammatory and non-inflammatory diarrhea
Inflammatory will have blood in the stool
Non-inflammatory will not have blood in the stool
List some of the common bacterial causes of inflammatory diarrhea
Shigella, salmonella, E. Coli
What are some common causes of inflammatory diarrhea
Inflammatory bowel disease, malignancy, celiac’s disease, whippers disease
HALLMARK Sx: blood in diarrhea
What are common viral causes of non-inflammatory diarrhea
Rotavirus, Norwalk virus
What are some common bacterial causes of non-inflammatory diarrhea
Vibriones, enterotoxin- producing E. Coli
What are some CHRONIC causes of non-inflammatory diarrhea
Lactose intolerance, IBS, and GIARDIA LAMBLIA
What is defined as acute gastroenteritis
3 or more times per day of rapid onset that lasts less than 2 weeks
What is re-absorbed in the ileum
Bile
What is absorbed in the ileum
B12
What is absorbed in the jejunum
Folate
What is absorbed in the duodenum
Iron
The ileum absorbs remaining nutrients such as what
B12, and bile salts.
Bile salts are recycled to the liver and gallbladder for reuse
What is a form of infectious gastroenteritis caused by a viral infections and/or by its corresponding toxins
Acute viral gastroenteritis
What is chronic diarrhea
Symptoms that last for longer than 2 weeks
What are conditions in which there is histologic evidence of (damage) inflammation of the epithelial or endothelial of the stomach
Gastritis
What is typically diagnosed at endoscopy, often being performed because of dyspepsia or upper gastrointestinal bleeding
Erosive and hemorrhagic gastritis or gastropathy
When symptoms occur with gastritis, what may this include
Epigastric pain, nausea and vomiting, upper GI bleeding with “coffee grounds” emesis or bloody aspirate on NG Tube
What are other causes of upper gastrointestinal bleeding
Peptic ulcer disease
Esophageal varices
Mallory-Weiss tear
Boerhaave Syndrome
What is the treatment for NSAID gastritis
Discontinue NSAIDs, reduce to lowest dosage or administer NSAIDs with meals
PPI 2-4 weeks
What is the treatment for alcoholic gastritis
Discontinue alcohol use
H2 receptor antagonists, PPIs
What is the treatment for H. Pylori gastritis
Triple or quadruple drug regimen BID for 2 weeks
PPI, AMOX, Clarithromycin, levofloxacin
How do internal hemorrhoids present
Located above the denante line and typically not painful in nature
How do external hemorrhoids present
Located below the dentate line and typically presents with pain
What are the primary locations that internal hemorrhoids commonly occur
Right anterior, right posterior, and left lateral
When is pain most severe for hemorrhoids
Within the first few hours but gradually eases over 2-3 days as edema subsides
Explain the stages of internal hemorrhoids
Stage I: confined to the anal canal
Stage II: prolapse occurs during straining and reduces spontaneously
Stage III: prolapsed hemorrhoids may require manual reduction
Stage IV: chronically protruding and unresponsive to manual reduction
What is the definitive treatment for internal hemorrhoids
Surgical excision (hemorrhoidectomy) OR
Surgical banding also known as rubber band ligation
What is usually linear or rocket shaped ulcers that are usually <5mm in length
Anal fissures
What is the hallmark C/C for a patient with anal fissure(s)
Severe, tearing pain DURING defecation followed by throbbing discomfort
This may lead to constipation due to fear of recurrent pain
What is the treatment for anal fissure(s)
Promoting effortless, painless bowel movements
Fiber supplements and sitz baths
What is the hallmark C/C for a patient with Anorectal Abscess
Throbbing pain that becomes worse immediately BEFORE defecation, is lessened defecation, but persists between bowel movements
What spaces are the most common and least often to become infected alone or in combination with each other
Most common: perianal abscess
Least common: supralevator abscess
