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human conditions > GI and Urinary Diseases > Flashcards

GI and Urinary Diseases Flashcards

1
Q

what is the two types of swallowing disorders?

A

esophageal and oropharangeal

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2
Q

swallowing is super complex cause

A

it reuquires coordination of over 50 nerves and muscles

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3
Q

3 stages of swallowing

A

voluntary oral stage

involuntary pharyngeal stage

esopheageal stage

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4
Q

Food is chewed and the bolus (food) is forced into the pharynx

A

voluntary oral stage

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5
Q

Pharynx share respiratory tracts, where food bypasses respiratory passages when the soft palate closes the epiglottis, and food travels to the esophagus

A

involuntary pharyngeal stage

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6
Q

Bolus continues to move to the stomach through peristalsis action

A

Esophageal stage

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7
Q

refers to the sensation of food sticking in the esophagus/ base of throat/chest

A

Esophageal Dysphagia

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8
Q

what causes esophageal dysphasia?

A

Achalasia

Diffuse spasm

Esophageal stricture

Esophageal tumors

Foreign bodies

Esophageal ring

Gastroesophageal reflux disease (GERD)

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9
Q

Achalasia (esophageal dyspagia)

A

lower esophageal muscle (sphincter) doesn’t relax properly, can cause regurgitation of food, tends to get worse over time

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10
Q

Diffuse spams (esophageal dysphasia)

A

produces multiple, high-pressure, poorly coordinated contractions of esophagus after a swallow
affects the involuntary muscles of lower esophagus

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11
Q

Esophageal stricture (esophageal dysphasia)

A

Narrowing of esophagus stricture can cause large pieces of food to get caught

may result from scar tissue, acid reflux or tumors

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12
Q

Esophageal tumors (esophageal dysphasia)

A

Difficulty swallowing tends to get progressively worse when esophageal tumors are present

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13
Q

Foregn bodies (esophageal dysphasia)

A

may partially block the throat or esophagus by food
Older adults with dentures or those with difficulty chewing properly more susceptible
Children may swallow small objects, such as coins or toy pieces

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14
Q

Esophageal ring (esophageal dysphasia)

A

narrowing in the lower esophagus can intermittently cause difficulty swallowing solid foods

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15
Q

acid reflux (esophageal dysphasia)

A

Damage to esophageal tissues from gastric acid backing up (refluxing) into your esophagus
can lead to spasm or scarring and narrowing of lower esophagus, making swallowing difficult
Also referred to as acid reflux

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16
Q

What type of dysphasia is caused by gastroesophageal reflux disease (GERD)

A

Esophageal stricture

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17
Q

related to throat, nerve. and muscle problems
make it difficult to move food from mouth into your throat
cause may be from brain disorders

A

oropharyngeal dysphasia

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18
Q

Oropharyngeal Dysphagia Chief Manifestations is also called

A

“high” dysphasia

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19
Q 
referring to an oral or pharyngeal location
Difficulty initiating swallow
Nasal regurgitation
Coughing
Nasal speech
Diminished cough reflex
Choking
A

refers to “high” dyspasia

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20
Q

swallowing disturbances are found frequently at

A

in nursing homes, 30–40% of patients have swallowing disturbances = aspiration complications

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21
Q

is the passage of food or liquid through the vocal folds into the lungs

A

aspiration

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22
Q

Persons who aspirate are at increased risk for serious respiratory problems
including

A

airway obstruction and aspiration pneumonia

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23
Q

aspiration caused by and may occur with…

A

often caused by impaired laryngeal closure

May occur with neurological disorders and swallowing dysfunction
overflow of food or liquids retained in the pharynx
gastroesophageal reflux
Aspiration precautions

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24
Q

Oropharyngeal dysphagia

A

Neurological disorders and damage

Pharyngeal diverticula
(collected food particles in the throat, leading to difficulty swallowing, gurgling sounds, bad breath, and repeated throat clearing or coughing

Cancer
Certain cancers and radiation, can cause difficulty swallowing

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25
Q 
These symptoms are for?
Pain while swallowing (odynophagia) 
Unable to swallow 
Sensation of food getting stuck in throat or chest
Drooling 
Hoarseness
Regurgitation 
Frequent heartburn 
Food or stomach acid backing up into your throat
A

swallowing disorders

26
Q

Complications of swallowing disorders

A 
Malnutrition and dehydration 
Respiratory problems 
aspiration
pneumonia 
upper respiratory infections
27
Q

food “sticks” after swallowing

A

esophageal dyspagia

28
Q

difficulty intiating swallowing (may include coughing, choking, or regurgitation)

A

oropharygneal dysphagia

29
Q

barium x-ray (fluroscopy)

A

Swallow a barium solution to coat the esophagus, allows the esophagus to show up better on X-rays
Able to see changes in the esophagus and assess muscle activity
Indications: dysphagia, globus sensation, and aspiration

Dynamic swallowing study.
swallow foods of different consistencies that have been coated with barium
helpful for diagnosing oropharyngeal dysphagia

Barium is an X-ray absorber and appears white on X-ray film.
barium coats the inside wall of the esophagus, stomach, or intestine
Makes visible on x-ray the inside wall lining, size, shape, contour, and patency (openness)
Fluoroscopy is often used during a barium study to study moving body structures—similar to an X-ray “movie”

30
Q

Esophageal Dysphagia Treatment

A

Esophageal dilation
endoscope with balloon to gently dilate and expand the width of esophagus for tight esophageal sphincter (achalasia) or an esophageal stricture

Surgery
esophageal tumor, achalasia or pharyngeal diverticula, may require surgery

Medications
Difficulty swallowing associated with GERD can be treated with prescription oral medications to reduce stomach acid

31
Q

Oropharyngeal Dysphagia OT Treatment

A

Speech or swallowing therapist (may be an OT)
Provide exercises to help coordinate swallowing muscles or re-stimulate the swallowing reflex
Teach swallowing techniques
simple ways to place food in mouth
or to position body and head

32
Q

If someone has difficulty initiating swallowing, which type of dysphagia do they likely have?

A

Oropharyngeal

33
Q

acid reflux is known as!

A

Gastroesophageal Reflux Disease

34
Q

acid reflux happens when

A

gastric juice refluxes into the esophagus

35
Q

acid reflux causes symptoms with or without

A

esophageal mucosal injury (esophagitis)

36
Q

what is linked to GERD?

A

obesity (chronic) and esophagitis

37
Q

Typical esophageal symptoms

for acid reflux

A

Heartburn
Regurgitation
Dysphagia

38
Q

Abnormal reflux can cause atypical (extraesophageal) symptoms, such as:

A 
Coughing and/or wheezing
Hoarseness, sore throat
Otitis media
Noncardiac chest pain
Enamel erosion or other dental manifestations
39
Q

GERD Diagnosis is confirmed via

A

Upper gastrointestinal endoscopy /esophagogastroduodenoscopy

Esophageal manometry

small, flexible high-resolution manometry catheter through nose, down esophagus and into stomach
helps surgical planning by determining the lower esophageal sphincter (LES) pressure
helps identify esophageal motility disorders

40
Q

GERD Treatment

A

antacids or PROTON PUMP INHIBITORS= decrease stomach acid production

many side effect risks

treatment based on lifestyle modification and control of gastric acid secretion

surgery w anti-reflux surgery

41
Q

goal of acid reflux treatment

A

control symptoms
heal esophagitis
and prevent esophagitis

42
Q

IBS is caused by

A

caused by changes in how the GI tract works

43
Q

In IBS symyptoms may be

A

symptoms may be frequent but GI tract not damaged

44
Q

common symptoms of IBS

A

abdominal pain or discomfort, often reported as cramping, along with diarrhea, constipation, or both

45
Q

IBS is diagnosed when

A

abdominal pain or discomfort occurs at least 3x per month for the last 3 months

46
Q

IBS affects 2x as many

A

women than men

47
Q

Possible causes of IBS

A

Brain-gut interaction

  • genetic
  • intestinal infection
  • chronic stressful life events or psychosocial factors
Abnormal motility (movement) 
Slow motility can lead to constipation and fast motility can lead to diarrhea

Psychological
anxiety, depression

Bacterial gastroenteritis
Infection stomach and intestines caused by bacteria

Food sensitivity
foods rich in carbs spicy or fatty foods, coffee, and alcohol

Visceral hypersensitivity
stretch on intestines from even small amounts of food may produce discomfort

48
Q

diagnosis of IBS

A

Medical history questions to ask:
questions about symptoms, family history of GI disorders, recent infections, medications
stressful events related to the onset of symptoms
For IBS to be diagnosed
symptoms must have started at least 6 months prior
and must have occurred at least 3 days per month for the previous 3 months

49
Q

IBS treatment

A

No cure
symptoms can be treated with a combination of the following:
changes in eating habits, diet, and nutrition
smaller more frequent meals, avoid high fat foods, increase or decrease fiber, eliminate other problematic foods
Medications
fiber supplements, laxatives for constipation, antidiarrheals, antispasmodics
antidepressants for those with moderate or severe IBS reduce IBS sx to include pain and to normalize GI motility

Probiotics
live microorganisms, usually bacteria, similar to microorganisms normally found in the GI tract
Bifidobacteria and certain probiotic combinations found to improve symptoms of IBS when taken in large enough amounts
Therapies for psychological issues to help reduce stress and improve symptoms

50
Q

IBS

A

Antidepressants can be effective as analgesics
used to treat chronic pain conditions as migraine headaches, diabetic neuropathy and fibromyalgia

Similarly, antidepressants are effective in treating symptoms of IBS and other functional GI disorders
Patients who take antidepressants for IBS
report significant improvement in their abdominal pain and reduction in other IBS symptoms

51
Q

colitis

A

inflammation of the colon

52
Q

IBD is a term for what?

A

Inflammatory bowel disease (IBD) is a generic term for three disorders associated with GI tract inflammation:
Crohn disease
Ulcerative colitis
Indeterminate colitis

53
Q

Group of disorders in which the intestines become inflamed
Most common forms of IBD are ulcerative colitis and Crohn’s disease
IBD runs in families, with possible genetic factors
Thought that immune system may trigger IBD
Immune system seems to overreact to normal bacteria in the digestive tract and fails to “shut off,” causing inflammation

A

inflammatory bowel disease

54
Q

Ulcerative colitis is slightly more common

A

males

55
Q

Crohn’s disease is marginally more frequent

A

in women

56
Q

IBD etiology

A

Etiology is unknown but is thought to involve genetic, immunologic, and environmental factors as evidenced by the following:
greatest relative risk of IBD disease is found among first relatives, suggesting a strong genetic component
Smoking is one of the more notable environmental factors
Ulcerative colitis is more prevalent among ex-smokers and nonsmokers
whereas Crohn’s disease is more prevalent among smokers

57
Q

chronic inflammatory IBD condition of the gastrointestinal tract

most commonly affects the end of the small bowel (the ileum) and the beginning of the colon, but it may affect any part of the GI tract
less able to absorb food nutrients, so body may not get enough nutrients

A

Crohn’s Diease

58
Q

undigested food that goes into the large intestine makes water absorption harder, causing diarrhea
can be both painful and debilitating, and sometimes may lead to life-threatening complications
no known cure, but therapies can greatly reduce symptoms and even bring about long-term remission

A

Crohn’s Disease

59
Q

Ulcerative colitis

A

IBD disease that causes inflammation and sores (ulcers) in the lining of the large intestine (colon)
Most people are diagnosed before the age of 30
Cause is unknown, but may be immune system overreacting to normal digestive tract bacteria
Small intestine absorbs nutrients as it should, but inflammation in the large intestine keeps it from absorbing water, causing diarrhea

60
Q

IBD Diagnostics

A 
Health & family history, physical exam, and different tests 
Blood tests 
to find signs of inflammation and anemia
Stool sample 
tested for blood and infection
Colonoscopy or sigmoidoscopy 
unable to reach small intestine
X-rays with barium (orally or as enema)
Computerized axial tomography (CT or CAT scan)
Capsule endoscopy
61
Q

IBD treatment options

A

Cause unknown – no proven prevention
Medications
to reduce the inflammation, relieve symptoms, and prevent flare-ups, immune system suppressants, antibiotics (for Crohn’s)
Surgery
25-40% with ulcerative colitis will need surgery at some point. Surgery that removes the entire large intestine can completely cure ulcerative colitis
also reduces risk of colon cancer
65-75% with Crohn’s disease need surgery at some point
to relieve symptoms and correct problems like strictures, fistulae, or bleeding in the intestine
since Crohn’s disease occurs in patches, surgery cannot cure

Changes in diet and nutritional supplements
Avoid greasy or fried foods
Avoid cream sauces and meat products
Avoid spicy foods 
Avoid foods high in fiber, such as nuts and raw fruits and vegetables 
Eat smaller, more frequent meals
Reducing stress and getting enough rest
stress does not cause IBD
but stress can cause a flare-up
62
Q

Probiotics is a form of treatment for which condition?

A

A. Ulcerative colitis
B. Crohn’s disease
C. Irritable bowel syndrome (IBS)
D. Inflammatory bowel disease (IBD)

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