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Medcon Rehab IV > GI Disease (ALL) > Flashcards

GI Disease (ALL) Flashcards

1
Q

GI System areas to be covered:

NOTICE SIDES OF EA. ORGAN!!!

A
  • Mouth
  • Esophagus
  • Gallbladder
  • Pancreas
  • Liver
  • Small/Large Intestines
  • Rectum
  • Anus
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2
Q

Liver side + Gallbladder

A

RIGHT

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3
Q

Stomach side

A

Left

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4
Q

Spleen side

A

LEFT

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5
Q

Pancreas side

A

RIGHT

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6
Q

Appendix side (McBurney’s Point)

A

RIGHT SIDE

Landmarks: ASIS + Umbilicus→ right in bw!!!

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7
Q

S/S GI Disease

A

Nausea, vom, dysphagia, achalasia (diff for food/liquid to pass to stomach), heartburn

Constipation, fecal incont, abd pain, GI bleed, anorexia

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8
Q

NORMAL ANATOMY OF UPPER GI

Great pic!!!

A

KNOW IT….LABEL IT!

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9
Q

Normal Anatomy of Upper GI

A
  • To Be Covered:
    • heartburn, substernal pain, diff or pain swallow
    • role of diaphragm and intrabdom pressure on sx’s
    • lower esophageal sphincter (@ bottom of esophagus)
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10
Q

NORMAL Anatomy pic vs.

A

Hiatal Hernia

  • Notice the Hiatus “hole” and how it is LARGER w/ the stomach protruding thru!!!
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11
Q

Hiatal Hernia

A
  • Stomach passes thru diaphragm into thoracic cavity
  • Age & gender
  • KNOW diaphragm and intraabdom pressure→ as diaphragm raises w/ INhale==== HIGHER intraabdom pressure!
  • Dx:
    • Ultrasonography, barium swallow w/ fluroscopy
  • Mgmt:
    • symptom control
    • sx mgmt
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12
Q

Sx for Hiatal Hernia and GERD

Recreates what?

A

Fundoplication

Lower Esophageal Sphincter (LES)

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13
Q

Gastroesophageal Reflux Disease (GERD)

A
  • LES opens spontaneously for pds of time, OR does not close properly→ allows stomach contents to rise UP INTO esophagus
  • *inflamm of esophagus
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14
Q

GERD Mgmt:

A
  • Pharmacological, lifestyle mods, elevate HOB, avoid reclining and vigorous activities 1-3hrs after eating
  • ID and avoid food/bev triggers, sx
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15
Q

Sx’s of _______ and ______ VERY SIMILAR

A

Hiatal hernia and GERD

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16
Q

Pharma Interventions for GERD

3:

A
  1. Proton Pump INhibitors (PPIs)
  2. Histamine 2 receptor blockers
  3. Antacids
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17
Q

GERD Pharma Interventions

Proton Pump Inhibitors (PPIs)

A
  • Acid suppression
  • Shut off acid pump, blocking acid prod.
  • ***FIRST LINE OF TX

EX: Prilosec OTC

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18
Q

GERD first line of tx:

A

PPIs

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19
Q

GERD Pharma Interventions

Histamine 2 receptor blockers

A
  • Acid reduction via prevention of acid secretion
  • ***Long-term relief

EX: Zantac, Pepcid AC

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20
Q

GERD Loooong-term relief

A

Histamine 2 receptor blockers

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21
Q

GERD Pharma Interventions

Antacids

A
  • Acid reduction via acid neutralization
  • **Acid production/secretion remains SAME
  • ***Short-term/IMMEDIATE relief

EX: TUMS, Pepto-Bismol

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22
Q

SHORT-TERM/IMMEDIATE GERD relief

A

Antacids !!!

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23
Q

Hiatal Hernia

PT Implications/Guidelines:

Whats a GREAT INTERVENTION TO USE???? You can also modify it to seated since they should NOT be in supine?????

A

Shaker head lift***

  • Supine/Seated/Elevated HOB
    • Chin tuck→ head lift & hold OR
    • Chin tuck→ head lift & repeated motions for reps
  • Bennies:
    • Swallow help & neck flexor strengthening
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24
Q

Shaker Head Lift

Think…..

A

Hiatal hernia intervention!!!

25
Q

Hiatal Hernia

PT implications/guidelines

A
  • AVOID:
    • Flat/supine
    • Valsalve
  • Educate:
    • MINIMIZE intraabdom. pressure
  • ***Shaker head lift!!!
26
Q

GERD

PT implications/guidelines:

ALL (then broken down w/ ?’s)

A
  • Elevate HOB
  • Left S/L to prevent regurgitation/aspiration
  • Exercise rx to avoid body agitation activities, strenuous exercise
  • Post-op pulm mgmt/pos’ing
  • polypharm
  • Screening ?’s:
    • READ BOOK!!!
27
Q

GERD

PT IMPLICATIONS:

LEFT sidelying….why?

A

Stomach on left side!

LESS likely to go back up into esophagus!!

28
Q

GERD

PT implications

Exercise rx…. why?

A

Strenuous exercise can irritate/cause sx’s!!!

29
Q

Gallbladder

FACTS:

A
  • Reservoir for bile
  • Stores/concentrates bile during fasting pds
  • Contracts to expel bile into duodenum in resp to arrival of food→ Signaled by release of cholecystokinin
30
Q

Cholelithiasis aka

A

Gallstone Disease

31
Q

Cholelithiasis (Gallstone Disease)

which system?

32
Q

Cholelithiasis (Gallstones)

FACTS:

A
  • Gallstones→ CHO or bile salts
  • INCd incidence:
    • Older adults, Native Am’s, obesity/post-gastric-bypass/rapid wt loss, women under 50 (role of estrogen)
  • Influences:
    • diet, esp. FATS
33
Q

Acute Cholecystitis aka

A

Inflamed Gallbladder

34
Q

Acute Cholecystitis aka Inflamed Gallbladder

What is it?

A

Impaction of gallstones in cystic duct

  • Obstructs bile flow
  • Painful distention of gallbladder
35
Q

Acute Cholecystitis aka Inflamed Gallbladder

S/S:

A
  • Sever pain→ R. subcostal region
  • Steady pain→ R. upper abdomen (incs rapidly and lasts 30mins→hrs esp after eating)
  • Referred pain→ midback bw scap, R. shoulder, R. upper trap, R. subscap
  • Fever, INCd WBC #
36
Q

Acute Cholecysitits aka Inflamed Gallbladder

Sx Procedures:

A

KNOW: Cholecystectomy

  • Laparoscopic cholecystectomy
    • referred pain up to 48hrs
  • Lithotripsy
    • the sound waves one
37
Q

Biliary Disease

PT Implications + Exercise Guidelines

A

Physical activity may prevent symptomatic cholelithiasis (gallstones)

  • 30 mins of endurance activity/day
  • 5d/week
38
Q

Biliary Disease

PT Implications

Post-op Cholecystectomy interventions:

A

Chest PT, breathing retraining, exercise activity, wound splinting

**Remember they just had stomach cut open!!!

39
Q

Label this Image!

A
  1. Liver
  2. Gallbladder
  3. Stomach
  4. Pancreas
  5. Duodenum
  6. Colon
40
Q

Liver = POWERHOUSE

FACTS

A
  • > 500 functions!
  • Key organ w/ gut in nutrient absorption/metabolism*
  • 500-1500 mL bile/day
  • Produces clotting factors
  • Sole source→ albumin, plasma PROs
  • Conversion/excretion bilirubin→ too much = jaundice
  • Stores vitamins
  • Reduces toxins in body
41
Q

Hepatic (Liver) Disease Symptoms:

ALL

A
  • GI Sx’s
  • Edema, ascites (distended stomach)
  • RUQ abdom pain
  • Lt/clay color stool
  • Skin changes→ jaundice, bruising, spider angioma, palmar erythema
  • dark urine
  • hepatic failure
  • Portal HTN
    • elevated pressure in portal venous system
    • Portal vein→ major vein leading to liver
    • most common cause→ cirrhosis (scarring) liver
42
Q

Hepatic (Liver) Disease Symptoms

Neuro involvement

A

Confusion, sleep disturbs, mm tremors, hypERactive reflexes, Asterixis (flapping tremor)→ literally what it sounds like!

43
Q

Cirrhosis (Scarring)

A
  • Chronic, progressive inflammation of liver
    • progressive liver tissue damage
  • Fibrous bands, partition liver into irreg nodules
  • *Sx’s:
    • Wt loss, fatigue, jaundice, unable to met. drugs, hypOalbuminemia, ascites
44
Q

Alcohol-Related Liver Disease

3 things:

A
  1. Fatty liver infiltrate
    1. fatty tissue infiltrates liver
  2. Alcoholic hepatitis
    1. inflamm of liver
  3. Alcoholic cirrhosis (scarring)
45
Q

Alcohol-Related Liver Disease

PT Implications:

A
  • Susceptible to infx’s→ Universal Precautions (handwashing)
  • Clotting dysf→ monitor bleed/bruising (Falls!)
  • Only 50% clients abusing alcohol ID’d by physician***
    • NONE OF THEM SAY ANYTHING!!!
46
Q

Hepatic Disease

BIG 2 THINGS TO LOOK FOR AND WHAT TO DO ABOUT IT!!!

A
  1. Jaundice→ refer to physician
  2. Ascites→ refer to physician
47
Q

Hepatic Disease

More PT Implications

A
  • Jaundice, Ascites→ refer to physician
  • AVOID→ active, intense exercise in active hepatic dis.
  • Clotting precautions, Universal precautions, Susceptible to infx’s
48
Q

When you see Malabsorption** Syndrome…..**

THINK……

A

Intestines + Rectum***

49
Q

Malabsorption Syndrome

A
  • Group of disorders characterized by reduced intestinal absorption of dietary components OR excess. loss of nutrients in stool
  • Maldigestion vs. Malabsorption
    • Includes:
      • Celiacs
      • CF
      • IBD
        • Crohn’s, ulcerative colitis
50
Q

Malabsorption Syndrome

2 components

A

Reduced intestinal absorption of dietary components

OR

Excess loss of nutrients in stool

51
Q

Malabsorption Syndrome

Malabsorption 2 components

A

Maldigestion vs Malabsoprtion

  • Under this umbrella:
    • Celiacs
    • CF
    • IBD
      • Crohn’s, Ulcerative colitis
52
Q

Malabsoprtion vs. Maldigestion

What’s the Difference? (all first)

A
  • Malabsorption:
    • Food fully digested
    • Not adequately absorbed by intestines
    • Celiacs, IBD
  • Maldigestion:
    • Deficiencies of enzymes or specific defects in the GI tract
    • CF→ pancreatic enzymes absent, Lactose intolerance
53
Q

Food fully digested, NOT adequately absorbed by intestines

Ex’s: Celiacs, IBD

A

Malabsorption

54
Q

Deficiencies of enzymes or defects in GI tract

CF, Lactose intolerance

A

Maldigestion

55
Q

Ex’s of Malabsorption

A

Celiacs, IBD

56
Q

Ex’s of maldigestion

A

CF, lactose intolerance

57
Q

Malabsorption Syndrome

S/S

Just recognize and ask if they make sense and WHY!!!

A
  • Wt loss, fatigue, depression, abdom bloating, bladder changes (nocturia), abdom cramps, indigestion, mm wasting/weakness*, changes in BMD/Osteoporosis*, low BP, parasthesias/neuro damage, dermatitis herpetiformis, infertility
  • Bowel changes:
    • steatorrhea (oily stools), explosive diarrhea, chronic diarrhea, flatulence
58
Q

Malabsorption Syndrome

Tx, Dx

A
  • Dx for various causes:
    • blood tests, fecal fat analysis, biopsy small intestine mucosa
  • Tx:
    • avoid triggers (gluten, lactose)
    • probiotics
    • nutrition supps, Total Parenteral Nutrition (TPN) in extreme cases
59
Q

Irritable Bowel Syndrome (IBS)

A
  • “Functional” disorder→ sx’s NOT attributed to any identifiable bowel abnorm
  • abnorm intestinal contraction
  • S/S:
    • pain, bloating, passage of mucus, changes in stool form, stool freq changes, diff defecating, cramping

Medcon Rehab IV (18 decks)

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