GI Exam 1 Flashcards
4 processes of the GI tract
Ingestion, Digestion, Absorbtion, Excretion
Ingestion
taking in food
Digestion
breaking down to molecules for absorbtion
Elimination
excretion of waste products of digestion
Mucosa
inner most layer. Protects, secretes, absorbs.
Submucosa
contain blood & lymph vessels. Transports nutrients
Muscularis or muscular layer
motility. smooth muscles circular and longitudinal
Serosa or serous layer
protection. Outer covering
Peritoneum
Lines walls of entire abdominal cavity
Omentum
fat covering, protection
Mesinteric arteries
supply blood to GI tract
Drains nutrient blood to the liver from GI
Potral vein
GI tract recieves how much of total cardiac output?
25-30%
Urge to defecate after eating
gastrocolic and duodenocolic reflex
Sympathetic
inhibits/decreases digestive action
parasympathetic
increases frequency, strength, velocity of GI contractions
Chewing
mastication
swallowing
deglutition
Functions of mouth
mastication (mechanical mix with saliva)
speech
expression
taste
Salivary glands produce
amylast (digest starch)
Which muscles regulate swallowing?
pharyngeal muscles
What does the esophagus do?
transport food to stomach
What 2 sphincters of esophagus
UES (pharyngo-esophageal) LES (gastroesophageal)
What does the LES prevent?
GERD
Gastrin
stimulates secretion of parietal & cheif cells
Parietal cells
secretes HCl and intrinsic factor
Cheif cells
pepsinogen > pepsin > protein digestion
Mucous neck cells
alkaline mucus to lubricate, protect stomach from self digestion
Pyloric glands
secretes mucus
What controls gastric emptying?
vagal stimulation, chyme (allows pancreatic juices to neutralize), hormonal effects
Purpose of small intestines
digestion & absorbtion
Villi
increase surface area, enhance absorbtion
Duodenum & jejunum absorbs…
carbs, amino acids, lipids, iron, calcium
Ileum absorbs…
water, electrolytes, bile salts, vitamins
Purpose of large intestines
absorb water and electrolytes. Store feces till elimination
Purpose of rectum
storage & expulsion of stool
2 sphincters of colon. Volontary & involontary
Internal-involontary
external- volontary
Defecation reflex
feces moves to rectum, distention, activate parasympathetic, relaxes sphincter, constricts muscles, force feces out.
Function of the Liver
bile production/secretion, carb metabolism, formation clotting factors, fat metabolism, vitamin & mineral storage, filtration, detoxification, blood storage
Kupffer cells
Liver cells: filter and destroy old blood cells, remove bacteria
Blood supply to the liver
portal vein, hepatic artry
How much blood is supplied to the liver by the portal vein
75%
Pancreas
pancreatic juice aid to digestion, neutralize chyme. Enter via common bile duct.
Gall bladder
store and concentrate bile
Bile
emulsifies fats
Bilirubin. What does it come from?
pigment derived from breakdown of hemoglobin- main component of bile.
Bile>bilirubin>urobilinogen>excretes in feces & urine
First sign of GI problem
pain
Cullen sign
bluish around umbilicus = internal bleeding
Blumberg’s sign
rebound tenderness sign of peritonitis
McBurney’s point
1/3 distance between umbilicum and iliac crest. Appendicitis
Order of abdominal assessment
Inspection, auscultation, percuss, palpate
Diagnostic studies
CBC, WBC, PT, electrolytes, Liver function(ALT), stool analysis, stool culture, fecal occult, gastric analysis
Paracentesis
aspirate fluid from abdomen
void prior to procedure!
GI cocktail
determine GERD or heart attack
litocane, donatol, maylox
Radiology tests
Xray, CAT/MRI, barrium swallow (upper and lower), abdominal angiogram
Endoscopy
EDG, colonoscopy
Liver biopsy
PTT, position patient on right side for 2 hours, monitor hemorrhage
Hungar
uneasy or painful sensation caused by lack of food
Hidden hunger
subclinical deficiencies but no obvious signs of undernutrition
Food insecurity
lack of access to food to meet dietary needs
Malnutrition
deficiency or excess of nutrients
Malcutrition causes…
weakens the immune system, stunts growth, delay wound healing, impairs mental and physical growth
under nutrition
state of poor nutrition from an inadequate diets of diseases that affect appetite and utilization of food
over nutrition
ingestion of more food than required for body needs
protein calorie malnutrition
chronic inadequate protein
high metabolic protein and energy requirements
Catabolism
without needed proteins and calories, body fills its energy needs by breaking down stored proteins and fats (loose muscle mass, weakness, fatigue, poor wound healing, death)
Kwashiorkor
lack of protein quality and quantity in presend of adequate calories (edema, acites)
Marasmus
calorie malnutrition in which body fat and proteins are wasted
Starvation
carbs used up, glycogen fats proteins converted to glucose plasma oncotic pressure decreases, fluid shift edema dry wrinkled skin sodium/potassum pump fail, cell expand and die death
Subjective data starvation
dietary intake for last 24 hours
profile for last 2 weeks
etoh intake
meds
Objective data starvation
physiccal exam
height and weight
mid arm circumference
BMI
Lab values starvation
PREALBUMIN
H&H
iron
protein
Starvation-exspected outcomes
achieve weight gain (1-2 lbs per week consume specific number of calories per day select good food choices take rest periods for 30 mins no evidence of infection
Goal of treatment for starvation
restore nutrition with diet high in calories and protein
Nursing interventions for starvation
small frequent meals supplemental feedings vitamin supplements foods from home good mouth care rest periods pain relief socialization at mealtimes observe for s/s of infection correct fluid & electrolyte imbalance treat infection TPN
Bariatric medicine
branch of medicine that deals with prevention, control, and treatment of obesity
Obesity patho
results when calrie intake exceeds energy demands for a prolonged period of time and the body stores excess calories as fat
Primary obesity
excess calorie intake for metabolic demands
Hypertrophic obesity
increase in size aof adipose cells. ADULT
Hyperplactic obesity
increase in cell size & number of fat cells (YOUNG AGE)
Android obesity
fat distributed over abdomen and upper body, apple shape. right for cardiovasular disease
Gynecoid obesity
fat distributed over hips, better prognosis. harder to loose weight.
BMI
Normal 18.5-24.9
Morbide obese 41-45
super obese >50
Complications of obesity
cardio, rasp, vascular, infection
Gastroplasty
stomach divided by surgery, stapling, or banding itno small upper portion and large distal portion
Primary cause of tooth decay
plaque
gingivitis
inflammation of gums
pockets form, collects bacteria, gums recede, bone destruction
Indication of gingivitis
painless bleeding of gums with normal brushing
Halitosis
bad breath
Stomatitis
inflamation of mouth
glossitis
tongue inflammation
