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GI (exam 4) Flashcards

1
Q

What parts of the body are a part of the GI tract?

A 
Mouth
Esophagus
Stomach
Small Intestine
Large Intestine
Rectum
Anus
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2
Q

Where does the majority of absorption occur?

A

Small intestine (90%)

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3
Q

When food passes through the GI tract is it considered to be internal or external?

A

External

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4
Q

What are the accessory organs of the GI system?

What do they do?

A

Liver
Gallbladder
Pancreas
Secrete substances into the GI to digest food

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5
Q

What are the functions of the GI tract?

A

Ingestion of food
Propulsion of food and wastes from mouth to anus (motility: segmentation and peristalsis)
Secretion of mucus, water, and enzymes
Mechanical digestion of food particles (masstication by mouth)
Chemical digestion of food particles
Absorption of digested food
Elimination of waste products by defacation

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6
Q

What are the 4 main organic substances we ingest?
What enzyme breaks each down?
Where does breakdown occur?

A

Carbs: amylase enzyme, in mouth and pancreas
Protein: proteases (pepsin, trypsin, chymokipsin), stomach secretes pepsin, pancreas secretes other two
Lipids: lipase after emulsification by bile, the liver produces bile, pancreas releases lipase
Nucleic acids: nuclease, DNA and RNA

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7
Q

What are the layers of the GI tract (inner to outer)?

Functions?

A

Mucosa: absorption
Submucosa: blood supply, glandular secretion
Muscularis: smooth muscle (2 layers: circular muscle layer- pinch and constrict, longitudinal muscle layer- propel food forward)
Serosa: visceral layer of peritoneum, serous membrane

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8
Q

What is the mesentery?

Function?

A

Part of the peritoneum

Holds everything in place

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9
Q

What is the job of the mouth?
What enzyme is released in the saliva?
Cranial nerves involved in mouth?
Teeth?

A

Chewing and mixing of food and saliva (start chemical digestion)
Amylase in saliva (carbs)
Taste buds: CN 7, 9: salty, sour, bitter, sweet, umami
Olfactory nerve: CN 1
32 permanent teeth

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10
Q

What are the salivary glands?

A

Submandibular (paired)
Sublingual (paired)
Parotid (paired)

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11
Q

What is in saliva?

What does it do?

A

Water with mucus, sodium, bicarb, chloride, potassium and amylase (carb digestion)
Start chemical digestion
Make a bolus of food to swallow

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12
Q

What is involved in swallowing (deglutition)?

Location/ Function?

A

Esophagus: peristalsis moves food
Upper esophageal sphincter: opening of esophagus, entrance
Lower esophageal sphincter (cardiac sphincter): enters into the stomach

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13
Q

What happens with an insufficient sphincter?

A

Can’t open or close, it is leaky

If lower sphincter get heartburn

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14
Q

What is a stenotic sphincter?

Risks?

A

To narrow of a sphincter
Upper: risk of choking
Lower: risk of vomitting

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15
Q

What is the stomach?
Muscles?
Parts of stomach?

A

Hollow, muscular organ that stores food, secretes digestive juices, mixes food with juices, propels partially digested food (chyme)
Muscle layers: longitudinal, circular, oblique (maximizes churning
Parts: cardiac sphincter- opening to stomach, pyloric sphincter- opening to duodenum, plylorus- called antrum and is lower region, fundus- upper rounded region, body

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16
Q

What is chyme

A

Bolus of food mixed with digestive juices

Gradually squirted into the duodenum

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17
Q

What is the order of food traveling in GI tract?

A 
Mouth
Upper esophageal sphincter
Esophagus
Lower esophageal sphincter
Stomach (Fundus, body, antrum)
Pyloric sphincter
Small Intestine (Duodenum, Jejunum, Ileum)
Ileocecal valve
Large Intestine (cecum, ascending colon, transverse colon, descending colon, sigmoid colo, rectum, anus)
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18
Q

What gastric juices are secreted in the stomach?

Functions?

A

Mucus: help protect the stomach lining
HCl acid: converts pepsinogen to pepsin to denature proteins
Enzymes: pepsin is the major one, to digest proteins
Hormones: gastrin (regulates digestive juices) and ghrlein (tummy grumbles)
Intrinsic factor: binds to B12 and allows for absorption (not enough results in pernicious anemia)

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19
Q

What are the glands/ pits of the stomach?

A

Parietal cells: HCl acid (antimicrobial properties and denatures proteins) and intrinsic factor
Chief cells: do chief job (break down proteins) through pepsinogen
G cells: gastrin, ghrlein

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20
Q

What nerves innervate the stomach?

A 
Vagus nerve (X)--> gastrin--> histamine (increase inflammation)--> parietal cells--> HCl
Autonomic Nervous System
Parasympathetic Nervous System
Involuntary
Release gastric juices
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21
Q

What are the phases of gastric secretion in the stomach?

A

Cephalic phase: brain part, thinking about food and salivate, cognitive phase
Gastric phase: stomach part, chemical signal, chemoreceptors (smell and taste) due to food exposure, secrete saliva and gastric
Intestinal phase: food leaves the stomach and enters the intestine, decrease secretions, inhibition phase

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22
Q

How long is the small intestine?
What is the main job?
What are the segments?

A

5-6 meters long
Absorption
3 segments: duodenum (10-12 inches, secretions from pancrease, liver and gallbladder enter here, bicarb to stop acidic digestive juices), jejunum, ileum

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23
Q

What makes up the edges of the small intestine?

Functions?

A

Villi: increase surface area for absorption, have epithelial cells with microvilli on it
Microvilli: increase surface area for absorption, form brush border
Lacteal: drains fat away

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24
Q

What are the pancreatic enzymes?

Functions?

A

Amylase: carb digestion
Trypsinogen and Chymotrypsinogen: protein digestion
Lipase: fats/ lipids digestion
Nuclease: RNA/ DNA

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25
Where are bile salts made? | Stored?
Made in the liver | Stored in the gallbladder
26
What is absorbed in the intestines?
``` Carbohydrates Proteins Fats Water Electrolytes ```
27
What are the parts of the large intestine?
Cecum Appendix: hang off the cecum, immune function- microbial flora storage Colon (ascending, transverse, descending, sigmoid) Rectum Anus
28
What is the leading are for GI obstruction? Constipation? Colorectal cancer?
Sigmoid colon and rectum Obstruction leads to constipation Incidence of GI cancers highest in sigmoid and rectum and most fatal
29
Where are there high levels of intestinal bacteria? | Low levels?
Stomach: relatively sterile due to HCl acid Duodenum: low due to bile acid secretion, motility and antibody production Jejunum: low concentration of anerobes Distal to ileocecal valve: highest # in colon
30
What is the hepatic portal system?
Venous drainage system Highly nutrient rich deoxygenated blood into the liver and bad things Liver filters and detoxifies it before it enters the vena cava
31
What are the types of cells in the liver? | Functions?
Hepatocytes: filter cells Sinusoids: specialized capillaries Kupffer cells: macrophages
32
What is the common bile duct?
Drains the bile away from the liver
33
What is bile? Where is it produced? What is it formed by?
Bile is an alkaline, bitter-tasting yellowish green fluid containing bile salts (emulsify fats), cholesterol, bilirubin, electrolytes and water Bile is produced in liver (stored in gallbladder) Formed by hepatocytes and secreted into the bile cancaliculi
34
What are the functions of the liver?
Blood storage Bacterial and foreign particle removal Synthesizes plasma proteins/ clotting factors Produces bile Metabolizes fats, proteins, and carbs Detoxification of metabolic products/ wastes Storage of minerals and vitamins
35
What is the function of the gallbladder?
Store and concentrate bile between meals
36
What are the regions of the pancreas? | Function?
Exocrin region: hormones (digestive) Endocrin region: insulin and regulate blood sugar Secrete enzymes
37
What are the secretions of the pancreas?
``` Bicarb Zymogens (trypsinogen, chymotrypsinogen, procarboxypeptidase) Pancreatic amylase Pancreatic lipase Nucleases ```
38
What happens if zymogens are activated to early?
Once activated zymogens digest proteins | If activated to early they autodigest pancreas cells
39
What are symptoms of GI dysfunction?
Anorexia: lack of appetite Vomiting Nausea: most common symptom, subjective experience Retching: dry heaving, non productive vomiting Abdominal pain: non specific, referred pain, dull, achy pain Constipation: most often in sigmoid or rectum Diarrhea: increased frequency or increased volume, fluidity, weight of the feces GI bleeding
40
What are the types of diarrhea? | When do they occur?
Osmotic diarrhea: electrolyte change that draws fluid into diarrhea Secretory diarrhea: bacterial toxins in our intestinal lumen (food poisoning) Motility diarrhea: increased movement of food through GI tract decreasing absorption, increasing diarrhea, nerve or smooth muscle issue (caffeine)
41
What are the types of GI bleeds? Where are they located?
Upper gastrointestinal bleeding: esophagus, stomach, duodenum Lower gastrointestinal bleeding: jejunum, ileum, colon, rectum
42
What is hematemesis? | When does it occur?
Vomiting blood | Upper GI bleed
43
What is hematochezia? | Where does it occur?
Red bloody stools | Bleed in sigmoid or rectum
44
What is melena? | Where does it occur?
Black, tarry stools | Bleed in jejunum, ileum or first half of colon
45
What is dysphagia? | How do we get it?
Motility disorder, difficulty swallowing | Get it through achalasia, which is the loss of nervous control or function
46
What is gastroesophageal reflux?
GERD Reflux of chyme from stomach to esophagus If it causes esophagus inflammation= Reflux Exophagitis Cardiac sphincter insufficiency
47
What is a hiatal hernia? | Types?
Motility disorder Protrusion of upper portion of stomach through diaphragmatic hiatus into thorax Sliding Paraesophageal
48
What is a pyloric obstruction?
Motility disorder Blocking or narrowing of opening between stomach and duodenum Leads to violent vomiting soon after eating
49
What is dumping syndrome?
Motility disorder Rapid emptying of chyme from a surgically created residual stomach into the small intestine Pyloric insufficiency Clinical complication of partial gastrectomy or pyloroplasty surgery Inducing violent diarrhea
50
What is an intestinal obstruction?
Motility disorder Anything that prevents flow of chyme through the intestinal lumen or failure of normal intestinal motility Mechanical blockage= true intestinal obstruction
51
What is an ileus?
Motility disorder Obstruction of the intestines from folding, pinching, or lack of peristalsis An intestinal obstruction (not a mechanical blockage) ileus= bad blood flow= ischemia= necrosis
52
What is a peptic ulcer?
Peptic ulcer is an umbrella for all upper GI ulcers A break or ulceration in the protective mucosal lining of the lower esophagus, stomach (gastric ulcers) or duodenum When it erodes through mucosa and submucosa and hit muscle layer= true ulcer
53
What are the types of peptic ulcers?
Duodenal ulcers (most common) Gastric ulcers Stress ulcers
54
What are duodenal ulcers?
Most common peptic ulcer Small intestine Cause: Helicobacter pylori infection (#1) , hypersecretion of stomach acid and pepsin, use of NSAIDS (#2), acid production by cigarette smoking
55
What are gastric ulcers?
Stomach ulcers | Cause: overuse of NSAIDS (#1), helicobacter pylori infection (#2)
56
What are stress ulcers?
Peptic ulcer related to severe illness, neural injury or systemic stress/ trauma
57
What is maldigestion? | What does it lead to?
Failure of the chemical processes of digestion | Leads to malabsorption
58
What is malabsorption?
Failure of the intestinal mucosa to absorb digested nutrients
59
What is pancreatic insufficiency?
Insufficient pancreatic enzyme production | Causes: pancreatitis, pancreatic carcinoma, pancreatic resection, cystic fibrosis
60
What is lactase deficiency?
``` Lactose intolerant Inability to break down lactose Causes gas (cramping, pain, flatulence, etc), osmotic diarrhea ```
61
What is bile salt deficiency?
Can't emulsify fats or absorb fat soluble vitamins Can result from liver disease and bile obstructions Fatty stools, diarrhea, loss of fat- soluble vitamins (A, D, E, K)
62
What are the fat soluble vitamin deficiencies?
Vitamin A: night blindness, retinal cells Vitamin D: decreased calcium absorption, bone pain, osteoporosis, fractures Vitamin K: needed for clotting, prolonged prothrombin time, purpura, petechiae Vitamin E: regulates cell processes
63
What is gastritis?
Inflammation of stomach lining (gastric mucosa) Acute gastritis: consumption of NSAIDs or alcohol Chronic gastritis: infection (H. pylori)
64
What is ulcerative colitis?
Chronic inflammatory disease that causes ulceration of the colonic mucosa Large intestine May increase colon cancer risk
65
What is Crohn's disease?
Idiopathic inflammatory disorder Affects any part of digestive tract Causes skip lesions (regions of bad, skip regions of good), and cobblestone effect (because of deep ulcerations, look like cobblestone)
66
What is diverticular disease of the colon?
Diverticula: out pouching of colon wall, weakening of wall, herniations of mucosa through muscle layers of colon wall (sigmoid) Diverticulosis: having 1 or more diverticula, weakened wall Diverticulitis: inflammatory stage of diverticulosis, food particles enter and get stuck causing inflammation and infection
67
What is appendicitis?
Inflammation of the veriform appendix | Right lower quadrant with rebound tenderness (pain when release not press in)
68
What is irritable bowel syndrome?
``` Idiopathis No specific structural or biochemical alterations More common in women 20-40 year olds Increase diarrhea ```
69
What is obesity?
Increase in body fat mass BMI greater than 30 Apple: above waist Pear: below waist
70
What are eating disorders characterized by?
Abnormal eating behavior Weight regulation Disturbed attitudes about body weight, shape and size
71
What country has the highest eating disorder rate? | Lowest?
USA highest | Sweden lowest
72
What is anorexia nervosa?
Refuses to eat | Can lose 25-30% of ideal body weight as a result of fat/ muscle depletion
73
What is bulimia nervosa?
Body weight remains near normal Want weight loss Binge eating (2 episodes per week for 3 months) Self-induced vomiting Pitted teeth, pharyngeal and esophageal inflammation, tracheoesophageal fistulas, rectal bleeding
74
What is starvation? What is cachexia? Effects of it?
Decreased caloric intake Wasting away Short term: glycogenolysis, gluconeogenesis Long-term: marasmus (skin and bones), kwashiorkor (distended belly)
75
What is portal hypertension?
High BP in portal venous system caused by resistance to portal blood flow Intrahepatic Posthepatic
76
What are consequences of portal HTN?
Varices: back up venous blood, can lead to vein rupture and GI bleed Splenomegaly Ascites Hepatic encephalopathy
77
What is hepatic encephalopathy?
Neurologic syndrome of impaired cognitive function Rapid development during fulminant hepatitis Slow development during chronic liver disease
78
What is jaundice? | Types
Lack of bilirubin metabolism in liver Obstructive jaundice: posthepatic obstruction, intrahepatic obstruction Hemolytic jaundice: prehepatic jaundice, excessive hemolysis of RBCs or absorption of hematoma
79
What is viral hepatitis? | Types?
Systemic viral disease of acute or chronic inflammation that primarily affects liver A B C, D, E and G
80
How is Hepatitis A transmitted? | Risk factors?
fecal-oral transmission route Crowded, unsanitary conditions Food and water contamination
81
How is Hepatitis B transmitted? What can it cause? Treatment?
Transmitted through contact with infected blood, body fluids, contaminated needles Maternal transmission if infected during 3rd trimester Can cause chronic hepatitis Vaccine available
82
Hepatitis C?
Responsible for most cases of post transfusion hepatitis 50-80% of cases result in chronic hepatitis infections related to IV drug use
83
Hepatitis D?
Depends on hepatitis B for replication
84
Hepatitis E?
Fecal-oral transmission | Developing countries
85
Hepatitis G?
Recently discovered | Parentally and sexually transmitted
86
What is Cirrhosis? | Steps of it?
Irreversible inflammatory disease that disrupts liver function and even structure Biliary channels become obstructed and cause portal HTN 1. Alcoholism 2. Liver cirrhosis 3. Hepatic portal HTN 4. Esophageal varices--> hematoemisis (puking blood) 5. Acitis
87
What is cholecystitis?
Obstruction or inflammation of gallbladder | Most common cause of gallbladder problems
88
What is cholelithiasis?
Gallstone formation Cholesterol: most common Pigmented: cirrhosis
89
What is pancreatitis?
Inflammation of pancreas Caused by injury or damage to pancreatic cells and ducts Chronic pancreatitis is related to chronic alcohol abuse

Patho (17 decks)

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