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IDC Stuff > GI MARTIN > Flashcards

GI MARTIN Flashcards

1
Q

What are the two groups of organs in the digestive system?

A

GI tract/Alimentary canal
Acessory digestive organs

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2
Q

What group of digestive system organs is a continous tube that extends from the mouth to the anus?

A

GI Tract/Alimentary Canal
Mouth
Pharynx
esophagus
stomach
small intestine
large intestine

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3
Q

What group of organs make up the acessory digestive organs?

A

Teeth
tongue
salivary glands
liver
gallbladder
pancreas

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4
Q

The abdomen is divided into what regions?

A

Intrathoracic
True abdomen
Retroperitoneal

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5
Q

What organs are in the intrathoracic region?

A

Liver
Gallbladder
Spleen
Stomach
Transverse colon

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6
Q

What organs are in the true abdomen?

A

Small intestines
Large intestines
Liver (lower)
Bladder
Female: uterus, fallopian tubes and ovaries

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7
Q

What organs does the retroperitoneal abdomen contain?

A

Kidneys
Urters
Pancreas
Posterior Duodenum
Asc and Desc Colon
Inf Vena Cava

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8
Q

What region lies behind the throacic and true abdominal regions?

A

Retroperitoneal

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9
Q

What are the six basic functions of digestion?

A

Ingestion
Secretion
Mixing and propulsion
Digestion
Absorption
Defecation

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10
Q

What function of digestion involves taking in food and liquid through the mouth?

A

Ingestion

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11
Q

What GI function that produces water, acid, buffers and enzymes to aid in digestion?

A

Secretion

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12
Q

What is the mixing and propulsion basic function of the GI system?

A

Smooth muscle contraction and relaxation, perastalsis, moving food along the GI tract

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13
Q

What function is described as mechanical and chemical process that breaks down food?

A

Digestion

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14
Q

Which function takes small molecules from digestion and used by cells?

A

Absorption

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15
Q

Defecation is described as what?

A

elimination of materials not absorbed by our body ingestion

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16
Q

What are the layers of the GI tract?

A

Mucosa
Submucosa
Muscularis
Serosa

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17
Q

Which layer of the GI tract is the innermost lining and is in direct contact of substances passing through?

A

Mucosa

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18
Q

Which layer of the GI tract contains skeletal muscles and smooth muscles?

A

Muscularis

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19
Q

What layer of the GI tract is made up of areolar connective tissue that bind the mucosa to the muscularis and contains blood and lymph vessels which assist with food molecule absorbtion?

A

Submucosa

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20
Q

What are the two layers of the serosa?

A

Visceral peritoneum
Parietal peritoneum

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21
Q

Which layer of the serosa is the outermost layer around the organs of the GI tract??

A

Visceral

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22
Q

Which layer of the serous lines the walls of the abdominal cavity?

A

Parietal peritoneum

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23
Q

What are the other layers found in the visceral peritoneum?

A

Greater omentum
Mesentery

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24
Q

Which part of the visceral peritoneum is described as the fatty apron and drapes over the transverse colon and small intestine?

A

Greater omentum

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25
Q

Which part of the visceral peritoneum binds the small intestine to the posterior abdominal wall?

A

Mesentery

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26
Q

What are the three pairs of the salivary glands that aid the GI tract?

A

Parotid
Submandibular
Sublingual

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27
Q

What enzyme begins the digestion of starches in the mouth?

A

Salivary amylase

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28
Q

Mucous is produced by salivary glands to do what?

A

lubricate food

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29
Q

Retro organs/structures:
S
A
D
P
U
C
K
E
R

A

S- suprarenal (adrenal) glands
A- aorta/inferior vena cava
D- duodenum (posterior)
P- pancreas
U- ureters
C- colon (asc/desc)
K- kidneys
E- esophagus
R- rectum

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30
Q

What type of tissue is the esophagus lines with?

A

Stratified squamous epithelium

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31
Q

What are the two sphincters at the ends of the esophagus?

A

Upper esophageal sphincter (UES)
Lower esophageal sphincter (LES)

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32
Q

Which esophageal sphincter is voluntary controlled?

A

UES

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33
Q

Which esophageal is involuntary controlled and may contribute to GERD if not function properly?

A

LES

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34
Q

What are the phases of swallowing?

A

Voluntary
Pharyngeal
Esophageal

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35
Q

Which phase of swallowing is when food is forced into the oropharynx by the tongue?

A

Voluntary

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36
Q

Which phase of swallowing begins when the bolus (food or water) is in the oropharynx?

A

Pharyngeal

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37
Q

What phase of swallowing is occuring when the bolus moves past the UES into the esophagus?

A

Esophageal

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38
Q

How is food pushed through the esophagus?

A

peristalsis

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39
Q

What is the j-shaped organ that serves as a reservoir and mixing chamber?

A

Stomach

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40
Q

What is the PH enviroment in the stomach?

A

Acidic
PH of 2 (1.5-3.5)

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41
Q

What is the sphincter at the tip of the duodenum where the stomach extends?

A

pyloric sphincter

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42
Q

The stomach can accommodate what volume of food or liquid?

A

6.4 liters

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43
Q

What are the four main regions of the stomach?

A

Cardia
Fundus (helmet)
Body
Pylorus

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44
Q

Gastric glands secrete what types of exocrine gland cells that combine to make gastric juice?

A

Mucous neck cells
Chief cells
Parietal cells

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45
Q

What does mucous neck cells secrete?

A

Mucous

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46
Q

What do chief cells secrete?

A

Pepsinogen, inactive gastric enzyme

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47
Q

What do parietal cells produce?

A

Hydrochloric acid and intrinsic factor

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48
Q

What converts pepsinogen to pepsin?

A

hydrochloric acid (HCL) from parietal cells

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49
Q

What is secreted that is involved in the absorption of vitamin B12?

A

Intrinsic factor

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50
Q

What cells secrete the hormone gastrin into the blood stream?

A

G cells

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51
Q

What is the major hormonal regulator of HCL secretion?

A

Gastrin

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52
Q

What is the term of the thick liquid in the stomach that is made up of gastric juices and macerated food particles?

A

Chyme

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53
Q

What organ in the digestion process has endocrine and exocrine function?

A

Pancreas

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54
Q

What are the specialized areas in the pancreas that contains alpha, beta and delta cells?

A

islets of Langerhans

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55
Q

What is the most common cell in the islets of Langerhans?

A

Beta Cells

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56
Q

What do beta cells produce?

A

Insulin

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57
Q

What is the hormone that is produced by alpha cells?

A

Glucagon

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58
Q

What is glucagon’s role in the body?

A

Prevent blood glucose levels from dropping too low

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59
Q

What ducts does pancreatic juice go through and combine with to form the hepatopancreatic duct?

A

pancreatic duct
common bile duct

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60
Q

What sphincter does the common bile duct pass through to the duodenum?

A

Sphincter of Oddi

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61
Q

What is the clear, colorless liquid that is made up of enzymes with a pH of 7.1-8.2 and contains mostly water, salts and sodium bicarbonate?

A

Pancreatic juice

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62
Q

What enzymes are located in pancreatic juice?

A

Trypsin
Chymotrypsin
Pancreatic amylase
Pancreatic lipase
Ribonuclease

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63
Q

Trypsin and chymotrypsin are responsible for what?

A

Protein digestion

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64
Q

Proteins are broken down into what by trypsin and chymotrypsin?

A

amino acids, dipeptides and tripeptides

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65
Q

Pancreatic amylase digests what?

A

Starches or carbohydrates

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66
Q

Carbs are broken down into what by pancreatic amylase?

A

monosaccharides

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67
Q

Pancreatic lipase is responsible for digestion of what?

A

Triglycerides or fat

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68
Q

Fats are broken down by pancreatic lipase into what?

A

monoglycerides and fatty acids

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69
Q

Ribonuclease digest what?

A

nucleic acid

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70
Q

What is the second largest organ in the body below the diaphragm?

A

Liver

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71
Q

The liver is responsible for what?

A

Carbohydrate metabolism
Lipid metabolism
Protein metabolism
Process drugs and hormones
Excrete bilirubin
Store vitamins and minerals
Activate vitamin d

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72
Q

What in the liver is responsible for metabolic, secretory and endocrine functions?

A

Hepatocytes

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73
Q

What is the chemical responsible for the brown color of human feces?

A

stercobilin

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74
Q

What is the pear-shaped sac that hands from the inferior margin of the liver?

A

Gallbladder

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75
Q

What is the function of the gallbladder?

A

stores bile
aids in chemical digestion

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76
Q

The left and right hepatic ducts transfer bile and waste into what structure?

A

common hepatic duct

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77
Q

The cystic duct transfer bile from the gallbladder and joins the common hepatic duct to form what structure?

A

common bile duct

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78
Q

The common bile duct and the pancreatic duct combine to form what structure?

A

hepatopancreatic duct

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79
Q

the hepatopancreatic duct passes through the sphincter of Oddi into what structure?

A

duodenum

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80
Q

The small intestinal glands contain what 3 types of endocrine cells?

A

S
CCK
K

81
Q

What do S cells secrete that stimulates secretion of pancreatic juice?

A

Secretin

82
Q

What do CCK cells secrete?

A

Cholecystokinin

83
Q

Cholecystokinin does what?

A

regulates gastric emptying
stimulates bile and pancreatic juice secretion
relaxation of the sphincter of oddi
feeling of satiety (feeling full to satisfaction)

84
Q

What is secreted by K cells that stimulates the release of insulin?

A

Glucose-dependent insulinotropic peptide (GIP)

85
Q

What are three segments of the small intestine?

A

Duodenum
Jejunum
Illeum

86
Q

What is the landmark located on the duodenum that demarcates upper and lower GI in relation to bleeds?

A

ligament of trietz

87
Q

What does the duodenum attach to?

A

pyloric sphincter of the stomach

88
Q

What is the middle section of the small intestine that primary function is the absorption of sugars, amino acids and fatty acids?

A

Jejunum

89
Q

What segment of the small intestine attaches to the large intestine via the ilececal sphincter and absorbs the remaining nutrients, B12 and bile salts?

A

Ileum

90
Q

Where are bile salts recycled from the ileum to for reuse?

A

Liver and gallbladder

91
Q

What are the two types of digestion

A

Mechanical
Chemical

92
Q

Mechanical digestion consist of what?

A

segmentation and peristalsis

93
Q

Chemical digestion is performed via what?

A

Pancreatic enzymes, bile and intestinal juice

94
Q

Absorption of nutrients into their simplest form is done by what?

A

microvilli and villi of GI Tract

95
Q

What is the last part of the GI tract?

A

Large intestine

96
Q

What are the four regions of the large intestine?

A

Cecum
Colon
Rectum
Anal canal

97
Q

What is the first segment of the large intestine where the appendix attaches?

A

Cecum

98
Q

What region is broken down into ascending, transverse, descending and sigmoid portions?

A

Colon

99
Q

What region of the large intestine connects the sigmoid colon to the anus?

A

Rectum

100
Q

What is the last 2-3 cm of the rectum which consists of internal and external sphincters?

A

Anal canal

101
Q

Which anal canal sphincter is voluntarily controlled?

A

External

102
Q

What are the three phases of digestion?

A

Cephalic
Gastric
Intestinal

103
Q

What phase of digestion involves the smell, sight and sound or thought of food that activates neural centers in the brain to stimulate salivary glands and gastric glands?

A

Cephalic

104
Q

What phase of digestion starts when food enters the stomach?

A

Gastric

105
Q

What is released when food enters the stomach during the gastric phase?

A

Gastrin

106
Q

What does gastrin do when it is secreted?

A

Promotes the release of gastric juice
Relaxes the pyloric sphincter
Promotes gastric emptying

107
Q

What phase of digestion starts when food enters the small intestine?

A

Intestinal

108
Q

What occurs during the intestinal phase of digestion?

A

Gastric emptying is slowed and pancreatic juices are secreted for absorption and digestion

109
Q

What topics should be focused on during the HPI?

A

Abdominal Pain
Indigestion
Nausea and vomiting
Diarrhea
Constipation
Fecal incontinence
Jaundice
Dysuria
Urinary frequency or incontinence
Hematurua
Past medical or surgical history
Family history
Personal and social history

110
Q

Persistent pencil like stool may indicate what?

A

Stenosis from scarring or malignancy

111
Q

LIght tan/gray stools means what?

A

Obstructive jaundice

112
Q

Tarry black stool indicates what?

A

Upper GI bleed

113
Q

Bright red blood in stool indicates what?

A

Lower GI bleed

114
Q

What are the two classifications of diarrhea?

A

Acute
Chronic

115
Q

Diarrhea <2 weeks is commonly caused by what?

A

infectious agents
bacterial toxins

116
Q

What is the prime absorptive surface for the GI Tract?

A

small intestine

117
Q

Acute gastroenteritis is usually caused by what?

A

Infectious agents

118
Q

Chronic diarrheal illness are classified as?

A

Osmotic
Inflammatory
Secretory
Chronic infection
Malabsorption
Motility disorders

119
Q

Osmotic chronic diarrheal illness are from what?

A

increase in osmotic load by excessive intake or diminished absorption

120
Q

What are some examples that can cause osmotic chronic diarrheal illness?

A

Medications
Zollinger-Ellison Syndrome

121
Q

What chronic diarrheal illness is present when the mucousal lining of the intestine is inflammed?

A

inflammatory

122
Q

What are some examples of causes for inflammatory diarrheal illnesses?

A

Inflammatory bowel disease
malignancy

123
Q

Secretory chronic diarrheal illness occur due to what?

A

increased secretory activity occurs

124
Q

What is an example of a chronic infections and parasite that can cause chronic diarrhea?

A

Giardia Lamblia

125
Q

What are examples of malabsorption syndromes that can cause chronic diarrheal illness?

A

Celiac disease
Whipple
Crohn disease
Lactose intolerance

126
Q

What is an example of a motility disorder than can cause chronic diarrheal illness?

A

Irritable bowel syndrome

127
Q

Acute infectious diarrhea can be classified into what two types?

A

inflammatory and non inflammatory

128
Q

Inflammatory acute infectious diarrhea will have what symptoms that are not present in non-inflammatory diarrhea?

A

Bloody diarrhea

129
Q

Inflammatory diarrhea suggest colonic involvement by what?

A

invasive bacteria
parasites
toxin production

130
Q

What are the typical complaints of an infectious inflammatory diarrhea patient?

A

bloody, small-volume stools
fever
abdominal cramps
tenesmus
fecal urgency

131
Q

What are common causes of inflammatory diarrhea?

A

shigella
salmonella
Escherichia coli
E coli O157:H7

132
Q

acute non inflammatory diarrhea is generally milder and caused by virus or toxins that interfere with what?

A

salt and water balance

133
Q

What are common causes of acute non inflammatory diarrhea?

A

Virus
- rotavirus
- norwalk virus
- vibrions
Enterotoxin-producing e. coli
food borne agents
Protozoal

134
Q

A toxin that has a short incubation period, 1 -6 hrs post consumption, is usually

A

preformed

135
Q

What conditions warrant evacuation for a patient with diarrhea?

A

Signs of inflammatory diarrhea
-fever
-bloody
-abdominal pain
Six or more unformed stools in 24 hrs
Profuse water diarrhea or s/s of dehydration

136
Q

Peritoneal findings for a patient with diarrhea may be present in what conditions?

A

C difficile
enterohemorrhagic E coli.

137
Q

When is hospitalization required for a diarrhea patient?

A

Severe dehydration
toxicity
marked abdominal pain

138
Q

Treatment for diarrhea includes?

A

Rehydration
Diet
Antidiarrheal Agents

139
Q

What are examples of antidiarrheal agents?

A

Loperamide
Bismuth Subsalicylate
Empiric Antibiotic therapy

140
Q

What is the condition in which there is histologic evidence of inflammation of the epithelial or endothelial of the stomach?

A

Gastritis

141
Q

What are the three categories of gastritis?

A

Erosive and hemorrhagic
Nonerosive and nonspecific
Specific types?

142
Q

Erosive and hemorrhagic gastritis or gastopathy are typically diagnosed how?

A

Endoscopy

143
Q

Erosive and hemorrhagic gastritis is commonly found in what patients?

A

Alcoholics
Critically Ill
NSAID users

144
Q

Erosive and hemorrhagic gastritis presents asymptomatically but may cause what sxs?

A

epigastric pain
Nausea
Vomiting
Hematemesis (usually nonspecific)

145
Q

Treatment of erosive or hemorrhagic gastritis includes what? NSAID? Alcohol?

A

NSAID
-d/c, reduce or give with meals
-PPI 2-4 weeks

Alcohol
-d/c alcohol
-H2 receptor antagonist, PPI

146
Q

What is the most common digestive complaint in the US?

A

Constipation

147
Q

What are some multifactorial causes of constipation?

A

Decreased fiber and fluid intake
Systemic disease
Medications
Structural abnormalities
Slow colonic transit
IBS
Hirschsprung disease

148
Q

What are some systemic diseases that can cause constipation?

A

hypothyroidism
hyperparathyroidism
diabetes
chronic neurologic disorders

149
Q

What medications may cause constipation?

A

Calcium channel blockers
iron
narcotic analgesics
antipsychotics

150
Q

What are some structural abnormalities that can cause constipation?

A

Colonic mass w/ obstruction
Neoplasm (adenocarcinoma)
Anal fissure

151
Q

Slow colonic transit is often found in what patients?

A

chronic laxative abuse
psychogenic or idiopathic

152
Q

Symptoms of constipation include what?

A

Infrequent stool
excessive straining
sense of incomplete evacuation
need for digital manipulation

153
Q

What type of imaging would you want for a patient complaining of constipation?

A

upright chest
abdominal flat and erect

154
Q

What are the lines of treatment for a constipation patient?

A

1st-lifestyle
2nd-stool softening or laxative
3rd-suppositories or enema
4th-fecal disimpaction

155
Q

What lifestyle changes would you make for someone with constipation?

A

increase water
increase fiber
strict dietary changes
exercise regimen

156
Q

Fiber supplementation generally takes how long to become effective?

A

7-10 days

157
Q

What emollient is used for constipation?

A

Docusate sodium 100mg BID

158
Q

What stimulant is used for constipation?

A

Bisacodyl 5-15mg QD or 10 PR TID

159
Q

What are the saline laxatives used for constipation?

A

Magnesium hydroxide 15-30ml QD
Magnesium citrate 100-300ml QD-BID

160
Q

What suppository may be given for constipation?

A

glycerin PR QD

161
Q

Complicated or chronic cases of constipation should have what disposition?

A

Refer to gastroenterologist

162
Q

What are the two types of hemorrhoids?

A

Internal
External

163
Q

Hemorrhoids located above the dentate line are what?

A

Internal hemorrhoids

164
Q

Which type of hemorrhoid has nervous innervation?

A

External hemorrhoids

165
Q

What contributes to a water tight closure of the anal canal and are present universally unless a previous intervention has taken place?

A

Hemorrhoidal venous cushions

166
Q

What are the common locations for internal hemorrhoids to occur?

A

right anterior
right posterior
left lateral

167
Q

What causes hemorrhoids?

A

Straining
constipation
prolonged sitting
pregnancy
obesity
low fiber diets

168
Q

Thrombosis of the external hemorrhoidal plexus results in what?

A

perianal hematoma

169
Q

What type of pain is common with external hemorrhoid?

A

most severe within the first few hours but gradually eases over 2-3 days as edema subsides

170
Q

How many stages of internal hemorrhoids are there?

A

Four

171
Q

What are the four stages of internal hemorrhoids?

A

Stage I - confined to the anal canal
Stage II - gradually enlarged, may protrude from canal, reduces spontaneously
Stage III - Prolapsed, may require manual reduction post BM
Stage IV - Chronically protruding, unresponsive to manual reduction

172
Q

What imaging would you get on a patient with hemorrhoids?

A

Colonoscopy for disease or sigmoid colon misinterpretation if bleeding is noted

173
Q

What is the treatment of hemorrhoids?

A

Warm sitz bath
Analgesic and oinments
I&D hematoma
Lifestyle changes S-I and S-II

174
Q

What is the definitive treatment of internal hemorrhoids?

A

surgical banding

175
Q

What are anal fissures?

A

linear or rocket shaped ulcers usually <5mm in length

176
Q

Anal fissures most commonly occur where?

A

posterior midline, 10% anteriorly

177
Q

An anal fissure off of the midline may indicate what?

A

Serious disease or sexual assault

178
Q

What are some chief complaints of a patient with anal fissures?

A

Severe, tearing pain during defecation followed by throbbing discomfort

179
Q

What is the treatment plan for anal fissures?

A

Fiber
Sitz baths
Topical anesthetics
Oral analgesics
topical nitroglycerin/diltiazem/Botox (chronic)

180
Q

What are the spaces where an anorectal abscess may form?

A

Perianal
intersphincteric space
ischiorectal space
deep post anal space
supralevator or pelvirectal space

181
Q

What is the most common location for an anorectal abscess?

A

perianal

182
Q

What is the least occurring location for an anorectal abscess?

A

supralevator

183
Q

What may form in addition to an anorectal abscess as a common chronic sequela?

A

Fistula

184
Q

What is the symptoms described by patients with anorectal abscess?

A

pain becomes worse immediately before BM, lessened after BM and persists between BM

185
Q

Which abscess are easily palpable and are usually not accompanied by fever, leukocytosis and sepsis?

A

perianal abscess

186
Q

What type of incision is recommended for a perianal abscess to prevent premature closure?

A

cruciate or elliptical

187
Q

Broad spectrum antibiotics are given to anorectal abscess that have what symptoms?

A

fever
leukocytosis
valvular heart disease
cellulitis

188
Q

What is the chronic manifestation of the acute perirectal process that forms an anal abscess?

A

anorectal fistula

189
Q

What are the causes of a pilonidal abscess?

A

hair containing cysts
sinuses
staphylococcus aureas through ingrown hair

190
Q

H pylori gastritis may be treated with what?

A

Triple or quadruple drug regimen BID x 2 weeks

191
Q

What is the triple or quadruple drug regimen for H pylori gastritis?

A

PPI, AMOX, clarithromycin
PPI, Levofloxacin, AMOX

Metronidazole for AMOX if PCN allergy exists

192
Q

What are the two types of inflammatory bowel disease?

A

Ulcerative colitis
Crohn’s disease

193
Q

What type of IBD is limited to the colonic mucosa?

A

Ulcerative colitis

194
Q

Which type of IBD can affect any segment of the GI tract from mouth to anus and has transmural inflammation??

A

Crohn’s disease

195
Q

What are extra-intestinal manifestations of crohn’s and UC?

A

Erythema nodosum, pyoderma gangrenosum, thromboembolic events

196
Q

What is a extra-intestinal manifestation of only crohn’s disease?

A

Oral ulcers, anorectal disease

197
Q

what are extra-intestinal manifestations of UC only?

A

peripheral arthritis, spondylitis, episcleritis, uveitis, hepatitis and sclerosing cholangitis

198
Q

What is the most common portion of the GI tract affected by Crohn’s

A

terminal ilium

IDC Stuff (67 decks)

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