GI part 1

Question 1

what are the 4 functions of the GI system?

Answer 1

Motility
Secretion
Digestion
Absorption

Question 2

common GI referral regions (SSSS MLHP)

Answer 2

Sternal area
Shoulder and neck
Scapular area
Sacrum
Midback
Lower back
Hip
Pelvis

Question 3

what are the 2 most common GI diseases that mimic MSK complaints?

Answer 3

Ulceration or infection of the mucosal lining

Question 4

Drug-induced GI disease can manifest up to ____ weeks after exposure

Answer 4

6-8

Question 5

what are the 3 most common drug-induced GI conditions?

Answer 5

-Antibiotic colitis
-Nausea, vomiting, and anorexia from digitalis toxicity
-NSAID-induced ulcers

Question 6

what is considered the Epigastric region, and what is its sympathetic nerve distribution?

Answer 6

-Anywhere from mid-sternum → xiphoid process
-T3-T5

Question 7

what is the nerve distribution of the periumbilical region?

Answer 7

T9-T11

Question 8

pain in the hypogastrium coming from the colon can be mistaken for what?

Answer 8

bladder or uterine pain

Question 9

what side of the hypogastrium do the ascending/descending colon refer pain to?

Answer 9

-Ascending colon: R side
-Descending colon: L side

Question 10

Large intestine/colon innervation

Answer 10

T10-T12

Question 11

T/F: pts with visceral pain have difficulty finding a comfortable position

Answer 11

true!

Question 12

are pts with inflammatory pain able to find a comfy position?

Answer 12

yes, they tend to seek a “quiet position” (sitting/lying with knees bent or in a curled up/fetal position) without movement

Question 13

ischemic pain is secondary to ____ or ____ causing strangulation of bowel tissue

Answer 13

-vascular disease
-obstruction

Question 14

T/F: ischemic pain can be relieved by analgesics

Answer 14

false! it cannot

Question 15

Afferent nerves from liver, resp diaphragm, and pericardium are inn by ____ and refer pain to ____

Answer 15

C3-C5; shoulder

Question 16

Afferent nerves from gallbladder, stomach, pancreas, and SI are inn by ____ and refer pain to ____

Answer 16

T6-T9; midback and scapular area

Question 17

Afferent nerves from colon, appendix and pelvic viscera are inn by ____

Answer 17

T10-T11

Question 18

Afferent nerves from sigmoid colon, rectum, ureters, and testes are inn by ____ and ____. They refer pain to what 4 areas?

Answer 18

-T11-L1 (lower splanchnic n.) AND S2-S4 (pelvic splanchnic n.)
-Refer to pelvis, flank, low back, or sacrum

Question 19

Dysfunction of what 5 organs can cause contraction, guarding, and splinting of rectus abdominis and muscles SUPERIOR to the umbilicus?

Answer 19

stomach, gallbladder, liver, pylorus, or resp diaphragm

Question 20

Dysfunction of what 6 structures can cause muscle spasm of rectus abdominis INFERIOR to the umbilicus?

Answer 20

ileum, jejunum, appendix, cecum, colon, and rectum

Question 21

Causes of dysphagia (“Ned said Not All Pepsi Cans are Garbage”)

Answer 21

Neoplasm
Non-GI conditions (ex. Neuro diseases)
Achalasia (esophagus muscles can’t relax)
Peptic esophagitis
Certain antidepressants, antipsychotics, antihypertensives, and asthma drugs
GERD

Question 22

what do you suspect if pain begins within 30-90 min after eating?

Answer 22

gastric ulcers

Question 23

what do you suspect if pain occurs 2-4h after meals or food relieves symptoms?

Answer 23

duodenal or pyloric ulcers

Question 24

what do you suspect with night pain btw midnight-3:00 am?

Answer 24

duodenal ulcer or cancer-related pain

Question 25

potential causes of early satiety (GOS POC)

Answer 25

Gastroparesis
Obstruction
Stomach cancer
PUD
Other tumors
Compression fx that results in severe back pain and deformity

Question 26

what is Kehr’s sign?

Answer 26

L shoulder pain provoked with pressure placed on upper abdomen

Question 27

what is the Danforth sign?

Answer 27

L shoulder pain with inspiration

Question 28

atypical symptoms of GERD (COW WAS DAS)

Answer 28

Chest pain unrelated to activity
Odynophagia
Weight loss
Wheezing, coughing, hoarseness
Anemia
Sensation of lump in the throat
Dysphagia
Asthma
Sore throat, laryngitis