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Chronic Rehab > GI Part 1 > Flashcards

GI Part 1 Flashcards

1
Q

innermost, thin layer of smooth muscle and exocrine cell

A

mucosa

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2
Q

connective tissue in GI tract

A

submucosa

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3
Q

smooth muscle in GI tract

A

muscularis

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4
Q

outermost, connective tissue in GI tract

A

serosa

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5
Q

Hollow muscular tube, lumen surrounded by 4 major tissue layers

A

GI tract

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6
Q

function of the GI tract

A

secretion, digestion, absorption, motility, elimination

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7
Q

function of GI tract in order of how food goes into body

A

ingestion, mechanical digestion, propulsion, chemical digestion, absorption, defecation

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8
Q

by myenteric plexus in smooth muscle and submucosa plexus in inner layer nerve plexuses runs length of GI tract

A

intrinsic stimulation

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9
Q

Parasympathetic stimulation by vagus nerve, connects with intrinsic system

A

autonomic system

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10
Q

stimulates motor and secretory activity and relaxes sphincters (CN X)

A

vagus

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11
Q

thoracic and lumbar splanchnic nerves slows movement, inhibits secretions and contracts sphincters

A

sympathetic system

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12
Q

function of mouth

A

Mastication, taste, begin movement
Glands produce 1 L of saliva/day
Saliva contains mucin and salivary amylase with begins to break down CHO

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13
Q

food is softened, made into a “bolus” and tongue moves to the back of the mouth

A

Oral preparatory phase

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14
Q

tongue presses bolus against hard palate, elevates the larynx and forces the food bolus to the pharynx, triggering swallowing

A

oral phase

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15
Q

soft palate elevates and seals nasal cavity, inhibits respirations and allows esophagus to open

A

pharyngeal phase

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16
Q

is when bolus enter at cricopharyngeal juncture, peristalsis now takes food to the stomach

A

esophageal phase

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17
Q

how long do all the mouth phases together take

A

10 seconds

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18
Q

what is the order of the oral stages

A

oral preparatory phase, oral phase, pharyngeal phase, esophageal phase

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19
Q

Canal about 10 in long, passes through the center of the diaphragm

A

esophagus

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20
Q

at rest it is closed to prevent air from entering the esophagus

A

upper esophageal sphincter

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21
Q

it sits at the gastroesophageal junction, at rest it is closed to prevent reflux of gastric contents, this is where GERD occurs

A

lower esophageal sphincter

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22
Q

function of esophagus

A

to propel food and fluids and prevent reflux

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23
Q

Digestive and endocrine organ, in midline and LUQ

A

stomach

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24
Q

what are the regions of the stomach

A

cardia, fundus, body, antrum

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25
Q

narrow part that is distal to the gastroesophageal junction (stomach)

A

cardia

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26
Q

left above the GE junction (stomach)

A

fundus

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27
Q

corpus- largest area (stomach)

A

body

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28
Q

pylorus, is the distal portion and is separated from the duodenum by the pyloric sphincter, prevents backflow from the duodenum (stomach)

A

antrum

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29
Q

what is the surface of the stomach covered by

A

is covered in rugae or folds and have smooth muscle for motility

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30
Q

what type of nerves does the stomach have

A

extrinsic and intrinsic

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31
Q

function of parietal cells in stomach

A

secrete HCL acid and intrinsic factor, which absorbs B 12, without it, what anemia can occur?

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32
Q

function of chief cells in stomach

A

secrete Pepsinogenpepsin

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33
Q

sight, smell and taste of food, regulated by vagus, begin secretory and contractile activity

A

Cephalic phase

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34
Q

G cells in the antrum secrete gastrin, which causes HCL and pepsinogen to be released. HCL changes pepsinogen to pepsin, which digest proteins. Mucous and Bicarb are secreted to protect the stomach wall

A

Gastric phase

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35
Q

chyme produced empties into the duodenum and causes distention, this produces secretin, which stops the acid production and gastric motility

A

intestinal phase

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36
Q

Longest portion of the GI tract, 16-19 ft..

Made up of 3 sections

A

small intestine

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37
Q

what are the 3 parts of the small intestine

A

duodenum, jejunum, ileum

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38
Q

first 12” and is attached to the pylorus. The CBD and pancreatic duct join to form the ampulla of Vater (hepatopancreatic ampulla) and empty into the duodenum at the duodenal papilla. This surrounded by a muscle, called the Sphincter of Oddi

A

duodenum

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39
Q

middle 8 ft. portion

A

jejunum

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40
Q

last 8-12 ft..

A

ileum

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41
Q

what is the inner lining of the small intestine made up of

A

is made up of intestinal villi and folds of mucosa and submucosa for digestion.

42
Q

what are the main functions of the small intestine

A

movement, digestion, absorption

43
Q

describe movement of small intestine

A

mixing and peristalsis

Moves chyme by segmental contractions and mixes with enzymes

44
Q

describe digestion of small intestine

A

enzymes produced by the intestinal cells make:
Enterokinase, peptidases, lactase, maltase and sucrose
Help to digest, CHO, proteins and lipids

45
Q

describe absorption

A

absorbs most of the nutrients from food, takes 3-10 hours for the contents to pass through

46
Q

what is the major organ for absorption

A

small intestine

47
Q

describe the cross section of the small intestine

A

Velvety appearance
Due to mucous fingerlike projections-intestinal Villi
Folds of mucosa and submucosa

48
Q

what are the three sections of the large intestine

A

cecum, colon, rectum

49
Q

is the beginning, dilated pouch like structure, appendix is attached to the base (large intestine)

A

cecum

50
Q

what are the 4 sections of the colon

A

Ascending, transverse, descending and sigmoid

51
Q

last 6-8” to the sphincter muscles and anus

A

rectum

52
Q

what is the function of the large intestine

A

movement, absorption, elimination

53
Q

segmental contractions, to allow time for the water and electrolytes to be absorbed

A

movement

54
Q

possible cause of bowel retention

A

Ignoring the “urge to go” or decreased peristalsis

55
Q

Leads to retention of stool in the rectum

A

Stool dries and hardens
Constipation
Impaction

56
Q

how do you prevent bowel retention

A

Hydration, Adequate dietary fiber, Regular toileting practices, Regular exercise, Avoidance of environmental contamination

57
Q

what to look for in family history of GI

A

GI disorders, cancer

58
Q

what to look for in personal history of GI

A

G I surgeries, RX & OTC meds, travel

59
Q

what to look for in diet history of GI

A

anorexia, dyspepsia, Food allergies, eating habits, alcohol, caffeine

60
Q

what to look for in health history of GI

A

N/V, diarrhea, constipation, # and color of stools, change in wt. or appetite

61
Q

how to assess abdominal pain

A 
P- precipitating
Q-quality- how intense, severe, type
R-region or radiation
S- severity scale- 0-10
T-timing- when did it first occur, duration and frequency
62
Q

what is decreased in malabsorption

A

Ca

63
Q

decreased with vomiting, diarrhea

A

K

64
Q

decreased indicates possible malabsorption in the small intestine

A

D-Xylose absorption

65
Q

increased with Crohn’s disease and malabsorption

A

stool for fecal fat

66
Q

used to monitor for cancer in the GI tract

A

Oncofetal antigens- CA19-9 and CEA

67
Q

increased with Crohn’s disease and malabsorption

A

stool for fecal fat

68
Q

pharynx to duodenojejunal junction, barium swallow and SBFT

A

Upper GI and small bowel-

69
Q

how do barium swallows in upper GI and SBFT work

A

NPO 8 hours before, drink barium, then lie, stand and turn in multiple directions to view movement of barium
SBFT- drink more barium and view passage
After drink fluids to pass barium

70
Q

Large intestine, done for obstructions, masses, not done is perforated colon or fistulas

A

barium enema

71
Q

how do you prepare for a barium enema

A

Only clear liquids for 12-24 hours prior, NPO, given bowel prep like Golytely

72
Q

large bowel, take biopsies and remove polyps, have a bowel prep prior, given versed and fentanyl prior

A

colonoscopy

73
Q

now done to visualize, apply a data recorder to the abdomen and the patient swallows the capsule

A

capsule enteroscopy

74
Q

like colonoscopy, only a rigid tube, less invasive and does not require the cleansing of the colonoscopy

A

Proctosigmoidoscopy

75
Q

what does GERD cause

A

causes esophageal mucosa to be irritated by the effects of gastric and duodenal contents, results in inflammation

76
Q

what does GERD stand for

A

gastroesophageal reflux disease

77
Q

what can lead to GERD

A

Inappropriate relaxation of the LES, sphincter tone is decreased
Irritation from refluxed material
Delayed gastric emptying, gastric volume or intra-abdominal pressure is increased
Abnormal esophageal clearance

78
Q

Factors contributing to decreased lower esophageal sphincter pressure

A

Fatty foods, Caffeinated beverages, Chocolate, Nicotine, Calcium channel blockers, Nitrates, Peppermint, Alcohol, Anticholinergic drugs, High levels of estrogen and progesterone, NG tube placement

79
Q

Refluxed material has a pH of

A

1.5-2

80
Q

esophagus normally has a pH of

A

6-8

81
Q

what cause tissue injury in the esophagus

A

gastric acid and pepsin

82
Q

thicker, but can be cancerous, can also cause hemorrhage, aspiration pneumonia, asthma, laryngitis and dental deterioration.

A

Barrett’s epithelium-

83
Q

heartburn, substernal or retrosternal burning that moves up and down in wavelike fashion, pain may radiate to neck or jaw or back, worsens when bends over, strains or lies on their back, occurs after meals and last 1-2 hours, helped by fluids and staying upright

A

dyspepsia

84
Q

food entering throat without nausea, watch for cough, hoarseness or wheezing

A

regurgitation

85
Q

water brash in response to reflux, fluid without sour or bitter taste

A

hypersalivation

86
Q

physical manifestations of GERD

A

dyspepsia, regurgitation, hypersalivation, dysphagia

87
Q

difficulty or painful swallowing, esophagus may be narrowed by inflammation or tumor, odynophagia-

A

dysphagia

88
Q

24 hour ambulatory pH monitoring- pass a small tube into esophagus and monitor pH levels

A

endoscopy

89
Q

foods that decrease LES pressure

A

chocolate, fat and mints. Also, smoking and alcohol decrease

90
Q

foods that increase gastric pressure

A

Carbonated foods

91
Q

what are the three nursing diagnoses with GERD

A

Impaired Nutrition, Acute Pain r/t irritation of the esophagus, Risk for aspiration r/t reflux of gastric contents

92
Q

what is the goal of drug therapy with GERD

A

Goal is to inhibit gastric acid secretion, accelerate gastric emptying and protect the gastric mucosa

93
Q

Elevate the pH and deactivate pepsin, good for heartburn, take 1 hour before and 2-3 hr after a meal

A

antacids

94
Q

name two antacids

A

maalox, mylanta

95
Q

Decrease acid, help promote healing of the esophagus

A

histamine receptor antagonists

96
Q

common histamine receptor antagonists

A

pepcid, zantic, tagment

97
Q

Main treatment for GERD, long acting inhibition of gastric acid secretions by inhibiting proton pump of parietal cell, can reduce by 90%/ day

A

proton pump inhibitor

98
Q

common proton pump inhibitors

A

prilosec, prevacid, aciphex, nexium, protonix

99
Q

other medications that lower LES pressure

A

oral contraceptives, anticholinergics, sedative, tranquilizers, B-adrenergic agonists, nitrates and Ca channel blockers

100
Q

for emptying and peristalsis- metoclopramide (Reglan)

A

prokinetic drugs

Chronic Rehab (18 decks)

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