GI Part One

Question 1

Adult teeth

Answer 1

32 teeth

Question 2

Esophagus

Answer 2

Muscular canal that passes from the larynx(throat) to the stomach and passes through the center of the diaphragm.

Primary function: move foods and fluids to stomach

Question 3

Upper esophageal sphincter

Answer 3

When at rest the UES presents airflow into the esophagus(to the stomach) during respirations

Question 4

Lower esophageal sphincter

Answer 4

“Cardiac sphincter”

When at rest the LES prevents reflux of gastric contents into the esophagus

If the LES does not work properly GERD can develop

Question 5

Parietal cells

Answer 5

Parietal cells line the stomach wall and secrete HCL acid(breaks down food kills bacteria)

Question 6

Intrinsic factor

Answer 6

Parietal cells also produce intrinsic factor a substance that AIDS in absorption of vitamin B12

Absence of intrinsic factor can cause pernicious anemia

Question 7

Chime

Answer 7

Slur of food and acids

Question 8

Pyloric sphincter

Answer 8

At distal end of stomach that separates it from small intestine

Opens to allow chyme to move into small intestine to allow start of absorption process

Question 9

Small intestine

Answer 9

16-19 feet long
Duodenum-12”(has sphincter of oddi portion)
Jejunum8-12’
Ileum8’

Three functions: movement,absorption, digestion

Question 10

Sphincter of oddi

Answer 10

Links vater duct which is where common bile duct and pancreatic duct combine.

Digestives enzymes enter the small intestines here. In the duodenum.

Question 11

Large intestine(colon)

Answer 11

5-6 feet
Cecum: meets at cecum(ileocecal valve)cecum is where appendix is located.
Ascending Colon(right side)
Transverse colon
Descending colon
Sigmoid colon

Question 12

Bacteria in large intestine

Answer 12

Homes millions of good bacteria

These bacteria break down some carbohydrates.

Children use for immune system

They are only healthy as long as they remain in the colon.

Question 13

Aging of GI system (elderly)

Answer 13

HCL acid production decreases leading to decreased iron and B12

Peristalsis decreases(constipation)
Bacteria count in colon increases
Decreased fat absorption&digestion

Oral cavity changes too

Question 14

Ask patient question about GI system

Answer 14

What is your normal eating pattern

Weight gain or loss?
Pain I’m GI system?
What meds are you taking?
Have you been traveling?

Question 15

Order of assessing GI system

Answer 15

1. inspect(look)
2. Auscultate
3. Light palpation

Question 16

GI inspection(looking)

Answer 16

Shape of abdomen.
Scars
Hernias
Pulsations 
Peristalsis

Question 17

Auscultating GI system

Answer 17

Position patient correctly:semi fowlers with knees bent

Listen in all four quadrants
Noise longer than 15 seconds is hypoactive(norm 1-15)

Bruits:swinging sound while listening,can be an artery(this is abnormal) usually indicates presence of aneurysm. DO NOT PALPATE STOMACH, CONTACT PROVIDER

Question 18

Light palpation of GI system

Answer 18

1/2” to an inch
If rigidity of abdomens is present,may indicate peritoneal inflammation

Palpate for distention, hernias and masses

Question 19

Vomitus

Examine it!!

Answer 19

Hematemesis

Coffee ground enema: blood has Been sitting in HCL acid for a little while

Green/yellow

Question 20

Stool

Examine it!

Answer 20

Food makes a difference in stool.
Eat lots of veggies

Beats can make purply red stool

Iron ‘makes black stool

Barium makes stool pasty yellow

Question 21

Melena

Answer 21

Dark tary sticky stool

Indicates GI bleed usually in stomach or esophagus

Most often upper GI bleed

Question 22

Steatorrhea

Answer 22

Fatty stool

Foamy with a ring of oil

Fat they have ingested but not absorbed

A pancreatic(disease or due to age) or meds can cause the problem

Question 23

Fecal occult blood testing

Answer 23

Traditional stool
Old method of looking for Colorectal cancer or other things

Not used as much
anymore
Gave false positive results

Question 24

Fecal immunochemical test

Answer 24

Newer testing

Test is not effected by foods or meds patient is on

If test is positive it opens the door to more testing

Question 25

Fecal fat in stool

Answer 25

Hold stool on ice for 24 hours

Question 26

Diagnostic evaluations

Answer 26

Consent is needed

Prep usually involves diet change,NPO

Consider post exam concerns

Question 27

Upper GI series Barium swallow

Answer 27

Drink barium and stand behind an X-RAY

Watches movement of barium through the body

Needs to be encouraged to drink fluids, rids barium from the body

Question 28

Lower GI barium enema

Answer 28

Enema is administered, visualizes outline of colon

Needs to be encouraged to drink fluids, rids barium

Question 29

Endoscopic procedures

Answer 29

Can biopsy 
View
Collect
Used 
Use moderate sedation
NPO 6-8 hours before 
Need consent

Question 30

Esophagogastroduodenoscopy

EGD

Answer 30

Visual examination of the esophagus stomach and duodenum

Question 31

Endoscopic retrograde cholangiopancreatograph

ERCP

Answer 31

Like an EGD but finds sphincter of oddi and finds common bile duct

Can remove gull stones

Question 32

Enteroscopy

Answer 32

Visualization of the small intestine

Must be advanced with peristalsis via capsule

Will have moderate sedation

Question 33

Endoscopic procedures continued

Answer 33

Vitals
NPO until gag reflex returns(sterile tongue blade to uvula)

No eating anything red or purple(makes vomit look red)

Question 34

Colonoscopy

Answer 34

Extensive bowel preparation, go lytely and moderate sedation

Clear liquid diet day before
Can cause fluid imbalance
Pass gas before being discharged
Someone stay with you for 24 hours

Screening suggested every ten years after age fifty. If unexpected finding every five years

Question 35

Alimentary canal

Answer 35

“GI tract”

25 feet long from mouth to anus