GI System Flashcards
What do accessory glands do?
Digestion, absorption, secretion, motility
List the layers of mucosa in order from superficial to deep
Serosa (lining of cavity), muscular external (motility), submucosa (BV, dispensability, elasticity), and mucosa (separates lumen from environment, absorption)
How does the stomach remain protected from the acidic environment it creates to digest food?
Epithelial cells of gastric mucosa (alkaline mucous), and the gastric mucosal cells which neutralize the acid with bicarb, increase blood flow, and synthesize prostaglandins
List the most common causes of GI hemorrhage?
Peptic ulcer disease, stress-related mucosal disease, esophagogastric varicose
Where do we see GI hemorrhage?
Upper: esophagus, stomach, duodenum
Lower: Jejunem, ileum, colon, rectum
What leads to peptic ulcer disease?
The body’s protective measures stope working which lead to mucosal breakdown. This extends into the muscle layers, leading to damaged blood vessels and bleeding- basically the penetrated lining allows the stomach to eat itself
What are the two main causes of peptic ulcer disease?
Bacteria: Helicobacter pylori
Drugs: NSAIDS (ASA, ibuprofen, naproxen), Corticosteriods
Stress-related MD is caused by the same pathogenesis of PUD, but what leads to the disruption in this disease?
Increased acid production and decreased mucosal blood flow leading to ischemia and damage to the mucosal lining
What are esophageal varicose?
Engorged and distended blood vessels of the esophagus and proximal stomach
What causes esophageal varices?
Portal HTN from hepatic cirrhosis (chronic liver disease) the resistance impedes blood from through the liver and develop into varices
Talk about the complication of hemorrhage in a GI bleed ?
Result of the erosion of granulation tissue at base of ulcer in healing or erosion of the ulcer through a major blood vessel
Gi-bleed complication of perforation?
Severe upper ABD pain, bowel sounds absent, resp shallow/rapid, firm ABD, elevated HR, fever, nausea, peritonitis
What is a gastric outlet obstruction?
Obstruction at the pylorus, the “outlet” of the stomach
What are the stages in a GI assessment when taking a client’s Hx?
Common GI symptoms, lifestyle, medical Hx, family Hx, current medication use
What meds should we take care to ask about?
Laxatives (can cause bleeding), ASA< NSAIDS, corticosteroids, anticoagulants
What labs are ordered in a GI hemorrhage assessment?
Hgb, hematocrit, INR, PTT, Creat, UREA, GFR, electrolytes, liver function, cardiac enzymes, H-pyloiri blood test, stool sample, urea breath test, occult blood
How can you tell the severity and location of bleeding?
Nasogastric lavage
What type of bleeding tells us it is an upper GI bleed?
Hematemesis (coffee grounds), melon (black, tarry stools)
What colour are stools in a lower GI bleed ?
Bright red
What are some key S&S that tells us the bleed is gastric?
eating-makes pain worse
Pain-dull/aching
Weight loss
Severe- vomiting bright red/coffee grounds
What are some S&S that tell us the pain is duodenal?
Eating- feels better, pain 3-4h after eating
Wakes in night
Pain-gnawing
Normal weight
Severe, tarry dark stool
What are we looking for with a colonoscopy?
lower GI tract
What are we looking for with a enteroscopy?
Small bowel
How many classes of hemorrhage are there?
4
