Lecture 5: Gastrointestinal System Flashcards
What is the basic function of the GI system?
To alter the chemical and physical composition of food so it can be absorbed and used by body cells
What is the GI system dependent on?
- Secretions of the endocrine and exocrine glands
- Controlled movement of ingested food through the digestive tract
What is the GI tract composed of?
Esophagus, stomach, small intestine, large intestine, liver, gall bladder and pancreas
What are pathologies of the esophagus?
- Tracheoesophgeal fistula
- Esophageal atresia
- Esophagitis
- Esophogeal Cancer
- Hiatal hernia
- Achelasia
What is traceoesophageal fistula?
An abnormal connection between the esophagus and the trachae that causes breathing and feeding issues
What are the two types of tracehoesophageal fistula?
Congenital and acquired
What is congenital form of traceoesophageal fistula?
Results from the failure of the esophageal lumen to develop completely separate from the trachea
What is acquired traceoesophageal fistula?
Caused by cancer, infection, trauma or performation
What is esophageal atresia?
A congenital medical condition that affects the aligmentary tract and is when the esophagus hasn’t finished developing
What does esophageal atresia cause?
The esophagus to end in a blind pouch rather than connecting normally to the stomach
What is esophagitis?
Is the backflow of acid and stomach contents into the esophagus
What is acute esophagitis most commonly the result of?
GERD
What does chronic esophagitis result in?
Strictures or barrett esophagus
What is barrett esophagus?
A condition when the lining of the esophagus changes to me more like the tissue that lines the esophagus
What is esophageal cancer?
Cancer of the esophagus where most are the squamous cell type of the esophogastric junction
What is esophageal cancer associated with?
Excessive alcohol intake or smoking
What are esophageal varices?
Large, swollen blood vessels around the esophagus caused by high blood pressure in the vessels in/around the liver
What are the symtoms of esophageal varices?
Typically asymptomatic but can bleed spontaneously
What causes esophageal varices?
Portal hypertension which is caused by cirrhosis of the liver
What is a hiatal hernia?
Protrusion of a portion of the stomach into the thoracic cavity through the esophageal hiatus in the diaphragm
What does a hiatal hernia typically cause?
GERD
What are the 3 degrees of herniation?
Type 1 - sliding
Type 2 - rolling
Type 3 - mixed
What is an inguinal hernia?
Intestines protrude the muscle wall of the groin
What is achalasia?
A functional obstruction of the distal esophagus with proximal dilation
What is achalasia caused by?
Incomplete relaxation of the lowe esophageal sphincter
What are disorders of the stomach?
- Gastritis
- Peptic ulcer disease
- pyloric stenosis
- gastric cancer
What is gastritis?
Inflammation of the stomach mucosa, often cause by alcohol, corrosive agents or infection
Which bacterial infection specifically causes gastritis?
H.pylori which is a bacteria caused by ulcers
What are the symptoms of gastritis?
Pain, reflux, nausea, vomiting and loss of appetite
What is pyloric stenosis?
A condition when the muscles around the pylorus become thicker than normal and narrow the passage into the small intestine
What is pyloric stenosis also known as?
Infantile hypertrophic pyloric stenosis (IHPS)
What are the symptoms of pyloric stenosis?
Forecful vomiting, dehydration and weight loss
What is pyloric stenosis often described as?
A mobile, hard “olive”
What does pyloric stenosis cause?
Obstruction preventing food from entering the duodenum
What is peptic ulcer disease?
Erosions (sores) in the stomach lining, common in the duidenal bulb
What is peptic ulcer disease caused by?
It is caused by action of acid and pepsin secreted by the stomach due to alcohol, food, medication, smoking or viruses
PUD is the most common cause of what symptom?
Upper gastrointestingal bleeding
Where is gastric cancer the most prevalent?
In Japan, Chile and parts of eastern europe
How is gastric cancer typically diagnosed?
In the late stages since it isn’t symptomatic
What is the prognosis of stomach cancer?
Poor since its not detected until late stage
What are small bowel disorders?
- Crohn’s disease
- Small Bowel Obstruction
- Adynamic Ileum
- Intussusception
- Malabsorption disorders
What is Crohn’s disease?
Chronic inflammation that often infects the terminal area of the ileum
Who is most affected by Crohn’s disease?
Young adults and brought on by stress
What is a small bowel obstruction caused by?
Most often caused by fibrous adhesions from surgery
What is the other causes of small bowel obstruction?
Hernia, liminal occlusion, intrinsic lesions
What are the different types of bowel obstruction?
Herniation, adhesions, intussesception and volvulus
What is adynamic ileus?
Also termed paralytic ileus and is when the intestines fail to perform peristalsis
What are the causes of adynamic ileus?
Foreigh object that was swallowed, impacted stool, tumors, twisted intestines, intissisception, scar tissue, hernia, gallstones
What is intussusception?
The telescoping of one part of the intestinal tract into another because of peristalsis
What group does intussusception usually affect?
Children
What are malabsorption disorders?
A digestive disorder that prevents your body from effectively absorbing nutrients from food
What is the result of malabsorption disorders?
Steatorrhea, which a foul smelling stool that floats
What is teh cause of malabsorption disorders?
Damage to the mucuous lining of the small intestine
What is tropical sprue?
A malabsorption disease found in tropical regions that causes flattening of the villi and inflammation of the small intestine
What is whipple disease?
A rare bacterial infection cause by bacterium tropheryma whipplei that affects the joints and digestive system
What are large bowel disorders?
- Appendicitis
- Diverticulosus and Diverticulitis
- Ulcerative colitis
- colon cancer
- large bowel obstruction
- volvulus
What is appendicitis?
Inflammation of the appendix, due to obstruction with the risk of rupturing
What are the symptoms of appendicitis?
Mild cramping in the upper abdomen (belly button) that moves to the lower right quadrant
What are causes of appendicitis?
- obstruction
- appendix stones, lymphoid hyperplasia, colitis, tumors, parasites and cystic fibrosis
What is Diverticulosis?
An outpuching of the intestinal layers through the bowel wall
Where does diverticulosis most commonly occur?
In the sigmoid portion of the large intestine
What is diverticulitis?
A complication of diverticulosis that leads to necrosing inflammation in the diverticula
What are the risks of diverticulosis/diverticulitis?
Infection, performation, abscesses and fistulas
What are the risk factors of diverticulitis?
Aging, obesity, fatty diet, straining during bowel movements, smoking and medicine
What is ulcerative colitis?
A chronic inflammatory disease of the bowel that is characterized by alternating periods of remission and relapse
What type of cancer is the 3rd leading cause of cancer in the US?
Colon cancer
At what age does colon cancer peak?
50-70
What are predisposing factors to colon cancer?
Long term ulcerative colitis or familial polyposis
What do most large bowel obstructions result from?
colon cancer
What is volvulus of the colon/
Twisting of the bowel on itself that can cause an obstruction
What are the most common sites of volvulus?
Cecum and sigmoid
What are heptobiliary and pancreatic disorders?
- gallstones
- cholecystitis
- cirrhosis
- hepatitis
- pancreatitis
- pancreatic cancer
What are gallstones?
Hardened deposits in the gallbladder
What are the two major types of gallstones?
Cholesterol and pigment gallstones
What are cholesterol gallstones?
The predominent type of gallstones that are yellow in color and mostly composed of undissolved cholesterol
What are pigment gallstones?
Dark brown or black stones from when the bile contains too much bilirubin
What are predispositions of gallstones?
Family history, age over 40, overweight and female
What is the modality of choice to diagnose gallstones?
Ultrasound
What is acute cholecystitis?
An acute inflammation of the gallbladder caused by cystic duct obstruction
What is emphsematous cholecystitis?
A rare condition when gas forming organisms grow in the gallbladder
Who doe emphysematous cholecystitis usually affect?
Elderly men or people with poorly controlled diabetes
What is hepatitis?
The most prevalent inflammatory disease of the liver which is caused by viruses
What are the viral types of hepatitis?
- Hepatitis A (HAV)
- Hepatitis B (HBV)
- Hepatits C (HCV)
- Hepatitis E (HEV)
Which type of Hepatitis are healthcare workers at risk of exposure?
HBV
What is cirrhosis?
The chronic destruction of liver cells and structure with nodular regeneration of the liver
What is the major cause of cirrhosis?
Chronic alcoholism
What is the most common symptom of cirrhosis?
Ascities, which is fluid accumulation in the abdomen
What is acute pancreatitis?
An inflammatory process in which digestive enzymes start to digest the pancreas itself
What are symptoms of acute pancreatitis?
Severe pain in the upper abdomen, nausea and vomiting
What is the most common cause of acute pancreatitis?
Excessive alcohol consumption
What is chronic pancreatitis?
Inflammation of the pancrease due to frequent injury and scar tissue
What are the symptoms of chronic pancreatitis?
Pain, malabsorption and diabetes
What is the most common type of cancer of the pancreas?
Adenocarcinoma
What is the most common site of pancreatic cancer?
The head of pancreas
What dictates the stages of pancreatic cancer?
The resectability
