lewis ch 38 - GI assessment

Question 1

4 layers of the stomach (inner to outer)

Answer 1

• mucosal: innermost
• submucosa connective tissue
• muscle (oblique, circular, longitudinal)
• serosa: outermost

Question 2

“rest and digest” - cholinergic system

Answer 2

parasympathetic nervous system

Question 3

“fight or flight” - anticholinergic system, decreases digestion

Answer 3

sympathetic nervous system

Question 4

major nerve that supplies blood to the GI tract and controls GI movements

Answer 4

auerbach plexic (myenteric)

Question 5

system that regulates motility and secretion along entire GI tract, can function independently of CNS

Answer 5

enteric nervous system (ENS)

Question 6

3 arteries that bring blood to the GI system

Answer 6

• celiac artery: stomach and duodenum
• superior mesenteric artery: distal small intestine to mid-large intestine
• inferior mesenteric artery: distal large intestine through anus

Question 7

what does the liver do in relation to the GI system

Answer 7

GI tract organs empty into hepatic vein which goes to the liver - liver cleans blood of bacteria and toxins from GI tract

Question 8

what percent of cardiac output does GI tract receive at rest? after eating?

Answer 8

25-30% at rest

35+% after eating

Question 9

lining of abdominal cavity walls

Answer 9

peritoneum

Question 10

lining of abdominal organs

Answer 10

visceral layer

Question 11

3 purposes of the GI system

Answer 11

• ingestion
• digestion
• absorption

Question 12

hormone involved in appetite suppression

Answer 12

leptin

Question 13

hormone involved in appetite stimulation

Answer 13

ghrelin

Question 14

what can inhibit appetite (5)

Answer 14

• stomach distention
• illness (with fever)
• hyperglycemia
• N/V
• certain drugs (amphetamines)

Question 15

3 divisions of pharynx

Answer 15

nasopharynx
oropharynx
laryngeal pharynx

Question 16

what does the lower esophageal sphincter prevent

Answer 16

reflux of acidic gastric contents into esophagus

Question 17

functions of stomach (3)

Answer 17

• store food
• mix food with gastric secretions
• empty contents in small boluses into small intestine

Question 18

functions of small intestine (2)

Answer 18

• digestion and absorption

- uptake of nutrients from gut lumen to bloodstream

Question 19

two types of cells found in the fundus of the stomach

Answer 19

chief cells

parietal cells

Question 20

what do chief cells secrete

Answer 20

pepsinogen

Question 21

what do parietal cells secrete

Answer 21

secrete hydrochloric acid, water, and intrinsic factor

Question 22

where is protein broken down (and by what)

Answer 22

broken down by pepsin in the stomach

Question 23

where are carbohydrates and fats broken down

Answer 23

in small intestine

Question 24

where does most absorption occur

Answer 24

small intestine

Question 25

what are the three sections of the small intestine

Answer 25

duodenum jejunum ileum

Question 26

4 sections of the large intestine

Answer 26

cecum colon rectum anus

Question 27

what does the large intestine absorb (2)

Answer 27

water and electrolytes

Question 28

what does the large intestine produce (2)

Answer 28

Vitamin K | some B vitamins

Question 29

in what patients would the valsalva maneuver be contraindicated (6)

Answer 29

- head injury - eye injury - heart problems - hemorrhoids - abdominal surgery - liver cyrrhosis with portal hypertension

Question 30

describe the valsalva maneuver

Answer 30

- patient holds breath and contract abdominal muscles - reduces venous flow to heart - decrease in cardiac output and bp drops - patient relaxes - sudden blood flow to heart, increased heart rate, bp rises

Question 31

what is the largest internal organ

Answer 31

liver

Question 32

what is the functional unit of the liver

Answer 32

lobule

Question 33

cells found in liver that carry out phagocytic activity, removing bacteria and toxins from blood

Answer 33

kupffer cells

Question 34

what form is bilirubin when its released into the bloodstream and binds to albumin

Answer 34

unconjugated bilirubin

Question 35

what form is bilirubin when its in the liver and combined with glucoronic acid as it is excreted as bile into intestine

Answer 35

conjugated bilirubin

Question 36

purpose of gallbladder

Answer 36

collects and stores bile (around 45 mL)

Question 37

exocrine function of the pancreas

Answer 37

contributes to digestion through release of enzymes

Question 38

endocrine function of pancreas

Answer 38

alpha cells in islet of langerhans secrete glucagon

Question 39

what do the beta cells in the islet of langerhans secrete

Answer 39

insulin | amylin

Question 40

aging adult considerations relating to GI system

Answer 40

- loss of teeth - decreased number of taste buds - decreased appetite - decreased sense of smell - less saliva - delayed emptying of esophagus - decreased HCl acid secretion - constipation - liver size decreased - gallbladder size decreased

Question 41

what is xerostomia

Answer 41

decreased saliva

Question 42

what are the four enzymes of the liver

Answer 42

ALT AST ALP GGT

Question 43

normal ALT levels

Answer 43

4-36 U/L

Question 44

normal ALP levels

Answer 44

30-120 U/L

Question 45

normal GGT levels (men and women over and under 45 yo)

Answer 45

male and female >45 yo: 8-38 U/L | female <45 yo: 4-27 U/L

Question 46

normal AST levels

Answer 46

0-35 U/L

Question 47

what is a normal prothrombin clotting time

Answer 47

11-16 seconds