lower gastrointestinal function Flashcards
1
Q
upper GI system
A
oral cavity, pharynx, esophagus, stomach
2
Q
lower GI system
A
small intestine, large intestine, anus
3
Q
hepatobiliary system
A
liver, gallbladder, pancreas
4
Q
functions of liver
A
metabolize, synthesize, storage, detoxify blood, maintain fluid volume, produce bile, prepare for excretion, remove old RBCs, blood reservoir, convert ketones to fatty acids
5
Q
hepatic artery
A
carries oxygenated blood to liver
6
Q
portal vein
A
carry partially deoxygenated blood from GI tract to liver
7
Q
disorders of lower GI tract
A
diarrhea, constipation, intestinal obstruction, appendicitis, peritonitis, celiac disease, inflammatory bowel diseases IBS, diverticular disease
8
Q
hepatitis
A
inflammation of liver; can be acute, chronic, or fulminant
9
Q
acute hepatitis
A
proceeds through four phases: asymptomatic incubation and 3 symptomatic phases
10
Q
chronic hepatitis
A
continued hepatic diseases (>6 months); can quickly deteriorate
11
Q
fulminant hepatitis
A
uncommon, rapidly progressing that can lead to liver failure, hepatic encephalopathy, or death within 3 weeks
12
Q
cirrhosis
A
chronic, progressive, irreversible, diffuse damage to liver resulting in decreased function; leads to fibrosis, nodule formation, impaired blood flow; eventually leads to liver failure
13
Q
nonalcoholic fatty liver disease and nonalcoholic steatohepatitis (NAFLD and NASH)
A
infiltration of hepatocytes with fat from triglycerides
14
Q
cholelithiasis
A
gallstones
15
Q
gallbladder
A
sits below/behind liver and stores bile created
16
Q
cholecystitis
A
inflammation/infection in biliary system caused by calculi (kidney stones)
17
Q
pancreatitis
A
inflammation of pancreas; acute pancreatitis is medical emergency
18
Q
exocrine gland pancreas
A
digestive function; secretes enzymes
19
Q
endocrine gland pancreas
A
hormonal function; secretes insulin and glucagon
20
Q
components of lower GI tract
A
small intestine, cecum, appendix, large intestine, colon, feces, rectum, defecation
21
Q
celiac disease
A
celiac sprue or gluten-sensitive enteropathy; autoimmune inherited malabsorption disorder; intestinal villi atrophy causing decreased enzyme production and absorption
22
Q
irritable bowel disease (IBD)
A
chronic inflammation of GI tract, usually intestines
23
Q
crohns disease
A
slow developing, progressive condition causing patchy areas of inflammation in intestinal wall (full thickness); stimulates intestinal motility decreasing digestion/absorption
24
Q
ulcerative colitis
A
progressive condition of rectum and colon mucosa characterized by inflammation causing surface erosion, epithelium loss, and ulceration
25
Irritable bowel syndrome (IBS)
chronic, noninflammatory GI condition exacerbated by stress
26
Rome IV criteria for IBS
recurrent abdominal pain at least 1day/week in past 3 months associated with 2 of the following: related to defecation, changes in stool frequency, changes in stool appearance
27
Diverticular disease
conditions related to development of diverticula, outwardly bulging pouches of intestinal wall
28
diverticulosis
asymptomatic diverticular disease with multiple diverticula present
29
diverticulitis
diverticula become inflamed (usually because of retained fecal matter) and is asymptomatic until serious; can lead to fatal obstruction, infection, abscess, perforation, peritonitis, hemorrhage, shock
30
meckel diverticulum
common malformation of GI tract resulting in herniation of all layers of bowel wall
31
appendicitis
inflammation of vermiform appendix usually caused by infection; fluid builds in appendix filling with purulent exudate causing ischemia, necrosis, and forces bacteria/toxins out to surrounding structures
32
peritonitis
inflammation of peritoneum which activate many protective mechanisms
33
gastric cancer
can occur in several forms (adenocarcinoma is most frequent); most commonly associated with salted, cured, pickled, preserved, and smoked foods
34
liver cancer
usually occurs as secondary tumor metastasized from breast, lung, or other GI structure; primary tumors caused by cirrhosis and hepatitis
35
pancreatic cancer
aggressive malignancy that metastasizes quickly (usually adenocarcinoma); by time symptoms develop the disease is very advanced
36
colorectal cancer
very common and fatal in US/worldwide; often asymptomatic until advanced; associated with fatty, caloric, low-fiber diets with red meat/processed meat/alcohol
37
lower GI system components
small intestine, large intestine, anus
38
hepatobiliary system components
liver, gallbladder, pancreas
39
small intestine function
longest section of GI tract for nutrient absorption
40
cecum
small pouch ending the small intestine
41
appendix
vestigial organ attached to cecum
42
large intestine
deep crypt for water absorption
43
colon
absorbs water and electrolytes
44
feces
waste with undigested or unabsorbed remnants and bacteria
45
rectum
reservoir to store feces
46
defecation
reflex elicited through spinal cord to eliminate waste
47
liver function
10: metabolize carb/protein/fats; synthesize glucose/proteins/cholesterol/triglycerides/clotting factors; store glucose/fats/micronutrients to release as needed; detox blood; maintain intravascular fluid; produce bile; inactivate/prepare hormones for excretion; remove damaged/old erythrocytes to recycle iron and protein; blood reservoir; convert fatty acids to ketones
48
liver failure decreases...
albumin which
49
symptoms of liver disorders
jaundice, reduced liver blood flow, delayed drug clearance, diminished regeneration capacity
50
hepatitis
inflammation of the liver that can be viral and non-viral; increased age and comorbidities can increases risk for liver failure/cancer/cirrhosis; can result in hepatic cell destruction/necrosis/autolysis/hyperplasia/scarring
51
acute hepatitis
4 phases: 1 asymptomatic and 3 symptomatic
52
chronic hepatitis
lasts >6 months; severity varies; can deteriorate quicky with associated liver integrity
53
fulminant hepatitis
uncommon; rapid progression to liver failure; hepatic encephalopathy or death within 3 weeks
54
Hepatitis A
vaccine available; contaminated food and water; poor sanitization
55
hepatitis B
vaccine available; spread in bodily fluids (birth); leading cause of liver cancer
56
hepatitis c
curable in 95% of cases; spread via blood (birth); 40% of people are unaware they have it; leading cause of liver transplant
57
hepatitis caused by
EtOH, infections (usually viral), Medications (tylenol, antiseizure, antibiotics), autoimmune disease,
58
cirrhosis of the liver
chronic, progressive, irreversible, diffuse damge to liver resulting in decreased liver function; leads t liver fibrosis, nodule formation, impaired blood flow, bile obstruction that can result in liver failure; extracellular matrix degrades from proteolytic activity
59
cirrhosis manifestations
portal HTN, ascites, jaundice, varicosities, enlarged organs, muscle wasting, hyperlipidemia, hyper/hypoglycemia, toxin and bile accumulation, clay colored stools, dark urine, itchiness, feminization and irregular menses (in women)
60
causes of cirrhosis
hepatitis, chronic EtOH
61
cause for dark urine d/t cirrhosis
bile in urine
62
gallbladder function
stores bile produced by liver; delivers bile to small intestine via common bile duct
63
cholecystitis
inflammation or infection in biliary system d/t calculi; pain in ABD d/t obstruction usually occurs after large fatty meal that causes contraction of gallbladder
64
cholelithiasis
gall stones
65
risk factors for developing cholelithiasis
advanced age, obesity, rapid weight loss, pregnancy, hormone replacement, long-term parenteral nutrition
66
cholelithiasis manifestations
biliary colic, abdominal distention, N/V, jaundice, fever, leukocytosis
67
pancreatitis
inflammation of pancreas d/t destruction of pancreatic tissue by digestive enzymes; can be acute or chronic
68
acute pancreatitis
sudden and sever; upper ABD pain that radiates to back and worsens after eating, somewhat relieved by leaning forward/pulling knees to chest; mild jaundice, low-grade fever; BP and pulse changes
69
chronic pancreatitis
insidious, upper ABD pain, indigestion, weight loss (unintentional), steatorrhea, constipation, flatulence
70
causes of pancreatitis
EtOH, cholelithiasis, biliary dysfunction, hepatotoxic drugs, metabolic disorders, trauma, renal failure, endocrine disorders, pancreatic tumors, penetrating peptic ulcers
71
diarrhea
change in bowel patter; increased frequency, amount, and water content of stool; results from fluid secretion, decreased fluid absorption, alteration in GI peristalsis
72
diarrhea small intestine
stool large, loose, provoked by eating; usually accompanied by RLQ pain
73
large intestine diarrhea
stool is small, frequent, often pain and cramping in LLQ
74
acute diarrhea
self-limiting, depends on causes, usually viral or bacterial, can be caused by medications, may be accompanied by cramping/fever/chills/nausea/vomiting
75
chronic diarrhea
longer than 4 weeks
76
causes of diarrhea
IBD, malabsorption syndromes, endocrine disorders, chemotherapy, radiation
77
DX of diarrhea
history, PE, stool analysis, CBC, chem, ABG, ABD US`
78
treating diarrhea
fasting, antidiarrheals, antibiotics, anticholinergics, antispasmodics, diet, dietary fiber
79
constipation
change in bowel pattern characterized by infrequent passage of stool; stool remains in large intestine longer than usual and removes more water; common in toilet training children
80
constipation manifestations
pain during BM, inability to pass stool, hypoactive BS
81
causes of constipation
low fiber diet, inadequate physical activity, insufficient fluid intake, delayed urge to defecate, laxative abuse, stress, travel, bowel disease, opioids, mental health issues, neurologic conditions, colon cancer
82
constipation complications
anal bleeding, anal fissure, pH disturbance, hemorrhoids, diverticulitis, impaction, intestinal obstruction, fistulas
83
intestinal obstruction
can be mechanical or functional; can be sudden or gradual; can be partial or complete
84
mechanical intestinal obstructions
foreign bodies, tumors, adhesions, hernias, intussusception, volvulus, strictures, Crohn's, diverticulitis, hirschsprungs, fecal impaction
85
intussusception
intestine telescopes on self and can cause tissue death
86
functional obstructions
neuro impairment, intra-abdominal surgery, chemical, electrolyte/mineral disturbances, infections, abdominal blood supply impairment, renal/lung disease, meds
87
crohn's diseases
insidious, develops in adolescence; patchy inflammation involving full thickness of intestinal wall and ulcerations; thick and rigid wall with narrow lumen; can appear as cobblestones; damaged tissue unable to absorb; motility increased
88
crohns disease manifestations
abdominal cramping/pain (RLQ), diarrhea, steatorrhea, constipation, palpable abdominal mass, melena, anorexia, weight loss, inflammation
89
ulcerative colitis
progressive inflammation of rectum and colon triggered by T-cell accumulation in colon mucosa; causes epithelium loss, surface erosion, ulceration beginning in rectum and extends entire colon; necrosis turns to abscesses
90
ulcerative colitis manifestations
watery diarrhea with blood and mucus, tenesmus, proctitis, ABD cramping, N/V, weight loss, inflammation
91
tenesmus
frequent urge but inability to defecate
92
IBS
chronic noninflammatory GI condition; exacerbations with stress; more common in women; alteration in bowel pattern and abdominal pain; less serious than IBD does not cause permanent damage
93
IBS manifestations
stress, mood disorder, food, hormone changes, ABD distention, fullness, bloating, ABD pain worsened by eating/relieved by defecation, chronic/frequent constipation, emotional stress, anorexia
94
Rome criteria for IBS
recurrent abdominal pain on avg of at least 1day/week in past 3 months with two or more of following: related to defecation, changes in stool frequency, changes in stool appearance
95
appendicitis
inflammation of vermiform appendix usually infectious; causes local edema and then obstruction
96
appendicitis manifestations
sharp ABD pain in RLQ (pain may subside if rupture but then return), N/V, ABD distention, bowel pattern changes, fevers, chills, leukocytosis, peritonitis
97
peritonitis
inflammation of peritoneum; exudate bonds to nearby structures and seals them; abscesses attempt to wall off infections and slow peristalsis
98
peritonitis manifestations
sudden severee, abdominal rigidity, ABD tenderness/pain, decreased peristalsis, intestinal obstruction
99
causes of peritonitis
chemical irritation (ruptured spleen or gallbladder), direct organism invasion (appendicitis)
100
gastric cancer
associated with increased salt intake, cured, pickled, smoked foods
101
liver cancer
causes of primary tumors due to chronic cirrhosis and hepatitis
102
pancreatic cancer
typically advanced disease when patient presents; jaundice, dark urine, dry-colored stools
103
colorectal cancer
flexible sigmoidoscopy every 5 years, high sensitivity fecal occult blood test yearly w/ fecal immunochemical tests, colonoscopy every 10 years; narrow stools from tumor compression
