Midterm Flashcards
absolute shunt
The sum of anatomic shunt and capillary shunt. It is refractory to oxygen therapy.
accessory muscles
Muscles not normally used during quiet breathing that are available for assisting either inspiration or expiration during times of increased work of breathing.
acids
Substances that dissociate or lose ions.
acute respiratory distress syndrome (ARDS)
A type of respiratory failure caused by diffuse injury to the alveolar-capillary membrane, resulting in noncardiogenic pulmonary edema.
air trapping
The abnormal retention of air in the lungs on exhalation.
anatomic shunt
Movement of blood from the right heart and back into the left heart without coming into contact with alveoli.
base excess
A measure of the amount of buffer required to return the blood to a normal pH state. It is used in reference to metabolic acid-base states. A person can develop a base excess (metabolic alkalosis) or a base deficit (metabolic acidosis).
bases
Substances capable of accepting ions.
buffer
A substance that reacts with acids and bases to maintain a neutral environment of stable pH.
capillary shunt
Normal flow of pulmonary blood past completely unventilated alveoli.
capnogram
Graphic representation of carbon dioxide levels during respiration.
capnometry
Measurement of carbon dioxide in expired gas.
carina
The junction of the Y formed by the right and left mainstem bronchi in the lungs.
compensated
A state in which the pH is within normal limits with the acid-base imbalance being neutralized but not corrected.
compliance (CL)
Measurement of the relative ease with which an organ can expand; reflects relative stiffness of the organ; in the lungs, it is the amount of force required to expand the lungs; measured in mL/cm H2O; normal is 50 to 100 mL/cm H2O.
cor pulmonale
Right ventricular hypertrophy and dilation secondary to pulmonary disease, resulting in pulmonary hypertension.
corrected
A state in which all acid-base parameters have returned to normal ranges after a state of acid-base imbalance.
crackles (rales)
Adventitious breath sounds associated with fluid or secretions or both in small airways or alveoli.
diffusion
Movement of gases across a pressure gradient from an area of high concentration to one of low concentration.
dyspnea
Subjective sensation of difficulty breathing.
end-tidal carbon dioxide (PETCO2 or ETCO2)
Concentration of carbon dioxide at the end of exhalation.
external respiration
Movement of gases across the alveolarcapillary membrane.
forced expiratory volume (FEV)
Measure of how rapidly a person can forcefully exhale air after a maximal inhalation; a measurement of dynamic lung function.
hemoptysis
Expectoration of bloody sputum.
hypercapnia
Abnormally high level of carbon dioxide in the blood.
internal respiration
Movement of gases across the systemic capillary-cell membrane in the tissues.
minute ventilation (VE)
The total volume of expired air in one minute.
nonvolatile acids
Metabolic acids that cannot be converted to a gas, requiring excretion through the kidneys.
orthopnea
Difficulty breathing while laying down, relieved in the upright position.
oxyhemoglobin dissociation curve
A graphic representation of the relationship between oxygen saturation of hemoglobin (SaO2) and the partial pressure of oxygen (PaO2) in the plasma.
PaO2
The partial pressure of oxygen as it exists in the arterial blood; normal range is 75 to 100 mm Hg.
parietal pleura
The moist membrane that adheres to the thoracic walls, diaphragm, and mediastinum.
paroxysmal nocturnal dyspnea (PND)
A symptom usually associated with transient pulmonary edema secondary to heart failure; patient awakens from sleep with severe orthopnea.
partial pressure
Pressure each gas exerts in a total volume of gases.
partially compensated
A state in which the pH is abnormal but the body buffers and regulatory mechanisms have started to respond to the imbalance.
perfusion
The pumping or flow of blood into tissues and organs.
pH
Represents free hydrogen ion concentration.
pleural rub
Adventitious breath sound caused by inflammation of the pleural membrane.
pleurisy (pleuritis)
Pain caused by inflammation of the parietal pleura.
positive end-expiratory pressure (PEEP)
The application of positive pressure to the airway at the end of expiration such that the airway pressure never returns to ambient.
pressure gradient
Difference between the partial pressures of a gas; influences rate of diffusion.
pulmonary shunt
The percentage of cardiac output that flows from the right heart and back into the left heart without undergoing pulmonary gas exchange or not achieving normal levels of PaO2 because of abnormal alveolar functioning.
pulmonary vascular resistance (PVR)
Afterload of the right ventricle; the resistance the right ventricle must overcome to open the pulmonic valve and eject the stroke volume into the pulmonary artery.
pulse oximetry
Noninvasive technique for monitoring arterial capillary hemoglobin saturation.
respiration
The process by which the body’s cells are supplied with oxygen and carbon dioxide is eliminated from the body; also refers to breathing, the movement of air in and out of the lungs.
rhonchi
Adventitious breath sounds associated with an accumulation of fluid or secretions in the larger airways.
shuntlike effect
Effect created by an excess of perfusion in relation to alveolar ventilation.
stridor
A type of wheeze heard loudest over the neck suggesting obstruction of the trachea or larynx.
surfactant
A lipoprotein produced by type II alveolar cells that reduces the surface tension of the alveolar fluid lining.
tidal volume (TV or VT)
The volume of air moved in and out of the lungs during one normal breath. It is also an important setting on a mechanical ventilator - if set too high the patient is hyperventilated and if set too low the patient is hypoventilated.
total lung capacity (TLC)
The amount of gas present in the lungs after maximal inspiration.
true shunt
Flow of blood from the right heart, through the lungs, and on into the left heart without taking part in alveolar-capillary diffusion or oxygen exchange.
uncompensated
An acid-base state in which the pH is abnormal because other buffer and regulatory mechanisms have not begun to correct the imbalance.
V/Q ratio
A ratio expressing the relationship of ventilation to perfusion.
venous admixture
The effect that a physiologic shunt has on the oxygen content of the blood as it drains into the left heart.
ventilation
The gross movement of air in and out of the lungs; airflow between the atmosphere and alveoli.
visceral pleura
The moist membrane that adheres to the lung parenchyma and is adjacent to the parietal pleura.
vital capacity (VC)
The volume of air that can be exhaled after maximum inhalation; an indication of respiratory muscle strength; normal is 65 to 75 mL/kg.
volatile acids
Acids that can convert to a gas form for excretion.
wheeze
Adventitious breath sound caused by air passing through constricted airways.
spiral CT scan
A specialized computerized axial tomography scan (CT scan) that continuously moves the patient through the scan quickly; provides greater visualization of blood vessels.
status asthmaticus
A life-threatening emergency of acute airway obstruction that does not respond to usual therapy.
surfactant
A lipoprotein produced by type II alveolar cells that reduces the surface tension of the alveolar fluid lining.
tidal volume (TV or VT)
The volume of air moved in and out of the lungs during one normal breath. It is also an important setting on a mechanical ventilator - if set too high the patient is hyperventilated and if set too low the patient is hypoventilated.
total lung capacity (TLC)
The amount of gas present in the lungs after maximal inspiration.
V/Q ratio
A ratio expressing the relationship of ventilation to perfusion.
ventilatory failure
A condition caused by alveolar hypoventilation; clinically, it is called acute respiratory acidosis.
wedge resection
Surgical procedure that removes a wedge-shaped section of the peripheral portion of the lung.
afterload
The resistance against which the ventricle pumps blood.
apical-radial pulse deficit
The difference between the apical and radial pulse rates, which reflects the number of heartbeats too weak to be transmitted to the periphery.
atrial gallop
Abnormal S4 heart sound caused by atrial contraction.
B-type natriuretic peptide
(BNP) Hormone released from the ventricles in response to increased preload; causes urinary excretion of sodium and diuresis. Its action results in reduced preload.
body surface area (BSA)
A measure of overall body size using both height and weight in its calculation.
C-reactive protein (CRP)
Peptide released by the liver in response to inflammation, infection, and tissue damage; downstream marker for inflammation now considered a major risk factor for heart disease.
cardiac index (CI)
Cardiac output divided by body surface area.
cardiac output (CO)
The amount of blood pumped by the heart each minute.
contractility
The ability of a muscle to shorten when stimulated; in particular, the force of myocardial contraction.
ejection fraction (EF)
The amount of blood ejected from the left ventricle per each heartbeat; normal is above 50 percent.
hyperlipidemia
A condition manifested by high levels of lipids in the blood.
inotrope
Factor that influences myocardial contractility; a positive inotrope increases myocardial contractility; a negative inotrope decreased myocardial contractility.
palpitations
Subjective feeling of heart rhythm abnormalities; perceived as a “skipping” or “thumping”; related to premature cardiac beats.
preload
The degree of stretch in myocardial fibers at the end of diastole.
pulse pressure
Difference between diastolic and systolic pulse pressure.
pulsus alternans
Alternating weak and strong pulses.
stroke volume (SV)
The volume of blood pumped with each heartbeat.
summation gallop
S3 and S4 heart sounds are present; indicative of severe heart failure.
syncope
A temporary loss of consciousness, followed by a spontaneous and complete recovery.
troponin
A protein found in cardiac muscle; when present in the blood, it is used as a marker of myocardial cell death.
ventricular gallop
S3 heart sound caused by decreased ventricular compliance.
aortic regurgitation (AR)
Aortic valve insufficiency that allows blood to flow back into the left ventricle from the aorta during diastole.
aortic stenosis (AS)
A narrowing of the aortic valve orifice so that blood flow is obstructed from the left ventricle into the aorta during systole.
cardiomyopathy
End-stage heart failure (class IV); the patient has symptoms of HF at rest and cannot perform activities of daily living.
constrictive cardiomyopathy
Condition associated with normal left ventricular size and a slightly depressed ejection fraction with a marked decrease in cardiac muscle compliance.
diastolic dysfunction
Heart failure characterized by impairment of ventricular relaxation.
dilated cardiomyopathy
Condition associated with left ventricular dilation and decreased ejection fraction.
drug allergy
Refers to an immune-based hypersensitivity reaction (for example, rash, or hypotension).
drug side effect
Refers to a predictable or expected undesirable effect of a drug.
echocardiogram
Noninvasive technology that allows visualization of the valves; their movement; as well as the size, thickness, and function of the aorta and ventricles.
heart failure (HF)
Clinical syndrome that can result from structural or functional cardiac disorders that decrease the ability of the ventricle to fill or eject.
hypertrophic cardiomyopathy
Condition associated with left ventricular hypertrophy that decreases the ability of the chamber to relax (diastolic dysfunction).
infective endocarditis (IE)
A disease caused by microbial infection of the endothelial lining of the heart, usually presenting with vegetations on a heart valve.
mitral regurgitation (MR)
Incompetent mitral valve allows blood to flow back into the left atrium during systole because the mitral valve does not fully close.
mitral stenosis (MS)
A narrowing of the mitral valve orifice so that blood flow is obstructed from the left atrium into the left ventricle during diastole.
mitral valve prolapse
A type of mitral valve insufficiency that occurs when one or both of the mitral valve cusps flow into the atria during ventricular systole.
orthopnea
Difficulty breathing while laying down, relieved in the upright position.
prehypertension
Defined as systolic blood pressure of 139 to 150 mm Hg and diastolic blood pressure of 80 to 89 mm Hg.
regurgitation
Backward blood flow through the chambers of the heart.
stenosis
Valve leaflets fuse together and cannot fully open or close.
systolic dysfunction
Heart failure characterized by ejection fraction less than 40 percent.
target organ damage
Dysfunction that occurs in organs affected by high blood pressure.
acute coronary syndrome (ACS)
Coronary artery insufficiency typically resulting from disruption of intracoronary plaque, resulting in partial or total occlusion of the artery with subsequent ECG changes and cardiac biomarker release.
akinesis
Lack of myocardial wall movement.
angina pectoris
Chest pain that is usually precipitated by exercise and relieved by rest.
anginal equivalents
Symptoms suggestive of coronary artery disease but that do not include angina (examples include dyspnea, fatigue, dizziness).
atheroma
Complicated atherosclerotic lesion that is calcified and contains hemorrhage, ulceration, and scar tissue deposits.
Beck’s triad
Classic signs of cardiac tamponade that include elevated right atrial pressure, hypotension, and muffled heart sounds.
C-reactive protein (CRP)
Peptide released by the liver in response to inflammation, infection, and tissue damage; downstream marker for inflammation now considered a major risk factor for heart disease.
cardiac markers
Proteins that necrotic myocytes release into the blood; when present in the serum, they signal myocardial damage.
cardiac tamponade
A life-threatening postoperative complication of coronary artery bypass surgery caused by bleeding into the pericardial sac.
dyskinesis
Myocardial wall movement in the opposite direction.
echocardiography
Imaging technique used to assess functional structures of the heart using ultrasound waves.
ejection fraction (EF)
The amount of blood ejected from the left ventricle per each heartbeat; normal is above 50 percent.
endothelium
Thin inner layer of blood vessels composed of endothelial cells.
fatty streaks
Type II atherosclerotic skin lesions characterized by macrophage migration across the endothelium and smooth muscle cells that contain lipid droplets.
fibrous atheromatous plaque
Basic lesion associated with atherosclerosis; lesion filled with lipids, collagen, scar tissue, and vascular smooth muscle cells.
high-density lipoprotein (HDL)
Lipoprotein molecule that has a high density (amount) of protein and a small amount of cholesterol; commonly known as the “good” cholesterol.
hypercholesterolemia
High levels of serum cholesterol.
hypokinesis
Decreased myocardial wall movement resulting from myocardial ischemia or injury.
lipoproteins
Cholesterol bound to protein and carried in the blood.
low-density lipoprotein (LDL)
Lipoprotein molecule that has a low density (amount) of protein and a large amount of cholesterol; commonly known as the “bad” cholesterol.
modifiable risk factors
Risk factors that can be altered through either lifestyle modification or medications (examples include obesity and smoking).
myocardial infarction (MI)
The complete occlusion of one or more coronary arteries leading to cell and tissue death.
myocardial ischemia
A state where oxygen demand exceeds supply causing chest pain (angina pectoris).
nonmodifiable risk factors
Risk factors that, regardless of therapy, cannot be altered (examples include genetics and age).
percutaneous coronary intervention (PCI)
The use of angioplasty balloons and coronary stents to alleviate stenoses of arteries and reestablish blood flow to ischemic myocardium.
perfusionist
A specially trained technician who controls the cardiopulmonary bypass machine during coronary artery bypass surgery.
precursor lesions
Types II and III atherosclerotic lesions that form during the teenage years.
Prinzmetal’s angina
See variant angina.
pulsus paradoxus
Exaggerated decrease (greater than 10 mm Hg) in systolic blood pressure during inspiration.
stable angina
Chest pain that is predictable and relieved with rest or nitrates.
unstable angina
Chest pain that is not predictable, and that occurs with rest or with minimal activity.
variant angina
Chest pain that is not predictable, may occur at night, and is caused by coronary artery spasm; also known as Prinzmetal’s angina.
xanthoma
A cholesterol-filled skin lesion.
arousal
The component of consciousness concerned with the ability of an individual simply to respond to environmental stimuli, such as opening the eyes to speech or turning the head toward a noise; degree of alertness or responsiveness to stimuli.
autoregulation
Mechanism used by tissues to regulate their own blood supply by dilating or constricting local blood vessels; the localized matching of cerebral blood flow with cerebral metabolism.
blood-brain barrier
A network of cells and membranes that control brain volume and contents by controlling permeability.
brain herniation
A catastrophic complication of traumatic brain injury caused by increased intracranial pressure.
central stimulation
Involves the trunk or central portion of the body and produces an overall body response; should be used for initial introduction of pain; refers to stimulation of the cerebral hemispheres rather than spinal cord.
cerebral blood flow (CBF)
Blood flow to the brain is maintained at a constant rate by vasodilation of the vessels to increase the flow or vasoconstriction to decrease the flow.
cerebral blood volume
The amount of blood in the cranial vault at any given point in time; occupies about 10 percent of the total intracranial volume.
cerebral hematoma
A group of focal cerebral injuries associated with the accumulation of blood in the cranial vault.
cerebral perfusion pressure (CPP)
An estimate of the adequacy of cerebral circulation; perfusion pressure to the brain that is the difference between the mean systemic arterial pressure and the mean intracranial pressure. It is calculated as follows: CPP = MAP ICP.
circle of Willis
An area in the brain where carotid arteries and vertebral arteries unite to provide collateral blood flow to either side of the brain.
consciousness
State of general awareness of oneself and the environment; made up of the components of arousal and content.
content
The component of consciousness concerned with interpreting environmental stimuli; includes thinking, memory, problem solving, orientation, and speech.
Cushing’s triad
Vital sign changes that occur where the pulse pressure widens until ICP equals MAP and includes (1) increased systolic blood pressure, (2) decreased diastolic blood pressure, and (3) bradycardia.
decerebrate posturing
Abnormal extension; neck is extended with jaw clenched; arms pronate and extend straight out; feet are plantar flexed.
decorticate posturing
Abnormal flexion; upper arms move upward to the chest; elbows, wrists, and fingers flex; legs extend with internal rotation; feet flex.
doll’s eye movements
Oculocephalic reflex; reflexive movements of the eyes in the opposite direction of head rotation.
expressive aphasia
The inability to write or use language appropriately.
global aphasia
The inability to use or understand language.
herniation
A catastrophic shifting or displacement of brain tissue, which causes pressure and traction on cerebral structures and produces clinical symptoms.
hydrocephalus
A clinical syndrome caused by an increased production of cerebrospinal fluid that exceeds the absorption rate.
hyperemia
A state in which cerebral blood flow is higher than cerebral metabolic needs; also known as luxury perfusion.
intracranial hypertension
Increased intracranial pressure.
intracranial pressure
Pressure exerted by the cerebrospinal fluid within the ventricles of the brain; normal pressure is 0 to 15 mm Hg.
Monro-Kellie hypothesis
A principle that states that the skull is a rigid vault filled with noncompressible contents: brain,blood, and cerebrospinal fluid; if any one component increases in volume, one or both remaining components must decrease in volume for overall volume to remain constant.
nystagmus
Lateral tonic deviation of the eyes toward a stimulus.
otorrhea
The drainage of cerebral spinal fluid through the ear; indicates possible tear in the meninges.
peripheral stimulation
Pain stimulus that is delivered more distally in extremities and is important in the differentiation between hemispheric conditions and spinal cord injury.
receptive aphasia
The inability to understand written or spoken words.
reticular activating system (RAS)
A pathway of neurons and neuronal connections for transmission of sensory stimuli from the lower brainstem to the cerebral cortex; the anatomic basis of the arousal component of consciousness.
brain death
Irreversible cessation of all brain function, including brainstem function.
brain herniation
A catastrophic complication of traumatic brain injury caused by increased intracranial pressure.
cerebral hematoma
A group of focal cerebral injuries associated with the accumulation of blood in the cranial vault.
cerebral salt wasting
A state of fluid overload of which the end result is the loss of sodium into the urine causing water to follow.
concussion
Mild traumatic brain injury caused by blunt trauma to the head.
contusion
Injury to superficial tissues, with disruption of blood vessels (bruising) with extravasation into the skin; in brain injury it is a moderate-to-severe injury with bruising of brain tissue.
diabetes insipidus
A condition associated with improper water balance and characterized by the decrease or absence of antidiuretic hormone (ADH) secreted by the posterior pituitary gland; this loss of ADH secretion results in diuresis.
diffuse axonal injury (DAI)
Injury that occurs when shearing forces disrupt the structure of neurons and their nearby blood vessels.
epidural hematoma (EDH)
Bleeding in the space between the dura mater and the skull.
focal injury
One of the two types of traumatic brain injury; typically occurs in a well-defined area of the brain and may be the result of a hematoma.
intracerebral hematoma (ICH)
Accumulation of blood in the parenchyma of brain tissue.
primary injury
Neurons sustain direct injury at the moment of impact.
rhinorrhea
The drainage of cerebral spinal fluid through the nose; indicates possible tear in the meninges.
seizure activity
A complication of traumatic brain injury.
subarachnoid hemorrhage (SAH)
Accumulation of blood between the arachnoid layer of the meninges and the brain.
subdural hematoma (SDH)
Accumulation of blood between dura and arachnoid layers of the meninges.
syndrome of inappropriate antidiuretic hormone (SIADH)
The retention of water due to the excessive secretion of antidiuretic hormone (ADH); characterized by the production of small amounts of concentrated urine with an associated decrease in serum sodium.
traumatic brain injury (TBI)
Injury that results from any mechanical disruption of brain tissue from an impact or injury to the head.
acinus
The exocrine functional unit of the pancreas; composed of acinar cells that produce, store, and secrete digestive enzymes and ductal cells that secrete bicarbonate and water (plural: acini).
alanine aminotransferase (ALT, SGPT)
An enzyme primarily found in the cells of the liver, kidneys, heart, and skeletal muscles.
alkaline phosphatase (Alk Phos, ALP)
An enzyme primarily found in the cells of the liver and kidneys.
ampulla of Vater
Formed by the junction at the duodenum of the main pancreatic duct and the common bile duct.
amylolytic
Facilitating the breakdown of carbohydrates.
antrum
The terminal portion of the stomach, located between the gastric body and the pyloric sphincter.
aspartate aminotransferase (AST, SGOT)
An enzyme primarily found in the cells of the liver, kidneys, heart, pancreas, and brain.
autodigestion
Breakdown of pancreatic tissues by its own enzymes.
bile
A substance produced by the hepatocytes that is essential to normal digestion, particularly for fats.
bilirubin
The end product of hemoglobin degradation.
body, gastric
The largest portion of the stomach located between the fundus and the antrum.
canaliculi
Small channels or canals that branch out and connect to lacunae.
chief cells
The particular cells of gastric glands that secrete pepsinogen, a precursor of pepsin for protein digestion.
cholecystokinin (CCK)
Hormone that stimulates pancreatic enzymes, increases contractility of the gallbladder, and inhibits gastric motility.
chyme
The mixture of partially digested food and secretions of digestion found in the stomach and small bowel.
chymotrypsin
A proteolytic pancreatic enzyme.
conjugated bilirubin
Bilirubin that has been joined with glucuronic acid to make it water soluble.
duct of Santorini
An accessory duct of the pancreas that exists in approximately 70 percent of the population.
duct of Wirsung
The main pancreatic duct.
elastase
A proteolytic pancreatic enzyme; its proenzyme, proelastase, requires trypsin to become activated; responsible for erosion of blood vessels contributing to hemorrhage in severe acute pancreatitis.
endoscopic retrograde cholangiopancreatography (ERCP)
An invasive endoscopic test that allows cannulation and direct viewing of the ampulla of Vater, and the pancreatic and bile ducts.
enzymes
Catalyst substances found in cells that assist in cellular activities.
fundus
The anatomic area of the stomach located above the lower esophageal sphincter, appearing as a bulge at the top of the stomach.
G-cell
Gastrin secreting cells located in the mucosa of the pyloric area of the stomach and duodenum.
GALT
A term that stands for gut associated lymphoid tissue, used for all lymphoid tissue associated with the gastrointestinal tract, including the tonsils, appendix, and Peyer’s patches.
gastric inhibitory peptide (GIP)
Hormone that helps digest carbohydrates and fats.
gastric tonometry
A technique to assess gut perfusion by using a gastric balloon to measure the mucosal CO2 level.
gastrin
A hormonal regulator produced by cells located in the pyloric region of the stomach; stimulates gastric glands to produce hydrochloric acid and pepsinogen.
gastrocolic reflex
A mass movement of the contents of the colon, frequently preceded by a similar movement in the small intestine, which sometimes occurs immediately following the entrance of food into the stomach.
gluconeogenesis
Formation of glucose from protein and fat stores in the body; seen in the ebb phase and flow phase; formation of glycogen in the liver from a noncarbohydrate substance.
glycogenolysis
Conversion of glycogen to glucose in the liver and muscles; seen in the ebb phase of the metabolic stress response.
gut
Refers to the bowel or intestine.
haustral churning
Movement of the large intestine.
hydrochloric acid
Secreted by the parietal cells to lower gastrointestinal pH and to regulate bacterial growth.
intrinsic factor
Secreted by the parietal cells; necessary for vitamin B12 absorption.
isoenzymes
A subgrouping of parent enzymes that are more specific to a particular cell type.
jaundice
A yellow cast of the skin, sclera, and mucous membranes caused by elevated bilirubin, a yellow pigment.
Kupffer’s cells
Fixed tissue macrophages found in the liver.
lipase
A lipolytic pancreatic enzyme; its action contributes to necrosis of fatty tissue surrounding the pancreas in the presence of pancreatitis.
lipolytic
Facilitating the breakdown of fats.
lobule
The functional unit of the liver.
lower esophageal sphincter
(cardiac sphincter) Separates the esophagus from the stomach.
magnetic resonance cholangiopancreatography (MRCP)
A test using magnetic resonance imaging to produce images of the hepatobiliary tree.
mesenteric circulation
Blood flow to the intestines.
mesentery
Part of the peritoneum that suspends the small intestine to the abdominal wall.
microvilli
Fingerlike projections covering the villi.
mucosa
Innermost layer of the GI wall.
muscularis
Muscular layer of the GI wall.
parietal cells
A fundic gland that secretes hydrochloric acid for pH regulation and intrinsic factor for vitamin B12 absorption.
partial thromboplastin time (PTT)
Measures the intrinsic coagulation pathway.
pepsin
A gastric enzyme that breaks down protein.
pepsinogen
An enzyme secreted by chief cells; converts to its active form of pepsin for protein digestion.
peritoneum
Serous membrane that lines the abdominal cavity and abdominal organs.
Peyer’s patches
Lymph tissue on the outer wall of the intestine.
phospholipase A
A lipolytic pancreatic enzyme, activated by either bile salts or trypsin; contributes to the development of pulmonary complications (acute respiratory distress syndrome [ARDS]) by decreasing surfactant in the lungs.
prothrombin time (PT)
Measures the coagulation extrinsic pathway.
secretin
A hormone present in the small bowel mucosa that stimulates sodium bicarbonate secretion by the pancreas and bile secretion by the liver; it decreases gastrointestinal peristalsis and motility.
serosa
Outermost layer of the GI wall.
sphincter of Oddi
A circular muscle that surrounds the ampulla of Vater; it helps control the rate of pancreatic enzyme and bile flow into the duodenum.
splanchnic circulation
The combination of the portal venous and arterial circulatory systems of the viscera; blood flow through the gut, spleen, pancreas, and liver.
submucosa
Layer of the GI wall that contains blood and lymphatic vessels.
trypsin
A proteolytic pancreatic enzyme; it exists in the pancreas in its proenzyme (inactive) state as trypsinogen. Most of the other pancreatic enzymes require trypsin for activation.
unconjugated bilirubin
Fat-soluble bilirubin that has not yet joined with glucuronic acid.
urea
A nitrogen substance produced by the liver from ammonia.
urobilinogen
Bilirubin in the urine.
villi
Fingerlike projections covering intestinal folds.
abdominal compartment syndrome (ACS)
Occurs when the intraabdominal pressure increases to a point where vascular tissue is compromised with subsequent loss of tissue viability and function.
gastric tonometry
A technique to assess gut perfusion by using a gastric balloon to measure the mucosal CO2 level.
gut
Refers to the bowel or intestine.
hematemesis
Vomiting of bright red blood or blood that resembles “coffee grounds.”
hematochezia
Bright red blood or maroon colored stool secondary to bleeding.
intestinal strangulation
Intestine twists to such an extent that circulation to the twisted area is impaired.
melena
Black, tarry, foul-smelling stools containing blood.
mucosa
Innermost layer of the GI wall.
muscularis
Muscular layer of the GI wall.
peritoneum
Serous membrane that lines the abdominal cavity and abdominal organs.
severe abdominal compartment syndrome
IAP greater than 25 mm Hg.
submucosa
Layer of the GI wall that contains blood and lymphatic vessels.
