Module 6 Flashcards
Primary function of GI tract (4)
-ingestion of food
-digestion of food into primary nutrients
-absorption of these nutrients
-elimination of the leftovers end products as solid waste
Gastroenterology
Study of the normal function of the GI tract and the diseases that can affect it
Gastroenterologist
Physician that specializes in the study of gastroenterology and the treatment of GI tract diseases.
Another name for GI tract
Alimentary canal
Continuous tube from mouth to anus
Can be up to 30 feet long
Forms the roof of the oral cavity
Soft and hard palates
Teeth are embedded in the _____ on the roof and floor
Gingivae
Glands that secrete saliva (3)
Sublingual salivary gland
Submandibular salivary gland
Parotid glands
Function of anterior and posterior portion of tongue
Anterior: free moving and helps to move food throughout mouth for chewing
Posterior: fixed within the mouth and functions to initiate swallowing
On the surface of tongue
Papillae and taste buds
Five types of tastes
Sweet, sour,salt ,bitter , and umami
Deciduous Teeth
Temporary teeth developed in infancy and are lost during childhood
Number of deciduous teeth and permanent teeth
20 deciduous teeth
32 permanent teeth
Types of teeth
Incisors
Canines
Premolars
Molars
Function of the different types of teeth
Incisors and canines: biting into food; have a sharp cutting edge
Premolars and molars: crushing food; crown of the tooth is broad
Food after mixed with saliva and swallowed
Bolus
Two sections of pharynx that food moves through?
Oropharynx
Laryngopharynx
Where is Nasopharynx located?
Superiorly to the soft palate
To and from esophagus extends from?
From pharynx to stomach
Sphincter
A muscle that encircles a tube, and when it contracts, it causes the tube to close
Found at the start and end of the esophagus (2)
Pharyngoesophageal sphincter
Lower esophageal sphincter / cardiac sphincter
Purpose of lower esophageal sphincter
Prevents stomach contents from regurgitating up from the stomach back into the esophagus.
Three layers of the stomach
Fundus: upper
Body: main part
Antrum: lower
Where are digestive juice glands located?
Rugae
Describe mechanical digestion
Occurs when the walls of the stomach contract. This causes churning and mixes food with digestive juices.
Rugae
Folds within the walls of the stomach that allows stomach to expand as it fills with food
Describe chemical digestion
Digestive juices made by glands in the Rugae , are acidic and contain enzyme/hormones that break down food and convert food to a liquid state.
Chyme
Digested food after chemical digestion in the stomach
Chyme moves out of stomach through the ___
Pyloric sphincter
Where does the small intestine extend to and from?
From pyloric sphincter to the ileocecal sphincter
Function of small intestine
- mixes chyme with digestive enzymes from liver and pancreas
-absorption of nutrients from the food into the bloodstream
Villi
Tiny projections from the mucus membrane surface of the small intestine
-increases surface area of the small intestine dramatically so there is more room for absorption
Nutrients absorbed in the small intestine
Carbohydrates
Proteins
Fats
Three parts of the small intestine
Duodenum: 1st 12 inches
Jejunum:
Ileum: last 12 inches
- entire small intestine is 21 feet in length
Where does large intestine extend to and from ?
From ileocecal valve to the anus
Difference in diameter and size between small and large intestine
Diameter:
Small: 1 inch
Large: 2.5 inches
Length:
Large: 5 feet
Small: 21 feet
Parts of the large intestine
Cecum
Colon. (ascending, transverse,decending)
Rectum
Anal canal
What is the appendix connected to?
The cecum
Large intestine function
-Absorbs water from chyme
-waste products are compacted into feces or stool
Defecation
Process of removing stool from the anal canal
Accessory organs to the digestive system
Salivary glands
Liver
Pancreas
Gallbladder
Connects accessory organs to alimentary canal
Ducts
The 4 salivary glands and their locations
Two parotid glands: located below the ear on either side of mouth
Submandibular gland: located in floor of mouth
Sublingual gland: below the tongue
Function of the liver (5)
-important for metabolism of nutrients
-carbohydrates converted from glucose to glycogen
-proteins stored, broke down, and formed within the liver
-fats stored within liver, processed and released into the bloodstream
-stores vitamins and irons
-detoxifies the blood and removes various drugs and alcohol
Metabolism
Process of chemically and physically breaking down tissues and creating different tissues that are needed for the body.
Bile
Digestive juice involved in fat metabolism
What structure does bile leave the liver through?
Hepatic duct
What connects gallbladder to the hepatic duct?
Cystic duct
Common bile duct
Joining of the hepatic duct and cystic duct
-travels to the small intestine to release digestive juices
Gallbladder function
Stores and concentrate bile for later use
Billary tree
Ducts that travel from the liver to the intestine
Structures of the biliary tree
Hepatic duct
Common hepatic duct
Cystic duct
Common bile duct
Pancreatic duct
Dyspepsia
Indigestion
Chronic (more than 1 month) or acute difficulty in digestion associated with pain in the upper abdomen
Dyspepsia causes
Eating too fast
Eating high fat food
Eating during times of high stress
Taking in too much alcohol or caffeine
Side effects of medication including antibiotics, anti inflammatory drugs, opioids, and antidepressants
Dyspepsia treatments
-Lifestyle changes
-Medications that decrease amount of stomach acid produced in the stomach
Bleeding the the upper GI tract includes:
Esophagus
Stomach
Beginning of the small intestine
Common conditions that lead to upper GI bleeding
Ulcers
Esophageal varices
Mallory Weiss tears
Stomach tumors
Vascular abnormalities (ie angiectasias)
Esophageal varices
Dilated veins in the lower esophagus due to portal hypertension
Superficial and prone to bleeding
Mallory Weiss tears and it’s causes
Lacerations to the Gastroesophageal junction that causes bleeding
-can be associated with excessive alcohol intake or vomiting
Angiectasias
Vessels in the submucosa of the GI tract that become dilated and are prone to bleeding due to obstructions in the vascular system
Symptoms of upper GI bleeding
Hematemesis
Melena
Significant blood loss:
-tachycardia
-hypertensive
- require stabilization with fluids and blood transfusions
Upper GI bleed treatments
EGD to identify location of bleeding
-these areas can be cauterized, clipped , or injected with medication to stop the bleeding
-underlying diseases treated with medication (ex. Acid inhib, hypertensive)
Lower GI bleed
Occur primarily in the large intestine
- can range from mild anorectal bleeding to massive blood loss called hematochezia
Hematochezia
The passage of large volumes of bloody stool
Causes of lower GI bleed
-Infectious colitis
-Anorectal disease (ex. hemorrhoids or anal fissures )
-Inflammatory bowel disease ( ulcerative colitis)
-diverticulosis, angiectasias, or tumors of the colon
Lower GI bleed treatment
-Source of bleeding identified through colonoscopy
–these areas can be cauterized, clipped , or injected with medication to stop the bleeding
-underlying diseases treated with medication
GERD
Condition where stomach contents reflex into the esophagus and cause symptoms and damage to the surface of the esophagus
Causes of GERD
-LES is either weak or relaxes inappropriately and allows reflux
-increase in abdominal pressure (seen commonly in pregnant pts and obese pts)
-Hiatal Hernia
Hiatal Hernia
GERD symptoms
Heartburn
Regurgitation
Bleaching
Chest pain
Cough
GERD treatment
-Decrease high acid foods
-weight loss
-smoking cessation
- PPI
- do not lay down for 3 hours after eating
Peptic Ulcer Disease
Condition where ulcers develop in the Stomach and duodenum
-stomach acid break down mucosal surface of the stomach and duodenum
Causes of peptic ulcer disease
-excessive use of anti inflammatory medications such as ibuprofen
- infection with h pylori
PUD symptoms
Full, aching, or gnawing epigastric pain
Pain temporary relieved with eating or antacid
PUF diagnosis and treatment
Diagnosed through an EGD and h pylori testing
- treated with antibiotics and PPI medication
Cholelithiasis
Condition where stones develop within the gallbladder
Symptoms of cholelithiasis
Gallstones in the gallabldder generally do not cause symptoms.
Symptoms can occur as gallstones migrate out of the gallbladder within the biliary tree
Cholecystitis
Inflammation of the gallbladder, frequently associated with gallstones
Causes of Cholecystitis
Gallstone obstructs the cystic duct and inflammation develops behind the obstruction
Symptoms of Cholecystitis
-RUQ pain
-fever
-vomiting
-jaundice
Jaundice
Yellowing of the skin and whites of the eyes
Treatment for Cholecystitis
-cholecystectomy will occur if there is repeated episodes of Cholecystitis leading to:
-chronic inflammation
-necrosis of the gallbladder due to ischemia
-choledocholithiasis
Appendicitis
Inflammation of the appendix that occur when the entrance of the appendix is obstructed by a fecalith, inflammation, foreign body, or tumor
Appendix
Worm like diverticulum that hangs from the large intestine
- attached to the cecum
Fecalith
Hard mass of stool
Physiology of appendicitis
When the appendix become obstructed, there is increased pressure within the large intestine.
- this causes infection and damage to the blood vessels
Symptoms of appendicitis
-RLQ pain, worse with standing or coughing
-nausea
-vomiting
-fever
-point tenderness at McBurney’s point
Diagnosis of appendicitis
Via an abdominal ultrasound or abdominal CT scan
Treatment of appendicitis
Laparoscopic appendectomy
Laparoscope
Minimally invasive surgical approach with a scope fitted with tools used to remove the appendix, rather than with a large incision.
Inflammatory Bowel disease
Ulcerative colitis
Crohns disease
-chronic, recurrent inflammation of the mucosal surface of the GI tract
Difference between crohns disease and ulcerative colitis
UC: inflammation of the lining of the colon only
CD: involve any portion of the GI tract
Symptoms of Crohn’s disease
Intermittent episodes of fever
Diarrhea
RLQ pain
-ileitis and ileocolitis
-palpable mass in the RLQ
-obstruction of the intestine
-fistula between large and small intestine
-perianal disease with skin tags, anal fissure , perianal abscesses, and fistulas
Anal fissure
Deep crack around the anus
Fistula
Abnormal passage between two areas that should not be connected
Symptoms of ulcerative colitis
Bloody diarrhea
Abdominal pain
Treatment for inflammatory bowel disease
Steroids and aminosalicylates to decrease inflammation
Immunomodulators: used in severe disease to help maintain remission
-surgery to remove section of bowel that is resistant to medication
Diverticulosis
Condition where pouches form within the walls of the colon
Causes and symptoms of Diverticulosis
Aging
The pouches themselves to do not cause any symptoms
Diverticulitis
Inflammation of one or more diverticula and do cause symptoms
Symptoms of Diverticulitis
Abdominal pain
Nausea
Vomiting
Fever
Blood in the stool
Diagnosis and treatment for Diverticulitis
Diagnosed with CT scan of the abdomen
Treatment: antibiotics, liquid diet for 2-3 days
IV fluids and IV antibiotics if symptoms do not improve (for severe cases)
Urinary system function
- removing waste from the bloodstream
-excreting waste from the body through urine
Nephrology
Study of medicine that studies the kidney and disease that affect the kidney.
Urology
Specialty of medicine that studies the male and female urinary tract and the male reproductive organs
Nephrologist
Physician that specializes in treatment of renal disease
Urologist
Physician that specializes in the treatment of pts with diseases of the urinary tract and male reproductive tract.
Function and location of kidneys
- filter waste products out of the bloodstream
- located on either side of the spine behind the abdominal cavity
Three layers that protect the kidney
Renal capsule: covers surface
Perirenal fat: Cushions the kidneys
Renal fascia: Anchors the kidneys in Their normal position within the abdominal cavity
Hilum
Notch on the medial side of the kidney
What structures enter the kidneys at the hilum?
Renal artery
Renal vein
Nerves
Lymphatic vessels
Ureter
Nephrons and it’s function
Structural and functional unit of the kidneys
-filter the blood, reabsorb needed components back into the blood, and regulate the normal fluid balance within the body.
Terms within the nephron (5)
Bowman’s capsule
glomerulus
Proximal convoluted portion
The loop of henle
Distal convoluted portion
Bowman’s capsule
Sac like structure around a capillary bed that filters blood to form urine
Glomerulus
Located within the bowman’s capsule
Contains capillary bed which reabsorbs needs components back to bloodstream
What components leave the blood from the bowman’s capsule and enters the proximal convoluted tubule (6)
Water
Urea
Uric acid
Creatinine
Sodium chloride
Potassium
Glomerular filtration
Process in which the blood is filtered within the bowman’s capsule ; waste products leave the blood and enter the proximal convoluted tubule
What occurs in kidneys after glomerular filtration?
Contents of filtrate are refined in proximal convoluted tubular, as it runs along a capillary.
Glucose, protein, water, and ions are reabsorbed back to blood
Additional waste products enter filtrate
Ureter
Long narrow tube that travels from the two kidneys to the bladder
Urinary bladder function
Collects urine from both kidneys until it is time to excrete urine from the body.
- muscular sac that can expand to hold more urine
Urethra function
Carrie’s urine from bladder to the outside of the body
Urinary meatus
The external opening of the urethra
Difference between male and female urethra
Male: 8 inches and Carrie’s both urine and semen
Female: 1.5 inches and only carries urine
Genitourinary tract infection and two examples
Infection of the urinary tract
Acute cystitis and acute pyelonephritis
Acute cystitis
Infection of bladder caused by E coli
Bacteria gains access of UT via the urethra
Symptoms, diagnosis and treatment for Acute cystitis
Frequency, dysuria, urgency,
Urinalysis and Culture and Sensitivity
Short course of antibiotics
Acute pyelonephritis
Inflammation of the kidney and renal pelvis due to infection of the kidney
This infection also descends to the lower urinary tract
Symptoms, diagnosis, and treatment for Acute pyelonephritis
Fever, tachycardia, flank pain, shaking chills, voiding symptoms, nausea, vomiting, and diarrhea.
Urinalysis, urine culture, imaging of kidney (renal ultrasound or CT scan)
IV antibiotics and IV fluids in hospital; can lead to sepsis and shock if not treated.
Acute kidney injury
Worsening of kidney function over a short period of time (hours to days)
Accumulation of waste products in the bloodstream
Accumulation of waste products in the blood.
What is the term and what are some waste examples?
Azotemia or uremia
Creatinine, urea, uric acid,
Signs of uremia
Changes in mental status
Nausea
Vomiting
Malaise
Three classifications of AKI
Prerenal
Intrinsic kidney disease
Postrenal
Prerenal AKI
Decrease in perfusion of the kidney with blood
Common causes of Prerenal AKI
Decreased cardiac output
Decreased blood volume from bleeding
Excessive diuretic use
Intrinsic kidney diseases
Acute tubular necrosis
Acute glomerulonephritis
Interstitial nephritis
Postrenal AKI causes
Obstruction of the ureters, bladder, or the urethra
Treatment for AKI
Treatment of the underlying cause of the AKI
Chronic kidney disease
Chronic renal failure
Decline in kidney function over months to years
Hypertension and diabetes are common risk factors
CKD symptoms
Uremic syndrome ; which causes nausea, vomiting, fatigue, metal taste in mouth, and anorexia
Puritis
Restless leg
Insomnia
Memory deficiency
Complications of CKD
Hypertension
Anemia
Hyperkalemia
Heart failure
Atrial fibrillation
Coronary artery disease
Treatment for CKD
Treatment of hypertension and diabetes
Dialysis
Renal transplant
Dialysis definition and the two common types
Medical procedure where the waste material In the blood is separated out and the normal fluid, electrolyte and acid base balance is maintained via a machine or chemical reaction
Hemodialysis and peritoneal dialysis
Hemodialysis
Blood is removed and processed through a dialyzer and then returned to the body
Completed through a arteriovenous fistula
arteriovenous fistula
Surgically created connection of an artery and vein
Peritoneal dialysis
Dialysate is brought into the peritoneal cavity and the peritoneal membrane filters the blood
Dialysate is removed from cavity and the dialysis fluid is replaced
Advantages and complication of peritoneal dialysis
Pt can complete this process within their own home
Peritonitis; inflammation of the peritoneal cavity
Renal transplantation
Kidney taken from either a living or deceased donor and then surgically placed in pt with CKD
Nephrolithiasis (urinary stone disease)
Development of stones within the urinary tract. These stones develop due to saturation of urine
Most common stone developed in nephrolithiasis
Calcium oxalate
Phosphate stone
Common causes for the development of renal stones or calculi
Medications
Inadequate hydration
Family history
Pts who live in hot and humid climates
Symptoms of renal calculi obstructuon
Severe pain in the flank
Nausea
Vomiting
Hard time finding comfortable position
Pain likely resolves once stone passes into the bladder and out the urethra
Procedures if renal stone does not pass on its own (3)
Extracorpeal shockwave lithotripsy
Ureteroscopic stone extraction
Percutaneous nephrolithotomy
Ureteroscopic stone extraction
Scope travels to the site of stone for removal
Percutaneous nephrolithotomy
Surgical procedure that removes stone from the renal pelvis via a scope that is inserted through the back that breaks up the stone with ultrasound and then removes the stone fragment
Extracorpeal shockwave lithotripsy
Ultrasound shock waves break up stones so it can pass easier
