Quiz 2 Flashcards

1
Q

Trigeminal nerve

A

nasopharynx

V

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2
Q

Glossopharyngeal nerve

A

posterior third of tongue and oral pharynx

IX

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3
Q

Superior laryngeal nerve

A

tongue base and inferior epiglottis to the vocal cords

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4
Q

Recurrent laryngeal nerve

A

vocal cords distally

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5
Q

Branches of Vagus nerve

A

remaining larynx and trachea

X

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6
Q

esophagus cervical location

A

C6

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7
Q

The esophagus passes through a space created by the ___________ of the diaphragm

A

right crus

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8
Q

The external muscular coat of the esophagus is made up entirely of ________ muscles in the upper third, of __________________ muscles in the middle third (A and B), and of ___________ muscle in the lower third

A

skeletal

skeletal and smooth

purely smooth

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9
Q

intrinsic innervation of the esophagus? Goes to?

A
  • myenteric or Auerbach plexus
  • submucosal or Meissner plexus

This system is a continuum that
extends from the esophagus to the anus?

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10
Q

extrinsic innervation of the esophagus?

A

Sympathetic
-Act on myenteric plexus to modulate rather than control motor activity

Parasympathetic

  • Causes esophageal muscular contraction
  • Causes relaxation of LES
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11
Q

Excitatory stimulation of UES occurs due to:

A
Inspiration
Gagging
Acidity of gastric contents
Valsalva maneuver
Esophageal distention
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12
Q

UES tone is reduced by:

A
  • Distention
  • Belching
  • Vomiting
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13
Q

Chronic alcoholism can lead to:

A

Degeneration of the Auerbach plexus
LES hypotonia
Impaired esophageal peristalsis
Mallory Weis Tear

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14
Q

Failure of the Lower esophageal sphincter tone to relax during swallowing accompanied with a lack of peristalsis

A

Achalasia

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15
Q

Can get Barret Esophagus from?

A
  • Chronic exposure to acidic gastric contents – GERD
  • Chronic alcohol abuse
  • Smoking
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16
Q

Types of hiatal hernia?

A
  • Sliding / Type I
  • Paraesophageal / Type II
  • Mixed / Type III
  • Type IV
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17
Q

which type of esophageal diverticula highest risk of aspiration?

A

Zenker, located in upper esophagus

18
Q

Daunorubicin and Doxorubicin/Adriamycin chemo drugs can cause?

A

chemotherapy induced cardiomyopathy

19
Q

Bleomycin chemo drug can cause?

A

Pulmonary fibrosis
Restrictive defect
Increased potential for oxygen toxicity

20
Q

The duodenum extends from the pylorus to the _________________.

A

ligament of treitz

21
Q

Layers of gastric wall

A
  • Serosa (external) (smooth muscle)
  • Muscularis Mucosae (smooth muscle)
  • submucosa
  • mucosa
22
Q

Acid release is mediated by:

A
  • Vagal stimulation (acetylcholine)
  • Gastrin release – G cells in response to gastric distention
  • Histamine
23
Q

produces hydrochloric acid in the stomach

A

parietal cells (reduced by PPIs/H-blockers

24
Q

Therapeutic Meds for PUD

A
  • PPIs
  • H2.blockers
  • sucralfate - binds to ulcer
  • ABX
  • misoprostol (synthetic prostaglandin) - prevents ulcers with NSAID use
25
Q

First line therapy for H.Pylori

A

PPI BID
Clarithromycin
amoxacillin

or

PPI BID
Clarithromycin
Metronidazole

26
Q

Gastric neoplastic disease types (and percentage)

A
  • adenocarcinoma (95%)
  • lymphoma (4%)
  • leiomyosarcoma (1%)
27
Q

The Pancreas: exocrine function

A
  • Secretes 1500-3000ml of pancreatic juice daily
  • Clear, colorless liquid with a pH of 8.3
  • Ionic composition is Na+, K+, bicarb, chloride
  • Principle function is to adjust duodenal pH
  • Promotes optimal function of pancreatic enzymes
28
Q

The Pancreas: endocrine function

A

Direct (non-ductal) production of insulin and glucagon to meet physiologic need

29
Q

Presence of acid in the duodenum caueses release of?

A

secretin (causes release of Bicarb)

30
Q

presence of fat in the duodenum causes release of?

A

Cholecystokinin (causes secretion of enzymes)

31
Q

Causes of Pancreatitis

A
  • Alcohol abuse
  • Direct or indirect trauma
  • Ulcerative penetration from adjacent structures
  • Infectious processes
  • Biliary tract disease
  • Metabolic disorders
  • Drug side effect
32
Q

Regulation of gallbladder contraction is primarily hormonal through the action of __________?

A

cholecystokinin (vagal stimulation also plays a role secondary to CCK)

33
Q

Three main functions of bile:

A
  • Emulsify and enhance absorption of ingested fats and fat-soluble vitamins.
  • Provide an excretory pathway for bilirubin, drugs, toxins, and immunoglobulin A (IgA)
  • Maintain duodenal alkalization
34
Q

S/S of Cholecystitis:

A
  • acute, severe, midepigastric pain that often radiates to right abdomen
  • Murphy sign -inspiratory effort accentuates the pain
  • increase in plasma bilirubin, alkaline phosphatase, amylase, and WBCs

(can present after a very fatty meal)

35
Q

Charcot triangle ? indicative of what disease?

A

-fever, chills, upper quadrant pain

Cholelithiasis/Choledocholithiasis

36
Q

Small intestine lengths:

A
  • Duodenum ~ 20cm
  • Jejunum ~ 100cm
  • Ileum ~150cm
37
Q

The function of the _________, the ______ and the _________ is to increase the amount of surface area available for the absorption of nutrients

A

plicae circulares

villi

microvilli

38
Q

Chron’s disease:

A
  • Cobblestoning
  • fat wrapping
  • thickened wall
  • can be in random spots
39
Q

Ulcerative Colitis:

A
  • Loss of haustra
  • pseudo polyps
  • crypt distortion
  • starts somewhere and continues on from there
40
Q

In the infant and adult it also destroys old red blood cells, recycles iron and globin and stores functional red blood cells, expelling them in response to a hemorrhage

A

spleen