Quiz #2 (GI) prep

Question 1

What is a gastric pull-up?

Answer 1

When part of all of the esophagus is removed, a surgeon pulls the stomach up, reshapes it into a tube and joins it to the esophagus that remains.

Question 2

What is anastomosis?

Answer 2

the surgical connection made between adjacent blood vessels, parts of the intestine, or other channels of the body.

Question 3

If the stomach cannot be used to replace the esophagus what will a surgeon use?

Answer 3

the colon (the largest part of the long intestine) or a piece of the small intestine.

Question 4

What is a surgical gastrostomy tube?

Answer 4

a feeding tube placed directly into the stomach through the abdomen.

Question 5

What is a surgical jejunostomy tube and what is it used for?

Answer 5

a feeding tube placed directly into the middle part of the small intestine (called the jejunum) through the abdomen.
this tube allow the patient to get all the nutrients they need while they recover from surgery.

Question 6

What controls movement of the GI system?

Answer 6

both neural & hormonal

Question 7

What is melena?

Answer 7

black stools, indicative of a upper GI bleed.

Question 8

What are the signs and symptoms of GI disease?

Answer 8

nausea & vomiting
diarrhea
anorexia
constipation
dysphagia (difficult swallowing)
achalasia (muscle in esophagus cannot relax)
heartburn
abdominal pain
GI bleeding 
hematemesis - vomiting blood
melena - upper GI bleed
hematochezia - lower GI bleed
fecal incontinence

Question 9

What are 4 PT implications for a patient with GI disease?

Answer 9

fluid & electrolyte balance
pelvic floor rehabilitation
exercise and GI function
referred pain patterns

Question 10

Why is fluid & electrolyte balance important for PT to consider?

Answer 10

fluid loss - orthostatic hypotension
muscle cramping during exercise
bismouth subsalicylate (pepto-) - can cause dark or black stool, also tongue

Question 11

Why is exercise important for GI disorders?

Answer 11

exercise can speed up decrease GI transit time.
decrease constipation
strengthen muscle for swallowing
reduce GI bleeds with regular exercise

Question 12

What is a sliding hiatal hernia?

Answer 12

the stomach and gastroesophageal junction are displaced up into the thorax.
most common type of hiatal hernia
most common cause of reflux esophagitis

Question 13

What is a rolling (paraesophageal) hiatal hernia?

Answer 13

the gastroesophageal junction remain below the diaphragm but all or part of the stomach pushes into the thorax.

Question 14

What is achalasia?

Answer 14

stenosis of the gastroesophageal junction.

Question 15

What are PT implications for patient with hernias?

Answer 15

avoid lying pt supine
avoid valsalva with treatment (intraabdominal pressure)
safe & proper lifting techniques
post operative instructions (watch for tubes)

Question 16

What is GERD?

Answer 16

gastoesophageal reflux disease (esophagitis)

Question 17

What are PT implications for a patient with GERD?

Answer 17

exercise - extra abdominal fat incr pressure.
Educate - avoid high caloric meals, timing meals before exercise
avoid supine flat position - after eating, good to sleep on left side
Polypharmacy - report and new or unusual symptoms.

Question 18

What orthopedic condition will a PT often treat with a GERD patient?

Answer 18

atypical head and neck symptoms (sensation of lump in throat) without heartburn.

Question 19

What exercise can be used to strengthen the upper esophageal sphincter muscle?

Answer 19

the shaker head-lifting exercise

Question 20

Why would the a PT want to strengthen the upper esophageal sphincter muscle?

Answer 20

to improve swallowing

Question 21

What are the PT implication for working with a patient with inflammatory bowel disease?

Answer 21

abdomen pain cand refer to low back
25% of patients present with migratory arthralgia, arthritis, or sacroilitis.
medication side effects
patient may have low bone mineral content and prone to osteoporosis.
possible dehydration - dry lips, dry hands, brittle hair
prone to emotional stress - exacerbates sxs
potential iliopsoas involvement -

Question 22

What is diverticula and what does it cause?

Answer 22

outputting of intestinal wall causing wall to become weaker.
can be easily obstructed or inflamed = diverticulitis.
usually occurs in older individuals

Question 23

What are special implications for PT with diverticular disease?

Answer 23

exercise but avoid intra-abdominal pressure
pt may have back pain
iliopsoas abscess - do manual muscle test

Question 24

What is the difference in location between the indirect and direct inguinal hernias?

Answer 24

indirect - sac herniates through the internal inguinal ring.

direct - directly behind and through external inguinal ring, above inguinal ligament.

Question 25

What is appendicitis?

Answer 25

inflammation of the vermiform appendix

Question 26

What causes appendicitis?

Answer 26

primarily - obstruction of the lumen

secondarily - bacterial infection

Question 27

What are PT implications for appendicitis?

Answer 27

McBurney’s point & pinch-an-inch test
if appendicitis is suspected keep pt lying down and quiet as possible, taking nothing by mouth (including water); heat is contraindicated

Question 28

What are the age related changes in the GI system?

Answer 28

changes begin around 50 y/o
constipation, incontinence, and diverticular disease common
esophagus, stomach, SI, and colon lose muscle tone
slower absorption
decr in production of intrinsic factor leading to it B12 deficiency