Quiz #2 (GI) prep Flashcards
What is a gastric pull-up?
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.
What is anastomosis?
the surgical connection made between adjacent blood vessels, parts of the intestine, or other channels of the body.
If the stomach cannot be used to replace the esophagus what will a surgeon use?
the colon (the largest part of the long intestine) or a piece of the small intestine.
What is a surgical gastrostomy tube?
a feeding tube placed directly into the stomach through the abdomen.
What is a surgical jejunostomy tube and what is it used for?
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.
What controls movement of the GI system?
both neural & hormonal
What is melena?
black stools, indicative of a upper GI bleed.
What are the signs and symptoms of GI disease?
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
What are 4 PT implications for a patient with GI disease?
fluid & electrolyte balance
pelvic floor rehabilitation
exercise and GI function
referred pain patterns
Why is fluid & electrolyte balance important for PT to consider?
fluid loss - orthostatic hypotension muscle cramping during exercise bismouth subsalicylate (pepto-) - can cause dark or black stool, also tongue
Why is exercise important for GI disorders?
exercise can speed up decrease GI transit time.
decrease constipation
strengthen muscle for swallowing
reduce GI bleeds with regular exercise
What is a sliding hiatal hernia?
the stomach and gastroesophageal junction are displaced up into the thorax.
most common type of hiatal hernia
most common cause of reflux esophagitis
What is a rolling (paraesophageal) hiatal hernia?
the gastroesophageal junction remain below the diaphragm but all or part of the stomach pushes into the thorax.
What is achalasia?
stenosis of the gastroesophageal junction.
What are PT implications for patient with hernias?
avoid lying pt supine
avoid valsalva with treatment (intraabdominal pressure)
safe & proper lifting techniques
post operative instructions (watch for tubes)
What is GERD?
gastoesophageal reflux disease (esophagitis)
What are PT implications for a patient with GERD?
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.
What orthopedic condition will a PT often treat with a GERD patient?
atypical head and neck symptoms (sensation of lump in throat) without heartburn.
What exercise can be used to strengthen the upper esophageal sphincter muscle?
the shaker head-lifting exercise
Why would the a PT want to strengthen the upper esophageal sphincter muscle?
to improve swallowing
What are the PT implication for working with a patient with inflammatory bowel disease?
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 -
What is diverticula and what does it cause?
outputting of intestinal wall causing wall to become weaker.
can be easily obstructed or inflamed = diverticulitis.
usually occurs in older individuals
What are special implications for PT with diverticular disease?
exercise but avoid intra-abdominal pressure
pt may have back pain
iliopsoas abscess - do manual muscle test
What is the difference in location between the indirect and direct inguinal hernias?
indirect - sac herniates through the internal inguinal ring.
direct - directly behind and through external inguinal ring, above inguinal ligament.
