Screening for GI Disorders Flashcards

1
Q

The important relationship between the GI system and immune system.

A

Significant amount of immune system function occurs in the GI system. Estimated 70% of immune system is found in the gut

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2
Q

Emerging evidence on GI and nervous system

A

Gut microbiota may be important in interactions between intestine and brain

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3
Q

Referral sites for GI disorders

A
Sternal region
Shoulder
Neck
Scapular region
Mid T/S
Lumbar region
Hip
Pelvis
Sacrum
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4
Q

The most common intra-abdominal disorders that refer pain to the musculoskeletal system are…

A

those that involve ulceration or inflammation of the mucosal lining of the GI tract

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5
Q

What is a huge problem causing GI pain?

A

Many patients use medications associated with GI distress. Also, they use medications to suppress the symptoms associated with GI distress

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6
Q

What medications are associated with GI distress?

A

Aspirin
NSAIDs
Cardiovascular medications
Steroids

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7
Q

Medications used to suppress symptoms associated with GI distress

A

Antacids
Histamine-2 inhibitor
Proton pump inhibitors

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8
Q

What different types of things cause general GI symptoms?

A
Food
Alcohol
Drugs
Emotions/stress
Disease
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9
Q

Clinically relevant signs and symptoms of GI disorders

A
Abdominal pain
Dysphagia or odynophagia
GI bleeding
Symptoms altered by food
Early satiety
Constipation
Diarrhea
Arthralgia
Shoulder pain
Obturator or psoas abscess
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10
Q

Reasons for abdominal pain

A

Inflammation
Distention/obstruction
Necrosis/ischemia

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11
Q

What can be inflammed in the GI disorder that can cause abdominal pain?

A

Visceral or parietal peritoneum

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12
Q

Describe the abdominal pain associated with inflammation

A

Steady, deep, and boring
Poorly localized if visceral peritoneum
Localized if parietal peritoneum

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13
Q

Visceral nociceptors are susceptible to…

A

Stretch or tension

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14
Q

Example of distention/obstruction leading to abdominal pain

A

Bowel obstruction

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15
Q

Describe the abdominal pain associated with distention/obstruction

A

May be described as “colicky pain” and patients may have difficulty finding a comfortable position

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16
Q

Necrosis/ischemia can be a source of…

A

visceral pain

17
Q

Describe the abdominal pain associated with necrosis/ischemia

A

Steady pain which is usually intense with no relief from analgesic medication

18
Q

Why does visceral abdominal pain occur in midline?

A

Due to embryological development in the midline and the tissues receive bilateral innervation from the spinal cord

19
Q

Why is visceral abdominal pain poorly localized?

A

Because the tissue is innervated via multiple segments of the spinal cord, spanning up to 8 spinal levels

20
Q

Regions primarily associated with pain due to GI organs

A

Epigastric
Periumbilical
Hypogastrium

21
Q

Sympathetic nerve distribution of the epigastric region

A

T3-T5

22
Q

Sympathetic nerve distribution of the periumbilical region

A

T9-T11

23
Q

Sympathetic nerve distribution of the hypogastrium

A

T10-L2

24
Q

Organs causing epigastric pain

A

Heart, esophagus, stomach, duodenum, gall bladder, liver, and pancreas

25
Q

Organs causing periumbilical pain

A

Pancreas, small intestine, appendix, and proximal colon

26
Q

Organs causing hypogastrium pain

A

Large intestine, colon, bladder, and uterus

27
Q

What may be the first indication of visceral disease?

A

Sudomotor changes