Section 2B Flashcards
What is gastritis?
Inflammation of the stomach lining
Acute gastritis is most commonly associated with what 4 local irritants?
Bacterial endotoxins
Alcohol
Aspirin
NSAIDS
What are 4 symptoms of acute gastritis
- Anorexia
- Nausea
- Emesis
- Transient pain and usually disappear once the agent is removed
What occurs during chronic gastritis
Atrophy of the glandular epithelium of the stomach
What is the most common form of chronic gastritis
Helicobacter pylori gastritis
What was the accepted medical paradigm to explain ulcers until the early 1980s
That excess acid damaged the gastric mucosa and that treatment should be aimed at reducing or neutralizing that acid. Many clinicians linked overproduction of acid to stress
What allows H. pylori to survive in the stomach?
It survives because it produces the enzyme urease, which generates substances (NH3) that neutralize the stomach’s acid and enable the bacteria to survive
T or F, H. pylori does not penetrate the gastric mucosa
False, It does
Other than H. pylori, what are 3 other risk factors for peptic ulcer disease?
- NSAIDs
- Smoking
- Ethanol
What is a hiatal hernia?
Occurs when a portion of the stomach prolapses through the diaphragmatic or esophageal hiatus
Name 5 predisposing factors of hiatal hernias
- Muscle weakening and loss of elasticity as people age
- More common in women. Pregnancy forces
- Western, fiber-depleted diet leads to chronic constipation and straining during bowel movement
- Obesity because of increased abdominal pressure
- presence of abdominal ascites
T or F, Hiatal hernias do not affect LES function
False, They may compromise LES function
Does a hiatal hernia increase the risk for GERD?
Yes, it may trap a reservoir of gastric contents above the diaphragm
What is the role of Intrinsic factor (IF) that is produced by the stomach?
IF binds to vitamin B12 in the small intestine. The complex is then absorbed by enterocytes of the terminal ileum, from which it is delivered to the bloodstream
What does inadequate absorption of vitamin B12 cause?
Pernicious anemia which is characterized by the appearance in the bloodstream of large primitive RBC precursors called megaloblasts
2 oral manifestations of pernicious anemia
- Erythema and atrophy of the dorsal tongue
2. Burning macular, erythematous mucosal lesions
Is the stomach necessary to survival?
No, survival is possible with the stomach completely removed. Pancreatic and small intestinal enzymes are adequate for full digestion
What 3 things must occur for digestion when a stomach is absent
- Food must be eaten in very small amounts, very frequently
- Vitamin B12 supplements must be taken
- Care should be taken to eat properly cleaned food
Vomiting expulses contents of what two parts of the GI tract
stomach and or proximal small intestine
Vomiting can have what 4 serious consequences?
Acid-base disorders
Volume and electrolyte depletion
Malnutrition
Aspiration pneumonia
Vomiting is usually experiences as the finale of what three events?
Nausea
Retching (dry heaves)
Emesis or vomiting
What is the association between nausea and gastric motility and tone?
Nausea is typically associated with decreased gastric motility and increased tone in the small intestine
T or F, there is often reverse peristalsis in the proximal small intestine
True
What occurs with the different regions of the stomach during the dry heaves
Antrum contracts
Funda and cardia relax
Outline the 3 steps of Emesis
- Deep breath is taken, glottis is closed and larynx is raised to open the upper esophageal sphincter. Soft palate is elevated to close off posterior nares
- Diaphragm is contracted sharply downward to create negative pressure in thorax, facilitating the opening of the esophagus and lower esophageal sphincter
- Muscles of abdominal walls are vigorously contracted squeezing the stomach and thus elevating intra-gastric pressure.
What are the causes of vomiting associated with GI tract
Bacterial toxins, alcohol, distension or obstruction of organs, pharyngeal irritation
Causes of vomiting associated with CNS
Psychogenic factors (sights, smells, feelings), pain, motion sickness, increased ICP
Causes of vomiting associated with therapeutic agents
Cancer chemotherapy, morphine, NSAIDs, antibiotics
Causes of vomiting associated with metabolic disorders
Ketoacidosis, renal failure
Other than irritating stimuli in the GI tract, what portion of the brain can cause vomiting?
Located bilaterally on the floor of the 4th ventricle called the chemoreceptor trigger zone
