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gi missing > session 7 > Flashcards

session 7 Flashcards

1
Q

2 types of diarrhoea

A

osmotic, secretory

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2
Q

osmotic diarrhoea

A

the gut lumen contains too much osmotic material due to malabsorption. causes excess water in poo

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3
Q

secretory diarrhoea

A

too much secretion of chloride or bicarbonate ions causes increased paracellular transport of Na+. water follows, increasing water in poo

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4
Q

causes secretory diarrhoea

A

infection

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5
Q

what is constipation

A

when you have to strain, pass hard stools or are unable to pass a bowel movement.

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6
Q

primary causes constipation

A

normal transit constipation, slow transit constipation and evacuation disorder

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7
Q

secondary causes constipation

A

medications , physical obstruction, metabolic and endocrine disorders, neurological and myopathic disorders

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8
Q

treatment diarrhoea

A

psychological support, increased fluid intake, increased activity, increased dietary fibre, fibre medication, laxitives

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9
Q

compare structure of colon to appendix

A

appendix has complete longitudinal layer of muscle, colon has teniae coli.

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10
Q

3 types acute appendicitis

A

acute, gangrenous, or perforated

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11
Q

cause appendicitis

A

obstruction of the appendiceal lumen by either a faecolith or lymphoid hyperplasia. The obstruction causes the intraluminal pressure in the appendix to rise which in turn causes ischaemia in the wall of the appendix. This ischaemia allows bacterial invasion of the wall with necrosis and/or perforation.

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12
Q

what causes atypical presentation of appendicitis

A

the appendix lies in a retro-caecal position or in the pelvis and so won’t necessarily irritate the parietal peritoneum. causes supra pubic/right sided rectal/vaginal pain

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13
Q

symptoms appendicitis

A

poorly localised peri-umbillical pain, anorexia, nausea, vomiting, low grade fever

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14
Q

signs appendicitis

A

fever, tachycardia, lie still, rebound tenderness

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15
Q

treatment appendicitis

A

open appendicectomy, laparoscopic appendicetomy

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16
Q

what is a diverticulum

A

mucosa and submucosa herniate through the external muscle layers of sigmoid colon

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17
Q

where do diverticula occur

A

sites of the major branches of the vasa recta

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18
Q

Diverticulitis definition

A

inflammation and/or infection of a diverticulum

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19
Q

what is diverticular disease

A

pain but no inflammation

20
Q

cause of acute diverticulitis

A

entrance to diverticula blocked by faeces, inflammation allows bacterial invasion of walll of diverticula, leading to perforation

21
Q

uncomplicated diverticulitis

A

inflammation and absecces confined to colonic wall

22
Q

complicated diverticulitis

A

larger abscesses, fistula, perforation

23
Q

symptoms diverticulitis

A

abdominal pain, fever, bloating, constipation

24
Q

signs diverticulitis

A

localised abdominal tenderness, distention, reduced bowel sounds peritonitis

25
Q

diagnosis acute diverticulitis

A

ultrasound scan, ct scan, colonoscopy

26
Q

blood supply to rectum

A

superior rectal artery (IMA), middle rectal artery (internal iliac) and inferior rectal (pudendal)

27
Q

venous rectum drainage

A

portal drainage through superior rectal vein, systemic drainage through internal iliac vein

28
Q

where is the start of the anal canal

A

proximal border of the anal sphincter complex

29
Q

factors required for continence

A

distensible rectum, firm bulky faeces, normal anorectal angle, anal cushions, normal anal sphincters

30
Q

what is the involuntary anal sphincter

A

thickening of circular smooth muscle, under autonomic control

31
Q

what is the external anal sphincter

A

striated muscle from levator ani mixing with pubo-rectalis to form a slimg. supply from pudundeal nerve. under conscious control

32
Q

how does the defecation reflex occur

A
  • contraction in rectum/sigmoid colon
  • relaxation of internal anal sphincter
  • contraction of external anal sphincter
33
Q

how is defecation delayed

A

contraction of external anal

sphincter and puborectalis muscle, reverse peristalsis

34
Q

how does defecation occcur

A

relaxation of external anal sphincter and puborectalis, forward peristalsis, valsalva maneuver

35
Q

what is the dentate line

A

the junction between endoderm and ectoderm. Proximal to the dentate line, there is sympathetic and parasympathetic innervation, and columnar epithelium. Distally, the nerve supply is somatic and epithelia is stratified squamous

36
Q

when do internal haemorroids cause symptoms

A

their connective tissue support collapses and the haemorrhoids prolapse.

37
Q

cause of internal haemorrhoid

A

loss of connective tissue support above dentate line.

38
Q

blood colour internal haemorroids

A

bright red

39
Q

treatment internal haemorrhoids

A

o soften stool and avoid straining hard when passing stool.

40
Q

what are external haemorroids

A

swellling of anal cushions below pectate line- painful.

41
Q

what is an anal fissurel

A

linear tear of the anoderm. They typically occur after passage of a large, hard bowel movement.

42
Q

cause of anal fissure

A

high interal anal sphincter tone, reduced blood flow to anal mucosa

43
Q

treatment anal fissure

A

increased fibre and water intake as well as hygiene and comfort measures

44
Q

what is haematochezia

A

passage of blood through anus

45
Q

causes of haemaochezia

A

diverticulitis, angiodysplasia, colitis, colorectal cancer, anorectal disease, upper gi bleed

46
Q

what is melaena

A

black tarry stools, offensive smelling due to haemoglobin being altered by digestive enzymes and gut bacteria

47
Q

common causes melaena

A

upper gi bleed caused by peptic ulecr disease/ variceal bleeds

gi missing (10 decks)

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