Small Intestines, Colon and Appendix A&P, Pathophysiology

Question 1

what is visceral pain

Answer 1

autonomic innervation and stimulated by distention, contraction
-vague pain, dull
not sensing of cutting or more localized pain

Question 2

what is somatic pain

Answer 2

from the parietal peritoneum, will have more localized discomfort
sharp pain, associated with infection, inflammation

Question 3

what is inflammation of the peritoneal cavity

Answer 3

peritonitis - BAD
fluid within peritoneum from underlying process

Question 4

what is diverticulosis

Answer 4

uninflamed diverticula - common cause of acute lower GI bleed (LGIB)

Question 5

what is diverticulitis

Answer 5

inflammation of diverticulum
commonly associated with micro or gross performations

Question 6

what is diverticular disease associated with

Answer 6

western diet
decreased fiber intake

Question 7

what are complication with divertucula

Answer 7

hemorrhage
fistula
inflammation
abscess
perforation

Question 8

what is Meckels Diverticulum

Answer 8

congenital diverticulum - occurs in utero
m/c at iliosecal valve
typically asymptomatic

Question 9

what can cause vascular occlusion associated with ischemic bowel disease

Answer 9

atheroscoerosis
aortic aneurysm
clot

Question 10

what is chronic, relapsing, immunologic disease that is hallmarked by GI upset, abdominal pain, weight loss, fatigue

Answer 10

inflammatory bowel disease

Question 11

what is included in IBD

Answer 11

ulcerative colitis and Crohn’s disease

Question 12

what is the gene associated with UC

Answer 12

HLA_B27

Question 13

what is the inflammatory response with IBD

Answer 13

T-helper cells and cytokines
increase free radicals (alter DNA)
cellular damage and increased risk of colon cancer

Question 14

where are defensins secreted

Answer 14

small bowels

Question 15

how do you test of Ulcerative colitis

Answer 15

P-ANCA

Question 16

what is localized chronic inflammatory disease

Answer 16

ulcerative colitis

Question 17

where does UC begin

Answer 17

rectum and spreads proximally thoguh colon
ulcers form wtihin mucosal lining of colon

Question 18

what is the most common location of crohns disease

Answer 18

ascending colon and ileum

Question 19

What are the genetic components with Crohns disease

Answer 19

CARD15 or NOD2 gene

Question 20

what is excessive dilation of the colon

Answer 20

toxic megacolon

Question 21

what is the result of toxic megacolon

Answer 21

> 6cm diameter colon
increased risk of preforation
leaky gut - translocation of bacteria

Question 22

where are bowel obstructions most common

Answer 22

small intestine

Question 23

what are the types of obstruction

Answer 23

mechanical vs pseudoobstruction

Question 24

what is a pseudo-obstruction

Answer 24

adynamic ileus

Question 25

what does bowel obstruction lead to

Answer 25

cessation of flow build up of food stuffs, gas, secretion distention malabsorption volume depletion electrolyte abnormalities

Question 26

what is the number one cause of small bowel obstruction

Answer 26

adhesions

Question 27

what is a ileus

Answer 27

functional obstruction

Question 28

what are LBO associated wtih

Answer 28

fecal obstruction, tumor, sigmoid volvulus can be associated with secondary edema/inflammation (diverticulitis, scaring)

Question 29

what is a volvulus

Answer 29

mal-rotation leading to obstruction

Question 30

where are volvulus most common

Answer 30

cecum or sigmoid

Question 31

What is normal transit constipation

Answer 31

difficulty with passage of the stool that is able to make it down the sigmoid functional constipation associated with low-fiber diet or low H20

Question 32

what is low transit constipation

Answer 32

decreased colonic motor activity idiopathic or secondary cause (DM, autonomic dysfunction, MS, parkinson's, meds, etc)

Question 33

what is pelvic floor dysfunction constipation

Answer 33

anal sphincter does not relax pelvic flood unable to tighten appropriately may be associated with hemorrhoids or other anal pathology

Question 34

where is the appendix attached

Answer 34

near ileocecal valve

Question 35

what is appendicitis most commonly associated with

Answer 35

obstruction typically with fecolith

Question 36

what is a tear of the anoderm

Answer 36

anal fissure

Question 37

what are anal fissures associated with

Answer 37

trauma constipation diarrhea vaginal delivery crohn's disease infectious disease

Question 38

what seperates the anal canal in half

Answer 38

dentate line separates vasculature and innervation