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Physiology 1 > Symptoms Of GI Disease: Nausea, Vomiting And Pain > Flashcards

Symptoms Of GI Disease: Nausea, Vomiting And Pain Flashcards

1
Q

What is the main aim of nausea and vomiting?

A

Poison defence system

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2
Q

What physiological changes are associated with nausea?

A

Shaky, pale and clammy, decreased gut motility and hormone changes

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3
Q

What does nausea trigger?

A

An aversion to a thing

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4
Q

What is an aversion?

A

Strong dislike or disinclination which leads to behavioural changes

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5
Q

What is the difference between vomiting and nausea?

A

Nausea is a sensation and vomiting is a physical act

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6
Q

What is the scientific name for vomiting?

A

Emesis

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7
Q

What happens in emesis?

A

Contents of upper GI tract expelled via mouth

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8
Q

What is the relationship between nausea and vomiting?

A

Produced by the same stimulus

Nausea generally preempts vomiting but one may happen without the other

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9
Q

What are the 13 emetic stimuli?

A

Poisining, GI infection, excessive alcohol, pregnancy, excessive eating, travel sickness, emotional upset, obstruction, raised intracranial pressure, metabolic disturbance, GI disease, IV drugs and other people being sick

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10
Q

How does taste and smell protect against ingested toxins?

A
  • prevent ingestion
  • built in dislike of bitter flavours
  • children don’t like trying new stuff
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11
Q

What are the gastric and upper GI protection against ingested toxins?

A
  • expel harmful agents before they can be absorbed

- associated with chemoreceptors cells

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12
Q

What do the gastric chemoreceptive cells respond to?

A

Naturally occurring toxins, damaging chemicals and inflammatory mediators

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13
Q

What is the chemoreceptor trigger zone?

A

The area postrema in the brainstem is where the blood-brain barrier is leaky and chemoreceptors can detect toxins in the blood

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14
Q

What is the vestibular system?

A

Organ of balance but also a strong trigger for emesis

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15
Q

Where is the nucleus tractus solitarius found?

A

In the medulla of the brainstem

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16
Q

What does the nucleus tractus solitarius do?

A

Integrates cardiac, respiratory and GI functions

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17
Q

What are the four types of warning inputs in the nucleus tractus solitarius?

A
  • Visceral afferents in the stomach and duodenum
  • area postrema
  • vestibular system
  • higher centres
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18
Q

What happens to the area postrema if there is a raise in intercranial pressure?

A

Gets squeezed out of the bottom of the skull, causing vomiting

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19
Q

What are the four types of visceral afferents in the stomach and duodenum?

A

Toxins, irritants, inflammation and distension

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20
Q

What nerve are the vestibular systems signals sent through?

A

8th cranial nerve

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21
Q

What are the three places the NTS can stimulate?

A

Higher centres, hypothalamus and autonomic efferents

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22
Q

What are the higher centres the NTS stimulates and what does it cause?

A

Cerebral cortex/ limbic system -> nausea and future avoidance

23
Q

What does the NTS cause the hypothalamus to secrete?

A

ADH

24
Q

What does the NTS cause autonomic efferents to do?

A

Increase salivation and vasoconstriction in the GIT

25
Q

Why does the NTS make the body increase salivation?

A

More protection against acidic chyme as saliva is alkaline

26
Q

Why does the NTS cause vasoconstriction in GIT?

A

Reduce absorption of substance into bloodstream

27
Q

What are the 5 steps the NTS takes to trigger nausea and vomiting?

A
  • reduces mixing and peristalsis
  • proximal stomach relaxes
  • giant retrograde contraction
  • retching
  • vomiting
28
Q

Why does the NTS reduce mixing and peristalsis?

A

Prevents toxins being carried through the system

29
Q

Why does the NTS relax the proximal stomach?

A

Means stomach is prepared to receive additional contents

30
Q

Why does the NTS cause a giant retrograde contraction?

A

Takes contents from mid-small intestine into the stomach

31
Q

What is the giant retrograde contraction controlled by?

A

Efferent vagal nerves

32
Q

What is retching?

A

Coordinated contractions of abdominal muscles and diaphragm

33
Q

Why is there no expulsion in retching?

A

Anti-reflux barriers intact

34
Q

What happens in the abdomen during retching?

A

Waves of high pressure- compresses stomach

35
Q

What happens when you vomit?

A

Oesophageal sphincters and crural diaphragm relaxes and further waves of contraction

36
Q

How are pain signals carried to the brain?

A

Visceral afferent nerves that converge on the greater and lesser splanchnic nerves at the thoracic vertebral level

37
Q

What do ‘pain’ receptors respond to?

A

Noxious stimuli

38
Q

What are ‘pain’ receptors actually called?

A

Nociceptors

39
Q

What do nociceptors respond to?

A

Distension, inflammation and muscle spasm

40
Q

What are noxious stimuli?

A

Things that have, are, or will cause damage to the body

41
Q

What inflammatory mediators do nociceptors respond to?

A

Injury, irritants, toxins, infection and autoimmunity

42
Q

What does inflammation do to nociceptors?

A

Depolarises them

43
Q

What do nociceptors do when depolarised?

A

Release proinflammatory chemicals

44
Q

What happens when positive nociceptor feedback increases?

A

Synapse potentiation

45
Q

What can the positive feedback synapse potentiation lead to?

A

Potentially self-sustaining activity that persists beyond the original cause

46
Q

How is somatic pain precisely localised?

A

Impulse taken to the somatosensory cortex, where there’s a map of the of the body

47
Q

What’s the map of the body in the somatosensory cortex called?

A

Somatosensory homonculus

48
Q

What is viscerosomatic convergence?

A

When an impulse synapses with a somatic nociceptor nerve at the spinal cord

49
Q

What does viscerosomatic convergence cause?

A

Referred pain

50
Q

What do the afferent nerve synapse segments match?

A

The embryonic origin of each organ

51
Q

Why can gallbladder infections refer their pain to C3-5?

A

Infection spreads to parietal peritoneum and diaphragm, and C3-5 is where their nerves come from

52
Q

What are the characteristics of visceral pain?

A
  • referred to regions of the body wall
  • diffuse and poorly located
  • each organ has characteristic patterns of referral
53
Q

Why is visceral pain generally referred to regions of the body wall?

A

Viscerosomatic convergence

54
Q

Why is visceral pain diffuse and poorly localised?

A

There’s a relatively small number of afferents and imprecise wiring

Physiology 1 (65 decks)

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