the gastrointestinal system 1 & 2 Flashcards
mouth, esophagus, stomach, and duodenum
upper GI tract
small intestine
large intestine
lower GI tract
what organ accomplishes digestion and absorption of nutrients
small intestine
what organ absorbs water and electrolytes, storing waste products of digestion until elimination?
large intestine
true or false: gut immune system has 70% to 80% of the body’s immune system
true
what is the muscular aspect of diarrhea?
electrolyte imbalance
endocrine disorder
what is the neurogenic aspect of diarrhea?
diabetic enteropathy
hyperthyroidism
diarrhea is caused by what medication?
antibiotics
constipation is caused by what medications?
opioids
diuretics
peptide ulcer disease
a break in the lining of the stomach or duodenum of 5 mm or more owing to a number of different causes
what are three types of peptic ulcer diseases?
gastric ulcer
duodenal ulcer
stress ulcer
what are the most common causes of PUD?
NSAIDs, low dose aspirin, and H. pylori bacterial infection (90%)
psychologic stress, diet, caffeine, tobacco use, and alcohol consumption
to prevent PUD, you must maintain a balance between the mucosal defenses and contributing insults. What are the defenses and insults?
defenses: mucous and bicarbonate layer, an epithelial barrier, prostaglandins, and adequate mucosal blood flow
contributing insults:
acid, pepsin, alcohol, bile salts, and drugs
what are the most common contributing insults to PUD?
NSAID use and H. pylori
how is PUD often discovered if there is no symptoms?
bleeding
what is a classic symptom of PUD and where is the pain referred?
burning, gnawing, or cramping near the xiphoid or radiating to the back
how can pain for PUD be relieved?
eating
what is hematemesis? and what disease is a sign of?
vomiting blood
PUD
what is hematochezia? and what disease is it a sign of?
bleeding per rectum
PUD
what is melena? and what is it a sign of?
dark, tarry stools secondary to blood
what is a perforation and where does it happen?
sudden severe pain
thoracic spine from T6-T10 with radiation to the right upper quadrant
what are some prevention and treatments for PUD?
medication modification
antibiotics for H. pylori
lifestyle changes
probiotics
endoscopy
where does perforate and hemorrhage refer pain?
back pain
where does ulcer pain radiate to?
mid thoracic back and right shoulder
what reduces the risk of GI bleeding?
moderate exercise training
what is a hiatal hernia?
esophageal hiatus of the diaphragm becomes enlarged, allowing the stomach to pass through the diaphragm into the thoracic cavity
what is the most common hiatal hernia?
sliding
What is a rectal fissure?
a rectal or anal fissure is an ulceration or tear of the lining of the anal canal, usually on the posterior wall
how does an acute rectal fissure occur?
excessive tissue stretching or tearing, such as childbirth or passage of a large, hard bowel movement through the area
what are some symptoms of a rectal fissure?
sharp pain
burning
accompanied by defecation, bleeding, spasms, mucus, and itching
when do anal fissures heal?
within 1-2 months
how do anal fissures get treated?
combination of bran and bulk of laxatives or stool softeners, sitz baths, and emollient suppositories
what are hemorrhoids?
varicose veins of a pillow-like cluster of veins that lie just beneath the mucous membranes lining the lowest part of the rectum and anus
what are PT implications for hemmorhoids?
spasms in sphincter, pelvic floor pain, and trigger points in pelvic and glut muscles
true or false: hemorrhoids are not associated with an increase in intraabdominal pressure
false: it is
what are internal hemorrhoids?
occur in the lower rectum
how are internal hemorrhoids noticed?
when a small amount of bleeding occurs during passage of stool, especially if straining occurs during a bowel movement
what are external hemorrhoids?
located under the skin around the anus bleed (bright red blood) if the hemorrhoid is injured or ulcerated
why external hemorrhoids painful?
they form in nerve-rich tissue outside the anal canal
how can external hemorrhoids be treated?
with local application of topical medications, sitz baths, high fiber diet, and avoidance of constipation and other causes of intra-abdominal pressure
what is diverticulosis?
the presence of outpouchings in the wall of the colon or small intestine
the mucosa and submucosa herniate through the muscular layers of colon
what is diverticulitis?
inflammation/infection of the diverticula with possible complications such as perforation, abscess formation, obstruction, fistula formation, and bleeding
what are some risk factors of diverticular disease?
constipation
physical inactivity
eating red
obesity
smoking
NSAID, chronic steroids, and immunosuppressants
what is uncomplicated diverticular disease?
when diverticula become blocked, bacteria that are trapped inside begin to proliferate, causing infection and inflammation
what is complicated diverticular disease?
a fistula may develop with the bladder
what is pneumaturia and fecaluria? what is it associated with?
air in the urine
urine in the stool
and it is associated with complicated diverticular disease
what are some medical management recommendations for diverticular disease?
CT imaging
test to see elevated WBCs
colonoscopy
lifestyle change
surgery
when should you get a colonoscopy for diverticular disease?
4-6 weeks after resolution of the initial attach, avoid in the acute stage
what medications should you take for diverticular disease?
antibiotics and pain control
what are some PT implications of diverticular disease?
avoid activities that increase intra-abdominal pressure to avoid further herniation
physical activity and exercise have protective effect and lowers the risk of diverticulitis and diverticular bleeding
where is diverticular disease refer pain to? and where does pain regularly occur?
referred pain in hip or thigh
back pain
what is appendicitis?
an inflammation of the vermiform appendix that results to necrosis and perforation with peritonitis
when does appendicitis mostly occur?
peak incidence between the ages of 15-19
does appendicitis happen in males or females more?
males
what is appendicitis primarily caused by? and is it secondarily caused by?
primarily: obstruction of the lumen
secondarily: bacterial infection
one third of appendicitis is caused by what occurence?
obstruction that prevents normal drainage
what happens if normal drainage in the appendix is obstructed?
the intraluminal pressure rises and eventually exceeds the venous pressure causing ischemia, necrosis, and perforation
what quadrants manifest abdominal pain for appendicitis?
epigastric
peri-umbilical
right lower quadrant
what does high fever indicate for adults with appendicitis?
perforation
where does pain shift for appendicitis?
right lower quadrant over the site at Mcburney point
what is the WBC count for appendicitis?
> 20,000
clients with appendicitis may present symptoms in what specific areas?
right thigh
groin (testicular)
pelvic
referred pain in the hip
