Upper gastrointestinal function Flashcards
1
Q
cleft palate
A
multifactorial congenital defect of the mouth and face that develops ~4-9 weeks gestation
2
Q
causes of cleft palate
A
genetic mutations, drugs, toxins, viruses, vitamin deficiencies, cigarette smoking
3
Q
esophageal atresia
A
birth defect where part of a persons esophagus does not develop properly
4
Q
causes of esophageal atresia
A
unknown but associated with VACTERL and CHARGE
5
Q
CHARGE
A
coloboma, heart defects, atresia of the choanae, retardation of mental and/or physical development, genital hypoplasia, ear abnormalities
6
Q
complication of E-A
A
aspiration pneumonia
7
Q
pyloric stenosis (infantile hypertrophic pyloric stenosis)
A
narrowing and obstruction of the pyloric sphincter causing difficulty for stomach to empty food into small intestine
8
Q
causes of pyloric stenosis
A
unknown but thought to be multifactorial; exposure to macrolides in early infancy increases risk
9
Q
dysphagia
A
difficulty swallowing
10
Q
emesis
A
voluntary ejection of chyme from stomach up through esophagus and out mouth; can lead to fluid, electrolyte, and pH imbalances
11
Q
mallory weiss tear
A
tear in esophagus from excessive strain during vomiting
12
Q
types of emesis
A
hematemesis, yellow or green vomitus, deep brown vomitus, undigested food vomitus
13
Q
hematemesis
A
blood in vomitus and resembles coffee grounds
14
Q
yellow or green vomitus
A
indicative of presence of bile; can occur as result of GI tract obstruction
15
Q
deep brown vomitus
A
indicative of content from lower intestine; frequently results from intestinal obstruction
16
Q
undigested food vomitus (Caused by)
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caused by conditions that impair gastric emptying
17
Q
esophageal varices causes
A
portal hypertension from abnormally high blood pressure in portal venous system as result of advanced liver disease
18
Q
varices
A
distended, tortuous collateral veins
19
Q
esophageal varices
A
distended veins in lower esophagus and stomach that can rupture and be life-threatening (low survival rate)
20
Q
signs of ruptured esophageal varices
A
bright red blood if acute; anemia or melena may be present indicative of slow bleed
21
Q
nerves controlling involuntary swallowing
A
cranial nerve V (trigeminal), cranial nerve IX (glossopharyngeal), cranial nerve X (vagus)
22
Q
hiatal hernia
A
section of stomach protrudes upward through opening in diaphragm towards lungs
23
Q
different types of hernias
A
sliding, rolling, and mixed
24
Q
Gastroesophageal reflux disease
A
chyme or bile periodically backs up from the stomach into the esophagus irritating the esophageal mucosa
25
Stress ulcers
major physiological stressor on body causes local tissue ischemia, tissue acidosis, bile salts enter stomach, and decreased GI motility
26
curling's ulcers
stress ulcers associated with burns
27
Cushing's ulcers
stress ulcers associated with head injuries
28
maldigestion
failure of chemical processes of digestion taking place in intestinal lumen
29
causes of maldigestion
deficient in enzymes like pancreatic lipase, intestinal lactase, inadequate secretion of biles, inadequate reabsorption of bile in ileum
30
malabsorption
failure of intestinal mucosa to absorb and transport digested nutrients
31
pancreatic exocrine insufficiency
insufficiency in pancreatic enzymes needed for digestion of proteins, carbohydrates, and fats
32
lactose deficiency
lactose intolerance: genetic deficiency in lactase inhibiting breakdown of lactose into monosaccharides which prevents lactose digestion and absorption across intestinal wall
33
bile salt deficiency
deficiency in conjugated bile acids necessary for digestion and absorption of fats in the small intestine
34
Mesenteric vascular insufficiency
Poor blood to intestines
35
cancers that affect the GI tract
oral cancer and esophageal cancer are just 2 examples
36
oral cancer
most common is squamous cell carcinoma of tongue and mouth floor
37
esophageal cancer
usually squamous cell carcinoma in distal esophagus; tumors can obstruct esophagus
38
gastritis
inflammation of stomachs mucosal lining involving entire stomach or a particular region
39
acute gastritis
can be mild, transient irritation, or can be severe ulceration with hemorrhage; develops suddenly and is accompanied by nausea and epigastric pain
40
chronic gastritis
develops gradually and can be asymptomatic but usually manifests as dull epigastric pain and fullness after minimal food
41
common cause of chronic gastritis
helicobacter pylori
42
esophagogastroduodenoscopy (EGD)
endoscope; lighted camera on end of tube passed down throat to visualize esophagus, stomach, duodenum; aka upper endoscopy
43
barium swallow
used to view mouth, back of throat, esophagus, stomach, first part of small intestine using fluoroscopy; can diagnose aspiration, difficulty swallowing, reflux
44
pathologies altering Upper GI tract
cleft palate, cleft lip and cleft palate, pyloric stenosis, dysphagia, vomiting, esophageal varices, atresia/fistula
45
cleft palate
failure of hard and/or soft palate to fuse; females 2x more likely
46
cleft palate and cleft lip
failure of maxillary and nasal elevations or upper lip to fuse during development; males 2x more likely
47
issues associated with cleft palate and cleft lip/cleft palate
consuming, digesting, absorbing food; often underweight and vitamin deficient, speech issues, ear infections, hearing issues
48
cleft palate and/or cleft lip i utero causes
develops 4-9 weeks gestation; genetic mutations, drugs, toxins, viruses, vitamin deficiencies, cigarette smoking
49
risk factors (increases risk) of cleft palate and/or cleft lip
American indian, hispanic, asian
50
atresia
esophagus ends in blind pouch; ending abnormally; causes aspiration pneumonia
51
atresia manifestations
excessive secretions, coughing, vomiting, cyanosis after feeding
52
atresia causes
unknown; VACTERL, CHARGE,
53
VACTERL
vertebral anomalies, anal atresia, cardiac malformations, tracheoesophageal fistula, EA, renal anomalies, radial aplasia, limb anomalies
54
risk factors (increases risks) of atresia
increased paternal age, maternal assisted reproduction
55
Atresia types
56
pyloric stenosis
narrowing/obstructed pyloric sphincter d/t thickening and stiffening of sphincter; causes difficulty emptying stomach into small intestine; dehydration/metabolic acidosis/excessive vomiting
57
dysphagia
difficulty swallowing; coughing, feeling like choking
58
vomiting
hematemesis: blood or coffee ground; yellow or green: bile, can be obstruction; dark brown: can mean intestinal obstruction; undigested food: impaired gastric emptying
59
esophageal varices
complication related to portal HTN due to high BP from liver failure/cirrhosis; associated with EtOH
60
acute esophageal varices
bright red bloody hematemesis
61
chronic/slow esophageal varices
cause anemia, melena due to digested dark blood with distinct foul odored stools
62
neurological controlled motility
swallowing is reflex controlled by cranial nerve V (trigeminal), IX (glossopharyngeal), and X (Vagus); motility controlled by cranial nerve X (vagus)
63
hiatal hernia
structural motility; stomach protrudes through an opening in diaphragm
64
risks for developing hiatal hernia
advanced age, smoking, weight
65
manifestations of hiatal hernia
indigestion, heartburn, frequent belching, nausea, chest pain, strictures, dysphagia, soft upper abdominal mass
66
GERD
chyme or bile backs-up into the esophagus, irritating the esophageal mucosa
67
GERD manifestations
heart burn, epigastric pain, dysphagia, dry cough, laryngitis, regurgitation of food, lump feeling in throat
68
GERD causes
chocolate, caffeine, carbonation, citrus, tomatoes, spicy/fatty foods, peppermint, nicotine, EtOH, hiatal hernia, obesity, pregnancy, meds, NG tube, delayed gastric emptying
69
peptic ulcer disease
lesions that affect the stomach lining or duodenum; can be superficial to complete penetration; due to imbalance between destruction and protective mechanisms
70
duodenal ulcers
commonly associated with excess acid or H pylori infections
71
H pylori infection ulcers
presents with epigastric pain that relieves with food
72
gastric ulcers
less frequent but more deadly; associated with malignancy and; pain worsens with eating
73
Peptic ulcer disease risks (whose mor at risk)
males, advancing age, NSAIDs, H pylori infections, certain gastric tumors, smoking, alcohol
74
PUD manifestations
epigastric or abdominal pain, abdominal cramping, heartburn, indigestion, N/V
75
maldigestion
failure of chemical processes of digestion that takes place in intestinal lumen; due to enzyme deficiencies- pancreatic lipase, intestinal lactase, inadequate secretion of bile salts, inadequate reabsorption of bile in ileum
76
malabsorption
failure of intestinal mucosa to absorb and transport digested nutrients d/t mucosal disruption from gastric or intestinal resection, vascular disorder, or intestinal disease
77
lactase deficiency
usually d/t genetic deficiency and inhibits breakdown of lactose into monosaccharides, preventing lactose digestion and absorption across the intestinal wall
78
lactase deficiency manifestations
undigested lactose remains in intestine, bacteria ferments and forms gasses, undigested lactose causes increase in osmotic pressure gradient causing irritation and osmotic diuresis, bloating, crampy abdominal pain, diarrhea, flatulence
79
conjugated bile salts
required for digestion and absorption of fats in small intestine; become conjugated in liver and are synthesized from cholesterol; secreted from liver
80
decreased production of bile production or secretion resulting in decreased micelle formation and fat absorption d/t
advanced liver disease (decreased production of bile salts), obstruction of common bile duct (decreased flow of bile into duodenum), disease or resection of ileum (prevents reabsorption and recycling of bile salts)
81
bile salt deficiency manifestations
poor intestinal absorption of fat and fat soluble vitamins (ADEK), steatorrhea (diarrhea and decreased plasma proteins)
82
Vitamin A deficiency
causes night blindness
83
vitamin D deficiency
causes decreased calcium absorption with bone demineralization, bone pain, and fractures
84
vitamin K deficiency
prolonged prothrombin time (PT), purpura, petechiae
85
vitamin E deficiency
uncertain but may cause testicular atrophy and neuro defects in children
86
mesenteric vascular insufficiency
decreased blood flow to large and small intestines causing ischemia and tissue necrosis; most common is acute mesenteric ischemia
87
Cancers of upper Gi tract
oral cancer, esophageal cacner
88
oral cancer manifestations
appear as painless whitish thickenings that develop into nodule or ulcerative lesion that persists and does not heal and bleeds easily; causes soreness; difficulty chewing/swallowing
89
risks for developing mouth cancer
smoking/tobacco, EtOH, viral infections, immunodeficiencies, inadequate nutrition, poor dental hygiene, chronic irritation, exposure to UV light, can metastasize to lymph nodes and esophagus
90
oral cancer
most related to squamous cell carcinomas of tongue and mouth floor; most common in men and AA
91
esophageal cancer
usually squamous carcinoma of distal esophagus; more common in men, associated with chronic irritation like GERD and obesity; tumors can grow to obstruct esophagus and create stricture
92
esophageal cancer complications
esophageal obstruction, respiratory compromise, esophageal bleeding, early asymptomatic (causes delay in treatment)
93
esophageal cancer manifestations
dysphagia, chest pain, weight loss, hematemesis
94
gastritis
inflammation of stomachs mucosal lining; involves whole stomach or only a region
95
acute gastritis
can be mild, transient irritation or severe with hemorrhage; develops suddenly and accompanied by nausea and epigastric pain
96
chronic gastritis
gradually develops, most commonly d/t H pylori, d/t food and water contamination or long term NSAIDs, excessive EtOH, stress, autoimmune
97
gastritis manifestations
indigestion, heartburn, epigastric pain, abdominal cramping, N/V, anorexia, fever, malaise, ulceration and bleeding (hematemesis and dark tarry stools)
98
gastritis complications
peptic ulcers, gastric cancer, hemoerrhage
