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Pathophysiology > Upper gastrointestinal function > Flashcards

Upper gastrointestinal function Flashcards

1
Q

cleft palate

A

multifactorial congenital defect of the mouth and face that develops ~4-9 weeks gestation

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2
Q

causes of cleft palate

A

genetic mutations, drugs, toxins, viruses, vitamin deficiencies, cigarette smoking

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3
Q

esophageal atresia

A

birth defect where part of a persons esophagus does not develop properly

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4
Q

causes of esophageal atresia

A

unknown but associated with VACTERL and CHARGE

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5
Q

CHARGE

A

coloboma, heart defects, atresia of the choanae, retardation of mental and/or physical development, genital hypoplasia, ear abnormalities

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6
Q

complication of E-A

A

aspiration pneumonia

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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

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8
Q

causes of pyloric stenosis

A

unknown but thought to be multifactorial; exposure to macrolides in early infancy increases risk

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9
Q

dysphagia

A

difficulty swallowing

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10
Q

emesis

A

voluntary ejection of chyme from stomach up through esophagus and out mouth; can lead to fluid, electrolyte, and pH imbalances

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11
Q

mallory weiss tear

A

tear in esophagus from excessive strain during vomiting

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12
Q

types of emesis

A

hematemesis, yellow or green vomitus, deep brown vomitus, undigested food vomitus

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13
Q

hematemesis

A

blood in vomitus and resembles coffee grounds

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14
Q

yellow or green vomitus

A

indicative of presence of bile; can occur as result of GI tract obstruction

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15
Q

deep brown vomitus

A

indicative of content from lower intestine; frequently results from intestinal obstruction

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16
Q

undigested food vomitus (Caused by)

A

caused by conditions that impair gastric emptying

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17
Q

esophageal varices causes

A

portal hypertension from abnormally high blood pressure in portal venous system as result of advanced liver disease

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18
Q

varices

A

distended, tortuous collateral veins

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19
Q

esophageal varices

A

distended veins in lower esophagus and stomach that can rupture and be life-threatening (low survival rate)

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20
Q

signs of ruptured esophageal varices

A

bright red blood if acute; anemia or melena may be present indicative of slow bleed

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21
Q

nerves controlling involuntary swallowing

A

cranial nerve V (trigeminal), cranial nerve IX (glossopharyngeal), cranial nerve X (vagus)

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22
Q

hiatal hernia

A

section of stomach protrudes upward through opening in diaphragm towards lungs

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23
Q

different types of hernias

A

sliding, rolling, and mixed

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24
Q

Gastroesophageal reflux disease

A

chyme or bile periodically backs up from the stomach into the esophagus irritating the esophageal mucosa

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25
Q

Stress ulcers

A

major physiological stressor on body causes local tissue ischemia, tissue acidosis, bile salts enter stomach, and decreased GI motility

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26
Q

curling’s ulcers

A

stress ulcers associated with burns

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27
Q

Cushing’s ulcers

A

stress ulcers associated with head injuries

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28
Q

maldigestion

A

failure of chemical processes of digestion taking place in intestinal lumen

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29
Q

causes of maldigestion

A

deficient in enzymes like pancreatic lipase, intestinal lactase, inadequate secretion of biles, inadequate reabsorption of bile in ileum

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30
Q

malabsorption

A

failure of intestinal mucosa to absorb and transport digested nutrients

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31
Q

pancreatic exocrine insufficiency

A

insufficiency in pancreatic enzymes needed for digestion of proteins, carbohydrates, and fats

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32
Q

lactose deficiency

A

lactose intolerance: genetic deficiency in lactase inhibiting breakdown of lactose into monosaccharides which prevents lactose digestion and absorption across intestinal wall

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33
Q

bile salt deficiency

A

deficiency in conjugated bile acids necessary for digestion and absorption of fats in the small intestine

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34
Q

Mesenteric vascular insufficiency

A

Poor blood to intestines

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35
Q

cancers that affect the GI tract

A

oral cancer and esophageal cancer are just 2 examples

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36
Q

oral cancer

A

most common is squamous cell carcinoma of tongue and mouth floor

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37
Q

esophageal cancer

A

usually squamous cell carcinoma in distal esophagus; tumors can obstruct esophagus

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38
Q

gastritis

A

inflammation of stomachs mucosal lining involving entire stomach or a particular region

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39
Q

acute gastritis

A

can be mild, transient irritation, or can be severe ulceration with hemorrhage; develops suddenly and is accompanied by nausea and epigastric pain

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40
Q

chronic gastritis

A

develops gradually and can be asymptomatic but usually manifests as dull epigastric pain and fullness after minimal food

41
Q

common cause of chronic gastritis

A

helicobacter pylori

42
Q

esophagogastroduodenoscopy (EGD)

A

endoscope; lighted camera on end of tube passed down throat to visualize esophagus, stomach, duodenum; aka upper endoscopy

43
Q

barium swallow

A

used to view mouth, back of throat, esophagus, stomach, first part of small intestine using fluoroscopy; can diagnose aspiration, difficulty swallowing, reflux

44
Q

pathologies altering Upper GI tract

A

cleft palate, cleft lip and cleft palate, pyloric stenosis, dysphagia, vomiting, esophageal varices, atresia/fistula

45
Q

cleft palate

A

failure of hard and/or soft palate to fuse; females 2x more likely

46
Q

cleft palate and cleft lip

A

failure of maxillary and nasal elevations or upper lip to fuse during development; males 2x more likely

47
Q

issues associated with cleft palate and cleft lip/cleft palate

A

consuming, digesting, absorbing food; often underweight and vitamin deficient, speech issues, ear infections, hearing issues

48
Q

cleft palate and/or cleft lip i utero causes

A

develops 4-9 weeks gestation; genetic mutations, drugs, toxins, viruses, vitamin deficiencies, cigarette smoking

49
Q

risk factors (increases risk) of cleft palate and/or cleft lip

A

American indian, hispanic, asian

50
Q

atresia

A

esophagus ends in blind pouch; ending abnormally; causes aspiration pneumonia

51
Q

atresia manifestations

A

excessive secretions, coughing, vomiting, cyanosis after feeding

52
Q

atresia causes

A

unknown; VACTERL, CHARGE,

53
Q

VACTERL

A

vertebral anomalies, anal atresia, cardiac malformations, tracheoesophageal fistula, EA, renal anomalies, radial aplasia, limb anomalies

54
Q

risk factors (increases risks) of atresia

A

increased paternal age, maternal assisted reproduction

55
Q

Atresia types

A
56
Q

pyloric stenosis

A

narrowing/obstructed pyloric sphincter d/t thickening and stiffening of sphincter; causes difficulty emptying stomach into small intestine; dehydration/metabolic acidosis/excessive vomiting

57
Q

dysphagia

A

difficulty swallowing; coughing, feeling like choking

58
Q

vomiting

A

hematemesis: blood or coffee ground; yellow or green: bile, can be obstruction; dark brown: can mean intestinal obstruction; undigested food: impaired gastric emptying

59
Q

esophageal varices

A

complication related to portal HTN due to high BP from liver failure/cirrhosis; associated with EtOH

60
Q

acute esophageal varices

A

bright red bloody hematemesis

61
Q

chronic/slow esophageal varices

A

cause anemia, melena due to digested dark blood with distinct foul odored stools

62
Q

neurological controlled motility

A

swallowing is reflex controlled by cranial nerve V (trigeminal), IX (glossopharyngeal), and X (Vagus); motility controlled by cranial nerve X (vagus)

63
Q

hiatal hernia

A

structural motility; stomach protrudes through an opening in diaphragm

64
Q

risks for developing hiatal hernia

A

advanced age, smoking, weight

65
Q

manifestations of hiatal hernia

A

indigestion, heartburn, frequent belching, nausea, chest pain, strictures, dysphagia, soft upper abdominal mass

66
Q

GERD

A

chyme or bile backs-up into the esophagus, irritating the esophageal mucosa

67
Q

GERD manifestations

A

heart burn, epigastric pain, dysphagia, dry cough, laryngitis, regurgitation of food, lump feeling in throat

68
Q

GERD causes

A

chocolate, caffeine, carbonation, citrus, tomatoes, spicy/fatty foods, peppermint, nicotine, EtOH, hiatal hernia, obesity, pregnancy, meds, NG tube, delayed gastric emptying

69
Q

peptic ulcer disease

A

lesions that affect the stomach lining or duodenum; can be superficial to complete penetration; due to imbalance between destruction and protective mechanisms

70
Q

duodenal ulcers

A

commonly associated with excess acid or H pylori infections

71
Q

H pylori infection ulcers

A

presents with epigastric pain that relieves with food

72
Q

gastric ulcers

A

less frequent but more deadly; associated with malignancy and; pain worsens with eating

73
Q

Peptic ulcer disease risks (whose mor at risk)

A

males, advancing age, NSAIDs, H pylori infections, certain gastric tumors, smoking, alcohol

74
Q

PUD manifestations

A

epigastric or abdominal pain, abdominal cramping, heartburn, indigestion, N/V

75
Q

maldigestion

A

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
Q

malabsorption

A

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
Q

lactase deficiency

A

usually d/t genetic deficiency and inhibits breakdown of lactose into monosaccharides, preventing lactose digestion and absorption across the intestinal wall

78
Q

lactase deficiency manifestations

A

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
Q

conjugated bile salts

A

required for digestion and absorption of fats in small intestine; become conjugated in liver and are synthesized from cholesterol; secreted from liver

80
Q

decreased production of bile production or secretion resulting in decreased micelle formation and fat absorption d/t

A

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
Q

bile salt deficiency manifestations

A

poor intestinal absorption of fat and fat soluble vitamins (ADEK), steatorrhea (diarrhea and decreased plasma proteins)

82
Q

Vitamin A deficiency

A

causes night blindness

83
Q

vitamin D deficiency

A

causes decreased calcium absorption with bone demineralization, bone pain, and fractures

84
Q

vitamin K deficiency

A

prolonged prothrombin time (PT), purpura, petechiae

85
Q

vitamin E deficiency

A

uncertain but may cause testicular atrophy and neuro defects in children

86
Q

mesenteric vascular insufficiency

A

decreased blood flow to large and small intestines causing ischemia and tissue necrosis; most common is acute mesenteric ischemia

87
Q

Cancers of upper Gi tract

A

oral cancer, esophageal cacner

88
Q

oral cancer manifestations

A

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
Q

risks for developing mouth cancer

A

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
Q

oral cancer

A

most related to squamous cell carcinomas of tongue and mouth floor; most common in men and AA

91
Q

esophageal cancer

A

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
Q

esophageal cancer complications

A

esophageal obstruction, respiratory compromise, esophageal bleeding, early asymptomatic (causes delay in treatment)

93
Q

esophageal cancer manifestations

A

dysphagia, chest pain, weight loss, hematemesis

94
Q

gastritis

A

inflammation of stomachs mucosal lining; involves whole stomach or only a region

95
Q

acute gastritis

A

can be mild, transient irritation or severe with hemorrhage; develops suddenly and accompanied by nausea and epigastric pain

96
Q

chronic gastritis

A

gradually develops, most commonly d/t H pylori, d/t food and water contamination or long term NSAIDs, excessive EtOH, stress, autoimmune

97
Q

gastritis manifestations

A

indigestion, heartburn, epigastric pain, abdominal cramping, N/V, anorexia, fever, malaise, ulceration and bleeding (hematemesis and dark tarry stools)

98
Q

gastritis complications

A

peptic ulcers, gastric cancer, hemoerrhage

Pathophysiology (11 decks)

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