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NUR 326 > Upper GI > Flashcards

Upper GI Flashcards

1
Q

upper GI

A

esophagus, stomach, beginning of SI

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2
Q

esophageal disorders

A

GERD
hiatal hernia

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3
Q

inflammatory disorders of the stomach

A

gastritis
acute gastroenteritis
PUD

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4
Q

dysphagia

A

difficulty swallowing
- begins with solids and progresses to liquid

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5
Q

common causes of dysphagia

A

mechanical obstruction
neuromuscular

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6
Q

what is mechanical obstruction of dysphagia

A

problem with structures that assist in swallowing
- stenosis or stricture
- diverticula
- tumors

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7
Q

what is neuromuscular dysphagia

A

related to
- CVA (stroke): esophagus is no longer innervated appropriately
- achalasia: LES cant open properly
- people that have been intubated or tracheostomies

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8
Q

GERD stands for

A

gastro esophageal reflux disease

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9
Q

GERD occurs because

A

the LES doesnt close properly allowing stomach contents to pass back into the esophagus
- backflow of gastric contents (highly acidic–> causes heart burn feeling)

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10
Q

2 reasons that GERD occurs

A
  • anything that alters the closure strength or LES
  • inc in abdominal pressure
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11
Q

examples of things that cause GERD

A
  • fatty, spicy, citrus, tomato foods
  • caffeine
  • large amount of alc
  • cigs
  • sleep position
  • obesity
  • pregnancy
  • drugs
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12
Q

clinical manifestations of GERD

A
  • heartburn (pyrosis)
  • dyspepsia
  • regurgitation
  • chest pain
  • dysphagia
  • pulmonary symptoms
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13
Q

more complex manifestations of GERD

A
  • tooth decay, gingivitis, bad breath
  • earache
  • chronic cough, worse asthma, recurrent pneumonias
  • hoarseness, chronic sore throat, laryngitis, post nasal drip
  • bloating, belching
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14
Q

complications of GERD

A

ulcers
scarring
strictures
Barrett esophagus

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15
Q

what is barrett esophagus

A

development of abnormal metaplastic tissue
- pre malignant
- inc risk of adrenocarcinoma of esophagus

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16
Q

hiatal hernia

A

defect in the diaphragm that allows part of the stomach to pass into the thorax cavity

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17
Q

types of hiatal hernias

A

sliding: usually small and doesn’t need treatment
paraesophageal: part of stomach pushed through diaphragm and stays there (peritoneum membrane becomes thin/defect and allows the stomach to sit up there)

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18
Q

cause of hiatal hernia

A

unknown

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19
Q

risks of hiatal hernia

A
  • age related
  • injury or other damgage that weakens the diaphragm muscles
  • repeated pressure on muscles around stomach like coughing, vomiting, constipation/straining
  • obesity
  • smoking
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20
Q

clinical manifestations of hiatal hernia

A

asymptomatic
belching
dysphagia
chest or epigastric pain
similar to gerd

21
Q

treatment for hiatal hernia

A
  • teach small frequent meals, dont lie down after meals
  • avoid tight clothing and abdominal supports
  • wt control
  • antacids
  • sometimes surgery
22
Q

what is gastritis

A

non specific inflammatory condition of the stomach

23
Q

what are the types of gastritis

A

acute and chronic

24
Q

what is acute gastritis

A

temporary inflammation of the stomach lining (no intestines)
- last 2-10 days

25
causes of acute gastritis
irritating substances (alc) drugs (NSAIDS-> cause dec of protected coating) infectious agents (h pylori)
26
what is chronic gastritis
progressive disorder with chronic infalmmation of stomach lining - weeks to years
27
complications of chronic gastritis
PUD (peptic ulcer disease) bleeding ulcers anemia gastric cancers
28
causes of chronic gastritis
- autoimmune where the parietal cells are attacked - chronic H pylori infection
29
what is h pylori
helicobacter pylori, gram - spiral that lives in acidic environments
30
why is h pylori problematic
it can become over grown causing a destructive pattern of persistant inflammation - can lead to chronic gastritis, PUD, stomach cancer
31
how is h pylori transmitted
person to person via saliva, fecal matter, vomit contaminated food or water
32
clinical manifestations of both gastritis
none anorexia NV postprandial discomfort (occurs soon after you eat) intestinal gas hemetemesis tarry stools anemia
33
what is acute gastroenteritis
inflammation of the stomach wall and SI
34
causes of acute gastroenteritis
viral infections: novovirus, rotavirus bacterial infections: e coli, salmonella, campylobacter parasitic infections
35
how long does acute gastroenteritis occur
1-3 typically, sometimes up o 10 days - typically let them play out, not treated w drugs unless lasts a while
36
what are the clinical manifestations of acute gastroenteritis
watery D --> can be bloody if bacterial ab pain NV fever malaise
37
complication of acute gastroenteritis
fluid volume deficits
38
what is PUD
peptic ulcer disease - ulcerative disorder of the upper GI (esophagus, stomach --> gastric ulcer, duodenum--> peptic ulcer)
39
why does a PUD occur
GI tract exposed to acid and h pylori infection
40
GI health balancing act: aggressive factors
h pylori NSAIDS acid smoking pepsin
41
GI health balancing act: defensive factors
mucus bicarbonate blood flow prostaglandins
42
causes of PUD
h pylori injury causing substances (alc, NSAIDS, ASA) excessive secretions of acids smoking fam hx stress --> inc gastric secretion so adds to the problem but not cause
43
risk factors of PUD
NSAIDS--> inhibit prostaglandins synthesis which dec mucus protective coating age hx of PUD chronic corticosteriod and anti coag serious systemic disordes (auto immune) h pylori
44
PUD pathogenesis
mucosa is damaged histamines are secreted which results in - inc acid and pepsin secretion --> inc damage - vasodilation--> causing edema if bv are around ulcer and get destroyed then bleeding ulcers result
45
PUD classifications
duodenal ulcers: most common, any age/early adulthood gastric/peptic: peak 50-70 bc inc use of NSAIDS, corticosteroids, anticoags, more likely to have systemic illnesses
46
PUD clinical manifestations
none NV anorexia wt loss bleeding burning pain--> middle of ab, usually worse when stomach is empty
47
what is the difference in clinical manifestations of gastric and peptic ulcers that distingusihes the two
gastric ulcer pain will occur around 1-2 hours after eating which duodenal pain will occur 2-4 hours after eating
48
PUD complications
HOP H: hemorrhage O: obstruction P: perforation and peritonitis

NUR 326 (20 decks)

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