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Internal Medicine > Week 10- GI System 1 > Flashcards

Week 10- GI System 1 Flashcards

1
Q

Includes mouth, esophagus, stomach, and duodenum

A

Upper GI tract

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2
Q

The upper GI tract aids in the…

A

Ingestion and digestion of food

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3
Q

Consists of the small and large intestines

A

Lower GI tract

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4
Q

___________ accomplishes digestion and absorption of nutrients

A

Small intestine

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5
Q

____________ absorbs water and electrolytes, storing waste products of digestion until elimination

A

Large intestine

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6
Q

Function completely independently of the CNS and have its own psycho-neuroses

A

Enteric nervous system

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7
Q

True or false: The enteric nervous system is based on a mind-body connection

A

True

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8
Q

This makes up the mind-body connection of the enteric nervous system

A

Emotions, brain functions, GI functions

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9
Q

Gut immune system has _____% of the body’s immune cells

A

70-80

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10
Q

True or false: The development and expression of the gut is dependent on systemic immunity

A

False

(independent)

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11
Q

True or false: Reduction of normal bacteria in the gut after antibiotic treatment or in the presence of infection may interfere with the nutrients available for immune function in the GI tract

A

True

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12
Q

Signs and symptoms of GI disease

A

-Nausea
-Vomiting
-Diarrhea
-Constipation
-Dysphagia
-Achalasia
-Heartburn
-Abdominal Pain
-Ischemic pain
-GI Bleeding
-Fecal incontinence
-Referred pain

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13
Q

SLIDE 6-9

A
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14
Q

Most common GI problems in older adults

A

Constipation, incontinence, and diverticular disease

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15
Q

True or false: Alimentary organs like all muscular structures, never lose some tone with age and still manage to perform almost as well in age as in youth

A

False

(they do lose some)

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16
Q

Changes within the alimentary tract include decreases in…

A

-Gastric motility
-Blood flow
-Nutrient absorption
-Volume and acid content of gastric juice

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17
Q

Esophageal hiatus of the diaphragm becomes enlarged, allowing the stomach to pass through the diaphragm into the thoracic cavity

A

Hiatal hernia

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18
Q

True or false: A hiatal hernia can be congenital or acquired

A

True

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19
Q

90-95% of hiatal hernias are _________

A

Sliding hernias

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20
Q

The remaining hiatal hernias (5-10%) are __________

A

Rolling/para-esophageal hernias

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21
Q

The stomach and gastroesophageal junction are displaced upward into the thorax

A

Sliding hernia

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22
Q

The gastroesophageal junction stays below the diaphragm, but all or part of the stomach pushes through into the thorax

A

Rolling/para-esophageal hernias

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23
Q

-5 per 1000 people
-Increases w/ age (60% in people > 60 y/o)
-Women > men

A

Hiatal hernia

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24
Q

Causes of increased intraabdominal pressure

A

-Lifting
-Straining
-Bending over
-Prolonged sitting or standing
-Chronic/forceful cough
-Pregnancy
-Ascites
-Obesity
-Congestive heart failure
-Lower fiber diet
-Constipation
-Delayed bowel movement
-Vigorous exercise

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25
Q

Symptoms of hiatal hernia

A

-Heartburn
-Reflux

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26
Q

Heartburns can occur _____ minutes after a meal and are posture related

A

30-60

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27
Q

Heartburn contributes to incompetence of the ___________ allowing acid into the esophagus

A

Lower esophageal sphincter (LES)

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28
Q

This contributes to GERD

A

Reflux

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29
Q

Reflux is associated with ___________ pain

A

Substernal

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30
Q

Regarding hiatal hernias, avoid flat supine position and any exercises requiring the ______________

A

Valsalva maneuver

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31
Q

True or false: A client with hiatal hernia does not have to be warned against activities that cause increased intraabdominal pressure or receive safe lifting instructions before discharge

A

False

(they have to be warned)

32
Q

The consequences from the reflux (backward flow) of gastric contents into the esophagus accompanied by a failure of anatomic and physiologic mechanisms to protect the esophagus

A

GERD

33
Q

GERD can be…

A

Erosive or non-erosive

34
Q

GERD occurs in ____% of adults and _________ with age

A

10-20
Increases

35
Q

Causes of GERD

A

-Decreased pressure of LES or alteration in esophageal acid clearance
-Gastric contents near junction

36
Q

In healthy people, three factors to remain healthy esophagus…

A

-Anatomic barriers between the stomach and the esophagus
-Mechanisms to clear the esophagus of stomach acid
-Maintaining stomach acidity and acid volume

37
Q

True or false: People with GERD have consistently low pressure of the LES or altered protective mechanisms due to the causes

A

True

38
Q

_____________ should be distinguished and evaluated before chest pain is assumed to be related to GERD

A

Cardiac chest pain

39
Q

Adults > ____ y/o are more likely to have atypical symptoms

A

70

40
Q

Atypical symptoms of GERD

A

Dysphagia
Vomiting
Respiratory difficulties
Weight loss
Anemia
Anorexia with or without heartburn or acid regurgitation

41
Q

3 extra-esophageal manifestations

A

Asthma
Cough
Laryngitis

42
Q

Treatment for GERD

A

Lifestyle modifications
Medications
Surgery

43
Q

Lifestyle modifications for GERD

A

Avoid aggravating food, smoking cessation and encouraged to reduce alcohol consumption, weight loss and elevation of the bed etc.

44
Q

Medications for GERD

A

Nonprescription antacids, H2 blockers, and proton pump inhibitors (PPIs)

45
Q

True or false: People with GERD may have trouble exercising, because some types of physical activity can worsen symptoms

A

True

46
Q

Strenuous exercise inhibits both ________ and _________ emptying

A

Gastric
Small intestine

47
Q

GERD induced by strenuous exercise is common among _________

A

Athletes

48
Q

Avoid _________ meals or ________ foods (or other triggers) immediately before exercising to avoid or minimize exercise-related GERD

A

High-calorie
Fatty

49
Q

________ position should be scheduled before meals and avoided just after eating.

________lying is better.

A

Supine
Left

50
Q

A break in the lining of the stomach or duodenum of 5 mm or more owing to a number of different causes

A

Peptic ulcer disease (PUD)

51
Q

Types of PUD ulcers

A

Gastric
Duodenal
Stress

52
Q

Occur in response to significant physiologic stress (e.g., severe trauma, surgery, extensive burns, brain injury)

A

Stress ulcers

53
Q

Most common causes of PUD

A

NSAIDs
Low-dose aspirin
H. pylori bacterial infection

54
Q

Risk factors for PUD

A

Psychologic stress
Diet
Caffeine
Tobacco use
Alcohol consumption

55
Q

Mucous and bicarbonate layer, an epithelial barrier, prostaglandins, and adequate mucosal blood flow

A

Mucosal defenses

56
Q

Acid, pepsin, alcohol, bile salts, drugs

A

Contributing mucosal insults

57
Q

If there is an imbalance between mucosal insults and mucosal defenses, an _________ can form

A

Ulcer

58
Q

There are symptoms or physical findings specific/sensitive for PUD. Many people with NSAID-induced PUD have pain at diagnosis.

A

False

(no symptoms or physical findings, they do NOT have pain)

59
Q

PUD is often discovered because of __________ or is noted on _______

A

Bleeding
EGD

60
Q

The classic symptom of PUD, when present, is _________ pain described as…

A

-Epigastric
-Burning, gnawing, or cramping near the xiphoid or radiating to the back

61
Q

PUD pain may be relieved with _________ or occur at ________

A

Eating
Night

62
Q

PUD complications

A

-Bleeding
-Perforation
-Penetration
-Gastric outlet obstruction

63
Q

PUD PT implications

A

-Monitoring symptoms and vital signs
-Referred pain patterns
-Moderate exercise training reduces the risk of GI bleeding

64
Q

Perforate and hemorrhage cause __________

A

Back pain

65
Q

Ulcer pain radiates to the…

A

Mid-thoracic back and right shoulder pain

66
Q

True or false: PUD MSK symptoms may recur after discontinuing NSAIDS, owing to the masking effects of these drugs

A

True

67
Q

_________ exercise training reduces the risk of GI bleeding

A

Moderate

68
Q

A polygenic disease with complex interactions between gut microbiota, host immunity, and intestinal mucosal response

A

Inflammatory bowel disease

69
Q

A chronic, lifelong inflammatory disorder that can affect any segment of the intestinal tract, although most commonly it affects the ileum and/or colon

A

Crohn disease

70
Q

A chronic inflammatory disorder of the mucosa of the colon, typically involving the rectum, which can then advance proximally in a continuous manner to involve the entire colon

A

Ulcerative colitis

71
Q

SLIDE 47-49

A
72
Q

Joint involvement ranging from _________ to _________ is the most common extra-intestinal finding in IBD

A

Arthralgia
Acute arthritis

73
Q

___________ associated with IBD is usually continuous and symmetric

A

Arthritis

74
Q

Arthropathies are divided into __________ and __________ involvement

A

Peripheral
Axial

75
Q

PT implications for IBD

A

-Periumbilical pain, referred pain to the corresponding low back, and lower right quadrant pain
-Psoas abscesses
-Joint problems: migratory arthralgia, monarthritis, polyarthritis, or sacroiliitis
-Any time a client presents with low back, hip, or sacroiliac pain of unknown origin, the therapist must screen for medical disease
-High prevalence of osteoporosis
-Hydration and nutrition
-Psychologic factors and ANS

Internal Medicine (25 decks)

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