Week 11- GI System 2 Flashcards
The presence of outpouchings in the wall of the colon or small intestine
Diverticulosis
The mucosa and submucosa herniate through the muscular layers of the ________ to form outpouchings
Colon
Inflammation/infection of the diverticula with possible complications such as perforation, abscess formation, obstruction, fistula formation, and bleeding
Diverticulitis
Diverticular disease has a higher incidence in…
Western countries
Risk factors of diverticular disease
-Constipation
-Physical inactivity
-Eating red meat
-Obesity
-Smoking
-NSAID, chronic steroids, and immunosuppressants use
-Several connective tissue disorders
_____% of affected with diverticular disease are asymptomatic
80%
Clinical manifestations of diverticular disease can be…
Uncomplicated
Complicated
Mild symptoms are nonspecific and there is episodic pain. When diverticula become blocked, bacteria that are trapped inside begin to proliferate, causing infection and inflammation.
Uncomplicated diverticular disease
A fistula may develop with the bladder (colovesical fistula).
Pneumaturia (air in the urine), fecaluria (urine in the stool), or recurrent urinary tract infections, in conjunction with fever, abdominal pain, or palpable mass.
Complicated diverticular disease
Medical management of diverticular disease
-CT imaging
-Elevated WBCs
-Colonoscopy (4-6 weeks after resolution of the initial attach; avoid in the acute stage)
-Medications (antibiotics and pain control)
-Lifestyle change
-Surgery
-Prognosis is good (low mortality for diverticulitis)
True or false: Physical activity and exercise have protective effect and lowers the risk of diverticulitis and diverticular bleeding
True
It is important to be careful to avoid activities that increase ____________ to avoid further herniation
Intraabdominal pressure
This type of pain is associated with diverticular disease
Back pain
Referred pain in hip or thigh
An inflammation that often results in necrosis and perforation with subsequent localized or generalized peritonitis
Appendicitis
Appendicitis affects the…
Vermiform appendix
Peak incidence of appendicitis is between the ages of _____
15-19
True or false: Appendicitis occurs more in females than males
False
(males more than females)
True or false: About half of all cases of acute appendicitis have a known cause
False
(no known cause)
Appendicitis occurs primarily from obstruction of the…
Lumen
Bacterial infection
True or false: One-third of appendicitis cases are caused by obstruction that prevents normal drainage
True
How appendix obstruction occurs
Distends the obstructed appendix – > the intraluminal pressure rises and eventually exceeds the venous pressure –> ischemia, necrosis, and perforation
Type of pain associated with appendicitis
Abdominal (epigastric, periumbilical, or right lower quadrant) pain accompanied by anorexia, nausea, vomiting, and low-grade fever in adults (high fevers if perforation)
True or false: Pain is constant and may shift within 12 hours of symptom onset to the right lower quadrant with point tenderness over the site at McBurney point
True
WBC count for appendicitis
WBCs > 20,000/mm3
____% of appendicitis cases are atypical because of the position of the tip of the appendix
40-50%
Treatment for appendicitis
-Antibiotics
-Appendectomy, or surgical removal, is performed ASAP, either by open procedure or laparoscopically (for uncomplicated patients)
Client with appendicitis may present with symptoms of…
Right thigh pain
Groin (testicular) pain
Pelvic pain
Referred pain in the hip
True or false: If appendicitis is suspected, medical attention is not immediate
False
(it is)
An ulceration or tear of the lining of the anal canal, usually on the posterior wall
Rectal/anal fissure
Occurs as a result of excessive tissue stretching or tearing, such as childbirth or passage of a large, hard bowel movement through the area
Acute fissure
Type of pain associated with rectal fissure
Sharp pain, followed by burning, accompanies defecation, bleeding, spasms, mucus, and itching
Anal fissures frequently heal within ________ when treated with a combination of bran and bulk laxatives or stool softeners, sitz baths, and emollient suppositories
1-2 months
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
Hemorrhoids
Hemorrhoids are associated especially with anything that increases ___________
Intraabdominal pressure
Occur in the lower rectum and usually are noticed first when a small amount of bleeding occurs during passage of stool, especially if straining occurs during a bowel movement
Internal hemorrhoids
Located under the skin around the anus bleed (bright red blood) if the hemorrhoid is injured or ulcerated and are very painful because they form in nerve-rich tissue outside the anal canal
External hemorrhoids
External hemorrhoids can be treated with…
-A local application of topical medications
-Sitz baths
-High-fiber diet
-Avoidance of constipation and other causes of increased intraabdominal pressure
