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Med 411 > Week 12 GI > Flashcards

Week 12 GI Flashcards

1
Q

What are the main components of the GI tract?

A

Oral cavity
Esophagus
Stomach
Small & large intestines

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2
Q

What are the 4 basic histological layers of the GI tract?

A

Mucosa
Submucosa
Muscularis externa
Serosa/Adventitia

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3
Q

Describe the gingiva

A

Gingiva = gums
Lightly keratinized stratified squamous epithelium
Richly vascularized lamina propria

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4
Q

What is the most common dental pathology in children and adults?

A

Gingivitis
Bacterial invasion results in accumulation of plasma cells/B cells in the lamina propria and destruction of collagen.

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5
Q

Describe oral mucosa

A

Stratified squamous epithelium
Basement membrane
Lamina propria
3 types:
Lining (lips, cheeks, soft palate)
Masticatory (gingiva, hard palate)
Specialized (dorsum of tongue)

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6
Q

What are the major salivary glands?

A

Parotid
Sublingual
Submandibular

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7
Q

Structure and function of salivary glands

A

Salivary glands are made up of serous and mucous cells surrounded by myoepithelial cells.
Striated ducts modify secretions by resorbing Na creating a hypotonic secretion.

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8
Q

What types of secretions come from the:
1. Parotid gland
2. Submandibular gland
3. Sublingual gland

A
  1. Totally serous
  2. Mostly serous
  3. Mostly mucous
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9
Q

What do glands secrete?

A

Amylase
Mucous
Bacterial lysozyme
Immunoglobulins

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10
Q

What is the 25 rule?

A

The GI tract is about 25 ft long
The esophagus is about 25 cm long

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11
Q

Discuss the structure of the esophagus

A

Mucosa
Submucosa
Muscularis externa
Adventitia

Mucosa: strat squam nonkeratinized epithelium, with underlying lamina propria and muscularis mucosae.

Small mucous glands release thin highly viscous mucous film to lubricate luminal surface.

Multilayer epithelium protects against abrasion. Renews 14-21 days.

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12
Q

Discuss the difference between the upper esophagus, middle esophagus, and lower esophagus

A

Upper: 2 layers of skeletal muscle
Middle: mixed skeletal and smooth muscle
Lower: 2 layers of smooth muscle

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13
Q

What delineates the esophagogastric junction?

A

Zigzag (Z) line: juncture of esophageal and gastric mucosa.
SSNKE transitions to simple columnar epithelium.

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14
Q

What are the anatomic regions of the stomach?

A

Cardia
Fundus
Body
Pylorus

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15
Q

What are the 4 layers of the stomach wall?

A

Mucosa
Submucosa
Muscularis externa
Serosa

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16
Q

What are the main cells types of the stomach?

A

Surface mucous cells
Mucus neck cells
Parietal cells
Chief cells
Enteroendocrine cells

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17
Q

What do parietal cells secrete?

A

HCl
Intrinsic factor

18
Q

What do chief cells secrete?

A

Pepsinogen
Lipase

19
Q

What is the proximal portion of the small intestine?

A

Duodenum

20
Q

What sphincter controls the movement of chyme from stomach to small intestine?

A

Pyloric sphincter

21
Q

Function of Brunner glands

A

Secrete alkaline mucous to neutralize acidic chyme.

22
Q

What structure pierces the duodenum 2/3 of the way down?

A

Major duodenal papilla from common bile duct and main pancreatic duct.

23
Q

What lines the villi of the duodenum?

A

Enterocytes
Goblet cells

24
Q

What is the middle portion of the small intestine and what structures are show up?

A

Jejunum
Lymphatic lacteals

25
Q

What is the distal portion of the small intestine and what new cells are present?

A

Ileum
Paneth cells that control bacteria are present at the base of intestinal glands (crypts)

26
Q

List the sections of the colon

A

Cecum
Ascending colon
Transverse colon
Descending colon
Sigmoid colon
Rectum

27
Q

What innervates the cecum to and including the transverse colon?

A

CNX

28
Q

What innervates the descending colon to and including the rectum?

A

S2,3,4

29
Q

Discuss the changes in the large intestinal wall.

A

Lacks villi
Contains intestinal glands
Numerous goblet cells
Fewer enterocytes
Lympohid nodules present

30
Q

Discuss the anorectal junction

A

Transition from colonic mucosa to SSNKE

31
Q

What plexi make up the enteric nervous system and what types of nerves are they?

A

Myenteric plexus - between inner circ and outer long muscularis externa layers.
Submucosal plexus - lies above submucosa.
Autonomic nerves, both sympathetic and parasympathetic.

32
Q

What are considered constitutional symptoms?

A

Fatigue and weakness: ask about when it occurs (ie normal response to stress/work vs abnormal/out of character d/t depression, infection, endocrine, etc.)

Fever, chills, night sweats (recurrent chills - possibly systemic bact. infection. night sweats - menopause, TB, malignancy)

Weight change (unintended weight loss, rapid weight gain, meds, nutrition)

Pain

33
Q

What are we routinely looking for in a general survey of a patient?

A

Height, weight, BMI, risk for obesity.

34
Q

How do you assess the patient’s general appearance?

A

Apparent state of health: acutely or chronically ill, frail, fit, robust.

Level of consciousness: awake, alert, responsive.

Apparent state of discomfort or distress: cardiac or respiratory distress, pain, anxiety or depression, pallor, diaphoresis, fidgety, flat affect, eye contact.

Skin colour and obvious lesions: Pallor, cyanosis, jaundice, rashes, bruises, etc.

Dress, grooming, personal hygiene: suitable clothing for weather, quality of footwear may suggest calluses, bunions, piercings, fingernails, dementia.

Facial expression: Parkinsonian mask, hyperthyroidism, depression.

Body and breath odor: diabetes, alcohol, liver failure.

Posture, gait, motor activity

Height and weight

Vitals: BP, pulse, HR, RR, temp, pain, physical activity

35
Q

List the head and neck lymph nodes to be assessed.

A

Occipital
Posterior auricular
Preauricular
Anterior superficial cervical
Posterior cervical
Tonsilar
Submandibular
Submental
Supraclavicular
Deep cervical

36
Q

Common or concerning symptoms of the head and neck.

A

Neck mass or lump
Thyroid mass, nodule, or goiter
Neck pain
Headache

37
Q

Key components of the head and neck exam.

A

Examine hair: quality, distribution, texture, patterns of loss.

Examine the scalp: scaliness, lumps, nevi, lesions.

Examine the skull: size, contour, deformities, depressions, lumps, tenderness.

Inspect the skin of head and face: expression, contours, asymmetry, involuntary movements, edema, masses.

Palpate the cervical lymph nodes: size, shape, delimitation, mobility, consistency, tenderness.

Examine the trachea: deviation, breath sounds over it.

Examine the thyroid gland: shape, size, consistency.

38
Q

What is the significance of an enlarge supraclavicular lymph node, especially on the left?

A

Virchow’s node
Suggests possible thoracic or abdominal malignancy.

39
Q

What is the protocol if enlarges or tender lymph nodes are found?

A
  1. Re-examine the regions they drain.
  2. Assess nodes in other regions to identify regional from general lypmphadenopathy.
40
Q

Discuss examination of the thyroid gland

A
  1. Inspect region below cricoid cartilage and identify contours of the gland.
  2. Observe patient swallowing, watching for upward movement of all structures,
    and symmetry.
  3. Palpate thyroid while swallowing.
    4.. Palpate the gland outlines, isthmus, and both lobe.
  4. If there is tenderness listen for bruit over lateral lobes.
41
Q
A

Med 411 (4 decks)

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