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S4- Acute Care > Week 7- GI > Flashcards

Week 7- GI Flashcards

1
Q

What are the primary organs of digestion?

A
  • oral cavity
  • pharynx/larynx
  • esophagus
  • stomach
  • small intestine(duodenum, jejunum, ilium)
  • large intestine
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2
Q

What are the 3 main functions of the stomach?

A
  • mechanical
  • exocrine
  • endocrine
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3
Q

What are some accessory organs of digestion?

A
  • teeth
  • tongue
  • salivary glands
  • liver
  • gallbladder
  • pancreas
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4
Q
  • What is in the RUQ?
  • What is in the RLQ?
  • What is in the LUQ?
  • What is in the LLQ?
A
  • RUQ: liver, gallbladder, colon, kidney, duodenum, small intestine
  • RLQ: ascending colon, caecum, appendix, small intestine
  • LUQ: stomach, spleen pancreas, kidney, colon, jejunum
  • LLQ: descending colon, colon, sigmoid colon, small intestine
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5
Q
  • When evaluating a patient whos chief complaint is due to a GI condition, make sure to investigate _____ patterns.
  • In patients who may not have a GI diagnosis, but have pain patterns that may not match the MOI, be alert for GI conditions.
A

pain

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6
Q

What are some common symptoms of GI dysfunction?

A
  • N/V/D
  • Hemoptysis (coughing up blood)
  • Incontinence/Diarrhea
  • Heartburn (reflux)
  • Abdominal pain
  • Dysphagia
  • Jaundice
  • Color changes in stool/urine
  • Hematochezia
  • Melena
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7
Q

What are some disorders that can also adversely affect the GI system?

A
  • Medical hx
  • Substance use disorder
  • Food intolerance
  • Thyroid dysfunction
  • DM
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8
Q

What are some diagnostic studies that may be seen in patients with GI issues? (6)

A
  • Laparoscopy
  • Barium swallow
  • Endoscopy
  • ERCP
  • GI bleeding screens
  • Upper GI series
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9
Q
  • What is a laparoscopy?

- It can be _________ or _________.

A
  • Insertion of laparoscope into abdominal cavity using small incision and local anesthetic.
  • diagnostic or therapeutic
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10
Q
  • What is a barium swallow test?
  • It is used to ID pathologic conditions of the ___________.
  • What is the modified barium swallow study used to diagnose?
A
  • Patient swallows barium liquid while x-ray images examine swallowing and peristalsis of esophagus.
  • esophagus
  • dysphagia
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11
Q

What is a endoscopy?

A

Insertion of endoscope into digestive tract.

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12
Q

What is a ERCP?

A

Uses endoscopy and fluoroscopy to diagnose and treat gallbladder, biliary system, pancreas, and liver problems.

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13
Q

What are GI bleeding scans?

A

Used to determine the presence and/or source of GI bleeding.

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14
Q

What is a Upper GI series used for?

A

Used to identify disorders of the esophagus, stomach, and duodenum.

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15
Q

What are some lab tests for liver function/biliary tests?

A
  • ALT
  • ALP
  • AST
  • albumin
  • bilirubin
  • ammonia
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16
Q

What are some lab tests for pancreatic function?

A
  • lipase
  • amylase
  • sweat test
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17
Q

GI CONDITIONS

A

GI CONDITIONS

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18
Q

Dysphagia:

  • What is dysphagia?
  • It can be either ____pharyngeal or _____phageal.
  • How is it diagnosed?
  • What are the causes?
  • How do we treat it?
A
  • Difficulty swallowing
  • oropharyngeal or esophageal
  • MBSS, endoscopy, CT, or MRI
  • Caused by neurological conditions (stroke, TBI), dementia, myasthenia gravis
  • Treat through airway protection and nutritional support.
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19
Q

GERD:

  • What is GERD?
  • What are the SxS?
  • How is it treated?
A
  • Backflow of gastric acid into esophagus.
  • heartburn and regurgitation
  • diet modification, weight loss, PPIs, H2 blockers, Nissen fundoplication
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20
Q

PUD:

  • What is PUD?
  • What are the causes?
  • What are the SxS?
  • How is it treated?
A
  • Ulceration in the stomach or duodenum
  • h.pylori infections and NSAIDs
  • hungerlike sensation, nocturnal pain
  • lifestyle modification, PPIs, antibiotiics, no NSAIDs/aspirin
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21
Q

Dumping Syndrome:

  • What is Dumping Syndrome?
  • Can result from a number of GI __________ including gastrectomy, gastric bypass surgery, PUD surgery, Nissen fundplication.
  • Early DS occurs within ____ minutes of a meal and involves palpitations, tachycardia, flushing, diaphoresis, syncope, and abdominal symptoms.
  • Late DS occurs __-__ hours after meal and the SxS are consistent with _____________.
  • What are the treatments?
A
  • Enhanced gastric emptying interrupts normal digestive sequence
  • surgeries
  • 30 minutes
  • 1-3 hours, hypoglycemia
  • dietary changes and medications
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22
Q

Dumping Syndrome (DS) occurs due to rapid transition and absorption of food from the _______ to the ________.

A

stomach to intestine

23
Q
  • GI Hemorrhage can be divided into _____ and _____.
  • With small GI bleeds we may not see intervention, however, severe bleeds are a medical emergency that can cause ___________ instability leading to hypovolemic shock.
A
  • UGIB and LGIB

- hemodynamic

24
Q

Upper GI Bleeds (UGIB):

  • Where do they occur?
  • Generally caused by ______, gastric erosion, and gastric/esophageal varices.
A
  • esophagus, stomach, or duodenum

- ulcers

25
Q

Lower GI Bleeds (LGIB):

  • Where do they occur?
  • Caused by _____, ischemic colitis, anal and rectal lesions, (hemorrhoids), ulcerate polyps and colorectal cancer.
A
  • colon and anorectum

- IBS (diverticulitis)

26
Q

What are the SxS of UGIB and LGIB?

A
  • hematemesis
  • hematochezia
  • melena
27
Q

What is the treatment of UGIB and LGIB?

A

-IV fluids, blood transfusions, management of causative factors

28
Q

Diverticular Disease:

  • What is the difference between diverticulosis and diverticuliltis?
  • What are the SxS?
  • What is the treatment?
A
  • Diverticulosis is the presence of diverticula (can be asymptomatic). Diverticulitis is inflammation and infection of the divertculi.
  • LLQ pain, polyuria, fever and elevated WBC, constipation, N/V
  • diet modification, clear liquids, IV fluids, pain meds, antibiotics, surgery
29
Q

Hiatal Hernia:

  • What is a hiatal hernia?
  • What are the SxS?
  • What is the treatment?
A
  • Protrusion of abdominal structures upward through esophageal hiatus.
  • heartburn-like pain, dysphagia, chest pain, dyspnea, hoarseness
  • Behavior modifications, eating small/frequent meals, bland food with high fiber content, acid-reducing meds; laparoscopic repair
30
Q

Abdominal Hernia:

  • What is a abdominal hernia?
  • What are the SxS?
  • What is the treatment?
A
  • protrusion of bowel that is classified by location of protrusion
  • abdominal distension, N/V, position changes with increased abdominal pressure (laughing, coughing), pain, paresthesia
  • monitor asymptomatic cases, Surgical repair for symptomatic, possible temporary colostomy
31
Q

What are 4 common areas for abdominal hernias?

A
  • Inguinal
  • Femoral
  • Umbilical
  • Epigastric
32
Q

With a hernia, if the contents can be replaced within the surrounding musculature it is called ___________. If you can’t replace the contents, it is ___________.

A

reducible

-irreducible

33
Q

A ____________ hernia has compromised circulation and can be fatal.

A

strangulated hernia

34
Q

Irritable Bowel Syndrome (IBS):

  • IBS is characterized by ___________ pain and altered _______ movements.
  • The diagnostic criteria includes that SxS persist for at least ___days/month in the past 3 months associated with _________ criteria.
  • Can increase or decrease GI motility, which can result in what?
A
  • abdominal pain and altered bowel movements
  • 3 days/month, Rome IV
  • diarrhea, constipation, or both
35
Q

What are the Rome IV criteria for IBS? (4)

A
  • recurrent abdominal pain
  • pain relieved by defacation
  • changes in stool frequency
  • changes in stool form or appearance
36
Q

What are 2 idiopathic inflammatory bowel diseases?

A
  • Crohn’s Disease

- Ulcerative Colitis

37
Q

Crohn’s Disease:

  • Idiopathic _________ bowel disease (IBD).
  • Where can it occur in the GI system?
  • What are the SxS?
  • What are the causes?
  • What is the treatment?
A
  • inflammatory
  • anywhere in the GI system (most common terminal ileum, proximal colon)
  • RLQ pain/mass, diarrhea, weight loss, fatigue, low grade fever
  • genetics, immune dysregulation, infectious agents, psychological issues, environmental factors
  • corticosteroids, antibiotics, immunosuppressants, nutritional support
38
Q

What are some complications that can result from uncontrolled Crohn’s Disease?

A

intestinal obstruction, inflammation of membranes, arthritis, ankylosing spondylitis, gallstones, B12 deficiency, thromboembolism

39
Q

Ulcerative Colitis:

  • Idiopathic ________ bowel disease (IBD).
  • Where does it occur?
  • What are the SxS?
  • What are the causes?
  • What is the treatment?
A
  • inflammatory
  • mucosal layer of rectum and proximal colon
  • lower abdominal pain relieved by defecation, bloody stools, diarrhea, incontinence, nocturnal defecation, fatigue, wt loss, dehydration
  • similar to Crohn’s Disease
  • anti-inflammatory meds, immunosuppressants, biologics, diet modification, surgery, monitoring for colon cancer
40
Q

Crohn’s Disease and Ulcerative Colitis Similarities:

  • Both are the main forms of _________ _______ ________.
  • Both characterized by __________ of digestive tract.
  • Both often develop in teenagers and young adults(___-___ years and ___-___ years).
  • Both affect men and women __________.
  • Symptoms are similar.
  • Causes are _________, but both diseases have similar types of contributing factors such as environmental, genetic, and inappropriate response to immune system.
A
  • inflammatory bowel diseases
  • inflammation
  • 15-35 years and 55-70 years
  • equally
  • unknown
41
Q

Crohn’s Disease and Ulcerative Colitis Differences:

  • Ulcerative Colitis is limited to the ______, while Crohn’s Disease can occur anywhere between the ______ and ______.
  • With Crohn’s Disease, there are _______ parts of the intestine mixed in-between inflamed areas. With Ulcerative Colitis, the inflammation is __________ within the colon.
  • Ulcerative Colitis affects the ___________ layer of the colon while Crohn’s Disease affects ______ layers.
A
  • colon, mouth and anus
  • healthy, continuous
  • innermost layer, all layers
42
Q

Morbid Obesity:

  • Chronic disease characterized by excessive body fat and BMI of ____ or higher.
  • Many comorbidities linked with morbid obesity!
  • What are the conservative treatments of morbid obesity?
  • What are the surgical treatments of morbid obesity?
  • Better outcomes associated with patients involved in _________ program.
  • Closely monitor exercise _________ with BP, HR, RR.
  • _____ inspection also key.
  • Be aware of weight limits for equipment.
A
  • 30 or higher
  • weight loss (goal: 10% reduction), diet modification, meds, behavior mgmt, increased physical activity.
  • gastric bypass, gastric banding, gastroplasty, gastrectomy
  • exercise
  • tolerance
  • skin inspection
43
Q

What are 2 liver and biliary disorders?

A
  • Encephalopathy

- Cholecystitis

44
Q

Encephalopathy:

  • May be caused by acute and chronic _____ disease.
  • Impaired _______ status and __________ dysfunction occurs over hours to days.
  • Altered __________. (ammonia intoxication, changes in cerebral blood flow)
  • Treatment includes reducing ________ levels, correcting _________ imbalance, antibiotics, nutritional support, and liver transplant.
A
  • liver
  • mental status and neuromuscular dysfunction
  • consciousness
  • ammonia levels, correcting electrolyte imbalance
45
Q

Cholecystitis:

  • Cholecystitis is commonly associated with obstructions by ___________.
  • What is cholecystitis?
  • What is cholelithiasis?
  • S/S include _____ pain that may radiate to R shoulder, abdominal rebound sign (________ sign), ________, N/V, fever.
  • What does treatment of cholecystitis involve?
A
  • gallstones
  • Cholecystitis: acute or chronic inflammation of the gallbladder
  • Cholelithiasis: gallstone formation
  • RUQ pain, Murphy’s sign, jaundice
  • laparoscopic cholecystectomy (gallbladder removal)
46
Q

MANAGEMENT OF GI CONDITIONS

A

MANAGEMENT OF GI CONDITIONS

47
Q

When looking at pharmacological management of GI disorders, we are either looking at meds to control ______ _____ secretion or meds to normalize GI __________.

A
  • gastric acid secretion

- GI motility

48
Q

Abdominal Surgical Approaches:

  • ____________ is open surgery of the abdomen to explore and/or repair issues; many different types of incisions, “midline” is the standard cut.
  • __________ is when short, narrow tubes (trochars) are inserted into abdomen through small (<1cm) incisions; surgical tools inserted through trochars to perform surgery. High resolution cameras provide visual of area of interest.
A
  • Laparotomy

- Laparoscopic

49
Q

Is a laparotomy or laparoscopic less invasive, and has faster recovery time.

A

Laparoscopic

50
Q

GI Surgical Procedures “-ectomies”:

  • ___________ is removal of appendix.
  • ___________ is removal of gallbladder.
  • ___________ is resection of portion of colon, usually involves a colostomy or iliostomy.
  • ___________ is removal of part or whole stomach.
  • ___________ is removal of spleen.
A
  • Appendectomy
  • Cholecystectomy
  • Colectomy
  • Gastrectomy
  • Splenectomy
51
Q

Colostomy:

  • What is a colostomy?
  • Is it temporary or permanent?
  • Make sure pouch is securely closed before patient __________.
  • Keep covered for patient _________.
  • Empty bag if full.
A
  • Procedure that reroutes stool from diseased colon to external bag.
  • Can be temporary or permanent.
  • interventions
  • dignity
52
Q

General PT Considerations for GI:

  • _________ to decrease tension on surgical site.
  • ______ knees while HOB lowered to decrease tension.
  • ______ can aggravate dysphagia and GERD.
  • ______ during mobility/coughing.
  • Increased ________ likely.
  • Be aware of _________ restrictions.
A
  • sidelying
  • flex knees
  • supine
  • splinting
  • fatigue
  • dietary
53
Q

If a patient has varices (dilated blood vessels), they may rupture with increased _______ pressure. Avoid __________ effects (coughing).

A
  • intraabdominal

- valsalva

54
Q

Ascites (fluid accumulation in the abdomen) hinders effective ___________ and restricts adequate _________.

A
  • coughing

- ventilation

S4- Acute Care (15 decks)

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