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Pathophysiology And Pharmacology 2 - notre dame > Wk1 > Flashcards

Wk1 Flashcards

1
Q

Name the different sphincters

A 
Upper oesophageal
Lower oesophageal
Pyloric
Ileocecal
Anal
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2
Q

Layers of gastrointestinal tract

A

Mucosa: simple columnar, has direct contact with food, scattered goblet cells secrete mucous for lube, lamina propria is connective tissue that provides capillaries for epithelial layer, muscularis mucosa is smooth muscle that provides muscular activity

Submucosa: connective tissue contains large blood vessels, nerves and secretary glands

Muscularis: 2 sub layers, inner layer around GI tract, outer aligned alongside GI tract

Serosa: outer layer of connective tissue, contains and supports GI tract

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3
Q

Enteric nervous system

A

Controls GI tract and digestive function

Sub mucosal plexus: sub mucosal layer, localised functions - blood flow, absorption and secretion from GIT to blood

Myenteric plexus: located between circular and longitudinal muscular areas

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4
Q

Sphlanchnic blood flow

A

Provides blood to oesophagus, stomach, intestines, liver, gallbladder, pancreas and spleen

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5
Q

These salivary glands include:

A

Submandibular
Sublingual
Parotid

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6
Q

Describe the process of deglutition

A

Swallowing
Saliva contain enzyme (amylase) which breaks down carbohydrates.
Relaxation of the stomach is facilitated by gastrin and cholecystokinin (polypeptide hormones secreted by GI mucosa)

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7
Q

Gastrin

A

Stimulus: presence of partially digested proteins in stomach

Action: stimulates HCL secretion and pepsinogen

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8
Q

Histamine

A

Stimulus: gastrin

Action: stimulates acid secretion

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9
Q

Acetylcholine

A

Stimulus: vagus and nerves in stomach

Action: increase GI motility

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10
Q

Motilin

A

Stimulus: presence of fat and acid in duodenum

Action: increase GI motility

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11
Q

Secretin

A

Stimulus: presence of chime in duodenum

Action: stimulates pancreas and liver, decreases motility and decreases gastrin and gastric acid secretion

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12
Q

Cholecystokinin

A

Stimulus: chime in duodenum

Action: stimulates gall bladder and pancreas, decreases GI motility, inhibits gastrin, constricts pyloric sphincter

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13
Q

Pancreatic polypeptide

A

Stimulus: protein, fat and glucose in small intestine

Action: decreases pancreatic bicarbonate and enzyme secretion

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14
Q

Vasoactive intestinal peptide

A

Stimulus: intestinal mucosa and muscle

Action: relaxes intestinal smooth muscle

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15
Q

Glycogenolysis

A

Breakdown of glycogen

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16
Q

What are parietal cells used for

A

Release stomach acid

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17
Q

What is Glycogenolysis

A

Breakdown of glycogen stores to release glucose

18
Q

What is Gluconeogenosis

A

Glycogen stores have been used, liver can convert amino acids and glycerol (proteins) to glucose

19
Q

What is gastro reflux

A

Backward movement of gastric content to oesophagus
Weak lower oesophageal sphincter
Over production of acid
Inflames and causes cellular damage to oesophagus where acid has burned

20
Q

Symptoms and nursing management of gastro reflux

A 
Heart burn 30-60mins after a meal
Painful to swallow
Burning in chest
Burping
Nausea
Mimic angina
Causes stricture: scar tissue
Oedema, muscular spasm
NC
Positioning: sit up, avoid bending 
Small meals
Weight loss
Antacids
Histamine 2 receptor agonists
Proton pump inhibitors PPI
21
Q

What is gastritis

A

Inflammation of gastric mucosa, local irritants such as alcohol, drugs, bacterial endotoxins, aspirin
May be severe

22
Q

What is chronic gastritis

A

Chronic changes to gastric mucosa
H.pylori
Autoimmune
Chemical: alkaline reflux from duodenum

23
Q

What is peptic ulcer disease

20% gastric
80% duodenum

A

Most caused by h.pylori
Aspirin and other NSAIDS
Stress - physiologic - burns
H.pylori produces enzymes and toxins which interfere with the mucosal protection against injury from gastric acid
Can penetrate mucosal lining, smooth muscle or perforate outer wall
Healing results in scarring - predisposes site to another ulcer

24
Q

Signs and symptoms of PUD and treatment

A

Burning, cramps, bleeding (coffee ground appearance if vomited), pain when stomach is empty, pain relieved by food or antacids temporarily, malemia: black tar from intestinal tract

Treatment: test: endoscopy, radiological studies (anaemia, faecal occult blood), antibiotics (h.pylori), antacids (relieve symptoms), heal ulcer crater, complications: haemorrhage, obstruction, perforation

25
Q

What is crohns disease

A

Recurrent inflammatory disease of sub-mucosal layer of GI tract
Mainly proximal colon and terminal ileum
Cause Unknown
Diagnosed by X-Ray, sigmoidoscopy, colonoscopy, complications include fistula formation, abdominal abscess, bowel obstruction

26
Q

S&S of crohns and treatment

A

S&S: colicky pain, weight loss, malaise, low fever, diarrhoea, Perianal skin ulceration

Tx: decrease inflammatory response with an anti inflammatory (corticosteroids), antibiotics for bacterial infection, pain relief, nutritional support, surgical resection of damaged bowel, rest bowel with temporary stoma

27
Q

What is ulcerative colitis

A

Inflammatory condition of colon. Mainly rectum and sigmoid colon (large bowel)
Affects continuous layer of bowel
Lesions forms in mucosal layer which may become necrotic or ulcerated

28
Q

S&S of ulcerative colitis and treatment

A

S&S: stools contain blood, anorexia, anaemia, cramping, exacerbation and remission, Perianal skin breakdown

Tx: anti inflammatory drugs (corticosteroids), immunosuppressant drugs if severe (cyclosporine), surgery to remove bowel

29
Q

Nursing management of ulcerative colitis

A 
Obs
Pain relief and meds
Skin care - stoma site, Perianal care
Support and reassurance
Education
30
Q

What is irritable bowel syndrome

A

Functional GI disorder (no physical changes to gastric wall)
No specific structural alterations as cause of disease
Altered bowel habits
Treatment includes: laxatives, antidiarrhoeals, low dose antidepressants, anti spasmodics

31
Q

Colorectal cancer

A 
Begin as benign polyps
Present for a long time before symptoms 
Change in bowel habits
Foetal occult blood test
Barium studies
Colonoscopy, sigmoidoscopy
32
Q

Treatment for colorectal cancer

A 
Polyp removal
Surgery
Temporary colostomy
Permanent colostomy
Postop chemo
Regular examination
Colonoscopy
33
Q

What is diverticulitis

A

Diverticula becomes inflamed. Causes lower quadrant abdo pain, fever, increased white cell count, cramping, nausea, diarrhoea

Diverticula: pouches within bowel wall

34
Q

What is appendicitis

A

Inflammation and infection of appendix, fever, pain, nausea and vomiting, CT ultrasound to confirm, antibiotics or removal

35
Q

What is bowel obstruction

A

Impaired movement of bowel contents

Mechanical: hernias, adhesions, tumours, strictures, volvolus(twisting of bowel), intussusception (bowel fold back)

Paralytic: impaired peristalsis, peritonitis, intestinal ischaemia

36
Q

S&S and nursing a management of bowel obstruction

A

Abdo pain and distension, constipation, anorexia,

History and examination, abdo X-ray, CT and ultrasound, NGT, IV hydration, surgery

37
Q

Signs and symptoms of liver cirrhosis

A 
Impaired protein synthesis
Impaired fat metabolism 
Impaired bile synthesis 
Impaired carb metabolism 
Impaired steroid hormone and drug metabolism
38
Q

What is liver cirrhosis

A

Liver tissue damage by toxins that is replaced by fibrous tissue. Disrupts flow within vascular and biliary channels
Weight loss, jaundice, pain as liver enlarges, anorexia

Late S&S: splenomegaly, ascites, portal hypertension, liver failure,

39
Q

What is hepatitis

A

Inflammation of liver
Caused by viruses (a,b,c,d and e) a.b.d are preventable, auto immune disorder, reaction to drugs and toxins, secondary to other infections
Malaise,joint pain, anorexia, nausea and vomiting, jaundice, right side abdo pain

40
Q

What is pancreatitis

A

Inflammation of pancreas
Pain in upper abdo
Fever
Diabetes

Pathophysiology And Pharmacology 2 - notre dame (8 decks)

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