Flashcards in Anderson Digestive Deck (69)
What condition is parotitis and orchitis associated with?
What is the difference in muscle between the lower and upper esophagus?
Upper: striated muscle
Lower: smooth muscle
What is the most common type of hiatal hernia?
What are some common causes of esophageal varices?
Portal HTN, alcoholic cirrhosis
What is a sequelae of GERD that can lead to adenocarcinoma?
Barrett's esophagus - squamous cells converted to columnar gastric cells
What are the three muscle layers of the stomach? What are the two attachments?
Internal - Oblique
Middle - Circular
External - Longitudinal
Lesser and greater omentum (METS can go here)
Main artery to stomach? Veins?
Innervation of stomach?
Gastric v. to portal v.
Sympathetic, splanchnic preganglionics, celiac plexus, parasympathetic (vagus)
Chronic or acute gastritis:
NSAIDs, ETOH, smoking, stress
Autoimmune w/ loss of parietal cells and IF
Erosion of superficial epithelium
Most asymptomatic, without erosion
Gastric or duodenal ulcer:
25% of all PUD
H. pylori ~75%
Worse with food
Burning epigastric pain
Assoc w/ MEN or blood type O
NSAIDs, Smoking, Blood type A
What is the respective portion of the duodenum, jejunum, and ileum?
D: 12 in
J: 40% of small intestine, less blood flow/lymph (peyer's patches)
I: 60% of small intestine, more blood flow/lymph (peyer's patches)
Name the pathology:
Paralysis of ileum, often due to vascular obstruction
Vascular compromise of intestine leading to necrosis
Vascular compromise of the GI leading to mucosal inflammation
One segment of SI telescopes into distal segment
General condition with inflammation of the GI
What is the name of the longitudinal smooth muscle in the large intestine? What are the pouches in the wall called?
Name the colon segments in order.
Ascending, hepatic flexures, transverse, splenic flexures, descending sigmoid
What type of muscle is the internal sphincter? how is it controlled?
What type of muscle is the external sphincter? how is it controlled?
Internal: smooth muscle, autonomic control
External: striated, pudendal nerve - conscious control
Name the pathology:
Herniation of colon mucosa through muscularis, submucosa, and adventitia.
Inflammation of above herniations
Varicosities inside and outside the anus
Giardia, ameba, viral/bacterial infection
Polypoid masses in proximal colon, METS, M>W, 60-70yo
Crohn's vs. UC:
Skip lesions throughout the intestines
Limited to rectum/colon
Usu. more abdominal pain
T/F: 60% of pancreatic cancer is the head.
What is migratory thrombophlebitis/clots assoc. with pancreatic cancer?
Name the pathology:
inflammation of the exocrine pancreas, pain radiates to back
toxic damage from acetaminophen
hepatitis, cirrhosis, metabolic disorders
reduction of bile flow
Acute liver failure
Chronic liver failures
What are some intrahepatic and extrahepatic causes of cholestasis?
Intra - viral, alcohol, drugs, sepsis
Extra - gallstones in common bile duct, neoplasm of pancreatic head, pancreatitis
Three sources of blood supply to stomach and their source:
Splenic a. -> short gastric a.
Celiac a. -> left gastric a.
Hepatic a. -> right gastric a.
Where does the inferior mesenteric vein drain? (hepatic v. or splenic v.)
The short gastric v. drains into the ______ which drains in the _______.
Inf. mesenteric v.
Breaks the rules!!
What conditions could lead to portal HTN? What are signs of portal HTN?
Liver cancer, alcoholism/cirrhosis, pregnancy.
Hemorrhoids, esophageal varices, caput medusae
What two plexuses make up the enteric nervous system?
Meissner's - submucosal - secretion
Myeneteric (Auerbach's) - motility
What does each cell secrete? What is the effect?
G - cells
I - cells
S - Cells
Gastrin - stimulates H+
CCK - stimulates GB contraction, pancreatic enz secretion, inhibits gastric emptying
Secretin - stimulates GB and pancreatic secretions, inhibits gastric emptying
What are the two main hormones in the stomach that stimulate H+?
Gastrin and Histamine (type 2 receptors)
What stimulates and inhibits gastrin?
(+) amino acids, stomach distention, vagal input
(-) enough H+, secretin, GIP
What are the three hormones of the duodenum/jejunum involved in digestion? What stimulates their release?
CCK: (+) AA, fatty acids
Secretin: (+) H+ and fatty acid
Gastrin Inhibitory Peptide (GIP): (+) oral glucose, AA, fatty acid