Clinical Intro to GI Tract Flashcards by Sophie Chung

What does the GI tract do?

Takes in food

Digests to extract and absorb energy and nutrients

Expels remaining waste

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What is formed at the end of mastication?

Bolus

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What are the three main salivary glands involved with eating?

Parotid

Sublingual

Submandibular

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What type of saliva is produced by the parotid?

Serous

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What type of saliva is produced by the submandibular?

Mixed

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What type of saliva is produced by the sublingual?

Mucous

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Which salivary gland is most active during eating/chewing?

Parotid

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What are the digestive functions of saliva?

Form bolus

Amylase and lipase

Taste

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What are the protective functions of saliva?

Dilution

Buffering

Lubrication

Remineralisation

Antimicrobial/antifungal/healing

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What are the three regions of the pharynx?

Nasopharynx

Oropharynx

Hypopharynx

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What prevents aspiration when you swallow?

Epiglottis

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How long is the oesophagus on average?

25cm

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How is food moved along the oesophagus?

Peristalsis

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What are the four layers of the oesophagus?

Mucosa

Submucosa

Muscle layer

Adventitia

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Describe the muscle arrangement of the oesophagus.

Upper third - voluntary

Middle third - mixed

Lower third - smooth

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Describe the epithelium of the oesophagus.

Non-keratinised, stratified, squamous epithelium

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At what level does the oesophagus pass through the diaphragm?

T10

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At what level does the inferior vena cava pass through the diaphragm?

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At what level does the aorta pass through the diaphragm?

T12

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What increases the secretion of saliva?

Parasympathetic and sympathetic stimulation

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What decreases the secretion of saliva?

Sleep

Dehydration

Atropine

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What are the characteristics of saliva?

Hypotonic

High HCO3- and K+

Contains α-amylase and lingual lipase

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What increases the secretion of gastric acid?

Gastrin

Acetylcholine

Histamine

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What decreases the secretion of gastric acid?

Chyme in duodenum

Somatostatin

Atropine

Cimetidine

Omeprazole

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What increases the secretion of bile?

Cholecystokinin Parasympathetic stimulation

What decreases the secretion of bile?

Ileal resection

What are the characteristic substances found in bile?

Bile salts Bilirubin Phospholipids Cholesterol

What increases pancreatic secretion?

Parasympathetic stimulation Secretin Cholecystokinin

What are the characteristics of pancreatic secretions?

Isotonic High HCO3- May contain pancreatic amylase, lipase, protease or pepsinogen or intrinsic factor

Which amylase is stronger?

Pancreatic

What does the stomach secrete?

Acid Enzymes

What are rugae?

Ridges of muscle tissue lining stomach

How many muscle layers are there in the stomach's muscularis externa?

Three

What opens to allow chyme to move into the duodenum?

Pyloric sphincter

How many lobes are in a human liver?

What are the functions of the liver?

Drug metabolism Produce clotting factors Produce bile

What are the cells of the liver called?

Hepatocytes

What is the function of the bladder?

Stores and concentrates bile

What is the common risk group for gall stones?

Females 40+ Fatty diet

What is the endocrine function of the pancreas?

Regulate blood glucose by producing glucagon or insulin from islets of Langerhans

What is the exocrine function of the pancreas?

Produce digestive enzymes

What separates the small and large intestines?

Ileo-caecal valve

What occurs in the large intestine?

Absorption of water Absorption of vitamins made by bacteria Reduction in acidity Infection defence

How does defence against infections occur in the large intestine?

Antibodies produced - especially by appendix Confluence of several lymphoid tissues for surveillance

What is an example of a direct dental defect?

Acid erosion by intrinsic acid reflux or extrinsic dietary acids

What is an example of an indirect dental defect?

Malabsorption (medical conditions, drugs)

What may result in enamel not forming or being translucent?

Hypercalcificaiton Fluorosis

What are two inflammatory bowel diseases?

Ulcerative colitis Crohn's disease

What part of the GI tract does ulcerative colitis affect?

Part/whole of large intestine

What is ulcerative colitis?

Inflammation, ulcers and pseudopolyps Bacteria can leave GI tract into blood

What are the oral manifestations of ulcerative colitis?

Oral ulceration Blood blisters Pyogenic granulosum Erythema

What is the characteristic timeline of Crohn's disease?

Starts in teens/early twenties Second peak in old age - 50-60yo

What symptom might indicate Crohn's disease?

Recurrent oral ulcers

What are the symptoms of Crohn's disease?

Intermittent abdominal pain, diarrhoea, abdominal distention Fever Anaemia and weight loss Melaena Fistulae and perianal sepsis Finger clubbing Uveitis, arthritis, skin rashes/erythemanodosum

What is orofacial granulamatosis?

Group of non-infectious, idiopathic disorders Histologically associated with non-caseating epitheloid granulomas and multinucleated Langhan's giant cells within oral mucosa

What does orofacial granulamatosis respond well to?

Injection steroids

What is orofacial granulamatosis associated with?

Preservatives in diet

What are some symptoms of orofacial granulamatosis?

Cracking Oral ulcerations Lip/soft tissue swelling Staghorning

What are the possible oral manifestations of inflammatory bowel diseases?

Ulcers Swelling (facial or labial) Mucosal tags "Cobblestone" proliferation of mucosa (buccal) Smoothing of tongue Angular cheilitis Gingival enlargement (secondary to drugs) Staghorning

What drugs may patients with IBD be taking?

Immunosuppressants Corticosteroids

What should you be aware of in patients with IBD?

Treat bacterial infections more aggressively Gingival swelling Hypertension, MI, hypotensive crises, cerebrovascular accidents HPA-axis suppression, impaired glucose tolerance, diabetes, osteoporosis, growth retardation Peptic ulceration Delayed wound healing and poor quality tissues

What is Coeliac disease?

Genetic hypersensitivity of small intestine mucosa to gliadin (in gluten) characterised by villous atrophy

What are the two tests for Coeliac disease and which is more reliable?

Blood tests to see if you produce gluten antibodies Small intestine biopsy - more reliable

What is the dental relevance of Coeliac disease?

Malabsorption of vit. B12, folate - beefier tongue Anaemia, iron-deficient Glossitis, burning mouth, angular stomatitis, recurrent oral ulceration

Why is malabsorption of vit. K important?

Patient will be prone to bleeding

Why is malabsorption of vit. D important?

Osteomalacia (adults) Rickets (children)

What does angular stomatits indicate?

Iron deficiency or fungal infection

What type fo ulcers do Coeliac disease patients tend to have?

Herpetiform (clusters)

Clinical Intro to GI Tract Flashcards

(68 cards)