Digestive and Urinary Systems Flashcards
1
Q
Objectives
List and describe major disorders of the digestive organs.
A
fyi
2
Q
Fairly common
Men affected twice as often: lips and tongue most affectedCarcinoma of mouth
A
Carcinoma of mouth
3
Q
Etiology: unknown
Leukoplakia: white tissue
Erythroplakia: red area: more likely to be cancerous
Squamous cell: most common
Others: salivary gland and lymphoma
A
Carcinoma of mouth
4
Q
- Increased risk: smoking, drinking (100x), pipe smoking, smokeless tobacco, UV light, HPV
- S/S: lumps in mouth, sores that do not heal: cheeks, roof of mouth, gums and tongue, pain in mouth, ear pain
- Prognosis: depends on stage: 5 yr survival 56%
A
Carcinoma of mouth
5
Q
- MI: dentist usually diagnoses, biopsy, laryngoscopy, CT, MRI, bone scans, surgery, radiation, chemo
- PT: rehab of muscles of mouth, work with SLP
A
Carcinoma of mouth
6
Q
- Periodontal disease: may lead to loss of teeth and TMJ disorder
- Also caused by arthritis, mm spasm, teeth clenching, surgeries with general anasthetics
- S/S: pain, limited mouth opening, painful motion, grinding
- Prognosis: may resolve, may need specialty treatment for pain
A
Temporomandibular Joint Dysfunction
7
Q
- MI: surgery, bite realignment, bit guard, heat, NSAIDS
- PT: Jt mobs, estim, ionto, phono, us, exercises, education
A
Temporomandibular Joint Dysfunction
8
Q
- Occurs when part of stomach slides up through the diaphragm
- Cause of enlarged area in diaphragm: unknown: can be congenital, excessive pressure on stomach, straining, etc
- s/s: heartburn, belching, difficulty swallowing
A
Hiatal Hernia
9
Q
Hiatal Hernia
- What position might give a patient more problems?
- What changes can you make during therapy to decrease symptoms
A
much like acid relux. Elevate head
10
Q
- Incidence varies around world: highest Japan, S. America, Middle East, parts of Eastern Europe
- 21,000 people in US per year, men more affected
- Usually over 65
A
Carcinoma of stomach
11
Q
- Etiology: over 75, smoked, pickled, salty food
- S/S: usually undetected until late, may have weight loss, dyspepsia, N&V, some abdominal pain
- Prognosis: poor unless found early
- MI: upper GI, barium swallow, CT, exploratory
- PT: mobility training
A
Carcinoma of stomach
12
Q
- Nonerosive: chronic gastritis
- Erosive: peptic ulcer disease
- Craterlike lesions
- Can perforate
- Etiology: NSAIDS, etoh consumption, smoking, viruses, stress
- non-erosive: no known cause, H-pylori, pernicious anemia
A
Gastritis
13
Q
- Prognosis: good: meds and lifestyle changes
- MI: endoscopy, barium swallow, medications, change in eating habits
- PT: possibly relaxation exercises
A
Gastritis
14
Q
- Inflammation
- Etiology
- Bacteria, virus, parasites
- Food poisoning, virus (rotovirus, norovirus), water contamination, contaminated food, E-coli, Samonella, Capmlybactor, Shigella, Clostridium difficile
- S/S: diarrhea, N&V, abdominal pain, fever, sweating, HA, fatigue
A
Gastroenteritis
15
Q
- Prognosis: good, may require medication
- MI: take precautions: wash hands, cooking meat, treat with appropriate medication, blood or stool cultures, fluids, vomiting, diarrhea
- PT: avoid spreading of infection
A
Gastroenteritis
16
Q
- Lack control of gastric emptying (usually high sugar/carb meal
- Gastric resection or bypass
- Chyme into SI without being diluted
- Early s/s: Occuring during or within 30 min of eating: Gastrointestinal : nausea, vomiting, diarrhea
- Cardiovascular: flushing, dizziness, heart palpitations, rapid heart rate
A
Dumping syndrome
17
Q
- Late s/s: developing 1-3 hours later (caused by large amount of sugar followed by a quick drop in sugar)
- Sweating, hunger, fatigue, dizzy, rapid heart rate and fainting
A
Dumping Syndrome
18
Q
Dumping Syndrome
What could you encourage the patient to do when they have a PT appointment?
A
go to bathroom
19
Q
- Infancy or acquired
- Infancy
- Regurge or projectile vomiting
- Fail to gain weight
- Acquired
- Feeling of fullness
- vomiting
A
Pyloric stenosis
20
Q
- Malabsorption syndrome, autoimmune disease
- Can develop in childhood, or adults
- Genetic factors
- Prevents digestion of gliadin (cannot breakdown gluten)
- Gluten is present in wheat, barley and rye, oats??
- Destroys villi: less surface absorption for food
A
Celiac disease
21
Q
- s/s:Steatorrhea, Muscle wasting, Failure to gain weight, Irritability, Malaise, Abdominal pain, Loose stools, poor absorption, osteoporosis
- Dermatitis herpetiformis: also associated with celiac disease
- 1 in 133 people in US
A
22
Q
- Diagnosis
- Blood tests
- Biopsy
- Gluten free diet
- Dermatitis herpetiformis is NOT Contageous
- Treat: maintain a gluten free diet
A
Celiac disease
23
Q
- Usually in sigmoid colon or rectum
- Most common malignant tumor of intestinal tract
- 4th most common cancer
- Etiology: diet, hereditary component, polyps, high fat diet, Crohn’s disease, ulcerative colitis
A
24
Q
S/S: initially none, constipation, blood in feces, narrow stool, stomach pain, weight loss
Prognosis: depends on stage
MI: colonoscopy: start age 50, fecal occult blood tests, barium enema, CT
A
Colorectal Cancer
25
* Development of herniation or outpouching of mucosa through muscle layer of colon
* Occurs usually in sigmoid colon
* Diverticulosis: asymptomatic
* Diverticulitis: inflammation of diverticula
* Form at gaps between bands of longitudinal muscle
* May have congenital weakness
* Weaker areas affected by strong mm contractions, low residue diet, irregular bowel habits, aging
Diverticular disease
26
Signs and symptoms
* Many times asymptomatic
* Mild discomfort, diarrhea, constipation and flatulence
* Inflammation: LLQ cramping or steady pain
Diverticular disease
27
Treatment
* Acute episodes
* Reduce food intake
* Antimicrobial drugs
* Increase bulk in diet
* Omit seeds and popcorn
Diverticular disease
28
* Crohn’s disease and ulcerative colitis
* Cause: unknown, equal male and female
* Genetic factor
* More common in certain groups: whites, Ashkenazi Jews (Eastern Europe)
* May have immune abnormalities
* Chronic Inflammatory Bowel Disease
29
* Usually small intestine
* **_Skip lesions (crow skipping along)_**: affected areas separated by normal tissue
* Start with shallow ulcers, form fissures over time: create **_cobblestone (crow skipping along on the cobblestones)_** appearance
* Thick rigid wall with narrow lumen, can become totally obstructed
* Damage decreases ability to absorb food and increases motility
* Hypoproteinemia, avitamintosis, malnutrition
Crohn’s disease
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Signs and symptoms
* Exacerbations: diarrhea and cramping
* Soft stools
* Melena may be present
* Pain and tenderness in RLQ
* Anorexia, weight loss, anemia, fatigue, malabsorption and malnutrition
* Inadequate protein, vitamins
* Treat: glucocorticoids
Crohn’s disease
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* inflammation begins in rectum and progresses proximally
* Mucosa and submucosa are involved
* Tissue is edematous, friable and ulcers develop
* Can develop toxic megacolon
* Increase risk of colorectal carcinoma
Ulcerative Colitis
32
Signs and symptoms
* Diarrhea: frequent watery stools with blood and mucous
* Cramping pain
* Severe exacerbations: will pass blood and mucous
* Rectal bleeding, anemia, fever and weight loss
Ulcerative Colitis
remeber its the other one
(not crhon's -crow skipping along the cobblestone)
33
Treatment
* Remove stress
* Anti-inflammatory meds
* Antimotility agents
* Nutritional supplementation
* Antimicrobials
* Immunotherapeutic agents
* Surgical resection
IBD
**inflammatory bowell disesase**
*IBD is the grouping of diseases like crohn's or ulcerative colitis*
34
* Does not damage the intestine, affects up to 20% of population
* Etiology: no specific cause, stress, immune condition?, can have reduced serotonin receptors
* S/S: alternating diarrhea/constipation, abdominal pain, urgency, mucus in stool, abdominal bloating
Irritable Bowel Syndrome
35
* Prognosis: good: modify diet, stress control
* MI: exclude other problems, fiber, laxatives, antidiarrheals, stress reduction
* PT: exercise program
Irritable Bowel Syndrome
36
* Gallstones: 10% of population
* Cholelithiasis: formation of gallstones
* Choleycystitis: inflammation of gallbladder and cystic duct
* Cholangitis: inflammation related to infection of bile ducts
* Choledocholithiasis: obstruction by gallstones of biliary tract
Know the difference as per DR C
Gallbladder disorder
37
* Vary in size and shape
* Form in bile ducts, gallbladder or cystic duct
* Small stones: silent
* Large stones: obstruct flow of bile in cystic or common bile ducts
* Form with high concentrations of cholesterol or deficit in bile salts
* Stone obstructs bile flow in cystic or bile duct
Gallstones
38
Etiology
* Occurs twice as often in women
* Obesity, high cholesterol intake, multiparity, oral contraceptives or estrogen
the 4 Fs
Female, fat, forty, and fertile
Gallstones
39
Signs and symptoms
* Asymptomatic
* May obstruct duct: sudden severe waves of pain, radiates to back o**_r rt shoulder (know)_**
* Can have N&V
* Jaundice, can rupture gallbladder
* Chronic cholecystitis: milder signs with acute episodes
Gallstones
40
treatment
* Surgical removal
* Bile acids
* Lithotripsy (blast the stones)
Gallbladder
41
* Usually metastatic (comes from somewhere else that has cancer and goes to liver)
* Primary tumors
* Hepatocellular carcinoma
* Linked to hep B (not everyone that has it)
* Carcinogenic substances
* Aflatoxin (mold affecting rice, soybeans, corn, wheat)
* Hep C with chronic alcohol use with hep B
Liver Cancer
42
* Signs and Symptoms
* Usually mild
* Anorexia, vomiting , weight loss, hepatomegaly, portal hypertension, splenomegaly
* Prognosis: poor: difficult to diagnose early, 5% have 5 year survival rate
Liver Cancer
43
* MI: blood testing, PE, CT, MRI
* Treatment
* Chemo, lobectomy, radiation, liver transplant
Liver Cancer
44
* Inflammation of pancreas
* Autodigestion of tissue
* Is a medical emergency
* Causes massive inflammation, bleeding and necrosis
* Enzymes may start digesting tissue surrounding pancreas
* Chemical peritonitis
* Severe pain neurogenic shock
* Sepsis may result from escape of bacteria into general circulation
* Complications: ARDS, Acute renal failure
Acute pancreatitis
45
Etiology
* Many factors may precipitate acute pancreatitis
* ETOH( don't assume alcoholism)
* Gallstones
* ETOH: stimulates increase of pancreatic enzymes
* Gallstones; obstruct flow of bile and pancreatic secretions
Acute pancreatitis
46
Signs and symptoms
* Severe epigastric pain or abdominal pain: radiate to back
* Sign of shock: LBP, pallor, sweating, rapid/weak pulse (due to inflammation and hypovolemia)
* Low grade fever, then will rise
* Abdominal distention, decreased bowel sounds
Acute pancreatitis
47
diagnostics
* Lab tests: amylase and lipase
* Low calcium
* leukocytosis
48
treatment
* No food intake
* Treat shock and electrolyte imbalance
* Pain medication
Acute pancreatitis
49
* Increased incidents
* 42,470 cases with 35,240 deaths
* Risk factors
* Cigarette smoking
* Pancreatitis
* Dietary factors
* Obstructs pancreatic and biliary flow
* Body and tail: asymptomatic
* 95% mortality rate
Pancreatic Cancer
50
* Inflammation of peritoneal membranes
* Chemical or bacterial
* Inflammation with chemical irritants: increases permeability of intestinal wall
* Necrosis or perforation
* Local inflammation develops: omentum and peritoneum develops thick, sticky exudates: tries to seal the area and localize the problem, may form abscess
* Fluid, protein and electrolytes cannot recycle into circulating blood
Peritonitis
51
* Etiology
* Chemical \_\_\_\_\_\_\_\_\_\_\_\_
* Enzymes released from pancreatitis, bile, blood
* Bacterial \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
* Direct trauma: rupture appendix, intestinal obstruction
* Abdominal surgery
* Pelvic inflammatory disease
Peritonitis
52
Signs and symptoms
Sudden, severe abdominal pain
Localized tenderness at site of underlying problem
Vomiting
Dehydration
Fever
Leukocytosis
Rigid abdomen
Peritonitis
53
treatment
Surgery
Antibiotics
Replace fluids
PT: ambulation, bed mobility, strengthening
Peritonitis
54
