Digestive funx Flashcards
(67 cards)
1
Q
normally in __, the __ __ responds to __ glucose. The __ or __ center responds to __ glucose levels.
A
hypothalamus, hunger center, low, satiety, satisfaction, increased
2
Q
4 facts about Anorexia
- seen in
- affected by
- related to
- precursor of
A
- seen in other d/o’s (cancer <3 dz renal dz)
- affected by smell emotions drugs
- can be related to psychosocial stress
- often precursor of nausea, pain diarrhea
3
Q
3 facts about nausea
- what type of experience
- associated with
- specific…
A
- subjective experience
- associated w/ variety of conditions
- no specific neural pathways identified
4
Q
major s/s of nausea
A
hypersalivation
tachy <3
diaphoresis
5
Q
what roles do the SNS & PNS play in N/V & retching
A
- diffuse sympathetic discharge causes
- increase <3 rate
- increase resp.
- diaphoresis - PNS mediates:
- increase salivation
- increase motility (& relaxation of both sphincters)
6
Q
what is the CTZ, location, funx
A
- chemoreceptor trigger zone
- 4th ventricle of brain
- receive stimuli from GI tract, vestibular apparatus, drugs, toxins, and hypoxia
7
Q
location & funx of the vomiting center
A
-medulla just above spinal cord & below pons
sensory
-receives sensory impulses (odor, smell, taste, gastric irritation, or ACh (hi dose of Rx ACh directly causes vomiting)
8
Q
what causes projectile vomiting
A
- direct stimulation of vomiting center
- neurologic lesions (tumors, aneurysms) of brain stem
- may be a symptom of GI obstruction
9
Q
metabolic consequences of vomiting
A
- fluid imbalance
- electrolyte imbalance (hypoCl-, hypoCa+, hypoK+)
- acid-base disturbances (alkalotic)
10
Q
causes of constipation
A
(constipation is a symptom not dz)
- mechanical
- physiological
- functional
- pharmacological
- psychological
11
Q
s/s of diarrhea
A
- 3 or more days of loose unformed stools
- pain, cramping, urgency
- hyper active BS borbygamous
12
Q
5 types of diarrhea
A
- large volume: r/t increase of h2o, secretions, or both
- small-volume: r/t increase in intestinal motility
- acute
- chronic
- steatorrhea
13
Q
describe acute diarrhea
A
sudden onset
2 wks or more duration
r/t increase of h2o secretions or both
-can be microorganism
14
Q
describe chronic diarrhea
A
3-4 wks recurring inflammatory bowel dz -fever bloody stools -crohns ulcerative collitis
15
Q
steatorrhea
A
fat in stools
related malabsorption syndrome (will float)
16
Q
3 mechanisms that cause diarrhea
A
- osmotic
- secretory
- motility
17
Q
describe osmotic diarrhea & it’s cause
A
- presence of nonabsorbable substance in intestines which draws excess water into intestine which increases stool weight/volume
- lactase & pancreatic enzyme deficiency
- excessive ingestion of synthetic, nonabsorbable sugars (sorbital)
18
Q
secretory diarrhea description & cause
A
excessive mucosal secretion of fluid & electrolytes which produces large volume diarrhea
- bacterial enterotoxins (e coli c-diff ATB therapy)
- small-volume secretory diarrhea caused by inflammatory disorder of intestine
19
Q
motility diarrhea description & cause
A
food not mixed properly which impairs digestion increases motility
- small bowel resection
- surgical bypass of section of intestine
- fistula formation btw loops of intestines
- gi bleeding
20
Q
Ab pain
A
- mechanical (ab organs are sensitive to stretching but not cutting tearing or crushing)
- inflammatory biochemical mediators stimulate nerve endings producing pain (histamine, bradykinin serotonin)
- infx/inflammation ->edema & vascular congestion
- ischemic d/t blood flow obsctruction
21
Q
define adhesion & when they occur
A
bands of tissue that form btw tissues & organs, occur after surgery
22
Q
3 types of pain
A
parietal
visceral
referred pain
23
Q
3 types of GI bleeds
A
- upper gi
- lower
- acute
24
Q
3 causes of upper GI bleeding
A
- esophageal varices
- peptic ulcers
- tearing (mallory-weiss tear) from weakness or retching
25
what is frank and occult blood
occult is hidden blood
| frank is obvious blood
26
lower GI bleed causes
- polyps
- inflammatory dz
- tumors
- hemorrhoids
27
consequence of acute GI bleed
life threatening medical emergency with sudden blood loss and is at high risk for decreased tissue perfusion and can affect all organ systems
28
define hematochezia & melena
hematochezia: bright red stools
melena: black or tarry stool, sticky, foul odor, increased BUN levels as a result of digestion of blood proteins
29
describe GERD
loss of muscle tone at the lower esophageal sphincter, reflux of chyme (along w/acid and pepsin) from stomach through LES esophagus
30
GERD clinical manifestations
```
<3 burn
acid regurgitation
dysphasia, hoarseness
maybe tirgger for asthma or chronic cough
upper ab pain within 1 hr of eating
```
31
What are inflammatory response in esophageal wall caused by GERD
```
hyperemia
increased capillary permeability
edema
tissue fragility
erosion
fibrosis and thickening
```
32
define hiatal hernia & major symptoms
- protrusion of upper part of stomach through diaphragm
| - heartburn after eating and swallowing
33
What are two types of hiatal hernia
1. sliding, related to congenitally short esophagus, trauma, or weakening of diaphragm muscles
2. paraesophageal: stomach slides up alongside esophagus
34
when does a sliding hiatal hernia worsen
coughing, bending, tight clothes, obesity, pregnancy
35
what s/s associated with paraesophageal hiatal hernia, what 2 things does it lead to, and what is the most serious complication
congestion of mucosal blood flow, leads to gastritis & ulcer formation, strangulation is the most serious/major complication
36
what is pyloris obstruction, 2 types
narrowing of blocking of opening btw stomach and duodenum
1. congenital (pyloric stenosis neonates)
2. acquired (inflammation) caused by peptic ulcer dz (usually duodenal) or nearby carcinoma
37
clinical signs of pyloric obstruct (View Pangs)
1 epigastic fullness after eating & late in day
2 nausea/epigastric pain (b/c of muscles contrax in attempt to force chyme past obstruction)
3 anorexia weight loss
4 gastric distention
5 succussion splash (sloshing)
6 copious vomiting- undigested food w/ no bile (projectile)
7 infrequent small stools
38
what is intestinal obstruction & 2 types
```
-any condition preventing normal flow of chyme through intestiene
1 simple (mechanical block)
2 functional: motility failure (paralytic ileus) can happen in post-op or in electrolyte imbalance
```
39
describe hernia protrusion & intussusception
1. d/t weakness in ab muscles or through inguinal ring
| 2. intussusception: telescoping of 1 part of intestine into another
40
what does intussusception cause and who is it more common in
usually causes strangulation of blood supply
| more common in infants
41
define torsion & constriction adhesions
1. torsion is intestinal twisting on its mesenteric pedicle
| 2 formation of fibrin and adhesions that attach to intestine, omentum, or peritoneum post-op most
42
what is associated with torsion and what does it create
| where are constriction adhesions most common
- torsion associated with fibrous adhesions & -creates blood supply occlusion
- most common in small bowel
43
where do diverticula usually form
(L) descending & sigmoid colon
44
s/s of diverticulitis
cramping
diarrhea
constipation
distention/flatulence
45
what is the most common surgical emergency of ab & what are 2 risks
- appendicitis
| - gangrene & perforation
46
clinical s/s of appendicitis
1. location of pain
2. 4 pieces of data used to diagnose give lab value
3. symptoms
1. RLQ
2. clinic. manifestations, WBC (10-16K w/ hi neutrophil #), ultrasound, CT
3. N/V anorexia low grade fever diarrhea (esp. in children)
47
pathophysiology of portal HTN, & what 4 conditions can it cause
- caused by blocked blood flow through portal venous sys or vena cava
1. varicies (esophageal, stomach, ab wall, or rectum (hemorrhoids)
2. ascites
3. splenomegaly
4. hepatic encephalopathy
48
clinical manifestations (4) of portal HTN
1. varices rupture and cause hemorrhage
2. hematemesis
3. melena
4. hi mortality rate
49
what is ascites, 3 causes in relation to
1. albumin
2. pressure
3. weeping
fluid accumulation in peritoneal cavity
1. lo albumin synthesis, decreasing capilary osmotic pressure
2. hi capillary hydrostatic pressure
3. hepatic lymph weeps into peritoneum carrying bacteria->peritonitis
50
define jaundice (aka) cause/related pathology
1. yellow or greenish skin pigmentation
2. icterus
3. hyperbilirubinemia
51
what causes jaundice in neonates
| adults
1. newborns impaired bilirubin uptake and conjugation
| 2, adults: 2 hepatobiliary (liver/gallbladder) causes & 1 hematologic cause
52
clinical manifestations of jaundice
fever, chills, liver pain d/t hepatitis
| anorexia, malaise, pruritis
53
2 types of hepatobiliary bilirubin increase, and what type of hyperbilirubinemia it causes
1. extrahepatic- bile ducts blocked (cholestasis)
- conjugated hyperbilirubinemia
2. intrahepatic (conjugated & unconjugated)
* liver pathology (cirrhosis & hepatitis)
* inherited problem w/bilirubin processing
54
cause of hemolytic jaundice & associated d/o's & type of hyperbilirubinemia
1. making too much bilirubin d/t increase RBC breakdown
2. d/t sickle cell anemia, hemolytic anemia, GI bleeding
3. (unconjugated)
55
5 characteristics of hepatic encephalopathy
1. complex...
2. ...funx
3. changes
4. result from
1. complex neurological syndrome associated with liver failure
2. impaired cerebral funx
3. EEG changes
4. primarily the result of protein related impaired ammonia metab.
56
give complication of advanced liver failure, 2 characterizations what does it accompany, and prognosis
1. hepatorenal syndrome
2. portal HTN & circulatory related Renal failure
3. accompanies sudden drop in circulatory volume
4. poor prognosis
57
2 main components of liver panel and give subcomponents of each
1. liver enzymes (ALT alanin transminase/AST asparate transminase)
2. Liver funx test (Bilirubin [direct, indirect], albumin, protein, ALP [alkaline phosphatase], PT [prothrombin time]
58
hep A characteristics, lab results transmission
1. self limiting, no carrier status
2. labs: *Anti-HAV IgM contagious infx *anti-HAV IgG earlier infx
3. fecal-oral
59
Hep B lab results transmission
1. HBsAG : surface protein of virus, acute chronic infx
2. HBeAG: protein indicative of acute contagiousness
3. HBcAb-IgM 1st antibody produced, detects acute infx
4. HBsAb-IgG: earlier infx or immunity
5. HBeAb: Recovery antibody
Transmission: parenteral, sexual, perinatal/vertical
60
Hep C characteristics, manifestations, labs, transmision
1. most common in many countries
2. fluctuating ALT, 25% jaundice, asymptomatic
3. Anti-HCV (previous infx, or chronic)
4. parenteral, sexual, vertical
61
Hep D characteristics, lab transmission
1. superinfx associated with Hep b
2. AntiHDV
3. parenteral sexual vertical
62
Hep E characteristics, lab, transmission
1. resembles Hep A, mainly in developing countries
2. * antiHEV IgM contagious infx * antiHEV IgG earlier infx
3. fecal oral
63
2 other organisms that cause Hep
Epstein Barr Virus, cytomegalovirus
64
describe cirrhosis (3)
1. what happens
2. type of dz
3. disrupts...
1. scarring, fibrosis, resistance to blood flow
2. irreversible inflamm dz
3. disrupts liver structure & funx
65
4 types of biliary cirrhosis
primary, secondary, postnecrotic, metabolic
66
describe primary and 2ndary biliary cirrhosis
1. primary: unknown etiology, inflamm & scarred bile ducts
| 2. 2ndary; obstruction (gallstones or neoplasms), inflamm and scarred bile ducts
67
describe cause & effect postnecrotic & metabolic biliary cirrhosis
postnecrotic
1. post viral hep, drugs, toxins, autoimmune dz
2. necrotic tissue replaced with cirrhotic tissue
metabolic
1. metab defects
2. inflamm scarring
