Flashcards in Diseases of the Digestive System (Unit 10) Deck (121):
Inflammation of the mucous membrane of the mouth.
- Vincent's Angina
- Aphthous stomatitis (Canker sores)
Types of stomatitis
Inflammation of the gums
- Results in redness, swelling, tendency to bleed.
- Mouth or upper respiratory infections (strep)
- Improper dental hygiene, plaque, loose fitting dentures, tooth decay.
Etiology of Gingivitis
Painful bacterial infection (Leptospira) and ulceration of the gums.
- Swelling and sloughing off of dead tissue from mouth and throat -> bleeding -> foul breath
- Usually in children or young adults
Vincent's Angina (trench mouth)
Inflammation of the tongue.
- Results in: tender, painful tongue covered with ulcers, edema.
- Candida yeast -> thrush (sore) mouth and tongue.
- Herpes viruses, syphilis, hot food or liquids (most common), mechanical injury, such as biting the tongue.
Etiology of Glossitis
Inflammation of the parotid glands (salivary glands) due to viral (mumps) or bacterial infection.
Parotitis (Epidemic parotitis)
Tiny ulcers (fluid filled vesicles) with red areola on mucosa of the mouth.
- Etiology is unknown
Aphthous stomatitis (canker sores)
- Hard tooth brush
- Sharp foods (coffee, nuts)
- Iron or vitamin deficiency (folic acid, B12)
- Stomach acid reflux
- Viruses, bacteria, stress
Mechanical causes of aphthous stomatitis (canker sores) is unknown
-Occur on lips, cheeks, gum, palate, or tongue.
- Related to exposure to sunlight, chewing tobacco, smoking pipes or cigars.
- Result in inflammation, ulceration, pain.
Neoplasms of the mouth
Located on the lips and tongue.
Squamous cell carcinoma
Located on the lips.
Basal cell carcinoma
Can metastasize to the GI
Both squamous cell and basal cell carcinomas
Located on the bones of the jaw.
Giant cell Tumor (epulus)
Inflammation of the mucous membrane and underlying parts of the pharynx.
- Streptococcus or other bacteria (e.g., diphtheria, bacteria- difficult breathing and swallowing)
- Food blockage in the throat
- Allergens, pollen, dust
Etiology of pharyngitis
- Cough, congestion, catarrhal lesions, crypts of pus -> giving tonsils white appearance -> airway obstruction.
Symptoms of pharyngitis
Inflamed mucous membrane.
Crypts of pus.
Highly contagious infection; spread by sneezing, coughing.
- Sore throat
- Bumpy rash on the skin
- Flushed cheeks
- "Strawberry tongue"
Symptoms of scarlet fever
- Rheumatic fever (heart disease)
- Glomerulonephritis (kidney disease)
Serious complications of scarlet fever
Inflammation of the esophagus, is rare.
- May lead to:
- Chronic esophagitis
- Barret's esophagus
Tube connecting the mouth and the stomach.
- Acid reflux, hot foods and liquids, chemical poisons, acids, alcohol, foreign bodies, food stuck in the throat, neoplasm.
- External pressure such as with hiatal hernia.
Causes of esophagitis
Scar tissue forms -> blockage (esophageal stricture = stenosis)
Tissue in the esophagus is replaced by tissue similar to intestinal lining. Most often a result of long-term gastroesophageal reflux disease (GERD)
- Associated with greater risk of developing esophageal cancer.
May spread from mouth, throat, or stomach cancer.
Esophageal squamous cell carcinoma
Inflammation of the stomach.
- Hot and spicy foods, fatty foods, high protein foods, garlic, alcohol- irritant, chemical poisons.
- Infections: quite rare because of acid in the stomach.
- Helicobacter pylori - bacteria that can survive (block acid production).
Cause of gastritis
An open sore or lesion of mucous membrane accompanied by sloughing of inflamed necrotic tissue.
A lesion in the lining of the digestive system.
- Esophageal ulcer
- Gastric ulcers (usually single ulcer)
- Duodenal ulcers (Small intestine, small and multiple ulcers)
- Presence of Helicobacter pylori or virus
- Excess acid production or alcohol
- Diet such as greasy foods
- Medications or stress
Triggers of ulcers
Pain, nausea, vomiting, hematemesis (blood in vomit), blood in feces (Melena), heartburn, fatigue, belching.
Symptoms of ulcers
- Formation of scar tissue
- Tearing of stomach lining
Complications of ulcers
Abnormal constriction of the pyloric valve.
- In children, more in males, 1st born males.
- Symptoms: mostly vomiting during the first four weeks of life.
Pyloric valve stenosis
- Can be squamous cell carcinoma or adenocarcinoma
- Symptoms: vomiting blood, weight loss
- Surgical removal, chemotherapy, radiation
- Dietary- smoked foods, red meats, salted fish, food additives
- Alcohol, coal tars from cigarettes
Risk factors for gastric cancer
Inflammation of the intestine, especially the small intestine, usually accompanied by diarrhea.
- Salmonella- most common
- Shigella, Hepatitis A, E. coli, dysentery, last stages of TB, cholera
- Spicy foods, alcohol, medication
Etiology of enteritis
Symptoms of enteritis
Bacterial infection by Salmonella.
- Invade the lining of the small intestine -> acute symptoms- gastroenteritis (nausea, abdominal cramping, and bloody diarrhea with mucous).
- Symptoms after 6-72 hours after ingestion, lasts 5-7 days.
- Requires no treatment, unless patient becomes severely dehydrated or infection spreads from the intestines.
- Fatality rate >1% for most strains of salmonella.
Abnormal protrusion of an organ or part of an organ through an abnormal opening in the wall of the cavity containing the organ.
- Obesity, age, trauma
- Congenital weakness in the wall
- Poorly healed wound or surgical incisions
Predisposing factors of hernias
- Reducible - can be pushed back without surgery.
- Irreducible- Can't be pushed back without surgery because of scar tissue and adhesions.
Types of hernia
Locations of hernias
Congenital, most common.
Male scrotum or female vagina.
Inside of the thigh.
Herniation of the esophagus.
Upwards into diaphragm.
- Rupture or perforation
- Strangulation - Blood vessels of wall of herniated intestines twist into knots -> gangrene can occur
- Obstruction or blockage
Complications of hernias
Inflammation of the mucous membrane of the colon (part of the large intestine).
- Ascending infections (parasites, worms)
- Descending infections (Shigella)
- Nervous tension
Etiology of colitis
- Ulcerative colitis
- Chrohn's disease
Complications of colitis
Erosion in lining of the rectum and lower part of the colon (may include the ileum).
- Idiopathic, probably the body's immune system reaction to virus or bacterium.
- Results in bleeding, perforation, increased risk for cancer.
- 25-40% of patients have colostomy
Ulcerative colitis (inflammatory bowel disease)
Removal of the colon and rectum.
Inflammation of the gastrointestinal tract anywhere from the esophagus to the anus ( including parts of the small and large intestine).
- Autoimmune disease, may be hereditary
- Triggered by stress and diet
- Affects full thickness of the wall
- Can result in ulcers, scarring, blockage of the intestine, rectal bleeding
- Mostly in young adults (20-35), often females.
The presence of a number of small bulging scars (diverticula) pushing outward from the colon wall.
Small bulging scars.
Inflammation of diverticula in the colon; may include infection.
Inflammation of the rectum.
- Complications include bleeding, exudates, abscess, rectal sinus, fistula.
- Ascending infections
- Retained feces
- Colon rectal cancer
- Irritating injections
- Mechanical injury to rectum.
Etiology of proctitis
Painful, inflamed veins (varicose vein) around the anus or lower rectum.
- Symptoms include bleeding, irritation, swelling
- Increased pressure in the veins due to constipation or diarrhea, obesity, pregnancy, anal intercourse, prolonged sitting.
Etiology of hemorrhoids
Bacterial infection by Shigella in polluted water ( human feces) transmitted via fecal- oral route and is very common in individuals with AIDS.
- Severe dysentery treated (e.g. ampicillin)
- 10- 15% fatality rate (by some strains of Shigella)
- Mild abdominal discomfort or full- blown dysentery (cramps, vomiting, diarrhea, fever, blood, pus, or mucus in stools).
- Begin 2-4 days after ingestion and last for several days to several weeks
Symptoms of Shigellosis
A rare but serious illness caused by Clostridium botulinum bacteria.
- Produce toxin- even tiny amounts lead to severe poisoning:
- abdominal cramps, difficulty breathing, no fever
- found in soil and untreated water.
- May enter through wounds, or the digestive system (from spores- can live in improperly canned or preserved food).
Malignant neoplasm; metastasizes early.
- Degree of tumor invasion and spread from mucosa -> muscular wall -> lymph nodes -> distant metastasis
- Causes bleeding
- More often in males
Vestigial (no function) diverticulum (pouch) located at the ileocecal junction
- Lower portion of the ascending colon -> high risk of fecal impaction (blockage of appendix by feces)
Appendix is infected by bacteria in the feces.
- Acute in younger people, chronic in older due to scar tissue and adhesions.
- Danger: perforation and spread of infection throughout the abdomen -> peritonitis
Inflammation of the membrane lining in the abdominal cavity (peritoneum).
- Infection or trauma to abdomen
- Rupture of an internal organ or vessel:
- Gall Bladder
- Portion of intestines
- Fallopian tubes
- Diabetes (dehydration due to excessive fluid loss).
Causes of peritonitis
Inflammation of the liver
Viruses (Hep A, B, C), bacteria, gallstones, trauma, injury, chemicals, alcohols, medications.
Causes of hepatitis
- Hepatomegaly (enlarged liver)
- Fatigue, nausea, vomiting
Symptoms of hepatitis
Conditions characterized by excessive concentration of bilirubin in the skin and tissues and deposition of excessive bile pigment in the skin, cornea, body fluids, and mucous membranes with the resulting yellow appearance of the patient.
- Caused by excessive bilirubin, defective liver or biliary obstruction.
Yellow pigment produced from hemoglobin of old RBC.
Liver infection -> hepatic cell destruction -> necrosis -> autolysis
Mild, spread by contaminated food or water; does not cause chronic hepatitis or cirrhosis.
Spread through blood transfusion, saliva, semen, shared needles; increased risk of cirrhosis or liver cancer.
Spread through blood transfusion, shared needles; cause chronic hepatitis.
A degeneration or atrophy of the parenchyma cells of an organ with hypertrophy of the interstitial connective tissue.
- End stage of chronic liver disease
1. Portal cirrhosis
2. Biliary (focal) cirrhosis
Two main types of Cirrhosis
Liver cell necrosis
- Liver tissue dies over time -> scar tissue forms -> body jaundice
- Liver enlargement (hepatomegaly)
- Liver retains fats, creamy yellow color
- Due to alcoholism or other chemical poisons.
Usually due to damage to bile ducts in liver -> body jaundice.
- Liver turns green, smaller than normal.
Biliary (focal) cirrhosis
- Ascites (abdominal edema)
- Mental dysfunction
- Blood clotting disorders
- A major cause of Hepatocellular carcinoma.
Complications of cirrhosis
- Heptocellular carcinoma
- Metastatic carcinoma
Tumors of the liver
Begins in hepatocytes
Starts in bile ducts of the liver.
Most common; doesn't originate in the liver, but spreads from primary malignancy in colon, lung or breast.
Enzyme for catabolism of phenylalanine is missing.
- Phenylalanine accumulates in blood and urine
- Affects development of nervous system -> brain damage.
PKU ( phenylketonuria)
Liver defect receptors in liver don't hold low- density lipoprotein (LDL) -> results in high level of cholesterol => atherosclerosis.
Inflammation of the gall bladder ( a sac under the liver that stores bile).
- Caused by:
- Gall stones (choleliths) 90%, retained bile surrounded by calcium
- Gall bladder cancer, hepatitis, infections (E. coli, strep), alcohol abuse.
Presence of one or more calculi (gallstones) in gallbladder.
- In developed countries, 10% of adults have gallstones.
- Tend to be asymptomatic
- Serious complications include cholecystitis or biliary tract obstruction.
Inflammation of the bile ducts; applies to inflammation of any part of the bile ducts, which carry bile from the liver to the gall bladder and intestine.
- Caused by infections from liver or gall bladder or gall stones, pushed into duct.
- Symptoms: jaundice, back pain, chest pain, clay colored faces.
Inflammation of the pancreas
- Caused by diabetes, pancreatic cancer, infection, trauma, injury to the abdomen.
Produces hormones (insulin and glucagon) and digestive enzymes (released into small intestine).
A term used to designate two diseases, diabetes insipidus and diabetes mellitus, each having the symptom of polyuria in common.
- Can be hereditary or acquired.
- Defective Beta cells in pancreas don't produce insulin => decreased insulin in blood (insulin send sugar = glucose into body cells) => excess sugar in blood => excess blood sugar to kidneys => excess urination => dehydration (thirst)
- Low energy, fatigue, vasoconstriction, dry gangrene, retina damage, risk of pneumonia.
Results in inability to move intestinal contents through the bowel.
- Bile duct
- Intussusception (invagination)
- Nervous tension
Causes of obstruction
Abnormal constriction of a channel or orfice; e.g., pyloric stenosis
Abnormal protrusion of part of organs through abnormal openings.
Decrease or absence of peristalsis (muscle movement)
e.g., result of postoperative condition or peritonitis
Blocked by gallstones.
Intestine twists on itself.
One part of the intestine slipping into a previous segment of the intestine (e.g., colon telescopes on itself, often at ileocecal juncture).
The body or part of it is invaded by a pathogenic agent that, under favorable conditions, multiplies and produces injurious effects.
Areas abnormally linked together; may result from previous surgery or inflammation.
-Tightens every muscle and nerve in the body.
-Restricts normal action, and free and rhythmic flow of substances.
- Is capable of disorganizing the entire digestive system as it inhibits both assimilation (digestion, absorption) and elimination (holds waste materials in the body).
- Rapid decomposition
- Rapid coagulation of blood
Abnormal accumulation of fluids in tissues or body cavities.
Accumulation of serous fluid in the abdominal cavity.
Loss of moisture from body tissue which may occur antemortem or postmortem.
Excessive body wasting.
Escape of blood from the vascular system.
Evacuation of the bowels.