[Exam 1] Chapter 43: Assessment of Digestive and GI Function Flashcards
(154 cards)
1
Q
Stomach has what four anatomic regions?
A
Cardia (entrance)
Fundus
Body
Pylorus (outlet)
2
Q
Small intestine has what three portions?
A
Duodenum, jejenum, and ileum.
3
Q
The portal venous system is composed of what five large veins?
A
Superior mesenteric, inferior mesenteric, gastric, splenic, and cystic veins.
4
Q
What do the sympathetic nerves do to GI tract?
A
Exert inhibitory effect , decreasing gastric secretion and motility and causing the sphincters and blood vessels to constrict.
5
Q
What do parasympathetic nerve stimulation cause on GI tract?
A
peristalsis and increases secretory activites.
6
Q
Function of Digestive System: What does salivary amylase do?
A
The enzyme that begins the digestion of starches.
7
Q
Function of Digestive System, Gastric Function: What is the function here?
A
To break down food into more absorable components and to aid in the destruction of most ingested bacteria
8
Q
Function of Digestive System, Gastric Function: What does PEpsin do?
A
Important enzyme for protein digestion, and is the end product of conversion of pepsinogen from chief sels
9
Q
Function of Digestive System, Gastric Function: What does IF do?
A
Combined with Vitamin B12 so that vitamins can be asborbed in the ileum. Without IF, B12 cannot be asborbed and anemia results.
10
Q
Function of Digestive System, Gastric Function: How long does food remain in stomach?
A
Anywhere from 30 minutes to several hours, depending on volume and osmotic pressure.
11
Q
Function of Digestive System, Gastric Function: What is the name of food by the time it enters the small intestine?
A
Chyme.
12
Q
Function of Digestive System, Small Intestine Function: What enzymes are received at the duodenum?
A
Amylase, lipase, and bile
13
Q
Function of Digestive System, Small Intestine Function: Digestive enzymes secreted by pancreas include what?
A
Trypsin (Digest PRotein)
Lipase (Digest fat)
Amylase (Digest Starch)
Which drain into pancreatic duct and drain into CBD at ampulla of Vater
14
Q
Function of Digestive System, Small Intestine Function: What does vile help with?
A
Secreted by liver and stored in gallbladder, and aids in emulsifying ingested fats, making them easier to absorb.
15
Q
Function of Digestive System, Small Intestine Function: Where is the sphincter of oddi found?
A
at the confluence of the CBD and duodenum and controls the flow of bile.
16
Q
Function of Digestive System, Small Intestine Function: What two contractions occur in the small intestine?
A
Segmentation contractions - produce mixing waves that move the intestine contents back and forth
Intestinal peristalsis - properls the contents of small intestine toward the colon.
17
Q
Function of Digestive System, Small Intestine Function: Carbohydrates broken down into what
A
disaccharides (sucrose, maltose, and galactose)
Monosaccharids (glucose, fructose)
18
Q
Function of Digestive System, Small Intestine Function: Ingested fats become what
A
monoglycerides and fatty acid through emulsification, which makes them smaller to absorb.
19
Q
Function of Digestive System, Small Intestine Function: What do Villi do?
A
Line the entire intestine and function to produce digestive enzymes as well as to absorb nutrients.
20
Q
Function of Digestive System, Small Intestine Function: Where does absorption begin?
A
In the jejenum and is accomplished by active transport and diffusion acorss the intestinal wall into circulation.
21
Q
Function of Digestive System, Small Intestine Function: Nutrients absorbed where?
A
At specific points in small intestine and duodenum
22
Q
Function of Digestive System, Small Intestine Function: What is absorbed in jejenum?
A
fats, proteins, carbohydrates, sodium and chloride.
23
Q
Function of Digestive System, Small Intestine Function: What is absorbed in ileum?
A
Vitamin B12 and Bile Salts
24
Q
Function of Digestive System, Small Intestine Function: What is absorbed in small intestine throughoout
A
magnesium, phosphate, and potassium
25
Function of Digestive System, Colonic Function: What happens within 4 hours of eating?
Residual waste material passes into the terminal ileum and slowly into proximal protion of right colon through ileocecal valve.
26
Function of Digestive System, Colonic Function: What assits with breaking down waste material, especially of undigested or unabsorbed proteins and bile salts?
Bacteria
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Function of Digestive System, Colonic Function: What two types of colonic secretions are added to the residual material?
An electrolyte solution and mucus.
28
Function of Digestive System, Colonic Function: What is the electrolyte solution that is added?
A bicarbonate solution that acts to neutralize the end products formed by the colonic bacterial action,
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Function of Digestive System, Colonic Function: What does the mucus do?
Protects the colonic mucosa from the interluminal contents and provides adherence for the fecal mass.
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Function of Digestive System, Colonic Function: What si the major function of the colon?
Effectient reabsorption of water and electrolytes
31
Function of Digestive System, Waste Products of Digestion: Brown color of feces results form ?
Breakdown of bile by the intestinal bacteria.
32
Function of Digestive System, Waste Products of Digestion: What controls and internal and external sphincter of the rectum?
Internal: Autonomic nervous system
Externa: Conscious control of cerebral cortex
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Assess of GI System, Common Symptoms - Pain: Most common presentation?
Abdominal pain, and character, duration, pattern, frequency, location, distribution of referred abdominal pain and time of pain vary greatly.
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Assess of GI System, Common Symptoms - Dyspepsia: What is this?
Upper abdominal discomfort associated with eating is the most common symptom of patients with GI dysfunction.
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Assess of GI System, Common Symptoms - Dyspepsia: What type of foods cause the most discomfort?
Fatty foods because they remain in stomach for longer than proteins or carbohydrates.
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Assess of GI System, Common Symptoms - Dyspepsia: What specific foods cause considerable gi distress?
Salds, coarse vegetables and highly seasoned foods.
37
Assess of GI System, Common Symptoms - N/V: Causes of this may include?
Visceral afferent stimulation
CNS disorders
Irritation of the chemoreceptor trigger zone from radiation therapy, systemic disorders, and endogenous toxins.
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Assess of GI System, Common Symptoms - N/V: Common cause of nausea?
Distention of the duodenum or upper intestinal tract.
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Assess of GI System, Common Symptoms - Change in Bowel Habits: What causes diarrhea?
When contents move so rapidly through the intestine or colon that theres inadequate time for GI secretions and oral contents to be asborbed.
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Assess of GI System, Common Symptoms - Change in Bowel Habits: Diarrhea is often associated with what?
abdominal pain or cramping and N/V.
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Assess of GI System, Common Symptoms - Change in Bowel Habits: How does blood shed in upper GI tract appear?
Tarry-black color (melena)
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Assess of GI System, Common Symptoms - Change in Bowel Habits: Blood shed in lower portion of GI tract will appear how?
Bright or dark red.
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Assess of GI System, Common Symptoms - Change in Bowel Habits: How will stools look in absence of bilirubin?
Light-gray or clay-colored
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Assess of GI System, Past Hx: Current nutritional stratus can be assessed how?
Via lab tests (complete metabolic panel including liver function studies, triglyceria, iron studies, and CBC)
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Assess of GI System, Physical Exam, Lips: Stensenn duct of each parotid gland is visible as what?
Small red dot in the buccal mocusa next to the upper molars
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Assess of GI System, Physical Exam, Tongue: This is the most common area for oral cancer, which may present as?
White or red plaque, lesions, ulcers, or nodules.
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Assess of GI System, Physical Exam, Abdomen: What is Tympani?
The sound that results from the presence of air in the stomach and small intestiness
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Assess of GI System, Physical Exam, Abdomen: Where is dullness heard?
Over organs and solid masses.
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Assess of GI System, Physical Exam, Rectal Inspection: Positions for this exam include what?
Knee-chest, left lateral with hips and knees flexed, or standing with hips flexed and upper body supported by exam table.
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Assess of GI System, Physical Exam, Rectal Inspection: Most patients comfortable in what position?
Right side with knees brought up to chesst
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Assess of GI System, Physical Exam, Rectal Inspection: External exam includes looking for what?
Inspection for lumps, rashes, inflammation, excoriation, tears, scars, pilonidal dimpling and tufts of hair at the pilonidal area.
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Diagnostic Eval: Preparation for many of these studies includes what?
Liquid diet, fasting, ingestion of liquid bowel preparation, use of laxative, and ingestion of contrast agent
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Diagnostic Eval, Serum Lab Studies: Initial diagnostic tests begin with what?
CBC, Complete Metabolic Panel, Prothrombin Time/pTT, Triglycerides, liver function, amylase, and lipase.
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Diagnostic Eval, Serum Lab Studies: More specific studies can include
Carcinoembryonic antigen (CEA), cancer antigen (CA) 19-9, and alpha- fetoprotein
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Diagnostic Eval, Serum Lab Studies: What is CEA?
Protein that is not normally detected in the blood of a healthy person, therefore detected when cancer present.
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Diagnostic Eval, Serum Lab Studies: What is CA 19-9?
Protein that exists on the surface of certain cells and is shed by tumor cells, making it useful as a tumor marker to follow the course of the cancer.
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Diagnostic Eval, Serum Lab Studies: CA 19-9 are usually at what level?
Are elevated in most patients with pancreatic cancers.
58
Diagnostic Eval, Stool Tests: Additional studies for the stool include?
Fecal urobilinogen, ,fecal fat, ntirogen, C. Diff, fecal leukocytes, parasites, and food residues.
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Diagnostic Eval, Stool Tests: What must you do with 24 and 72 hour collections?
Must be refrigerated until transported to the lab.
60
Diagnostic Eval, Stool Tests: Most commonly performed stool test?
Fecal Occult Blood Testing (FOBT) . Useful in initial screening for several disoroders.
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Diagnostic Eval, Stool Tests: What is the Hemoccult II?
Most widely used in office or at home occult blodo test. Inexpensive, noninvasive.
62
Diagnostic Eval, Stool Tests: What must you do 72 hours before FOBT?
Avoid ingesting red meats, aspirin, NSAIDs, turnips and horseradish.
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Diagnostic Eval, Stool Tests: What are Fecal Immunologic tests"?
They use monoclonal or polyclonal antibodies to detect the globin proetin in human hemoglobin
64
Diagnostic Eval, Breath Tests: What does the hydrogen breath test do?
Evaluate carbohydrate absorption, in addiiton to aiding in diagnosis of bacterial overgrowth in the intestine and short bowel syndrome. Determines amount of hydrogen expelled in the breath after it has been produced in colon.
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Diagnostic Eval, Breath Tests: What does the urea breath test do?
Detects the presence of H. Pylori. Patient ingests capsule and breath sample obtained 10-20 minutes later. The labeled carbon is absorbed quickly.
66
Diagnostic Eval, Breath Tests: What must patient avoid before urea breath testing?
Patient instructed to avoid antibiotics or bismuth subsalicylate for 1 month before the test.
67
Diagnostic Eval, Abdominal Ultrasonography: What is this?
Noninvasive technique in which high-frequency sound waves are passed into internal body structures and the ultrasonic echoes are recorded on an oscilloscope as different densities are struck.
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Diagnostic Eval, Abdominal Ultrasonography: What is this useful for?
In detection of an enlarged gallblader or pancreas, presence of gallstones, an enlarged ovary, or appendicitis.
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Diagnostic Eval, Abdominal Ultrasonography: Advantrage sof this?
Absence of ionizing radiation, no side effects, low cost, and immediate results.
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Diagnostic Eval, Abdominal Ultrasonography: Cannot be used with what?
Structures that lie behind bony structures. Also gas and fluid in abdomen or air in lungs prevent transmission.
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Diagnostic Eval, Abdominal Ultrasonography: What is a Endoscopic Ultrasonography (EUS)?
Specialzied enteroscopic procedure that aids in the diagnosis of GI disorders by providing direct imaging of target area. SMall high-frequency ultrasonic transducer is mounted at tip of fiberoptic scope, whcih displays images that are of higher quality resolution.
72
Diagnostic Eval, Abdominal Ultrasonography: EUs is used for what?
Evaluate submucosal lesions. Can also help with evaluating barrett esophagus, portal hypertension, chronic pancreatitis, suspected pancreatic neoplasm.
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Diagnostic Eval, Abdominal Ultrasonography, Nursing Intervention: Patient instructed to do what before surgery?
8-12 hours before testing to decrease gas in bowel.
74
Diagnostic Eval, Abdominal Ultrasonography, Nursing Intervention: What is done if patient is preparing for gallbladder studies???
Should eat a fat-free meal the evening before.
75
Diagnostic Eval, Abdominal Ultrasonography, Nursing Intervention: What to know if barium studies are to be d one?
Should be schedueld after ultrasonography because barium could interfere with transmission of sound waves.
76
Diagnostic Eval, Imaging - Upper GI Tract Study: What does a upper GI fluroscopy do?
Delineates the entire GI tract after intro of contrast agent. Radiopaque liquid used. Can detect or exclude anatomic disorders .
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Diagnostic Eval, Imaging - Upper GI Tract Study: What does a upper GI fluroscopy aid with?
Diagnosis of ulcers, varcies, tumors, regional enteritis and malabsorption syndromes.
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Diagnostic Eval, Imaging - Upper GI Tract Study: What happens as barium descends into the stomach?
The position, patency, and caliber of esophagus are visualzied, enabling examiner to detect abnormalities.
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Diagnostic Eval, Imaging - Upper GI Tract Study: How does FLuroscopic examiniation work?
Extends next to the stomach as its lumen fulls with barium, allowing observation of stomach motility, thickness of gastric wall, and patency of pyloric valve.
80
Diagnostic Eval, Imaging - Upper GI Tract Study: What does a double-contrast method of examining the upper gi tract involve?
Administration of a thick barium suspension to outline the stomach and esophageal wall, after which tablets release CO2 in presence of water. Shows esophagus and stomach in finer detail
81
Diagnostic Eval, Imaging - Upper GI Tract Study: What is enteroclysis?
Detailed, double-contrast study of entire small intestine that involves infusion of 500-1000 mL of thin barium sulfate suspension. Observed by fluroscopy at frequent intervals as they pass through jejenum and ileum.
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Diagnostic Eval, Imaging - Upper GI Tract Study, Nursing Intervention: What should be done before procedure?
Clear liquid diet, and NPO from midnight before study. ALso do not chew gum because gastric secretions excreted.
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Diagnostic Eval, Imaging - Upper GI Tract Study, Nursing Intervention: What bowel cleaning agent given before procedure?
Polyethylene glycol (PEG) based solutions
84
Diagnostic Eval, Imaging - Lower GI Tract Study: Visual of lower GI tract obtained how
after rectal installation of barium. Takes 15-30 mins.
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Diagnostic Eval, Imaging - Lower GI Tract Study: Using barium enema can help detect what?
presence of polyps, tumors, or other lesions of large intestine and demonstrate any anatomic abnormalities.
86
Diagnostic Eval, Imaging - Lower GI Tract Study: How does a double-contrast or air-contrast barium enema work?
Instillation of a thicker barium solution, followed by instillation of air. May feel cramping.
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Diagnostic Eval, Imaging - Lower GI Tract Study, Nursing Intervention: Preparation includes what
Emptying nd cleansing the lower bowel. Often necessitates a low-reisude diet 1-2 days before test, clear liquid diet and laxative the evening before.
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Diagnostic Eval, Imaging - Lower GI Tract Study, Nursing Intervention: When would enemas be contraindicated?
If patient has active inflammatory disease, or when there are signs of perforation or obstruction
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Diagnostic Eval, Imaging - Lower GI Tract Study, Nursing Intervention: Postprocedural patient education includes?
Information about increasing fluid intake, evaluating bowel movement for evacuation of barium, and noting increased number of bowel movements.
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Diagnostic Eval, CT: What do volume CT scanners do?
Provide more accurate reconstruction of patient data into alternate planes, require shorter scan times, and have less artifiact.
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Diagnostic Eval, CT: Why is CT a valueable tool?
Good for detecting inflammatory conditions of colon like appendicitis, diveriticulitis, and colitis, as well as evaluating liver, spleen, kidney disease
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Diagnostic Eval, CT, Nursing Intervention: Common risks for IV contrast agents include
allergic reactions and acute kidney injury.
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Diagnostic Eval, CT, Nursing Intervention: What must be determined before admin of contrast agent?
Any llergies to contrast agents, current serum creatinine level, and pregnancy status.
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Diagnostic Eval, CT, Nursing Intervention: Kidney protective measures include what
IV sodium bicarbonate 1 hour before and 6 hours after IV contrast and oral n-acetycysteine before or after surgery.
95
Diagnostic Eval, MRI: How does this work?
Uses magnetic fields and radio waves to produce images of the area being studied. Oral contrast agents enhance images has increased application for diagnosis of GI disease.
96
Diagnostic Eval, MRI: What may create a les-than-clear image?
Heartbeat, respiration, and peristalsis
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Diagnostic Eval, MRI - Nursing Intervention: What must be done before procedure?
NPO 6-8 hours before study and removal of all jewerly and other metals.
98
Diagnostic Eval, Positron Emission Tomography: How do they take images?
By detecting radiation emitted from radioactive substances. Injected into body IV and usually tagged with radioactive isotopes of oxygen, nitrogen and carbon.
99
Diagnostic Eval, Scintigraphy: What is this?
Relies on use of radioactive isotopes to reveal displaced anatomic structures, changes in organ size. Can also measure the uptake of tagged red blood cells.
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Diagnostic Eval, Scintigraphy: Tagging of red blood cells and leukocytes by injection is performed why
to define areas of inflammation, abscess, blood loss , or neoplasm. Useful to determine internal bleeding.
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Diagnostic Eval, GI Motility Studies: How does gastric emptying studies work?
Liquid and solid components of meal (scrambled eggs) are tagged with radionuclide markers. After ingestion of meal, patient is positioned under scintiscanner which measures passage from stomach.
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Diagnostic Eval, GI Motility Studies: What are colonic transit studies used for?
Evaluate colonic motility and obstructive defecation syndromes.
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Diagnostic Eval, GI Motility Studies: How is a colonic transit study performed?
Patient is given a capsule containing 20 radionuclide markers and instructed to follow a regular diet . Abdominal x-rays taken every 24 hours.
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Endoscopic Procedure, Upper GI Fibroscopy/ Esophagogastroduodenoscopy: What does Fibroscopy of upper GI tract allow?
Direct visualization of esophageal, gastric, and duodenal mucosa through a lightened endosope
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Endoscopic Procedure, Upper GI Fibroscopy/ Esophagogastroduodenoscopy: EGD is valueable when?
Esophageal, gastric, or duodenal disorders or inflammatory processes are suspected.
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Endoscopic Procedure, Upper GI Fibroscopy/ Esophagogastroduodenoscopy: How does an EGD work?
Views the GI tract through a viewing lens and can obtain images through the scope to document findings. Electronic video endoscopes also are available.
107
Endoscopic Procedure, Upper GI Fibroscopy/ Esophagogastroduodenoscopy: How does Capsule endoscopy work?
Requires that patients swallow a capsule that travels by peristalsis through small intestines. Images transmitted to patients wrist.
108
Endoscopic Procedure, Upper GI Fibroscopy/ Esophagogastroduodenoscopy: How does Endoscopic Retrograde Cholangiopancreatography (ERCP) work?
Uses endoscope in combo with x-rays to view the bile ducts, pancreatic ducts, and gallbladder. Side scopes are used to visualize the common bile duct and pancreatic/hepatic ducts through ampulla of vater in duodenum.
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Endoscopic Procedure, Upper GI Fibroscopy/ Esophagogastroduodenoscopy: ERCP helpful in evaluating what?
Jaundice, pancreatitis, pancreatic tumors, common bile duct stones, and biliaary tract disease.
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Endoscopic Procedure, Upper GI Fibroscopy/ Esophagogastroduodenoscopy: ERCP is associated with what after procedure?
Pancreatitis, therefore other things are perofmred like a EUS.
111
Endoscopic Procedure, Upper GI Fibroscopy/ Esophagogastroduodenoscopy: Therapeutic endoscopy can be used why?
To remove common bild duct stones, dilate strictures, adn treat gastric bleeding and esophageal varicies.
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Endoscopic Procedure, Upper GI Fibroscopy/ Esophagogastroduodenoscopy, Nursing Intervention: What should be done before surgery?
NPO 8 hours prior to exam. Also given local anesthetic gargle before surgery.
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Endoscopic Procedure, Upper GI Fibroscopy/ Esophagogastroduodenoscopy, Nursing Intervention: What position are they positioned in?
Left lateral position to facilitrate clearance of pulmonary secretions.
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Endoscopic Procedure, Upper GI Fibroscopy/ Esophagogastroduodenoscopy, Nursing Intervention: What is assessed after gastroscopy?
LOC, Vital Signs, Oxygen saturation, pain levels, and monitoring for signs of perforation.
115
Endoscopic Procedure, Fiberoptic Colonoscopy: WHy is this done?
Used for cancer screening and for surveillance in patients with previous colon cancer or polyps. Tissue biopsies can be obtained as needed and polyps can be removed.
116
Endoscopic Procedure, Fiberoptic Colonoscopy: What is a goal of colonscopic polypectomy?
Early detection and prevention of colorectal cancer. You are able to remove polyps of the colon during the procedure.
117
Endoscopic Procedure, Fiberoptic Colonoscopy: How can areas of bleeding be treated?
By using bipolar or unipolar coagulators and heater probes as well as injections of sclerosing agents or vasoconsstrictors.
118
Endoscopic Procedure, Fiberoptic Colonoscopy: What position are they in?
Left side with the legs drawn up toward the chest.
119
Endoscopic Procedure, Fiberoptic Colonoscopy: What may be passed through the scope during the procedure?
Biopsy forceps or a cytology brush to obtain specimens for histology.
120
Endoscopic Procedure, Fiberoptic Colonoscopy: Complications udring and after can include?
Cardiac dysrhythmias and respiratory depression resulting from meds given, vasovagal reactions and circulation overlaod or hypotension.
121
Endoscopic Procedure, Fiberoptic Colonoscopy: Postprocedure discomfort results from what?
Instillation of air to expand the colon and insertion and movement of scope during procedure.
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Endoscopic Procedure, Fiberoptic Colonoscopy - Nursing Intervention: Success of colonoscopy depends on what?
How well the colon is prepared. Adequate cleaning provides optimal visualization and decreased time in procedure.
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Endoscopic Procedure, Fiberoptic Colonoscopy - Nursing Intervention: How can colon be prepared?
Laxative two nightes before exam and saline enema until the return is clear the mornong of test
PEG electrolyte lavage solutions are preferred. Ingests it orally every 3-4 hours before procedure
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Endoscopic Procedure, Fiberoptic Colonoscopy - Nursing Intervention: Sodium phosphate tablet can also be used,, how does this work?
20 latblets (4 tabs every 15 m ins) with 8 oz of clear liquid on the evening prior to the exam, and 12 tablets taken in same manner the m orning of.
125
Endoscopic Procedure, Fiberoptic Colonoscopy - Nursing Intervention: Side effects of lavage with electorlyte solutions include
nausea, bloating, cramps , abdominal fullness, fluid and electrolyte imbalance and hypothermia.
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Endoscopic Procedure, Fiberoptic Colonoscopy - Nursing Intervention: What may cause a colonoscopy to not be performred?
If there is suspected or documented colon perforation, acute severe diverticulitis, or fulminant colitis.
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Endoscopic Procedure - Anoscopy, Proctoscopy, and Sigmoidscopy: Exam of these three are done why?
To evaluate chronic diarrhea, fecal incontinence, ischemic colitis, and lower GI hemorrhage and to observe for ulceration.
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Endoscopic Procedure - Anoscopy, Proctoscopy, and Sigmoidscopy: If polyps are present, how can they be removed?
With a wire snare, which is used to graspthe pedicle or stalk. Electrocoagulatig current is then used to sever the polyp and prevent bleeding.
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Endoscopic Procedure - Anoscopy, Proctoscopy, and Sigmoidscopy - Nursing Intervention: Require only limited bowel preparation, which include what?
Warm tap water or fleet enema until returns are clear.
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Endoscopic Procedure - Anoscopy, Proctoscopy, and Sigmoidscopy - Nursing Intervention: Durign procedure, what does nurse monitor for?
Vital signs, skin color, temperature, pain tolerance, and vagal response.
131
Endoscopic Procedure - Small Bowel Studies: What is Capsule Endoscopy?
Allows for noninvasive visualiztion of the mucosa throughout the entire small intestine. Useful for evaluating obscure GI bleeding. Passes in 1-2 days, and information passes to device worn by patient.
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Endoscopic Procedure - Small Bowel Studies: What is double-balloon enteroscopy?
Two balloons, one attached to distal end of scope and other attached to transparent overtube that slides over the endoscope. Advanced alternately inflating and deflating the balloons.
133
Manometry and Electrophysiologic Studies: What is this?
Methods for evaluating patients with GI motility disorders.
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Manometry and Electrophysiologic Studies: What does a manometry test measure?
Changes in intraluminal pressures and coordination of msucle activity in the GI tract with pressures transmitted to ta computer analyzer.
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Manometry and Electrophysiologic Studies: Esophageal manometry is used to detect what?
Motility disorders of the esophagus and upper and lower esophagus sphincter. Can detect achalasia (absence of peristalsis), diffuse esophageal spasm, scleroderma, and other esophageal motor disorders.
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Manometry and Electrophysiologic Studies: What must be done before esophageal manometry?
Patient must refrain from eating and drinking for 8-12 hours before test.
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Manometry and Electrophysiologic Studies: How is a esophageal manometry performed?
Pressure sensitive catheter inserted through the nose and is conencted to a transducer and a video recorder. Patient then swallows small amounts of water while the resultant pressure changes recorded.
138
Manometry and Electrophysiologic Studies: Why are gastroduodenal, small intestine, and colonic manometry procedures used?
To evaluate delayed gastric emptying and gastric and intestinal motility disorders like irritable bowel syndrome. or atonic colon
139
Manometry and Electrophysiologic Studies: What does anorectal manometry measure?
The resting tone of the internal anal sphincter and the contractibility of the external anal sphincter. Helps for those with chronic constipation or fecal incontinence.
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Manometry and Electrophysiologic Studies: What is given before anorectal manometry?
Dibasic sodium or a saline cleansing enema 1 hour before the test
141
Manometry and Electrophysiologic Studies: Rectal sensory functions studies are used why
to evaluate rectal sensory function and neuropathy.
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Manometry and Electrophysiologic Studies: How are rectal sensory studies performed
catheter and balloon are passed into the rectum, with increasing balloon inflation until patient feels distention. Then t one and pressure of rectum measured.
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Manometry and Electrophysiologic Studies: What is a electrogastrography?
To assess gastric motility disturbances and can be useful in detecting motor or nerve dysfunction in stomach. Electrodes placed over abdomen.
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Manometry and Electrophysiologic Studies: What are defecography studies?
Measures anorectal function and is performed with very thick barium paste instilled into rectum.
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Gastric Analysis, Gastric Acid Stimulation Test and pH Monitoring: Analysis of gastic juice yields information about what
secretory activity of the gastric mucosa and presence or degree of gastric retention in patients.
146
Gastric Analysis, Gastric Acid Stimulation Test and pH Monitoring: What to do before procuedre?
NPO 8-12 hours before procedures. Smokoin not allowed morning of.
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Gastric Analysis, Gastric Acid Stimulation Test and pH Monitoring: How is this perofrmed?
Small nasogastric tube with catheter tip marked at various points. Tube secured to check and entire stomach content is aspirated and samples collected every 15 mins.
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Gastric Analysis, Gastric Acid Stimulation Test and pH Monitoring: Important information that can be gained from gastric analysis?
Pernicious Anemia: Secrete no acid under basal conditions
Severe Chronic Atrophic Gastritis: Secrete littel or no acid
Gastric Ulcer: Secrete some acid
Duodenal Ulcer: Secrete excess acid
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Gastric Analysis, Gastric Acid Stimulation Test and pH Monitoring: What can stimulate gastric secretions?
Histamine or pentagastric given SQ.
150
Gastric Analysis, Gastric Acid Stimulation Test and pH Monitoring: What to do before pH monitoring?
NPO for 6 hours. Probe inserted above lower esophageal sphincter. Connected to external recording device and worn for 24 hours while patient continues daily activites.
151
Gastric Analysis, Gastric Acid Stimulation Test and pH Monitoring: What is the Bravo pH monitoring system?
Offers advantage of pH monitoring of esophagus without the transnasal catheter. Attaches capsule to patients esophageal wall. pH info transmitted to pager-sized receiver. Spontaneously detaches in 7-10 days. .
152
Laparoscopy: How is this done?
Pneumoperitoneum (CO2 injected into cavity), small incision then made . allows for direct visualization of organs. Biopsy samples can also be taken.
153
Laparoscopy: Why may this be done?
To evalaute peritoneal disease, chronic abdominal pain, abdominal masses, and gallbladder/liver disease.
154
Laparoscopy: One of the benefits of this procedure?
After visualization of problem, excision can then be performed if approrpiate.
