exam 2- gastro

Question 1

digestion

Answer 1

the process that takes substances in one form and breaks them down into molecules small enough to pass through the intestinal wall into the blood

Question 2

mouth

Answer 2

beginning point with ingestion of food. major functions: chewing, saliva secretion

Question 3

what is salivary amylase

Answer 3

ptyalin starts carbo breakdown in the saliva

Question 4

how much saliva is made in a day

Answer 4

leter to a leter and a half

Question 5

pharynz

Answer 5

food is swallowed and moved into esophagus at this time the trachea is closed off

Question 6

esophagus

Answer 6

muscular tube that lies behind the trachea, initiates peristalsis

Question 7

pyloric sphincter

Answer 7

allows stomach to empty and prevents blackflow into stomach from the small intestine

Question 8

small intestine

Answer 8

includes the
duodemun, jejunum, ilieum
major function:
absorption of nutrients 90%

Question 9

large intestine

Answer 9

includes:
ascending, transverse, descending and sigmoid colin
major function:
absorption of water and electrolytes and formation of wastes

Question 10

rectum and anal canal

Answer 10

function is excretion of waste

Question 11

cleft lip/palate

Answer 11

genetic structural disorder 1/600-1/5000 births

Question 12

what causes a cleft lip/palate

Answer 12

decrease in mesenchyme (forms connective tussue migrating to area)

Question 13

incomplete fusion of the nasomedial or intermaxillary process

Answer 13

cleft lip

Question 14

incomplete fusion of uvula, soft palate or hard palate

Answer 14

fleft palate

Question 15

cleft lip and cleft palate can occur separately or together and can be minor to severe

Answer 15

yep.

Question 16

esophageal atresia

Answer 16

cells of embryonic foregut fail to develop. .. leads to a puch at the end of eh esophagus and no connection to the stomach (1-3000/4500 births)

Question 17

who is at risk for esophageal atresia

Answer 17

premi and low birthwate babies

Question 18

tracheo-esopheageal fistula

Answer 18

the foregut fails to seperate into a totally seperate esophagus and trachea resulting in a patent fistula (open connection)between the two structures

Question 19

what are the manifestations for both esophageal atresia at TEF

Answer 19

unable to handle oral secretions
coughing/choking/spitting up
aspiration into lungs
abdominal distention with air swallowed

Question 20

pyloric stenosis

Answer 20

genetically influenced abnormal narrowing of pyloric sphincter
1-200/1000 males more

Question 21

what is the patho of pyloric stenosis

Answer 21

sphincter muscle hypertrophies during development which narrow opening– delayed stomach emptying

Question 22

what is the manifestation of pyloric stenosis

Answer 22

vomiting (primary)

constipation

Question 23

how is pyloric stenosis diagnosed

Answer 23

ultrasound

Question 24

where is the vommiting center located

Answer 24

the medulla of brain

Question 25

what is the first pathway for vomiting

Answer 25

cortical stimulation: direct | all senses exposure to noxious stimuli or emotional stress

Question 26

what is the second pathway for vomiting

Answer 26

chemoreceptor trigger zone: direct located in the brain responds to impulses of motion (inner ear) and chemicals (drugs)

Question 27

what is the third pathway for vomiting

Answer 27

``` Visceral receptors (sympathetic afferents) receptors in many organs and are irritated with inflammation, menstruation, obstruction or spasms ```

Question 28

what is the fourth pathway for vomiting

Answer 28

receptors of stomach itself receptors respond to distention, gas, inflammation, irritation, ischemia and stimulate vomiting center through the vagus nerve

Question 29

what are the four component of actual vomiting

Answer 29

esophageal sphincter opens pyloric sphincter closes glottis closes off airway diaphragm, intercostal muscles and abd muscles contract

Question 30

what are the clinical manifstations of vomiting

Answer 30

``` nausea/vomiting sympathetic stim and para (perspiration, salvation, pallor, decreaded Bp and HR) presence of underlying cause dehydration electrolyte imbalance ```

Question 31

what two types of cells are found in the crypts of lieberkuhn

Answer 31

cells that secrete intestinal juices | absorptive cells

Question 32

malabsorption

Answer 32

impared absorption of fats, carbos, proteins, vitamins, minerals, water into bloodstream

Question 33

ulcerative colitis

Answer 33

chronic inflammatory disease that causes ulceration of the colonic mucosa ulually in the rectum and sigmoid colin (20-40 yoa)

Question 34

what are the etiologies of UC

Answer 34

``` genetic infectious immunologic psychosomatic dietary ```

Question 35

where does UC usually start

Answer 35

in rectum and extend into sigmoid colon inflammatory process begins at bases of crypts of lieberkuhn leads o ulceration and mucosal destruction

Question 36

what is the patho chain for UC

Answer 36

``` inflammatory process mucosa becomes hyperemic and edematous mucosal hemorrhages ulceration/mucosal destruction cloughing ```

Question 37

clinical mani of UC

Answer 37

``` cramping abdominal pain bloody mucousy diarrhea fluid and electrolyte imbalances weight loss anemia ```

Question 38

how is evaluation done for UC

Answer 38

sigmoidoscopy or barium enema looking for ulcerations of sigmoid and rectal areas

Question 39

chrohn's disease (regional enteritis)

Answer 39

chronic, inflammatory disorder that can affect both large and small intestine

Question 40

etiology of chron's

Answer 40

same as UC

Question 41

patho chain of chrohn's

Answer 41

``` inflammatory process in submucosa spreads inward and outward "skip lesions" "transmural" (entire width of wall) strictures fissures can extend inflammation ```

Question 42

clinical manifestations of Crohn's

Answer 42

``` nonspecific diarrhea for several years non-bloody diarrhea abominal pain (LRQ) fluid/electrolyte imbaance vitamin deficiencies weight loss obstruction fissures ```

Question 43

stress ulcers

Answer 43

``` caused by shock, burns, drugs, infections acute related to ischemia (sock shunts blood) superficial gastric erosiions occure in stomach or duodenum do not penetrate the muscularis layer ```

Question 44

two different peptic ulcer disease

Answer 44

gastric ulcers | duodenal ulcers

Question 45

gastric ulcers

Answer 45

ulcers of gastric mucosa 55-65yoa

Question 46

which is more common gastric or doudenal ulcers

Answer 46

doudenal

Question 47

gastric ulcer risk factors

Answer 47

``` smoking NSADS alcoho chronic diseases psychologic stress infection (helicobcter pylori) ```

Question 48

what is the patho change of gastric ulcers

Answer 48

mucosal barrier has increased permeabiity to H+ back dffusion of acid ulceration

Question 49

clinical mani of gastric ulcers

Answer 49

pain upper abd pain hemorrhage/perforation tend to be more chronic

Question 50

evaluation for gastric and duodenal ulcers

Answer 50

barium x rays or endoscopy

Question 51

duodenal ulcers affect

Answer 51

affect younger people, men

Question 52

risk factors for doudenal

Answer 52

similar to gastric except | hypersecretion of acid or pepsin

Question 53

patho chain of duodenal ulcers

Answer 53

increased acid concentrations penetrate the mucosal barrier ulceration

Question 54

clinical mani of duodenal ulcers

Answer 54

chronic intermittent epigastric pain (pain, food, relief) pain reoccurs 2-3 hrs after eating hemorrhage/perferation

Question 55

megacolon (hirshprung disease)

Answer 55

congential functional obstruction of colon caused by inadequate motility usually the distal end of sigmoid colon where a malformation of the para affects motility

Question 56

patho chain of hirshprung disease

Answer 56

absence of autonimic para ganglion calls in colon lack of peristalsis obstruction

Question 57

clinical mani of hirshprung disease

Answer 57

sonstipation small volume diarrhea (first sign) inflammation/inflectin

Question 58

eval of hirshprung

Answer 58

rectal biopsy which show absence of ganglion cells | xray

Question 59

adult intestinal obstruction etiology/patho

Answer 59

hernia torsion or twisting of bowel diverticulosis (outpouching of bowel) ileus (decreased motility of bowel)

Question 60

clinical mani of adult intestinal obstruction

Answer 60

``` distention abd pain loss of bowel sounds fluid/electrolyte imbalances vomiting ```

Question 61

eval of adult intestinal obstruction

Answer 61

based on clinical mani and xrays