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SRNAanatomy > Exam 4- GI > Flashcards

Exam 4- GI Flashcards

(60 cards)

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1
Q

Parietal

A

HCl, IF,

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2
Q

Chief cells

A

Pepsin

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3
Q

G cells

A

Gastrin

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4
Q

Production of intrinsic factor –

A

Essential for the absorption of vitamin B12 in ileum

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5
Q

Parasympathetic nervous system (stimulatory_

– Primarily through

A

vagus (CN X)

  • Increased motility
  • Increased secretions
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6
Q

Sympathetic nervous system is

A

inhibitory

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7
Q

________Maintain continuous flow of saliva in mouth

A

C.N. VII & IX –

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8
Q

Gastrin

A

– Secreted by stomach in response to distention

• Increases gastric secretions & motility, relaxes pyloric and ileocecal sphincters – promotes stomach emptying

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9
Q

Histamine(H2 receptor)

A

– Increased secretion of hydrochloric acid

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10
Q

Secretin

A

– Decreases gastric secretion

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11
Q

Cholecystokinin (CCK)

A

Inhibits gastric emptying; stimulates contraction of gallbladder

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12
Q

Fat-soluble vitamins

A

Vitamins A, D, E, K

Absorbed with fats

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13
Q

Water
-soluble vitamins
–

A

Vitamins B and C –

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14
Q

Neuroendocrine cells of G.I. tract
• Enterochromaffin Cells
• Use tryptophan hydroxylase-1 to________
•______% of serotonin store in body
• Stimulates secretory, peristaltic and vagal reflexes
via___________
• Important in generating__________
• Ondansetron mechanism: 5-HT 3 receptor antagonist
• (Ginger)

A 
synthesize Serotonin (5-HT) 
90%

5-HT 3 receptor
nausea/vomiting

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15
Q

Neuroendocrine cells, they release
_________stimulates parietal cells
via H2 receptors HCl production

A

Histamine

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16
Q

Small intestine

A

Duodenum -Jejunum - Ilium

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17
Q

Anorexia and vomiting

A

– Can cause serious complications

• Dehydration, acidosis, malnutrition

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18
Q

Vomiting

A

Vomiting center located in the medulla

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19
Q

Increased intracranial pressure

A

– Sudden projectile vomiting without previous

nausea

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20
Q

Hematemesis

“Coffee grounds” –

A

brown granular material indicates action of HCl on hemoglobin

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21
Q

– Frank blood –

A

acute esophageal or gastric Hemorrhage

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22
Q

Fat soluble

A

Be careful

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23
Q

Prolonged diarrhea may lead to

A

dehydration,
electrolyte imbalance, acidosis, malnutrition,
weight loss

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24
Q

Steatorrhea – “fatty diarrhea”

A

** Characteristic of malabsorption syndromes

– Frequent bulky, greasy, loose stools
– Foul odor

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25
Upper GI bleeding | •
Esophagus, stomach, or duodenum –
26
Lower GI bleeding
• Below the ligament of Treitz: bleeding from the | jejunum, ileum, colon, or rectum
27
_______ and _______are common complications of GI tract disorders. Electrolytes –
Dehydration and hypovolemia Lost in vomiting and diarrhea • Acid-base imbalances • Diarrhea causes loss of bicarbonate.
28
Metabolic alkalosis
• Results from loss of HCl w/ vomiting
29
Metabolic acidosis
Severe vomiting causes a change to metabolic acidosis | due to the loss of bicarbonate of duodenal secretions.
30
Types of abdominal pain
* Visceral * Somatic * Referred
31
VISCERAL: Burning sensation –
Inflammation and ulceration in upper GI tract
32
VISCERAL :Dull, aching pain –
Typical result of stretching of liver capsule
33
VISCERAL:Cramping or diffuse pain –
Inflammation, distention, stretching of intestines
34
VISCERAL: Colicky, often severe pain –
Recurrent sooth muscle spasms or contraction | Response to severe inflammation or obstruction
35
Somatic pain receptors directly linked to spinal | nerves –
May cause reflex spasm of overlying abdominal muscles Steady, intense, often well-localized pain Rebound tenderness” – over area of involvement / inflammation of peritoneum
36
Malnutrition: | 2 types
Vitamin B12 deficiency = pernicious anemia | – Iron deficiency = iron deficient anemia
37
Antacids | •
– To relieve pyrosis
38
• Antiemetics
– To relieve vomiting
39
• Laxatives or enemas
– Treatment of acute constipation
40
Antidiarrheals
– Reduction of peristalsis | – Relieve cramps
41
Sulfasalazine | •
- Anti-inflammatory and antibacterial | – For acute episodes of inflammatory bowel disease
42
• ABX
- Clarithromycin Clarithromycin or azithromycin azithromycin – Effective against Heliobacter pylori infection • Usually combined with a proton pump inhibitor
43
Sucralfate
Coating agent – Enhance gastric mucosal barrier against irritants such as NSAIDs
44
Anticholinergic drugs
Reduce secretions &motility
45
H2 blockers
Useful in gastric reflux
46
• PPIs
Reduce gastric secretion
47
Disorder: Cleft lip palate: Intubation
May require intubation with RAE endotracheal tube for | surgical repair
48
Fistula complicates airway because
airway connected to esophagus
49
Dilation may
cause airway impingement
50
GERD | Anesthesia concenrs is aspration
Anesthesia concerns: Aspiration • Possible related respiratory concerns with GERD: • Laryngitis • Recurrent pneumonia • Asthma (50% of pt.s have endoscopic evidence of esophagitis)
51
Hemorrhage
* Due to erosion of blood vessels * Common complication * May be the first sign of a peptic ulcer
52
Obstruction
• May result later due to the formation of scar tissue
53
Perforation
* Ulcer erodes completely through the wall. * Chyme can enter the peritoneal cavity. * Results in chemical peritonitis
54
DUMPING syndrome | Hyperosmolar chyme draws what?
``` fluid from vascular compartment into intestine. – Intestinal distention – Increased intestinal motility – Hypotension, Tachycardia, Diaphoresis, Pallor ```
55
Hypoglycemia __________ | –
2-3 hours after meal High glucose levels in chyme stimulate increased insulin secretion → hypoglycemia
56
Acute pancreatitis
Pancreas lacks a fibrous capsule ***** Hypovolemia and circulatory collapse may follow – Destruction may progress into tissue surrounding the pancreas – Substances released by necrotic tissue lead to widespread inflammation
57
– Adult respiratory distress syndrome and acute renal | failure occur in
25% of patients | – GI hemorrhage & DIC may also occur
58
Gastrinoma
• Large volumes of gastric fluid usually present at time of anesthesia induction = ↑risk of reflux / aspiration. • Profuse watery diarrhea = hypokalemia & metabolic alkalosis. • IV ranitidine (H2 blocker) useful for preventing acid hyper-secretion intra-op
59
Appendicitis – Signs and Symptoms
• “Boardlike” abdomen, tachycardia, | hypotension
60
Intestinal obstruction
Mesenteric thrombosis (Dehydration in HHS)

SRNAanatomy (25 decks)

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