gastrointestinal system

Question 1

contents of the upper GI tract

Answer 1

mouth
esophagus
stomach
duodenum

Question 2

contents of lower GI tract

Answer 2

small intestine
large intestine

Question 3

what is the small intestine’s job

Answer 3

digestion and absorption of nutrients

Question 4

what is the large intestine’s job

Answer 4

absorbs water and electrolytes
stores waste products of digestion until elimination

Question 5

enteric nervous system

Answer 5

the “second brain” in the gut

Question 6

the gut immune system has ____% to ___% of the body’s immune cells

Answer 6

70% to 80%

Question 7

what are the 3 most common GI problems in older adults

Answer 7

constipation
incontinence
diverticular disease

Question 8

hiatal hernia

Answer 8

esophageal hiatus of the diaphragm becomes enlarged which causes the stomach to poke through into the thoracic cavity

(basically stomach squeezes into thoracic cavity)

Question 9

are sliding hernias or rolling hernias more common

Answer 9

sliding hernias

Question 10

____% of people over 60 have hiatal hernias

Answer 10

60%

Question 11

what is the main symptom of having a hiatal hernia

Answer 11

Reflux –> causes heart burn

Question 12

what structure is most involved in heart burn

Answer 12

incompetence of the lower esophageal sphincter (LES)

Question 13

valsalva maneuver

Answer 13

breath technique that increases intraabdominal pressure

(think about bracing abs when lifting)

Question 14

post-prandial heartburn

Answer 14

heart burn shortly after eating (typically 30-60 mins)

Question 15

what is GERD

Answer 15

backflow of gastric contents into the esophagus (reflux) typically due to the esophageal sphincter being open

Question 16

foods that increase GERD incidence

Question 17

____% to ___% of adults have GERD

Answer 17

10% to 20%

Question 18

what are the 2 main causes of GERD

Answer 18

1. decreased pressure of the lower esophageal sphincter
2. gastric contents near junction (typically from increased intraabdominal pressure)

Question 19

3 barriers in healthy people that prevent GERD

Answer 19

1. anatomic barriers in tact
2. mechanisms that clear stomach acid from esophagus
3. maintaining stomach acidity & volume

Question 20

3 extra-esophageal manifestations of GERD

Answer 20

asthma
cough
laryngitis

Question 21

what are the 2 recommended sleeping positions for patients with GERD

Answer 21

supine
left side-lying

Question 22

what is peptic ulcer disease

Answer 22

a break in the lining of the stomach or duodenum of 5mm or more

Question 23

what are the 2 most common ways of developing peptic ulcer disease

Answer 23

1. NSAID medications
2. H. pylori bacterial infection

Question 24

what are the main symptoms of a peptic ulcer

Answer 24

epigastric pain
burning, gnawing, cramping near xiphoid or radiating to the back

Question 25

4 main complications of peptic ulcers

Answer 25

1. bleeding 2. perforation 3. penetration 4. gastric outlet obstruction

Question 26

Crohn disease

Answer 26

chronic inflammatory disorder that can affect any segment of the intestinal tract (most commonly ileum and/or colon)

Question 27

ulcerative colitis

Answer 27

chronic inflammatory disorder of the mucosa of the colon and rectum

Question 28

age at onset of crohn disease vs ulcerative colitis

Answer 28

crohn:10-30 years ulc: 10-40 years

Question 29

family history of crohn disease vs ulcerative colitis

Answer 29

20-25% (c) 20% (u)

Question 30

granulomas, thickened bowel wall, fissures, and narrowed lumen are common in _______ (crohn or ulcerative)

Answer 30

crohn disease

Question 31

inflammation of just the mucosal layer is involved is most common in _______ (crohn or ulcerative)

Answer 31

ulcerative

Question 32

location of lesions mostly on rectum and left colon are common in _______ (crohn or ulcerative)

Answer 32

ulcerative

Question 33

where does an abdominal mass form in crohn disease

Answer 33

right lower quadrant

Question 34

does growth retartation occur in crohn disease or ulcerative colitis

Answer 34

crohn disease

Question 35

does crohn disease or ulcerative colitis typically have bloody stools

Answer 35

ulcerative colitis

Question 36

does crohn disease or ulcerative colitis commonly have a cancer association

Answer 36

ulcerative colitis

Question 37

diverticulosis

Answer 37

the presence of out pouching in the wall of the colon or small intestine

Question 38

diverticulitis

Answer 38

inflammation/infection of the diverticula

Question 39

diverticular disease is asymptomatic in ___% of affected people

Answer 39

80%

Question 40

in complicated diverticular disease, what develops with the bladder

Answer 40

fistula

Question 41

what exercises should be avoided in patients with diverticular disease

Answer 41

increased intraabdominal pressure

Question 42

risk factors of diverticular disease

Answer 42

constipation physical inactivity eating red meat obesity smoking

Question 43

pneumaturia

Answer 43

air in the urine

Question 44

fecaluria

Answer 44

urine in the stool

Question 45

what referred pain can be present in diverticular disease

Answer 45

back pain referred hip/thigh pain

Question 46

what age and what gender is most susceptible to appendicitis

Answer 46

15-19 males

Question 47

1/3 appendicitis cases are caused by

Answer 47

an obstruction that prevents normal drainage

Question 48

what structure of the appendix is primarily obstructed

Answer 48

lumen

Question 49

where will the pain be for appendicitis

Answer 49

lower right quadrant with tenderness

Question 50

40-50% of appendicitis cases are atypical because

Answer 50

the position of the tip of the appendix

Question 51

symptoms of appendicitis

Answer 51

abdominal pain nausea/vomiting low-grade fever Referred pain: thigh groin pelvic hip

Question 52

rectal fissure

Answer 52

ulceration/tear of the lining in the anal canal

Question 53

what part of the anal canal is typically torn in a rectal fissure

Answer 53

posterior wall

Question 54

how do hemorrhoids typically develop

Answer 54

through anything that increases intraabdominal pressure