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MEDS5009 > Gastrointestinal System > Flashcards

Gastrointestinal System Flashcards

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1
Q

functions of the digestive system

A

ingestion, mechanical breakdown, secretion, digestion, transport, absorption, excretion

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2
Q

upper GI tract

A

pharynx, oesophagus

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3
Q

lower GI tract

A

stomach, small intestine, large intestine

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4
Q

nasopharynx

A

Top part of pharynx that is a muscular box-shaped passageway behind the nose, above roof of mouth.

Allows air to pass from nose into windpipe and eventually into lungs.

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5
Q

oropharynx

A

Part of the throat at back of the mouth behind oral cavity. Includes back third of tongue, soft palate, side and back walls of throat and tonsils.

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6
Q

laryngopharynx

A

hypopharynx - most caudal position, crucial connection point which water, food and air pass. Point which the pharynx divides anteriorly into larynx and posteriorly into oesophagus.

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7
Q

swallowing

A

collaboration between somatic and visceral muscles and nervous system to receive food into mouth, prepare it and move if from mouth to stomach

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8
Q

oral phase

A

First stage of swallowing

Tongue collects food and makes it ready for swallowing by moving it around mouth with help of jaw to chew. Chewing mixes food with saliva which softens to the food and makes it easier to swallow.

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9
Q

pharyngeal phase

A

Second stage of swallowing

Tongue pushes food to the back of the mouth. This triggers a swallowing response that passes the food through the pharynx. During this phase, larynx closes tightly and breathing stops to prevent food or liquid from entering the airway and lungs

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10
Q

oesophageal phase

A

Third phase of swallowing

Food enters the oesophagus and is transported to stomach in 3 seconds.

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11
Q

oesophageal sphincter

A

Separates the contents of the stomach from the oesophagus, prevents acid entering oesophagus and causing heartburn/reflux.

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12
Q

mucus

A

secreted by goblet cells to protect stomach lining

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13
Q

gastric acid

A

secreted by parietal cells

e.g. HCl

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14
Q

pepsinogen

A

protease precursor secreted by chief cells

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15
Q

somatostatin

A

inhibits acid secretion, secreted by D cells

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16
Q

gastrin

A

stimulates acid secretion, secreted by G cells

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17
Q

Parts of the small intestine

A

duodenum, jejunum, ileum

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18
Q

characteristics of small intestine

A

plicae circulares, villi, microvilli

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19
Q

duodenum

A

mostly retroperitoneal, not suspended in mesentery and 1/2 foregut

function - digestion and absorption, which needs increased SA

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20
Q

jejunum

A

suspended by mesentery, thicker walls, more vascular with long vasa recta

large, tall, dense plicae; few peyer’s patches

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21
Q

ileum

A

suspended by mesentery, thinner walls, less vascular with short vasa recta.

low, sparse, absent distally pliace; many peyer’s patches

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22
Q

Peyer’s patches

A

important in immune surveillance of intestinal lumen and facilitating production of immune response within mucosa

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23
Q

regions of large intestine

A

caecum, appendix, colon, rectum, canal

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24
Q

cecum

A

region of large intestine that acts as temperature storage and responds via reflex

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25
vermiform appendix
blind-ended region of large intestine with good blood supply and contains lymphatic nodules
26
ascending colon
retroperitoneal
27
transverse colon
mesocolon and greater omentum
28
descending colon
retroperitoneal
29
sigmoid colon
mesocolon
30
stratified mucosal cells
found in oesophagus as only involved in transport (no absorption)
31
folds and intestinal villi
found only in small intestine to increase SA for absorption
31
simple columnar epithelium
found in all GI tube structures except oesophagus, involved in absorption
32
common symptoms of GI disorders
anorexia, nausea, vomiting, dysphagia, odynophagia, GI bleeding
33
dysphagia
difficulty swallowing
34
odynophagia
painful swallowing
35
hematemesis
blood in vomit bright red or coffee ground appearance
36
melena
blood in stool colour ranges from bright red to tarry black, can be hidden
37
occult
hidden
38
possible meaning of fresh blood in stool
bleeding in lower part of GI tract
39
steatorrhea
fatty stool, often pale and bulky
40
oesophageal diverticulum
small, pouch like bulge that can appear in the oesophagus and stops food before it enters the stomach
41
signs of oesophageal diverticulum
gurgling, burping, coughing, foul-smelling breath
42
gastroesophageal reflux disease (GERD)
result of reflux of gastrointestinal contents into oesophagus occurs because tone of lower oesophageal sphincter is decreased or inappropriately relaxed
43
reflux oesophagitis
reflux which is characterised by acute symptoms of inflammation
44
reflux
gastric volume or intra-abdominal pressure is elevated resulting in backward flow of gastrointestinal contents into oesophagus
45
manifestations of GERD
dyspepsia, regurgitation, hypersalivation, dysphagia, odynophagia, chronic cough, asthma, atypical chest pain, burping, flatulence, bloating after eating, nausea and vomiting
46
dyspepsia
indigestion
47
gastric mucosal barrier protection
impermeable epithelial cell surface covering, mechanisms for selective transport of H and HCO3, solubility characteristics of mucus
48
factors linked to gastric irritation and ulcer formation
aspirin and non-steroidal anti-inflammatory drugs infection of H.pylori
49
aspirin and NSAIDS
irritate gastric mucosa and inhibit prostaglandin synthesis
50
infection of H.pylori
thrives in acidic environment and has evolved to drill into mucus to reach cells disrupts the mucosal barrier that protects stomach from harmful effects of digestive enzymes increases risk of peptic ulcer disease and gastric cancer by 20%
51
acute gastritis
transient inflammation of gastric mucosa commonly associated with local irritants
52
local gastric irritants
bacterial endotoxins, alcohol, aspirin
53
long term complication of gastritis
ulcer
54
chronic gastritis
absence of grossly visible erosions and presence of chronic inflammatory changes. leads to atrophy of glandular epithelium of stomach
55
types of chronic gastritis
helicobacter pylori gastritis, autoimmune gastritis, multi-focal atrophic gastritis, chemical gastropathy
56
H.pylori
accounts for 90% of duodenal ulcer, 50-80% of gastric ulcer and 70-90% of gastric carcinoma
57
H.pylori tolerance to acidic conditions
1. urease providing buffering (conversion of urea to ammonium) 2. resides on mucus and epithelial cells 3. capacity to create ionic gradient at low pH 4. release factors that decrease acid secretion in early infection
58
establishing H.pylori infection
C urea breath test, stool antigen test, endoscopic biopsy for urease testing, blood tests to obtain serologic titers of H.pylori antibodies
59
symptoms of peptic ulcer
abdominal pain, nausea, abdominal indigestion, hematesis, melena, unintentional weight loss, fatigue
60
complications of peptic ulcer
hemorrhage, obstruction, perforation
61
peptic ulcer
open sore in lining of stomach or duodenum
62
causes of peptic ulcer
H.pylori infection and/or NSAIDS
63
hemorrhage
caused by bleeding from granulation tissue or from erosion of an ulcer into an artery or vein
64
obstruction
caused by edema, spasm or contraction of scar tissue and interference with free passage of gastric contents through pylorus or adjacent areas
65
perforation
occurs when an ulcer erodes through all layers of the stomach or duodenum wall
66
conditions which alter intestinal function
irritable bowel disease, inflammatory bowel disease, diverticulitis, appendicitis, alterations in bowel motility, malabsorption syndrome, cancer of colon and rectum
67
inflammatory bowel disease
Crohn's disease and ulcerative colitis
68
Crohn's disease
recurrent, granulomatous type of inflammatory response that can affect any area of the GIT characterised by skip lesions and cobblestone mucosa
69
Ulcerative colitis
nonspecific inflammatory condition of colon characterised by continuous involvement
70
key sign of inflammatory bowel disease
malabsorption
71
skip lesions
affect any part of GIT, skipping layers and spread out, making them very hard to remove without surgical implications
72
Assessment for GIT disorder diagnosis
personal and family hx, demographic data, genetic risk, diet history (anorexia, dyspepsia), blood panel for electrolyte and hydration levels
73
signs of GIT disorder
pattern of bowel movement, colour and consistency of feces, diarrhea and constipation (and effective action taken to relieve), melena, presence of abdominal distension or gas
74
physical exam for GIT disorder diagnosis
mouth and pharynx, abdomen and extremities (inspection, palpitation, percussion an auscultation)
75
skin changes in GI disorders
skin discolouration and rashes, itching, jaundice, increased susceptibility of bruising, increased tendency to bleed
76
referred pain
painful sensation that is felt in an area of body that is not actually source of pain (usually felt superficially even though source is deeper)
77
lab tests
complete blood count, clotting factors, electrolytes, assays of liver enzymes, serum amylase and lipase, bilirubin, urinalysis, inflammatory markers, kidney function test and vitamin and iron status
78
barium enema
enhances radiographic visualisation of large intestine clear liquids given 12-24 hours before test, NPO night before, bowel cleansing done post-test: expel barium, white, chalky stool 24-72 hours after
79
esophagogastroduodeno-scopy (EGD)
Visual examination of oesophagus, stomach and duodenum NPO 6-8 hours before procedure, conscious sedation post-test: NPO until gag reflex returns, throat discomfort
80
colonoscopy
endoscopic examination of entire large bowel liquid diet 12-24 hours before, NPO 6-8 hours before. Bowel cleansing done post-test: blood in stool if polypectomy
81
proctosigmoidoscopy
endoscopic examination of rectum and sigmoid colon. liquid diet 24 hours before, cleansing enema and laxative. client positioned on left side with knee-chest posture post-test: mild gas pain and flatulence, small bleeding if biopsy done
82
malabsorption tests
lactose intolerance test and breath hydrogren tests following lactose challenge
83
lactose intolerance test
ingestion of 50g test dose and glucose levels monitored at 0, 60 and 120 mins diagnostic - increase BG by less than 20mg/dL and development of symptoms
84
false negative results in lactose intolerance test
diabetes, bacterial overgrowth, abnormal gastric emptying
85
measurements of breath hydrogen
diagnostic - increase in breath hydrogen by more than 20 ppm used to diagnose specific forms of CHO malabsorption

MEDS5009 (19 decks)

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