GI Flashcards

1
Q

What is included in the upper GI?

A
mouth
pharynx
esophagus
stomach
duodenum
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2
Q

What is included in the lower GI?

A

small intestine
large intestine
rectum/anus

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3
Q

What are the accessory organs of the GI system?

A
teeth
tongue
salivary glands
liver
gall bladder
pancreas
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4
Q

List the diagnostic studies for GI, hepatic, biliary, pancreatic, and splenic systems (7)

A
Laparoscopy
Barium swallow
Modified barium swallow study
Endoscopy
Endoscopic retrograde cholangiopancreatography (ERCP)
GI bleeding scan (scintigraphy)
Upper GI series
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5
Q

Describe a laparoscopy and what it is used for

A
  • insertion of a laparoscope into the abdominal cavity
  • uses a small incision and local anesthetic
  • can be diagnostic or therapeutic
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6
Q

Describe a barium swallow study and what it is used for

A
  • patient swallows barium liquid while XR and fluoroscopic images examine swallowing and peristalsis of esophagus
  • used to ID pathologic conditions of the esophagus (propulsion of liquid through esophagus into stomach)
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7
Q

Describe a modified barium swallow study and what it is used for

A
  • used to diagnose dysphagia

- analyzes oral, pharyngeal, and upper esophagus

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8
Q

Describe endoscopy

A

insertion of endoscope into digestive tract (esophagus, stomach, small intestines)

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9
Q

Describe ERCP and what it is used for

A

Endoscopic retrograde cholangiopancreatography

- uses endoscopy and fluoroscopy to diagnose and treat gall bladder, biliary system, pancreas, and liver problems

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10
Q

Describe what GI bleeding scans (scintigraphy) are used for

A

to determine the presence/source of GI bleeding

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11
Q

Describe what an upper GI series is used for

A

to identify the disorder of the esophagus, stomach, and duodenum

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12
Q

What is a small bowel series used for?

A

to visualize the jejunum and ileum

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13
Q

What are the common lab values associated with the liver?

A
ALT
ALP
AST
albumin
bilirubin
ammonia
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14
Q

What are the common lab values associated with pancreatic function?

A

lipase
amylase
sweat test

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15
Q

Name the different health conditions that affect the GI system (15)

A
  • Dysphagia
  • GERD
  • PUD
  • Dumping syndrome
  • Upper GI bleed
  • Lower GI bleed
  • Diverticular disease
  • Hiatal hernia
  • Abdominal hernia
  • Crohn’s disease
  • Ulcerative colitis
  • Morbid obesity
  • Encephalopathy
  • Cholecystitis
  • Cholelithiasis
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16
Q

Describe dysphagia, its causes, diagnosis, and treatment

A
difficulty swallowing (oropharyngeal or esophageal)
Dx:
- MBSS
- endoscopy
- CT
- MRI
Causes:
- neurological conditions (stroke/TBI)
- dementia
- myasthenia gravis
Tx:
- airway protection
- nutritional support
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17
Q

Describe GERD, its SxS and treatment

A
backflow of gastric acid into the esophagus
SxS:
- heartburn
- regurgitation
Tx:
- diet modification
- weight loss
- PPIs
- H2 blockers
- Nissen fundoplication
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18
Q

Describe PUD, its causes, SxS, and Tx

A
ulceration in the stomach or duodenum
Cause:
- H. pylori infection
- NSAIDs
SxS:
- hunger-like sensation
- nocturnal pain
Tx:
- lifestyle modifications
- PPIs
- antibiotics
- no NSAIDs/aspirin
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19
Q

Describe Dumping Syndrome, its causes, the types, and treatment

A
enhances gastric emptying and interrupts normal digestive sequence
Causes:
- GI surgeries (gastrectomy, gastric bypass surgery, PUD surgery, Nissen fundoplication)
Types:
- early DS
- late DS
Tx:
- dietary changes
- medication
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20
Q

Describe Early Dumping Syndrome

A
occurs within 30 minutes of a meal
SxS:
- palpitations
- tachycardia
- flushing
- diaphroesis
- syncope
- abdominal symptoms like cramping and bloating
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21
Q

Describe Late Dumping Syndrome

A

occurs 1-3hrs after a meal
SxS:
- consistent with hypoglycemia

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22
Q

Describe upper GI bleed and its causes

A
bleeding that occurs in the stomach, esophagus, or duodenum
Causes:
- ulcers
- gastric erosion
- gastric/esophageal varices
23
Q

Describe a lower GI bleed and its causes

A
a bleed that occurs in the colon and anorectum
Causes:
- IBS (diverticulitis)
- ischemic colitis
- anal and rectal lesions (hemorrhoids)
- ulcerate polyps
- colorectal cancer
24
Q

What are the SxS of a GI bleed?

A
  • hematemesis
  • hematochezia
  • melena
25
How is a GI bleed treated?
- IV fluids - blood transfusions - management of causative factors
26
Describe the SxS and treatment for diverticular disease
``` SxS: - LLQ pain - polyuria - fever - elevated WBCs - constipation - NV Tx: - diet modification - clear liquids - IV fluids - pain meds - antibiotics - surgery (abscess drainage, colectomy) ```
27
Describe a hiatal hernia, its SxS, and treatment
``` a protrusion of abdominal structures upward through the esophageal hiatus SxS: - heartburn-like pain - dysphagia - chest pain - dyspnea - hoarsness Tx: - behavior modifications - eating small/frequent meals - bland food with high fiber - acid-reducing medications - laparoscopic repair ```
28
Describe an abdominal hernia, its SxS and treatment
``` a protrusion of bowel that is classified by location of protrusion SxS: - abdominal distension - NV - position changes with increased abdominal pressure (laughing, coughing) - pain - paresthesia Tx: - monitor asymptomatic cases - symptomatic --> surgical repair - possible temporary colostomy ```
29
Describe Crohn's disease
an idiopathic inflammatory bowel disease that can occur anywhere in the GI system - most common in the terminal ileum and proximal colon
30
What are the causes of Crohn's disease?
- genetics - immune dysregulation - infectious agents - psychological issues - environmental factors
31
What are the SxS of Crohn's disease?
- abdominal cramping - RLQ pain/mass - diarrhea - weight loss - fatigue - low grade fever
32
What are the treatments for Crohn's disease?
- corticosteroids - antibiotics - immunosuppressants - nutritional support
33
What are some complications that may occur due to Crohn's disease?
- intestinal obstruction - inflammation of membranes - arthritis - ankylosing spondylitis - gallstones - vitamin B12 deficiency - thromboembolism
34
Describe Ulcerative colitis and its causes
an idiopathic inflammatory bowel disease that occurs in the mucosal layer of the rectum and proximal colon Causes: - not well known but appear similar to crohn's disease (genetics, immune dysregulation, infectious agents, psychological issues, environmental factors)
35
What are the SxS of ulcerative colitis?
- lower abdominal pain relieved by defecation - bloody stools - diarrhea - incontinence - nocturnal defecation - fatigue - weight loss - dehydration
36
What are the treatments for ulcerative colitis?
- anti-inflammatory meds - immunosuppressants - biologics - diet modification - surgery - monitoring for colon cancer
37
Describe morbid obesity and what should be monitored
a chronic disease characterized by excessive body fat and BMI of 30 or higher. - many comorbidities are linked with morbid obesity Monitor: - exercise tolerance (BP, HR, RR) - skin inspection - weight limits for equipment
38
What are the different treatments for morbid obesity?
``` Conservative tx: - weight loss (goal: 10% reduction) - diet modification - medication - behavior management - increased physical activity (better outcomes) Surgical Tx: (BMI>40) - gastric bypass - gastric banding - gastroplasty - gastrectomy ```
39
Describe encephalopathy, its causes, symptoms, and treatment
``` Causes: - acute/chronic liver disease SxS: - impaired mental status and NM dysfunction that occurs over hours to days - altered consciousness (mild to coma) - ammonia intoxication - changes in cerebral blood flow Tx: - reduce ammonia levels - correct electrolyte imbalance - antibiotics - nutritional support - liver transplant ```
40
Describe cholecystitis, its symptoms, and treatment
acute or chronic inflammation of the gall bladder SxS: - RUQ pain that may radiate to R shoulder - abdominal rebound tenderness (Murphy's sign) - jaundice - NV - fever Tx: - laparoscopic cholecystectomy
41
What is the only difference between cholecystitis and cholelithiasis?
Cholelithiasis is gallstone formation and cholecystitis is inflammation of the gall bladder
42
List the GI surgical procedures (8)
- laparotomy - laparoscopy - appendectomy - cholecystectomy - colectomy - gastrectomy - splenectomy - colostomy
43
Describe a laparotomy
``` an open surgery of the abdomen to explore and repair tissues Standard incision: midline Used for: - situations involving multiple dense adhesions - grossly distended intestines - massive ascites - severe bleeding - blunt and penetrating trauma ```
44
Describe a laparoscopy
- a short, narrow tube is inserted into the abdomen through a small (<1cm) incision (trochar) - surgical tools are inserted through the trochar to perform surgery - high resolution provide visual area of interest - less invasive, faster recovery time, shows better QOL outcomes
45
What is an appendectomy?
removal of the appendix
46
What is a cholecystectomy?
removal of the gall bladder
47
What is a colectomy?
resection of a portion of the colon | - usually involves a colostomy or ileostomy
48
What is a gastrectomy?
removal of whole or part of the stomach
49
What is a splenectomy?
removal of the spleen
50
What is a colostomy?
a procedure that reroutes stool from diseased colon to an external bag
51
What are the types of colostomy?
- end colostomy - double barreled colostomy - loop colostomy
52
What should be checked when working with a patient with a colostomy bag?
- make sure it is securely closed before interventions - keep covered for pt dignity - empty bag if full
53
What are PT considerations for GI issues?
- patient positioning for comfort - increased fatigue is likely - be aware of dietary restrictions - Avoid Valsalva. (varices may rupture with increased abdominal pressure) - ascites hinders effective coughing and restricts adequate ventilation
54
List the important positioning tips/techniques
- sidelying decreases tension on surgical site - have pt flx knees while lowering HOB to decrease tension on abdomen - supine may aggravate dysphagia and GERD - splinting should be done during mobility/coughing