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Pathophysiology > GI System > Flashcards

GI System Flashcards

1
Q

GI Tract

A 
GI TUBE: anything passing through is external, once absorbed it is internal
mouth
esophogus
stomach
small intestine
large intestine
recturm
anus
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2
Q

zymogens

A

enzymes that are inactive “ogen” = inactive, immature

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3
Q

fxns of GI tract

A
  • INGESTION of food
  • MOTILITY: peristalsis and segmenta - propulsion of food and wastes from mouth to anus
  • SECRETION of mucus, water, and enzymes
  • MASTICATION mechanical digestions of food particles
  • chemical digestion of food particles
  • absorption of digested food - small intestines
  • elimination of waste products by defecation
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4
Q

GI Enzymes

A
  • carbs: amylase (saliva, pancrease)
  • protein: prolease (stomach pepsin) (pancrease trypsin, chymotrpson)
  • lipids/fats: lipase (after emulsification by bile)
  • nucleic acid/DNA/RNA: nuclease
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5
Q

GI tract Layers

A
  1. mucosa: inner layer, absorption
  2. submucosa: secretions, blood supply
  3. muscularis: 2 layers of smooth muscle - circular (pinch and constrict) & longitudinal (propel food forward)
  4. serosa: visceral layer - peritoneum
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6
Q

Mouth

A
  • chewing and mixing food with saliva: mastication, and start of chemical digestion
  • taste buds (CN VII, IX): salty, sour, sweet, bitter, umami
  • olfactory nerves (CN I) smell involved in taste
  • teeth - 32 premanent teeth, mastication
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7
Q

salivary glands

A
  • paried glands: submandibular, sublingual, parotid
  • saliva: water with mucous, sodium, bicarbonate, chloride, potassium, and amylase (carb digestion)
  • bollus = matter that we swallow
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8
Q

deglutination

A

swallowing - then involuntary movement begins

  • esophogus: peristalsis & segmentation
  • upper esophogeal sphincter: stenotic sphincter, oral cavity to eshophogus, Choking, gerd
  • lower esophageal sphincter: cardiac sphincter = entrance to stomach, vomiting, heart burn
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9
Q

stomach

A
  • holds food 2-6 hours
  • hollow, muscular organ that stores food, secretes digestive juices, mixes food with juices, and propels partially digested food (Chyme = bollus once mixed with gastric juices in stomach)
  • 3 layers: longitudinal, circular, oblique
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10
Q

Stomach Gastric Juices

A

JUICES

  • mucus
  • HCL acid: converts pepsinogen to pepsin
  • enzymes: pepsin (breaks down protein)
  • hormones: gastrin and grelin (hunger hormones), regulates gastric juices
  • intrinsic factor: vitamin B12 absorption, pernicuious anemia

GLANDS/PITS

  • parietal cells: hydrochloric acid (breaks down) and intrinsic factor (b12)
  • chief cells: pepsinogen (protein digestion)
  • G Cells: gastrin and grelin (hunger cells)
  • hydrochloric acid: denatures proteins, antimicrobal, converts pepsinogen to pepsin

vagus nerve –> gastrin –> hisamine –> parietal cells –> HCL

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11
Q

Gastric Secretion

A

gastric secretion/acid secretion/ saliva secretions

  • cephalic phase: congitive - thinking about food makes you salivate and secrete gastric juices
  • gastric phase: stomach - chemicle signal (exposure to tongue) and chemoreceptors (smell and taste)
  • intestinal phase: food enters into duodenum (through pyloric sphincter), decreased saliva and gastric juices, inhibition phase
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12
Q

small intestines

A
  • 5-6 cm long
  • absorption - doesn’t secrete anything
  • three segements: dueoden –> jejunum –> ilium (iliosecal valve from small to large intestine)
  • peritoneum - mesentaries, hold intestines in place in body
  • villi: lactile (drains fats in middle of villi), has hairs to increase surface area, burshborder epithelium
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13
Q

intestinal digestion

A

pancreatic enzymes: amylase (carbs), trypsinogen and chymotripsinogen (protein), lipase (fats), nuclease (DNA, RNA)
- Bile salts: made in liver, stored in gallbladder

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14
Q

intestinal absorption

A

carbs, proteins, fats, water, electrolytes

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15
Q

where are diff nutrients absorbed?

A
  • stomach: water, alcohol, caffein, nasals (aspirin)
  • duodeunum: iron, calcium, fats, sugars, water, proteins, vitamins, magnesium, sodium
  • jejunum: sugars, proteins
  • ilium: bile salts, vit b12, chloride
  • colon: water, electrolytes
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16
Q

large intestine

A
  • cecum: next to appendix, iliocecual valve
  • appendix: stores microbial flora of gut
  • colon: ascending, transverse, descending, sigmoid
  • recturm
  • anus
  • colorectal cancer is most common in rectum and sigmoid. most fatal. highest site of pathogens, compactions, constipation
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17
Q

liver

A

LOBES: separated and attached to the anterior abdominal wall by falciform ligament
- right lobe - caudate lobe, quadrate lobe & left lobe

  • Hepatic portal vein & system
  • vein enters into liver to be detoxified then puts it into systemic circulation: blood from GI tract, filtrations from spleen, other bad stuff absorbed
  • if liver fails then you get hepatic portal hypertension = ascites, splenomegaly, verses

LIVER LOBULES

  • hepatocytes
  • sinusoids (specialized capillaries)
  • kupffer cels (Macrophages)
  • common bile duct
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18
Q

liver secretion of bile

A
  • cholesterol produces bile
  • bile is alkaline, yellow/green, contains bile salts, cholesterol, bilirubin, electrolytes and water
  • bile is formed by hepatocytes and secreted into bile canaliculi
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19
Q

functions of liver

A
  • blood storage
  • bacterial/foreign particle removal
  • synthesizes plasma proteins/ clotting factors
  • produces bile
  • metabolizes fats, proteins, carbs
  • detoxes metabolic products and wastes
  • storage of minerals, vitamins
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20
Q

gallbladder

A

stores and concentrates bile between meals

- lies inferior to liver

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21
Q

pancrease

A
  • secrete enzymes and alkaline fluids to assist in digestions
  • exocrine: amylase, lipase, trysin, chymotrypsin, nuclease
  • endocrine: insulin, glucagon (NOT GI, blood sugar)
    SECRETIONS: bicarb, symogens, pancreatic amylase, pancreatic lipase, nuclease
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22
Q

symptoms of GI dysfunction

A
  • anorexia: lack of desire to eat
  • vomiting: emptying of stomach and intestinal contents, hyper salivation, tachycardia
  • nausea: most common symptom
  • retching: dry heaving, nonproductive vomiting, can induce vomiting of bile
  • abdominal pain: referred pain, dull, achy, decrease in number of nociceptors
  • constipation: sigmoid or recturm, infrequent or difficult defecation
  • diarrhea: frequency or volume increases, fluidity, weight of feces
    > mechanisms of diarrhea
  • osmotic diarrhea: electrolyte change draws fluid into intestine instead of out
  • secretory diarrhea: bacterial toxins in instestin, food poisoning, increase in H2O, increased motility
  • motility diarrhea: increased motility decreases digestion increases diarrhea, smooth muscle or nerve issue (anxiety), caffeine
  • GI bleed: hematemesis (vom blood), hematochezia (Bloody stools)
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23
Q

dysphagia

A
  • difficulty swallowing

- achalasia: loss of nervous control, decreases swallowing ease

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24
Q

Gastroesophageal reflux (GERD)

A

reflux of chyme from stomach to esophagus

  • insufficiency of cardiac sphincter
  • inflamm of esophoagus = reflux esophagitis
  • any condition that increases abdominal pressure can contribute to gerd
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25
Q

hiatal hernia

A
  • movement of intestine into an area it shouldn’t be
  • through diaphragm
  • protrusion of upper portion of stomach through diaphragmatic hiatus into thorax
  • sliding or paraesophageal
26
Q

pyloric obstruction

A

stenosis, bottom of stomach

  • blocking or narrowing of opening between the stomach and duodenum
  • vomiting soon after eating
27
Q

dumping syndrome

A

rapid emptying of chyme from a surgically created residual stomach into the small intestine

  • pyloric unsufficiency: bypasses pyloric sphincter, violet diarrhea
  • bariatric surgeries
  • clinical complication of partial gastrectomy or pyloroplasty surgery
28
Q

intestinal obstruction

A

any condition that prevents flow of chyme through intestinal lumen or failure of normal intestinal motility - mechanical blockage
- ileus: an obstruction of intestines from folding, pinching, lack of peristalsis = decreases peristalsis, physiological response = ischemia/necrosis

29
Q

peptic ulcer disease

A

break or ulceration in protective mucosal lining of lower esophagus, stomach, duodenum

  • acute and chronic ulcers
  • upper GI ulceration in esophogus, stomach or duodenum
30
Q

Duodenal Ulcers

A

Duodenal ulcers:

  • small intestine
  • most common
  • H pylori infection
  • hyper secretion of stomach acid and pepsin (use of nasals, cigarette smoking produces acid)
    1st. H pylori
    2nd. nsaids
31
Q

gastric ulcers

A

stomach

  • tend to develop in astral region of stomach
  • 1st over use of nasals
  • 2nd. H pylori
32
Q

stress ulcers

A

peptic ulcer that is related to severe illness, neural injury, systemic stress/trauma

33
Q

maldigestion

A
  • failure of chemical processes of digestions
    leads to…
    malabsorption: failure of intestinal mucosa to absorb digested nurients
  • frequently occur together
34
Q

pancreatic insufficiency

A

insufficient pancreatic enzyme production: lipase, amylase, trypsin, chymotrypsin

  • causes: pancreatitis, pancreatic carcinoma, pancreatic resection, cystic fibrosis
  • fat maldigestions is a major problem, so patient will exhibit fatty stools and weight loss
35
Q

lactase defficiency

A

issue breaking down dairy cow milk

  • can’t break down lactose into monosaccharides and therefore prevents lactose digestion and monosaccharide absorption
  • isn’t broken down in small intestine then moves to large intestine where there is increased flatulance and diarrhea
36
Q

bile salt defficiency

A

can’t emulsify fat

  • conjugated bile salts are synthesized from cholesterol in the liver needed to emulsify and absorb fat
  • can results from liver disease and bile obstructions
  • poor intestinal absorption of lipids causes fatty stools, diarrhea, loss of fat-soluable vitamins (A, K, D, E)
37
Q

fat soluble vitamin deficiencies

A
  • vit A: retina vitamin, lack of clack and white vision, night vision
  • vit D: decreased calcium absorption, bone pain, osteoporosis, fractures
  • vit K: prolonged prothrombin time, pupura, petachiae, lack of clotting
  • vit E: regulates cell processes
38
Q

inflammatory disorders

A

chronic, relapsin inflammatory bowel disorders or unknown origin

  • genetics, allegations of epithelia barrier functions, immune reactions to intestinal flora, abnormal t cell responses
  • idiopathic
39
Q

gastritis

A

inflammation of stomach lining

  • inflame of gastric mucosa
  • acute - over consumption
  • chronic - infection, h pylori, nsaids, alcohol
40
Q

ulcerative colitis

A

large intestine

  • chronic inflamm causes ulceration of colonic mucosa - sigmoid colon and rectum
  • may lead to increased risk of colon cancer
41
Q

H pylori

A

normal in large intestine

- not normal in stomach or small intestine

42
Q

hematochysia

A

bleeding from colon

43
Q

chrohn’s disease

A

anywhere from mouth to anus

  • idopathic inflamm disorder that affects any part of digestive tract
  • difficult to differentiate ulcerative colitis with crohn’s
  • causes skip lesions (spots of necrosis) and cobblestone effect (deep ulcerations)
44
Q

diverticular disease of the colon

A

diverticula = out pouching
- herniations of mucosa through the muscle layers of the colon wall, especially the sigmoid colon

diverticulosis = one of more pouches

  • asymptomatic diverticular disease
  • weakening of intestinal wall

diverticulitis = inflammatory stage of diverticulosis

  • food traps in diverticula
  • tomato and chile seeds lodge in diverticula
45
Q

appendicitis

A

houses flora (bacteria)

  • inflamm of the vermiform appendix
  • possible causes are obstruction, ischemia, increased intraluminal pressure, infecton, ulceration
  • RLQ pain with rebound tenderness
  • rupture releases tons of bacteria
46
Q

irritable bowl syndrome

A

idiopathic

  • 20% worldwide
  • more common in women
  • youth and middle age
  • associated with anxiety and depression
47
Q

obesity

A

genetics, hormones, increase in body fat
- BMI greater than 30
- cause of morbidity, death, increased health care costs
risk factor for many diseases and conditions
- associated with hormone imbalances and hypothalamus dysfunction

48
Q

starvation

A

short term: glycogenolysis, gluconeogenesis (normal weight loss)
long term: marasmus (emaciated), kwashiorkor (protruding belly)

49
Q

portal hypertension

A

liver disorder

  • high BP in portal venous system caused by resistance to portal blood flow
  • varices: back up of venous blood that can lead to vein rupture and blend in the GI tract
  • splenogmegaly
  • ascites
  • hepatic encephalopathy
50
Q

hepatic encephalopathy

A

neurologic syndrome of impaired cognitive function

- develops rapidly during fulminant hepatitis or slowly during chronic liver disease

51
Q

jaundice

A

lack of bilirubin metabolism in liver leading to yellowing

  • obstructive jaundice - post hepatic and intrahepatic
  • hemolytic jaundice - perhepatic, excessive hemolysis of RBSs or absortion of a hematoma
52
Q

viral hepatitis

A

systemic viral disease of acute or chronic inflammation that primarily affects the liver

  • HEP A: infections hepatitis
  • HEP B: serume hepatitis
  • HEP C, D, E, G
53
Q

Hep A

A

transmitted by fecal-oral route

  • found in feces, bile, sera
  • risk factors - crowded, unsanitary conditions, food and water contamination
54
Q

HEP B

A

transmitted through contact with infected blood, body fluids, contaminated needles

  • maternal transmission can occur if the mother is infected during the 3rd trimester
  • can cause chronic hepatitis
  • hep B vaccine
55
Q

HEP C

A

responsible for most cases of post-transfusion hepatitis

  • also implicated in infectious related IV drug use
  • 50%-80% of hepatitis C cases result in chronic hepatitis
56
Q

HEP D

A

depends on HEP B for replication

57
Q

HEP E

A

fecal-oral transmission

- developing countries

58
Q

HEP G

A

recently discovered

- parentally and sexually transmitted

59
Q

Cirrhosis

A

irreversible inflammatory disease that disrupts liver function and even structure

  • slow development to chronic disease
  • decreased hepatic function caused by nodular and fibrotic tissue synthesis
  • biliary channels become obstructed and cause portal hypertension
  • blood shunted away from liver and hypoxic necrosis develops
  • alcoholic: oxidation of alcohol damages hepatocytes
  • bilary: cirrhosis begins in the bile canaliculi and ducts
  • fatty liver disease: fat build up causes fibrosis and scarring, NASH
60
Q

disorders of gallbladder

A

obstruction or inflammation (Cholecystitis) is most common cause of gallbladder problems

  • cholelithiasis - gallstone formation
  • cholesterol, most common
  • pigmented, cirrhosis
61
Q

disorders of pancreatitis

A
  • inflamm of pancreas
  • caused by injury or damage to pancreatic cells and ducts, causing leakage of pancreatic enzymes into pancreatic tissue
  • activated zymogens cause autodigestions of pancreatic tissue and leak into bloodstream to cause injury to blood vessels and other organs
  • chronic pancreatitis - related to alcohol abuse

Pathophysiology (13 decks)

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