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NURS 2514 > GI system: week 2 (prep material) > Flashcards

GI system: week 2 (prep material) Flashcards

1
Q

what’s the difference between an voluntary and involuntary process when referring to the GI system

A

A voluntary GI process is something that you can decide on (ex. Chewing and swallowing food is an example of voluntary, digestion is involuntary)

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2
Q

what are the 4 layers of the digestive tract from inside to outside

A

Mucosa
submucosa
muscularis
serosa

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3
Q

what does the mucosal layer of the digestive tract do

A

it is an epithelial layer that produces mucous, digestive enzymes, and absorbs nutrients

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4
Q

which layer of the digestive tract would cause a change in food absorption if damaged?

A

mucosa

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5
Q

what is the submucosa and what does it contain?

A

it is connective tissue containing nerves, blood and lymph vessels

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6
Q

what does the muscular of the digestive tract do?

A

it is a smooth muscle layer that preforms paristalsis which moves food through Gi tract

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7
Q

what does the serosa do?

A

it is the outer connective tissue layer that forms the visceral peritoneum

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8
Q

why would it be bad if there was an issue with the serosa?

A

because the peritoneum is large so issues with it will be wide spread

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9
Q

what are the four gastric glands and what do they produce

A

Mucous neck cell: basically forms the mucosal layer of the stomach, protects the stomach from its own digestive enzymes
chief cell: pepsinogen
parietal cell: HCL
Endocrine cell: histamine

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10
Q

why are mucous cells so important?

A

they protect the stomach from its own digestive enzymes so that it doesn’t cause a gastric ulcer

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11
Q

what does the villi mucousa do?

A

it increases the surface area of the small intestine to maximise absorption

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12
Q

what do the crypts do in the large intestine?

A

they aide in reabsorption of fluid and electrolytes, if there is an issue with these it will cause F&E imbalances

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13
Q

where is most alchohol absorbed

A

in the small intestine (jejunum)

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14
Q

which neurons control swallowing

A

skeletal motor neurons

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15
Q

what are the three major symptoms associated with GI disorders

A

anorexia
nausea
vomiting

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16
Q

why is it important to know what is triggering vomiting

A

it helps us know what antiemetic to use because they trigger different things

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17
Q

define nausea

A

subjective feeling of discomfort in the epigastrium

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18
Q

which receptors does the vestibular system use (nausea and vomiting brain mechanisms)

A

Muscarinic receptors

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19
Q

which receptors does the enteric and vagus nervous system use to cause nausea and vomiting

A

serotonin receptors

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20
Q

which part of the brain will cause commixing from stress or strong emotions

A

the CNS

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21
Q

which receptors does the CTZ use?

A

dopamine, serotonin, opiate, acetylcholine

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22
Q

what are 3 complications that can occur with constant vomiting

A
  • aspiration: stomach contents enter respiratory tract
  • Mallory weiss tear: tear in mucosal lining of esophagus
  • fluid and electrolyte imbalance: metabolic alkalosis
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23
Q

why would prolonged vomiting cause metabolic acidosis

A
  • physical loss of bicarb (basic)
  • forceful vomiting produces lactic acid from the effort, which consumes bicarb
  • ketoacidosis from body trying to find energy from fat because you can’t consume glucose if you’re vomiting
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24
Q

what is the main structure that causes GERD

A

the lower oesophageal sphincter (it tightens during normal digestion, GERD is abnormal relaxation, and the stomach contents of back up into esophagus)

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25
Q

what is pyrosis

A

heartburn

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26
Q

when would pyrosis occur

A

it would typically occur 30-60 minutes after a meal, worse when bending at the waist

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27
Q

define regurgitation

A

effortless return of gastric contents, often described as hot butter r sour liquor

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28
Q

what is esophageal stricture?

A

narrowing of esophagus caused by scar tissue formation which can lead to dysphagia (as a response to ongoing inflammation)

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29
Q

what is Barrett’s esophagus and why is it a significant compliation of GERD

A

long term inflammation can cause change in cell structure of esophagus to resemble stomach/intesting (stratified squamous turns into simple columnar epithelium)

only 10% of patients will develop cancer

30
Q

what is a hiatal hernia

A

portion of stomach pushing into the esophagus through an opening in the diaphragm

31
Q

what would symptoms look like in a patient with hatial hernia

A

symptoms will be similar to GERD and often occur when supine, after a large meal, and with smoking/alcohol

32
Q

what are 2 contributing factors that could lead to a hiatal hernia

A
  1. weakening of muscles around the diaphragm around esophogastric opening
  2. increase in intra abdominal pressure (ex. obesity, pregnancy, heavy lifting)
33
Q

how would symptoms of oesophageal cancer progress

A
  1. starts off asymptomatic
  2. you would notice dysphagia with meat, then soft food, then liquids
  3. then neck pain
  4. sore throat
  5. weight loss
34
Q

what is a complication of esophageal cancer

A

bleeding as tumour erodes the mucosal lining of esophagus

35
Q

why can GERD cause respiratory symptoms

A

if you aspirate stomach contents (which is very possible) that is BAD

36
Q

Why would oesophageal cancer cause dysphagia

A

because tumour restricts esophagus which makes food harder to get down

37
Q

what is PUD

A

Peptic Ulcer Disease occurs when lesions are caused by exposure of the stomach mucose to HCL acid-pepsin secretions (which are used to break down food)

38
Q

what are the two most common causes for PUD

A

H. pylori infection and NSAID use

39
Q

what are some preventative risk factors for PUD

A

diet (lack of high fibre foods and vitamin A)
smoking
alcohol
stress

40
Q

what do prostaglandins do

A

they promote secretion of bicarb and protective mucous, suppress secretion of gastric acid so it doesn’t go all crazy, and it maintains a submucosal blood flow via vasodilation

41
Q

why would NSAIDS cause PUD

A

because they suppress prostaglandins which causes a decrease in mucous production, increased gastric acid and vasoconstriction

42
Q

how deep is a chronic ulcer

A

it would go al the way down to the serosa (deepest layer from stomach to abdomen)

43
Q

what’s the difference in symptoms of a gastric ulcer vs. a duodenal ulcer

A

gastric will have gaseous pain in the epigastric area which occurs 1-2 hours after eating
duodenal will have cramp like pain in midepigastric 2-4 hours after eating

44
Q

where would pain be located in a gastric ulcer

A

in the epigastric area

45
Q

where would pain be located in a duodenal ulcer

A

midepigastric of back pain

46
Q

what is hematemesis

A

blood in vomit

47
Q

what is occult blood

A

small amount of blood in stool, only detected when stool is sent for testing

48
Q

how could PUD cause peritonitis

A

If the ulcer perforates and gastric contends enter peritoneal cavity (life threatening because its a sterile area, may cause sepsis)

49
Q

how would PUD cause emesis

A

if there is a gastric outlet obstruction (ongoing inflammation can obstruct a gastric outlet which means things won’t go down as easy)

50
Q

what are the 3 major complications of PUD

A

haemorrhage, perforation, gastric outlet obstruction

51
Q

what are 3 common causes of diarrhea

A
  • decreased fluid absorption
  • increased fluid secretion
  • mobility disturbances
52
Q

how would mucosal damage cause diarreha

A

it can decrease fluid absorption which in turn will cause water to stay in digestive tract so stool is not properly formed

53
Q

why would someone experiencing diarrhoea also experience kussmauls respirations (heavy breathing)

A

prolonged diarrhoea will result in loss of bicarbonate which will cause metabolic acidosis
your body will try and compensate by breathing faster and deeper to get rid of acidic CO2

54
Q

why would someone with diarrhoea experience cardiac arrhythmias

A

because they are likely hypokalemic from losing potassium in stool

55
Q

what’s the difference between melena and frank rectal bleeding

A

melena is black stool and indicates and issue with the upper GI
frank rectal bleeding will be bright red and indicate an issue in the lower GI tract

56
Q

what are some risk factors for constipation (just broad categories)

A
  • diet
  • medications
  • metabolic and muscular disorders
  • structural and functional abnormalities
  • physiologic reasons
57
Q

what happens to the appendix to cause it to become inflamed

A

obstruction (by fecalith/hard piece of feces) or twisted bowel

58
Q

what causes pain in appendicitis

A

obstruction causes pressure within appendix which leads to schema and necrosis which will cause pain `

59
Q

why is an inflamed appendix so dangerous

A

because it can rupture into the peritoneum which is life threatening

60
Q

what is the mcburney point

A

area where the appendix is located in the right lower quadrant

61
Q

what are some indicators of appendicitis

A

anorexia, N/V, rebound tenderness, persistent and continuous pain

62
Q

What is peritonitis

A

inflammation of peritoneal membranes from chemical irritation or bacterial infection

63
Q

what is gastroenteritis

A

inflamation of the mucosa of the stomach and small intestine due to an infection (the stomach flu)

64
Q

what are the 2 types of IBD

A

Crohn’s disease and Ulcerative colitis (both chronic and autoimmune)

65
Q

what’s the difference between crohns and ulcerative colitis

A

crohns: affects ileum and any other part of the GI tract (can skip around) , deep
ulcerative colitis: more superficial to mucosa and submucosa, affects rectum and up

66
Q

how can a patient with an intestinal obstruction become hypotensive

A

swelling will increase pressure on fluid wall, fluid will exit the CV system and enter the intestine which will cause low circulating fluid = hypotenstion

67
Q

which IBD is more likely to cause wight loss

A

Crohns

68
Q

what are the two types of intestinal obstuction

A

mechanical (something physical is blocking)
nontechnical: occupes from a numerological impairment or peristalsis aint working (often called paralytic ileus)

69
Q

what’s the difference in symptoms between an obstruction in the small bowel vs. large bowel

A

small bowel will have rapid onset of symptoms, it will be crampy and usually involves vomiting since its so high up in the tract
large bowel will include low grade cramping with significant abdominal distention and no BM (minimal N/V because food has to accumulate farther

70
Q

where is the most common place for colorectal cancer to occur

A

in the colon within reach of sigmoidoscope

NURS 2514 (31 decks)

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