LO1-2 Pathophysiology of GI Disorders

Question 1

Peristalsis

Answer 1

propel food bolus toward the stomach without involvement of brain stem

Question 2

Portal vein

Answer 2

transports venous blood from the GI tract directly to the liver for processing of nutrients that have been absorbed

Question 3

The cardiac sphincter

Answer 3

controls the amount of food that moves back up the esophagus

Question 4

Chyme

Answer 4

the materials that exit through the pyloric sphincter

Question 5

Duodenum

Answer 5

the portion of the small intestine that begins the absorption of nutrients and where the pancreas, liver and gallbladder connect to digestive system

Question 6

Stomach absorbs

Answer 6

water, fat soluble substances

Question 7

Alcohol is absorbed

Answer 7

rapidly in small intestine

Question 8

primary role of the large intestine

Answer 8

is to complete the reabsorption of water

Question 9

Abdominal disorders can result from

Answer 9

inflammation, infection, and obstruction

Question 10

Gastroesophageal reflux

Answer 10

occurs when acid, normally localized to

the stomach, enters the esophagus

Question 11

Other causes of gastroesophageal reflux are:

Answer 11

• Nicotine
• Fried or fatty foods
• Chocolate
• Coffee
• Citrus fruits and juices
• Peppermints
• Pregnancy

Question 12

Esophagitis

Answer 12

Esophagitis is the irritation and inflammation of the esophagus caused by stomach acids and
digestive enzymes repeatedly refluxing up from the stomach

Question 13

Esophagitis Signs and Symptoms

Answer 13

•Burning sensation in chest
•Pain when swallowing
•Dysphagia (caused by the narrowing of lower esophagus due to scarring resulting in food
sticking in the area)
•Bleeding if ulcers develop (noted by black stools, anemia and vomiting blood)

Question 14

Gastritis

Answer 14

Gastritis is an acute or chronic inflammation of the gastric mucosa caused by an increase gastric
acid secretion.

Gastritis is often associated with alcohol ingestion, drugs, and stress.

Question 15

Esophageal Varices
what is it
signs and symptoms
treatment

Answer 15

Condition: hemorrhagic

Pain, bright red blood, Melena, shock

Common with hepatic disease and often result from portal hypertension caused by cirrhosis of the liver

Tachy, hypotension, pale cool clammy skin

Give fluid to map of 65
Check peripheral pulses
Airway issues

Question 16

Bowel Obstruction
what is it
signs and symptoms
treatment

Answer 16

Signs include

• abdominal pain and fullness.
• Rigidity usually all over
• Look pregnant
• Diarrhea initially
• Constipation may eventually result.
• Nausea and vomiting are common in later stages
• Extreme cases have feculent breath

Management

• watch for sepsis
• Fluid resuscitation can be useful
• Needs fluid even if map is good

Question 17

Peptic Ulcer Disease

Answer 17

Protective layer of the stomach and small intestine erode allowing the acid to eat into the lining of the stomach
Condition: Acute inflammation
Pain, often relieved by food intake, bleeding

Question 18

Upper GI bleed

Answer 18

Mouth, stomach, esophagus
Condition: hemorrhagic
Pain, hemorrhage
Upper GI bleeding: The upper GI tract is located between the mouth and the upper part of the small intestine.

Question 19

Mallory-Weis Syndrome

Answer 19

the oesophageal lining tears during severe vomiting and may lead to severe haemorrhage and sepsis

Question 20

Perforated ulcer

Answer 20

when it eats all the way through the stomach

Question 21

Cholecystitis
what is it
signs and symptoms
treatment

Answer 21

-Gall stones, gall bladder attack

Obstruction of the cystic duct leading from the gallbladder to the duodenum, Inflammation of the gallbladder; usually by gallstones

Fever, jaundice, tachycardia

Gallbladder is in right upper under liver

Pain radiates to right shoulder

ALS for pain med
Give Zofran
Give IV for n/v meds

Question 22

cholecystjts Risk factors

Answer 22

Risk factors 
Females 
Pregnant 
Older people 
Caucasians 
Overweight or recent extreme weight loss

Question 23

Cirrhosis
what is it
signs and symptoms

Answer 23

• Cirrhosis is the final phase of chronic liver disease.
• irreversible scarring of the liver resulting in poor liver function.

Signs and symptoms

• Edema and ascites (fluid from the peritoneal cavity)
• Jaundice
• Itching
• Gallstones
• Medication sensitivity
• Toxicity

Question 24

Hepatitis

what is it
signs and symptoms

Answer 24

• Infectious
• Inflammation and damage of the liver
• Associated with the sudden onset of malaise, weakness, anorexia, intermittent nausea and vomiting, and dull RUQ pain

Question 25

hepatitis cause | treatment

Answer 25

- Causes o Viral(Hep A,B,C-in Canada D,E,F,G)  A and E: transmitted through fecal matter  B,C and D transmitted through contact typically sexual o Epstein Barr virus o Bacterial Infections o Liver Cancer - Pain meds from ALS - IV yes - O2 based on signs and symptoms of shock o Nasal cannula for n/v pts

Question 26

Pancreatitis what is it signs and symptoms

Answer 26

- Pancreas creates enzymes that we use to digest our food o Creates insulin - In the area of the epigastric - Some common contributing factors to pancreatitis are an increase in alcohol consumption and Gallstones - More prevalent in the male population - Can also be caused by certain medications, trauma, cancer Signs and Symptoms - Nausea and Vomiting - Sharp, Epigastric or RUQ pain that can radiate to back - Possible fever, tachycardia, hypotension, possible muscle spasms in extremities - Grey turner sign: bruising to flanks - Cullen sing: bruising around umbilical region

Question 27

Appendicitis what is it signs and symptoms

Answer 27

- Caused by an accumulation of material, usually feces. - Lower right - Obstruction of normal flushing - Ripe condition for bacterial reproduction - Can result in ultimate rupture, peritonitis ( generalized abdominal pain), sepsis, and death Signs and Symptoms - Periumbilical pain that migrates to RLQ - Duration is usually less than 48 hours - As the condition progresses the pain will change characteristics and locations - Guarding - Rebound tenderness (parietal pain): doesn’t hurt when you push but when you let go it hurts

Question 28

Diverticulitis what is it signs and symptoms

Answer 28

- Is caused typically by a decrease in fiber intake - Consistency of stool become more solid - Hard stools take more contractions - Small defects in colonic wall fail - Diverticula: Feces become trapped in these pouches - Fistula: abnormal connection between two cavities and are typically found between colon and bladder - Can occur anywhere in the colon but most common in LLQ Signs and Symptoms - Abdominal pain - Tends to be localized to the left side of the lower abdomen - Classic signs of infection - Fever, malaise, body aches, chills, nausea, and vomiting

Question 29

Crohn’s Disease:

Answer 29

- May affect the entire GI tract - Immune system attacks the GI tract. - Most likely site of inflammation is the ileum. - Scarred, narrow, stiff, and weakened portion of the small intestine

Question 30

Ulcerative Colitis what is it signs and symptoms

Answer 30

``` Caused by o Generalized inflammation of the colon o Chronic inflammation o Thinning of the wall of the intestine o Weakened, dilated colon prone to infections by bacteria and bleeding o Most common second decade of life ``` - Signs and Symptoms o Bloody diarrhea o Abd pain (mild to severe)

Question 31

Lower GI bleeding

Answer 31

- The lower GI tract is located between the upper part of the small intestine and the anus. The lower GI tract includes the small and large bowels. - Intestinal Bleeding Causes – Polyps, ulcers, diverticulitis, tumors, radiation therapy - Rectroanal Area bleeding – Hemorrhoids resulting from straining

Question 32

Hemorrhoids

Answer 32

- Swelling and inflammation of blood vessels surrounding the rectum - Common problem - Increased pressure on the rectum - Irritation of the rectum

Question 33

Bowel Obstruction

Answer 33

- Presentation Varies according to the underlying cause - Signs include abdominal pain and fullness. o Rigidity usually all over o Look pregnant - Diarrhea initially - Constipation may eventually result. - Nausea and vomiting are common in later stages - Extreme cases have feculent breath

Question 34

- Hematochezia

Answer 34

bright red bleeding

Question 35

- Hyperperistalsis | - Hypoperistalsis

Answer 35

- Hyperperistalsis: Increased activity in the bowel | - Hypoperistalsis: decreased bowel sounds

Question 36

- Absent bowel sounds

Answer 36

mean no sounds for 2 mins

Question 37

- Biliary pain

Answer 37

commonly radiates around the right side of the back and angle of the scapula

Question 38

- Pancreatic pain

Answer 38

goes straight through the epigastrium to the back in the midline

Question 39

- Blood/puss under the diaphragm

Answer 39

may present as pain in the top of the shoulder

Question 40

- A leaking or ruptured aneurism

Answer 40

causing abdominal pain and back pain which may radiate to upper thighs

Question 41

- Uterine and rectal pain

Answer 41

will present in suprapubic area, lower back or both

Question 42

Visceral pain

Answer 42

- Hollow organs - Difficult to localize: described as burning, cramping, gnawing or aching usually felt superficially - Cause: organ contracts too forcefully or is distended (stretched)

Question 43

Parietal pain/ rebound pain

Answer 43

- Peritoneum - Steady, achy pain, more easy to localize than visceral, pain increases with movement - Causes: inflammation of the peritoneum

Question 44

Somatic pain

Answer 44

- Peripheral nerve tracts - Well localized pain usually felt deeply - inflammation or injury to tissue, causing activation of peripheral nerve tracts

Question 45

Referred pain

Answer 45

- peripheral nerve tracts - pain originating in the abdomen and causes pain in distant locations; similar paths for the peripheral nerves of the abdomen and the distant location - causes: usually occurs after an initial visceral, parietal or somatic pain