Pathophysiology of the GIT Flashcards
features of a bulbar palsy
LMN lesion reduced palatal sensation reduced gag choking dysphasia flaccid tongue
features of a psuedobulbar palsy
UMN lesion
Spastic tongue
jaw jerk increase
What can cause dysphagia
Benign obstruction
oesophageal carcinoma
achalasia - peristalsis failure
What is Gastro oesophageal reflux disease (GORD)
Transient relaxation of lower oesophageal sphincter between meals
loss of valve effect of an intra-abdominal oesophagus/diaphragmatic constriction
fialure of mucosal defence mechanisms
What are some consequences of GORD
Oesphagitis and heartburn
increase in ?
Treatment for GORD
Weight loss
Aliginates to heal mucosa
antacids
reducing acid production
Side effects of a large amount of vomiting
large fluid loss - dehydration
HCl loss- risk of hyperchloremic alkalosis
Features of bowel obstruction
Pain Nausea/vomiting/constpiraion sounds dehdration abdominal distension X-ray signs
Causes of bowel obstruction
Lumen blocked
Wall tumour
Adhesions
ileus
Causes of diarrhoea
Increase in intestinal activity
Malabsorption
increase in intestinal secretion
Intestinal inflammation
2 Common microorganisms associated with
e. coli
c difficile
What can diarrhoea lead to
Dehydration
K+ and HCO-3 loss
hypokaelamia metabolic acidosis
Common bowel defects
IBD
infective dysentry - cause of dehydration
not reabsorb water in a large bowel
features of constipation
< 3 stools a week straining more than 25% of the time hard stools ( grading ) incomplete evacuation anrectal blockage
What is meant by transit time
Time taken from mouth to anus
What are defactory disorders
Contraction of EAS
anterior rectocele
rectak prolapse during straining
What is meant by a megacolon
Dilated colon
Prolonged constipation
Hirschprungs disease- non- functioning rectum
Management for megacolon
May need to be surgical perforation
Dietary fibre and fluid
Laxatives- acute releif
Neuro/psychological causes of faecel incontinence
Spinal trauma - transection Stroke Nerve damage Dementia Spina bifida MS
Causes of anal sphincter dysfunction
AR nerve damage
Perineal descent
Problems with the slaivary glands
Dry mouth - Sjug rens syndrome - drugs - dehydration/shock Salivary duct obstruction
Gastric acid secretion 3 phases
Cephalic phases
gastric phase
intestinal phase
What is malabsorption
Failure of digestion and absorption
Why would there be failure of digestion
pancreatic failure
specific failure
bile salt failure
