Test #1 Flashcards
(110 cards)
0
Q
The hollow tube that begins at the mouth & continues through the body to the anus
A
Alimentary Canal (GI tract)
1
Q
What is the order of examination?
A
Inspection
Auscultation
Percussion
Palpation
2
Q
What are the 4 major organs of the GI tract?
A
Esophagus
Stomach
Small Intestines
Large Intestines
3
Q
What are the 4 appendages (organs) of the GI?
A
Salivary glands
Liver
Gallbladder
Pancreas
4
Q
2 Primary functions of the GI tract?
A
Assimilation - digestion & absorption
Elimination
5
Q
Part of assimilation process that occurs as a result of both physical & chemical processes
A
Digestion
6
Q
Cardinal Signs/Symptoms of GI pathology
A
Heartburn, Indigestion, Dysphasia, Chest pain, Abdominal Pain, Nausea, Vomiting, Gas, Distention, Diarrhea, Constipation, Weight loss, Bleeding
7
Q
Hormone that stimulates stomach cells to produce acid for digestion
A
Gastrin
8
Q
Hormone that controls pancreatic digestive enzyme secretion controls bile production form the liver
A
Secretin
9
Q
Hormone that causes pancreas to produce pancreatic enzymes & stimulates gallbladder emptying; stops the production of stomach acid
A
Cholecystokinin
10
Q
How long is the small intestine?
A
21-25 ft long
11
Q
Disease of the Ileum causes what type of problems?
A
Fat malabsorption syndromes
12
Q
What vitamins are stored in the liver?
A
B-12, D, A, K,E
13
Q
The gallbladder secretes bile into the duodenum via contraction of what?
A
Cystic duct into common bile duct
14
Q
What nutrients are broken down by trypsin/chymotrypsin?
A
Proteins
15
Q
What is the nervous system that controls the digestive system called?
A
Enteric or Intrinsic
16
Q
This plexus is located b/w the longitudinal & circular layers of muscle in the tunica muscularis. It’s primary function is control of digestive tract motility
A
Myenteric Plexus
17
Q
What is the primary function of the submucosa plexus?
A
Senses the luminal environment
18
Q
What 3 arteries provide the main blood supply to the GI tract?
A
Celiac Artery
Superior Mesenteric Artery
Inferior Mesenteric Artery
19
Q
What are the walls of the GI tract from innermost to outermost?
A
Mucosa
Submucosa
Muscularis Propia
Adventitia (Serosa)
20
Q
What are the 4 protective mechanisms of the GI tract?
A
Sensory Mechanism - ability to reject food based on sensory input from mouth, nose, tongue working together
Physical Mechanism - Mucus present on mucosa traps & coats pathogens
Chemical Mechanism - Stomach acid & detergents in SI kill bacteria
Immune Mechanism - Found in specialized lymphoid, M-cells located in mucosal layer
21
Q
Narrowing or complete blocking of an area is called what?
A
Obstruction
22
Q
Type of obstruction where the bowel is twisted
A
Volvulus
23
Q
Type of obstruction where one part of bowel is pulled into distal lumen by peristalsis
A
Intususseption
24
Type of obstruction in which part of bowel loses its peristaltic ability (usually d/t loss of innervation) causing the bolus to serve as a blockage
Ileus
25
An out-pouching of the intestine
Diverticula
26
Vomiting up of blood
Hematemesis
27
Black, tarry stools usually indicative of upper GI bleeding
Melena
28
Gross passage of frank (bright red) blood through the rectum, usually indicative of lower GI bleeding
Hematochezia
29
What is the composition of the lower esophageal sphincter?
Upper 1/3rd of esophagus = skeletal muscle
| Lower 2/3rds of esophagus = smooth muscle
30
What is an example of a generalized smooth muscle disorder that affects only distal portion of esophagus?
Scleroderma
31
Which is not a function of the esophagus?
- Transfers food & liquid bolus from pharynx to stomach
- Isolates upper GI tract from outside world
- Prevents reflux from stomach
- Communication b/w upper GI tract & outside world
Esophagus is not a communication b/w upper GI tract & the outside world
32
Is the LES normally in a relaxed or contracted state?
Contracted state
33
Difficulty swallowing is called what?
Dysphagia (M/C manifestation of esophageal disease)
34
What is pain produced w/ swallowing called?
Odynophagia
35
What is difficulty emptying material from the oropharynx into the esophagus called?
Oropharyngeal dysphagia
36
When a pt has problem swallowing solids only, specifically meat & bread, what type of obstruction do they have?
Mechanical obstruction
37
What are 2 intrinsic disorders that cause mechanical obstruction?
Peptic strictures
| Esophageal cancer
38
What is an extrinsic disorder that causes mechanical obstruction?
Enlarged L atrium
39
Failure of a ring of muscle around a sphincter to relax is called what?
Achalasia
40
Dysphagia of both solids & liquids is caused by what type of obstruction/disorder?
Motility obstruction/disorder
41
Abnormal pouch in which food can b/co trapped just superior to UES is called what?
Zenker's diverticulum
42
2-4mm mucosal stricture (probably congenital) causing ring-like narrowing of distal esophagus at squamocolumnar junction (just above LES)
Shatzki's Ring
43
A thin mucosal membrane that grows across lumen of esophagus
Esophageal Web AKA's Plummer-Vinson Syndrome, Paterson-Kelly Syndrome, Sideropenic Dysphagia
44
Compression of the esophagus from any of several congenital vascular abnormalities. M/C vascular abnormality from R subclavian art. arising from L side of aortic arch
Dysphagia Lusoria
45
Motility (motor) disorders that causes dysphagia involve what part of the esophagus?
Lower 2/3rd (smooth muscles)
46
Achalasia is AKA?
Cardiospasm
Esophageal Aperistalsis
Megaesophagus
47
What is NOT a common symptom of achalasia?
Chest pain
48
A barium x-ray that reveals a "gourd-like" dilation w/ narrowed "bird's beak" ending at lower esophageal sphincter area is assoc. w/ diagnosing what disorder?
Achalasia
49
One of many motility disorders characterized by non-propulsive contractions, hyperdynamic (spastic) contractions, or elevated LES pressure.
Symptomatic Diffuse Esophageal Spasm AKA Spastic Pseudodiverticuolsis AKA Rosary Bead/Corkscrew esophagus
50
How is Symptomatic Diffuse Esophageal Spasm diagnosed?
Barium x-ray
| Manometry
51
Zenker's (pharyngeal) diverticula go post. through the cricopharyngeal muscle as a result of what?
UES not relaxing
52
Where do epiphrenic diverticula occur?
Just above the diaphragm (just above the LES)
53
Sudden appearance of copious amounts of bitter tasting saliva (or fluids) in the mouth
Waterbrash
54
Pain upon swallowing
Odynophagia
55
Regurgitation of food after eating & then re-chewing it & swallowing it again
Rumination
56
Spitting up of gastric contents w/o assoc. nausea or forceful abdominal contractions
Regurgitation
57
When the LES is incompetent it allows gastric contents to back up into esophagus. Occurs in approx. 40% of adults & frequently in infants
GERD
58
Prolonged reflux may lead to esophagitis which can then progress to stricture & sometimes further progress into metaplasia
Barrett's Esophagus
59
What are risk factors for GERD?
```
Weight gain
Fatty food
Caffeinated or carbonated beverage
Alcohol
Tobacco smoking
```
60
What is the typical symptom of GERD? Occurs 30-60mins after meals & sometimes upon reclining or bending over
Heartburn
61
What lifestyle changes are the initial approach to treating GERD?
Eating smaller meals
Exclude foods that reduce LES pressure
Quit smoking
No sleeping/laying down until minimum 2-3 hours post prandial
Avoid tight clothing
Reduce body weight by at least 5-10lbs
Raise the head of the bed 6" off the ground
62
What is the mainstay tx for most pts w/ GERD?
Antacids
63
Barrett's Esophagus is a premalignant condition that may later develop into what?
Adenosarcoma
64
Protrusion of stomach through diaphragmatic hiatus. Dx by barium swallow.
Hiatal Hernia
65
Makes up 90% of hernias. Stomach slides up & down through diaphragmatic hiatus
Sliding hiatal hernia
66
What type of hernia is M/C in females?
Femoral
67
Non-penetrating mucosal laceration of distal esophagus &/or prox. stomach caused by vomiting, retching, or hiccupping
Mallory-Weiss Syndrome
68
What is the major sign/symptom of Mallory-Weiss Syndrome?
Hematemesis (vomiting up of blood)
69
Gaseous feeling, feeling of fullness that may also be a gnawing or burning pain that's localized in epigastric region (sometimes substernal) that has no specific cause
Dyspepsia AKA Indigestion, Stomach ache, stomach cramps, stomach spasms
70
What are symptoms of dyspepsia?
Heartburn
Nausea
Anorexia
Abdominal Distention
71
Parotid tumors are generally ______ while submandibular & sublingual are more likely ________
Benign; malignant
72
What are the 3 major functions of saliva?
Lubrication
Oral Hygiene
Enzymatic function
73
Bilateral swelling of the salivary glands w/ pain often indicates what?
Systemic infection (mumps)
74
Unilateral swelling of the salivary glands usually indicates what?
Acute salivary obstruction (by salivary stone)
75
Chronic unilateral painless swelling of the salivary gland may indicate what?
Salivary tumor
76
Dryness of mouth usually a defective sense of taste & difficulty chewing or swallowing food
Xerostomia
77
Small ulcers in lining of mouth that are frequently painful & sensitive. Develop usually on the movable parts of mouth (tongue, cheeks, inside lining of cheeks)
Canker sores
79
Any disorder that impairs secretion of both salivary glands & lacrimal glands of eyes
Mikuliczs Syndrome
80
Inflammation of any salivary gland
Acute Sialadenitis
81
Salivary gland obstruction d/t a stone; salivary gland formation
Sialolithiasis
82
Over half of all salivary gland neoplasms are what type?
Benign Pleomorphic Adenomas
83
Type of salivary gland neoplasm that is M/C in men & M/C occurs in parotid gland
Warthin's Tumor AKA Papillary Cystadenoma Lymphomatosum
84
Malignant Salivary Gland tumors usually arise where?
In the sublingual salivary glands
85
What is the M/C malignant salivary neoplasm?
Adenocarcinoma (2nd M/C is Adenoid Cysti Carcinoma)
86
Spitting up blood is called what?
Hemoptosis
87
Vomiting up blood is called what?
Hematememis
88
Suspensory muscle of duodenum which attaches from diaphragm to duodeno-jejunal flexure
Ligament of Treitz (anything above is Upper GI)
89
Dilated veins in distal esophagus or prox. stomach caused by increase pressure in portal venous system, typically by cirrhosis
Varices
90
Gross passage of blood through the rectum
Hematochezia
91
Black tarry stool. Indicative of Upper Gi bleeding
Melena
92
What are common causes of Upper GI bleeding?
```
Duodenal Ulcers (M/C)
Gastric/Duodenal Erosions (M/C)
Varices
Gastric Ulcer
Mallory-Weiss Tear
Erosive Gastritis
```
93
Common causes of lower GI bleeding?
```
Anal fissures
Colitis (test question)
Colonic carcinoma
Colonic Polyps
Diverticular disease
```
94
What are the 3 main stomach functions?
Motor (mixes food & acid together
Secretory (produces acid, pepsin, water, IF, & electrolytes)
Endocrine (Gastrin & somatostatin)
95
What are 2 things that interfere w/ the mucus & bicarbonate layers & predispose the stomach to gastritis & peptic ulcer disease?
NSAIDS
| Helicobacter pylori
96
General term that applies to any inflammation of the stomach mucosa
Gastritis
97
What are symptoms of gastritis?
Dyspepsia (indigestion)
Nausea
Upper abdominal bloating
Epigastric pain
98
What is the main difference b/w acute gastritis and chronic gastritis?
Moderate fever w/ acute gastritis & no fever w/ chronic gastritis
99
Refers to a variety of histological abnormalities that are mainly a result of Helicobacter pylori infections
Non-erosive Gastritis
100
Used to diagnose presence of H. Pylori bacteria
Rapid Urease Test (RUT)
101
Enlarged gastric rugae w/ excess mucus secretion; Barium studies shows "bag of snakes" appearance
Hypertrophic Gastritis
102
Disease that affects the pancreas & duodenum. Produces tumors (gastromas) which produce gastrin that stimulates increased stomach acid production which produces severe peptic ulcers
Zollinger-Ellison Syndrome (rare)
103
What is the main cause of peptic ulcer disease?
H. Pylori bacterial infection
104
How is peptic ulcer disease diagnosed?
Urea breath test
| Rapid Urease Test
105
What are symptoms/signs assoc. w/ peptic ulcer disease?
Gastric/Duodenal Ulcers - burning, gnawing or deep hunger type pain
Gastric Ulcers - eating tends to exacerbate pain
Duodenal Pain - Relived by food
106
What is the tx for peptic ulcer disease?
50% of duodenal ulcers & a smaller % of gastric ulcers heal spontaneously
107
Phase of stomach acid secretion where sight, smell, or thought of food stimulates stomach acid secretion via vagal nerve stimulation
Cephalic Phase
108
Phase of stomach acid secretion that occurs when food enters stomach & causes distention (enlargement), which causes hormone Gastrin to be, released which in turn causes release of more stomach acid
Gastric Phase
109
Phase of stomach acid secretion when food moves into duodenum & stretch receptors detect distention causing release of Somatostatin & Cholecystokinin, which inhibit release of Gastrin, which in turn stops secretion of stomach acid
Intestinal Phase
110
Paralysis of the stomach
Gastroparesis
