Week 10- GI System 1 Flashcards by Amber Zimmer

Includes mouth, esophagus, stomach, and duodenum

Upper GI tract

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The upper GI tract aids in the…

Ingestion and digestion of food

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Consists of the small and large intestines

Lower GI tract

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___________ accomplishes digestion and absorption of nutrients

Small intestine

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____________ absorbs water and electrolytes, storing waste products of digestion until elimination

Large intestine

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Function completely independently of the CNS and have its own psycho-neuroses

Enteric nervous system

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True or false: The enteric nervous system is based on a mind-body connection

True

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This makes up the mind-body connection of the enteric nervous system

Emotions, brain functions, GI functions

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Gut immune system has _____% of the body’s immune cells

70-80

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True or false: The development and expression of the gut is dependent on systemic immunity

False

(independent)

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True or false: Reduction of normal bacteria in the gut after antibiotic treatment or in the presence of infection may interfere with the nutrients available for immune function in the GI tract

True

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Signs and symptoms of GI disease

-Nausea
-Vomiting
-Diarrhea
-Constipation
-Dysphagia
-Achalasia
-Heartburn
-Abdominal Pain
-Ischemic pain
-GI Bleeding
-Fecal incontinence
-Referred pain

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SLIDE 6-9

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Most common GI problems in older adults

Constipation, incontinence, and diverticular disease

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True or false: Alimentary organs like all muscular structures, never lose some tone with age and still manage to perform almost as well in age as in youth

False

(they do lose some)

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Changes within the alimentary tract include decreases in…

-Gastric motility
-Blood flow
-Nutrient absorption
-Volume and acid content of gastric juice

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Esophageal hiatus of the diaphragm becomes enlarged, allowing the stomach to pass through the diaphragm into the thoracic cavity

Hiatal hernia

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True or false: A hiatal hernia can be congenital or acquired

True

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90-95% of hiatal hernias are _________

Sliding hernias

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The remaining hiatal hernias (5-10%) are __________

Rolling/para-esophageal hernias

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The stomach and gastroesophageal junction are displaced upward into the thorax

Sliding hernia

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The gastroesophageal junction stays below the diaphragm, but all or part of the stomach pushes through into the thorax

Rolling/para-esophageal hernias

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-5 per 1000 people
-Increases w/ age (60% in people > 60 y/o)
-Women > men

Hiatal hernia

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Causes of increased intraabdominal pressure

-Lifting
-Straining
-Bending over
-Prolonged sitting or standing
-Chronic/forceful cough
-Pregnancy
-Ascites
-Obesity
-Congestive heart failure
-Lower fiber diet
-Constipation
-Delayed bowel movement
-Vigorous exercise

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Symptoms of hiatal hernia

-Heartburn -Reflux

Heartburns can occur _____ minutes after a meal and are posture related

30-60

Heartburn contributes to incompetence of the ___________ allowing acid into the esophagus

Lower esophageal sphincter (LES)

This contributes to GERD

Reflux

Reflux is associated with ___________ pain

Substernal

Regarding hiatal hernias, avoid flat supine position and any exercises requiring the ______________

Valsalva maneuver

True or false: A client with hiatal hernia does not have to be warned against activities that cause increased intraabdominal pressure or receive safe lifting instructions before discharge

False (they have to be warned)

The consequences from the reflux (backward flow) of gastric contents into the esophagus accompanied by a failure of anatomic and physiologic mechanisms to protect the esophagus

GERD

GERD can be...

Erosive or non-erosive

GERD occurs in ____% of adults and _________ with age

10-20 Increases

Causes of GERD

-Decreased pressure of LES or alteration in esophageal acid clearance -Gastric contents near junction

In healthy people, three factors to remain healthy esophagus...

-Anatomic barriers between the stomach and the esophagus -Mechanisms to clear the esophagus of stomach acid -Maintaining stomach acidity and acid volume

True or false: People with GERD have consistently low pressure of the LES or altered protective mechanisms due to the causes

True

_____________ should be distinguished and evaluated before chest pain is assumed to be related to GERD

Cardiac chest pain

Adults > ____ y/o are more likely to have atypical symptoms

Atypical symptoms of GERD

Dysphagia Vomiting Respiratory difficulties Weight loss Anemia Anorexia with or without heartburn or acid regurgitation

3 extra-esophageal manifestations

Asthma Cough Laryngitis

Treatment for GERD

Lifestyle modifications Medications Surgery

Lifestyle modifications for GERD

Avoid aggravating food, smoking cessation and encouraged to reduce alcohol consumption, weight loss and elevation of the bed etc.

Medications for GERD

Nonprescription antacids, H2 blockers, and proton pump inhibitors (PPIs)

True or false: People with GERD may have trouble exercising, because some types of physical activity can worsen symptoms

True

Strenuous exercise inhibits both ________ and _________ emptying

Gastric Small intestine

GERD induced by strenuous exercise is common among _________

Athletes

Avoid _________ meals or ________ foods (or other triggers) immediately before exercising to avoid or minimize exercise-related GERD

High-calorie Fatty

________ position should be scheduled before meals and avoided just after eating. ________lying is better.

Supine Left

A break in the lining of the stomach or duodenum of 5 mm or more owing to a number of different causes

Peptic ulcer disease (PUD)

Types of PUD ulcers

Gastric Duodenal Stress

Occur in response to significant physiologic stress (e.g., severe trauma, surgery, extensive burns, brain injury)

Stress ulcers

Most common causes of PUD

NSAIDs Low-dose aspirin H. pylori bacterial infection

Risk factors for PUD

Psychologic stress Diet Caffeine Tobacco use Alcohol consumption

Mucous and bicarbonate layer, an epithelial barrier, prostaglandins, and adequate mucosal blood flow

Mucosal defenses

Acid, pepsin, alcohol, bile salts, drugs

Contributing mucosal insults

If there is an imbalance between mucosal insults and mucosal defenses, an _________ can form

Ulcer

There are symptoms or physical findings specific/sensitive for PUD. Many people with NSAID-induced PUD have pain at diagnosis.

False (no symptoms or physical findings, they do NOT have pain)

PUD is often discovered because of __________ or is noted on _______

Bleeding EGD

The classic symptom of PUD, when present, is _________ pain described as...

-Epigastric -Burning, gnawing, or cramping near the xiphoid or radiating to the back

PUD pain may be relieved with _________ or occur at ________

Eating Night

PUD complications

-Bleeding -Perforation -Penetration -Gastric outlet obstruction

PUD PT implications

-Monitoring symptoms and vital signs -Referred pain patterns -Moderate exercise training reduces the risk of GI bleeding

Perforate and hemorrhage cause __________

Back pain

Ulcer pain radiates to the...

Mid-thoracic back and right shoulder pain

True or false: PUD MSK symptoms may recur after discontinuing NSAIDS, owing to the masking effects of these drugs

True

_________ exercise training reduces the risk of GI bleeding

Moderate

A polygenic disease with complex interactions between gut microbiota, host immunity, and intestinal mucosal response

Inflammatory bowel disease

A chronic, lifelong inflammatory disorder that can affect any segment of the intestinal tract, although most commonly it affects the ileum and/or colon

Crohn disease

A chronic inflammatory disorder of the mucosa of the colon, typically involving the rectum, which can then advance proximally in a continuous manner to involve the entire colon

Ulcerative colitis

SLIDE 47-49

Joint involvement ranging from _________ to _________ is the most common extra-intestinal finding in IBD

Arthralgia Acute arthritis

___________ associated with IBD is usually continuous and symmetric

Arthritis

Arthropathies are divided into __________ and __________ involvement

Peripheral Axial

PT implications for IBD

-Periumbilical pain, referred pain to the corresponding low back, and lower right quadrant pain -Psoas abscesses -Joint problems: migratory arthralgia, monarthritis, polyarthritis, or sacroiliitis -Any time a client presents with low back, hip, or sacroiliac pain of unknown origin, the therapist must screen for medical disease -High prevalence of osteoporosis -Hydration and nutrition -Psychologic factors and ANS

Week 10- GI System 1 Flashcards

(75 cards)