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129 Cards in this Set
- Front
- Back
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What is dysphagia of the esophagus?
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-difficulty in swallowing resulting in either from mechanical obsturxtion or from neyuromuscular dysfuntion
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What is esophageal varices?
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-dilatation opf the esophageal venous plexus due to diversion of blood from the portal ciruclation due tio portal hypertension
-the most common underlying disorder is cirrhosis ofd the liver due to alcoholism |
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What is reflux esophagitis?
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irritation and inflammation of the mucosa due to backflow of the acid contents of the stomach into the esophagus
-caused mainly either by a histal hernia or an incompetant esophagogastric sphincter |
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What is histal hernia?
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-a tear in the diaphragm which allows the stomach to pass into the thorax
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What is carcinoma of the esophagus?
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-may cause narrowing or stenosis of the esophagus
-a partiularly deadly form of cancer -rarly occurs before middle age and affects men about five times as frequently as women |
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What is acute gastritis of the stomach and duodenum?
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-benign and transient response of the stomach to local irritants
-mucosal cells are denuded exposing the submucosa, however, rapid regeneration of the sloughed epithelium prevents any damage (heartburn) |
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What is chronic gastritis of the stomach and duodenum?
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-a slow erosion of the mucosa with increasing age due perhaps to long-term irritation from a variety of sources
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What is atrophic gastritis of the stomach and duodenum?
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-a progressive and irreversible atrophy of the glandular epithelium of the stomach
-with loss of the acid-secreting parietal cells and the pepsin-secreting chief cells -incidence increases markedly with age and is quite common in the elderly |
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What is a peptic ulcer of the stomach and duodenum?
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-a condition in which the mucosa fails to withstanfd the destructive action of hydrochloric acid
-pepsin gastric juice is unable to repair adequatly the mucosal injury |
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How many american currently have or will get a peptic ulcer?
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-estimated 10 per cent of the population of the US has or will have peptic ulcer
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What is the symptom of a peptic ulcer?
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-the outstanding symptom of peptic ulcer is pain, cxharacterized by its chronicity, periodcity,a nd relation to the ingestion of food
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Where do peptic ulcers occur?
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98 percent occur in the duodenum or the stomach with duadenal ulcers 5-10 times more common than gastric ulcers
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What is the most probable casue of duadenal ulcers? Gastric ulcers?
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duandenal: due to higher than normal acid secretion
gastric: more likly a result from decreased tissue resistance |
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What does a gastric ulcer resemble?
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a duadenal ulcer in its chronicicty, recurrences, complications, and tendency to heal
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What are various causes and risk factors of peptic ulcers as a whole?
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-presence of bacterium Helicobacter pylori
-decreased mucus secretion and/or inadequate blood flow in the stomach and.or duadenum -Stress -hereditary -increased cigareete smoking can impair ability to buffer hydrochloric acid secretions |
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How is stress a risk factgor for peptic ulcers?
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-peptic ulcer is largely confines to the "civiolized" world and is more frequent in "Type A" personalitites (vagal influences
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how is hereditary a factor for peptic ulcers?
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-presdisposition of individuals with blood type O to develop lesions as opposes to those with other blood groups
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What is a carcinoma of the stomach/duadenum?
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-cancer of the stomach
-relativly infrequent form of malignant disease -forth most important casue of death from cancer in US |
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What influences a carcinoma of the stomach/duodenum's existance?
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-familial, environmental, and geographic factors influence the incidence of gastric tumors as well as the existance of pernicious anemia, atrophic gastritis, achlorhydria, and gastric adenomas (polyps)
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What are the various inflammations of the intestinal tract?
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-Ulcerative colitis
-Crohn's disease -appendicitis |
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What are the various esophagus disorders?
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-dysphagia
-esophageal varices -reflux esophagitis -carcinoma |
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What are the disorders of the stomach/duodenum?
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-gastritis
-peptic ulcer -carcinoma |
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What is ulcerative colitis of the intestinal tract?
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-a rather common, chronic, relapsing disease of unknown cuase, characterizerd by diffuse superfical ulceration of the colon and rectum, with bleeding, mucosal abscesses, and pseudopolyps.
-distribution is in the distal portions of the intestinal tract and is always continuous when moving to more proximal areas of the tract |
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What si Crohn's disease of the intestinal tract?
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-a chronic, relapsing, granulomatous inflammatory disorder which affects the terminal lieum and proximal (right) colon
-charactgeristics of the disorder is the segmental nature of the involvement and "skip" lesions |
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What is appendicitis of the intestines?
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acutye inflammation of the appendix, usually due to bacterial infection, which may be precipitated by obstruction of the lumen which blocks outflow of mucus secretuion distending the appendix
-reducing blood flow within its walls and rendering it vulnerable to invasion by ordinarily harmless native bacteria |
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What are disorders of motor and absorptive functions of the intesitnal tract?
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-irritable colon syndrome
-nontropical sprue (celiac disease) |
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What is irritable colon syndrome? Factors that may casue it?
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-an alteration in bowel habits accompanies by abdominal pain (spastic, variety)
-diarrhea may alternate wotj constipation -food irritants, as well as emotional factora are implicated as possible causes |
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What is nontropical sprue (Celiac disease)? What are the symptoms?
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-intestinal malabsorption caused by either a toxic or hypersensitiity reaction to a wheat or rye gluten characterized by marked atrophy of the villi and microvilli of the jejunum
-clinically, diarrhea, weight-loss and malnutrition are classically observed |
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What is diverticular disease of the intestinal tract?
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-outpouchings or herniations of mucosa and submucosa of the colon wall
-secondary inflammation, or dierticulitis, is thought to develop when feces become impacted within the dierticula |
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What are tumors of the small intestine?
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-carcinoma is rare
-most tumors are those which have metastasized there |
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What are tumors of the colon and rectum?
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-benign adenomatous polyp
-benign illous adenoma -malignant adenocarcinoma |
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What is an adenomatous polyp?
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-most common benign neoplasm
-may undergo a malignant transformation |
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What is a villous adenoma?
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-muiltiple folds lined with numerous goblet cells which produce extremely large quantities of mucus secretion
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What is adenocarcinoma? symptoms?
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-most common malignant neoplasm
-symptoms: "napkin ring" lesion, constipation, ribbon stools, and intestinal obstruction -anemia may occur in cases of high blood loss -disease of the older age groups with a 40% 5 year survival rate |
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What is the macroscopic structure of the liver?
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-largest organ in the adult
-divided into 4 lobes -3/4 of incoming blood comes from the portal vein which drains the digestive system and is rich in nutrients and toxins -the remainder enters by way of the hepatic artery znd is rich in oxygen |
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What is the microscopic structure of the liver? What are lobules? What is the portal triad? What are sinusoids?
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-three, overlappign circular plates called lubules each have a central vein
-b/t the three lobules is a triangular area called the portal triad, whcich contains a vein, an artery, and a bile duct -within each lobule are hepastic cords which radiate outward -sinusoids lie b/t the cords and carry blood from the central vein to the veins in the portal triad |
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What are the major functions of the liver?
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-detoxification of the blood
-gluconeogenesis -production of fatty acids -processing of bile |
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What is congestion of the liver?
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-seen in congestive heart failure
-central veina nd sinusoids becomes distended with blood -if back pressure is severe enough, there will be destruction of the liver -scarring may occur |
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What is necrosis of the liver? How does it repair itself? What is massive rapid necrosis?
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-the liver is a tremendous regenerative ability as up to 90-95% of the liver can be destroyed and still be self-repaired
-as long as hepatocytes and not the supporting network (reticular fibers) are destroyed, repair can occur -in massive rapid necrosis, reticular fibers may collaspe and then healing will be by scarring |
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What is diffuse necrosis of the liver?
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-liver undergoes a fatty metamorphosis and becomes yellowish and atrophies in response to insult from alcohol (slow) or carbon tetrachloride (rapid)
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What is focal necrosis of liver?
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-refers to the area of involvement
-may be central, midzonal, or peripheral |
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What is eclampsia of the liver?
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a condition of young, pregnant women characterized by high blood pressure, massive body edema, progressive kidney, and rarely liver failure
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What is type A viral hepatitis (infectious hepatitis)? Incubation period? Signs and symptoms? Mortality rate?
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-result of coming into contact with water or food which has been contaminated by human feces
-incubation period is 1 month -may last 6 months -one forth of patients have large amount of kidney damage -mortality rate is low, 0.5% |
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What is type B hepatitis (sereus hepatitis)? How is it contracted? incubation period? mortality rate?
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-a viral infection of the liver acquires by contact with blood or blood products of an infectd indivdual
-normally contracted when given a blood transfusion, more prevalent due to abuse and use of "dirty" needles -incubation period is 3 months -more severe than Type A hepatitis -1/2 patients develope jaundice -mortality rate is 4% |
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What is cirrhosis of the liver in general?
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-scarring of the liver due to a prolonged chronic, toxic process (alcoholism) having a deleterious effect on the hepatocytes but not killing them
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What is portal cirrhosis of the liver?
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-alcoholism is the most common cause
-triads increase in size with the entire area surrounding them getting scarred -preesure builds up in the portal vein and the blood return to the heart through the hemorrhoidal and epigastric veins |
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What do portal cirrhosis of the liver cause? How does the liver heal this? What is the liver termed now?
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-can develop esophageal varices and can be life threatening if they rupture
-in an attempt to regenerate, the liver developes pseudolobules with no central vein -becomes "caput medussa" and it can "weep" as much 10-15 liters of fluid into the abdominal cavity (ascites) |
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What is postnecrotic cirrhosis of the liver?
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-follows massive necrosis
-dense, wide scarring -pseudonodules are large -livers shrinks quickly -death may occur within two years |
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What is primary biliary cirrhosis of the liver?
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-arises de novo
-progressive destruction of the bile duct in the portal triad -type of autoimmune condition of the 20-30n year old age group -untreatable and death will occur within 20 years |
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What is abscesses of the liver Amoebic? Cysts (echinococcus cycts)?
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-rare, following infection
-amoeba lodge in liver blocking ducts -tape worms; inject cyst with formaldehyde or remove it |
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What are the tumors of the liver? benign? malginant?
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-benign has little clincial importance (adenoma)
-malignant: hepagtoma is most common primary liver tumor, most neoplasms are metastatic tumors, prognosis is bleak |
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What is the anatomy of the gall bladder?
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-bag-like structure located under right lobe of liver
-cystic duct branches off the common bile duct and leads to the gall bladder |
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What is the function of the gall bladder?
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-to store and concetrate the bile produced by the liver
-gall bladder contracts in response to fat in the digetsive system releasing bile salts which aid in lipid digestion |
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What is acute cholecystitis of the liver?
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-inflammation
-severe right upper quadrant admonial pain -develops after 2 hours eating a fatty meal |
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What are gall stones of the gall bladder?
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-most common cause of gall bladder inflammation
-consists largely of cholesterol -lodged in cystic duct and block rlease of bile -occur in people with high fat diets -females predominate 10 to 1 -if lodged at lower end, jaundice can occur |
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What are tumors of the gall bladder?
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-no benign tumors
-malignant tumors are usually detcted late in their development -prognosis is poor |
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What is the structure of the pancreas?
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-a gland centrally located below the liver whose function is to produce proteolytic enzymes
-another gland within the pancreas consists of multiple islet cells (islets of langerhans) dispersed throughout the pancreas -these cells secrete insulin, glucogon, and gastrin |
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What is diabetes mellitus of the pancreas?
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-decreased insulin production
-characterized by polydipsia, polyphagia, and polyuria -inability to get glucose into the muscle cells |
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What is juvenile diabetes of the pancreas?
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-most severe form
-complete shut-down is islet cells -usually appears at 12-13 years of age -side effects of renal failure, blindness and heart failure often occur later in life |
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What is the adult-onset (maturity) diabetes of the pancreas?
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-islet cells are not producing enough insulin becuase of an inability to split the insulin precursor molecule
-treatment is to stimulate the pancreas using drugs to produce more insuli9n -disorder normally doesn't appear until 40 years althouhg the 20-40 year old interval is uncertain |
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What is pancreatitis?
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-inflammation of the pancreas
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What is acute pancreatitis?
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-more prevalent in women
-cause usually known although 15% due to gallstone formation |
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What is acute hemorrhagic pancreatitis?
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-severest form
-cells rupture and digest surrounding tissues -death due to tetanus as a result of low calcium levels |
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What is chronic pancreatitis?
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-mainly in alcoholics
-constant, slow fibrosis and calcification of pancreas |
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What are tumors of the pancreas?
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-islet cell tumors are generally benign but if functional, their effects may be fatal
-malignant tumors occur generally in people's 40's or 50's -adenocarninoma -treatability depends upon its location -if in body or tail of pancreas, situyation is hopeless upon detection -cancer at head has a better prognosis cause detected earlier. |
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What is the site of production of salivary amylase? Stimulus? Substrate or organ involved? Effect or end product?
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-salivary glands
-nervous stimulus -cooked starch -dextrins 95-97% -disaccharides 3-5% |
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What is the site of production of HCl? Stimulus? Substrate or organ involved? Effect or end product?
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-stomach, parietal cell
-nervous and chemical stimulus -pepsinogen -produces pepsin |
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What is the site of production of Pepsin? Stimulus? Substrate or organ involved? Effect or end product?
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-stomach, zymogenic cell
-nervous or chemical stimulus (as pepsinogen) -protein substrate -produces proteoses and peptones |
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What is the site of production of Rennin? Stimulus? Substrate or organ involved? Effect or end product?
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-Stomahc,zymogenic cell
-nervous and chemical stimulus -milk protein substrate -curdles protein |
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What is the site of production of gastric lipase? Stimulus? Substrate or organ involved? Effect or end product?
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-stomach,zymogenic cell
-nervous and chemical stimulus -fat substrate -fatty acid and glycerol production |
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What is the site of production of Gastrin? Stimulus? Substrate or organ involved? Effect or end product?
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-stomach mucosa
-secretagogues -stomach -scretion of gastric glands |
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What is the site of production of Enterokinase? Stimulus? Substrate or organ involved? Effect or end product?
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-duodenal mucosa
-food entering duodenum -trypsinogen -trypsin |
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What is the site of production of Trypsin? Stimulus? Substrate or organ involved? Effect or end product?
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-Pancreas (as trypsinogen)
-primary chemical -proteoses and peptones and inactive pqanreatic proteoses -dipeptides and active proteoses |
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What is the site of production of chymotrypsin? Stimulus? Substrate or organ involved? Effect or end product?
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-pancreas (as chrymotrypsinogen)
-primary chemical is stimulent -proteoses and petones substrates -dipeptides are produced |
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What is the site of production of carboxypolypeptidase? Stimulus? Substrate or organ involved? Effect or end product?
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-pancreas (asprocarboxypolypeptidase)
-primary chemical is stimulent -proteases and peptones substrates -dipeptides produced |
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What is the site of production of pancreatic amylase? Stimulus to production? Substrate or organ affected? Effect or product?
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-pancreas
-primary chemcial stimulent -dextins is substrate -disaccharides are product |
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What is the site of production of pancreatic lipase? Stimulus to production? Substrate or organ affected? Effect or product?
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-located in pancreas
-primary chemical stimulent -fats are substrate -fatty acids and glycerol is product |
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is the site of production of erepsin? Stimulus to production? Substrate or organ affected? Effect or product?
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-located in small intestine
-primary chemical stimulent -dipeptides are substrate -amino acids are product |
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is the site of production of sucrase? Stimulus to production? Substrate or organ affected? Effect or product?
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-located in small intestine
-primary chemical stimulent -sucrose are substrate -glucose and furctose is product |
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is the site of production of maltase? Stimulus to production? Substrate or organ affected? Effect or product?
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-located in small intestine
-primary chemical stimulent -maltose is substrate -2 glucose is product |
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is the site of production of lactase? Stimulus to production? Substrate or organ affected? Effect or product?
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-located in small intestine
-primary chemical stimulent -lactose is substrate -produces glucose and galactose |
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is the site of production of bile? Stimulus to production? Substrate or organ affected? Effect or product?
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-located in liver
-chemical stimulent -fats are substrate -emulsifies fats to fatty acids |
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What does food in the duodenal mucosa cause?
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stimulus of the secretion of gastric glands
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is the site of production of secretin? Stimulus to production? Substrate or organ affected? Effect or product?
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-located in duodenal mucosa
-HCL in duodenum is stimulus -pancreas and liver is affected -secretion of pancreas stimulate bile production |
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is the site of production of pancreozymin? Stimulus to production? Substrate or organ affected? Effect or product?
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-located in duodenal mucosa
-HCl in duodenum is stimulus -pancreas is affected -secretion of pancreatic glands |
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is the site of production of enterocrinin? Stimulus to production? Substrate or organ affected? Effect or product?
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-located in duodenal mucosa
-stretch or contact in duodenum is stimulus -small intestine is affected -secretion of intestinal glands |
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is the site of production of gastrone? Stimulus to production? Substrate or organ affected? Effect or product?
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-located in duodenal mucosa
-acid in duodenum is stimulus -stomach is affected -inhibits gastric secretion |
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is the site of production of cholecystokinin? Stimulus to production? Substrate or organ affected? Effect or product?
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-located in duodenal mucosa
-fats in duodenum is stimulus -gall bladder is affected -causes expulsion of stored bile |
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is the site of production of mucus? Stimulus to production? Substrate or organ affected? Effect or product?
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-located in all organs
-stimlus is probably inherant to programming in cell -no specific substrates or organs affected -casues lubrication |
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Gastric juice contains the following enzymes?
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-pepsin, rennin, lipase, and amylase
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Pavlovian response is the basic principle underlying?
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-cephalic phase of gastric secretion
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What are characteristics of condtioning reflex includes the following?
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-there are many based upon inborn reflex, easily lost, require learning
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The hormone produced in the duodenal mucosa which stimulates secretion of pancreatic enzyme is?
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-pancreozymin
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A tear in a muscle allowing underlying tissue to become exposed and entrapped is know as?
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- a hernia
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The enyzme in the parietal cells that is essential for the available of hydrogen ion is?
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-carbonic anhydrase
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The cardiac sphincter is located between?
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-the proximal portion of stomach and distal esophagus
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Pancreatic juice enters the duodenum through?
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-ampulla of vater
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The activating substance converting procarboxyolypeptidase to active enzyme is?
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-trypsin
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The hormone produced in the duodenal mucosa which inhibits gasric secretion is?
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-gastrone and somatostatin
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An inflammation of the gall bladder is known as?
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-cholecystitis
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The sphincter located b/t the distal portion of the small intestine and proximal region of the large intestine which is relaxed by gastrin is the?
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-llio-cecal sphincter
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The enzymes in the gastrointestinal tract that digest protein are?
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-pepsin, trypsin, carboxypolypeptidase and chymotrypsin
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Heliobacter pylori is the organism that plays a role in the pathogenesis of?
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-gastric ulcer
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The enzymes in saliva are secreted primarily from?
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-parotid gland
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The proteolytix pro enyzme secreted by the gastric mucosa is activated by the action of?
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-HCl
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The hormone that stimulates secretion of intestinal juice is?
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-enterocrinin
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The substance necessary to activate trypsinogen is?
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-enterokinase
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The mucosal tissue of the following are most sensitive to hydrocloric acid erosion?
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-mouth, esophagus, and duodenum
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The scarring of the liver due to prolonged alcoholism is known as?
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-cirrhiosis
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The major intrinsic factors in the pathogenesis of gastric ucers are?
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-increase HCl
-decrease mucous -increase pepsin -H. pylori virus |
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The phases of gastric secretion are?
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-cephalic, gastric, intestinal
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The hormone that causes the forceable expulsion of bile?
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-Cholecystokinin
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An alkalne secretion of pancreatic juice high in bicarbonate and low in enzymes is stimulated by?
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-secretin
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The accumulation of calcus under gingival marin may lead to?
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-gingival ischemia
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The major exogenous etiologic factor in the pathogenesis of gastric ulcer is?
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-non-steroidal anti-inflammatory medication
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Substances in bile that reduce surface tension are?
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-salts of toura and glycocholic acids
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Blockage of the cystic duct results in?
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-inhibition of bile flow
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The plexus of auerbach plays a role in?
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-peristalsis
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The duodenal hormone which inhibits gastric motility is?
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-enterogastrone
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A tear in the diaphragm which allows for gastric reflux is termed?
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-hiatal hernia
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The most common underlying disease which may lead to esophageal varices?
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-cirrhosis of liver
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A chronic glanulomatous inflammation disorder affecting the terminal illeum and proximal colon is known as?
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-crohn's disease
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Malabsorption due to an allergic reaction causing flattening of the mucosal cells of the intestine is known as?
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-non-tropical Sprue
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Sympathetic preganglionic fibers which synapse in the submucosa of the intestine and affect glandular secretion are known as?
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-plexis of meissner
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Stimulation of the olfactory and gustatory nerves result in secretion from?
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-salivary glands
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The distension of the duodenum by chyme and the drop in pH to 3.5-4.0 evokes?
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-enterogastric reflex
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Excessive absorption of bile salts in the extracellular fluid may be characterized by the symptom of?
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-jaundice
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The intestinal glands of secretion are located in the?
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-crypts of leiberkuhn
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Accretions in the gall bladder are due to?
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-constriction of cystic duct
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