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50 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Stomach purpose |
Digests food and prepares nutrients for absorption. |
Acts as a reservoir |
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Stomach parts |
Cardia, fundus, body, & antrum |
Lesser and greater curvatures |
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Pylorus |
Portion near Duodenum |
Pyloric sphincter |
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Omentum |
Coverall peritoneum covers the exterior of the stomach. |
Greater & Lesser omentum |
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Rugae |
Wrinkled ridges of the interior stomach. |
Allow for expansion |
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Arterial blood supply to stomach |
Celiac axis |
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Vagus nerve |
Parasympathetic innervation is via the vagus nerve. |
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Dual purpose of vagus nerve |
Fundus & body promotes stimulates acid secretion |
Antrum stimulates motility |
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Cardiac glands |
Secrete mucus and pepsinogens |
HCl acid converts to pepsin |
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Oxyntic gland areas 4 types |
Chief cells- zymogen Parietal cells- |
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G cells |
Gastrin secretion |
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Enterochromaffin cells |
Secrete serotonin |
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Somatostatin & glucagon production |
Produced by nine different endocrine cells by the mucosa |
ie, Cardiac, oxyntic, & pyloric mucosa |
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Chyme |
Good bolus mixes with digestive juices |
Creates a semi liquid |
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Gastric emptying rate |
Controlled by neural impulses, composition of the chyme and by hormones is the small intestine |
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Ulcers |
Gastric inflammation |
Mechanical, chemical, infectious, or ischemic nature |
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Helicobacter pylori |
Infection, risk factor |
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Gastric ulcer risk factors |
H. Pylori Salicylates, NSAIDS Family history Cigarette smoking |
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Peptic ulcer complications |
Hemorrhage 15% Perforation. 7% Obstruction |
S/s upper abd pain, guarding, rebound tenderness, absent bs. |
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Penetration and perforation |
Pathologically similar. S/s back pain, night distress, epigastric pain. |
Surgical intervention. Obstruction of gastric outlet r/t scaring at GE jct. |
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Gastric obstruction s/s |
Abdominal distension Tympany succussion splash Vomiting Early satiety Vague abd pain |
Tx NG tube decompression Fluid, electrolyte rebalance H2 blockers Surgery |
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Bacteria H. Pylori inveftion less to gastritis, gastric & Duodenum ulcers. |
Has adapted to and avoids the acidic nature of the stomach by burrowing beneath the mucosa and Duodenum. |
Transmission via fecal/oral route |
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Culture is gold standard |
H. Pylori dx |
Eradication, combo of drugs. Compliance, effectiveness, and economic considerations |
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Gastric cancer |
Hereditary, blood type A, lower socioeconomic status. Black> white, North USA, men>women. |
Certain foods, ulcers, surgery, achlorhydria, pernicious anemia, intestinal metaplasia, adenomatous polyps, |
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Gastric ca s/s |
Epigastric discomfort, vomiting, occult blood. Weight loss, early satiety, anorexia, anemia, mass, outlet obstruction, acities, lymph nodes. |
Mets: direct to omentum, liver, pancreas, spleen, transverse colon. |
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Mets: 4 routes |
1 Direct extension 2 Lymphatic to nodes 3 Hematogenous to liver, lungs, bone or cns. 4 peritoneal to pelvis |
May see hypoalbuminemia |
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5 yr. Survival rate gastric ca |
95% if limited to mucosa or sub mucosa. |
Early detection best. Linitis plastica is worst |
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Polyp |
Any circumscribed, discrete stomach tumor |
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Polyp types |
1. Hyperplastic 2. Adenomas 3. Leiomyoma 4. Adenomyomas |
1. Most common, always benign 2. - 3. Smooth muscle 4. Hamartomas, benign mixtures |
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Superficial gastritis |
Path change limited to upper 1/3 |
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Atrophic gastritis |
Full thickness of mucosa, producing atrophy of gastric glands. Loss of chief and parietal cells. |
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Gastric atrophy |
Marked or total gland loss but little inflammation, and the mucosa is thinned. |
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NNG |
Non-erosive, non-specific gastritis |
Common with aging, gastric ulcers, pernicious anemia, cancer, or h. Pylori |
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Pernicious anemia |
Tx vit B12 |
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Curling's Ulcer |
Significant burn injuries pt. |
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Cushing's Ulcer |
Intracranial trauma, head injuries, craniotomy |
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Stress ulcers |
Serve trauma, ongoing sepsis, serious illness |
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Chronic drug ingestion ulcer |
NSAIDS, alcohol |
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Gastric varicies |
Occurs in 2/3 of eso varicies. Higher mortality. 90% reoccurrence. |
Portal htn and collateral circ pressure |
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Varicies objectives |
1. Hemodynamic stability 2. Stop bleeding 3. Reduce portal pressure via shunt. Or TIPS |
Transjugular intrahepatic portosystemic shunt |
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Hiatal hernia |
Stomach protrudes through diaphragm into thoracic cavity |
Sliding, weakened LES & GERD |
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Infantile hypertrophic pyloric stenosis |
Age 6 wks. Boys. Familial. projectile vomiting. Dx ultrasound. Tx pyloromyotomy |
Dehydration, electrolyte imbalances, metabolic alkalosis, hypokalemia. |
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Atresias |
Blind ends or occlusions |
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Microgastria or hypoplasia |
Stomach never differentiates into true fundus, body and pylorus |
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Gastric duplication |
Mass lesion with all stomach layers |
Occurs in stomach |
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Neonatal perforations |
Assoc with prematurity, peptic ulcers, distal sm intestine obst |
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Dumping syndrome |
Rapid emptying w/ group symptoms. Anxiety, weakness, dizziness, tachycardia, diaphoresis, flushing, cramps, and diarrhea. |
Symptoms can result from hypoglycemia. LOC may occur |
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Gastric outlet obstruction |
Obst of pyloric sphincter. Tx restore fluid & electrolyte balance, decompression of stomach, correct nutrition deficiency. Dilatation of pylorus. |
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Caustic injury |
Alkaline agent causes liquefactive necrosis. Acids primate coagulation necrosis. |
Mouth& ESO. Gastric perforation leads to mediastinitis, peritonitis, shock |
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Bezoars |
Concretions of foreign material found in stomach |
Result in anorexia, vomiting, ulceration, bleeding, perforation, obstruction |
