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46 Cards in this Set
- Front
- Back
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List the 3 primary roles of the GI system |
-detoxification -hormonal/neural control -feeding mechanisms |
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What are the 2 roles of the upper esophageal sphincter? |
-prevents air swallowing -prevents food and secretions from entering wind pipe |
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What are the 2 roles of the lower esophageal sphincter? |
-controls passage of food to stomach -prevents gastric reflux |
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Differentiate between primary and secondary peristalsis |
1: circular waves of contraction 2: local distention (for leftover substance) |
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Describe the 4 layers of the stomach wall |
1. Serous: lubrication 2. Muscular: contracts to mix 3. Submucous: support 4. Mucous: glandular juices produced and secreted to aid digestion |
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Food is liquified to form __________________. Passage of food from stomach-small intestine is controlled by the _____________________________ |
-chyme -pyloric sphincter |
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List the 4 main anatomic divisions and their functions |
1. Cardia: food from esophagus to stomach; acids and enzymes produced 2. Fundus: stores undigested food 3. Corpus: partial digestion 4. Pylorus: connected to duodenum |
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What is the role of epithelial cells in the stomach? |
-secrete alkaline mucous to maintain protective barrier -prevents bacteria breakdown which could cause hemorrhage |
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What are the 3 main roles of gastric mucousal cells? |
-increase blood flow -synthesize prostaglandin and bicarb secretion -assist with acid reduction |
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List the 3 types of gastric mucousal cells |
-chief, G-cells, ECLs |
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What are the 2 types of gastric secretion glands? |
-Pyloric: secrete gastrin and mucous for protection -Oxyntic: secrete HCl and pepsinogen |
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Describe the functions of prostglandins (4) |
-inflammatory response -vasoconstriction -inhibit acid synthesis -increase secretion of protective mucous |
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Describe the primary roles of the small intestine |
-jejunum: nutrient absorption -ileum: absorbs mainly B12, water-soluble vitamins, bile salts |
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Describe the types of motility within the small intestine |
-peristalsis -segmentation (mixing with enzymes) |
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Describe the primary small intestinal secretions |
-alkaline fluid: aid in digestion -mucous, water, electrolytes -bicarb to protect mucousa and rid infectious organisms |
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Blood supply of the small intestine |
1. Duodenum- gastroduodenal artery, pancreaticoduodenal artery 2. Jejunum + ileum- superior mesenteric |
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What do the Brunner's glands secrete? Why? |
-duodenal glands -bicarb: protection from acidic chyme and lubrication -urogastrone: inhibit acid secretion |
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What is the Ligament of Treitz? |
-muscle connecting duodenum, jejunum |
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Describe the major functions of the large intestine |
-water absorption from remaining indigestible food matter -transports waste out of body -vitamin reabsorption -secretes bicarb to reduce acidity -fluid reabsorption to prevent dehydration |
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Describe the major functions of the liver |
1. Nutrient metabolism 2. Digestion: bile production (emulsifies fats, breaks down old RBCs to produce bilirubin) 3. Detoxification of drugs 4. Storage: nutrients, vitamins, glucose 5. Production: plasma components, coagulation factors |
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Describe the biliary system |
-gall bladder, bile ducts, liver cells -controls release of bile -drains waste products |
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What is the role of the gall bladder? |
-to store bile produced by the liver (transported by the hepatic duct) -before a meal, gall bladder is full with bile |
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What is the role of the pancreas? Describe the 2 functions |
-to convert food into energy i) Exocrine: aids digestion; enzyme production ii) Endocrine: regulates blood sugar; insulin and glucagon |
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What is the role of alpha cells? Beta cells? |
-alpha: increase glucose via glucagon -beta: decrease glucose via insuline |
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What does a bruit indicate? |
-blood passing an arterial obstruction |
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List the common symptoms of GI problem |
-nausea, vomiting, jaundice, diarrhea, oral lesions, weight gain, bowel bleeding |
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In the bowel, a dark, tarry colour indicates _______________________, whereas a bright colour indicates ______________________. |
-upper bleed -lower bleed |
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What are the common findings in a hepatocytes injury? |
-normal alkaline phosphatase -elevated liver enzymes and bilirubin |
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What are the common findings in a extrahepatic biliary obstruction? |
-normal liver enzymes -elevated alkaline phosphatase and bilirubin |
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What is the function of an endoscopy in relation to GI assessment? |
-examining interior of hollow cavity -see mucousal change, motility dysfunction, narrowing/occlusion -can inject vasoconstricting medications |
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Describe peptic ulcer disease |
-H. pylori, NSAID use disrupt mucousal defence and repair -risk for hemorrhage, obstructed gastric secretion |
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Describe stress-related mucousal disease |
-disruption in balance between aggressive and protective factors -erosive ischemia -hypersecretion of gastric acid |
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Describe esophagogastric varices |
-when blood flow to liver is obstructed -develops due to portal HTN, veins cannot tolerate pressure, may rupture |
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List the 3 primary causes of acute GI hemorrhage |
-hypovolemic shock, shock response, multi-organ dysfunction syndrome |
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What are the 3 main signs of acute GI hemorrhage? How would you differentiate between an upper and lower bleed? |
-hematemesis (bright red- lower; coffee- upper) -hematochezia (fresh blood in stool- lower) -melena (black stool- upper) |
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How can bleeding be controlled for each of the following: i) peptic ulcer disease ii) stress-related iii) varices |
i) vasoconstriction, PPI, antibiotics, H2 antagonist ii) catheter to femoral artery iii) treat portal HTN, reduce resistance to blood flow |
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Describe acute pancreatitis |
-acute inflammation -affects blood sugar and digestive enzymes |
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What are the common causes of acute pancreatitis? |
-gallstone migration (blockage) -alcoholism (overstimulation) -may lead to systemic release of toxins |
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How is acute pancreatitis assessed and diagnosed? |
-Ransons scale rates severity i) Mild pancreatitis/edematous ii) Severe pancreatitis/ necrotizing -CT is the primary diagnostic tool |
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Describe acute liver failure |
-sudden, severe liver cell dysfunction -coagulopathy, mental status changes -no pre-existing cirrhosis -develops over 1-3 weeks -hepatic encephalopathy within 8 weeks |
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What are the signs and symptoms of acute liver failure? |
-cerebral edema, hyperammonemia, INR>1.5, sepsis, headache, bruising, hyperventilation, spider nebae, hypotension, tachycardia |
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For acute liver failure, what does medical management focus on? |
-decreasing ammonia levels -Vk to control bleeding, prevent infection |
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For acute liver failure, what does therapeutic management consist of? |
-GI intubation (suction, feeding) -endoscopic injection (control bleeding) -endoscopic variceal ligation (bands) -transjugular intrahepatic shunt (connect veins) -bronchodilators, ambulation, pain management |
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For acute liver failure, which pharmocologic agents are commonly used? |
-antiulcer (H2 antagonist, PPI, gastric mucousal agent) -vasopressin (antidiuretic, constricts vessels) -octreotide (vasoconstriction, reduces pressure) |
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What does elevated lipase indicate? |
-acute pancreatitis |
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What does hyperammoninemia indicate? |
-acute liver failure -restrict dietary protein, provide glucose -hemodialysis |
