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171 Cards in this Set
- Front
- Back
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5 functions of the GI tract
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Motility
Secretion Digestion Absorption Elimination |
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3 accessory organs of the digestive system
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Liver
Gallbladder Pancreas |
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2 functions of the digestive system
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provide nutrients
Eliminate waste products |
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Age related GI alterations in the very young
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Lower esophageal sphincter pressure is low
GI motility is not coordinated slower peristalsis secretory and absorptive functions mature by age 2 |
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Age related GI alterations in the very old
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less: taste buds, sense of smell, saliva, motility, blood flow.
ability to detoxify drugs decreases secretion of enzymes |
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Manifestations of GI dysfunction
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Abdominal pain
vomiting Constipation diarrhea bleeding dysphagia |
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causes of abdominal pain
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stretching tissue: can be caused by swelling, vascular congestion, bacteria or viral infection
Chemical mediators: prostaglandins, serotonin, etc.... Ischemia |
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Constipation: definition, causes, and consequences
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infrequent difficult bowel movements, caused by low fiber diets, sedentary lifestyle, aging. causes fecal impaction.
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what is osmotic diarrhea?
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large volume diarrhea: ingestable but nonabsorbent substances draw sodium and water into lumen.
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what is secretory diarrhea?
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excessive secretion of fluid and electrolytes in response to bacterial enterotoxins (s aureus) or exotoxins (c difficile) after antibiotic therapy.
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what is abnormal motility?
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chyme moves rapidly through the small intestine, overwhelms the absorption capacity of the large intestine.
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what are the clinical manifestations of diarrhea?
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dehydration, metabolic acidosis (headache, abdominal pain, and CNS depression)
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what is hematemesis?
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blood in the vomit, most likely to be brown and look like ground up coffee
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what is hematochezia?
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blood in the stool, if its from lower GI tract its going to be red or burgundy color
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what is melena?
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dark and tarry blood in the stool, comes from the upper GI tract
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what is occult blood?
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blood in the stool that can only be found in a guiac test
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what is Gastrointestinal reflux disease?
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regurgitated chyme causes tissue damage in the esophagus.
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how does obesity contribute to GERD?
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it increases intra-abdominal pressure
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how does cigarette smoking and caffeine contribute to GERD?
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they alter the closure strength of the LES (lower esophageal sphincter)
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what are the manifestations of GERD?
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heartburn, regurgitation, chest pain within 1 hour of eating- increases when pt. lays down.
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what is a hiatal hernia?
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A defect in the diaphragm that allows a portion of the stomach to herniate through the opening
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what are the risk factors for a hiatal hernia?
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pregnancy, obesity, chronic straining or coughing and ascites
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what are the manifestations of a hiatal hernia
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they can be asymptomatic or the same as GERD (what are the symptoms of GERD?)
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describe a functional intestinal obstruction
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a loss of propulsive activity due to inflammation, swelling or ischemia
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describe a mechanical intestinal obstruction
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obstruction due to tumors, adhesions, volvulus or intussusception
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describe what happens to the body when the intestines are blocked?
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fluid and gas accumulate, distention occurs and circulation decreases. perstalsis increases, increasing luminal pressure. the bowel wall becomes swollen, causing ischemia.
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what is an adhesion?
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a band of scar tissue that binds together two anatomic surfaces that are normally separate from each other
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what is intussusception?
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the bowel telescopes into distal segment, causeing ischemia and necrosis
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what is a volvulus?
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the bowel twists on itself, causing obstruction, ischemia, and possible necrosis.
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what are manifestations of an intestinal obstruction?
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colicky pain followed by vomiting, sweating, nausea, and hypotension due to autonomic response. may also include constipation or diarrhea, or absent bowel sounds.
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what is gastritis?
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inflammation or erosion of the gastric mucosa
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what factors can lead to erosion of the gastric mucosa?
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prostaglandin inhibitors such as asprin, alcohol intake, histamine, and metabolic disorders such as uremia
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what are the manifestations of acute gastritis?
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vague abdominal pain, epigastric tenderness, hematemesis
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what are the manifestations of non-acute gastritis?
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anorexia, fullness, nausea, vomiting, pain, GI bleed may be only indicator.
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what are the two types of gastritis?
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type A, fundal and Type B, antral
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describe type a chronic gastritis
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more severe than type B- the gastric mucosa degenerates in the fundus and body. caused by H. pylori.
acid secretion and vitamin B12 absorption decreases due to loss of chief cells and parietal cells. |
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describe type B chronic gastritis
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more common than type A. also called antral, caused by H. pylori, causes reflux of bile and pancreatic enzymes.
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what is peptic ulcer disease?
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disruption of the protective mucosal lining in the lower esophagus, stomach and duodenum. breaks in stomach lining cause submucosa areas to be exposed to gastric juices.
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what are some risk factors for PUD?
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NSAID or gluccocorticoid use, infection of mucosa, smoking, alcohol, advanced age, or chronic disease such as emphysema, arthritis, cirrhosis, and diabetes.
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describe gastric ulcers
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ulcers develop in antral region of stomach, next to acid secreting mucosa of the body of the stomach.
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Bob has pain immediately after eating, anorexia, vomiting and weight loss. what is bob suffering from?
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a Gastric Ulcer.
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in this disorder, the body has more acid secreting cells (parietal cells) than normal
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Duodenal ulcers
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Nancy has pain 2-3 hours after eating, and in the middle of the night. when she eats tums or a meal, it disappears. Nancy has __________
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a duodenal ulcer
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what is dumping syndrome?
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the stomach suddenly deposits it's contents into the small intestine. this draws means more glucose is absorbed, so more insulin is secreted. this causes rebound hypoglycemia and sympathetic nervous system stimulation.
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Willow Bailey has cramping pain, nausea. vomiting, osmotic diarrhea, weakness, paleness, tachycardia, and hypotension. what is wrong with Willow Bailey?
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she has dumping syndrome
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this is stomach inflammation caused by reflux of bile and pancreatic secretions.
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alkaline reflux gastritis.
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this is iron malabsorption
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Anemia
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this is inflammation of the rectum and colon
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ulcerative colitis
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Timothy has diarrhea 10-20 times a day, blood and mucous in his stool and crampy abdominal pain. he is losing weight and is anemic, has anal fissures and hemorrhoids. what condition does Timothy have?
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Ulcerative colitis
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Luke has alterations of IgA production and increased T lymphocyte activity. what is Luke at risk for?
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Crohn disease
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this is an inflammation that can affect the entire small and large intestines and involves all layers of the intestinal wall.
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Crohn disease.
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in this disorder, the submucosa, mucosa and serosa are all affected. inflammation extends to the lymph tissue and ulceration form. however, there are many remissions and exacerbations and can go on for years with no specific symptoms.
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Crohns disease.
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what is pseudomembranous enterocolitis?
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acute inflammation of and necrosis of the small and large intestines. caused by C. difficile.
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this is a saccular outpouching of the mucosa through the circular muscle of the intestinal wall
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diverticula
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what is diverticulosis?
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non inflammed diverticula
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what is diverticulitis?
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inflammation of the diverticula
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what causes diverticula?
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increased intralumen pressure causes protrusions through the bowel wall
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when the lumen gets obstructed, this condition occurs
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appendicitis
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Betty is having pain around her belly button and on the right lower side of her body. she is complaining of nausea, diarrhea and fever. what is wrong with Betty?
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she has appendicitis
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what are the four functions of the liver?
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1) it produces albumin
2) it produces clotting factors 3)it metabolizes hormones and other drugs 4) it makes bile from bilirubin |
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describe the process of liver function
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1. heme gets broken down to biliverdin
2. lipid soluble bilirubin is changed to water soluble 3. it is excreted as bile into the duodenum 4.bile in the colon is converted to urobilnogen and excreted as brown stools |
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Gerald has too much heme to be metasbolized. what does Gerald have?
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Prehepatic Jaundice
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Jenny's liver does not properly process bilirubin. what does Jenny have?
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Intrahepatic Jaundice
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Steve has an obstruction in his bile ducts. what is steve suffering from?
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posthepatic jaundice
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green-yellow pigmentation, elevated bilirubin count and light colored stools are all signs of what?
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Jaundice
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what is the function of portal veins?
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they carry blood from teh GI tract and the spleen and pancrease to the liver, the hepatic veins, and inferior vena cava and the right atrium
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what happens when a portal vein gets clogged?
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splenomegaly, verices, ascites, and altered LOC
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what are gastroesophogeal varices?
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distended esophageal vessels
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what happens when esophageal vessels become distended?
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they rupture easily and can cause shock, anemia, melena, and hematemesis
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this is a neurologic condition in which blood is shunted to collateral vessels rather than to the liver, so toxins are not filtered out
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hepatic encephalopathy
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an increase in ammonia, or GABA in the blood is a sign of what disorder?
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Hepatic encephalopathy
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Darrin has had a change in personality, seems very irritable, cant remember anything and seems very lazy. these are early warning signs of what?
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hepatic encephalopathy
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what is Ascites?
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accumulation of fluid in the peritoneal cavity
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what are the signs of ascites?
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distended belly, enlarged abdomen, dyspne due to pressure on the diaphragm, and fatigue.
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what is hepatorenal syndrome?
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acute renal failure associated with liver failure, usually due to decreased blood flow to kidneys
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define hepatitis
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inflammation of liver parenchyma due to viral infection
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which types of hepatitis cause chronic hepatitis?
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strand B and C
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which types of hepatits are transmitted through feces?
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types A and E
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which types of hepatitis are transmitted parenterally?
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B, C, and D
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John is newly diagnosed with Hepatitis. he is tired, nauseous, has a cough and appears greenish yellow. what stage of hepatitis is he in?
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the prodromal phase
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describe the icteric phase of hepatitis
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begins 1-2 weeks after the prodromal phase, and lasts 2-6 weeks. includes enlarged liver, light stools and jaundice
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describe the recovery phase of hepatitis
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begins after jaundice disappears, liver function returns to normal, but remains enlarged and tender
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what condition makes the liver have a cobblestone appearance, due to fibrosis and nodular regeneration between fibrous bands?
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cirrhosis
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what is biliary cirrhosis?
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autoimmune cirrhosis that begins in the bile ducts. may also be caused by obstruction of the bile duct or cycstic fibrosis
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what is cholelithiasis?
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gall stones.
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what are risk factors for cholelithiasis?
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obesity, contraceptives, sickle cell disease and cystic fibrosis, being native american
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what are symptoms of cholelithiasis?
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epigastric and back and shoulder pain, excessive farting, nausea vomiting and sweating.
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inflammation of the gall bladder is known as what?
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cholecystitis
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describe cholecystitis
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gallstones obstruct the cystic duct and gallbladder becomes distended and inflammed. bacterial infection may arise from ischemia and chemical irritation.
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what are the symptoms of cholecystitis?
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jaundice and back pain, abdominal muscle guarding
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what do isles of Langerhans cells produce?
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Glucagon, Insulin, Somatostatin
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what do acinar cells produce?
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Trypsin and Chymotrypsin, amylase, and lipase and phospholipids.
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what are the symptoms of pancreatitis?
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edema of pancreas, tachycardia, hypocalcemia, hypotension, fever, nausea
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describe esophogeal cancer
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usually squamous cell carcinoma, may be adenocarcinoma. presents as chest pain or heart burn, and dysphagia.
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what are the symptoms of celiac disease?
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intolerance to gluten, includes diarrhea, weight loss, and fatigue. low potassium, calcium and magnesium leads to easy bruising, bone fractures and pain.
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what is necrotizing enterocolitis?
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an ischemic inflammitory condition of the bowels in premature infants.
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describe neonatal jaundice
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jaundice due to high bilirubin levels
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what is kernicterus?
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a brain injury as a result of hyperbilirubinemia. permanent damage to basal ganglia and thalamus. causes movement disorders, cerebral palsy and retardation.
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name the skin layers in order
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epidermis, dermis and subcutaneous
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yellowish, crusty scales on the scalp or anywhere oil can collect
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cradle cap
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example of a macule
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freckle
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example of a papule
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wart
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example of a wheal
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hives
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example of a nodule
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xanthoma
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example of a vesicle
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herpes zoster
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example of a pustule
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acne
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flat, circumscribed, less than 1 cm
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macule
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elevated, circumscribed, less than 1 cm
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papule
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elevated, irregular, diameter varies, may cause swelling
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wheal
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elevated, firm, circumscribed, deep in dermis, 1-2 cm
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nodule
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elevated, circumscribed, superficial, filled with serous fluid, less than 1 cm
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vesicle
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a reddened area on the skin that does not turn white when touched
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stage 1 pressure ulcer
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partial thickness skin loss involving epidermis or dermis
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stage 2 pressure ulcer
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full thickness skin loss involving damage or necrosis of subcutaneous tissue that may extend to the fascia but not through it
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stage 3 pressure ulcer
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extensive destruction, tissue necrosis, damage to muscle, bone, or supporting structures with or without full thickness skin loss
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stage 4 pressure ulcer
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this is a highly contagious pox virus that grows in the follicular epithelium. lesions are dome shaped and pitted and appear in the trunk, arms and face of children
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molluscum contagiosum
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this disease incubates for 14-21 days and is most contagious for one week around appearance of rash. enters blood via respiratory system. appears at face and moves downward.
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Rubella
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this disease is characterized by white spots in the mouth that are surrounded by a red ring before a rash appears. in a few days a rash appears at the hairline and appears confluent.
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Rubeola
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this disease is an appearance of vesicles on the trunk scalp or face that later spreads to extremeties, begins as a macular rash, then papular, then vesicular, then as crusted lesions.
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chicken pox
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this disease is associated with cold sores or fever blisters
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herpes simplex 1
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this disease is a virus that embeds in sensory nerve endings and goes to the dorsal root ganglion, where it develops a life long latency. then travels back down peripheral nerve to site of infection.
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herpes simplex virus
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this disease begins as a rash or cluster of painful vesicles which eventually rupture and form a crust. the lesions may last 2-6 weeks.
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herpes simplex virus
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in this disease,there is a vesicular eruption along the facial, thoracic or cervical lumbar. the vesicles lie in a red base that follow a dermatome
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shingles
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these are benign skin lesions that are caused by a DNA virus that causes the skin to become irregularly thickened
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warts
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what is cellulitis?
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infection of the dermis and subcutaneous tissue
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what is impetigo?
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a superficial skin infection that presents as pustules, vesicles and honey colored or golden crusting
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this type of dermatitis includes an increase in IgE, eosinophils, and interleukin 4. it causes intense pruritis.
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atopic dermatitis
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this is cell mediated type IV hypersensitivity, in which the T cells secrete lymphocytes. includes swelling and reddened skin with pruritic vesicular legions.
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allergic dermatitis
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what is the difference between squamous cell carcinoma and basal cell carcinoma?
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basal cell carcinoma appears as a pearly or ivory lesion with regular rolled borders and a depressed center. squamous cell carcinoma usually appears as an open sore or scaly red patch.
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this type of skin cancer has irregular borders and resembles a large freckle.
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melanoma
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this type of burn only affects the epidermis
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first degree burn
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this type of burn affects the epidermis and some of the dermis
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second degree burn
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this type of burn affects the epidermis, the dermis and the subcutaneous tissue
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third degree burn
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electrical injuries are also called fourth degree burns. why?
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because they often affect muscle and bone.
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the tissue most damaged in an electrical burn is what tissue?
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the tissue around the exit wound
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red bone marrow is found in _______
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spongy bone
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what are the five stages of bone fracture healing?
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1) fracture
2) hematoma and granulation tissue 3) cartilagenous callus 4) bony callus 5) remodeling |
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what is non union?
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failure of bone ends to grow together after a break. fibrous tissue and cartilage fills in after a break
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what is delayed union?
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failure of fracture to heal in 8 or 9 months
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what is a malunion?
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healing in a non anatomical position secondary to unequal stress or muscle pull and gravity.
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what is a dislocation?
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total loss of contact of bones at a joint
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what is a subluxation?
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partial loss of contact of bones at a joint.
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what is a sprain?
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a ligament tear
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what is a strain?
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a muscle or tendon tear
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what is an avulsion?
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a complete separation of tendon or ligament from its bony attachment
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what is compartment syndrome?
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high pressure in the muscle compartment due to injury. injury causes edema, which causes ischemia, hypoxia and necrosis, which compresses nerves and limits movement.
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what are the manifestations of compartment syndrome?
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painis unrelieved with pain meds, paralysis of limb, paleness and pulselessness.
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what is myoglobin?
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an intracellular muscle protein that contains a heme group. it is the primary o2 carrying pigment of muscles.
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what causes myglobinuria?
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severe muscle trauma, sucha s drug use, long distance running or electric shock
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what are the manifestations of myoglobinuria?
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dark reddish brown pigment in urine
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what is the WHO defenition of osteoporosis?
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more than 2.5 standard deviations below bone density of a 30 year old Caucasian woman.
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what does OPG do?
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handles the interaction and balance between osteoclasts and osteoblasts.
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what is RANKL?
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essential cytokine for formation and activation of osteoclasts
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the balance between OPG and RANKL determines waht?
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bone loss
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what causes rickets?
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insufficient vitamin D
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what causes osteomalacia?
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vitamin D deficiency
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define osteomyelitis
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bone infection
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describe bone tumors
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aka multiple myeloma, b cell cancer.
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what are the manifestations of multiple myeloma?
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pain, hypercalcemia, proteinuria and renal failure, and the abnormal immunoglobulin becomes prominent in the blood (Bence-Jones protein).
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what is osteoarthritis?
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non inflammatory joint disease. cartilage between joints has too much water in it, due to changes of proteoglycans which regulates pumping water in and out of cartilage.
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what are manifestations of osteoarthritis?
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pain in joints, especially weight bearing joints. joint stiffness disappears with movement, nocturnal pain not relieved by rest.
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this is a systemic autoimmune disease characterized by inflammation in the synovial membranes
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rheumatoid arthritis
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what are the manifestations of rheumatoid arthritis?
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morning stiffness, swelling of at least 1 wrist, positive rheumatoid factor, systemic manifestations- malaise, fatigue, musculoskeletal pain
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Max is 9 years old and has chronic inflammation of his synovial membranes in his joints that is resulting in permanent joint damage. what does Max have?
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juvenile rheumatoid arthritis
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this is an inflammitory autoimmune disease that affects multiple organs and is characterized by exacerbations and remissions. also presents inflammitory responses in basement membranes of capillaries of kidneys, heart, skin, brain and joints which causes vasculitis.
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Systemic Lupus Erythematosus
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Diane has a butterfly rash and red skin with scaly patches. it seems to come and go. what is diane probably suffering from?
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Systemic Lupus erythematosus
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this is caused by urate crystals in joints and soft tissue.
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Gout
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Ryan has tophi in and around his joints and hyperuricemia. he complains of abrupt pain in his big toe and has kidney stones. what does Ryan have?
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Gout
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Jenni has a chronic musculoskeletal syndrome characterized by a burning, gnawing pain, profound fatigue, and tender joints. what condition does she have?
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fibromyalgia syndrome
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this term refers to more than 0 inherited diseases that cause muscle weakness and loss.
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muscular dystrophy
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this form of muscular dystrophy is the most severe and progressive form
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duchenne MD
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