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85 Cards in this Set
- Front
- Back
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What is the first GI disorder that can arise?
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Swallowing problems
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What directly damages the swallowing reflex?
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Damage to CN 5, 9, 10.
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3 diseases that commonly cause swallowing center damage in the brain stem:
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-Polio
-Encephalitis -Stroke |
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What inherited disease damages the voluntary motor pathway for swallowing?
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Muscular dystrophy
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What 2 neuromuscular transmission disorders cause paralysis of swallowing muscles?
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-Myesthenia gravis
-Botulism |
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What induced thing causes failure to swallow?
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Deep anesthesia
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What is the main problem caused by swallowing disorders?
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Food enters the airway.
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What is the result of deep anesthesia induced swallowing problems?
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Vomit into your airway
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What is Achalasia?
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Failure of the lower esophageal sphincter to relax during swallowing - remains spastic.
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What causes Achalasia?
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Damage to the myenteric plexus
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What mechanism is lacking in achalasia?
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Receptive relaxation
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what is the result of chronic achalasia?
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Megaesophagus able to hold 1L of food
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What results from megaesophagus?
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infection due to long periods of static food, caught up at the spastic esophageal sphincter.
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What are 2 treatments for megaesophagus?
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-Balloon dilation
-antispastic drugs |
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3 common disorders of the STOMACH:
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1. Gastritis
2. Gastric atrophy 3. Peptic ulcers |
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What is Gastritis?
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Inflammation of the gastric mucosa
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Causes of Gastritis:
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-Irritations
-Ulcerations -Bacterial infections |
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What is Gastric atrophy?
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-Loss of gastric mucosal layers
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Result of gastric atrophy:
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Little to no mucosal secretions - lose mucus, HCl, and IF
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What results from lack of HCl?
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Pepsin can't work on proteins - food is poorly digested.
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What results from lack of IF?
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Pernicious anemia
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What causes Peptic Ulcers?
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Imbalanced ratio of
-Acid Secretion vs. -Mucosal secretion |
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What is a peptic ulcer?
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Excoriorated area of the stomach or small intestine
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5 causes of peptic ulcers:
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-High acid/peptic content
-Irritation -Poor blood supply -Poor mucus secretion -Infection of H pylori |
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Most common site of peptic ulcers:
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Pylorus
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2 ways that the stomach and sm intestine are protected from acid:
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-Mucous secretions (5 types!)
-Alkaline Juice secretions from pancreas and bile and brunner's |
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Where are brunner's glands?
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In the upper duodenum
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How is acid secretion normally inhibited?
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By negative feedback of HCl on Gastrin secretion from pyloric glands, and the ENS nerves
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What is inhibited by Gastrin inhibition?
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-Gastric sercretions and motility
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What does acid secretion inhibit? Stimulate?
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Inhibits: Gastrin secretion
Stimulates: Secretin secretion |
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What is the effect of Secretin?
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Stimulated Bicarb solution from the ducts of the Pancreas and Bile duct.
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What is the Main causative agent of peptic ulcers?
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H. Pylori
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Other causes of peptic ulcers?
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-Alcohol
-Smoking -Aspirin |
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Why does aspirin cause peptic ulcers?
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Because it inhibits Cox-1 from making prostaglandins, which are needed to protect the stomach.
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Normal action of Prostaglandins in the stomach:
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Stimulate cAMP to promote mucus secretions of goblet cells and Brunner's glands.
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What patients get peptic ulcers from aspirin?
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Chronic arthritis patients
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How can you help arthritis patients' pain but not give them peptic ulcers?
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Give Cox-2 inhibitors - the main cox enzymes in the stomach are Cox-1 so you are ok with this.
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What are 2 common causes of peptic ulcers in the initial part of the duodenum?
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2X normal HCl secretion due to
-bacterial irritation -Psychic disturbances (stress) |
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How does Smoking cause peptic ulcers?
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It stimulates the release of ACh and enhances HCl secretions.
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2 types of treatments for peptic ulcers:
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-Antibiotics
-Ranitidine |
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What is Ranitidine?
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An acid suppressent that blocks histamine so it can't stimulate HCl secretions from parietal cells.
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What is the common name for Ranitidine?
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Nexium - the purple pill
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2 General types of disorders in the SMALL INTESTINE:
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-Pancreatic disturbances
-Malabsorption |
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What results from pancreatic insufficiency (failure)?
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The inability to digest food.
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Symptoms of pancreatic failure:
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-Wasting
-Fat in feces |
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3 causes of pancreatic insufficiency:
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-Pancreatitis
-Pancreatic duct blockage -Removal of pancreatic head due to cancer |
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What blocks the pancreatic duct?
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Gallstones
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What is pancreatitis? 2 types?
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Inflammation of the pancreas
-Chronic -Acute |
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Most common cause of pancreatitis:
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Excess alcohol intake
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What happens in pancreatitis?
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The pancreatic enzymes are held in the duct long enough that they overwhelm Trypsin Inhibitor and active Trypsin digests the pancreas itself.
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What is the common name for malabsorption?
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Sprue
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What is idiopathic sprue, often seen in what population?
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Gluten-intolerance - often seen in pediatrics
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How does gluten affect idiopathic sprue patients?
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Directly destroys enterocytes.
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What causes Tropical sprue?
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Bacteria
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What is the problem in tropical sprue?
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Irritation of the intestines causing inflammation and copious secretions.
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What is a major symptom of severe sprue?
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Steatorrhea - excess fat in stools due to increased secretions.
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4 problems that develop as a result of sprue:
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1. Severe nutrition deficiency
2. Osteomalacia 3. Insufficient clotting (K) 4. Pernicious anemia (IF) |
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3 types of disorders of the LARGE INTESTINE:
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1. Constipation
2. Diarrhea 3. Spinal Cord paralysis causing inability to defecate |
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Common cause of constipation:
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Consistent inhibition of the natural urge to defecate.
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Result of chronic constipation:
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MEgacolon
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Common name for megacolon:
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Hirschsprung's disease
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What is Hirschsprung's disease?
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A lack of ganglion cells in the Myenteric plexus, resulting in no defecation reflexes or peristaltic power propulsion.
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What happens to the colon in hirschsprung's?
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-Asc/Transv/Desc colon distend
-Sigmoid is small and spastic |
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3 types of diarrhea:
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-Enteritis
-Psychogenic -Ulcerative |
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What is enteritis?
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Inflammation due to virus/bacteria in the GI tract
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How specifically does Cholera toxin cause diarrhea?
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-Toxin stimulates cGMP
-Stimulates secretion from Crypts of Lieberkuhn in ilium |
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How much loss does Cholera toxin cause?
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10-12 L per day of water
Much K and HCO3 |
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What is ulcerative colitis?
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An immune disorder where the walls of the lg intestine become inflamed and ulcerated.
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What causes the diarrhea in ulcerative colitis?
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Increased motility - mass movements occur all day instead of only 10-30 min.
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Usual therapy for ulcerative colitis:
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Ileostomy (bag)
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What type of SC injury impairs defecation?
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Upper spinal cord
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What component of defecation is impaired by an upper SC injury?
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The voluntary component
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How is defecation achieved in spinal cord injuries?
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By exciting the process with an enema; then the involuntary reflex in the lower spinal cord takes over.
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What is the function of vomiting?
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To clear the GI tract when excessively irritated, distended, of excitable.
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What transmits the impulse for vomiting from the GI tract to the brain?
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CN 5, 7, 9, 10, 12
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Where in the brain do impulses for vomiting go?
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To Vomiting Center - a collection of nuclei in the brain stem.
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What type of info is carried in the aforementioned cranial nerves?
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MOTOR Impulses FROM the vomiting center
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What carries impulses for vomiting FROM gi tract TO the vomiting center?
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-Vagal visceral afferents
-SNS visceral afferents |
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What carries the motor impulses from the vomiting center to the GI tract?
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CN 5,7,9,10,12 -> upper GI
Vagal/SNS efferents -> lower GI Spinal nerves -> Diaphragm and Abdominal muscles |
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What type of motility precludes vomiting?
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Antiperistalsis - retropulsive
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Function of antiperistalsis:
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Moves contents of sm intestine and stomach into esophagus.
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What must relax for vomiting to occur?
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Relaxation of the Esophageal-gastric sphincter
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6 steps in vomiting:
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1. Deep breath
2. Raise hyoid bone/larynx 3. Close glottis 4. Close nares (lft soft palate) 5. Contract abdominal muscles 6. Complete relaxation of lower esophageal sphinter |
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What region of the brain is responsible for the relationship of drugs and motion to vomiting?
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The Chemoreceptor Trigger Zone
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What drugs can excite this center?
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-Morphine
-Digitalis |
