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29 Cards in this Set

  • Front
  • Back
What two medullary centers are involved with vomiting?
1. vomiting center in the medulla 2. chemoreceptor trigger zone on the floor of the 4th ventricle
What are causes of GI bleeding?
- disease or trauma to the GI structures (peptic ulcers) - blood vessel abnormalities (esophageal varices, hemorrhoids) - disorders in blood clotting
What is occult blood?
hidden blood that can only be detected by chemical means, such as guaiac-based stool tests
What is the function of the lower esophageal sphrincter (or gastroesophageal sphincter)?
- normally the sphincter remains constricted to prevent reflux of gastric contents into the esophagus - during swallowing, there is receptive relaxation of the the lower esophageal sphincter, which allows easy propulsion of the esophageal contents into the stomach
What are causes of dysphagia?
- can be causes by altered nerve function (lesions of the CNS and stroke that involve the cranial nerves that control swallowing (V, IX, X, XII)) - disorders that produce narrowing of the esophagus (strictures, cancer, scleroderma)
What is scleroderma?
- an autoimmune disease that causes firbous replacement of tissues in the muscularis layer of the GI tract - an important cause of dysphagia
What is achalasia?
- when the lower esophageal sphincter fails to relax and food has difficult passing into the stomach, causing enlargement of the esophagus above the lower esohphageal sphincter - increased risk for aspiration of esophageal contents into the lungs when the person lies down
What is an esophageal diverticulum?
- an outpouching of the esophageal wall caused by a weakness of the muscularis layer - common complaints are that ood stops before it reaches the stomach, qurgling, belching, coughing, and foul-smellin breath - can cause esophagitis and ulceration
What are Mallory-Weiss tears?
longitudinal tears in the esophagus at the esophagogastric junction
What can cause gastroesohpageal reflux?
- a weak or incompetent lower esophageal sphincter - decreased clearance of the refluxed acid from the esophagus after it has occurred
What is Barrett's esophagus?
- squamous mucosa that normally lines the esophagus is gradually replaced by columnar epithelium resembling that in the stomach or intestines - associated with increased risk for dfevelopment of esophageal cancer
What are the 2 types of esophageal cancers?
1. squamous cell carcinoma - usually caused by alcohol and tobacco; usually occur in the middle and lower third of the esophagus 2. adenocarcinoma - usually found in the distal esophagus and may invade the adjacent upper part of the stomach; are more closely linked to esophageal refulx and Barrett's esophagus
What is the gastric mucosal barrier?
- mechanisms that contribute to the protection of the gastric mucosa - include: an impermeable epithelial cell surface covering, mechanisms for the selective transport of hydrogen and bicarbonate ions, and chacteristics of the gastric mucus
Which cells in the stomach secrete hydrochloric acid?
parietal cells of the stomach
What are the 2 major causes of gastric irritation and ulcer formation?
NSAIDs and infection with H. Pylori
What is acute gastritis?
refers to a transient inflammation of the gastric mucosa
What are characteristics of chronic gastritis?
- absence of grossly visible erosions and the presence of chronic inflammatory changes leading to atrophy of the glandular epithelium of the stomach - 3 major types: 1)H. pylori gastritis 2) autoimmune gastritis and multifocal atrophic gastritis 3) chemical gastropathy
What are some characteristics of H. pylori gastritis?
- a chronic inflammatory disease of the antrum and body of the stomach - can lead to gastric atrophy, peptic ulcer, associated with increased risk for gastric adenocarcinoma and low-grade B-cell gastric lymphoma - H. pylori produces enzymes and toxins that have the capacity to interfere with the local protenction of the gastric mucosa against acid, produce intense inflammation, and elicit an immune response - treatment includes combination therapy that includes two antibiotics and bismuth or a proton-pump inhibitor (PPI)
What are some characteristics of peptic ulcer disease?
- a group of ulcerative disorders that occur in areas of the upper GI tract that are exposed to acid-pepsin secretion - most common forms are duodenal and gastric ulcers - complications include hemorrhage, obstruction, and perforation
What are 2 pharmacological methods for reducing gastric acid contents?
1. antacids - neutralizes gastric acid 2. H2-receptor antagonist or proton-pump inhibitors - to decrease gastric acid production
What are some characteristics of irritable bowel syndrome?
- a functional GI disorder characterized by a variable combination of chronic and recurrent intestinal symptoms not explained bu structural or biochemical abnormalities - the hallmark of IBS is abdominal pain that is relieved by defecation and associated with a change in consistency or frequency of stools
What are the 2 inflammatory bowel diseases?
1. Crohn disease 2. ulcerative colitis
What are characteristics of Crohn disease?
- can affect any area of the GI tract from the mouth to the anus - sharply demarcated, granulomatous lesion that are surround by normal-appearing mucosal tissue - presence of skip lesions (lesions interspersed between normal segments of bowel) - involves all layers of the bowel (submucosal layer involvement is greatest) - surface of bowel has a "cobblestone" appearance - lead pipe or rubber hose appearance of the bowel wall
What are some characteristics of ulcerative colitis?
- confined to the rectum and colon - usually begins in the rectum and spreads proximally - affects the mucosal layer of the bowel causing stools to contain blood and mucus
What are some characteristics of diverticular disease?
- diverticulosis is a condition in which the mucosal layer of the colon herniates through the muscularis layer - diverticula develop between the longitudinal muscle bands of the haustra, in the area where the blood vessels pierce the circular muscle layer to bring blood to the mucosal layer - diverticulitis is a complication of diverticulosis in which there is inflammation and gross or microscopic perforation of the diverticulum
What is the difference between small-volume and large-volume diarrhea?
1. small-volume - results from an increase in the propulsive activity of the bowel 2. large-volume - results from an increase in water content of the stool
What are some characteristics of peritonitis?
- an inflammatory response of the serous membrane that lines the abdominal cavity and covers the visceral organs - most common causes are perforated peptic ulcer, ruptured appendix, perforated diverticulum, gangrenous bowel , pelvic inflammatory disease, and gangrenous gallbladder
What are some characteristics of adenomatous polyps?
- most common type of neoplasm of the intestine - arise from the mucosal epithelium - classified as tubular, villous, or tubulovillous adenomas