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43 Cards in this Set
- Front
- Back
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paralysis of swallowing, nerve damage
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CN 5, 9, or 10
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poliomyelitis or encephalitis damage swallowing via…
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damage to swallow center in brain stem
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what can cause swallowing impairment due to muscles
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myasthenia gravis or batulism, muscular dystrophy
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What occurs when swallowing impaired
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1) swallowing can't occur 2) failure of glottis to close (food goes into lungs) 3) failure of soft palate and uvula (food goes to nose)
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achalasia
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lower esphageal sphincter fails to relax during swallowing; damage to myenteric plexus
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what is much gastritis caused by
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chronic bacterial infection of gastric mucosa
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what are 2 most common substances that damage tight epithelial jxns
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alcohol, aspirin
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why doesn't the stomach absorb much
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1) tight jxns 2) lines with highly resistant mucous cells
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what does gastic atropy and stomch secretion depletion lead to
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achlorhydria and occasionally pernicious anemia
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diagnosis of achlorhydria
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pH of stomach secretions fail to decrease below 6.5 after maximal stimulation
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intrinsic factor is made by and helps absorption of…
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parietal cells in stomch, vit B12
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commonpeptic ulcer locations
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around pyloric sphincter
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cause of peptic ulcer formation
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1) excess secretion of acid and pepsin by stomach 2) diminished ability of gastroduodenal mucosal barrier to protect
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large amount of bicarb provided in…
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1) secretions of large brunner's glands 2) bile from liver
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two methods of mediating acid entering duodenum
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1) inhibit gastric secretion 2) secretin stimulates pancreatic juice release
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factors predisposing to ulcers
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1) smoking 2) alcohol 3) aspirin
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ranitidine
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acid-suppressant drug; anti-histiminic, reduces acid secretion by 70-80%
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when does lack of pancreatic secretion occur
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1) pancreatitis 2) duct blocked by gallstone 3) head of pancreas removed due to malignancy
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what percent of fat is not digested if pancretic secretion doen't occur
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60%, along with 1/3 to 1/2 proteins and carbs
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most common cause of pancreatitis
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drinking excess alcohol, then gallstone blocking papilla of vater
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sprue
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malabsorption by intestinal mucosa
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nontropical sprue
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toxic effects of gluten present in some types of grain; also called idiopathic sprue , celiac disease in children, and gluten enteropathy
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what happens in nontropical sprue
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direct destructive effect on intestinal enterocytes
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tropical sprue
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thought to be caused by unidentified infectious agents
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how can you tell sprue is malabsorption rather than inability to digest
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fat in stools is in the form of salts of fatty acids, not undigested fat
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steatorrhea
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excess fat in stools
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severe sprue can cause…
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1) nutritional deficiency 2) osteomalacia 3) inadequate blood coagulation 4) macrocytic anemia (pernicious anemia)
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spasms in colon
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constipation for several days followed by a day or so of diarrhea due to colonic secretions
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megacolon aka hirschsprung's disease
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lack of or deficiency of ganglion cells in myenteric plexus of sigmoid colon
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pstchogenic diarrhea
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excessive stimulation of parasympathetic nervous system which excites motility and excess mucous secretion
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healing ulcers in ulcerative colitis
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iliostomy to allow small intestine contents to drain exterior while heals
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spinal cord injury btwn conus medullaris and brain
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voluntary portion of defecation blocked, but basic cord reflex still intact
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where so sensory signals that initiate vomiting originate
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pharynx, esophagus, stomach, upper portions of small intestine; travel via vagal and sympathtic afferent nerve fibers to multiple nuclei in brain stem
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motor impulses of vomiting
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CN 5, 7, 9, 10, and 12 to upper GI, vagus and sympathetic to lower GI, and spinal nerves to diaphram and abdominal muscles
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antiperistalsis
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up GI tract 2-3 cm/sec; eberything in stoch in 3-5 minutes; distention of duodenum/stomach causes vomiting
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vomiting
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1) deep breath 2) raising of hyoid bone and larynx to pull upper esophageal sphincter open 3) closing glottis 4) lifting soft palate to close nares 5) contraction of diaphragm and abdominal muscles
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chemoreceptor trigger zone
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motion sickness, some drugs; located bilaterally on floor of 4th ventricle
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nausea causes
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1) irritative impulses from GI tract 2) impulses from brain due to motion sickness 3) impulses from cerebral cortex
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common causes of GI obstruction
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1) cancer 2) fibrotic constriction from ulceration or peritoneal adhesions 3) spasm of segment of gut 4) paralysis of segement of gut
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obstruction at pylorus
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depresses body nutrition, loss of H+ ions (body alkalosis)
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obstruction beyond stomach
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loose large amount of water, electrolytes; no acid-base imbalance
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obstruction near distal end of large intestine
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feces accumulate, no vomiting at first, then severe vomiting
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gases formed in large intestine vs expelled gas
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7-10 liter; 0.6 L expelled, remaining is absorbed into blood and mucosa and expelled through lungs
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