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24 Cards in this Set
- Front
- Back
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Why does anesthesia pose problems for swallowing?
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Anesthesia is problematic because it paralyzes the swallowing reflex. WHen patients vomit under anesthesia, they can choke on the vomit.
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What CN damage can cause problems swallowing?
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5, 9, 10
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What diseases can damage BS swallowing center?
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Polio, encephalitis
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How do DMD, MG, and botulism pose swallowing problems?
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DMD- muscle paralysis of swallowing muscles
GM/botulism - NMJ transmission issues |
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The two biggest problems with swallowing are
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Vomit enters the airways because the soft palate doesnt close AND
the glottis doesnt close so food passes into the lungs. |
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What is achalasia. What causes it. How is it treated?
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The lower ES cannot relax due to damage of the neural network of the lower 2/3 of the esophagus.The musculature remains spastically contracted and no receptive relaxation occurs. This can cause megaesophagus (infection and huge dilation of esophagus). This then is treated by stretching the lower end of the esophagus with a balloon inflated on end and antispasmodic drugs.
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What is GIRD?
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gastrointestinal reflux
disease This is caused by pregnancy/overweight, loss of LES tone, hiatal hernia. Treatments are antiacids, H2 receptor blockers, H+ ATPase inhibitors |
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What is gastritis?
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Can be superficial or deep and harmful and cause complete atrophy of gastric mucosa- irritation of the stomach caused by bacterial infection. Alcohol and aspirin can contribute too this.
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Gastric atrophy?
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Can be caused by completely atrophied mucosa in gastritis. No gastric gland secretions remain- this means loss of hcl secretion (no HCl, no functioning pepsin, no IF -leads to pernicious anemia)
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What is a peptic ulcer?
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Excoriated area of intestine caused by excess of gastric juice over protective bicarb from pancreas/ mucus from duodenum.
Main cause- helicobacter pylori. Treatments in the past involved cutting the vagus nerve or removing parts of the stomach. Now, antibiotics and zantac -antacid are used. Aspirin, alcohol can also contribute. |
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What is dumping syndrome?
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Neurologic condition caused by surgery. Gastric emptying accelerated and undigested food makes it out the anus- patient barely makes it to bathroom.
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What is pyloric stenosis?
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Pediatric condition- projectile vomitting. Failure to thrive
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What is cholestasis?
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Cholestasis is a failure to secrete bile. Can be caused by failure to secrete bile acids/salts or obstruction in the billiary tree.
Cholestasis leads to jaundice. Cannot excrete billirubin in bile - unconjugated (indirect) and conjugated (direct) bilirubin. |
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What are the causes of abnormal digestion in SI due to lack of pancreatic secretion?
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Pancreatitis,
block of pancreatic duct by gallstone, head of pancreas removed by malignancy. This leads to lack of pancreatic enzymes most importantly you get fatty stool because no pancreatic lipase. |
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What are the most common causes of pancreatitis?
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Excess EToh
blockage of papila of vater by gallstone. Eventually so much trypsinogen accumulates that it overcomes the typsin inhibitor. Pancreas gets digested. |
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What is sprue- malabsoprtion by small intestine?
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Gluten intolerance causes damage to enterocytes or microvilli- IDIOPATHIC.
Tropical sprue- caused by bacteria that destroy enterocytes. |
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What is the whipple procedure?
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Removes the pancreas if cancerous.
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What are problems with the duodenum removal in whipple procedure
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Removal of duodenum- loss of
enterogastric reflexes- no feedback inhibition of gastric secretion or motility • Secretin and CCK- Loss of pancreatic enzyme and fluid secretion- no gall bladder continuous bile secretion • Poor digestion, fat absorption, bloating, high gas production. |
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Why is cholera problematic?
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Cholera- extreme case-cholera toxin stimulate cAMP to stimulate
secretion from the crypts of Lieberkuhn in ileum- loss of 10-12 liters a day and exceed the capacity of the colon to reabsorb. Tremendous loss of volume K and HC03. Antibiotics and IVs. |
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what is ulcerative cholitis?
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Ulcerative colitis-immune disorders, ileostomy - Will be discussed in the
clinical correlation. |
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Problems with paralysis and defecation?
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Paralysis of defecation reflexes-spinal cord injury. Loss of voluntary
control-increased abdominal pressure and voluntary relaxation of the sphincter. Spinal reflexes must be stimulated. |
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Describe vomitting reflex
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Vomiting act-deep breath, gag reflex to
open lower esophageal sphincter, closing of the glottis to protect airway, lifting of the soft palate to close off the nares. Strong contraction of the abdominal walls |
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What controls vomitting?
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Chemoreceptor in the brain medulla.
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What nerve impulses direct vomiting?
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Vagal and sympathetic afferents
to vomiting center-motor impulses via 5, 7, 9, 10 and 12 cranial nerves |
