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28 Cards in this Set

  • Front
  • Back
cardia of stomach
portion near gastric esophageal junction
fundus of stomach
(body) middle portion of stomach
antrum of stomach
area between fundus and the pylorus
parietal cells
produce hydrochloric acid and are located in the fundus
chief cells
produce pepsinogen and are also located in the fundus
mucous neck cells
found in the fundus; cardia; and antrum and produce mucous and are the mucosa progenitor cells
G cells
produce gastrin and only found in antrum
phases of secretion of acid
1 cephalic; vagal activity; stimulated by taste smell; and swallowing; 2 gastric phase; vagal component via direct stimulation of parietal cells or indirectly thru g cell production of gastrin; 3 antral phase: presence of food in stomach stimulates gastrin and stimulation of parietal cells; 4 intestinal phase; ends gastric secretion when food leaves stomach and exposes duodenum to acid food contents
gastric defenses against autodigestion
1 mucous secretion 2 bicarbonate secretion; 3 cellular barriers (tight junctions, rapid migration and proliferation of epithelial cells); 4 mucosal blood flow: highly sensitive to requirements of gastric bed, removes excess H+
Acute gastritis etiologies
1 drugs (aspirin, nsaids for eg); 2 alcohol; 3 smoking; 4 chemotherapy; 5 food poisoning, staphylococcal enterotoxin; 6 uremia (renal failure); 7 shock (esp/ sepsis); 8 helicobacter pylori
pathogenesis of acute gastritis
A: gastric mucosal barrier breakdown: agents may break down protective barrier; B blood flow; blood may be shunted away from area, resulting in injury to mucosa
complications of acute gastritis
ulceration or erosion of the mucosa; GI bleeding
chronic gastritis risk factors
1 h pylori; 2 autoimune conditions such as pernicious anemia; 3 reflux of bile especially after gastric surgery; 4 miscellaneous: smokeing, alcohol, etc
chronic active gastritis
used when neutrophil component is sidnificant and h pylori is present in superficial mucous layer
chronic superficial gastritis
chronic inflammatory cell infiltrate peredominates
chronic atrophic gastritis
atrophy of gastric glands
autoimmune gastritis morphology
fundus most severely affected
h pylori gastritis morphology
antral injury predominates
chronic peptic ulcer disease
chronic, usually solitary ulcers occurring at any level of the GI tract exposed to acid pepsin juices
etiologies of peptic ulcer disease
1 psychological factors; 2 environmental factors, such as aspirin and nsaids, alcohol, coffee, cola, cigarettes; 3 bacterial: h pylori; 4 altered gastric secretion (increased secretion in duodenal ulcers, but usually normal in gastric)
pathogenesis of duodenal ulcers
1 hypersecretion of acid and pepsin; 2 increased responsiveness of gastric mucosa to stimulation to secrete acid; 3 rapid gastric emptying
morphology of peptic ulcers
punched out appearance, 80% chronic peptic solitary; may be very deep, thru wall
most common sites of chronic peptic ulcers
1 anterior wall of first portion of duodenum; 2 posterior wall of first portion of duodenum; 3 second portion of duodenum; 4 antral region of stomach along the lesser curvature; 5 other sites: other parts stomach, lower esophagus, malformation of GI (meckels) stomal ulcers (anastomoses from prev surgery)
differences between acute and chronic peptic ulcers
Number(multiple vs single); size (smaller vs larger); depth (shallow vs deep); scarring (no vs yes); margins (ragged vs sharp); chronic gastritis (no vs yes)
acute gastric ulcers causes
1 acute brain damage or neuroseurgery (cushing’s ulcers); 2 extensive burns (curling’s ulcers); 3 shock, especially septic shock; 4 trauma esp to brain; 5 aspirin, large or chronic doses; 6 nsaids
morphology of acute peptic ulcers
superficial, usually multiple, small, anywhere in stomach; ragged edges, fibrinoid necrosis, granulation tissue, little if any scar tissue
gastric carcinoma morphology
gross appearance usually exophytic fungating tumor arising from mucosa. some are flat or excavated with ulceration. 80% 2-10 cm.
linitis plastica
results when stomach is diffusely involved by carcinoma and has the characteristics of a leather bottle