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Patho Exam 2 GI
Stark: GI & disorders thereof
18
Pathology
Graduate
10/23/2013

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Term
Layers of GI tract
Definition
Lumen IF YOU WILL--> mucosa: epithelium, lamina propria, muscularis mucosa (lubricate and protect)--> submucosa--> muscularis externa: circular (constriction), longitudinal (peristalsis)--> Serosa: connective
Term
Cells of gastric secretion: types & functions
Definition
mucous cells: mucous: soluble: mixes/lubricates food; insoluble: protects lining from acid
Parietal cells: HCl and intrinsic factor
Chief Cell: pepsinogen & Gastric acid
G-Cells: gastrin: stimulates release of gastric acid
Term
saliva
Definition
released by salivary glands; protects, lubricates, digests starches (amylase); parasympathetic increases, sympathetic decreases
Term
substances that promote gastric acid secretion
Definition
Gastrin (G-cells)
Histamine 2
Acetylcholine (parasympathetic/vagus nerve neurotransmitter, binds muscarinic receptor)
Term
GI Hormones
Definition
"Good God, CSI!"
Gastrin
Ghrelin: stimulates GH and appetite
Cholecystokinin: releases bile into GI (fat digestion)
Secretin: stimulates release of bicarb from pancreas and liver into duodenum to neutralize gastric acid
Incretins: GLP-1 & GIP: slow motility to absorb more glucose-->stimulates insulin release
Term
Gastric Acid Function
Definition
bond-breakage, protein denaturation, and activation of other enzymes (pepsinogen--> pepsin for example)
Term
Pepsinogen
Definition
synthesized and secreted by chief cells, activated by gastric acid becomes pepsin, a proteolytic enzyme
Term
GI motility & autonomic & enteric nervous affects on GIT
Definition
motility: slow wave, peristalsis by smooth muscle
autonomic: sympathetic (FoF) slows motility, sphincter control; parasympathetic (RaD) promotes motility and secretions
enteric: consists of Auerbach's (motility, both PNS&SNS innervation) and Meissner's (mucosal secretion, PNS only) plexuses
Term
Intestinal Flora
Definition
consists of 300-500 species of bacteria, mostly anaerobic (very few in the stomach, large intestine is better); they produce vitamin K, help with digestion, and can outcompete pathogenic microbes
Term
Nausea/vomiting
Definition
stimulation of medullary vomiting center (duodenal distention, etc.), or chemoreceptor trigger zone (chemotherapy, etc.)--> nausea--> vomiting (forceful expulsion of stomach contents)
Term
Diarrhea vs. Constipation
Definition
increased fluidity and motility of stools: watch for dehydration and electrolyte imbalance

vs

small, infrequent, and difficult BMs; risk for impaction--> obstruction
Term
GERD
Definition
gastroesophageal reflux disease: weakness of the cardiac sphincter/increased intrabdominal pressure--> gastric acid enters the lower esophagus (heartburn)--> burning and breakdown of lumen--> inflammation--> scarring--> strictures--> Barrett's esophagus

S&S: chronic heart burn
Term
peptic ulcer disease
Definition
overproduction of pepsin/gastric acid or underproduction of mucus--> wearing away of lumen--> bleeding--> peritonitis
Term
Aggressive and Defensive Factors for Acidic GI diseases (4 each)
Definition
Aggressive: H pylori, drugs, acid/pepsin, age/heredity
Defensive: mucus, bicarbonate, prostaglandins, and blood flow
Term
Inflammatory Bowel Diseases
Definition
Ulcerative Colitis vs. Crohn Disease
continuous colonic involvement, rectal bleeding, and cancer risk

vs

Skip lesions, granulomatous inflammation, and fistulas/strictures/abscesses
Term
Diverticular disease
Definition
poor diet/exercise/bowel habits--> weakened colonic wall--> out-pouchings (diverticula)--> object lodges in diverticula--> inflammation--> abscess--> obstruction--> hemorrhage--> peritonitis
Term
intestinal obstruction
Definition
inflammation/undigested feces/mechanical obstruction--> blockage of flow of feces (obstruction)
Term
Peritonitis
Definition
when any part of the GI tract (stomach forward) hemorrhages releasing digestive fluid/feces/flora into the the peritoneum, causing inflammation
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