Term
| Three kinds of Abdominal pain |
|
Definition
Parietal
Visceral
Referred |
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Term
| Where does parietal pain come from |
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Definition
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Term
| Why is parietal pain lateral? |
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Definition
| at any one point, the peritoneum is innervated by only 1 side of the nervous system |
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Term
| Where is Visceral Pain felt? |
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Definition
| Midline at the epigastrum, midabdomen or lower abdomen. |
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Term
| What kind of pain is Visceral pain? |
|
Definition
| diffuse and vague, as nerve endings in the abdominal organs are sparse. |
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Term
|
Definition
| Visceral pain felt at distance from affected organ. It is localized and felt in skin or deep tissue sharing a central afferent pathway. |
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Term
|
Definition
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Term
| What two areas does upper GI bleeding come from? |
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Definition
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Term
| What kind of blood is in upper GI bleeding? |
|
Definition
| "coffee ground" material. ( due to the effets of acid on the blood) |
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Term
| 3 causes of upper GI bleeding |
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Definition
| bleeding carices (dilated veins) in the esophagus, peptic ulcers or tears in the esophageal- gastric junction. |
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Term
| 4 places that lower GI bleeding come from? |
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Definition
| Jejunum, Ileum, Colon, Rectum |
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Term
| 4 causes Lower GI bleeding? |
|
Definition
| polps, inflammatory disease, cancer, hemorrhoids |
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Term
|
Definition
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Term
| Two kinds of Dysphagia obstructions? |
|
Definition
intrinsic obstruction - has to do with something in the esophageal wall itself (tumor, outpouching)
extrinsic obstruction- originates from outside of the esophagus and may be pushing on it (tumor outside of esophagus) |
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Term
| 2 things that can cause dysphagia? |
|
Definition
| Neural dysfunctions and muscular disorders. This can commonly happen with diseases like myasthenia graves and Parkinson's because of problems with the striated muscle of the upper esophagus interferes with voluntary swallowing. |
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Term
| What is Gastroesophageal Reflux? |
|
Definition
| reflux of chyme from the stomach into the esophagus. People with this are at high risk for esophagus cancer. |
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Term
|
Definition
| lower esophageal sphincter spontaneously relaxes 1-2 hours after eating causing gastric contents to regurgitate into the esophagus. |
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Term
| 3 Psyco-social things you can do to prevent GURD? |
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Definition
Don't lay down after eating
No drinking
Loosing Weight |
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Term
|
Definition
| When the stomach protrudes through the diaphragm into the thorax. |
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Term
| Two main kinds of Hiatal Hernia |
|
Definition
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|
Term
|
Definition
| Stomach Slides through esophageal hiatus (opening in diaphragm for esophagus) |
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Term
| Seven things that cause sliding hiatal hernia? |
|
Definition
Short Esophagus
Trama
Weakening of the diaphragmatic muscle
coughing
bending
tight clothes
ascites (abdominal fluid being held in the abdomen)
pregnancy |
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|
Term
|
Definition
| Stomach herniates through secondary opening in the diaphragm and lies along the esophagus. |
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Term
| 4 manifestations of haital hernia? |
|
Definition
GURD
dysphagia
heartburn
epigastric pain |
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|
Term
| What is Pyloric Obstruction? |
|
Definition
| narrowing or locking of opening between the stomach and the duodenum |
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Term
| Simple obstruction vs. functional obstruction? |
|
Definition
simple - mechanical blockage
Functional - due to impaired motility |
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Term
| What causes intestinal obstruction |
|
Definition
| anything that prevents the flow of chyme through the track. |
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Term
| What happens if there is an obstruction is at the pyloris or high in the small intestine? |
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Definition
| Metabolic alkalosis develops as a result of loss of hydrogen ions that are normally reabsorbed from the gastric juices |
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Term
| What happens if there is an obstruction low in the small intestine? |
|
Definition
metabolic acidosis more likely, because bicarbonate from pancreatic secretions and bile are not absorbed.
causes extreme hypokalemia, which results in loss of muscle tone in intestinal wall |
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Term
| What makes metabolic acidosis worse? |
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Definition
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Term
| What happens if pressure from obstruction is severe? |
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Definition
| It could occlude arterial circulation, causing lactic acid build up and worsens metabolic acidosis. Could cause portions of intestine to die. |
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Term
|
Definition
| inflammatory condition of gastric mucosa |
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Term
|
Definition
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Term
|
Definition
| Surface epithelium erode? |
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Term
| What happens with acute gastritis? |
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Definition
| injury to protective mucosal barriers from anti-inflammatory drugs or chemicals. drugs inhibit protaglandins that normally stimulate mucus secretions. |
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Term
| Three things that contribute to acute gastritis? |
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Definition
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|
Term
| Two types of chronic gastritis? |
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Definition
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Term
| What happens with chronic gastritis? |
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Definition
| causes thinning and degeneration of stomach wall. |
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Term
|
Definition
More severe than antral
mucosa degenerates in the stomach causing atrophy. This might be an autoimmune disorder because people with this disease has antibodies against parietal cells. Without functioning parietal cells, individual could develop pernicious anemia. |
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Term
| Loss of what kinds of cells with Fundal Gastritis? |
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Definition
Chief (secrete pepsinogen) and parietal cells (secrete HCL and IF)
this results in a decreased amount of acid secretions. |
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Term
| What happens during fundal Gastritis? |
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Definition
| high serum gastrin levels occur due to lack of gastric secretions. (Gastrin is secreted by mucosa cells to stimulate HCL and pepsinogen secretions when partially digested proteins are in the stomach) |
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Term
| Why does pernicious anemia occur with fundal Gastritis? |
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Definition
| due to loss of intrinsic factor to facilitate vitamin B12 absorption |
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|
Term
| What causes antral gastritis? |
|
Definition
|
|
Term
| 3 ways antral and fundal gastritis different? |
|
Definition
with antral,
occurs more frequently
not associated with HCL secretions, prenicious anemia, parietal cell antibodies, mucosal atrophy is rare. |
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Term
| Why do high serum gastrin levels occur with Fundal |
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Definition
| Due to lack of feedback inhibiting gastrin secretion (gastrin is secreted by mucosa cells to stimulate HCL and pepsinogen secretion when partially digested proteins are in the stomach. |
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Term
|
Definition
| ulceration in the protective mucosa of the lower esophagus, stomach. There is a break that exposes the body to acid and causes autodigestion. |
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Term
|
Definition
| erosions- they erode mucosa but do not penetrate the muscularis mucosae |
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Term
|
Definition
| extend into muscularis mucosa and damage blood vessles, cause hemorrhage and may perforate the GI wall. |
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Term
| 6 Risk factors for peptic ulcers |
|
Definition
-smoking
- non steroidal anti-inflammatory drugs
-alcohol
-chronic diseases (emphysema, cirrhosis_
-infection with H. pylori
-stress |
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|
Term
| What is the most frequent type of ulcers? |
|
Definition
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|
Term
| Who do duodenal ulcer usually occur in |
|
Definition
younger people
people with type O blood |
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Term
|
Definition
hypersecretion of acid and pepsin
or... more parietal cells in gastric mucosa, high serum gastrin levels that remain elevated, failure of feedback mechanism where acid in the antrum inhibits gastrin release. |
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Term
| Main clinical manifestation of duodenal ulcer? |
|
Definition
| chronic intermittent epigastric pain that begins 2-3 hours after eating. relieved by food and antacids. |
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Term
| Where do Gastric Ulcer occur? |
|
Definition
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|
Term
| What is chronic gastritis? |
|
Definition
| associated with gastric ulcers and may limit mucosa's ability to secrete mucus. |
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Term
| What happens with gastric ulcers? |
|
Definition
| abnormality that increase mucosal permeability to hydrogen ions. |
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Term
| Gastric ulcer pathophysiology |
|
Definition
Increased bile salts disrupt mucosa and may reduce electrical potential across mucosal membrane. Hydrogen ions then diffuse into the mucosa and disrupt cell permeability properties and cell structure.
A cycle may occur in which damaged mucosa releases histamine, which increases acid and pepsinogen, blood flow and capillary permeability. Mucosa becomes swollen, loses plasma probteins and bleeds. |
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Term
| Three effects of gastric ulcers |
|
Definition
anorexia
vomiting
weight loss |
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Term
|
Definition
| acute form of peptic ulcer that accompany sever illness trama or neural injury. occurs at multiple sites along the stomach. reduced mucosal blood flow is important contributing factor. |
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Term
| When does postgastrectomy syndrome occur? |
|
Definition
| after gastric re sectioning |
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|
Term
|
Definition
Occurs with postgastrectomy syndrome-
rapid emptying of hypertonic chyme from remaining stomach to small intestine 10-20 minutes after eating |
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|
Term
| Alkaline reflux gastritis |
|
Definition
occurs with postgastrectomy syndome
stomach inflammation from reflux of bile and alkaline pancreatic secretions from proteolytic enzymes |
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|
Term
| Afferent Loop Obstruction |
|
Definition
Occurs with postgastrectomy syndrome
intermittent severe pain and epigastric fullness due to hernia, adhesions or stenosis of the duodenal stump after a gastrojejunostomy |
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Term
| What happens with malabsorption syndromes |
|
Definition
| interfere with nutrient absorption in small intestine. |
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Term
| Types of malabsorption syndromes |
|
Definition
pancreatic insufficiency - not enough lipase, amylase, trypsin or chymotrypsin
lactase deficiency- usually congenital deficiency of lactase that prevents breakdown of lactose to monosaccharides; osmotic diarrhea and gas problems occur due to lactose in the intestinal lumen.
bile salt deficiency- results in reduced micelle formation and fat malabsorption; manifestations are due to poor fat absorption and poor absorption of fat soluble vitamins
-ulcerative colitis and crohns disease
-diverticular disease |
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|
Term
| What is Ulcerative Colitis? |
|
Definition
| Chronic inflammatory disease causing ulceration of colonic mucosa |
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|
Term
| Two common risk factors of ulcerative colitis |
|
Definition
| family history and jewish descent |
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Term
| Patho of Ulcerative Colitis |
|
Definition
| T cells attack epithelium, other autoimmune diseases usually accompany this disease. It is severe in the rectum and sigmoid colon. The mucosa becomes hyperemic and appears dark and velvety. Small erosions form, abscesses form and necrosis occurs. Edema and thickening of the mucosa may also narrow lumen of the colon. |
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Term
| Five things that happen with ulcerative colitis? |
|
Definition
| bleeding, cramping and urge to defecate, frequent diarrhea with small amounts of blood and mucosa. |
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Term
| Most common sign of crohn disease? |
|
Definition
|
|
Term
|
Definition
| inflammatory disease affecting large and small intestine |
|
|
Term
|
Definition
| Saclike outpuching of mucosa through muscle layer of colon |
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|
Term
|
Definition
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|
Term
|
Definition
|
|
Term
| Who is diverticular disease common in? |
|
Definition
| the elderly but has become more common in younger people in countries where refined foods are common |
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Term
|
Definition
| inflammation of the appendix |
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|
Term
| What happens during appendicitis |
|
Definition
| stool obstructs the appendix, obstruction may cause increased pressure from continued mucus secretion. High pressure may reduce blood flow causing it to be hypoxic. |
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Term
|
Definition
| The stomach and intestine are supplied by three vessels, the occlusion of two of the supplying vessles can lead to ischemia. |
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Term
|
Definition
| Has to do with child onset obesity, greater than normal number of fat cells |
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Term
|
Definition
| has to do with child onset obesity, greater than normal size of fat cells. |
|
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Term
|
Definition
| tends to be distributed all over ones body. |
|
|
Term
|
Definition
hypertrophic (great than normal size of fat cells)
tends to be more centrally located. |
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|
Term
|
Definition
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|
Term
| Common problems obese people are at risk for.... |
|
Definition
CAD
Breast cancer, cervical cancer, liver cancer, endometrial cancer (females)
prostate, colon, rectal cancer in males |
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|
Term
| Pulmonary functions compromised in the obese |
|
Definition
Gas exchange, VC, expired volume decrease
These all cause low oxygen tension and high carbon dioxide tension, sleep apea can occur, exercise intolerance can occur. |
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Term
| Characteristic of Anorexic Person? |
|
Definition
| body weight less than 15% than normal due to refusal to eat. loss of consecutive periods of females. |
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Term
| What happens during short term starvation? |
|
Definition
Gycogenolysis peaks in 4-8 hours
gluconeogenesis (formation of glucose begins in the liver
these two processes deplete stored nutrients
protein catabolism begins |
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Term
| What happens during long-term starvation |
|
Definition
increased use of ketone bodies (products of lipid and pyruvate metabolism_
decreased dependence on gluconeogensis
depressed insulin and glucagon promote lipolysis in fat tissue
liberates fatty acids to supply energy to skeletal and cardiac muscle
liberates ketone bodies to sustain the brain
after adipose tissue depleted, proteolysis begins
muscle breakdown occurs last |
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|
Term
| five clinical manifestations of liver disorders |
|
Definition
portal hypertension
ascites
hepatic encephalopathy
Jaundice
Hepatorenal syndrome |
|
|
Term
| What causes portal hypertension |
|
Definition
| anything that impedes or obstructs flow through portal system or vena cava |
|
|
Term
| obstructive causes of portal hypertension |
|
Definition
| thrombosis, inflammation fibrosis |
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|
Term
| What is portal hypertension |
|
Definition
| high pressure in the portal system, |
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|
Term
| most common portal hypertension |
|
Definition
|
|
Term
| 4 long term effects of portal hypertension |
|
Definition
carices (distended vollateral veins)
splenomegaly
ascites (fluid in abdominal cavity)
Hepatic encephaolopathy |
|
|
Term
|
Definition
| FLuid trapped in the "third space" fluid cannot escape. Decreases fluid available for physiological function. |
|
|
Term
| most common cause of ascities |
|
Definition
|
|
Term
|
Definition
| irreversible inflammatory disease that disrupts liver structure and function. Portal hypertension and decreased albumin production by hepatocytes lead to ascites. Liver dysfucntion permits accumulation of hormones that regulate sodium and water. Ascites sequesters more water, kidneys retain sodium and water. Retention expants plasma volume but worsens portal hypertension and ascites. |
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|
Term
| What is chronic degenerative disease of the liver? |
|
Definition
| lobes of liver covered with fibrous tissue, parenchyma degenerates, fat infiltrates the lobes. |
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|
Term
| What is responsible for most cases of post-transfusion hepatitis? |
|
Definition
|
|
Term
|
Definition
| No vaccine, treated with interferon and ribaviron. |
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|
Term
| Most common abdominal surgical emergency |
|
Definition
|
|
Term
| obesity... exogenous vs. endogenous |
|
Definition
exogenous - eating too much
endogenous- inherent metabolic problems |
|
|
Term
| what are the mmHg classification of portal hypertension |
|
Definition
| 10 mmHg (normal is 3 mHg) |
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