Term
| What are the 6 functions of the Digestive system? |
|
Definition
1. Ingestion
2. Secretion
3. Mixing and propulsion
4. Digestion
5. Absorption
6. Defecation |
|
|
Term
| What do orexins stimulate? |
|
Definition
|
|
Term
| What do Anorexins inhibit? |
|
Definition
|
|
Term
|
Definition
| A sick feeling associated with many conditions. Increased salvation and tachycardia. |
|
|
Term
|
Definition
| Forceful emptying of the stomach and intestinal contents through the mouth. Stimuli in the medulla can stimulate the vomiting reflex. |
|
|
Term
|
Definition
| Strong involuntary effort to vomit. Deep inspiration, abdominal muscles contract, upper esophageal sphincter remains closed. |
|
|
Term
|
Definition
| Difficult or infrequent defecation. |
|
|
Term
| What causes constipation? |
|
Definition
| Anything that reduces bowel motility can cause constipation. |
|
|
Term
| What is the daily fecal output? |
|
Definition
| Average of 150mL a day. Appr 100mL of water and 50mL of solid waste. |
|
|
Term
|
Definition
| Increased frequency of defecation and an increase in the fluidity and volume of the feces. |
|
|
Term
| What are the 3 different ways diarrhea is caused? |
|
Definition
| Osmotic (something draws fluid to the lumen), Secretory (excess mucosal secretion due to toxins), and Motility (surgical resection). |
|
|
Term
| What is Parietal abdominal pain? |
|
Definition
| Sharp and well localized pain. Because these nerves travel with skin nerves from the same area. |
|
|
Term
| What is Visceral abdominal pain? |
|
Definition
| Poorly localized and dull pain. Distension, inflammation, and ischemia. |
|
|
Term
| What is referred abdominal pain? |
|
Definition
| Gall bladder pain. If intense will refer to the back and/or between the scapulae. |
|
|
Term
| What are the 3 stages of Deglutition (Swallowing)? |
|
Definition
1. Voluntary stage
2. Pharyngeal stage
3. Esophageal stage |
|
|
Term
| What is the Voluntary stage of deglutition? |
|
Definition
| Skeletal muscle controls this swallowing stage. |
|
|
Term
| What is the Pharyngeal stage of deglutition? |
|
Definition
| Epiglottis closes of the trachea. |
|
|
Term
| What is the Esophageal stage of deglutition? |
|
Definition
| Upper esophageal sphincter opens and peristalsis moves bolus through esophagus. |
|
|
Term
|
Definition
| Difficulty swallowing due to an obstruction or a disorder that affects esophageal motility. (includes voluntary and involuntary processes) |
|
|
Term
|
Definition
| Loss of cells in the autonomic ganglia in the wall of the esophagus. Results in a dilated esophagus with absent peristalsis and a lower esophageal sphincter the that doesn't open. |
|
|
Term
| What pressure zone does the lower esophageal sphincter maintain? |
|
Definition
| A high pressure zone. The pressure in the esophagus is should be higher than the stomach. |
|
|
Term
|
Definition
| A traveling wave of contraction that moves from the mouth to the anus. |
|
|
Term
| Peristalsis is controlled by... |
|
Definition
| The autonomic nervous system in the bowel wall. |
|
|
Term
| How does the GI tract react to Laxatives? |
|
Definition
| Laxatives act by increasing GI motility. |
|
|
Term
| What does increased motility of the GI tract mean? |
|
Definition
| Faster Transit time and less absorption of water and nutrients. |
|
|
Term
| What factors increase bowel motility? |
|
Definition
| Chyme volume (more volume more motility), chemical composition (either increases or decreases motility), osmolarity (some substances are not absorbed and increase motility). |
|
|
Term
| What are 2 signs of Gastroesophageal Reflux Disease (GERD)? |
|
Definition
1. Transient relaxations of the lower esophangeal sphincter.
2. Decreased acid clearance from peristalsis failure. |
|
|
Term
| What are the causes of GERD? |
|
Definition
1. High intraabdominal pressure (obesity).
2. Sliding hiatal hernia acts as a fluid trap for acid.
3. Ulcers (delay in gastric emptying)
4. Drugs |
|
|
Term
|
Definition
| It is the protrusion of the upper stomach through the diaphragm into the thorax. (weak diaphragm muscles and a short esophagus) |
|
|
Term
| A hiatal hernia can lead to... |
|
Definition
| Dysphagia, heartburn, reflux, and frequent epigastric pain. |
|
|
Term
| What is the treatment for a hiatal hernia? |
|
Definition
| Decreased meal size, remain upright after eating, and Nissen fundoplication (making a muscular collar or ring from the stomach). |
|
|
Term
| What is a pyloric obstruction (gastric outlet obstruction)? |
|
Definition
| Obstruction in the pyloric region, between the body of the stomach and the duodenum. |
|
|
Term
| What pyloric obstruction happens in newborns? |
|
Definition
| Smooth muscle hyperplasia (pyloric stenosis). |
|
|
Term
| What pyloric obstruction is common in adults? |
|
Definition
|
|
Term
| What intestinal obstruction is Volvulus? |
|
Definition
|
|
Term
| What intestinal obstruction is Intussusception? |
|
Definition
|
|
Term
| What intestinal obstruction is foreign bodies? |
|
Definition
| Any foreign object obstruction. |
|
|
Term
| What intestinal obstruction is a herniation? |
|
Definition
| Passing through a muscle layer when it isn't supposed to. |
|
|
Term
| Name 3 intestinal obstructions. |
|
Definition
| Tumor growths, strictures (narrowing of lumen), electrolyte imbalances, and drugs. |
|
|
Term
| What is a paralytic Ileus? |
|
Definition
| Is a failure of bowel motility after surgery (anesthetics, inflammation, opiods, and sympathetic stimulation). |
|
|
Term
| What happens when a part of a bowel losses it's blood supply? |
|
Definition
|
|
Term
| What happens when a segment of bowel losses neurons in the enteric ganglia? |
|
Definition
|
|
Term
| What does hydrochloric acid do in the stomach? |
|
Definition
| The parietal cells secrete it to aid in digestion and protect from invaders. |
|
|
Term
| What assists hydrocloric acid regulation? |
|
Definition
| Acetycholine from parasympathetic stimulation (vagus), gastrin from G cells, histamine from mast cells in lamina propria (via H2 receptors). |
|
|
Term
|
Definition
| An inflammatory disorder of the gastric muscosa and is usual superficial. |
|
|
Term
| What is Peptic Ulcer Disease? |
|
Definition
| An ulceration that exposes the submucosa to gastric secretions (acid and pepsin). Acid cannot distinguish between food and ourselves. |
|
|
Term
| What does gastritis and peptic ulcer disease have in common? |
|
Definition
| An imbalance of agressive factors (acid production, pepsin production, and histamine or inflammation) and defensive factors (mucus, bicarbonate, and blood flow). |
|
|
Term
| What is acute gastritis is caused by? |
|
Definition
| Inflammation of the gastric mucosa over a wide area. |
|
|
Term
| What are the signs and symptoms of acute gastritis? |
|
Definition
| Vague abdominal discomfort and epigastric tenderness. |
|
|
Term
| What conditions promote acute gastritis? |
|
Definition
| Uremia, trauma, and stress. |
|
|
Term
| What drugs promote acute gastritis? |
|
Definition
| NSAIDS, ethanol, histamine, and digitalis. |
|
|
Term
| What is chronic gastritis? |
|
Definition
| Occurs in adults due to thinning or breakdown of the stomach wall. |
|
|
Term
| What results can occur with chronic gastritis? |
|
Definition
| Loss of chief and parietal cells, diminished secretion of pepsinogen, hydrochloric acid and intrinsic factor. Intrinsic factor is needed to absorb vitamin B12 from the diet. Pernicious anemia can occur. |
|
|
Term
| What risk factors increase peptic ulcer disease? |
|
Definition
| Smoking, NSAID usage, stress and alcohol. |
|
|
Term
| What is the prevalence of peptic ulcer disease? |
|
Definition
| Percentage matches age in years. 20% at age 20, 30% at age 30, ect. |
|
|
Term
| Gastric ulcers usually occur where? |
|
Definition
|
|
Term
| What is the primary defect that causes gastric ulcers? |
|
Definition
| Increase permeability of the mucosa to H+ ions. Reflux of bile through a defective pyloric sphincter can as well. |
|
|
Term
| What is the clinical presentation of gastric ulcers? |
|
Definition
| Pain-food-relief-pain. GI bleeding if untreated. |
|
|
Term
| What ulcers are more common than gastric ulcers? |
|
Definition
|
|
Term
| What gender is more affected by duodenal ulcers? |
|
Definition
|
|
Term
| What is the most likely age to develop duodenal ulcers? |
|
Definition
|
|
Term
| What are the contributing factors for duodenal ulcers? |
|
Definition
| Increased acid, decreased HCO3- and mucus, a larger number of acid secreting cells, high gastrin levels, rapid gastric emptying, NSAIDS, toxins, and enzymes. |
|
|
Term
| What is the treatment for duodenal ulcers? |
|
Definition
| Relieve symptoms and find the cause. |
|
|
Term
| What is pancreatic insufficiency? |
|
Definition
| Insufficient enzyme production by exocrine pancreas. (Lipase, amylase, trypsin, or chymotrypsin) |
|
|
Term
| What are the causes of pancreatic insufficiency? |
|
Definition
| Pancreatitis, pancreatic carcinoma, pancreatic resection, and cystic fibrosis. |
|
|
Term
| What is the main problem with pancreatic insufficiency? |
|
Definition
| Fat maldigestion. (fatty stool and weight loss) |
|
|
Term
| What is Lactase deficiency? |
|
Definition
| Lactase is the enzyme which breaks the milk sugar lactose into galactose and glucose. (Lactose intolerant) |
|
|
Term
| What helps with lactose breakdown in Lactase insufficiency? |
|
Definition
| Bacteria that causes lactase fermentation. (gas, cramping, pain, flatulence, and osmotic diarrhea) |
|
|
Term
| What is bile salt deficiency? |
|
Definition
| Bile salts are needed to breakdown fats. Therefore there is little absorption of fats. |
|
|
Term
| What are the causes of bile salt deficiency? |
|
Definition
| Bile salt deficiency is cause by liver disease and bile obstruction. |
|
|
Term
| Bile salt deficiency has poor intestinal absorption that causes? |
|
Definition
| Fatty stools, diarrhea, and malabsorption of fat soluble vitamins. |
|
|
Term
| What will vitamin A deficiency cause? |
|
Definition
|
|
Term
| What will vitamin D deficiency cause? |
|
Definition
| Decreased calcium absorption, bone pain, osteoporosis, and fractures. |
|
|
Term
| What will vitamin K deficiency cause? |
|
Definition
| Deficiency in clotting factors II, VII, IX, and X. Which causes bleeding disorders and bruising. |
|
|
Term
| What will vitamin E deficiency cause? |
|
Definition
| The result of this deficiency is unknown. |
|
|
Term
| What are the signs and symptoms of Ulcerative Colitis and Crohn Disease? |
|
Definition
| Abdominal pain and bloody/mucus filled diarrhea. |
|
|
Term
| What risk is increased with Ulcerative Colitis and Crohn disease? |
|
Definition
|
|
Term
| Ulcerative Colitis affects what part of the colon? |
|
Definition
| The last 1/3. (Sigmoid and rectum) |
|
|
Term
| Ulcers are limited to ____ in Ulcerative Colitis? |
|
Definition
|
|
Term
| What are treatments of Ulcerative Colitis? |
|
Definition
| Broad spectrum antibiotics, steroids, salicylates, immunosuppressants, and surgery. |
|
|
Term
| Ulcerative Colitis causes what in the colon? |
|
Definition
| Polyps that can be confused by precancerous polyps. |
|
|
Term
| Crohn disease affects what? |
|
Definition
| Typically the distal Ileum. But can cause inflammation anywhere in the GI tract from the mouth to the anus. |
|
|
Term
| What is not absorbed well because of Crohn's disease? |
|
Definition
| Vitamin B12 and folic acid. This leads to anemia. |
|
|
Term
| What is Gluten Sensitive Enteropathy (Celiac disease)? |
|
Definition
| Gluten acts as a toxin causing loss of villous epithelium in the intestinal tract. |
|
|
Term
| What is the demographic for Gluten Sensitive Enteropathy (Celiac disease)? |
|
Definition
| Mostly Whites. Appears to be dietary, genetics, and immunologic. |
|
|
Term
| What is the treatment for Gluten Sensitive Enteropathy (Celiac Disease)? |
|
Definition
| Vitamin D, iron, and folic acid supplements. |
|
|
Term
|
Definition
| Herniation's of mucosa through the muscle layers of the colon wall usually in the sigmoid colon. |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Diverticulitis usually occurs in who? |
|
Definition
| The elderly who eat very little fiber and bulk. Resulting in a weakening of the colonic wall. |
|
|
Term
| What are the signs and symptoms of diverticulitis? |
|
Definition
| Constipation alternating with diarrhea, distension and flatulence, and may progress to bowel obstruction and perforation. |
|
|
Term
| What is the treatment for diverticulitis? |
|
Definition
| Antibiotics, fiber, and exercise. |
|
|
Term
|
Definition
| Inflammation of the veriform appendix. |
|
|
Term
| What are the causes of appendicitis? |
|
Definition
| Obstruction and infection. |
|
|
Term
| What are the signs and symptoms of appendicitis? |
|
Definition
| Diffuse epigastric pain, pain eventually becomes peri umbilical, then localizes to RLQ: McBurney's point. |
|
|
Term
| What is the most serious complication of Appendicitis and diverticulitis? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Obesity increases risk of? |
|
Definition
| Cardiovascular disease, cancer, diabetes, breast, cervical, endometrial, prostatic, colon, rectal, and liver cancer. |
|
|
Term
| What are the causes of obesity? |
|
Definition
| Excess caloric intake, metabolic problems, number and size of adipose cells, genetics, diabetes, and psychological. |
|
|
Term
| What is Anorexia Nervosa? |
|
Definition
| A disorder of body image leads to starvation. BMI < 18. Electrolyte imbalance may lead to cardiac failure. |
|
|
Term
|
Definition
| Cycle of Binge-Purge-Starve eating habit. |
|
|
Term
|
Definition
| Pitted teeth, pharyngeal and esophageal inflammation and tracheoesophageal fistulae. |
|
|
Term
| True or False: Eating a larger portion of food than normal people in 2 hrs is a sign of Bulimia? |
|
Definition
|
|
Term
| True or False: People with Bulimia have a sense of lack of control over eating? |
|
Definition
|
|
Term
| True or false: Bulimics will use an inappropriate way of losing weight. |
|
Definition
|
|
Term
| How often (to be considered Bulimic) do you have to binge eat or use inappropriate compensation to lose weight? |
|
Definition
| Twice a week for 3 months. |
|
|
Term
| What does the body do once it has used up it's glycogen stores during starvation? |
|
Definition
| The body tries to produce glucose from non-carbohydrate molecules. |
|
|
Term
| What blood vessel sends an oxygen-poor blood supply to the liver? |
|
Definition
|
|
Term
| What is the normal pressure for the Hepatic portal vein? |
|
Definition
|
|
Term
| If there is hepatic portal hypertension what is the pressure? |
|
Definition
|
|
Term
| Pre hepatic cause of portal hypertension is? |
|
Definition
| Clots, or narrowing of the portal vein. |
|
|
Term
| Intrahepatic cause of portal hypertension is? |
|
Definition
| Liver disease interferes with blood flow. |
|
|
Term
| Post Hepatic cause of portal hypertension is? |
|
Definition
|
|
Term
| What is Cirrhosis of the Liver? |
|
Definition
| An irreversible inflammatory disease that disrupts liver structure. |
|
|
Term
| In Cirrhosis, what channels are blocked and what does this obstruction cause? |
|
Definition
| Biliary channels, and portal hypertension. |
|
|
Term
| In Cirrhosis, what does portal hypertension cause? |
|
Definition
| Blood to be shunted away from the liver and hypoxic necrosis develops. |
|
|
Term
| What are the 3 types of Cirrhosis of the Liver? |
|
Definition
| Alcoholic cirrhosis (oxidative damage to hepatocytes), Biliary cirrhosis (Primary biliary cirrhosis is an autoimmune disorder, secondary biliary cirrhosis is caused by an obstruction), and Post Necrotic (may follow viral hepatitis, dietary deficiencies, and other chronic diseases). |
|
|
Term
| What is Hepatic Encephalopathy? |
|
Definition
| Liver fails to adequately filter toxins, which then affect the brain. |
|
|
Term
| Astocytes are most affected by hepatic encephalopathy because of? |
|
Definition
| These cells clean up the brain and die from ammonia. Ammonia metabolizes to glutamate with leads to excitotoxicity. |
|
|
Term
| Hepatic encephalopathy affects the blood brain barrier how? |
|
Definition
|
|
Term
| What is Hyperbilirbinemia? |
|
Definition
| Too much bilirubin in the blood. |
|
|
Term
| What are the 3 types of hyperbilirubinemia? |
|
Definition
| Prehapetic (before conjugation), Hepatic (Hepatitis and cirrhosis), and Post Hepatic (after conjugation). |
|
|
Term
|
Definition
| Accumulation of fluid in the peritoneal cavity (bulging belly). |
|
|
Term
| What is Ascites caused by? |
|
Definition
| Cirrhosis of the Liver, heart failure, constrictive percarditis, abdominal cancer, nephrotic syndrome, and malnutrition. |
|
|
Term
| What complications does Ascites cause? |
|
Definition
| Hepatic portal hypertension, vasodilation, heptocyte failure, and sodium retention. |
|
|
Term
|
Definition
| An infection caused by viruses that attack the liver. |
|
|
Term
| What is the prodromal phase of hepatitis? |
|
Definition
| From the time of exposure until jaundice appears. |
|
|
Term
| What is the Icteric phase of hepatitis? |
|
Definition
| Yellow phase, painful swollen liver. |
|
|
Term
| What is the Recovery phase of hepatitis? |
|
Definition
| Jaundice resolution (6-8 weeks) |
|
|
Term
| Who is at risk for Chronic hepatitis? |
|
Definition
| Pt's with blood and body fluid associated hepatitis are at higher risk. |
|
|
Term
| What is the lab test for viral hepatitis? |
|
Definition
| Liver enzyme (ALT, AST), and prolonged bleeding times and low serum albumin levels. |
|
|
Term
| What 2 viruses can cause hepatitis? |
|
Definition
|
|
Term
| How to diagnose Hep non A-E? |
|
Definition
| You have to diagnose and exclude Hepatitis A-E. |
|
|
Term
| Hepatitis and Hippocrates? |
|
Definition
| He noticed jaundice in military camps. |
|
|
Term
| What percent of adults gain immunity to Hep A but don't get the disease? |
|
Definition
|
|
Term
| What are risk factors for Hep A? |
|
Definition
| Overcrowding, poor sanitation, Military, and adult/childcare facilities. |
|
|
Term
|
Definition
|
|
Term
| What is the prodromal/incubation stage of Hep A? |
|
Definition
|
|
Term
| Where does viral replication for Hep A take place? |
|
Definition
|
|
Term
| Where is the Hep A virus excreted? |
|
Definition
| Through the biliary system into the feces. |
|
|
Term
| What are symptoms of Hep A? |
|
Definition
| Nausea and vomiting, loss of appetite, malaise, jaundice and diarrhea. |
|
|
Term
| What population is at risk for Hep B? |
|
Definition
| Homosexuals, IV drug users, prisoners, and health care workers. |
|
|
Term
| Hepatitis B does what after you contract it? |
|
Definition
| The virus travels to the liver where it replicates in hepatocytes. |
|
|
Term
| What is the order of bile production, storage and release? |
|
Definition
| Bile produced by hepatocytes-Bile canaliculi-bile duct(portal triad)-right and left hepatic ducts-common bile duct-storage in gall bladder or release in small intestine. |
|
|
Term
|
Definition
| Infection and inflammation of the common bile duct. |
|
|
Term
|
Definition
| Obstruction of biliary drainage from gallstones. |
|
|
Term
| Who is at risk for gallstones? |
|
Definition
| Obese, middle age, female, and diseases of the gallbladder, pancreas, or ileum. |
|
|
Term
| What are symptoms of gall stones? |
|
Definition
| Heartburn/epigastric discomfort, RUQ abdominal pain (biliary colic), Intolerance eating fatty food, jaundice, leukocytosis. |
|
|
Term
| What is the treatment for gall stones? |
|
Definition
| Laparoscopic cholecystectomy, Administration of stone dissolving medications. |
|
|
Term
| What are the 2 organs of the pancreas? |
|
Definition
| The Exocrine (digestive function) pancreas and the Endocrine pancreas. |
|
|
Term
| What are the main hormones from the Endocrine pancreas? |
|
Definition
| Insulin, glucogon, somatostatin, ghrelin, and pancreatic polypeptide. |
|
|
Term
| What does the acini in the pancreas secrete? |
|
Definition
| Sodium bicarb to buffer the stomach. Starch, protein, fat, RNA, and DNA digesting enzymes. |
|
|
Term
|
Definition
| Inflammation of the pancreas. |
|
|
Term
| What is pancreatitis caused by? |
|
Definition
| Inflammation causes a leakage of pancreatic enzymes. |
|
|
Term
| Can gall stones cause pancreatitis? |
|
Definition
| Yes, they cause obstructions of the pancreatic ducts and damage the tissue. |
|
|
Term
| What does the leaking pancreatic juices do? |
|
Definition
| Autodigestion of the pancreas and other organs. |
|
|
Term
| What are the signs and symptoms of pancreatitis? |
|
Definition
| Epigastric pain radiating to the back, fever and leukocytosis, Hypotension and hypovolemia, blood serum lypase and amylase levels increase. |
|
|
