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Gastro Phys
LCCW Gastro Phys - Exam 1
| Question | Answer |
|---|---|
| What does the GI tract do for us? | transportation, digestions, absorption, excretion, defensive role |
| What stimulates the stretch receptors? | The bolus |
| Control of swallowing comes from where? | The swallowing center in medulla and lower pons |
| What pulls medially to form a slit so that large pieces can't pass? | Palatopharyngeal Fold |
| A series of wave-like muscle contractions that moves food to different processing stations in the digestive tract? | Peristalsis |
| Nervous control - Afferent : | Sensory from mouth travels CN V and IX to medulla oblongata |
| Nervous control - Efferent: | From swallowing center in medulla impulses travel thru CN V, IX, X, and XII, and some upper cervical Nerves |
| Primary Peristalsis: | Transports food from pharynx to stomach (8-10 sec) |
| When does secondary peristalsis occur? | if the whole bolus doesn't enter stomach. Occurs until esophagus is empty. |
| Peristalsis is initiated where? | In the Myentaric system back through glossopharengeal and vagal efferent. |
| Stomach transports the bolus through contractions called what? | Peristalsis and Pyloric pump |
| Pyloric Pump? | Vigorous contractions designed to empty the stomach |
| Segmentations: | Transportation of content in the small intestine |
| Haulstrations: | Transportation of content in the Large Intestine |
| Digestion involves what? | The Breakdown of the food we eat into nutrients that are readily absorbed |
| Ingestion: | Bringing food into the mouth |
| Mechanical digestion: | Physical process prepares food for chemical digestion |
| Chemical Digestion: | Enzymes breakdown food into basic elements |
| Absorption: | from lumen of GI tract into blood or lymph |
| Where does most absorption happen? | In the small intestine |
| Where does absorption of water and electrolytes happen? | In the large intestine |
| Defecation? | elimination of indigestibile substances from the body |
| Which part of the GI is responsible for defecation? | The Large Intestine |
| Salivary glands produce how much per day? | 800-1500 mL/day |
| Parotid Produces what and is where? | Serious Secretion as well as a majority of the saliva. Vestibule - next to the second upper molar. |
| The Submandibular gland produces what and is where? | More Serous >> Mucous. Lingual Frenulum. |
| The Sublingual gland produces what and is where? | More Mucous >> Serous. 10-12 ducts. Open into the floor of mouth. |
| The Ebner's Glands produces what and is where? | Serous only - Circumvallate Papillae (lipase) |
| What is Saliva good for? | cleanses mouth. Dissolves food chemicals (allows us to taste). Moistens food and aids in form bolus. Contains enzymes. contains factors that destroy bacteria. Contain protein antibodies. |
| What destroys bacteria (via saliva)? | Thiocyanate ions, and lysozyme |
| What destroys oral bacterial? | The Protein antibodies in the saliva |
| Parotid gland is stimulated by: | CN IX --> Sup and Inf salivary nuclei --> CN IX ---> 1 ganglion --> parotid gland |
| Sibmandibular and sublingual glands are stimulated by: | taste and tactile receptors on tongue --> CN VII --> sup and inf salivatory nuclei --> CN VII --> Submandibular ganglion --> submandibular and sublingual gland |
| Deciduous teeth: | 20 baby teeth (6 months --> 2 years) |
| Each quarter in baby teeth: | 2 incisors, 1 canine, 2 molars |
| Permanent teeth come in at what age? | 6 years old and take up until 20 years of age to completely erupt |
| Incisor: | Chisel cutting or nipping |
| Canine: | Conical tear or pierce |
| Premolar and molar: | crowns with rounded cusps grinding |
| Enamel: | The white stuff that we see - it's the hardest structure on our bodies. |
| Dentin: | Very Porous. like bone. |
| Pulp/Root Canal: | Space within the tooth |
| Cementum: | Material that binds tooth to the jaw. Adheres to the peridontal ligament. |
| Dental carries: | (Cavities) - caused by dental plaques |
| Dental plaques: | Film of debris (bacteria and sugar) |
| What metabolizes sugars into acids? | Bacteria. Ut de-mineralizes the enamel |
| Bacteria are usually what? | Streptococcus mutans |
| Calculus (tartar): | formed by accumulation of plaque can lead to gingivitis |
| Gingivitis: | Inflammation of tooth/gum interface |
| If Gingivitis is left untreated, it progresses to what? | Periodontal disease |
| What happens that leads up to tooth loss? | Pockets are created on surface of tooth, then bacterial enzymes dissolve the dentin, which leads to tooth loss |
| Xerostomia: | "dry mouth" - absence of saliva production |
| Leukoplakia: | White patches on the surface of mucous membranes |
| Hyperkeratosis: | abnormal thickening of the outer layer of the skin. |
| Xerostomia is caused by what? | mumphs, sjorgens disease, Sarcoidosis and some meds |
| Erythroplakia: | flat red patch or erosions on floor of mouth, tongue or soft palate |
| Erythroplakia is associated with what? | Dysplasia and is precancerous |
| Upper 1/3 of esophagus? | Striated muscles (= voluntary) |
| Lower 1/3 of esophagus? | Smooth muscle (= involuntary) |
| middle of esophagus? | smooth and striated muscles |
| Primary peristalsis is a continuation of what? | The pharyngeal stage |
| What happens to the bolus if it's still present after primary peristalsis? | secondary peristalsis occurs from the distension of esophagus |
| Esophageal stage of swallowing is stimulated by what? | The myenteric n.s. and by reflexes traveling from the vagal afferent fibers (which initiate contraction) |
| LES: | lower esophageal sphincter - is the last 3 cm of esophagus |
| LES's AKA? | Gastroesophageal sphincter |
| LES is normally ________ to prevent reflex | Constricted |
| Atresia: | Absence of a normal opening (pre stomach). Discovered right away |
| Fistula: | Abnormal connection from esophagus to trachea. |
| What is the most common fistula? | The lower esophageal fistula (near where the trachea "Y"s) |
| What are the 2 S/S of Atresia? | Regurgitation and excessive secretions |
| What is the least common fistula? | H-Type fistula |
| S/S of H-type fistula? | Cyanosis (turning blue) and distended abdomen |
| S/S of Fistula? | Choking, Cyanosis, aspertation pnemonia |
| Diverticula (of esophagus): | Is an outpouching of the wall of the esophagus |
| Diverticula is caused by what? | motor disturbance |
| Zenker Diverticulum? | Uncommon. HIGH on esophagus. |
| S/S of Zenker Diverticulum? | Regurgitation of food eaten a few days prior |
| Traction Diverticulum? | Outpouchings occuring at MIDPOINTS of the esophagus. Usually Asymptomatic. |
| Epiphrenic diveritculum? | Occurs LOW on the esophagus. |
| Achalasia: | Failure of LES to relax in response to swallowing, and absence of peristalsis |
| What is associated with Achalasia? | Associated with a loss of inhibitory ganglion cells in the myenteric plexus of esophagus |
| Achalasia is a compluication of what disease? | Chagas disease - Ganglion cells destroyed by Trypansoma cruzi |
| S/S of Achalasia? | Dysphasia, Odynophagia, and regurgitation. |
| Dysphasia: | Difficulty swallowing |
| Odynophagia: | Painful swallowing |
| Reflux Esophagitis: | Inflamation of esophagis. MOST COMMON ESOPHAGITIS (GERD) |
| GERD = ? | Gastro Esophageal Reflex disorder |
| What is GERD in conjunction with? | Sliding hiatal hernia |
| Factors that lead to LES? (<-- is that supposed to be GERD? Pg 8) | Alcohol, caffeine, chocolate (stimulate gastric secretion), Fatty Foods (slow down gastric emptyin) and Nicotine, CNS depressants, pregnancy and estrogen therapy ( decrease LES activity) |
| S/S of Reflux esophagitis? | Dysphasia, odynophagia, dypepsia, pyrosis, and excessive salivation |
| Pyrosis = | Heart burn |
| What is GERD diagnosed to (if it worsens)? | Barrett Esophagus |
| Barrett Esophagus: | Squamous Epithelium of esophagus is replaced with pseudocolumnar epithelium as a result of chronic reflux |
| Where does Barrett Esophagus occur? | In the lower 3rd of esophagus |
| Barrett Esophagus is increased risk with what? | Smoking |
| Chemical Esophagitis: | Accidental poisoning of children, or attempted suicide in adults |
| Chemical esophagitis can happen due to what? | Alkaline agents (lye), strong acids (sulfuric or hydrochloric) found in cleaners |
| Chemical esophagitis will cause what? | Inflammation and cell death |
| Esophageal Varices: | Dialated Veins beneath the mucousa. Pron to rupture and hemorrhage. In the lower 3rd of esophagus |
| Esophageal Varices is due to what? | Hepatic portal hypertension from cirrhosis of liver |
| S/S of esophageal varices? | Blood in vomit, black tarry stool, and shock |
| Hiatal Hernia: | Herniation of the stomach through an enlarged esophageal hiatus in diaphragm - usually asymptomatic |
| S/S of Hiatal Hernia? | Heartburn and regurgitation |
| Causes of hiatal hernia? | Relacation of LES when stomach full. Tight Clothing around mid and upper abdomen. Lying down after a big meal. Large amount of abdominal adipose tissue. |
| Sliding Hernia: | MOST COMMON (75-95%). The Hiatal laxity allows cardia of stomach and LES to pass above the diaphragm. Most often asymptomatic |
| Paraesophageal (rolling) Hernia: | Portion of the gastric fundus above the diaphragm. Can continually enlarge and in extreme cases stomach herniates into thorax. |
| Which type of hernia NEEDS surgical intervention? | Paraesophageal (rolling) hernia |
| Scleroderma: | Systeic sclerosis is the type that can affect the esophagus |
| Scleroderma is caused by what? | Fibrosis (hardening) in many organs and an abnormality of esophageal mm fixation |
| Scleroderma is primarily where? | The lower third and LES |
| Plummer Vinson syndrome, AKA? | Paterson-kelly syndrome |
| Plummer Vinson syndrome Characterised by what? | Cervical esophageal web (thickening on upper esophagus) causes dysphagia, mucosal lesions of mouth and pharynx and iron deficiency anemia. |
| What can be a complication of plummer-vinson syndrome? | Carcinoma of oropharync and upper ...... upper what? |
| 90% of plummer-vinson syndrome happen in which gender? | Women |
| Mallory-Weiss Syndrome: | Lacerations of the lower esophagus and upper stomach |
| Mallory-Weiss Syndrome is caused by what? | Severe retching, often associated with alcoholism. Pt can also vomit blood. |
| Mallory-Weiss Sydrome can lead to what? | Could also lead to peritonitis or pleurisy due to contents leaking out |
Created by:
walkingbyfaith09
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