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Exam 5- Anatomy
Digestive System
| Question | Answer |
|---|---|
| Why is it important to know the mucosal layers of the digestive system? | bc different parts of the digestive tract do not have the same mucosal layers and this could play a role in how that type of cancer spreads |
| What is the innermost layer of the mucosal layers? | mucosa |
| What does the mucosa line? | insides of organs and cavities |
| What portions is the mucosa divided into? | epithelium, lamina propria, and muscularis portions |
| What does the thickness of the mucosa depend on? | where in the digestive system it is located |
| What does the epithelial layer in the mucosa do? | absorbs and secretes mucus and digestive enzymes |
| What is found in the lamina propria layer of the mucosa? | blood and lymph vessels |
| What is found in the muscularis layer of the mucosa and what does it do? | smooth muscle and it breaks down foods |
| What are the functions of the mucosa layer? | -functions in the body's immune system -provides a barrier against foreign particles -protects against harmful agents -absorbs during digestion |
| How does the mucosa provide a barrier against foreign particles? | traps them in the mucus |
| T or F. The mucosa protects against the body's own stomach acid and urine. | True |
| What would nursing intervention be for radiation induced mucositis? | magic mouthwash |
| What does magic mouthwash contain? | numbing agent (e.g. lidocaine), coating agent (to stick to membrane), benadryl (to reduce inflammation and redness), antibiotic (in case of infection) |
| What is the second layer of the mucosal layers? | submucosa |
| What does the submucosa contain? | connective tissue, glands, blood vessels, lymphatic vessels, and nerves |
| What does the connective tissue in the submucosa help the gut do? | regain and maintain its shape after food passes through |
| What is the third layer of the mucosal layers? | muscularis |
| What is the muscularis layer responsible for? | movement (peristalsis) |
| What is the outermost layer of the mucosal layers? | serosa |
| What is the serosa composed of? | thin layer of connective tissue and a layer of cells capable of secreting serous fluid |
| What are the functions of the serosa? | functions as a protective membrane and assists in organ movement |
| What are the 3 serous cavities in the body? | pericardial, pleural, and peritoneal |
| The loops of the digestive tract are anchored to the posterior wall of the abdominal cavity by a double fold of the peritoneal tissue called the ________________. | mesentery |
| Do all digestive system organs have a serosal layer? | No |
| What does the esophagus have instead of a serosa? | adventitia |
| What is adeventitia? | outer layer of fibrous connective tissue that lines an organ |
| The esophagus is divided into what 3 portions? | upper, middle, lower |
| The upper 1/3 of the esophagus is diagnosed more commonly with that type of cancer? | squamous cell |
| The middle and lower portions of the esophagus is more commonly diagnosed with what type of cancer? | adenocarcinoma |
| The most common type of cancer in the esophagus is what? | adenocarcinoma |
| Is esophagus cancer more common in men or women? | men |
| What are some etiological factors of esophageal cancer? | -chronic irritation (GERD/reflux and Barrett's esophagus) -smoking -alcohol -processed foods -HPV |
| What is the most common symptom of esophageal cancer? | dysphagia (difficulty swallowing) |
| What is the treatment for esophageal cancer? | surgery if possible, radiation combined with chemo |
| Why might an esophageal tumor be considered unresectable? | not enough margin around the tumor to remove depending on where the tumor is |
| What is something that could happen with esophageal cancer since there is no serosa? | since there is not that lining that would hold the tumor in place for a period of time, it is possible for the cancer to cause skip lesions |
| What is Aflotixin? | mold or fungus that is found on foods that grow in the ground; associated with tumors of the digestive system |
| What are the 3 portions of the stomach? | fundus at the top, body, and pylorus at the bottom |
| How much food can the stomach hold? | 3 pints |
| Is stomach cancer more common in men or women? | men |
| What age range does stomach cancer most commonly affect? | over 65 |
| What are some etiological factors of stomach cancer? | H. pylori bacteria, processed foods, alcohol, smoking, previous stomach surgeries, EBV, polyps, pernicious anemia, family hx |
| What is the most common histopathology of stomach cancer? | adenocarcinoma (90-95%) |
| What are other histopathology types that can occur in the stomach? | sarcomas (GIST -- gastrointestinal stromal tumors) or lymphomas (MALT -- mucosal associated lymphatic tissues) |
| What is the most common symptom of stomach cancer? | persistent indigestion/heartburn |
| Stomach cancer treatment depends on what? | diagnosis |
| The pancreas functions as what 2 glands? | endocrine and exocrine glands |
| What does the endocrine gland produce? | insulin which helps regulate and store glucose |
| What does the exocrine gland produce? | enzymes that digest fat, protein, and carbs |
| Tumors of the pancreas are often _________________ when diagnosed. | advanced |
| A 5 year prognosis is around a _______-________%. | 5-20% |
| Why is the prognosis fairly low for pancreatic cancer? | it is bc the general age of being diagnosed is 70+ and are normally in poor health and cannot tolerate treatment |
| Is pancreatic cancer more common in men or women? | men |
| What are some etiological factors of pancreatic cancer? | family hx, chronic pancreatitis, coffee, alcohol, smoking, H. pylori, Hep B, and Lynch syndrome |
| What is Lynch syndrome? | inherited syndrome that increases the risk of malignancies |
| What is the most common histopathology of pancreatic cancer? | adenocarcinoma |
| The symptoms for pancreatic cancer depends on what? | the location of the tumor |
| If the pancreatic tumor is on the head of the pancreas, what kind of symptom would occur in 80-90% of cases? | jaundice |
| If the pancreatic tumor is on the tail of the pancreas, what kind of symptom would occur in 10-20% of cases? | causes pain |
| What surgery would be performed for pancreatic cancer? | whipple procedure |
| What is the whipple procedure? | removal of the head of pancreas, duodenum, bile ducts, gall bladder, and any involved tissues |
| Other than the whipple procedure, what treatment would be done for pancreatic cancer? | chemotherapy 5-FU and gemcitabine (may be combined w/ rad therapy) |
| What is the largest gland of the body? | liver |
| The liver is an _______________ gland that secretes __________. | exocrine; bile |
| What kind of prognosis does liver cancer have? | poor prognosis |
| Is liver cancer more common in men or women? | men |
| What are some etiological factors of liver cancer? | Hep B and C, cirrhosis, alcohol, smoking, and obesity |
| What is the histopathology of liver cancer if it is a primary tumor? | hepatocellular carcinoma |
| What is the histopathology of liver cancer if it is a secondary tumor? | liver mets |
| Is a primary or secondary tumor more likely in the US? | secondary |
| What treatment options are there for liver cancer? | -surgery -chemo -embolization -radiofrequency -rad therapy |
| What does the gallbladder store and release? | bile which helps to dissolve fat |
| T or F. Gallbladder cancer is rare and carries a poor prognosis. | True |
| Is gallbladder cancer more common in men or women? | women |
| What is the average age of diagnosis of gallbladder cancer? | 72 |
| What are some etiological factors of gallbladder cancer? | gallstones, porcelain gallbladder, obesity, smoking, choledochal cysts, polyps, and family hx |
| What is the hisopathology of gallbladder cancer? | cholangiocarcinoma |
| What are the most common symptoms of gallbladder cancer? | pain, nausea/vomiting, and jaundice |
| What are the treatment options for gallbladder cancer? | surgery and chemo |
| Villus (villi) contain a rich network of _____________. | capillaries |
| What do the capillaries in the villi do? | absorb glucose and amino acids |
| How are villus arranged? | in plica (folds) |
| Why are villus arranged in plica? | bc this increases the surface area and make it well suited for the absorption of water and nutrients |
| What does each villi contain? | micro-villi that further increase the surface area for absorption |
| What are lacteals in the villi? | the lymphatics that absorb fats |
| These are found in the villi and are located at the base and secrete digestive enzymes that control the microbial environment of the bowel. | crypts of Lieberkuhn (or paneth cells) |
| What are the 3 sections of the small intestine? | duodenum, jejunum, and ileum |
| What gland is found in the duodenum and what does it do? | Brunner's glands which secrete intestinal liquids that mix with bile and pancreatic secretions to breakdown fluid |
| What is the jejunum responsible for? | digestion |
| What is the ileum responsible for? | absorption of fat and soluble vitamins like A, D, E, and K |
| How long is the small intestine? | 15-20 feet |
| What are Peyer's patches? | gut associated lymphatic tissues (GALT) located in the small intestine and prominent ileum |
| Are men or women more affected by cancer of the small intestine? | men |
| What age range is typically affected by small intestine cancer? | older (60s-70s) |
| What are some etiological factors of small intestine cancer? | smoking, alcohol, celiac disease, Chron's disease, and Lynch syndrome |
| What are the 4 histopathology types of small intestine cancer? | adenocarcinomas, carcinoid tumors, lymphomas, sarcomas (GIST) |
| Symptoms associated with small intestine cancer. | pain, nausea/vomiting |
| What are the treatment options for small intestine? | surgery and chemo |
| Why would rad therapy not be an option for small intestine cancer? | limited by dose and small bowel can't be immobilized for reproducibility |
| What is cancer of the large intestine/colon often referred to as? | colo-rectal disease |
| What is the primary responsibility of the large intestine? | reclaim water |
| How is colo-rectal disease preventable? | by screening via colonoscopy starting at age 45 |
| At what age is colo-rectal disease seen in people? | over 50 |
| Why is colo-rectal disease starting to be seen in people younger than 50? | due to change in lifestyle (poor diet and lack of exercise) |
| What are some etiological factors of colo-rectal disease? | polyps, obesity, processed food, poor diets, family hx, Lynch syndrome, Chroh's disease, smoking, and alcohol |
| What are the 4 histopathology types of colorectal disease? | adenocarcinomas, carcinoid tumors, sarcomas (GISTs), and lymphomas |
| What is the treatment option for early stage (I - III) colorectal disease? | surgery |
| What is the treatment option for late stage (IV) colorectal disease? | surgery, chemo, and rad therapy |
| At what point in the anus do we see a change in tissue and cell type? | dentate line |
| Who is more affected by anal cancer? | white women and black men |
| What are some etiological factors of anal cancer? | HPV, HIV, anal warts, anal sex, and smoking |
| What is the histopathology type seen in anal cancer? | squamous cell carcinoma (90%) others: adenocarcinoma, basal cell carcinoma, melanomas, GISTs |
| What are some benign things seen in the anus? | -polyps -skin tags -warts -lipomas |
| What are the symptoms associated with anal cancer? | -rectal bleeding -rectal itching -rectal mass -narrowing of stool |
| What are the treatment options for anal cancer? | -surgery, rad therapy, and chemo |
| Where in the GI systema would H. pylori cause cancer? | stomach and pancreas |
| Where in the GI system would a diet low in fruits/veggies cause cancer? | stomach and colon |
| Where in the GI system would processed (salted, smoked, preserved) foods cause cancer? | esophagus, stomach and colon |
| Where in the GI system would polyps cause cancer? | stomach, gallbladder, and colon |
| Where in the GI system would having a family hx of the disease cause cancer? | stomach, pancreas, gallbladder, and colon |
| Where in the GI system would Hep B and C cause cancer? | pancreas and liver |
| Where in the GI system would Lynch syndrome cause cancer? | pancreas, small intestine and colon |
| Where in the GI system would obesity cause cancer? | gallbladder, liver, and colon |
| Where in the GI system would celiac disease cause cancer? | small intestine and colon |
| Where in the GI system would Crohn's disease cause cancer? | small intestine and colon |
| Where in the GI system would alcohol cause cancer? | esophagus, stomach, pancreas, liver, small intestine, and colon |
| Where in the GI system would HPV cause cancer? | esophagus and anus |
| Where in the GI system would smoking cause cancer? | **linked to all esophagus, stomach, pancreas, gallbladder, liver, small intestine, colon, and anus |
| How is smoking linked to GI system cancer? | because you can swallow the carcinogens from smoking and this will stay in the GI tract until it passes through |
| TD 5/5 for kidney I | 2300 |
| TD 5/5 for bladder | 6500 |
| TD 5/5 for spinal cord | 4500 |
| TD 5/5 for heart | 4000 |
| TD 5/5 for esophagus | 5500 |
| TD 5/5 for stomach | 5000 |
| TD 5/5 for small intestine | 4000 |
| TD 5/5 for colon | 4500 |
| TD 5/5 for rectum | 6000 |
| TD 5/5 for liver | 3000 |
| CT # for air | -1000 |
| CT # for bone | 1000 |
| CT # for water | 0 |
| CT # for fat | -50 - -100 |
Created by:
lheard
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