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68WM6 Ph 2 GI2

Gastrointestinal System

this sphincter prevents reflux of gastric contents into the esophagus cardiac (lower esophageal) sphincter
this sphincter regulates the rate of stomach emptying into the small intestin pylorlic sphincter
the chief coenzyme of gastric juice which converts proteins into proteases and peptones pepsin
necessary for the absorption of vitamin B12 intrinsic factor
enzyme that controls gastric acidinty gastrin
this part of the small intestine contains the openings of the bile and pancreatic ducts duodenum
digests starch to maltose amylase
reduces maltose to monosaccharide glucose maltase
splits lactose into galactose and glucose lactase
reduces sucrose to fructose and glucose sucrase
splits nuclec acids to nucleotides nucleose
activates trypsinogen to trypsin enterokinase
these play a vital role in the synthesis of some B vitamins and vitamin K intestinal bacteria
prevents contents of the large intestine from entering the ileum ileocecal valve
this organ synthesizes glucose, amino acids, and fats liver
this organ stores 200 to 400 mL of blood and also filters the blood liver
stores and concentrates bile and contracts to force bile into the duodenum during the digestion of fates gallbladder
the cystic duct joins the hepatic duct to form common bile duct
the presence of fatty materials in the duodenum stimulates the liberation of this, which causes contraction of the gallbladder and relaxation of the sphincter of Oddi cholecystokinin
secretes sodium bicarbonate to neutralize the acidity of the stomach contents that enter the duodenum pancreas
examination of the upper GI tract under fluoroscopy after the patient drinks barium sulfate barium swallow (upper GI seies)
after a barium swallow test, the client should be instructed to increase po fluid until stools resume their normal color
a fluoroscopic and radiographic examination of the large intestine after the rectal instillation of barium sulfate barium enema (lower GI series
the diet restrictions before a barium enema study include low residue diet for 1-2 days, clear liquid diet day before and laxative the evening before, NPO after midnight
requires the passage of a NG tube into the stomach to aspirate gastric contents for analysis of acidity, appearance, and volume gastric analysis
how long should a patient be NPO before gastric analysis 8 to 12 hours
upper GI endoscopy is also known as esophagogastroduodenoscopy(EGD)
following sedation, an endoscope is passed down the esophagus to view the gastric wall, sphincters, and duodenum EGD
how long should a patient remain NPO following EGD 1 to 2 hours
use of a rigid scope to examine the anal canal anoscopy
before anoscopy, proctoscopy, and sigmoidoxcopy enemas are given until returns are clear
a fiberoptic endoscopy study in which the lining of the large intestine is visually examined colonoscopy
following endoscopic examinations, guarding of the abdomen, increased fever and chills, pallor, abdominal distensiona and pain, restlessness, tachycardia, and tachypnea are signs of bowel perforation; peritonitis
performed with a fiberoptic laparoscope that allows direct visualization of organs and structures within the abdomen laparoscopy (peritoneoscopy)
performed to detect gallstones and to assess the ability of the gallbladder to fill, concentrate its contents, contract, and empty cholecystography
before colecystography, patient should be assessed for allergies to iodine or seafood
examination of the hepatiobiliary system performed via a flexible endoscope inserted into the esophagus to the descending duodenum endoscopic retrograde cholangiopancreatography (ERCP)
examination involving injection of dye directly into the biliary tree percutaneous transhepatic cholangiography
transabdominal removal of fluid from the peritoneal cavity for analysis paracentesis
why should a patient void before paracentesis is performed? to move the bladder out of the way of the paracentesis needle
how is a patient positioned for parcentesis? upright on edge of bed, or fowlers if bedridden
needle inserted through the abdominal wall to the liver to obtain a tissue sample for biopsy and microscopic evaluation liver biopsy
these laboratory values should be checked before a liver biopsy is performed PT, PTT, INR
patient should like on this side for this long after a liver biopsy right side, two hours
urea breath test detects the presence of ________, which is the bacteria that causes perptic ulcer disease heicobacter pylori
__________ is released during liver damage or biliary obstruction alkaline phosphatase, (bilirubin is also an acceptable answer)
prothrombin time is _________ with liver damage prolonged
_________________ assesses the ability of the liver to deanimate protein byproducts serum ammonia
liver enzymes are ______________ with liver damage elevated
an increase in _________ indicates pancreatitis or biliary obstruction cholesterol
increased values of amylase and lipase indicate __________ pancreatitis
normal bowel sounds occur every __ to ___ seconds 5 to 15
how long must you listen before assuming that bowel sounds are absent? 5 minutes
backflow of gastric and duodenal contents into the esophagus gastroesophageal reflux
causes of GERD incompetent lower esophageal sphincter, pyloric stenosis, or motility disorders
also known as esophageal or diaphragmatic hernia hiatal
inflammation of the stomach or gastric mucosa gastritis
in chronic gastritis, a deficiency of this vitamin may develop B12
ulceration in the mucosal wall of the stomach, pylorus, duodenum, or esophagus peptic ulcer
the proper order for performing an abdominal assessment inspect, auscultate, percuss, palpate
chronic gastritis is distuinguished from acute gastritis by the following symptoms in addition to nausea, vomiting, and anorexia belching, heartburn after eating, sour taste in mouth, vitamin B12 deficiency
ulcers are named according to their _____ location
most common sites of peptic ulcers stomach and duodenum
mucosal barrier protectants should be administered... 1 hour before meals
pain with gastric ulcers is usually located in ___________ and occurs ________ after meals mid or left epigastric, 30 to 60 minutes
pain with duodenal ulcers is usually located in ___________ and occurs _________ after meals midepigastric, 1.5 to 3 hours
removal of the stomach with attachment of the esophagus to the jejunum or duodenum total gastrectomy (esophagojejunostomy or esophagoduodenostomy)
surgical division of the vagus nerve to eliminate the vagal impulses that stimulate hydrochloric acid secretion in the stomach vagotomy
removal of the lower halv of the stomach and usually includes a vagotomy gastric resection or antrectomy
partial gastrectomy with the remaining segment anastomosed to the duodenum billroth I, or gastroduodenostomy
partial gastrectomy with the remaining segment anastomosed to the jejunum billroth II, or gastrojejunostomy
enlargement of the pylorus to prevent or decrease pyloric obstruction and enhance gastric emptying pyloroplasty
should an NG tube be irrigated following gastric surgery? no
rapid emptying of the gastric contents into the small intestine that occurs following gastric resection dumping syndrome
loud gurgles indicating hyperperistalsis; stomach growling borborygmi
results from a deficiency of intrinsic factor pernicious anemia (vitamin B12 deficiency)
signs of pernicious anemia smooth, beefy red tongue, parasthesias of hands and feet, gait a balance disturbances
to prevent dumping syndrome, this diet should be followed high protein, high fat, low carbohydrate
foods that contain vitamin B12 yeast, citrus fruits, dried beans, green leafy vegetables, liver, nuts, organ meats
following bariatric surgery, the patient is restricted to liquid and pureed food for how many weeks 6
dilated and tortuous veins in the submucosa of the esophagus esophageal varices
esophageal varices are caused by ______ _________ portal hypertension
how should a patient with esophageal varices be positioned? head elevated
this medication is administered to induce vasoconstriction and reduce bleeding of esophageal varices vasopressin
this medication is administered in conjunction with vasopressin to prevent vasoconstriction of the coronary arteries (in treatment of bleeding esophageal varices) nitroglycerin
this should be avoided by a patient with esophageal varices vasovagal responses
the injection of a sclerosing agent into and around bleeding varices sclerotherapy or endoscopic injection
ligation of varices with an elastic rubber band endoscopic variceal ligation
this type of ulcerative colitis results in vascular congestion, hemorrhage, edema, and ulceration of the bowel mucosa acute
this type of ulcerative colitis causes muscular hypertrophy, fat deposits, and fibrous tissue with bowel shortening, thickening, and narrowing chronic
key signs of ulcerative colitis severe diarrhea with blood and mucus, dehydration and electrolyte imbalance, vitamin K deficiency
ulcerative colitis can be cured by protocolectomy with permanent ileostomy
intraabdominal pouch that stores the feces constructed from the terminal ileum kock pouch
before colostomy/ileostomy, intestinal antiseptics and antibiotics are administered to decrease baceria in the colon
normal stoma color is bright pink or red, and shiny
key signs of crohn's disease crampy colicky pain after meals, semisolid diarrhea, dehydration, electrolyte imbalances
surgery for this inflammatory bowel disease is avoided because recurrence of the disease process is likely to occur crohn's disease
outpouching or herniation of the intestinal mucosa diverticulosis
inflammation of one or more diverticula diverticulitis
a perforated diverticulum can progress to peritonitis
key signs of diverticulosis/itis LLQ pain that increases with coughing, straining or lifting, palpable, tender rectal mass, blood in stools
dilated varicose veins of the anal canal hemorrhoids
_________ are caused by portal hypertension, straining, irritation, or increased venous or abdominal pressure hemorrhoids
key sign of hemorrhoids pain and bright red bleeding on defecation
how often should sitz baths be used 3 to 4 times per day
key sign for appendicitis abdominal pain most intense at McBurney's point, rebound tenderness
how will a patient with acute appendicitis usually position themselves? side lying with abdominal guarding and knees flexed
inflammation of the peritoneum peritonitis
following appendectomy with appendix rupture, how should a patient be positioned right side lying or low to semi fowlers with legs flexed to facilitat drainage
chronic, progressive disease of the liver characterized by diffuse degeneration and destruction of hepatocytes cirrhosis
cirrhosis that is alcohol induced, nutritional, or portal laennec's
cirrhosis as a complication of acute viral hepatitis or exposure to hepatotoxins postnecrotic
cirrhosis as a complication of chronic biliary obstruction, bile stasis, or obstructive jaundice biliary
cirrhosis associated with severe right sided congestive heart failure cardiac
persistent increase in pressure within the portal vein that develops as a result of obstruction to flow portal hypertension
the accumulation of fluid within the peritoneal cavity that results from venous congestion of the hepatic capillaries ascites
progressive renal failure associated with hepatic failure hepatorenal syndrome
a patient with ascites would have a dietary restriction of sodium and fluid
coarse tremor chacterized by rapid, nonrhythmic extension and flexion in the wrist and fingers asterixis
fruity, musty breath odor of severe chronic liver disease fetor hepaticus
this medication decreases the pH of the bowel, decreases production of ammonia by bacteria in the bowel, and facilitates the excretion of ammonia lactulose (chronulac)
this mecications inhibits protein synthesis in bacteria and decreases the production of ammonia neomycin; metronidazole (flagyl)
this type of cholecystitis results when inefficient bile emptying and gallbladder muscle wall disease cause a fibrotic and contracted gallbladder chronic
this type of cholecystitis occurs in the absence of gallstones and is due to bacterial invasion via the lymphatic or vascular systems acalucous
key signs of cholecystitis epigastric pain 2 to 4 hours after eating fatty foods, pain in RUQ, Murphy's sign (inability to take a deep breath when the examiner's fingers are passed below the hepatic margin)
removal of the gallbladder cholecystectomy
incision into the common bile duct to remove a stone choledocholithectomy
these two activities should be encouraged following gallbladder surgery to avoid respiratory complications coughing, deep breathing
acute or chronic inflammation of the pancreas with associated escape of pancreatic enzymes into surrounding tissue pancreatitis
key signs of pancreatitis midepigastric or LUQ pain that is aggravated by a fatty meal, alcohol, or lying in a recumbent position
discoloration of the abdomen and periumbilical area (pancreatitis) cullen's sign
discoloration of the flanks (pancreatitis) turner's sign
elevated serum lipase and amylase are indicators of pancreatitis
signs of chronic pancreatitis LUQ mass, seatorrhea and foul smelling stools, diabetes mellitus
the first stage of hepatitis preceding the appearance of jaundice; flu like symptoms preicteric stage
the second stage of hepatitis which includes the appearance of jaundice and associated symptoms such as elevated bilirubin levels, dark urine, and clay colored stools icteric stage
the convalexcent stage of hepatitis in which jaundice decreases and urine and stool color return to noromal posticteric stage
how is hepatitis A most commonly transmitted fecal-oral route
how is hepatitis B most commonly transmitted parenterally
how is hepatitis C most commonly transmitted parenterally
how is hepatitis D most commonly transmitted parenterally, and only in conjunction with hepatitis B
How is hepatitis E most commonly transmitted contaminated water
how is hepatitis G most commonly transmitted parenterally
Created by: ewoff85
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