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Intro to GI
CM1-Fall 2011
| Question | Answer |
|---|---|
| Which phase of digestion involves seeing, smelling, and tasting food? | Cephalic phase |
| Which phase of digestion involves the arrival of food in the stomach which stimulates gastric secretion? | Gastric phase |
| Which phase of digestion involves the movement of chyme into the duodenum and decreases the gastric secretions? | Intestinal phase |
| What are the names of the salivary glands and which one produces the most saliva? | 1. Parotid (Stenson's) 2. Submandibular (Wharton's) **MOST SALIVA produced here 3. Sublingual |
| What enzyme in the saliva initiates carb digestion? | Amylase |
| What is the pH of the mouth and why? | 7.4; to protect tooth enamel |
| What prevents bacterial infex in the mouth? | Immunoglobulin A |
| What phase of swallowing involves the formation of a bolus and movement into the esophagus? | Oropharyngeal phase |
| What is the muscle character of the esophagus? | Upper 1/3=Voluntary (striated muscle) Middle 1/3=mix of invol and vol Lower 1/3=Involuntary (smooth muscle) |
| What swallowing phase is when the bolus is moved down the esophagus by peristalsis? | Esophageal phase |
| What are some d/o's of the esophagus? | -Heartburn -Dysphagia -Odynophagia |
| What is the condition called that involves difficulty swallowing food, liquids, saliva? | Dysphagia (Obstruction v. Neuromuscular?) |
| What condition involves sharp pain w/swallowing? | Odynophagia |
| Odynophagia may be assoc w/? | -Infections -Mucosal lesions of esophagus -Hrtburn |
| Which test measures the strength and coordination of peristalsis? | Manometry |
| What is the anatomy of the stomach? | -Fundus,body,antrum -Cardiac and pyloric sphincters |
| Where in the GI tract is alcohol absorbed? | Stomach |
| Which cells secrete pepsinogen? What is it? | *Chief cells -Precursor to pepsin which is an enzyme that breaks down proteins |
| What do parietal cells secrete? | -HCl and Intrinsic factor |
| Role of HCl in stomach? | -Dissolves food -Is bacteriocidal -Converts pepsinogen to pepsin |
| What is intrinsic factor required for? | Absorption of Vit B12 |
| Mucous cells secrete? | Mucus and bicarb; protective barrier |
| What do enterochromaffin-like cells do? | Secrete histamine H1 which stimulates gastric acid |
| Which cells secrete somatostatin? | D cells |
| What is the role of somatostatin? | Inhibits gastric acid and pepsinogen |
| Which cells are involved in gastric secretion? | -Parietal cells -Chief cells -Mucous cells -Enterchromaffin-like cells -D cells |
| Which hormone is secreted in response to partially digested protein in the stomach and fxns to ^motility and HCl production? | Gastrin (via G cells) |
| Which hormone is secreted in response to acid entering the duodenum and ^es GI motility? | Motilin |
| Which hormone decreases gastric motility and gastric secretion of HCl and stimulates pancreatic alkaline secretion and the liver to release bile? | Secretin |
| Which hormone decreases gastric motility and is involved in the contraction of the GB to release bile and stimulation fo the pancreatic alkaline secretion? | Cholecystokinin |
| What are some things that can cause gastritis? | NSAIDS, H.pylori infex, alcohol, dietary irritants |
| What is a break in the gastric mucosa resulting from acid and pepsin? | Peptic ulcer dz (assoc w/H.pylori,NSAIDS, or hypersecretion conditions) |
| What is the primary site for digestion and absorption? | SI (Duodenum=primary site for chemical digestion) |
| What is the shortest portion of the SI? | Duodenum |
| Where is iron absorbed? | Duodenum |
| What separates the duodenum from the jejunum? | Ligament of Trietz |
| Where in the SI are most nutrients absorbed? | Jejunum |
| Where are vit B12 and bile salts absorbed? | Ileum |
| 80-90% of H2O is absorbed where? | SI |
| In the SI, carbs are broken down into? | Mono and disaccharides |
| What happens to proteins in the SI, and how? | Broken down into aa's and peptides via pancreatic enzymes |
| What happens to fats in the SI? | Reduced to FAs and monoglycerides |
| B12 is absorbed in the ileum, where are Ca2+ and iron absorbed? | Duodenum; remainder is absorbed in the jejunum |
| Which infection attacks the SI and impairs ability to absorb nutrients? | Giardia |
| When there is a loss of peristalsis in the SI, it is called? | Ileus |
| What are the risks for SBO? | Surgical adhesions and hernias (In 3rd world countries=usually d/t tumor) |
| What are the short segmental movements that fxn to ^ contact time for absorption of H2O and Na+? | Haustral contrax (~q25 minutes) |
| What fxns to propel intestinal contents and usually happens post-prandial? | Mass movement (1-3x/day~) |
| What is reabsorbed from the LI and what is excreted in the feces? | Reabsorbed: H2O, Na+, Cl- Excreted: K+ and bicarb |
| What makes up 30-50% of the stool? | Bacteria!! (eeeeew) |
| Which dz of the LI involves skip lesions, any location in the GI tract and most commonly the terminal ileum? | Crohn's Dz |
| Who is appendicitis most likely to occur in? | The young and old |
| What is the condition where ^d luminal pressure produces out-pouching usually in the sigmoid colon? | Diverticulosis |
| What system is comprised of the liver, GB and pancreas? | Biliary |
| When bilirubin is bound by albumin and is lipid soluble it is called? | Unconjugated bilirubin |
| How does bilirubin bcome conjugated? | Via glucoronic acid in the liver -- making it water soluble |
| Bacteria in the colon deconjugate bilirubin into urobilinogen which is? | Reabsorbed and secreted in the urine |
| What is jaundice? | Accumulation of bilirubin the body tissue |
| In jaundice, what turns yellow first? | Sclera of eyes |
| What is the viral infection of the liver that can be autoimmune, or alcohol or drug-induced? | Hepatitis (A,B,C,D,E) |
| What is the condition called that involves fibrosis of the liver which results in loss of fxn? | Cirrhosis (mc assoc w/alcohol use and viral hepatitis) |
| What drains blood from the GI tract and spleen, to the liver? | Hepatic portal vein |
| When there is ^d pressure in the hep portal vein, this is called? | Portal HTN |
| Distended veins caused by prolonged elevation of pressure assoc w/portal HTN is called? | Varices |
| When toxins produced in the gut pass into systemic circulation and cause altered CNS symptoms, what is this called? | Encephalopathy |
| Accum of fluid in the peritoneal cavity from decreased oncotic pressure is known as? | Ascites |
| The hepatopancreatic duct empties via what, in the duodenum? | Sphincter of Oddi |
| About 5% of the pancreas fxn is endocrine, in nature. What is secreted? | 1.Insulin:in response to ^ blood sugar 2. Glucagon:in response to low blood sugar |
| The other ~90% of the pancreas fxn is exocrine, in nature. Trypsin and chymotripsin, lipase, amylase, and bircarb are secreted, what are their roles? | 1.Trypsin and chymotrypsin break down protein 2.Lipase breaks down TGs 3. Amylase brks down starch/carbs 4.Bicarb neutralizes the acid from the stomach |
| What may be some causes of RUQ pain? | -Cholecystitis -Pancreatitis -Gastritis/PUD -Hepatitis |
| What may be some causes of RLQ pain? | -Appendicitis -Ovarian pain -Ectopic pregnancy |
| -What may be some causes of LUQ pain? | -Splenic infarction -Pancreatitis -Gastritis/PUD |
| What may be some causes of LLQ pain? | -Diverticulitis -Ovarian pain -Ectopic preg |
| What kind of pain is sharp,localized,and lateralizes (can pt right to it)? | -Parietal pain |
| What kind of pain is midline, poorly localized, and dull (vague-all over)? | -Visceral pain |
| Appendicitis, diverticulitis, cholecystitis, and pancreatitis all have what kind of pain assoc w. them? | Parietal pain |
| Gastroenteritis, bowel obstrux, and constipation all have which kind of pain assoc w/ them? | -Visceral pain |
| What is hematemesis? | Vomiting blood (assoc w/upper GI bleed) |
| What is hematochezia? | Bright red blood per rectum (BRBPR) -Assoc w/lower GI bleed or massive upper GI bleed |
| What is melena? | Dark, tarry stool - assoc w/upper GI bleed |
| What kind of bleed would be occurring in the esophagus, stomach or duodenum? | Upper GI bleed |
| What kind of bleed would be occurring in the Jejunum, Ileum, LI, or rectum? | Lower GI bleed |
| Normal # of stools/week? | 3-12 (varies) |
| How much material (#) does the intestine process/day? | ~9L of material/day (-7L from intestinal secretions, 2L from ingestion) |
| 99% of fluid is absorbed..where? | 90% in SI, 9% in colon |
| What are 2 markers of liver INJURY and which is more specific to the liver? | AST and ALT, ALT is more specific to the liver |
| An elevated alk phos may indicate? | Bile duct obstrx |
| What are the markers of pancreas inflamm? | 1. Amylase rises quicker w/pancreatitis 2. Lipase stays elevated longer w/pancreatitis |
| What electrolyte disturbances can be seen w/ 1.vomiting 2.Diarrhea 3.Dehydration | 1.Vom=Hypochloremic metabolic alkalosis (reduced HCl) 2.Diarrhea=hypokalemia 3.Dehydration=hyperNa+ |
| What test combines endoscopy w/the injection of iodinated contrast agent into the biliary and pancreatic ducts? | ERCP (endoscopic retrograde cholangiopancreatography) |
| What is the non-invasive technique for evaluating the biliary and pancreatic ductal systems using magnetic resonance? | MRCP (magnetic resonance cholangiopancreatography) |
| What test involves tagging neutrophils and macrophages w/technetium-99 albumin and administering it via IV? | Hida scan (the tagged cells go to the site of inflammation) -Time-consuming and not widely available |
Created by:
ferrier.kath
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