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Intro to GI

CM1-Fall 2011

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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