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210 ch. 34

GI function

Where is the stomach located left upper portion of abd under left lobe of liver and diaphragm overlaying most of pancreas
How much does the stomach hold 1500ml
What are four anatomic regions of stomach? what are two sphincters cardia(entrance), fundus, body, pylorus(outlet)... LES(lower esophageal) and pyloric
what is fx of sm int..21ft? what are three sections? absorption is primary, then secretion Duodenum, jejunum(middle), ileum
What does the ileocecal valve do? ileum terminates at valve and controls flow of digested material from ileum to cecal, prevent reflux
What is attached to cecum? appendix
What empties into the duodenum at the ampulla of Vater? common bile duct
what are parts of lg int...5-6ft ascending, transverse, descending(left side of abd), sigmoid colon, rectum, anus
What are the five major veins that make up the vena portae that enters liver sup mesenteric, inf mesenteric, gastric, splenic, cystic vv...
which vv supply O2 and nutriets to stomach and intestine stomach: gastric intestine: mesenteric
Which part of the lg int has the most motility transverse, it moves with expanding stomach
What two things are key to the elderly with hospitilzation and the GI hydration bc low saliva, so help food intake excercise bc slower digestion
when assessing pt with GI issues what is important about meds, elimination, excercise, chief complaint Some meds incr (cholinergics)/ decr(anticholinergics) GI fx look at color,smell,consistency normal excercise amount
How should you obtain physical exam of GI issue? Inspection:bruise/lesions auscultation:4 quads percussion:high/solid/dull, low/gas/tympani palpation: can move things @
What is fx of GI tract digestion, absorption, elimination
What enzyme do chief cells secrete and what is fx pepsin, protein digestion
What is intrinsic factor and where is it secreted by parietal cells in gastric mucosa, combines w/ B12 so can be absorbed by ileum. If absent, get pernicious anemia.
What is pH of stomach vs sm int pH of stomach can be as low as 1. Sm int is more alkaline, bicarbonate
what is difference and similarities of pepsin and trypsin Both are digestive enzymes. Pepsin is in gastric mucosa. Trypsin is released from pancreas
What are two types of contractions in sm. int. segmentation contractions: mixing waves, churning contents Intestinal peristalsis: propel to colon. Both stimulated by presence of chyme.
Discuss difference and similarities of absorption of nutrients vs fats/proteins/carbs/Na/chloride/B12/bile salts/Mg/Ph/K Sm Int/Duodenum:nutrients Jejunum:fats/proteins/carbs/Na/Cl Ileum: B12/bile salts Sm Int: Mg/Ph/K
What are two types of colonic material added to residual material electrolyte solution: bicarbonate and mucus to protect lining and help fecal adherence.
Where does the brown color of poop come from breakdown of bile
What are age related changes to GI loss of teeth, decr salivation, motility, HCL acid, peristalsis, tone in sphincters
what is dyspepsia indigestion
Pain in upper right shoulder can indicate liver probs
Appendicitis will show pain where LLQ
Blood in stool presented from? black color in stool? bright/dk red blood in stool? Red streaked bloody stool? black(melena): upper GI tract bright/dk red: lower GI streaked: lower rectal/anal
Other stool abnomalities: bulky,greasy,foul smell clay colored, no bilirubin mucus threads or pus small, dry, rock-hard loose, watery
A large "V" formation with thin white coat on tongue, is this normal? yes
What are 9 regions of stomach starting from LUQ to right lft hypochondriac-epigastric-rt hypchondriac Lft lumbar-umbilical-rt lumbar lft inguinal-hypogastric-rt inguinal
what are four types of bowel sounds heard on auscultation normal, hyperactive, hypoactive, absent(none for 3-5min)
Diagnostic serum tests for GI CBC, PTT, triglycerides, liver fx, amylase, lipase, CEA(carcinoembryonic antigen) and CA(cancer antigen 19-9 for colon Ca
Stool tests FOBT- early Ca detection, blue=blood..assess diet before: avoid red meat, aspirin, NSAIDs, turnips, horseradish, Vit C. Gather in dk stool area
How should you handle Ova/parasite stool samples? stools for lipids? parasite: warm sample, 3 specimens lipid: put on ice, Crohn's dis test
What is breath test looking for in GI overgrowth of bacteria in intestine and short bowel syndrome. Test for levels of hydrogen to test fot Hpylori bacteria
Ultrasonic testing for GI tests for gallstones, enlarged ovary, enlarged gallbladder/pancreas, ectopic preg, appendicitis Nsg mgmt: NPO to lower gas
Upper GI radiologic tests Lower GI tests swallow barium barium enema..always scheduled b4 upper GI tests and not for active inflammatory dis or perforations/obstructions
CT scans are suited for what body type? thin, not much fat..schedule b4 barium
When is MRI contraindicated? pt with pacemaker, artificial heart valves, defibrillators, insulin pumps, anxiety of closed spaces
What is most important nsg mgmt after endoscopy check gag reflex with tongue blade from Versed.
What does "til clear" mean with barium enemas run enemas three times till poop gone. Now Go-LYTELY, CoLyte) If bleeding, use Gastrografin contrast agent
What are nsg mgmt of endoscopy Lay on left side to aid clearance of pulmonary secretions. Watch what you say, cause 8th cranial nerve(hearing) last to go
what is ERCP endoscopic retrograde cholangiopancreatography looking for common bile duct and looking for gallstones
what concern is nsg looking for after colonoscopy? bowel perforation, rectal bleeding, abd pain/distention, fever
Created by: palmerag