CH 20
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| Intrinsc Factor is produced by? | show 🗑
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| show | It has hepatocytes and it does production of plasma proteins and clotting factors
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| What enzymes and electrocytes does the pancreas secrete? | show 🗑
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| show | Increased motility Increased secretions
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| show | Stimulated by fear, anger etc Inhibits gastrointestinal activity Causes vasoconstriction Reduced secretions and regeneration of epithelial cells
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| What is Gastrin? | show 🗑
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| show | Increased secretion of hydrochloric acid
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| What does secretin do? | show 🗑
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| What does Cholecystokinin do? | show 🗑
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| Anorexia,vomiting,and nausea are caused by? | show 🗑
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| show | Dehydration, acidosis, malnutrition
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| Nausea is happens when? | show 🗑
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| show | Medulla where it;Coordinates activities involved in vomiting Protects airway during vomiting
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| What makes up vomit? | show 🗑
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| What activates vomiting? | show 🗑
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| hematemesis | show 🗑
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| "Brown coffee ground" looking blood means? | show 🗑
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| Red blood vomit indicates? | show 🗑
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| show | Bile from the duodenum
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| Deeper brown color vomit | show 🗑
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| Recurrent vomiting from food means? | show 🗑
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| Diarrhea | show 🗑
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| show | Watery stool resulting from increased secretions into intestine from the plasma Often related to infection Limited reabsorption due to reversal of normal carriers for sodium and or glucose
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| show | Often due to inflammatory bowel disease Stool may contain blood, mucus, pus May be accompanied by abdominal cramps and tenesmus
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| show | Frequent bulky, greasy, loose stools Foul odor Characteristic of malabsorption syndromes i.e., celiac disease or cystic fibrosis Fat usually the first dietary component affected Presence interferes with digestion of other nutrients
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| Frank blood in stool | show 🗑
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| occult blood in stool | show 🗑
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| show | Dark-colored, tarry stool May result from significant bleeding in upper digestive tract
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| show | From swallowed air, e.g., drinking from a straw Bacterial action on food Foods or alterations in motility
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| show | Eructation Borborygmus Abdominal distention and pain Flatus
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| show | Acute or chronic problem May be due to decreased peristalsis Increased time for reabsorption of fluid
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| Chronic constipation causes? | show 🗑
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| show | Weakened smooth muscle from age or illness, Inadequate dietary fiber,Inadequate fluid intake,Failed response to defecation reflex, Neurologic disorders,Drugs,antacids,iron medications Obstructions by tumors or strictres
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| show | Dehydration and Hypovolemia
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| Metabolic alkalosis | show 🗑
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| show | Severe vomiting causes a change to metabolic acidosis due to the loss of bicarbonate of duodenal secretions. Diarrhea causes loss of bicarbonate
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| show | Inflammation and ulceration in upper digestive tract
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| Visceral pain (dull,aching) | show 🗑
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| show | Inflammation, distention, stretching of intestines
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| Visceral pain (colicky, often severe) | show 🗑
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| show | Somatic pain receptors directly linked to spinal nervesMay cause,Steady,intense, often well-localized abdominal pain,Involvement or inflammation of parietal peritoneum, “Rebound tenderness”identified over area of inflammation when pressure is released
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| Referred pain | show 🗑
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| Specific problems of malnutrition | show 🗑
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| General problems of malnutrition | show 🗑
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| show | Radiographs,ultrasounds,ct's,radioactive tracers through ct's and mri's, fiberoptic endoscopy,sigmoidoscopy,colonoscopy,analysis of stool, and blood tests
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| show | gluten-free diet (celiac disease) Reduced intake of alcohol and coffee Increased fiber and fluid intake
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| Antacids | show 🗑
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| show | relieve vomiting
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| Laxatives or enemas | show 🗑
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| show | reduce peristalsis and cramps
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| Sulfasalazine | show 🗑
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| show | Effective against Heliobacter pylori infection
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| Sucralfate | show 🗑
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| Anticholinergic drugs | show 🗑
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| show | useful in gastric reflux
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| Proton pump inhibitors | show 🗑
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| show | Cleft lip and cleft palate Arise in sixth to seventh week of gestation, Most likely of multifactorial origin, Feeding problems of the infant, High risk of aspirating fluid into respiratory passages,Speech development impaired,Surgical repair
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| Inflammatory lesions: aphthous ulcers | show 🗑
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| Candidiasis | show 🗑
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| show | People receiving bread-spectrum antibiotics During and after cancer therapy Immunocompromised individuals or persons with diabetes
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| Candida albicans | show 🗑
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| Herpes simplex virus type 1 (HSV-1) | show 🗑
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| Syphilis | show 🗑
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| show | Chancre, a painless ulcer on tongue, lip, palate Heals spontaneously (1 or 2 weeks)
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| Seconds stage of syphilis | show 🗑
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| Caries | show 🗑
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| Peridontitis | show 🗑
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| show | Leukoplakia (example) Whitish plaque or epidermal thickening of mucosa Occurs on buccal mucosa, palate, lower lip May be related to smoking or chronic irritation. Epithelial dysplasia beneath plaque may develop into squamous cell carcinoma
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| Squamous cell carcinoma | show 🗑
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| Kaposi sarcoma | show 🗑
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| show | Inflammation of the salivary glands May be infectious or noninfectious Most commonly affected – parotid gland
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| show | Viral infection Vaccine available
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| show | Often in older adults who lack adequate fluid intake and mouth care
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| show | difficulty swallowing from Neurologic deficit, Muscular disorder,Mechanical obstruction
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| Neurolic problems with dyphagia | show 🗑
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| show | muscular dystrophy
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| show | Dyshagia obstrucion ;Developmental anomaly Upper and lower esophageal segments are separated
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| show | Dysphagia causing obstruction;Narrowing of the esophagus,developmental or acquired,secondary to fibrosis,chronic inflammation,ulceration,radiation therapy, Stenosis or stricture result from scar tissue.treatment with repeated mechanical dilation
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| Esophageal diverticula | show 🗑
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| Esophogeal cancer | show 🗑
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| haiatal hernia | show 🗑
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| show | More common type Portion and part of stomach and gastroesophageal junction slide up above the diaphragm
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| Rolling or paraesophageal hernia | show 🗑
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| show | Heartburn or pyrosis Frequent belching Increased discomfort when laying down Substernal pain that may radiate to shoulder and jaw
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| Gastroesophageal Reflux Disease | show 🗑
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| show | Gastric mucosa is inflamed.May be ulcerated and bleeding,May result from,Infection by microorganisms,Allergies to foods,Spicy or irritating foods,Excessive alcohol intake, Ingesting aspirin,other NSAIDs,corrosive toxic substances,Radiation,chemotherapy
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| Basic signs of gastrointestinal irritation | show 🗑
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| Acute gastritis is usually self-limiting. | show 🗑
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| Gastritis – Chronic Gastritis | show 🗑
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| Peptic Ulcer – Gastric and Duodenal Ulcers | show 🗑
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| show | Inadequate blood supply by vasoconstriction,Interferes with rapid regeneration of epithelium,extra glucocorticoid secretion or medication, Ulcerogenic substances break down mucus layer.Aspirin,NSAIDs,alcohol,Atrophy of gastric mucosa,Chronic gastritis
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| Increased acid-pepsin secretions w/ Peptic Ulcer – Gastric and Duodenal Ulcers | show 🗑
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| Complications with peptic ulcer | show 🗑
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| show | Epigastric burning or localized pain usually following stomach emptying
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| show | Fiberoptic endoscopy Barium x-ray Endoscopic biopsy
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| show | Combination of antimicrobial and proton pump inhibitor to eliminate H. pylori Reduction of exacerbating factors
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| Stress ulcers | show 🗑
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| show | Arises primarily in mucous glands,Early carcinoma Confined to mucosa and submucosa Later stages Involves muscularis,Eventually invades serosa and spreads to lymph nodes Asymptomatic in the early stages,Often the prognosis is poor on diagnosis
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| show | Diet seems to be a key factor particularly smoked foods, nitrites, and nitrates. Genetic influences play a role. Symptoms vague until cancer is advanced.
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| show | Control of gastric emptying is lost and gastric contents get dumped in the duodenum W/O complete digestion.after gastric resection,chyme draws fluid from vascular compartment into intestine.Intestinal distention,Increased intestinal motility,Decreased BP
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| show | Occurs during or shortly after meals,Hypoglycemia 2 to 3 hours after meal
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| show | Narrowing and obstruction of pyloric sphincter,develops anomaly,Signs appear w/in several weeks after birth.vomiting after feeding,mass can be palpated at pylorus.Infant fails to gain weight,dehydration,hunger,Surgery required.feeling full,vomiting
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| Cholelithiasis | show 🗑
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| show | Inflammation of gallbladder and cystic duct
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| show | Inflammation usually related to infection of bile ducts
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| Choledocholithiasis | show 🗑
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| Gallstones are made of? | show 🗑
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| Risk factors for gallstones | show 🗑
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| Obstruction of a duct by a large calculi | show 🗑
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| Prehepatic jaundice | show 🗑
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| Intrahepatic jaundice | show 🗑
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| Posthepatic jaundice | show 🗑
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| show | Cell injury results in inflammation and necrosis in the live. Liver is edematous and tender. Causative viruses Hepatitis A virus (HAV) Hepatitis B virus (HBV) Hepatitis C virus (HCV) Hepatitis D virus (HDV) Hepatitis E virus (HEV)
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| show | Small RNA virus,Infectious hepatitis,Transmitted by fecal-oral route in areas of inadequate sanitation or hygiene,contaminated H20 or shellfish,anal sex,Acute self-limiting,No carrier or chronic state Fecal shedding before signs,Vaccine available
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| show | Partially double-stranded DNA virus, Over 50% of HIV-positive, 50% of cases are asymptomatic but contagious due to carrier state.Chronic inflammation, Transmission by infected blood,Sexual transmission,Tattooing and body piercing, Vaccine
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| show | Single-stranded RNA virus Most common type transmitted by blood transfusion May exist in a carrier state About half the cases enter the chronic state. Increases risk of hepatocellular carcinoma Treated with interferon injections
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| show | Also called delta virus Incomplete RNA virus Requires HBV to replicate and produce active infection HDV infection increases severity of HBV infection Transmitted by blood
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| show | Single-stranded RNA virus Transmitted by oral-fecal route No chronic or carrier state
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| show | Fatigue and malaise Anorexia and nausea General muscle aching
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| show | Onset of jaundice Stools light in color, urine becomes darker Liver tender and enlarged, mild aching pain
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| Posticteric stage of hepititis | show 🗑
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| Treatment of heptititis | show 🗑
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| show | hepatotoxins can cause inflammation and necrosis of the liver.Drugs include Acetaminophen,halothane,phenothiazines, tetracycline,Chemicals include Carbon tetrachloride,toluene,ethanol,Direct effect of toxins
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| Cirrhosis | show 🗑
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| Biliary cirrhosis | show 🗑
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| show | Linked with chronic hepatitis or long-term exposure to toxic materials
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| Metabolic cirrhosis | show 🗑
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| show | Enlargement of the liver Asymptomatic and reversible with reduced alcohol intake
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| Second stage of cirrhosis – alcoholic hepatitis | show 🗑
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| Third stage – end-stage cirrhosis | show 🗑
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| show | Decreased removal and conjugation of bilirubin,production of bile,Impaired digestion/absorption of nutrients, Decreased blood-clotting factors,Impaired glucose/glycogen metabolism,conversion of ammonia to urea ,inactivation of hormones/drugs and toxins
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| show | Initial often mild;Fatigue, anorexia,weight loss,anemia,diarrhea,Dull aching pain in upper right quad, Advanced cirrhosis;Ascites/peripheral edema Increased bruising,Esophageal varices May rupture,hemorrhage,circulatory shock Jaundice,encephalopathy
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| Cirrhosis – Treatment | show 🗑
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| Hepatocellular carcinoma | show 🗑
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| show | Arises from areas served by the hepatic vein or spread along the peritoneal membranes
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| Acute Pancreatitis | show 🗑
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| Etiology of Acute Pancreatitis | show 🗑
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| show | Severe epigastric or abdominal pain radiating to the back,Signs of shock, Low-grade fever until infection develops, Abdominal distention and decreased bowel sounds,Decreased peristalsis and paralytic ileus
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| Diagnostic tests for acute pancreatitis | show 🗑
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| show | Oral intake is stopped. Treatment of shock and electrolyte imbalances Analgesics for pain relief
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| Pancreatic Cancer | show 🗑
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| Adenocarcinoma | show 🗑
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| show | Malabsorption syndrome,Primarily a childhood disorder,occurs in adults,genetic link Defect in intestinal enzyme,Prevents further digestion of gliadin, Toxic effect on intestinal villi, Malabsorption and malnutrition result
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| Chronic Inflammatory Bowel Disease | show 🗑
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| show | Affects digestive tract usually small intestine,Inflammation occurs,Skip lesions-affected areas,Progressive inflammation and fibrosis cause obstructed areas.Damaged walls impair processing and absorption of food.Inflammation stimulates intestinal motility
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| show | Inflammation in rectum,then through colon,inflamed Mucosa and submucosa.Tissue destruction interferes with absorption of fluid and electrolytes.acute episodes,toxic megacolon,Diarrhea.Contains blood and mucus Accompanied by cramping pain
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| show | Team approach Anti-inflammatory medications Sulfasalazine or glucocorticoids Antimotility agents Nutritional supplements Antimicrobials Immunotherapeutic agents Surgical resection Usually ileostomy or colostomy
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| Appendicitis – Development | show 🗑
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| Appendicitis s/s | show 🗑
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| Diverticulum | show 🗑
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| show | Asymptomatic diverticular disease
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| Diverticulitis | show 🗑
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| show | Form at gaps between muscle layers Congenital weakness of wall may be a factor. Weaker areas bulge when pressure increases. Many cases are asymptomatic. Diverticulitis stasis of material in diverticula leads to inflammation and infection.
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| Colorectal Cancer | show 🗑
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| Intestinal Obstruction | show 🗑
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| show | After abdominal surgery Spinal shock following spinal cord injuries Inflammation related to severe ischemia Pancreatitis, peritonitis, infection in the abdominal cavity Hypokalemia Mesenteric thrombosis Toxemia
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| show | Adhesions that twist or constrict intestine Hernias Strictures caused by scar tissue Masses – tumors or foreign bodies Intussusception Volvulus Hirschsprung disease Gradual obstruction from chronic inflammatory conditions
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| show | Inflammation of the peritoneal membranes
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| Chemical peritonitis may result from? | show 🗑
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| show | By direct trauma affecting the intestine Ruptured appendix Intestinal obstruction and gangrene
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| S/S PERITONITIS | show 🗑
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