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GI Flashcards

(48 cards)

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1
Q

What are the main functions of the GI tract?

A
  • Motility
  • Digestion
  • Absorption
  • Excretion
  • Circulation

The GI tract constitutes approximately 5% of total body mass.

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2
Q

List the layers of the GI tract from outermost to innermost.

A
  • Serosa
  • Longitudinal muscle layer
  • Circular muscle layer
  • Submucosa
  • Mucosa
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3
Q

What does the longitudinal muscle layer do?

A

Contracts to shorten the length of the intestinal segment

Works with the circular muscle layer to propagate gut motility.

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4
Q

What does the circular muscle layer do?

A

Contracts to decrease the diameter of the intestinal lumen

This layer works with the longitudinal muscle layer for gut motility.

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5
Q

What is the role of the Celiac plexus?

A

Innervates the GI organs up to the proximal transverse colon

Blocked through various approaches for pain management.

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6
Q

What does the Hypogastric plexus innervate?

A

Descending colon and distal GI tract

May be blocked to treat pelvic pain.

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7
Q

What are the components of the mucosa?

A
  • Muscularis mucosa
  • Lamina propria
  • Epithelium

Each component has specific functions related to movement, absorption, and sensing.

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8
Q

What are the two parts of the autonomic nervous system that innervate the GI tract?

A
  • Extrinsic nervous system (SNS & PNS)
  • Enteric nervous system

The extrinsic system includes sympathetic (SNS) and parasympathetic (PNS) components.

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9
Q

What is the function of the myenteric plexus?

A

Controls motility via enteric neurons

Located between the smooth muscle layers.

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10
Q

What does the submucosal plexus control?

A

Absorption, secretion, and blood flow

It transmits information to the enteric nervous system and CNS.

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11
Q

What is esophagogastroduodenoscopy?

A

Scope of the esophagus, stomach, and duodenum

Anesthesia challenges include sharing airway with the endoscopist.

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12
Q

What does esophageal manometry measure?

A

Esophageal pressures and LES tone

It is used to assess esophageal function.

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13
Q

What are the three categories of esophageal diseases?

A
  • Anatomical
  • Mechanical
  • Neurologic

Many disease states may overlap among these categories.

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14
Q

What is dysphagia?

A

Difficulty swallowing

It can be oropharyngeal or esophageal.

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15
Q

What is the most common esophageal disease?

A

Dysphagia & GERD

GERD involves the return of gastric contents into the pharynx.

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16
Q

What is achalasia?

A

Neuromuscular outflow obstruction

It leads to dysphagia, regurgitation, and chest pain.

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17
Q

What are the symptoms of esophageal cancer?

A
  • Progressive dysphagia
  • Weight loss

Poor survival rate due to lymphatic metastasis.

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18
Q

What is the treatment for GERD?

A
  • Avoid trigger foods
  • Medications: Antacids, H2 blockers, PPIs
  • Surgery: Nissen Fundoplication, LINX

Bile reflux is associated with Barrett metaplasia and adenocarcinoma.

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19
Q

What is peptic ulcer disease commonly associated with?

A
  • Helicobacter Pylori
  • NSAIDs
  • Alcohol

It is the most common cause of non-variceal upper GI bleeding.

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20
Q

What is the main function of the small intestine?

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A

Absorb nutrients through segmentation

Circular and longitudinal muscles coordinate contractions for nutrient absorption.

21
Q

What are the symptoms of Ulcerative Colitis?

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A
  • Abdominal pain
  • Nausea/Vomiting
  • Fever
  • Weight loss
  • Diarrhea
  • Bleeding

It is a chronic inflammatory disease of the colon.

22
Q

What is Crohn’s Disease characterized by?

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A

May affect any/all of the bowel

Most common site is the terminal ileum.

23
Q

What is a carcinoid tumor?

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A

Most carcinoid tumors originate from the GI tract

They secrete serotonin and other vasoactive substances.

24
Q

What is the most common cause of pancreatitis?

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A
  • Gallstones
  • Alcohol abuse

These account for 60-80% of cases.

25
What are the **common causes** of pancreatitis?
* Gallstones * Alcohol abuse * Immunodeficiency syndromes * Hyperparathyroidism/↑Ca² ## Footnote Gallstones obstruct the ampulla of Vater, causing enzymes to back up, while excessive alcohol activates pancreatic enzymes and triggers inflammation.
26
What are the **symptoms** of acute pancreatitis?
* Intense epigastric pain radiating to back * Nausea/Vomiting * Abdominal distention * Steatorrhea * Ileus * Fever * Tachycardia * Hypotension ## Footnote These symptoms indicate inflammation and complications associated with acute pancreatitis.
27
What **labs** are indicative of acute pancreatitis?
* ↑serum amylase * ↑serum lipase ## Footnote Elevated levels of these enzymes are commonly associated with pancreatitis.
28
What imaging techniques are used for diagnosing acute pancreatitis?
* Contrast CT * MRI * Endoscopic ultrasound (EUS) ## Footnote These imaging methods help visualize the pancreas and assess for complications.
29
What are the **treatment options** for acute pancreatitis?
* NPO (nothing by mouth) * IV hydration * Enteral feeding (preferred over TPN) * Opioids ## Footnote TPN is associated with a greater risk of infectious complications.
30
What is the purpose of **Endoscopic-retrograde cholangiopancreatography (ERCP)**?
To examine biliary and pancreatic ducts ## Footnote Interventions during ERCP may include stone removal, stent placement, sphincterotomy, and hemostasis.
31
True or false: **Upper GI bleeding** is more common than lower GI bleeding.
TRUE ## Footnote Upper GI bleeding is typically more prevalent and can be indicated by symptoms such as melena.
32
What does **melena** indicate regarding GI bleeding?
Bleed is above the cecum ## Footnote Melena suggests that the source of bleeding is in the upper gastrointestinal tract.
33
What is the typical BUN level in cases of upper GI bleeding?
>40 mg/dL ## Footnote This indicates absorbed nitrogen into the bloodstream due to bleeding.
34
What are the **causes** of lower GI bleeding?
* Diverticulosis * Tumors * Colitis ## Footnote Lower GI bleeding is more common in the elderly and may require specific diagnostic procedures.
35
What is **ileus**?
Intestinal paralysis without mechanical obstruction ## Footnote It leads to intestinal distention and can be caused by electrolyte disorders, immobility, opioids, and pancreatitis.
36
What are the **treatment options** for ileus?
* Electrolyte balance * NG suction * Hydration * Mobilization * Enemas ## Footnote Neostigmine can produce immediate results in 80-90% of cases.
37
What is the effect of **volatile anesthetics** on the GI system?
They further depress GI activity ## Footnote Higher anxiety levels lead to greater GI inhibition due to sympathetic nervous system stimulation.
38
What is the recovery order of the GI tract after anesthesia?
* Small intestine first * Stomach in 24 hours * Colon in 30-40 hours ## Footnote This order reflects the varying recovery times of different parts of the GI tract.
39
What is the effect of **nitrous oxide (N2O)** on the GI system?
Causes GI distention ## Footnote N2O is 30x more soluble than nitrogen and can lead to distention if bowel is already distended.
40
What is the role of **neostigmine** in GI motility?
Increases PNS activity and GI peristalsis ## Footnote It acts as an acetylcholinesterase inhibitor.
41
How do **opioids** affect GI motility?
Reduce GI motility ## Footnote Opioids stimulate mu, delta, and kappa receptors, leading to slower GI transit and other side effects.
42
Enteric NS controls? X3
motility, secretions, blood flow
43
Myenteric plexus controls motility via X3
enteric neurons, intestitial cells of cajal, smooth muscle cells
44
GI pacemaker cells
interstitial cells of Cajal
45
tnasmits info to the enteric NS and CNS
Submucosal plexus
46
rediologic assessment of swallonging and GI transit
Barium GI series
47
food (eggs) ungested with radiotracer, serial xray for 1-2 hours
Gastric emptying study
48
Anatomical diseases of esophagus X3
diverticula, hiatal hernia, GERD
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