Pathophysiology > GI System > Flashcards

GI System Flashcards

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1
Q

GI Tract

A 
GI TUBE: anything passing through is external, once absorbed it is internal
mouth
esophogus
stomach
small intestine
large intestine
recturm
anus
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2
Q

zymogens

A

enzymes that are inactive “ogen” = inactive, immature

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3
Q

fxns of GI tract

A
  • INGESTION of food
  • MOTILITY: peristalsis and segmenta - propulsion of food and wastes from mouth to anus
  • SECRETION of mucus, water, and enzymes
  • MASTICATION mechanical digestions of food particles
  • chemical digestion of food particles
  • absorption of digested food - small intestines
  • elimination of waste products by defecation
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4
Q

GI Enzymes

A
  • carbs: amylase (saliva, pancrease)
  • protein: prolease (stomach pepsin) (pancrease trypsin, chymotrpson)
  • lipids/fats: lipase (after emulsification by bile)
  • nucleic acid/DNA/RNA: nuclease
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5
Q

GI tract Layers

A
  1. mucosa: inner layer, absorption
  2. submucosa: secretions, blood supply
  3. muscularis: 2 layers of smooth muscle - circular (pinch and constrict) & longitudinal (propel food forward)
  4. serosa: visceral layer - peritoneum
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6
Q

Mouth

A
  • chewing and mixing food with saliva: mastication, and start of chemical digestion
  • taste buds (CN VII, IX): salty, sour, sweet, bitter, umami
  • olfactory nerves (CN I) smell involved in taste
  • teeth - 32 premanent teeth, mastication
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7
Q

salivary glands

A
  • paried glands: submandibular, sublingual, parotid
  • saliva: water with mucous, sodium, bicarbonate, chloride, potassium, and amylase (carb digestion)
  • bollus = matter that we swallow
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8
Q

deglutination

A

swallowing - then involuntary movement begins

  • esophogus: peristalsis & segmentation
  • upper esophogeal sphincter: stenotic sphincter, oral cavity to eshophogus, Choking, gerd
  • lower esophageal sphincter: cardiac sphincter = entrance to stomach, vomiting, heart burn
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9
Q

stomach

A
  • holds food 2-6 hours
  • hollow, muscular organ that stores food, secretes digestive juices, mixes food with juices, and propels partially digested food (Chyme = bollus once mixed with gastric juices in stomach)
  • 3 layers: longitudinal, circular, oblique
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10
Q

Stomach Gastric Juices

A

JUICES

  • mucus
  • HCL acid: converts pepsinogen to pepsin
  • enzymes: pepsin (breaks down protein)
  • hormones: gastrin and grelin (hunger hormones), regulates gastric juices
  • intrinsic factor: vitamin B12 absorption, pernicuious anemia

GLANDS/PITS

  • parietal cells: hydrochloric acid (breaks down) and intrinsic factor (b12)
  • chief cells: pepsinogen (protein digestion)
  • G Cells: gastrin and grelin (hunger cells)
  • hydrochloric acid: denatures proteins, antimicrobal, converts pepsinogen to pepsin

vagus nerve –> gastrin –> hisamine –> parietal cells –> HCL

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11
Q

Gastric Secretion

A

gastric secretion/acid secretion/ saliva secretions

  • cephalic phase: congitive - thinking about food makes you salivate and secrete gastric juices
  • gastric phase: stomach - chemicle signal (exposure to tongue) and chemoreceptors (smell and taste)
  • intestinal phase: food enters into duodenum (through pyloric sphincter), decreased saliva and gastric juices, inhibition phase
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12
Q

small intestines

A
  • 5-6 cm long
  • absorption - doesn’t secrete anything
  • three segements: dueoden –> jejunum –> ilium (iliosecal valve from small to large intestine)
  • peritoneum - mesentaries, hold intestines in place in body
  • villi: lactile (drains fats in middle of villi), has hairs to increase surface area, burshborder epithelium
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13
Q

intestinal digestion

A

pancreatic enzymes: amylase (carbs), trypsinogen and chymotripsinogen (protein), lipase (fats), nuclease (DNA, RNA)
- Bile salts: made in liver, stored in gallbladder

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14
Q

intestinal absorption

A

carbs, proteins, fats, water, electrolytes

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15
Q

where are diff nutrients absorbed?

A
  • stomach: water, alcohol, caffein, nasals (aspirin)
  • duodeunum: iron, calcium, fats, sugars, water, proteins, vitamins, magnesium, sodium
  • jejunum: sugars, proteins
  • ilium: bile salts, vit b12, chloride
  • colon: water, electrolytes
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16
Q

large intestine

A
  • cecum: next to appendix, iliocecual valve
  • appendix: stores microbial flora of gut
  • colon: ascending, transverse, descending, sigmoid
  • recturm
  • anus
  • colorectal cancer is most common in rectum and sigmoid. most fatal. highest site of pathogens, compactions, constipation
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17
Q

liver

A

LOBES: separated and attached to the anterior abdominal wall by falciform ligament
- right lobe - caudate lobe, quadrate lobe & left lobe

  • Hepatic portal vein & system
  • vein enters into liver to be detoxified then puts it into systemic circulation: blood from GI tract, filtrations from spleen, other bad stuff absorbed
  • if liver fails then you get hepatic portal hypertension = ascites, splenomegaly, verses

LIVER LOBULES

  • hepatocytes
  • sinusoids (specialized capillaries)
  • kupffer cels (Macrophages)
  • common bile duct
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18
Q

liver secretion of bile

A
  • cholesterol produces bile
  • bile is alkaline, yellow/green, contains bile salts, cholesterol, bilirubin, electrolytes and water
  • bile is formed by hepatocytes and secreted into bile canaliculi
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19
Q

functions of liver

A
  • blood storage
  • bacterial/foreign particle removal
  • synthesizes plasma proteins/ clotting factors
  • produces bile
  • metabolizes fats, proteins, carbs
  • detoxes metabolic products and wastes
  • storage of minerals, vitamins
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20
Q

gallbladder

A

stores and concentrates bile between meals

- lies inferior to liver

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21
Q

pancrease

A
  • secrete enzymes and alkaline fluids to assist in digestions
  • exocrine: amylase, lipase, trysin, chymotrypsin, nuclease
  • endocrine: insulin, glucagon (NOT GI, blood sugar)
    SECRETIONS: bicarb, symogens, pancreatic amylase, pancreatic lipase, nuclease
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22
Q

symptoms of GI dysfunction

A
  • anorexia: lack of desire to eat
  • vomiting: emptying of stomach and intestinal contents, hyper salivation, tachycardia
  • nausea: most common symptom
  • retching: dry heaving, nonproductive vomiting, can induce vomiting of bile
  • abdominal pain: referred pain, dull, achy, decrease in number of nociceptors
  • constipation: sigmoid or recturm, infrequent or difficult defecation
  • diarrhea: frequency or volume increases, fluidity, weight of feces
    > mechanisms of diarrhea
  • osmotic diarrhea: electrolyte change draws fluid into intestine instead of out
  • secretory diarrhea: bacterial toxins in instestin, food poisoning, increase in H2O, increased motility
  • motility diarrhea: increased motility decreases digestion increases diarrhea, smooth muscle or nerve issue (anxiety), caffeine
  • GI bleed: hematemesis (vom blood), hematochezia (Bloody stools)
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23
Q

dysphagia

A
  • difficulty swallowing

- achalasia: loss of nervous control, decreases swallowing ease

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24
Q

Gastroesophageal reflux (GERD)

A

reflux of chyme from stomach to esophagus

  • insufficiency of cardiac sphincter
  • inflamm of esophoagus = reflux esophagitis
  • any condition that increases abdominal pressure can contribute to gerd
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25
hiatal hernia
- movement of intestine into an area it shouldn't be - through diaphragm - protrusion of upper portion of stomach through diaphragmatic hiatus into thorax - sliding or paraesophageal
26
pyloric obstruction
stenosis, bottom of stomach - blocking or narrowing of opening between the stomach and duodenum - vomiting soon after eating
27
dumping syndrome
rapid emptying of chyme from a surgically created residual stomach into the small intestine - pyloric unsufficiency: bypasses pyloric sphincter, violet diarrhea - bariatric surgeries - clinical complication of partial gastrectomy or pyloroplasty surgery
28
intestinal obstruction
any condition that prevents flow of chyme through intestinal lumen or failure of normal intestinal motility - mechanical blockage - ileus: an obstruction of intestines from folding, pinching, lack of peristalsis = decreases peristalsis, physiological response = ischemia/necrosis
29
peptic ulcer disease
break or ulceration in protective mucosal lining of lower esophagus, stomach, duodenum - acute and chronic ulcers - upper GI ulceration in esophogus, stomach or duodenum
30
Duodenal Ulcers
Duodenal ulcers: - small intestine - most common - H pylori infection - hyper secretion of stomach acid and pepsin (use of nasals, cigarette smoking produces acid) 1st. H pylori 2nd. nsaids
31
gastric ulcers
stomach - tend to develop in astral region of stomach - 1st over use of nasals - 2nd. H pylori
32
stress ulcers
peptic ulcer that is related to severe illness, neural injury, systemic stress/trauma
33
maldigestion
- failure of chemical processes of digestions leads to... malabsorption: failure of intestinal mucosa to absorb digested nurients - frequently occur together
34
pancreatic insufficiency
insufficient pancreatic enzyme production: lipase, amylase, trypsin, chymotrypsin - causes: pancreatitis, pancreatic carcinoma, pancreatic resection, cystic fibrosis - fat maldigestions is a major problem, so patient will exhibit fatty stools and weight loss
35
lactase defficiency
issue breaking down dairy cow milk - can't break down lactose into monosaccharides and therefore prevents lactose digestion and monosaccharide absorption - isn't broken down in small intestine then moves to large intestine where there is increased flatulance and diarrhea
36
bile salt defficiency
can't emulsify fat - conjugated bile salts are synthesized from cholesterol in the liver needed to emulsify and absorb fat - can results from liver disease and bile obstructions - poor intestinal absorption of lipids causes fatty stools, diarrhea, loss of fat-soluable vitamins (A, K, D, E)
37
fat soluble vitamin deficiencies
- vit A: retina vitamin, lack of clack and white vision, night vision - vit D: decreased calcium absorption, bone pain, osteoporosis, fractures - vit K: prolonged prothrombin time, pupura, petachiae, lack of clotting - vit E: regulates cell processes
38
inflammatory disorders
chronic, relapsin inflammatory bowel disorders or unknown origin - genetics, allegations of epithelia barrier functions, immune reactions to intestinal flora, abnormal t cell responses - idiopathic
39
gastritis
inflammation of stomach lining - inflame of gastric mucosa - acute - over consumption - chronic - infection, h pylori, nsaids, alcohol
40
ulcerative colitis
large intestine - chronic inflamm causes ulceration of colonic mucosa - sigmoid colon and rectum - may lead to increased risk of colon cancer
41
H pylori
normal in large intestine | - not normal in stomach or small intestine
42
hematochysia
bleeding from colon
43
chrohn's disease
anywhere from mouth to anus - idopathic inflamm disorder that affects any part of digestive tract - difficult to differentiate ulcerative colitis with crohn's - causes skip lesions (spots of necrosis) and cobblestone effect (deep ulcerations)
44
diverticular disease of the colon
diverticula = out pouching - herniations of mucosa through the muscle layers of the colon wall, especially the sigmoid colon diverticulosis = one of more pouches - asymptomatic diverticular disease - weakening of intestinal wall diverticulitis = inflammatory stage of diverticulosis - food traps in diverticula - tomato and chile seeds lodge in diverticula
45
appendicitis
houses flora (bacteria) - inflamm of the vermiform appendix - possible causes are obstruction, ischemia, increased intraluminal pressure, infecton, ulceration - RLQ pain with rebound tenderness - rupture releases tons of bacteria
46
irritable bowl syndrome
idiopathic - 20% worldwide - more common in women - youth and middle age - associated with anxiety and depression
47
obesity
genetics, hormones, increase in body fat - BMI greater than 30 - cause of morbidity, death, increased health care costs risk factor for many diseases and conditions - associated with hormone imbalances and hypothalamus dysfunction
48
starvation
short term: glycogenolysis, gluconeogenesis (normal weight loss) long term: marasmus (emaciated), kwashiorkor (protruding belly)
49
portal hypertension
liver disorder - high BP in portal venous system caused by resistance to portal blood flow - varices: back up of venous blood that can lead to vein rupture and blend in the GI tract - splenogmegaly - ascites - hepatic encephalopathy
50
hepatic encephalopathy
neurologic syndrome of impaired cognitive function | - develops rapidly during fulminant hepatitis or slowly during chronic liver disease
51
jaundice
lack of bilirubin metabolism in liver leading to yellowing - obstructive jaundice - post hepatic and intrahepatic - hemolytic jaundice - perhepatic, excessive hemolysis of RBSs or absortion of a hematoma
52
viral hepatitis
systemic viral disease of acute or chronic inflammation that primarily affects the liver - HEP A: infections hepatitis - HEP B: serume hepatitis - HEP C, D, E, G
53
Hep A
transmitted by fecal-oral route - found in feces, bile, sera - risk factors - crowded, unsanitary conditions, food and water contamination
54
HEP B
transmitted through contact with infected blood, body fluids, contaminated needles - maternal transmission can occur if the mother is infected during the 3rd trimester - can cause chronic hepatitis - hep B vaccine
55
HEP C
responsible for most cases of post-transfusion hepatitis - also implicated in infectious related IV drug use - 50%-80% of hepatitis C cases result in chronic hepatitis
56
HEP D
depends on HEP B for replication
57
HEP E
fecal-oral transmission | - developing countries
58
HEP G
recently discovered | - parentally and sexually transmitted
59
Cirrhosis
irreversible inflammatory disease that disrupts liver function and even structure - slow development to chronic disease - decreased hepatic function caused by nodular and fibrotic tissue synthesis - biliary channels become obstructed and cause portal hypertension - blood shunted away from liver and hypoxic necrosis develops * alcoholic: oxidation of alcohol damages hepatocytes * bilary: cirrhosis begins in the bile canaliculi and ducts * fatty liver disease: fat build up causes fibrosis and scarring, NASH
60
disorders of gallbladder
obstruction or inflammation (Cholecystitis) is most common cause of gallbladder problems - cholelithiasis - gallstone formation - cholesterol, most common - pigmented, cirrhosis
61
disorders of pancreatitis
- inflamm of pancreas - caused by injury or damage to pancreatic cells and ducts, causing leakage of pancreatic enzymes into pancreatic tissue - activated zymogens cause autodigestions of pancreatic tissue and leak into bloodstream to cause injury to blood vessels and other organs - chronic pancreatitis - related to alcohol abuse
Pathophysiology
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