GI

Subdecks (1)

Cards (39)

  • Disorders of the oral cavity
    • oral cancer: lips, gums, inside structures of the mouth
    • cancerous ulcers
    • risk factors: smoking , chewing tobacco, HPV exposure
    • pathophysiology
    • leukoplakia (oral cancer)
    • malignant transformation (about 20 percent of occurrence)
    • erythroplasia (red mucosal plaque without inflammation)
  • Disorders of the oral cavity
    • cleft lip and palate
    • congenital splitting or defect in integrity of lip; with or without splitting of the palate
    • believed to be environmental effect during pregnancy
    • pathophysiology
    • disfigurement causes varying degrees of impairment
    • risk of aspiration increased
    • clinical manifestations
    • facial deformity, difficulty feeding
    • delayed development of teeth and speech
  • Esophageal alterations
    • gastroesophageal reflux disease (GERD)
    • regurgitation of gastric contents into the esophagus
    • incompetent lower esophageal sphincter
    • hiatal hernia
    • esophageal mucosa injury
    • substernal pain
    • normally cleared and neutralized
    • esophagitis
    • chronic = increase risk for cancer
  • esophageal alterations
    • esophageal cancer
    • risk factors: alcohol, tobacco, obesity
    • Barrett esophagus
    • normal esophageal lining replaced by abnormal epithelium
    • clinical manifestations
    • dysphagia
    • weight loss, pain fatigue
  • esophageal alterations
    • achalasia
    • inability of the cardiac sphincter to relax
    • absence of esophageal peristalsis
    • food is retained
    • hypertrophy and dilation of lower esophagus
    • symptoms
    • dysphagia
    • vomiting
    • pain
  • esophageal alterations
    • esophageal atresia
    • concurrent abnormality of trachea common
    • esophagus ends in blind pouch or fistula from trachea to stomach
    • clinical manifestations
    • aspiration of gastric contents into respiratory system
    • abdominal distention
    • coughing and cyanosis with feeding
    • recurrent pneumonia
  • alterations in the stomach and duodenum
    • inflammatory disorders of gastric mucosa (gastritis)
    • risk factors: cigarettes, alcohol, spicy foods, caffeine, aspirin, NSAIDs
    • Helicobacter pylori (H. pylori) infection
    • increases gastric acid production and produces cellular injury
    • ulcerative lesions
    • blood vessel erosion may occur
    • Zollinger-Ellison syndrome: pathological secretion of gastric acid
  • alterations in the stomach and duodenum
    • inflammatory disorders of gastric mucosa (gastritis)
    • pathophysiology
    • increased gastric acids
    • superficial erosion of surface epithelium: usually regenerates
    • chronic inflammation leads to damage to mucosa = peptic ulcer disease
    • one or all layers of mucosa
    • perforation of the bowel: peritonitis
    • chronic = scar tissue
  • alterations in the stomach and duodenum
    • inflammatory disorders of gastric mucosa (gastritis)
    • clinical manifestations
    • heart burn
    • bleeding
    • epigastric cramping
    • severe with perforation
  • alterations in the stomach and duodenum
    • stomach cancer
    • risk factors: dietary preservatives, recurrent gastritis, genetics
    • clinical manifestations: often asymptomatic
    • heart burn, anorexia, weight loss, vomiting, abdominal mass, vague pain
  • alterations in the stomach and duodenum
    • hypertrophic pyloric stenosis
    • obstruction of gastric outlet resulting from hypertrophy of musculature surrounding pylorus
    • projectile vomiting within 3-10 weeks of birth with no bile in emesis (vomit)
    • dehydration
    • pylorus can often be palpated
  • Disorders of small and large intestines
    • inflammatory disorders
    • gastroenteritis (infectious enterocolitis): stomach, intestines, or both -- "stomach flu"
    • bacterial toxins or irritants in food
    • pathophysiology
    • organisms multiply rapidly
    • local inflammation stimulates GI smooth muscle and secretory cells
    • clostridium difficile: loss of normal flora due to antibiotic therapy
    • clinical manifestations: pain, vomiting, diarrhea, occult blood
  • Disorders of small and large intestines
    • inflammatory disorders
    • inflammatory bowel disease
    • Crohn's disease
    • "skip lesions" interspersed between normal segments of bowel
    • cobblestone appearance
    • all layers involved
    • fibrotic changes to submucosal layer
    • absorption disrupted
  • Disorders of small and large intestines
    • inflammatory disorders
    • ulcerative colitis
    • inflammatory mucosal lesions become necrotic: filled with exudate
    • more continuous in bowel
    • thickening of the bowel
  • Disorders of small and large intestines
    • inflammatory disorders
    • Crohn's disease & Ulcerative colitis
    • manifestations of both: diarrhea, pain, weight loss, fluid and electrolyte issues
  • Disorders of small and large intestines
    • inflammatory disorders
    • irritable bowel syndrome: combination of chronic and recurrent intestinal symptoms not explained by structural or chemical problems
    • pathophysiology: dysregulation of intestinal motor and sensory function controlled by CNS
    • clinical manifestations
    • increased motility and intestinal contractions
    • persistent and recurrent abdominal pain relived by defecation
    • symptoms > 3 months
  • Disorders of small and large intestines
    • inflammatory disorders
    • diverticular disease
    • diverticulosis (involves ballooned segments of colon that can herniate)
    • diverticulitis (involves herniations)
    • clinical manifestations: LLQ pain, altered elimination
  • Disorders of small and large intestines
    • obstructive disorders
    • paralytic ileus: functional bowel obstruction
    • lack of neural stimuli
    • leads to mechanical obstruction
    • clinical manifestations
    • abdominal distention
    • crampy pain
    • absence of bowel sounds
    • vomiting
  • Disorders of small and large intestines
    • obstructive disorders
    • hirschprung's disease: congenital lack of colonic innervations
  • Disorders of small and large intestines
    • obstructive disorders
    • mechanical obstrction
    • intussesception (bowel telescopes in on itself)
    • volvulus (bowel twists)
  • Disorders of small and large intestines
    • obstructive disorders
    • hernia
    • abdominal wall defect
    • scrotal, inguinal, umbilical
    • incisional
    • protrusion of stomach or intestinal wall through defect
    • intermittent
    • strangulated
  • Disorders of small and large intestines
    • obstructive disorders
    • intestinal ischemia or infarction
    • lack of oxygen supply to intestine
    • prolonged ischemia
    • epithelial cells detach -> protrusion of subendothelial blebs
    • impaired absorption
    • mucosal layer becomes necrotic
    • perforation of intestine
    • peritonitis and bacteremia (sepsis) because bacteria enters the blood
  • Disorders of small and large intestines
    • disorders of intestinal absorption
    • celiac disease (AKA celiac spruce and gluten-sensitive enteropathy): genetic component
    • inappropriate T-cell response against gluten
    • intense inflammatory reaction results in loss of absorptive villi
    • impaired nutrient absorption: macro and micro nutrients
    • manifestations: diarrhea and pain
  • Disorders of small and large intestines
    • disorders of intestinal absorption
    • malabsorption syndromes
    • lactose intolerance: congenital or secondary (enzyme lacking of lactase or infection/bowel surgery)
    • pathophysiology of lactose intolerance
    • carbohydrate malabsorption results in lack of carbohydrate in blood
    • carbohydrate accumulates in lumen of bowel
    • osmotic pressure from unabsorbed carbohydrate
    • acid production from bacterial action
    • manifestations: flatulence, crampy abdominal pain, watery diarrhea
  • Disorders of small and large intestines
    • Colorectal cancer
    • risk factors
    • dietary: fat, fiber intake
    • polyps: growth protruding into intestine
    • clinical manifestations
    • bleeding (highly significant early clinical manifestation)
    • occult blood
    • change in bowel habits
    • pain
  • Eating disorders
    • anorexia nervosa: psychological and physiological disorder of self starvation, failure to maintain minimum weight with fear of being overweight
  • Eating disorders
    • anorexia nervosa
    • pathophysiology: decrease in body weight -> depletion of body fat and protein stores, muscle wasting
    • female hormones: decreased estrogen may lead to absence of menstruation
    • bone loss
    • male hormones: fluctuating testosterone level
    • thyroid function reduced: cold intolerance, constipation, skin with lanugo (fine hair)
    • cardiac effects
    • electrolyte imbalances = cardiac rhythm problems
    • hypotension
    • ketoacidosis from increased breakdown of fat as fuel source
    • renal failure: due to decrease CO and build up of protein byproducts
    • anemia
  • Eating disorders
    • Bulimia nervosa (binge-purge syndrome)
    • excessive consumption of food; self induced vomiting, use of laxatives and diuretics
    • complications
    • dental disorders
    • esophagitis
    • hypokalemia (potassium loss in vomiting)
  • exocrine disorders of the pancreas
    • pancreatitis: acute or chronic inflammation of pancreas
    • risk factors
    • obstruction of pancreatic ducts
    • alcohol: stimulation of pancreatic enzymes
  • exocrine disorders of the pancreas
    • pancreatitis
    • pathophysiology
    • reflux of bile or duodenal contents into pancreatic ducts and inappropriate activation of pancreatic enzymes within the pancreas
    • begins with activation of trypsin
    • trypsin activates other digestive enzymes
    • inflammatory response leading to autodigestion
    • destructive effects
    • elastase: activated by trypsin
    • hemorrhage
    • release of bradykinin -> increased vascular permeability
    • leukocyte reaction
  • exocrine disorders of the pancreas
    • pancreatitis
    • clinical manifestations
    • abdominal pain, nausea, vomiting
    • edema: plasma shift from vasodilation
    • hypotension
    • tachycardia
    • respiratory distress
    • pleural effusion from retroperitoneal fluid
    • pressure on diaphragm
    • hypocalcemia
    • extension lypolysis of tissue
    • releases free fatty acids which combine with calcium
    • parathyroids unable to compensate rapidly
    • elevated serum amylase and lipase
    • hyperglycemia
    • swollen pancreas
  • exocrine disorders of the pancreas
    • pancreatitis
    • chronic pancreatitis (recurrent inflammation with alcohol that gets worse each time)
  • exocrine disorders of the pancreas
    • pancreatic cancer
    • risk factors: age, cigarette smoking, chronic pancreatitis
    • genetics (maybe?)
    • adenocarcinoma of the ductal epithelium
    • manifestations
    • jaundice
    • pain
    • weight loss
    • metastasis