Download 1 - WordPress.com

1. mouth- lips, oral cavity, hard & soft palate, teeth, tongue, taste receptors, salivary
glands ( parotid, submaxillary, sublingual)
Esophagus- upper 1/3 striated skeletal muscle distal 2/3 smooth muscle, lower
Esophageal sphincter
Stomach- contains gastric fluid and mucus, fundus, body antrum, rugae, chief
cells
Secrete pepsinogen, parietal cells secrete hydrochloric acid, water and intrinsic
Factor
SI- 23 ft long duodenum, jejunum, ileum, ileocecal valve prevents reflux of LI
Content into SI, villi have goblet cells that secrete mucus and epithelial cells that
Produce intestinal digestive enzymes, microvilli compose brush border, crypts of
Lieberkuhn, Brunner cells secrete mucus
LI- 5-6 ft long cecum and appendix, colon-ascending, transverse,
Descending, sigmoid, rectum, anus, microorganisms- breakdown protein,
bacteriaSynthesize Vit K and some Vit B and produce flatus
2. Function of Enteric nervous system- composed of 2 layers, known as the Gut
brain, has ability to control movement and secretion of the GI tract
3. Auerbach’s Plexus- provides motor innervations to longitudinal and circular layer,
secretomotor innervations to mucosa, has sympathetic and parasympathetic input
4. Meissner’s Plexus- has only parasympathetic fibers, innervate cells in epithelial
and smooth muscle of intestine
5. activated by sight smell and taste of food, indirectly causes parietal cells to secrete
HCl and directly stimulates chief cells to secrete pepsinogen
6. parasympathetic- rest and digest, mainly excitatory, peristalsis increased
7. Sympathetic-fight or flight, mainly inhibitory, peristalsis decreased.
8. mastication- chewing of food
9. saliva- lubricate and soften food,
10. amylase(ptyalin) which hydrolyzes starches to maltose
11. less than 7 acidic greater than 7 alkaline, saliva is 7.4
12. produce saliva which consists of water, protein, mucin, organic salts, salivary
amylase, produce one liter a day,
13. Segmentation(mixing) and peristalsis(propulsion)
14. aboral-opposite or away from mouth
15. peristalsis-wavelike muscle contractions of alimentary tract that moves food along
16. stomach 3-4 hrs, SI 4 hrs LI till ya poop
17. appendicitis
18. LES-lower esophageal sphincter- prevents reflux of acidic gastric contents into
esophagus pyloric sphincter- lets food into duodenum and prevents it from
coming back up ileocecal- limit reflux of colonic contents into ileum
19. Chyme- food mixed with gastric secretions in SI
20. CCK in response to Chyme enters bloodstream and stimulates contraction of GB
and relaxation of ODDI, also stimulates pancreas to synthesize enzymes for
digestion of protein carbs and fat
21. crypts of lieberkuhn-contain base columnar cells that are stem cells for other
epithelial types
22. Produced in stomach, promotes B12 absorption in SI
23. ph of stomach 1-1.5, HCl acid released by parietal cells contributes to pH, gastrin
and somatostatin regulate secretion of stomach acid
pH of duodenum 7, controlled by secretin which stimulates pancreas to release
Fluid with high bicarbonate CCK- causes GB to release alkaline bile into
Duodenum
24. hormones- gastrin, CCK, ghrelin, leptin,secretin, gastric inhibitory peptide
neurotransmitter- acetylcholine, adrenalin
25. water soluble B/C and fat soluble D/E/A/K absorbed in SI
26. Vitamin K, B12, sodium, chloride and H2O
27. Vit K/and some B
28. Bile helps breakdown fat
29. salivary glands-1k-1500, stomach 2500,SI 3k, pancreas 700, liver/GB 1k
30. Colon extracts H2O from solid waste before it is eliminated from body.
31. ?
32. Vit D
34. lactobacilli, streptococci, candida albicans
33. digestion of self
34. Acidic environment
35. peristaltic rush- powerful wave of contractile activity that travels long distances
down SI
36. 5-6 ft and 2 inches in diameter
37. Haustra-series of pouches that give LI its puckered look
38. the four parts are cecum and appendix, colon- ascending, transverse, descending,
sigmoid, rectum, anus
39. ? ASCENDING COLON AND APPENDIX
40. ascending transverse descending sigmoid
41. secretes mucus which acts as lubricant and protects the mucosa
42. It extracts water and salt from solid wastes before they are eliminated from the
body, and is the site in which flora-aided (largely bacteria) fermentation of
unabsorbed material occurs.rectum keeps intestine sealed shut till need to pass
feces arises. The anal canal serves to transmit and lubricate stool as it passes
externally from the rectum
43. absorption of water and electrolytes, also forms feces and serves as reservoir for
fecal mass
44. hausal churning-kneading action and propulsive peristalsis
45. ?
46. mucus
47. The main bacteria in the colon are Bacteroides, Bifidobacterium, Eubacterium,
Coliforms, Streptococcus, Lactobacillus and Clostridium
48. ?
49. water, bacteria, unabsorbed minerals, undigested foodstuffs, bile pigments and
desquamated epithelial cells
50. reflex action involving voluntary and involuntary control, feces in rectum
Stimulate sensory nerve endings that produce desire to defecate, parasympathetic
Nerve fibers produce contraction of rectum and relaxation of internal anal
Sphincter, defecation is controlled voluntarily by relaxing the external anal canal
Sphincter when desire to defecate is felt
51. ?
52. ?
53. anemia-atrophy of gastric mucosa, result of cobalamin malabsorption
Bleeding tendenciesConstipation- reduction in dietary fiber, reduced fluid intake and decreased
Physical activity
53. SI jejunum most of them ileum-b12 LI- Vit K biotin, NaCl chloride potassium
55. Parietal cells in stomach release intrinsic factor, intrinsic factor promotes
Cobalamin absorption in Ileum. No intrinsic factor or ileostomy you give B12
shots
56. The digestion process of starch is started in mouth by amylase (ptyalin)
57. Dysphasia, odynophagia- pain when swallowing in mouth or esophagus, water
brash, eructation, pain in jaw or back, Barrett’s epithelium
58. Lifestyle modification and nutritional therapy
59. Antireflux procedures – to reduce reflux of gastric contents by enhancing the integrity of
the LES. The fundus is wrapped around the lower portion of the esophagus to reinforce and
repair defective barrier. Nissen fundoplication
60Nissen
61. Prevent respiratory complications, maintain F&E, prevent infection
62. It is an H2 receptor blocker – are a class of drugs used to block the action of
histamines on parietal cells in the stomach, decreasing the production of acid by these
cells.
63. zantac- H2R blocker decrease the secretion of HCl by the stomach
64. sulcrafate- antiulcer drug, cytoprotective properties
65. Protnix (Pantroprazole) - PPI decrease gastric HCl acid secretion
66. Gastrostomy tube may be needed
67. PEG- fewer risk, no general anesthesia,
NG short term feedings, decreased likelihood of regurgitation and aspiration, can
be placed in comatose pt, easily clogged
68. Ranges from localized injury of epithelial cells to desquamation and destruction
of
the mucosa, with mucosal congestion, edema, and hemorrhage.
69. NSAIDS-have direct irritating effects on the gastric mucosa, inhibit synthesis of
Prostaglandins that are protective to the gastric mucosa, Cytotec prevents ulcers
by protecting stomach lining and decreasing HCl
70. H pylori produces urease to protect itself from destruction?
71. Antibiotic biaxin, amoxicillin or tetracycline, along with flagyl, PPI- prilosec
72. Anorexia, N/V wt loss, dyspepsia treat with antacids, sulcralfate
73. Sharp abd pain, rigid abd
74. Obstruction of intestine due to paralysis of intestinal muscles
75. These vitamins are absorbed in ileum.
76. Diarrhea or steatorrhea, signs of malnutrition and multiple vitamin and mineral
Deficiencies, lactase deficiency and bacterial overgrowth, oxalate kidney stone
77. The urea breath test is a rapid diagnostic procedure used to identify infections by
H.pylori a spiral bacterium implicated in gastritis, gastric ulcer, and peptic ulcer
disease. It is based upon the ability of H. pylori to convert urea to ammonia. Urea
breath tests are recommended in leading society guidelines as a preferred noninvasive choice for detecting H. pylori before and after treatment.
78. Rapid diagnostic procedure to identify infection of h pylori
79. CEA carcinoembryonic antigen- tumor marker
80. rectosigmoid over 50%
81 Crohn’s- wt loss may be severe, infrequent rectal bleeding, tenesmus is rare,
Recurrent at site of anastamosis
UC- fever during acute attacks, minimal incidence of malabsorption and
Nutritional deficiencies, occasional granulomas, fistulas are rare, occasional
Strictures, rare anal abscess, cured with colostomy
82 abscess that is characteristic of UC in the mucosa of LI
83. Small superficial ulcerations with granulomas
84. Seen in crohn’s affected area separated by non affected area
85.?
86. Because disease usually recurs at area of anastamosis
87. It is a sudden cure.
88. High fiber prevent constipation bulk laxatives 8 glasses of H20, decreased intake
of fat and red meats, exercise, wt reduction, avoid increase in intrabdominal
Pressure-tight clothes vomit, lifting, bending
89. anorexia-abn wt loss, self starvation, fear of wt gain, lanugo, refusal to eat,
Continuous dieting, hair loss, sensitivity to cold, compulsive exercise, absent or
Irregular menses, dry skin, constipation,
Bulimia- binge eating and self induced vomiting, normal wt for ht, macerated
Knuckles, swollen salivary glands, broken blood vessels in eyes, and dental
Problems
90. Jejunoileal bypass- reduces absorption in SI, join jejunum to distal segment of
Ileum, could cause short bowel syndrome, malabsorption of nutrients, decreased
K Ca Vit B
Gastric stapling- small pouch, limits oral intake to 50-60 ml for morbidly obese,
Increase frequency of meals and replace Vit and minerals