GI Packet #1

Upper GI tract (5 parts)

1. Mouth

2. Pharynx

3. Esophagus

4. Stomach

5. Duodenum

The pharynx is AKA...

Throat

The esophagus is AKA...

Food pipe

The duodenum is the _______ part of the small intestine.

First

Lower GI tract (4 parts)

1. Jejunum

2. Ileum

3. Large intestine/Colon

4. Anus

The jejunum is the _______ part of the small intestine.

Middle/Second

The ileum is the ______ part of the small intestine.

Last

The large intestine is also called the...?

Colon

Definition of Digestion

Breakdown of food into smaller particles and individual nutrients

5 Parts of Digestion

1. Movement of liquids and solids

- Via peristalsis

2. Lubrication of foods

3. Mechanical breakdown

4. Reabsorption of nutrients and water

5. Excretion of waste

Where does digestion begin?

The mouth

What prompts the initial breakdown of food in the mouth?

Salivary amylase

Once a bolus of food is chewed, where does it move to once it is done in the mouth?

The pharynx

What is a bolus?

Clump of food

Where does the bolus move to after the pharynx?

The epiglottis

How does the bolus move to the epiglottis?

Peristalsis

What is peristalsis?

Waves of muscular contraction

Once in the epiglottis, where does the bolus travel to next?

Into the stomach and breaks down

What is food called?

Chyme

After being in the stomach, what organ does the chyme flow into and in what order?

The small intestine; flows through the duodenum, followed by the jejunum, then the ileum

Where does most digestion occur?

The duodenum

How long does it take to complete digestion?

3-5 hours

Waste flows into what organ?

Large intestine/Colon

The large intestine absorbs what?

Water

Once water is absorbed, waste is processed for __________.

Elimination

What removes water from waste?

Large intestine/Colon

What is the total transit time of digestion?

24-30 hours

Length of small intestine

22 feet

Length of large intestine

6 feet

What are the 4 quadrants of the stomach?

1. Left upper quadrant (LUQ)

2. Left lower quadrant (LLQ)

3. Right upper quadrant (RUQ)

4. Right lower quadrant (RLQ)

What are the 3 regions of the stomach?

1. Epigastric

2. Periumbilical

3. Pelvic/Hypogastric

What causes abdominal pain in the LUQ? (3)

-Spleen

-Stomach

-Left kidney

What causes abdominal pain in the LLQ? (3)

-Sigmoid colon

-Left ovary

-Left ureter

What causes abdominal pain in the RUQ? (3)

-Gallbladder

-Liver

-Right kidney

What causes abdominal pain in the RLQ? (4)

-Ileum

-Appendix

-Cecum

-Right ureter

What causes abdominal pain in the epigastrium? (6)

-Stomach

-Gallbladder

-Pancreas

-Duodenum

-Heart

-Esophagus

What causes abdominal pain in the periumbilical region? (5)

-Jejunum

-Ileum

-Cecum

-Appendix

-Right colon

What causes abdominal pain in the pelvic/hypogastric region? (3)

-Bladder

-Uterus

-Sigmoid colon

Pain is _____________!!!!!!

SUBJECTIVE

What is the pain scale used to ask to Pts?

Pain 1-10

Pain of 0 or 1 means...?

No pain

Pain of 10 means.....?

Worst pain

Documentation is based on what?

Patient complaints

Sources of pain can be....? (2)

Intra-abdominal or Extra-abdominal

TRUE OR FALSE: All abdominal pain is from an abdominal source.

False

Anatomical etiologies of intra-abdominal pain (5)

1. Gallbladder

2. Small or large bowel

3. Appendix

4. Stomach

5. Liver

Disease processes of the stomach causing intra-abdominal pain (2)

-Ulcer formation

-Gastritis

Disease processes of extra-abdominal pain in the stomach (8)

1. Heart attack/AMI

2. Ovarian cysts

3. Ectopic pregnancy

4. Testicular pain

5. Muscle strain

6. Pneumonia (lungs)

7. Psychological illness

8. Abuse

What is considered elderly when making a differential diagnosis (specific to GI)?

Over 50 years old

Most common differential diagnosis in the elderly (4)

1. Bowel obstruction

2. Diverticulitis

3. Gastroenteritis

4. Urinary tract Infection

Which differential Dx can cause odd Sx, including neurological Sx?

Urinary tract infection

What are the 7 factors?

1. Setting

2. Location

3. Chronology

4. Quality

5. Quantity

6. Aggravating/Alleviating Factors

7. Associated Manifestations

What is the proper order of physical examination for GI issues?

1. Inspection

2. Auscultation

3. Percussion

4. Palpation

Inspection

Look and inspect (visual)

What might be found during inspection on PE? (5)

-Coloration

-Lumps

-Bumps

-Open wounds

-Post-surgical scars

Auscultation

Stethoscope placed on stomach to listen to bowel sounds/gurgling

TRUE OR FALSE: Diseases can make specific sounds/gurgling of the stomach?

True

TRUE OR FALSE: You do not have to listen in all 4 quadrants of the stomach.

False

Hyperactive vs. Hypoactive

-Hyperactive= Over active

-Hypoactive= Under active

Percussion

Using hands to identify density while listening

What is suggested if you hear tympany?

Air

What is suggested if you hear dullness?

An organ, fluid, or feces

Palpation

Hands on exam

Light palpation vs. deep palpation

-Light palpation: One hand, lighter

-Deep palpation: Two hands, deeper

What areas of the stomach should you palpate first?

Areas with no pain

What areas of the stomach should you palpate last?

Areas with pain

What is the available testing methods? (6)

1. X-rays

2. Ultrasound

3. CT scan

4. Lab studies

5. MRI

6. Physical exam

TRUE OR FALSE: The red flags for abdominal pain applies to all parts of the stomach (upper, middle, and lower).

True

What are the red flags for abdominal pain? (5)

1. Abrupt/sudden onset of pain that does not stop

2. Persistent vomiting

3. Rapid pulse or breathing

4. Abdominal distention

5. High fever or chills

How does persistent vomiting pose a threat?

Dehydration

Who specifically does persistent vomiting threaten the most?

Pregnant women; can cause loss of baby

How can you detect dehydration on P.E.? (2)

-Dry mouth

-Tenting the skin

What can an abdominal distension suggest? (3)

-Fluid

-Tumor

-Growth

Having a high fever or chills indicates what kind of process?

Infectious