HSA GI EXAM

What are the organs in the GI system.

Liver, Gallbladder, Large intestine, stomach, small inestine

What are the function of the GI system

Intake % Digestion of food

Absorption of nutrients

Elimination of wastes

Ingestion

Process if taking food into the digestive system so that it can be digested.

Digestion

The breakdown of food (either chemically of mechanically) in order to utilize nutrients

Mechanical digestion

breaking down food in the mouth by chewing and moving the food around w/ the tongue.

Chemical digestion

Breaking down food using enzymes in the saliva

Mucin

slippery protein (mucus)

protects soft lining of digestive system

lubricates food for easier swallowing

Buffers

Neutralizes acid to prevent food decay

Anti-bacterial chemicals

kill bacteria that enter mouth w/ food

what does Mouth do?

Chemical and mechanical digestion

Food is chewed (masticated) mechanically

A bolus is formed with saliva and the tongue

Digestive glands

groups of specialized secretory cells

Found in the lining of the alimentary canal or accessory organs

Pharynx

The back of the throat, 12cm long

Larnyx

passage for air, closes when we swallow. 5cm long

Epiglottis

Flap of cartilage

Closes trachea

Food travels down esophagus

involuntary muscle contraction to move food along

Esophagus

A muscular tube that moves the bolus from the mouth to the stomach

Peristalsis

involuntary muscle contractions to over food along the digestive tract

Stomach

Food is temporarily stored here

gastric juices are secreted

has layers of muscle that line the inside

Mechanically and chemically breaks down food

Function of stomach

Food storage

dissect food

chemical digestion by pepsin

Gastric juices

secreted by the stomach

Acidic (pH 1,5-2.5)

food is further broken down into a thin liquid called chyme

pepsin

an enzyme in the stomach that breaks down large proteins and amino acids

Accessory organs

Pancreas

Gall bladder

Liver

Liver

Produces Bile

breaks up fats

-acts like detergent to break down fats

Where is bile stored?

In the gallbladder until needed

Bile contains

colors from old red blood cells collected in the liver

Why is feces brown

the inron in red blood cells rusts and makes it brown

Gallbladder

pouch like structure located near the liver which concentrates and stores bile

Bile duct

a long tube that carries BILE

BILE

breaks down fats

is bitter, green-yellow alkaline fluid, stored in the gallbladder between meals and upon eating Is discharged in to the duodenum where it aids the process of digestion

Pancreas

Digestive enzymes

digests proteins with trypsin and chymotrypsin

digests starch w/ amylase

Buffers

neutralizes acid from stomach

Small intestine function

chemical digestion

major organ of digestion and absorption

absorption through lining

Small intestine structure

-3 sections

duodenum= most digestion

jejunum= absorption of nutrients and water

ileum= absorption of nutrients and water

Small intestine

simple sugars and amino acids are absorbed into the inner lining of the small intestine

fatty acids and glycerol go to lymphatic system

lined with villi, which increase surface area for absorption, one cell thick

Duodenum

1st section of small intestines

• acid food from starch

• majority of digestion occurs here

• mixes with digestive juices from: increase, liver, gallon bladder

jejunum and ileum

main areas or absorption of nutrients from the villi into the bloodstream to be distributed throughout the body

Absorption by Small intestines

through villi and microvilli

• finger-like projections

• increase surface area for absorbtion

Appendix

vestigial organ

Large intestines (colon)

Function

• re-absorbes the rest of the water and electrolytes

• not enough water absorbed? diarrhea

• too much water? constipation

• bacteria produce vitamin K and B Vitamins (B12, thiamine, and riboflavin

Structure of large intestine

ascending colon

transverse Colon

descending colon

Good bacteria

E.Coli

• produce vitamins K and B

• Generate glasses which are the by-product of bacterial metabolism

• methane, hydrogen sulfide

  Breaks down remaining food

Rectum

last section of colon

• eliminates feces

• undigested materials

• - extracellular waste from cellulose of plants

• roughage or fiber

• - masses of bacteria

Digestive homeostasis disorders

Ulcer- erosion of the surface of the alimentary canal generally associated with some kind of irritant

Digestive Homeostasis Disorders

constipation- a condition in which the large intestine is emptied with difficulty

too much water is reabsorbed

and the solid waste hardens

Diarrhea

a gastrointestinal disturbance characterized by decreased water absorption and increased peristaltic activity of the large intestine

This results in increased, multiple, watery feces.

This condition may result in serve dehydration, especially in infants

Apendicitis

an inflammation of the appendix due to infection

common treatment is removal of the appendix via surgery

Kidney stones

an accumulation of hardened cholesterol and/or calcium deposits in the gallbladder

can either be “passed” or surgically removed

Anorexia Nervosa

a psychological condition where an individual thinks they appear overweight and refuses to eat.

Weighs 85% or less than what is developmentally expected for age and height

young girls do not begin to menstruate at the appropriate age

Heart Burn

ACID from the stomach backs up into the esophagus

geront/o

elderly

Legal Responsibilities

Those that are authorized or based on

the law.  This includes civil laws and 

criminal laws.

Criminal Law:

focuses on wrongs against a person, property, or society

Example:  

• Practicing as a doctor without a license

• Murder

Civil Law

focuses on legal relationships between people and the protection of a person’s rights

Torts:

wrongful acts that do not involve contracts: occurs when a person is harmed or injured because a health care provider does not meet the established or expected standards of care.

Malpractice:

(bad practice)

  “the failure of a professional to use the degree of skill and learning commonly expected in that individual’s profession, resulting in injury, loss, or damage to the person receiving care”

(This was done with intent) 

• Failure to diagnose or misdiagnosis.

• Misreading or ignoring laboratory results.

• Unnecessary surgery.

• Surgical errors or wrong site surgery.

• Improper medication or dosage.

• Poor follow-up or aftercare.

• Premature discharge

Negligence:

“failure to give care that is normally expected of a person in a particular position, resulting in injury to another person”  There was no intent>

Medical negligence

failure to meet the standard of care that is expected from a person with certain training. (performing incorrectly or not at all)

Assault:

a threat about receiving unwanted treatment

Battery:

the touching a patient or performing a procedure on them without consent

 To Avoid Charges of Battery, Obtain:

Informed consent: 

Informed consent: 

permission granted voluntarily by a person who is of sound mind after the procedure and all risks have been explained in terms the patient can understand

Invasion of Privacy: 

• unnecessarily exposing an individual or revealing personal information about an individual without that person’s consent

False Imprisonment:

•   restraining an individual or restricting an individual’s freedom

Abuse: 

any care that results in physical

harm, pain, or mental anguish

- physical abuse

- verbal abuse

- psychological abuse

 - sexual abuse

Defamation:

false statements either cause a person to be ridiculed or damage the person’s reputation

Libel:

written

Slander:

spoken

What does the
health care worker need to
protect against lawsuits?

• Medical Malpractice Insurance

• Average cost (doctors) is about $40,000 per year

• Some medical specialties pay higher rates:

  - OB/GYNs, surgeons :  

$100,000 - $200,000 per year

Contracts

 Agreements between two or more parties

 Offer:

 action that starts the contract process

(pt visits dentists for toothache)

Acceptance:

both parties agree to do  something,

                    enter a contract.

(pt and dr agree to do a filling)

Consideration:

something of value must be 

                    exchanged by the parties.  (payment for filling)

**A signed document outlining the terms of the agreement is NOT required. (handshake)

Implied Contracts:

actions of the parties create the contract. Most used by healthcare providers.  (EX:  going to dentist, getting filling, and paying for it complete a contract)

Expressed Contracts:

• stated in distinct and clear language, either orally or in writing  

*If a contract is not performed according to the agreement, it is breached or broken, and can be cause for legal action

legal disability

- minors (under the age of 18)

  - mentally incompetent persons

     - persons under the influence of drugs that alter the mental state

     -semiconscious or unconscious persons

Agent:

person working under the supervision of an employer

Principal:

employer

The principal is responsible or liable for the actions of the agent and can be required to pay or otherwise compensate people who have been injured by the agent

Privileged  Health Information (PHI)

All information concerning patients is PHI.

By law, it must be kept confidential and shared only with other members of the health care team.  It can only be released to others with written consent.

Exemptions From Privileged Communication Rules

1. Births and deaths

2. Injuries caused by violence that may require police involvement

3. Drug abuse

4. Communicable diseases

5. STDs

   All medical records (patient charts) are

       legal documents.

   You can not erase anything in a

    patient’s chart.  Mark one line 

    through any mistakes.

HIPAA

Federal guidelines established by the Department of

Health and Human Services:

• 1. Privacy Rule:  regulates the use and sharing of individually identifiable health care information

• 2.  Security Rule: mandates safeguards to maintain the privacy of individually identifiable electronic health care information

• Applies to health insurance companies, billing companies, and health care providers

• Failure to comply with HIPAA rules can result in criminal or civil penalties

Patient’s Bill of Rights

1. Considerate and respectful care

2. Obtain complete, current info concerning diagnosis, treatment, and prognosis

3. Receive info necessary to give informed consent

4. Refuse treatment to the extent of the lawConfidentiality

5. Reasonable response to a request for services

6. Obtain info regarding relationship of hospital to other institutions

7. Right to refuse to participate in any research project

8. Expect reasonable continuity of care

9. Be allowed to review medical bills

10. Be informed of hospital rules and methods available to resolve grievances