GI function - 1

What structures are included in the upper GI tract?

• Esophagus

• stomach

What structure are included in the lower GI tract?

Small intestines and large intestines

Which organs are listed as accessory organs?

• Liver

• Gallbladder

• Pancreas

What is vomiting (Emesis)?

Involuntary or voluntary forceful ejection of the Chyme from the stomach up through the esophagus and out the mouth

Which structure coordinates the vomiting reflex?

The medulla

What are complications of vomiting?

Fluid, electrolyte, and pH imbalances, aspiration

What is hematemesis?

Blood in the vomitus

What does yellow or green vomitus usually indicate?

Th presence of bile

What may deep brown vomitus indicate?

Content from the lower intestine

What causes undigested food vomitus, according to the slides?

Condition that impair gastric emptying (like pyloric stenosis = narrowing/hardening caused by plaque build up)

What is esophageal atresia?

Incomplete formation of the esophagus

What may occur with esophageal atresia?

Can occur with fistula to the trachea

What are the listed risk factors for esophageal atresia?

Increased paternal age and maternal use of assisted reproduction

What are manifestations of esophageal atresia?

Excessive secretions, coughing, vomiting, and cyanosis after feeding

What is a complication of esophageal atresia?

Aspiration pneumonia

What is pyloric stenosis?

Narrowing and obstruction of the pyloric sphincter

What happened to the pyloric sphincter muscle fibers in pyloric sphincter

The pyloric sphincter muscle fibers become thick and stiff, making it difficult for the stomach to empty food into the small intestines

At approximately what age do most cases of pyloric stenosis present?

Approximately 3 weeks of like

What are the manifestations of pyloric stenosis?

• Hard mass in the abdomen

• regurgitation

• projectile vomiting/wavelike stomach contractions

What is dysphagia

Difficulty swallowing

What are causes of dysphagia listed in the slides?

• Congenital atresia: esophageal stenosis or stricture, fibrosis

• Esophageal diverticula (small, bulging pouches or sacs that form in the walls of the large intestine (colon)

• Achalasia = difficulty/pain w swallowing

• Neurological Damage : CN V, VII, IX, X, XII

What are the manifestations of dysphagia?

A sensations of food being stuck in the throat, choking, coughing, “pocketing” food in the cheeks, difficulty forming a food volume, delayed swallowing, and odynophagia

What are complications of vomiting?

• Fluid

• electrolyte

• pH imbalances

• Aspiration

What is a hiatal hernia?

A stomach section protrudes upward through an opening in the diaphragm toward the lung

What are cause of hiatal hernia?

• Wearing of the diaphragm muscle, frequently resulting from increased intrathoracic pressure or increased intra-abdominal pressure

• Trauma

• Congenital defects

What are risk factors for hiatal hernia?

Advanced age and smoking

What are manifestations of hiatal hernia?

• Indigestions

• heartburn

• frequent belching

• nausea

• chest pain

• strictures

• dysphagia

• soft upper abdominal mass

What can worsen hiatal henri manifestations?

• Recumbent positioning

• eating (especially after large meals)

• Bending over

• Coughing

What is gastroesophageal reflux disease (GERD)?

Chyme if blue periodically backs up form the stomach into the esophagus, irritating the esophageal mucosa

What cause of contributes to GERD, according to the slides?

• Certain foods (choco, caffeine, carbonated beverages, citrus fruit, tomatoes, spicy or fatty foods, and peppermint)

• Alcohol consumption

• Nicotine, hurt hernia

• Obesity

• Pregnancy

• Certain medications

What are complications of GERD?

• Esophagitis

• strictures

• ulcerations

• esophageal cancer

• chronic pulmonary disease

What is gastritis?

Inflammation of the stomach’s mucosal lining (may involve the entire stomach or a region)

Is gastritis acute or chronic?

Acute or Chronic

What are manifestations of gastritis?

• Indigestion

• heartburn

• epigastric pain

• abdominal cramping

• nausea

• vomiting

• anorexia

• fever

• malaise

What is the most common cause of chronic gastritis?

Helicobacter pylori

How does Helicobacter pylori contribute to chronic gastritis?

Embeds itself in the mucous layer, activating toxins and enzymes that cause inflammation

What are complications of chronic gastritis?

• Peptic ulcers

• gastric cancer

• hemorrhage

What is peptic ulcer disease (PUD)?

Lesions affecting stomach lining or duodenum

What are risk factors for peptic ulcer disease?

• Being male

• advancing age

• nonsteroidal anti-inflammatory drug use

• H. pylori infections

• certain gastric tumors

• those for GERD (e.g., smoking and alcohol use)

What are complications of peptic ulcer disease?

• GI hemorrhage

• obstruction

• perforation

• peritonitis

How does duodenal ulcer pain typically behave in the presence of food?

Epigastric pain that is relieved in the presence of food

How does gastric ulcer pain typically behave with eating?

Pain typically worsens with eating

What are stress ulcers associated with?

• A major physiological stressor on the body due to local tissue ischemia

• tissue acidosis (a local/systemic condition where the pH of body tissues drops below normal levels due to accumulations of acidic byproducts or a failure of clearance)

What is cholelithiasis?

Gallstones: a common condition that varies in severity based on size, but affects both genders and all ethnic groups relatively equally

What is cholelithiasis?

Gallstones: a common condition that varies in severity based on size, but affects both genders and all ethnic groups relatively equally

What is cholecystitis?

Inflammation or infection in the biliary system caused by calculi

What are risk factors for cholelithiasis?

• Advancing age

• obesity

• diet

• rapid weight loss

• pregnancy

What are manifestations of cholelithiasis?

• Biliary colic

• abdominal distension

• nausea

• vomiting

• jaundice

• fever

What can occur if gallstones obstruct bile flow?

• Gallbladder rupture

• fistula formation

• gangrene

• hepatitis

• pancreatitis

• carcinoma

What is hepatitis?

Inflammation of the liver

What are causes of hepatitis?

• Infections (usually viral)

• alcohol, medications (e.g., acetaminophen [Tylenol],antiseizure agents, and antibiotics)

• or autoimmune disease

How can hepatitis be classified?

Acute or chronic, active or nonactive

What can hepatitis result in?

• Hepatic cell destruction

• necrosis

• autolysis

• hyperplasia

• scarring

How do viral and nonviral hepatitis differ in contagiousness?

• Nonviral hepatitis is noncontagious

• Viral hepatitis is contagious

What is cirrhosis?

• Chronic

• progressive

• irreversible

• diffuse damage to the liver resulting in decreased liver function; may develop over 40 years even if underlying cause is addressed

What changes occur in the liver with cirrhosis?

Fibrosis, nodule formation, impaired blood flow, and bile obstruction that can result in liver failure

What are the most frequent causes of cirrhosis in the United States, according to the slides?

Hepatitis C infection and chronic alcohol abuse

What are complications or manifestations associated with cirrhosis?

• Jaundice; esophageal varices

• hemorrhoids; portal hypertension

• caput medusa

• ascites

• enlarged organs

• splenomegaly

• slow or severe bleeding

• clotting changes; decreased clotting

• muscle wasting

• hyperlipidemia

• bile accumulation

• clay-colored stools and dark urine

What is jaundice?

Yellowing of eyes/skin

What are esophageal varices and hemorrhoids described as in the slides?

• Enlarged veins

• easily rupture

What is ascites?

Fluid accumulation in the peritoneal cavity

What is pancreatitis?

Inflammation of the pancreas

What types of pancreatitis are listed?

Acute or chronic

What causes pancreatitis?

• Cholelithiasis

• alcohol abuse

• biliary dysfunction

• hepatotoxic drugs

• pancreatic tumors

• penetrating peptic ulcer

How does pancreatic injury cause tissue damage in pancreatitis?

• Pancreatic enzymes leak into the pancreatic tissue and initiate autodigestion —> resulting in edema, vascular damage, hemorrhage, and necrosis

What happens to pancreatic tissue in chronic pancreatitis, according to the slides?

Pancreatic tissue is replaced by fibrosis, which causes exocrine and endocrine changes and dysfunction of the islets of Langerhans

What are manifestations of acute pancreatitis?

• Usually sudden and severe; upper abdominal pain that radiates to the back, worsens after eating, and is somewhat relieved by leaning forward or pulling the knees toward the chest; nausea and vomiting

• low-grade fever

• blood pressure and pulse changes

What are manifestations of chronic pancreatitis?

• Upper abdominal pain; indigestion

• losing weight without trying

• steatorrhea

• constipation

What are complications of pancreatitis?

• Acute respiratory distress syndrome

• diabetes mellitus

• infection

• shock

• disseminated intravascular coagulation

• renal failure

• malnutrition

• pancreatic cancer

• pseudocyst

• abscess

Which lower GI disorders are named in the slide outline?

• Diarrhea/Constipation

• Intestinal Obstruction

• Appendicitis

• Inflammatory Bowel Disease

• IBS (irritable bowel syndrome)

• Diverticulitis (a gastrointestinal condition that occurs when small, bulging pouches, called diverticula, in the wall of the large intestine, called colon, become inflamed or infected)

What GI cancer-related topics are named in the slide outline or content?

Gastric cancer; esophageal cancer; pancreatic cancer; carcinoma