cheiloplasty
surgical correction of cleft lip/palate
cleft lip can be repaired
soon after birth
cleft palate can be repaired
after 1 to 2 years of age, requiring speech therapy
temporary deciduous teeth
20
permanent teeth
32
tetracycline
antibiotic harmful to enamel formation causing permanent discoloration in crowns
dental plaque
sticky film formed from bacteria mixing with saliva
dental caries
tooth decay from plaque combined with bacterial action
dental cavity
loss of tooth structure from bacterial action
patients with xerostoma have a higher incidence of cavities because
saliva buffers bacterially produced acid
periodontal disease
inflammation in tissues supporting teeth forms pockets of infection between teeth and gums
stomatitis
inflammation of oral cavity
stomatitis caused by iritamts
alcohol, tobacco, hot and spicy foods
stomatitis caused by infectious agents
herpes virus, candida albicans fungus, bacteria responsible for trench mouth
oral cavity carciomas
arise from squamous epithelium
location of oral cavity carcinomas
lips, cheeks, tongue, palate, back of throat
elderly oral cavity carcinomas
alcohol tobacco use, bad prognosis
young people oral cavity carcinomas
HPV from oral sex, better prognosis
cardiac sphincter
gastroesophageal, the lower sphincter
tears at gastroesophageal junction
from repetitive vigorous contractions increasing intrabdominal pressure
cardiospasm
cardiac sphincter fails to open, malfunction of nerve plexus, esophagus dilated from food retention
incompetent cardiac sphincter
sphincter remains open letting gastric juice into esophagus
complications of incompetent cardiac sphincter
reflux esophagitis, ulceration and scarring, Barrett esophagus
Barret Esophagus
glandular metaplasia change from squamous to columnar epithelium, increasing risk for cancer
tracheoesophageal fistula
carcinoma of esophagus invades trachea
food impaction of esophagus
occurs in distal part
stricture of esophagus
from scar tissue due to necrosis and inflammation from corrosive chemicals such as lye
gastric mucosal tears
linear tears caused by vomiting leading to blood vomit
acute gastritis
inflamed gastric lining from NSAIDS or alcohol
NSAIDS that inhibit cyclooxygenase enzyme (cox)
aspirin, ibuprofen, naproxen
Cox-1
promotes synthesis of prostaglandin that protects gastric mucosa
cox-2
promotes synthesis of prostaglandin that mediates inflammation
drugs that inhibit cox 2
increase risk of heart attack and stroke
alcohol
gastric irritant stimulating gastric acid and secretion
H Pylori gastritis
gram negative organisms colonize surface of gastric mucosa, producing urease and breaking down mucus layer
urease
decomposes urea into ammonia, neutralizing gastric acid and allowing organisms to flourish
H pylori gastritis increases risk of
mucosa associated lymphoid tissue MALT
H pylori gastritis progression
increases with age
peptic ulcer
increased acid secretion digests mucosa, H pylori associated
peptic ulcer common locations
distal stomach or proximal duodenum
peptic ulcer complications
hemorrhage, perforations, peritonitis, obstruction from scarring
peptic ulcer treatment
antacids, antibiotics, surgery
carcinoma of stomach
upper abdomen discomfort and iron deficiency anemia, diagnosed through biopsy
carcinoma of stomach treatment
surgical resection of affected area, long term survival relatively poor
acute enteritis
common intestinal infection causing nausea, vomiting, abdominal discomfort and loose stools
chronic enteriris
less common and more difficult to treat
Regional enteritis or Crohn disease
chronic scattered inflammation and ulceration of mucosa with thickening and scarring of bowel wall
treatment of enteritis
drugs, possible surgical resection
antibiotic associated colitits
broad spectrum antibiotics destroy normal intestinal flora allowing growth of C diff
symptoms of colitis
diarrhea, abdominal pain, fever
diagnosis of colitis
stool culture, toxin in stool
treatment of colitis
stop antibiotics. give vancomycin or metronidazole
drugs that prolong colitis
drugs that decrease intestinal mobility
Meckel Diverticulum
congenital outpouching in the small intestine, located near the junction of the small and large intestines. It can cause abdominal pain or bleeding.
food intolerance
crampy abdominal pain, distension, flatulency, loose stools
lactose intolerance
Condition where the body can't digest lactose, a sugar found in milk. Symptoms include bloating, diarrhea, and gas after consuming dairy products.
glucose intolerance
chronic diarrhea impairing absorption of fats and nutrients, weight loss, and vitamin deficiencies
Irritable Bowel Syndrome
spastic/mucous colitis, excessive mucus secreted by colonic mucosal glands, alternating diarrhea and constipation
IBS manifestations
episodes of crampy abdominal discomfort, loud gurgling bowel sounds and disturbed bowel function without structural or biochemical abnormalities
IBS diagnosis
exclude pathogenic infections, food intolerance, and inflammatory conditions
IBS treatment
reduce emotional tension and improve intestinal ability
Appendicitis
most common inflammatory lesion of the bowel
appendicitis pathogensis
appendix plugged with fecal material, secretions drain poorly, creating pressure and compressing blood supply, or bacteria invade causing inflammation
appendicitis manifestations
abdominal pain in RLQ, rebound tenderness, rigidity
ulcerative colitits
large intestine and rectal mucosa inflamed without bowel thickening
ulcerative colitis complications
bleeding, bloody diarrhea, perforation, cancer of colon or rectum
ulcerative colitis treatment
supportive measures, antibiotics, corticosteroids, immunosuppressive drugs, surgical resection
intestinal obstructions
a serious condition blocking normal passageway of intestinal contents, severity depends on location and interference with blood supply
high intestinal obstruction
sever, crampy abdominal pain from vigorous peristalsis, vomiting with loss of H2O and electrolytes causing dehydration
low intestinal obstruction
symptoms less acute, mild, crampy abdominal pain, moderate distension of abdomen
common causes of intestinal obstruction
adhesions, hernia, tumor, volvulus, intussusception
intestinal adhestions
adhesive bands of connective tissue, may cause loop of bowel to become kinked, compressed, twisted, causes obstruction proximal to site of adhesion
hernia
protrusion of loop of bowel through a small opening, usually in abdominal wall, herniated loop pushes through peritoneum to form herniated sac
inguinal hernia
common in men, loop of small bowel protrudes through a weak area in inguinal ring and descends downward into scrotum
umbilical and femoral hernia common in
both sexes
umbilical hernia
loop of bowel protrudes through umbilucus through defect in abdominal wall
femoral hernia
loop of intestine extends under inguinal ligament along course of femoral vessels into the groin
reducible hernia
herniated loop of bowel can be pushed back into abdominal cavity
incarcerated hernia
herniated loop of bowel can not be pushed back into abdominal cavity
strangulated hernia
loop of bowel tightly constricted, obstructing the blood supply to the herniated bowel; requires prompt surgical intervention
volvulus
rotary twisting of bowel impairing blood supply; common site is sigmoid colon
intussception
telescoping of segment of bowel into adjacent segment; from vigorous peristalsis or tumor, common site is terminal ileum
mesenteric thrombosus
thrombosus of superior mesenteric artery, extensive bowel infarction
diverticulosis
outpouching or diverticula of colonic mucosa through weak area areas in muscular wall of large intestine
predisposes to diverticulosis
low residue diet, because increased intralumenal pressure must be generated to propel stools through colon
diverticulitis
inflammation incited by bits of fecal material trapped within outpouchings
diverticulitis complications
inflammation, perforation, bleeding, scarring, abcess
benign pedunculated polyps of colon
frequent, tip may erode causing bleeding, removed during colonoscopy
types of carcinoma of colon
cecum and right ½ of colon or left half of colon
tumor of cecum and right ½ of colon
does not cause obstruction because caliber is large and bowel contents are relatively soft. tumor can ulcerate and bleed leading to chronic iron deficiency anemia, weakness and fatigue
tumor of left ½ of colon
causes obstruction and symptoms of lower intestinal obstruction
diagnosis of colon carcinoma
narrowed colon on barium enema
change from normal colon to small benign polyp
loss of APC gene
change of small benign polyp to large benign polyp
oncogenic mutation in Ras gene
change of large benign polyp to invasive malignant colon cancer
mutation or loss of p53 function
imperforate anus
congenital abnormality where colon fails to acquire a normal opening, two types
easily treated by incising tissue covering anal opening
rectum and anus normally formed and extends to level of skin just without an anal orifice
corrected surgically, more technically difficult with less satisfactory results
entire distal rectum fails to develop with associated abnormalities of urogenital and skeletal system
hemorrhoids
varicose veins of hemorrhoidal venous system that drains rectum and anus
predisposal to hemorrhoids
constipation and straining