patho p3 q1

mastication

chewing

deglutition

is a complex process that requires coordination of many muscles in the head and neck and the precise opening and closing of esophageal sphincters.

peristalsis

rhythmic smooth muscle contractions

duodenum

The greatest amount of digestion occurs in the

bile

is an emulsifier, a substance that acts like soap by dispersing the fat into

very small droplets that permit it to mix with water.

diarrhea

results from increased motility of the small bowel, which floods the colon with an excessive amount of water that cannot be completely absorbed.

appendix

has no functional importance in digestion, it is often classified as an accessory digestive organ merely because of its location.

liver

is the largest gland in the body and is responsible for several vital functions

liver

plays an important role in maintaining the proper level of glucose in the blood by taking up excess glucose absorbed by the small intestine and storing it as glycogen

gallbladder

• is a pear-shaped sac that lies on the under-surface of the liver

• Its function is to store bile that enters by way of the hepatic and cystic ducts and to concentrate the bile by absorbing water

pancreas

controls the level of circulating blood glucose by secreting insulin and glucagon in the islets of Langerhans.

Congenital tracheoesophageal (TE) fistulas

result from the failure of a satisfactory esophageal lumen to develop completely separate from the trache

TYPE I TE Fistula

• second most common

• Pure esophageal atresia—upper and lower ­esophagus blind pouches

Type II TE fistula

• Upper esophagus communicates with trachea; lower segment blind pouch

Type III TE fistula

• most common

• Upper esophagus forms blind pouch (esophageal atresia) with a distal esophagus communicating with the trachea

Acquired TE fistula

Fistula caused by:

(1) Mediastinal malignancy

(2) Infection process

(3) Trauma

GERD

describes any symptomatic condition or structural changes caused by reflux of the stomach contents into the esophagus

Reflux esophagitis

develops when the lower esophageal sphincter fails to act as an effective barrier to the entry of gastric acid contents into the distal esophagus

Barrett’s esophagus

is a condition related to severe reflux esophagitis in which the normal squamous lining of the lower esophagus is destroyed and replaced by columnar epithelium similar to that of the stomach

candida (fungal) & herpesvirus

are the organisms most often responsible for infectious esophagitis, which usually occurs in patients with widespread malignancy who are receiving radiation therapy, chemotherapy, corticosteroids, or other immunosuppressive agents.

esophageal divertivula

are common lesions that either contain all layers of the wall (traction or true diverticula) or are composed of only mucosa and submucosa herniating through the muscular layer (pulsion or false diverticula)

Zenker’s diverticula

• arise from the posterior wall of the upper (cervical) esophagus

• they can become so large that they almost occlude the esophageal lumen

Epiphrenic diverticula

• arise in the distal 10 cm of the esophagus

• are associated with incoordination of esophageal peristalsis and sphincter relaxation, which increases the intraluminal pressure in this segment

Esophageal Varices

• are dilated veins in the wall of the esophagus that are most commonly the result of increased pressure in the portal venous system (portal hypertension), which is in turn usually a result of cirrhosis of the liver

Hiatal hernia

• is the most common abnormality (occurring in 50% of the population) detected on upper GI examination.

Achalasia

is a functional obstruction of the distal section of the esophagus with proximal dilation caused by incomplete relaxation of the lower esophageal sphincter. It is related to a paucity or absence of ganglion cells in the myenteric neural plexuses of the distal esophageal wall.

Mallory-Weiss syndrome

an increase in intraluminal and intramural pressures associated with vomiting (severe retching) after an alcoholic bout causes superficial mucosal laceration or fissures near the esophagogastric junction that produce severe hemorrhage.

perforation of the espphagus

may be a complication of esophagitis, peptic ulcer, neoplasm, external trauma, or instrumentation.

Helicobacter phylori

can cause chronic gastritis that may lead to peptic ulcer disease.

Alcoholic gastritis

may producethickening of gastric folds, multiple superficial gastric erosions, or both

corrosive gastritis

the acute inflammatory reaction heals by fibrosis and scarring, which result in severe narrowing of the antrum and may cause gastic outlet obstruction.

Chronic atrophic gastritis

refers to severe mucosal atrophy (wasting) that causes thinning and a relative absence of mucosal folds, with the fundus or entire stomach having a bald appearance

Pyloric stenosis

also known as infantile hypertrophic pyloric stenosis (IHPS), occurs when the two muscular layers of the pylorus become hyperplastic and hypertrophic. Environmental and hereditary factors are believed to cause this process in 2 to 4 per 1000 live births.

Peptic ulcer disease

is a group of inflammatory processes involving the stomach and duodenum. It is caused by the action of acid and the enzyme pepsin secreted by the stomach and occurs most frequently on the lesser curvature.

• is the most common cause of acute upper GI bleeding

Duodenal ulcer

is the most common manifestation of peptic ulcer disease. More than 95% of duodenal ulcers occur in the first portion of the duodenum (the duodenal bulb).

Gastric ulcer

usually occur on the lesser curvature of the stomach. Unlike duodenal ulcers, which are virtually always benign, up to 5% of gastric ulcers are malignant

Superficial gastric erosions

are ulcerations that are so small and shallow that they are rarely demonstrated on conventional single-contrast upper GI examinations.

Crohn’s disease

a chronic inflammatory disorder of unknown cause that most often involves the terminal area of the ileum but can affect any part of the GI tract.

• most common in young adults

Adynamic ileus

is a common disorder of intestinal motor activity in which fluid and gas do not progress normally through a nonobstructed small and large bowel.

localized ileus

refers to an isolated distended loop of small or large bowel (the sentinel loop), which is often associated

with an adjacent acute inflammatory process

Colonic ileus

refers to selective or disproportionate gaseous distention of the large bowel without an obstruction

• usually accompanies or follows an acute abdominal inflammatory process or abdominal surgery

Intussusception

• is a major cause of bowel obstruction in children; it is much less common in adults.

• is the telescoping of one part of the intestinal tract into another because of peristalsis, which forces the proximal segment of bowel to move distally within the ensheathing outer portion

Malabsorption disorder

refers to a multitude of condition in which there is defective absorption of carbohydrates, proteins, and fats from the small bowel

steatorrhea

the passage of bulky, foul-smelling, high-fat-content stools that float.