Patho 3/12
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Created by:
chelsie7n7 on March 23, 2012
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102 terms
Terms | Definitions |
|---|---|
 layers of the wall of the digestive tract | mucosa, submucosa, muscularis externa/propria, and serosa |
| mucosa | produce mucus to lubricate and protect smooth inner surface of the bowel wall; secrete enzymes for digestion of proteins |
| submucosa | contains blood vessels, lymph vessels, nerves & mucus-producing glands |
| muscularis externa/propria | muscle provides propulsive peristalsis to move food and breaks down food for absorption |
| serosa | produces fluid to lubricate the outer surface of the bowel |
| salivary glands | secrete saliva, which contains enzymes that initiate breakdown of carbohydrates |
| liver | produces bile, which emulsifies fat |
| gallbladder | stores bile and introduces it into small intestine |
| pancreas | produces and secretes pancreatic juice, containing digestive enzymes and bicarbonate ions, into small intestine |
| mouth | mechanical breakdown of food; begins chemical digestion of carbohydrates |
| pharynx | connects mouth with esophagus |
| esophagus | peristalsis pushes food to stomach |
| stomach | secretes acid and enzymes; mixes food with secretions to begin enzymatic digestion of proteins |
| small intestine | mixes food with bile and pancreatic juice; final enzymatic breakdown of food molecules; main site of nutrient absorption |
| large intestine | absorbs water and electrolytes to form feces |
| rectum | regulations elimination of feces |
| general signs and symptoms of GI diseases | altered motility, pain, bleeding, and perforation |
| altered motility | dysphagia, diarrhea, constipation, obstruction, vomiting |
| pain | heartburn, epigastric pain, right lower quadrant |
| bleeding | hematemesis, melena, hematochezia, occults |
| tests for GI diseases | endoscopy, radiologic studies, endoscopic studies, biopsy, gastric fluid analysis, stool, and stool culture |
| diseases of the esophagus | Hiatus Hernia; Achalasia; Mallory Weiss; Reflux esophagitis; Barrett's esophagus; Esophageal Carcinoma |
| Hiatus Hernia age range | >50 years old |
| Hiatus Hernia pathology | stomach protrudes above diaphragm into the thorax due to loosening of diaphragmatic sphincter |
| Hiatus Hernia patients prone | chronic cough in COPD, chronic constipation, rigor, diarrhea, pregnancy, etc. |
| Hiatus Hernia treatment | surgery, medication, change lifestyle |
| Reflux esophagitis | Acid remains in the stomach, which is then capable of rising up, causing irritation & inflammation |
| Achalasia pathology | Failure of lower esophageal sphincter (LES) to relax & doesn't allow food to enter the stomach |
| Achalasia symptoms | dysphagia, vomiting, chest pain, aspiration pneumonia, increased risk of squamous cell carcinoma of esophagus |
| Achalasia treatment | Botox injections used to relax muscle, surgery |
| Mallory Weiss syndrome aka | Gastroesophageal laceration syndrome |
| Mallory Weiss syndrome symptoms | upper GI bleeding, which might lead to shock |
| Mallory Weiss syndrome treatment | supportive measures, curative to use Epi to cause vasoconstriction or sclerotherapy to sclerose the blood vessels so there's no further bleeding |
| Mallory Weiss syndrome pathology | tear in esophagus at GE junction |
| Esophageal Varices pathology | Affects veins at the lower end of the esophagus; Veins dilated due to excessive pressure |
| varices | dilated blood vessels at distal end of esophagus, close to GE junction |
| Esophageal Varices etiology | portal HTN & cirrhosis |
| Esophageal Varices symptoms | asymptomatic or lots of bleeding |
| Esophageal Varices treatment | hemodynamic support, curative Endoscopic sclerotherapy (banding/ligation of varices), balloon tapenade used in emergencies |
| Reflux esophagitis etiology | Incompetent lower esophageal sphincter causing reflux of acid from stomach; Esophageal hiatal hernia, obesity, pregnancy, etc. |
| Reflux esophagitis risk factors | Alcohol, smoking, cocaine |
| Reflux esophagitis manifestations | Heartburn, hemorrhage (w/ ulcer), dysphagia (w/ stricture) (inflammation or scarring/narrowing of lumen) |
| Reflux esophagitis pathology | Eosinophils (+/- neutrophils) in the epithelium are characteristic |
| Reflux esophagitis treatment | Cessation of alcohol, smoking, drugs; Surgery; Medicine (tums, histamine receptor blockers, proton pump inhibitors) |
| Candida esophagitis | Seen in diabetics; Plaque-like membrane on surface of esophagus |
| Herpes esophagitis | Inflammation caused by herples simplex virus (type I more common); Immune compromised; Viral cytopathic effect |
| Barrett's esophagus (BE) definition | Complication of chronic gastroesophageal reflux disease (GERD) |
| Barrett's esophagus (BE) pathology | Squamous mucosa of esophagus is replaced by intestinal type mucosa containing goblet cells |
| Barrett's esophagus (BE) symptoms | inflammation of the mucosa, & prolonged injury results into epithelial metaplasia (Barrett esophagus) that may progress to adenocarcinoma |
| Esophageal carcinoma | squamous cell carcinoma (worldwide); adenocarcinoma (US) |
| Esophageal carcinoma risk factors | achalasia, alcohol, tobacco, nitrites & nitrosamine in food as preservatives (worldwide); Barrett esophagus (US) |
| Esophageal carcinoma pathology | tumor obstructs lumen of esophagus; keratin pearl formation in SCC |
| Esophageal carcinoma treatment | mesh tube in esophagus; stent is placed as a palliative procedure in advanced SCC |
| Esophageal carcinoma symptoms | dysphagia, weight loss |
| diseases of the stomach | Gastritis; Peptic Ulcer Disease; Gastric Carcinoma |
| Gastritis definition | inflammation of the stomach |
| Chronic gastritis | plasma cells & lymphocytes are main inflammatory cells |
| Chronic gastritis pathology | helicobacter pylori; intestinal metaplasia |
| Chronic gastritis manifestations | dysplasia and carcinoma (IM); gastric lymphoma (h. pylori) |
| Autoimmune gastritis | Due to antibodies against acid producing parietal cells of stomach - atrophic gastritis |
| Autoimmune gastritis infects | upper portion of stomach |
| Autoimmune gastritis causes | hypochlorhydria; loss of acid & IF production; Vit B12 deficiency; mucosal atrophy; increased risk of gastric cancer |
| acute gastritis etiology | Aspirin, alcohol, smoking, NSAIDs, acid or alkali ingestion; Stress caused by burns, surgery, trauma, shock |
| acute gastritis pathogenesis | imbalance of aggressive factors that take over so there's inflammation in the gastric mucosa --> intestinal metaplasia --> peptic ulceration |
| Peptic ulcer disease (PUD) pathogenesis | exposure of mucosa to gastric acid and pepsin |
| Peptic ulcer disease (PUD) etiology | Helicobacter pylori, drugs, stress, alcohol, smoking, excessive acid production in stomach by a tumor in pancreas |
| Zollinger Ellison syndrome | patients have intractable peptic ulcers; Caused by gastrin secreting tumor of pancreas; Results in gastritis and ulcerations |
| Peptic ulcer site | duodenum (most frequent), gastric ulcer |
| Peptic ulcer manifestation | Abdominal pain, nausea, vomiting, pain could radiate to back if severe, cancer |
| Peptic ulcer complications | massive or occult hemorrhage, peritonitis, obstruction and fibrosis (healed), chronicity (failure to heal) |
| Peptic ulcer symptom relief | Remove precipitating causes, antacid, H2 receptor antagonists, PPI, antibiotics for H. Pylori; surgery; vagotomy |
| Carcinoma of stomach cause | Diet; Helicobacter pylori; Chronic gastritis; Pernicious anemia/atrophic gastritis; Genetic |
| Carcinoma of stomach manifestations | Loss of appetite, weight loss, abdominal discomfort, anemia, abdominal mass, bleeding; Lesion visualized by upper GI series & gastroscopy |
| types of adenocarcinoma (of stomach) | intestinal type, exophytic growth; or diffuse type w/ signet ring cells, thickened muscle wall |
| diseases of small and large intestine | Meckel's Diverticulum, Congenital Pyloric Stenosis, Hirschsprung's Disease, Ischemic Bowel Disease, Hemorrhoids, Infections, Malabsorption Syndromes, Acute appendicitis, Inflammatory Bowel Disease, Diverticulosis, Polyps, Carcinoma |
| Meckel's diverticulum | Remnant of embryonic structure; Asymptomatic or may present w/ symptoms similar to appendicitis |
| Congenital pyloric stenosis | Narrowing of the outlet of stomach; Hypertrophic so obstruction; Onset at age 2-4 wks (more common in male babies), can't pass milk down GIT, projectile vomiting |
| Ischemic bowel disease causes | loss or decreased blood supply; thrombosis, embolism; cardiac failure, shock, vasoconstrictive drugs |
| Ischemic bowel disease pathology | can affect small or large bowel; acute (thrombosis or embolism) or chronic (defective circulation); older age |
| Ischemic bowel disease symptoms | Ischemic bowel disease (fatal); abdominal pain, blood in stool |
| hemorrhoids pathology | Abnormal dilation of anal venous plexus |
| hemorrhoids symptoms | chronic constipations, bleeding |
| organisms responsible for diarrheal diseases | virus, bacteria (E. coli, salmonella, shigella, staphylococcus, campylobacter), protozoa (ameba) |
| infectious enterocolitis pathogenesis | ability to adhere & invade the mucosa, toxin production |
| food poisoning pathogenesis | E. coli causes really bad food poisoning, diarrhea, bleeding from rectum, dehydration, shock, cardiac failure, Traveler's diarrhea |
| Pseudomembranous enterocolitis | C. diff; inflammation & diarrhea; prolonged antibiotic therapy leads to overgrowth of bug; membrane formed |
| malabsorption etiology | reduced surface area of bowel, defective digestion, altered continuity of GIT, infecitons; gluten sensitivity (celiac disease), Crohn's disease, pancreatic insufficiency (US) |
| malabsorption manifestations | Steatorrhea; Weight loss; Vitamin/mineral deficiencies; Abnormalities of tests for fat & carbohydrate absorption; May be abnormal intestinal biopsy (celiac disease) |
| Celiac disease | Gluten in oat & wheat causes immune injury to small intestinal mucosa; Inflammatory injury to small intestinal epithelium, loss of villi, loss of surface for absorption; Increased risk of small intestinal lymphomas |
| acute appendicitis etiology | unknown; sometimes fecalith |
| acute appendicitis pathology | Acute inflammation of appendix; Abscess & perforation leading to peritonitis are complications |
| acute appendicitis manifestations | Abdominal pain; Rebound tenderness; Fever; Leukocytosis |
| inflammatory bowel disease | UC & Crohn's disease; Young adults; Diarrhea, abdominal pain, bleeding, malabsorption |
| Colonic diverticulosis general | Outpouchings of colonic mucosa through muscularis; >60 yrs old |
| Colonic diverticulosis manifestations | Usually none; Abdominal cramps, altered bowel function; Complications - diverticulitis (inflammation of diverticuli), bleeding, perforation |
| Colonic diverticulosis pathogenesis | Increased intraluminal pressure; Defect in muscle wall of colon |
| Colonic polyps | Pedenculated mass that projects into the bowel lumen |
| non neoplastic colonic polyps | Hyperplastic polyp; Retention/Juvenile polyps; Overgrowth of mucosa |
| neoplastic colonic polyps | Adenoma; Premalignant and may contain cancer; Risk is higher in villous adenomas |
| Carcinoma of colon predisposing conditions/risk factors | Adenoma, Familial adenomatous polyposis, Lynch syndrome, Ulcerative factors |
| Carcinoma of colon manifestations | Change in bowel movements; Occult fecal blood or fresh blood, Fe-deficiency anemia; Lesion seen by sigmoidoscopy; Abdominal mass |
| Genetics of colorectal carcinogenesis | APC/Beta catenin pathway (mutations in tumor suppressor genes); DNA mismatch repair pathway (mutations in DNA repair genes) |
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