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Patho Exam #2: GI Disorders

Terms in this set (198)

- abdominal/chest pain
- altered ingestion of food
- altered bowel movements
- GI tract bleeding

The four common symptoms and signs of GI diseases are:

_____________ is difficulty swallowing.

__________ is painful swallowing.

_______________ agents suppress the appetite.

GI tract bleeding

The #1 cause of anemia in the US is from _______________.

The GI tract can be divided into the esophagus, stomach, intestines and gallbladder (T/F)

_______________ is a disease related to the lack of peristalsis (muscular movement to swallow food)

_______________ is the formation of gallstones in the gall bladder.

________________ refers to inflammation of the gallbladder.

______________ is when acid produced by the stomach instead of going into small intestine it goes upward into esophagus.

______________ are abnormal veins in the lower part of the tube running from the throat to the stomach. Usually develop when blood flow to the liver is blocked. They often occur in people with advanced liver disease. (Vomiting blood)

diverticular disease

________________ is a common condition that causes bulges or sacs to form in the wall of the colon. The membrane invaginates and forms cavities that trap food.

______________________ is a condition that affects the stomach muscles and prevents proper stomach emptying. (common complication in type 2 diabetes). It is a change in the movement of the wall in the stomach and opening of the sphincters.

________________ is an intestinal infection marked by diarrhea, cramps, nausea, vomiting, and fever.

dumping syndrome

In ____________________, sphincter does not close properly, and food goes directly from the esophagus into the stomach.

_______________ is an intestinal disorder causing pain in the belly, gas, diarrhea, and constipation. (disease of large intestine) form of inflammation

diabetic autonomic neuropathy

______________ is the damage of the nerve endings that supply the GI tract. Peristalsis is affected.

acute gastroenteritis

______________ is when the GI tract is infected with a bacteria/fungus, causing inflammation.

An ________________ is the formation of a hole in the GI tract

A hole formed in the duodenum is a ___________________.

A hole formed in the stomach is a ____________________.

The complications of ____________ GI disease include dehydration, sepsis and bleeding.

The complications of _____________ GI disease include malnutrition and deficiency states (vitamins).

The food stays in the ___________ for 2-5 hours.

small intestine

It takes food about 4.5 hours to reach the ________________.

ascending colon

It takes food 5.5 hours from ingestion until it reaches the ________________.

descending colon

It takes 9.5 hours to reach the __________________.

It takes 12-24 hours to _____________ from the point of ingestion.

The small intestine (6-7m) is longer than the large intestine (1-1.5m) (T/F)

The small intestine is formed from the duodenum, jejunum, ilium and ileocecal valve. (T/F)

ileocecal valve

__________________ allows passing of food from small intestine to large intestine.

The ____________ is the last part of the small intestine that connects to the large intestine via the ileocecal valve

small intestine

The process of absorption and nutrition will happen in the __________________ due to high surface area.

The beginning of the GI tract is the ________________.

The esophagus opens into the ________________.

Mucus secretion occurs in all parts of the stomach (T/F)

- cardiac
- fundic
- pyloric

What are the types of mucosa in the stomach?

The _________________ is composed of the cardiac sphincter, pyloric sphincter, fundic portion, body (corpus) portion, lesser curvature, greater curvature and incisura.

greater curvature

The _______________ of the stomach located at the body.

lesser curvature

The _______________ of the stomach is located between the sphincters.

- cardiac
- pyloric

There are two sphincters of the stomach: .

The _____________ sphincter is located at the top of the stomach.

The _____________ sphincter is located at the end of the stomach.

The _____________ mucosa of the stomach secretes acid and pepsin.

The acidity in the stomach is mainly due to the ________________ portion.

________________ secrete pepsinogen which is later activated into pepsin.

_________________ are responsible for secretion of HCl and intrinsic factor

Pepsin digests _______________.

Intrinsic factor is responsible for ___________________.

The wall of the GI tract is composed of ______________ main layers.

mucosa, submucosa, muscularis externa, serosa

From lumen outward the wall of the GI tract is composed of:

serosa, muscularis, submucosa, mucosa

From mesothelium to lumen the GI tract is composed of:

The mucosal layer surrounds the _______________.

The mucosal layer is divided into ________ sublayers.

epithelial cells, lamina propria, muscularis mucosae.

From center outwards, the mucosal layer is composed of:

The ________________ is a connective tissue that has lymphocytes/lymphatic vessels.

The submucosa layer is composed of the submucosal ____________.

The blood supply for the GI tract comes mainly from the ______________ layer

The neurons in the submucosal plexus control _______________.

- circular
- longitudinal

The muscularis externa can be divided into what kinds of muscles?

muscularis externa

The ________________ contains the myenteric plexus.

The neurons in the myenteric plexus control ________________.

The innermost muscles of the muscularis externa are ___________________.

The outermost muscles of the muscularis externa are _________________.

The ________________ is a connective tissue (squamous mesothelial cells) that has specialized cells on the outer layer that forms the mesothelium.

The outermost layer of the serosa is the ________________.

The ____________________ serves as a protective coating and reduces friction

The __________________ (outside of the epithelium) binds the digestive tract to the abdominal wall.

_________________ is the passage or transport of digested materials form the lumen into the blood.

Absorption can happen in the stomach or intestine. (T/F)

Transcellular communication is __________ cells.

Paracellular communication is ______________ cells

passive transport

In _______________ transport no energy is required and molecules are moved down their concentration gradient.

simple diffusion

In ___________________, uncharged molecules move down the gradient.

facilitated diffusion

In ________________, charged molecules use channels/transporters to move a molecule down a concentration gradient.

active transport

___________________ requires energy (ATP) and acts against gradient

In ________________ active transport, the molecule uses ATP directly.

______________ enzyme hydrolyzes ATP to create energy. Energy is used to transport NA molecules out of the cell.

secondary active transport

________________________ depends on the gradient generated by a neighbor's primary active transport.

In _____________ active transport, a neighbor cell hydrolyzes ATP, creates energy and then shares it.

SGLT (sodium dependent glucose transporter) is a ________________

The concentration of __________ is greater outside of the cell.

The concentration of _________ is greater inside the cell.

There is ______ Na+ moved out of the cell for every _____ K+ moved into the cell.

Endocytosis and exocytosis are used for _____________ (larger/smaller) molecules like proteins.

This transport occurs by fusion of membrane vesicles with the plasma membrane resulting in uptake into epithelial cells

This transport occurs by pinching off membrane vesicles from the plasma membrane resulting in export out of the epithelial cells

The adaptive and innate immune system both play a role in GIT immunity. (T/F)

lymphoid/adaptive

The __________ immune system is responsible for Peyer patches (filled with B and T cells)

The _______________ immune system is responsible for dendritic cells and macrophages.

_____________ cells usually exist beyond mucosal layer; extended processes interact w/ intestinal epithelial barrier.

- Secretion of fluid and electrolytes
- Tight junctions between epithelial cells
- Mucus secreted by goblet cells

The innate immune system is responsible for:

GIT is regulated by endocrine and paracrine hormones (T/F)

_______________ hormones are secreted into the blood vessel and transported to other organ/tissue via the blood stream. (distant)

In ____________ hormonal transport, the cell releases a hormone that acts on a neighbor cell; it does not have to be released into the blood stream. (close)

The GI tract is the only organ that has both intrinsic and extrinsic innervations. (T/F)

If the cell body of the nerve cell is outside of the GI tract it is _______________ innervation.

parasympathetic

_________________ innervation is mediated by the vagal and pelvic nerve.

The upper portion of the parasympathetic innervations is innervated by the ____________ nerve

The lower portion of the parasympathetic innervations is innervated by the _____________ nerve.

________________ receptor recognizes Ach released from preganglionic.

___________________ receptors in parasympathetic innervation recognize Ach released from postganglionic.

________________ nerves in the parasympathetic nervous system release Ach and peptides in the .

Preganglionic nerves in the parasympathetic release _______________.

Sympathetic neural control is often _________________ to GI functions.

Postganglionic in the sympathetic nervous system releases _____________ and that is recognized by ____________ receptors.

If the cell body of the nerve exists inside the GI tract it is _________________ innervation.

________________ neurons are intrinsic and they use neuropeptides

Enteric neurons

______________ are composed of sensory/afferent neurons (also called IPANS).

________________ neurons sense pH, osmolality and wall stretch.

extrinsic neurons

________________ are composed of interneurons and secretomotor/efferent neurons.

esophageal achalasia

____________________ is a result of enteric nervous system defects, the body of the esophagus is quiet, and the lower sphincter is contracted.

________________ stimulates gastric acid secretion

CCK (cholecystokinin)

__________________ stimulates gallbladder contraction, pancreatic enzyme and bicarbonate secretion and growth of exocrine pancreas

___________________ stimulates pancreatic bicarbonate secretion, biliary bicarbonate secretion, growth of exocrine pancreas, pepsin secretion and inhibits gastric acid secretion

GIP (gastric inhibitory peptide)

__________________ was recently changed to glucose-dependent insulinotropic peptide. Stimulates insulin release (inhibits gastric acid secretion).

GLP-1 (glucagon-like peptide 1)

_________________ stimulates insulin secretion and is used to treat type II diabetes.

________________ stimulates gastric & duodenal motility.

pancreatic polypeptide

______________ are secreted by islets of Langerhans and inhibit pancreatic bicarbonate and enzyme secretion.

If something is __________________, it stimulates the secretion of insulin by the pancreas

______________ are hormones secreted by the GI and stimulate insulin secretion by the pancreas.

___________________ inhibits the release of most other peptide hormones (eg, gastrin)

___________________ increase mucus and bicarbonate secretion from gastric mucosa

______________ stimulates gastric acid secretion.

_________ cells secrete gastrin.

_________ cells secrete somatostatin.

_____________ are responsible for the production of the mucus layer that protects the epithelial cells/mucosa.

The most common disorder in the small intestine and colon is:

A __________________ is surgical transection of the vagus nerve trunks. Affects both motility and acid secretion.

Zollinger-Ellison syndrome

Vagotomy is still sometimes used as a treatment for ______________________.

Zollinger-Ellison syndrome

________________ involved acid hyper secretion and is a severe peptic ulcer disease caused by a gastrin secreting tumor.

hypertrophic pyloric stenosis

____________________ is when food cannot pass freely out of the stomach leading to spasmodic narrowing of the pyloric outlet caused by hypertrophy of the pyloric musculature.

Acid peptic diseases are mainly derived from microbic infections like _______________.

_________________ is a common complication of diverticulosis.

Definite diagnosis of diverticulitis is made by a __________________.

abdominal guarding

____________________ is the tensing of the abdominal wall muscles to guard inflamed organs within the abdomen from the pain of pressure on them.

rebound tenderness

______________________ refers to the pain upon removal of pressure rather than application of pressure to the abdomen.

Patients with ______________, may present with
- fever
- symptoms of peritoneal irritation
- abdominal guarding
- rebound tenderness
- absence of bowel sounds

The main symptom of ____________ disease is chronic constipation.

Diverticular disease is restricted to the bowels (large intestine) (T/F)

In ______________ disease, entrapment of food in the colon increases intraluminal pressure. The muscles of colon wall try to contract to get rid of the entrapment but cannot. This results in the increase of bowel muscle.

Diverticular disease often results from acquired deformity of the colon (T/F)

In _____________ disease, mucosa and submucosa herniate through the underlying muscularis.

- age
- consumption of highly refined foods

Incidence of diverticular disease increases with:

Complications of diverticular disease include diverticular bleeding. (T/F)

acute pancreatitis

________________ occurs as a consequence of an episode of acute cholecystitis. A stone travels down the common bile duct but fails to clear the sphincter of Oddi, thereby blocking the pancreatic duct.

_________________ is inflammation of the gallbladder and the major clinical presentation of gallstones. Can be acute or chronic.

The gall bladder secretes bile into the ________________.

The pancreatic duct contains pancreatic juice (T/F)

- Bile
- Pancreatic

The sphincter of Oddi is composed of what two ducts?

_____________ is fluid produced by the liver and aids in the digestion of lipids in the small intestine.

Gallstones are composed largely of cholesterol with or without calcium deposits (T/F)

____________ is produced continuously in the liver and stored and concentrated in the gallbladder.

Gallstones can be composed of bilirubin or cholesterol (T/F)

Patients with __________________ present with mild nausea and abdominal discomfort after eating fatty or fried foods.

- is female
- has a history of high dietary fat intake

The typical patient with cholelithiasis:

__________________ is delayed gastric emptying in the absence of mechanical obstruction.

A patient with _________________ may feel full, bloated, be vomiting, and experience constipation or diarrhea.

______________ may present similar to excessively rapid emptying (dumping syndrome).

Patients with gastroparesis may experience development of bezoars. (T/F)

Gastroparesis is a common complication of poorly controlled type II diabetes (T/F)

autonomic neuropathuy

_______________ is caused by high blood glucose levels over time. Nerve fibers that control the opening/closing of the pyloric sphincter are damaged.

_______________ agents can be used to improve the motility of the GI walls.

______________ is a drug that stimulates motilin receptors in the GI tract. Can be used in the treatment of gastroparesis.

acute erosive gastritis

_______________ is inflammation from superficial mucosal injury. The submucosa and muscularis mucosa are not penetrated.

- alcohol use
- drug use
- stress

Acute erosive gastritis can be caused by:

Gastric mucosal atrophy leads to the death of parietal cells (T/F)

Acute erosive gastritis can be autoimmune. (T/F)

A ______________ is a sarcoma associated with MALT tissue.

A _________________ is caused by altered mucosal inflammatory responses and excessive acid secretion.

Psychologic stress and genetic factors play a role in the formation of duodenal ulcers. (T/F)

erosive gastritis

Gastric ulcers are distinguished from _______________ by the depth of the lesion.

Gastric ulcers penetrate through the mucosa. (T/F)

A decrease in prostaglandins would lead to decrease in defensive mucosal layer and can lead to a ________________.

- delaying emptying of gastric contents
- food retention and increased acid production
- duodenal contents reflux and damage mucosal barrier

Motility defects of a gastric ulcer include:

esophageal achalasia

______________ is disordered peristalsis mainly caused by degeneration of the myenteric plexus.

Patients with esophageal achalasia have increased ___________ tone.

- dysphagia
- regurgitation
- chest pain

Patients with esophageal achalasia may experince:

Esophageal achalasia resembles chagas disease (a parasite infection) (T/F)

reflex esophagitis

The predominant presenting symptom in _____________ is burning chest pain.

recurrent mucosal injury

Reflux esophagitis is caused by:

- Reflux may be worse at night or when laying supine

What are the counseling points for patients with reflex esophagitis?

A ____________ occurs when a portion of the proximal stomach slides up into the chest cavity with upward displacement of the LES.

If a patient has an incompetent pyloric sphincter and a relaxed lower esophageal sphincter, what reflux would you expect to occur?

The ___________ is a hole in your diaphragm that the esophagus goes through and connects to the stomach.

If you increase pressure on the LES, you can ______________ heartburn.

If you decrease pressure on the LES you can _______________ heartburn.

- secretin
- CKK
- somatostatin
- vasoactive intestinal peptide (VIP)
- Fat
- chocolate

The following substances decrease pressure on the LES:

- gastrin
- motilin
- substance P
- protein meals
- histamine

The following substances increase pressure on the LES:

The bacterium H. pylori can lead to both hypo or hyper acid secretion (T/F)

_______________ results from acid hyposecretion caused from the H. pylori bacterium.

antral-type gastritis

_______________ results from acid hypersecretion caused from the H. pylori bacterium.

In _____________, inflammation will occur at all parts of the stomach. (can come from high salt, low vitamins of C and E). End result is gastric cancer.

antral-type gastritis

In ___________________, inflammation is localized to the antral. End result is acid hypersecretion/ duodenal ulcers. Permanent because parietal cells weren't damaged

__________________ innervation comes from the thoracolumbar region.

The ______________ region is between the vagal and pelvic nerve.

pre vertebral ganglion

The ganglions in the sympathetic innervation are called:

Postganglion in the parasympathetic are enteric (T/F)

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