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PHS3300 - GI Disorders Exam Study Set
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PHS3300 - GI Disorders Exam Study SetDigestive processes - Answer Ingestion
Propulsion (directional)
Mechanical Digestion (Mixing)
Chemical Digestion
Absorption
Defecation
Ingestion - Answer process of taking food into digestive tract
Propulsion (directional) - Answer move food through GI tract
swallowing: initiated voluntarily
peristalsis: involuntary alternate waves of contraction & relaxation of muscles
Mechanical Digestion (Mixing) - Answer chewing, mixing with saliva (tongue), churning
food in stomach, segmentation (intestines)
Chemical Digestion - Answer due to action of secreted enzymes
begins in mouth; completed in small intestine
Absorption - Answer movement of products into blood or lymph
primarily in small intestine
Defecation - Answer expulsion of indigestible material (feces)
saliva - Answer cleanses the mouth
dissolves food chemicals so they can be tasted
moistens & compacts food
enzymes that begin digestion of starches
3 pairs of extrinsic salivary glands + small intrinsic buccal glands
Control of salivation - Answer stimulated 10ly by parasympathetic division of ANS
(salivatory nuclei in brainstem) in response to activation of chemoreceptors and
pressoreceptors (movement of lower jaw)
salivation also triggered by: sight, smell, thought of food, irritations in lower GI tract
(bacteria, spicy food, excess acid)
,What happens to salivary production during GI irritation? - Answer You will increase
saliva production (it has a neutral pH compared to the acidic stomach environment) →
sending it down will help
xerostomia - Answer Dryness of the mouth caused by reduction of saliva
stomatitis - Answer inflammation of the oral mucosa due to:
- Microorganisms
- Trauma
- chemotherapy (you are not turning the lining enough increasing infection risk
- nutritional deficiencies (we need substances to allow us to make new cells to replace
damaged cells in the oral cavity)
- occurs often in individuals with AIDS (immunocompromised)
herpes simplex virus - Answer affinity for skin & nervous system; once acquired, this
virus tends to remain latent in the dorsal ganglia of the spinal cord & can be reactivated
by stress
angular stomatitis - Answer risk factors include lack of vitamin B2 (riboflavin - important
in energy metabolism and to maintain mucosae) and iron-deficient anemia, possibly
followed by secondary opportunistic fungal or bacterial infection coming from saliva;
also mask wearing!
"Strawberry tongue" - Answer Caused by group A streptococcus bacteria (scarlet
fever), they are white lesions of Candida albicans
mumps - Answer inflammation of parotid glands (myxovirus); in adult males, 25% risk
that testes can be infected ⇒ could interfere with fertility
achalasia - Answer definition: uncommon disorder of esophageal motility (more for
elderly)
symptoms:
- decreased peristalsis of esophagus
- loss of tone of GE sphincter in between meals
- decreased relaxation of GE sphincter in response to swallowing
cause: degeneration of esophageal ganglion cells & atrophy of smooth muscle (neural
degeneration) - food feels like it is not going down
diagnosis: barium swallow
treatment: pneumatic dilation of GE sphincter, small meals with lots of fluid, botox
, GERD (gastroesophageal reflux disease) - Answer definition: solids and fluids return to
the mouth from the stomach
symptoms: substernal pain; exacerbated by supine position (lying down), pulmonary
aspiration a risk; over time, damage can reach muscularis
diagnosis:
- clinical manifestations
- esophageal endoscopy (+ biopsy)
- most effective tests are pH measurement in esophagus + biopsy to demonstrate
inflammatory changes
treatments: antacids, elevation of head, weight reduction, H2 blockers, PPIs
hiatal hernia - Answer protrusion of a part of the stomach upward through the opening
in the diaphragm (sliding and rolling)
Barrett's esophagus - Answer GERD can start off as minor but can escalate into disease
- normally the esophagus is lined by stratified squamous epithelium but if it sees
constant acid, it changes into simple columnar epithelium (through mitotic activity this
increases cancer risk)
sliding hiatal hernia - Answer 90%; stomach slides through esophageal hiatus when
supine or intra-abdominal pressure increased » slides back when standing
potential causes: defect in diaphragm or weakening of diaphragm muscles
(progesterone during pregnancy has a relaxing effect); sporadic
rolling (paraesophageal) hernia - Answer 10%; part of greater curvature of stomach
protrudes through 2nd or enlarged opening in diaphragm
GE sphincter remains below diaphragm, so reflux uncommon; can have gastritis, ulcers
in herniated region; continuous
esophageal varices - Answer swollen, varicose veins at the lower end of the esophagus
a consequence of portal hypertension (high blood pressure in the portal system that
links small intestine with the liver)
carcinoma of the esophagus - Answer represents 5-10% of GI malignancies; usually
asymptomatic until unresectable
Symptoms: not much; mild dysphagia which worsens with time; weight loss
Diagnosis: endoscopy + biopsy; barium swallow, chest film, blood tests
Prognosis: poor (3-5% past 5 yr), surgery is difficult location
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