structures/anatomy
what structures are considered to be part of the upper GI tract?
lower?
mouth, esophagus and stomach
lower: intestines, liver, gall bladder and pancreas
salivary amylase is found in the ____ and is responsible for breaking down _____
saliva; carbohydrates
true or false: the pancreas in covered in a fibrous capsule, while the liver is not
false; the pancreas is NOT covered in a fibrous capsule, while the liver IS
circulation of fat and cholestoral is determined by what organ?
liver
what causes activation of the parasympathetic NS to act on the GI tract?
which one causes more dehydration, vomiting or diarrhea?
diarrhea
failure to thrive
malnutrition
antacids are taken for...
what are two examples
intermittent or mild heartburn
tums (calcium carbonate) and Gaviscon
the upper GI is responsible for...
the lower GI is responsible for...
upper...preparing food to become nutrients
lower...distributes nutrients and there are many enzymes involved
which congenital abnormalities fall under the category of an upper GI pathology? why?
which section of the small intestine is the major site of nutrient absorption? what structure increases the general SA for absorption?
ileum; plicae circulares
cholecystokinin's primary effect is to
decrease emptying and increase bile production to break down fat
what does the release of bicarbonate into the intestines do?
bicarbonate will be released into the small intestine to bring the pH back up
what can PTs do for patients with constipation?
exercise may relieve constipation, buts difficult because patients may not want to exercise due to discomfort/pain and inability to relax the pelvic floor
if an individual is having GI problems, they should not be given _____ _______.
if individuals are experiencing pancreatic pain, they cannot be given _____
oral medicine, because it doesn't get absorbed if GI not working well
opioids
which proton pump inhibitor is commonly seen on a medication list and is sold OTC
Prilosec
list the layers of the gut tube from inner to outer
mucosal
sub-mucosal
smooth circular muscle
longitudinal muscle
serosa
what cells are located in the stomach and responsible for producing the enzyme pepsin?
why is this important?
gastric chief cells
they produce pepsin and bicarbonate, which functions to constantly neutralize acidity already located within the stomach
which 2 substances are made by the pancreas?
insulin and digestive enzymes
as a result of food, protein, caffeine and an increase in pH, the hormone ______will be released from the _____ ____ to increase gastric motility and emptying
gastrin; gastric chief cells
sign and symptom of Crohn's disease is
fever, malaise weight loss and RLQ pain
if a patient has diarrhea, a PT should be aware because they will have ___ electrolytes and ____ CO.
severe diarrhea can lead to dangerously low levels of _____, which can progress the patient into a state of _______ _______
low; low
bicarbonate; metabolic acidosis
why should PTs care about patients experiencing malnutrition?
healing potential is decreased
energy availability is decreased= decrease endurance
increased risk of osteoporosis
what are the two types of acid-reduction medications?
histamine-2 blockers
-pepcid and zantac
proton pump inhibitors
-prilosec and prevacid
what does it mean that the mucosal inner is ablative? why is this a good thing?
this layer is designed to wear away, but also provides protection against the sharp things found in the gut tube
describe these upper GI infections
candida albicans
HSV type 1
HSV 2
herpes zoster
candida albicans--> opportunistic fungal infection; seen in babies, chemo patients
HSV type 1--> from kissing, close contact; remains dormant and expresses with stress
HSV 2--> genitals
herpes zoster--> chicken pox
list the functions of the liver
maintains BG
amino acid storage and management
produces clotting factors, lipoproteins and cholesterol
detoxifies drugs and alcohol
blood reservoir
produces bile to emulsify fats
which hormone is released from the intestinal mucosa when protein and fat enter the duodenum?
cholecystokinin
which nerves are stimulated with parasympathetic control? what do they do?
CN X (vagus nerve)--> increases motility and digestive secretions like bile to work on the gut
CN VII and CN IX --> saliva and moisture of oral mucosa (works on saliva)
what does "coffee-ground emesis" indicate in a patient?
what about "frank red blood?"
they have partially digested blood and they are bleeding somewhere in the mouth or esophagus
red blood is in the vomit
for patients with nausea, we should...
take more breaks and avoid certain positions or activities
what are
cholelithiasis
cholecystitis
cholangitis
choledocholithiasis
cholelithiasis--> formation of gall stones
cholecystitis--> inflammation of gall bladder and cystic duct
cholangitis--> inflammation of bile duct
choledocholithiasis--> gallstones obstructing biliary tract
give brief detail regarding the
mesentery
greater omentum
2. double layer of peritoneum that supports intestines and help move blood
3. fatty apron over intestines
where can an infection go to from the mouth? how?
the heart via sublingual veins
describe how the pancreas helps neutralize acidity of chyme before it enters the intestine
acid and food mixture coming from the stomach is known as chyme. the pH is close to 1, so the pyloric sphincter that connects pancreas to SI opens and allows for bicarbonate to be dumped and help raise the pH
secretin from the intestinal mucosa is released when there is a(n) _____ in pH in the duodenum
decrease
central vasoconstriction is done through activation of the ______ NS. what does this do?
sympathetic NS
blood will be taken away from visceral organs in order to supply the brain and limbs. High enough stimulation will empty out whatever is left in the body to make it more functional.
what is the main reason that PT's should be aware if the patient has bulimia?
Bulimia causes low energy and may result in possible arrhythmias to electrolyte imbalances
the individual is probably not getting enough energy/nutrients, even though they may look normal, and we don't want to over-prescribe exercise
GERD is the result of a defective ...
lower esophageal sphincter pressure or function
hyperbilirubinemia, also known as ______, is considered a _____, not a _____.
what types are most commonly seen
jaundice
color; disease
pre-hepatic in newborns
intrahepatic in liver disease
what is the peritoneal cavity?
potential space with a small amount of fluid
when working with patients that have dysphagia, what do PTs need to consider?
is it easier for them to swallow thin or thick liquids?
they have difficulty swallowing= difficulty with exercise tolerance
thicker liquids are easier to control
describe how stool is formed and where it is formed. what is feces made of?
most water and electrolytes are absorbed at the end of the GI track and there is not more digestion/absorption of nutrients in the colon (large intestine)
feces contains fiber, old mucosal cells and bacteria
gastrin and cholecystokinin differ in that gastrin ______ gastric emptying, while cholecystokinin _____ gastric emptying
increases; decreases
Sign and symptom of ulcerative colitis is
Diarrhea, rectal bleeding and abdominal cramping
fluid and electrolyte imbalance can impact physical therapy because...
muscle activation could be dysfunctional, they may have an irregular heart rate, feel fatigue, at risk for seizures
the lower esophageal sphincter causes GERD when...
this is more common to happen in which position?
it spontaneously relaxes
commonly occurs in supine
compare hepatitis of the liver and cirrhosis
what does idiopathic hepatitis mean?
liver "failure" occurs when __-___% of tissue is destroyed
hepatitis: inflammation of liver commonly due to a viral infection
idiopathic= non-alcoholic steatohepatitis (NASH)
cirrhosis: progressive destruction of liver tissue
80-90%
what structures allow for large volumes of "stuff" and allows distension when there is a lot of gas build up
the peritoneal cavity and abdominal musculature
swallowing is a _____
reflex
how does the liver maintain blood glucose?
when there is an increase in BG, the liver stimulates the process of glycogenesis to form glycogen
when there is a decrease in BG, the liver stimulates the process of gluceoneogenesis
what 3 hormones are involved in the control of pH level
gastrin, secretin and cholecystokinin
there is too much random info
sorry
the most common sites for ulcers are ...
duodenal
gastric
H. pylori
compare the s/s of people are take vast amount of NSAIDS, have high amounts of stress and those with H pylori
NSAIDS H pylori stress
pain chronic chronic acute
site gastric duodenal gastric
sx asymp. epigastric asymp.
depth deep superficial most superficial
bleeding more severe less more
pancreatitis can have sudden and acute attacks after....
large meals or large amounts of alcohol