patho test 4 GI

difficulty swallowing

mechanical obstructions causing dysphagia

dysorders of skeletal muscle of upper 1/3 of esophogus

neural or muscular disorder that affects the lower 2/3 of esophogus

the reflux of chyme from the stomach to the esophagus

2 risk factors of GERD

most common type of hiatal hernia

what 2 cells does the fundus contain

what are the parietal cells responsible for

what are the chief cells responsible for

4 triggers of GERD

pyrosis

dysphagia is associated with

etiologies of GERD

GERD with symptoms of inflammation

the narrowing or blocking of the opening between the stomach and duodenum

when is pyloric obstruction more distressing

initial clinical manifestations of pyloric obstructions

later clinical manifestations of pyloric obstructions

lack of muscle tone and motility

stomach sloshing if jarred

cardinal sign of pyloric obstructions

7 treatments for pyloric obstructions

mechanical blockage of the lumen by a lesion

most common type of simple obstruction

obstruction type with a failure of motility (paralytic ileus)

7 causes of intestinal obstruction

main cause of small bowel obstructions

main cause of large bowel obstructions

second leading cause of small bowel obstructions

ovarian cysts are relatively common and usually disappear without treatment, but can cause what

lower bowel obstructions can lead to

as the condition of distension worsens what happens

cardiac symptoms of intestinal obstructions

autonomic responses of intestinal obstruction

S & S of intestinal obstruction if strangulation

if distension pushes up on the diaphragm what can occur

3 treatments for intestinal obstructions

inflammatory of disorder of the gastric mucosa

4 risk factors of gastritis and stress ulcers

erodes the surface epithelium in a diffuse or localized  pattern
erosions are usually superficial
can occur as bleeding, stress-related gastritis in seriously ill ICU patients

causes thinning and degeneration of stomach wall

atrophic gastritis
most rare and severe
decrease
    chief & parietal cells
    pepsinogen
    HCl
    intrinsic factor --> pernicious anemia-->carcinoma
increase
    elevated plasma gastrin
auto immune

H. pylori is a major causative factor
bile reflux can contribute

4 risk factors for peptic ulcer disease

often located in antral area of stomach or duodenum
H. pylori
high prolonged gastrin levels
rapid gastric dumping

occurs in the middle of the night when the stomach is empty
relieved byeating or antacid medications
dull gnawing ache
occurs 2 to 3 hrs after a meal

tx of PUD

acute form of peptic ulcer
multiple sites of injury in stomach or duodenum
superficial lesion of epithelium

decreased mucosal blood flow
mucosal lining degenerates
allows stomach acid to diffuse back to mucosa
inflammation, ulceration

what is absent from a peptic ulcer that is seen in stress ulcers

2 types of stress ulcers

stress ulcer that has rapid development

stress ulcer associated with severe head injury
high incidence of perforation

ulcer developed of ischemia after a burn

is H. pylori involved with a stress ulcer

the most common surgical emergency of the abdomen and affects 7-12% of the population
most common age 20-30 yo

localized pain
rebound tenderness RLQ
obstruction with 2ndary distension and bacterial invasion of the wall
1/2 of the cases are not obstructed

wound infection is the most common post-op complication
surgery and antibiotics

mucosal hypoxia
ulcerations
bacterial or other pathogens invade
inflammation and edema
thrombosis of luminal blood vessels
gangrene
perforation
peritonitis

S&S
localized pain
increase WBC cound
increase C-reactive protein

3 arteries supplying the intestines and stomach

atherosclerotic lesions
thrombi
emboli
chronic mesenteric insufficiency

cardinal symptoms of mesenteric insufficiency: colicky abdominal pain after eating
mortality is high in accute occlusion

bowel ischemia

complication is abdominal angina