1. hernia
    sliding (rolling) where stomach slides or moves into thoracic cavity
  2. obstructions of the digestive function
    • hernia
    • intussusception
    • volvulus
    • adhesions
    • diverticulosis
  3. obstructions hernia
    protusion thru abdonminal wall or inguinal canal
  4. intussuscepiton
    telescoping intestine
  5. volvulus
  6. diverticulosis
    "twinkee" diet of low residue results in saccular weakenings of intestinal wall
  7. types of ulcers
    • peptic ulcer
    • duodenal ulcer
    • gastric ulcer
  8. peptic ulcer
    is breaking down of mucosal lining resulting in autodigestion
  9. duodenal ulcer
    occurs in even greater frequency... keep in mind H. pylori is a prominant player in this disease
  10. gastric ulcers
    are less common and tend to be more chronic ulcers generally follow the pain-food-relief pattern, or relief b the use of antacids.
  11. crohns disease
    is regional (skip areas) in both sm and lg intestine, familial like ulcerative colitis, and hard to differentiate from it also
  12. appendicitis
    inflammation of veriform appendix, often by fecalith-hardened fecal material blocking appendix resulting in pressure, hypoxia and anaerobic bacterial growth. rebound tenderness of rt lower quad
  13. portal hypertension results from what?
    • obstruction of blood flow thru liver, most commonly by cirrhosis.
    • varicies, splenomegaly, ascites result.
    • blood shunts around the obstructed liver
    • jaundice results from hyperbilirubinemia.
    • jaundice can also occur from obstruction (ex gall stone in common bile duct) or hemolytic breakdown where excess unconjugated bilirubin is present (ex sickle cell; newborns)
  14. alcoholic cirrhosis is the result of what?
    alcohol toxicity. cellular damage is seen as "fatty change" where cells accumulate fat, liver turns pasty color... is reversible.

    • cirrhosis develops slowly over many years... mallory bodies inside hepatocytes indicates cellular death and liver fibrosis
    • eventually liver will have cobblestone appearance
  15. viral hepatitis
    • is common and of several strains ...all can cause the same symptoms, but damage is most severe in B and D.
    • the hep B vaccine protects against both as D can only grow simultaneously with B infection
  16. Biliary colic
    if stone lodges in cystic or common bile duct
  17. pancreatis
    • inflammation of pancreas- autodigestion, digestive enzyme into blood stream.
    • chronic form usually due to chronic alcohol abuse
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