HIT 135 - CH 5

exocrine pancreatic juices

-electrolytes: (alkaline sodium bicarb) neutralizes the acid chyme -Enzymes: -amylase (breaks down polyssacharide starch into disaccharides and monosaccharides) -Lipase (breaks down triglyceride fat into fatty acids adn monoglycerides) -trypsin, chymotrypsin and carboxypeptides (split protein into their amino acids

jaundice (icterus) types

-physiological : normal will resolve in a few days -breast milk: 3-12 wks no TX needed -breast-feeding failure: will resolve once breast feeding is resolved -hemolytic disease of newborn (Rh disease): too many RBC breakdown and release bilirubin -inadequate live function: ie. Wilsons disease (retention of copper in the liver)

peristalsis in small intestine main fucntions

1. mix chyme w intestinal and pancreatic juices 2. churn chyme for digestion and absorption 3. move residue to large intestine 4-6 hours

Small intestine 4 major layers

1. mucosa: epitheliail cells 2. submucosa: connective tissue containing blood vessels, lymphatic vessels and nerves 3. muscularis: smooth muscle 4. serosa: connective tissue adn epithelial cells

Salivary Glands

2parotid, 2 sublingual, 2 submandibular glands

Saliva

95% water -amylase break down starch -lipase breaks down fat -lysozymes and IgA protect the growth of bacteria in the mouth -mucus lubricate the food

IBS (irritable bowel syndrome)

A chronic condition in which the bowels are sensitive to certain foods and stress; treated with laxatives and antidiarrheals according to symptoms causing chronic abd pain, abd discomfort, bloating diarrhea or constipation

Thrush (oral candidiasis)

A fungal infection of the mouth commonly found in young children that presents as a thick white film on the tongue or other oral tissues. Fevers are rare, except in cases where the infection spreads beyond the oral cavity. Candida albicans

Endocrine gland pancreas

A gland (as the thyroid or the pituitary) that produces an endocrine secretion -- called also ductless gland, gland of internal secretion. islet cells that produce insulin and glucagon

Cholecystokinin (CCK)

A hormone secreted by the small intestine (duodenum) in response to the presence of fats. It promotes release of bile from the gallbladder and pancreatic juice from the pancreas,and reduces stomach motility. gallbladder

Gallbladder

A muscular sac attached to the liver that secretes bile and stores it until needed for digestion

cirrhosis of the liver

A severe medical condition where scar tissue in the liver replaces functional tissue. chronic irriversable diseases tx consists of alleviating the symptoms. ascites

anal fissures

A small tear in the lining of the anus.

UTI medications

Alpha-blocking agents Urinary Analgesics Antibiotics

Digestive enzymes 3 main groups:

Amylase : carbs lipases: fat Protease: protien

Digestion

Breakdown of food substances into simpler forms that can be absorbed and used

Secretin in pancreatic secretion

Digestive hormone that stimulates the pancreas to release bicarbonate to neutralize acid in duodenum.

cystic duct

Duct leading from the gallbladder to the common bile duct; carries bile to form the COMMON BILE DUCT

food intolerance

GI symptoms such as bloating, diarrhea, gas, heartburn

Bladder CA - diagnostic test

IVP Urine test to detect hematuria cytoscopy with biopsy

Cholesystitis

Inflammation of the cholecyst (gallbladder) right upper abd pain, n/v, jaundice, dark urine and pale-colored stool

Chyme

Partially digested, semiliquid food mixed with digestive enzymes and acids in the stomach.

Absorption

The transport of dissolved substances into epithelial cells.

Villi

Tiny finger-shaped structures that cover the inner surface of the small intestine and provide a large surface area through which digested food is absorbed produces maltase and dextrinase that breakse down disaccharides into monosaccharides

dysentery

a bacterial gastroenteritis of the intestines marked by severe diarrhea (blood and mucus)

Food allergy

a condition in which the body's immune system reacts to substances in some foods IgE antibodies test for allergy.

mucus

a sticky film containing mucin secretion from the mucosal glands

anal fistula

abnormal opening between the rectum and the exterior perianal skin abscesses in the anal glands from infected glands that have healed anal canal has 6-7 glands that secrete mucus to lubricate the canal

diverticulosis

abnormal outpouchings in the intestinal wall of the colon inflammation of a diverticulum small pouches bulging outward through weak spots in teh intestinal lining.

Minerals

absorbed through the small intestine and surplus is excreted

Jaundice: Hemolytic

accelerated destruction of the RBCs that the liver cannot remove the bilirubin excess fast enough. most often seen in newborns blood incompatibility with moms and infants.

Ascities

accumulation of free serous fluid in the abdominal cavity d/t blocked portal viens

elimination

act of removal of materials from the body; in the digestive system, the removal of indigestible materials as feces

Hep B (HBV)

also known as *serum hepatitis.* Serum hepatitis is spread by *blood and blood-borne products.* *Needlesticks* are a source of infection, and can be *sexually transmitted.* NOTE - there is also a vaccine, and consists of 3 shots over the span of 1 year - it is mandatory!! some become chronic carriers can lead to CA

celiac disease

an inherited autoimmune disorder characterized by a severe reaction to foods containing gluten damages lining of the small intestine

Diverticulitis

asymptomatic until pouches become infected or inflamed sx: abd pain, vomiting, constipation, fever

Sjogren's syndrome

autoimmune destruction of minor salivary glands and lacrimal glands SX: dry mouth and eyes

jaundice - obstructive jaundice

bile ducts are obstructed (by gall stones) so bile cannot drain out of the liver and overflows into the blood

Black stools results from ingested food - 3

black licorice, pepto-bismol, blueberries

melena

black, tarry stools; feces containing digested blood usually upper GI tract, Blood is digested and hemoglobin is oxidized as it passes through teh intestines

occult blood

blood that cannot be seen in the stool but is positive on a fecal occult blood test. Hemoccult test

Protein

broken down by trypsin turning into amino acids

amino acids process of distribution

building blocks of proteins taken in by epithelial cells and released through the capillaries of villi and carried away in the hepatic portal circulation to be used as building blocks for new tissue formation.

glossodynia

burning sensation of the tongue postmenopausal womn

Dental Carries (Tooth Decay)

caused by bacteria "Streptococcus mutans" its softens the hard tissue of teeth. It breaks down sucrose (disaccharide) into monomers (glucose and fructose) can lead to Gingivitis, abscess, periodental disease

ulcerative colitis

chronic inflammation of the colon with presence of ulcers

pancreas endoscopic US (EUS)

detailed imaging and analysis of the pancreas. thin US tube is inserted through the mouth down the stomach and first part of the small intestine emits sound waves that bounce though the structures

ERCP (endoscopic retrograde cholangiopancreatography)

diagnose and treat billiary ductal system. inject a radiographic dye in the billiary duct

pyrorrhea

discharge of pus, purulent discharge -dental carries

Mouth Ulcers (Canker Sores)

erosions of the mucous membrane lining the mouth most common type APHTHOUS ULCERS lasting 3-4 days

panendoscopy

examination of esophagus, stomach and duodenum

capsule endoscopy

examination of the small intestine made by a tiny video camera placed in a capsule and then swallowed; images are transmitted to a waist-belt recorder and then downloaded onto a computer for assessment of possible abnormalities; traditional endoscopy cannot completely access the small intestine because of its length and complexity

hyperbilirubinemia

excessive level of bilirubin (bile pigment) in the blood caused when RBC break down producing a yellow pigment causing jaundice.

Vitamins ADEK are

fat soluble absorbed by lipids

Hep E

fecal-oral similar to HAV, underdeveloped countries

rugae

folds of epithelium on the hard palate and the wall of the stomach assist the tongue for mechanical and chemical digestion prior to swallowing.

halitosis

foul-smelling breath

liver function tests -types of enzymes

group of blood tests that evaluate liver injury, liver function, and conditions commonly associated with the biliary tract -protiens (protiens, albumin, globulin) low levels indicate liver damage -liver enzymes (ALT, AST SGOT) high levels indicate liver damage -cholestatic (break down of phospherous- high levels indicate liver and billiary duct disorders) -bilirubin

Chronic hepatitis

hepatitis inflammation and necrosis for longer than 6 months progresses slowly, lasts for years and difficult to treat

Hemochromatosis

hereditary disorder with an excessive buildup of iron deposits in the body

stomatitis

infection / inflammation of the mucosa of the mouth

Jaundice: Hepatocellular

infection or poison injuries the liver cells, preventing the removal of bilirubin from the blood

IBD (inflammatory bowel disease)

inflammation of the colon and small intestine usually involving ulcerative colitis or Crohns disease.

proctitis

inflammation of the lining of the rectum

gastritis

inflammation of the lining of the stomach giardia lamblia

gastroenteritis

inflammation of the mucous membrane lining the stomach and intestines initiated by contaminated food

peritonitis

inflammation of the peritoneal cavity d/t burst appendix

proctitis

inflammation of the rectum and anus

appendicitis

inflammation of the vermiform appendix tenderness over the Mcburney point. can lead to peritonitis

Water

ingested 92% into the cap of villi along with water soluble vitamins ( C and B complex) except for Vit b12 (too large of a molecule) passes through the bloodstream.

cystic fibrosis (CF)

inherited disorder of exocrine glands resulting in thick mucinous secretions in the respiratory tract that do not drain normally apparentin infancy and childhood affects respiratory and digestive

Intusseption

inward telescoping of the intestines can be cured by an enema or surgery

Polyps

large intestines intot he bowel lumen Tumors that grow on stem, resembling mushrooms. Polyps bleed easily, and some have the tendency to become malignant. most are benign needs endoscopic procedure to determine CA

enteroscope

lighted instrument for visually examining the intestines

hilum of kidney

medial depression for blood vessels and ureter to enter kidney chamber

segmental contractions

mixing contractions that occur in the small intestine in propulsion.

digestive system / Alimentary Canal consists of:

mouth, pharynx esophagas, stomach, small instestine, large instestine, rectum, anus

propulsion

movement of food through the alimentary canal to teh anus. taking 24-36 hours steps: Deglutition: swallowing Peristalsis: waves of contractions and relaxation through the alimentary canal. Segmental contractions: contractions in the small intestines.

ileus

obstruction of the intestine, often caused by failure of peristalsis paralytic ileus

gastric ulcers

occurring in the stomach causing perforation.

vomiting of "coffee grounds"

occurs when bleeding from an upper GI source has slowed or stopped. blood has been converted into HEMATIN by gastric acids.

Lobule contains (pancreas) islet cells

pancreatic islet alpha cells (secrete glucagon) beta cells (secrete insulin) vein

hematochezia

passage of fresh, bright red blood from the rectum indicating lower GI bleed form sigmoid colon, rectum or anus

stomach secretes 5

pepsinogen converts HCL to pepsin that breaksdown protien hydrochloric acid breaks down connective tissue and destroys pathogen intrinsic factor absorbs vit b12 in small intestine The mucous/mucin secreted by the stomach protects the stomach lining from the acids and juices. chemical messengers triggers other gastric enzymes

mucosal

pertaining to mucosa

STD and treatments

pg 176 chlamydia : single dose of azithromycin/zithromax

HILA

plural of hilum The renal hilum is the entry and exit site for structures servicing the kidneys: ...

carbohydrates are ingested in 3 forms

polysaccharides : starches disaccharides : sucrose (table sugar) and lactose (milk sugar) monosaccharides: glucose (basic sugar), Fructose ( fruit sugar) and galactose (milk sugar)

polyposis

presence of several polyps

peptic ulcers

regions of the GI tract that have been eroded by H. pylori - HCl and pepsin stomach and duodenum dyspepsia

mucous

relating to mucus

resection

removal of part or all of a structure, organ, or tissue usual tx for CA.

papillae

rough, bumpy elevations on dorsal surface of tongue containg 4,000 taste buds that is replaced every 7-10 days.

Digestive enzymes are produced by:

salivary glands, stomach, pancreas, small intestine

Secretion

secretiosn that lubricate, liquefy and digest the food. Mucus lubricates water liquefies Enzymes digests

ingestion

selective intake of food

nasogastric aspiration and lavage

shows bright red blood indicates active upper GI bleeding

cold sores (fever blisters)

small fluid-filled blisters that itch and sting, caused by a herpes simplex infection

cancer

small intestine ca occur more frequently than GI ca. adenocarcinoma malignant tumor

oral CA

squamous cell carcinoma mets to lymph nodes, bone, lung, liver 5 year survival rate is only 51%

mucin

substance which lubricated food and protects teh lining of the stomach

Roux-en-Y

surgical procedure to reduce the size of the stomach

hemorrhoids

swollen, twisted, varicose veins in the rectal region thrombosed hemorrhoids (clotted blood) are very painful

accessory organs consists of:

teeth, tongue, salivary glands, liver, gallbladder, pancreas

intussusception

telescoping of a segment of the intestine

mucosa

the lining of a tubular structure

Leukoplakia

thickened, white, leathery-looking spots on the inside/outside of the mouth that can develop into oral cancer. prevalent in immuno compromised people (HIV) could be precancerous

barium swallow (upper GI series) or barium meal

use of barium sulfate to see upper portion of digestive system less accurate than enteroscopy

Hepatitis A (HAV)

virus transmitted through direct contact with fecally contaminated food or water most contagious occurring in schools camps and institutions

laparscopy

visual examination of the abdomen

hematemesis

vomiting bright red blood indicating upper GI source

angiography

x-ray imaging of blood vessels after injection of contrast material (dye)

Hep C (HCV)

› Blood › Drug abuse › Sexual contact often asymptomatic can be treated with antivirals but can be progress to chronic hep and cirrhosis

hep D (HDV)

› Coinfection with HBV › Injection drug users › Unprotected sex with infected individual homeless populations