LCCW Gastro Phys - Exam 1

Question Answer
What does the GI tract do for us? transportation, digestions, absorption, excretion, defensive role
What stimulates the stretch receptors? The bolus
Control of swallowing comes from where? The swallowing center in medulla and lower pons
What pulls medially to form a slit so that large pieces can't pass? Palatopharyngeal Fold
A series of wave-like muscle contractions that moves food to different processing stations in the digestive tract? Peristalsis
Nervous control – Afferent : Sensory from mouth travels CN V and IX to medulla oblongata
Nervous control – Efferent: From swallowing center in medulla impulses travel thru CN V, IX, X, and XII, and some upper cervical Nerves
Primary Peristalsis: Transports food from pharynx to stomach (8-10 sec)
When does secondary peristalsis occur? if the whole bolus doesn't enter stomach. Occurs until esophagus is empty.
Peristalsis is initiated where? In the Myentaric system back through glossopharengeal and vagal efferent.
Stomach transports the bolus through contractions called what? Peristalsis and Pyloric pump
Pyloric Pump? Vigorous contractions designed to empty the stomach
Segmentations: Transportation of content in the small intestine
Haulstrations: Transportation of content in the Large Intestine
Digestion involves what? The Breakdown of the food we eat into nutrients that are readily absorbed
Ingestion: Bringing food into the mouth
Mechanical digestion: Physical process prepares food for chemical digestion
Chemical Digestion: Enzymes breakdown food into basic elements
Absorption: from lumen of GI tract into blood or lymph
Where does most absorption happen? In the small intestine
Where does absorption of water and electrolytes happen? In the large intestine
Defecation? elimination of indigestibile substances from the body
Which part of the GI is responsible for defecation? The Large Intestine
Salivary glands produce how much per day? 800-1500 mL/day
Parotid Produces what and is where? Serious Secretion as well as a majority of the saliva. Vestibule – next to the second upper molar.
The Submandibular gland produces what and is where? More Serous >> Mucous. Lingual Frenulum.
The Sublingual gland produces what and is where? More Mucous >> Serous. 10-12 ducts. Open into the floor of mouth.
The Ebner's Glands produces what and is where? Serous only – Circumvallate Papillae (lipase)
What is Saliva good for? cleanses mouth. Dissolves food chemicals (allows us to taste). Moistens food and aids in form bolus. Contains enzymes. contains factors that destroy bacteria. Contain protein antibodies.
What destroys bacteria (via saliva)? Thiocyanate ions, and lysozyme
What destroys oral bacterial? The Protein antibodies in the saliva
Parotid gland is stimulated by: CN IX –> Sup and Inf salivary nuclei –> CN IX —> 1 ganglion –> parotid gland
Sibmandibular and sublingual glands are stimulated by: taste and tactile receptors on tongue –> CN VII –> sup and inf salivatory nuclei –> CN VII –> Submandibular ganglion –> submandibular and sublingual gland
Deciduous teeth: 20 baby teeth (6 months –> 2 years)
Each quarter in baby teeth: 2 incisors, 1 canine, 2 molars
Permanent teeth come in at what age? 6 years old and take up until 20 years of age to completely erupt
Incisor: Chisel cutting or nipping
Canine: Conical tear or pierce
Premolar and molar: crowns with rounded cusps grinding
Enamel: The white stuff that we see – it's the hardest structure on our bodies.
Dentin: Very Porous. like bone.
Pulp/Root Canal: Space within the tooth
Cementum: Material that binds tooth to the jaw. Adheres to the peridontal ligament.
Dental carries: (Cavities) – caused by dental plaques
Dental plaques: Film of debris (bacteria and sugar)
What metabolizes sugars into acids? Bacteria. Ut de-mineralizes the enamel
Bacteria are usually what? Streptococcus mutans
Calculus (tartar): formed by accumulation of plaque can lead to gingivitis
Gingivitis: Inflammation of tooth/gum interface
If Gingivitis is left untreated, it progresses to what? Periodontal disease
What happens that leads up to tooth loss? Pockets are created on surface of tooth, then bacterial enzymes dissolve the dentin, which leads to tooth loss
Xerostomia: "dry mouth" – absence of saliva production
Leukoplakia: White patches on the surface of mucous membranes
Hyperkeratosis: abnormal thickening of the outer layer of the skin.
Xerostomia is caused by what? mumphs, sjorgens disease, Sarcoidosis and some meds
Erythroplakia: flat red patch or erosions on floor of mouth, tongue or soft palate
Erythroplakia is associated with what? Dysplasia and is precancerous
Upper 1/3 of esophagus? Striated muscles (= voluntary)
Lower 1/3 of esophagus? Smooth muscle (= involuntary)
middle of esophagus? smooth and striated muscles
Primary peristalsis is a continuation of what? The pharyngeal stage
What happens to the bolus if it's still present after primary peristalsis? secondary peristalsis occurs from the distension of esophagus
Esophageal stage of swallowing is stimulated by what? The myenteric n.s. and by reflexes traveling from the vagal afferent fibers (which initiate contraction)
LES: lower esophageal sphincter – is the last 3 cm of esophagus
LES's AKA? Gastroesophageal sphincter
LES is normally ________ to prevent reflex Constricted
Atresia: Absence of a normal opening (pre stomach). Discovered right away
Fistula: Abnormal connection from esophagus to trachea.
What is the most common fistula? The lower esophageal fistula (near where the trachea "Y"s)
What are the 2 S/S of Atresia? Regurgitation and excessive secretions
What is the least common fistula? H-Type fistula
S/S of H-type fistula? Cyanosis (turning blue) and distended abdomen
S/S of Fistula? Choking, Cyanosis, aspertation pnemonia
Diverticula (of esophagus): Is an outpouching of the wall of the esophagus
Diverticula is caused by what? motor disturbance
Zenker Diverticulum? Uncommon. HIGH on esophagus.
S/S of Zenker Diverticulum? Regurgitation of food eaten a few days prior
Traction Diverticulum? Outpouchings occuring at MIDPOINTS of the esophagus. Usually Asymptomatic.
Epiphrenic diveritculum? Occurs LOW on the esophagus.
Achalasia: Failure of LES to relax in response to swallowing, and absence of peristalsis
What is associated with Achalasia? Associated with a loss of inhibitory ganglion cells in the myenteric plexus of esophagus
Achalasia is a compluication of what disease? Chagas disease – Ganglion cells destroyed by Trypansoma cruzi
S/S of Achalasia? Dysphasia, Odynophagia, and regurgitation.
Dysphasia: Difficulty swallowing
Odynophagia: Painful swallowing
Reflux Esophagitis: Inflamation of esophagis. MOST COMMON ESOPHAGITIS (GERD)
GERD = ? Gastro Esophageal Reflex disorder
What is GERD in conjunction with? Sliding hiatal hernia
Factors that lead to LES? (<– is that supposed to be GERD? Pg 8) Alcohol, caffeine, chocolate (stimulate gastric secretion), Fatty Foods (slow down gastric emptyin) and Nicotine, CNS depressants, pregnancy and estrogen therapy ( decrease LES activity)
S/S of Reflux esophagitis? Dysphasia, odynophagia, dypepsia, pyrosis, and excessive salivation
Pyrosis = Heart burn
What is GERD diagnosed to (if it worsens)? Barrett Esophagus
Barrett Esophagus: Squamous Epithelium of esophagus is replaced with pseudocolumnar epithelium as a result of chronic reflux
Where does Barrett Esophagus occur? In the lower 3rd of esophagus
Barrett Esophagus is increased risk with what? Smoking
Chemical Esophagitis: Accidental poisoning of children, or attempted suicide in adults
Chemical esophagitis can happen due to what? Alkaline agents (lye), strong acids (sulfuric or hydrochloric) found in cleaners
Chemical esophagitis will cause what? Inflammation and cell death
Esophageal Varices: Dialated Veins beneath the mucousa. Pron to rupture and hemorrhage. In the lower 3rd of esophagus
Esophageal Varices is due to what? Hepatic portal hypertension from cirrhosis of liver
S/S of esophageal varices? Blood in vomit, black tarry stool, and shock
Hiatal Hernia: Herniation of the stomach through an enlarged esophageal hiatus in diaphragm – usually asymptomatic
S/S of Hiatal Hernia? Heartburn and regurgitation
Causes of hiatal hernia? Relacation of LES when stomach full. Tight Clothing around mid and upper abdomen. Lying down after a big meal. Large amount of abdominal adipose tissue.
Sliding Hernia: MOST COMMON (75-95%). The Hiatal laxity allows cardia of stomach and LES to pass above the diaphragm. Most often asymptomatic
Paraesophageal (rolling) Hernia: Portion of the gastric fundus above the diaphragm. Can continually enlarge and in extreme cases stomach herniates into thorax.
Which type of hernia NEEDS surgical intervention? Paraesophageal (rolling) hernia
Scleroderma: Systeic sclerosis is the type that can affect the esophagus
Scleroderma is caused by what? Fibrosis (hardening) in many organs and an abnormality of esophageal mm fixation
Scleroderma is primarily where? The lower third and LES
Plummer Vinson syndrome, AKA? Paterson-kelly syndrome
Plummer Vinson syndrome Characterised by what? Cervical esophageal web (thickening on upper esophagus) causes dysphagia, mucosal lesions of mouth and pharynx and iron deficiency anemia.
What can be a complication of plummer-vinson syndrome? Carcinoma of oropharync and upper …… upper what?
90% of plummer-vinson syndrome happen in which gender? Women
Mallory-Weiss Syndrome: Lacerations of the lower esophagus and upper stomach
Mallory-Weiss Syndrome is caused by what? Severe retching, often associated with alcoholism. Pt can also vomit blood.
Mallory-Weiss Sydrome can lead to what? Could also lead to peritonitis or pleurisy due to contents leaking out

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