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Flashcards in GI Deck (71):
1

dysphagia causes

anasthetic, neuro defects, oesophageal tumour

2

saliva contains

amylase, Iodide, alkaline, calcium, lysozymes

3

secretions of salivary glands?

parotid - serous
sub max - mixed
sublingual - mucus

4

saliva secretion cell

ductal side has NaKATPase and HCO3-Cl antiporter. ECF side has Na-KATPase, KCl symporter, and Na-H antiporter

5

stimulated saliva and resting properties

stimulated - increase volume, hco3, enzymes, more hypotonic
resting - slightly alkaline

6

sympathetic and PS innervation of salivary glands

symp - superior cervical ganglion (decrease volume)
PS - glossopharyngeal (increase volume)

7

swallowing process

bolus to pharynx then pressure receptor in palate. Glottis closes, larynx lifts, resp inhibited

8

solids and liquids dysphagia. or solids then liquids

solids and liquids - motility problem
solids then liquids - mechanical obstruction

9

what is achalasia

failure of smooth muscle to contract e.g. upper oesophageal sphincter

10

components of lower oeso sphincter

+ve intra-abdo pressure, gastric rugae, acute angle, right cruz of diaphragm

11

gastric cells and secretions

Neck - mucus and HCO3
parietal - HCl and intrinsic
Chief - pepsinogen
G cell - gastric

12

cephalic, gastric and intestinal phase

cephalic - CNS stimulates acid
gastric - neutralisation, peptides and distention stimulate gastrin
intestinal - decrease pH and peptides stimulates secretin secretion which inhibits gastrin.

13

Where secretin from. what stimulate and its action. CCK too

from S cells of duodenum
stimulates HCO3 from pancerase and bile from liver
stimulated by low ph in duodenum

CCK from duodenal APUD cells. stimulates enzymes from pancreas and gall bladder and stim by FAs and AAs in duodenum

14

what causes atresias, stenosis, exampholos, gastroichisis

atresia - failure of anal membrane to rupture
stenosis - failure of recanalisation usually in duodenum
exampholos - gut and peritoneum herniates through umbilical cord
gastroischisis - failure of abdo wall to close, no sac

15

action of obliques

fleex trunk, rotate, compress and support abdo viscera

16

what is divariation recti and ectopia cordia and meckels

DR - widening of linea alba
ectopia - heart outside thoracic due to failure of ventral mesoderm
meckels - 2 ft from ilieocecal valve, gastric or pancreatic tissue, 2 inches

17

referred pain from cardic, gastric, duodenum, gallbladder, hepatic, retroperitoneal

cardiac - chest, neck, left shoulder
oesophagus - epigastric
gastric - back
duodenum - epigastric or umbilicus
gallbladder - right hypochondriac, R lumbar and R shoulder
hepatic - epigastric, R hypochondriac, R neck shoulder and back
retroperitoneal - back pain

18

diaphragmatic irritation causes

spleen, ectopic pregnancy, perforated ulcer

19

borders hasselbachs triangle

inguinal ligament, inf epigastric artery and vein, rectus sheath

20

inguinal canal borders

ant - internal oblique fascia
post - transversalis fascia
inf - inguinal ligament
sup - aponeurosis of obliques

21

which strangulated more inguinal or femoral

femoral

22

presentation, treat gastritis

presents - GORD. dyspepsia, epigastric pain, lying down and hot drinks worse
treat - lose weight, decrease alcohol and fatty foods. Amoxicillin and clarithromycin and omeprazole. Endoscopy

23

symptoms of gastric and duodenal ulcer. treat?

gastric - worse at night, worse when aeating. relieved with antacids. N&V. weight loss, haematemssis. treat with clarith and amoxici and omeprazole

duodenal - better when eating. delayed pain when acid secreted into duodenum

24

where are the stomach cells found? stomach histology

columnar cells with glands.
cardia - G cells
Fundus and body - neck, parietal, chief cells
pylorus - neck and g cells

25

gastric vsculature

see book
coeliac trunk, gastroepiploic, R L short gastric, proper hepatic, gastroduodenal, splenic

26

drainge of gastric and gastroeipoloic

gastric into hepatic
gastroepiploic into superior mesenteric

27

properties of chyme

hypertonic, acidic, partially digested

28

components of liver bile acid dependent and independent

dependent - cells lining canalliculi secrete. cholesterol, bile acid (e.g. chenodeoxycholic acid) and pigments
independent - cells lining bile ducts. alkaline juices

29

describe how bile acid recycled

reabsorbed in terminal ileun post bacterial conjugation and then back to liver

30

gall stones symptoms

right hypochondriac pain, radiate to back or R shoulder, N&V, fatty meal = worse

31

endocrine pancreas secertionsq

alkaline juice and enzyme (chymotrypsinogen, trypsinogen, carboxypeptidase, amylase, lipase)

32

what is cholecystatis and symptoms

cystic duct obstructed. fever, oedema, increase WCC,

33

what is biliary cholic and symptoms

biliary duct obstructed. jaundice.

34

how duct cells secrete hco3

basolateral side - NaKatpase, naHantiporter
CO2 diffuses in then becomes HCO3 and then into lumen

35

how fats digested in guts

bile acids emulsify. lipases. FAs to unstirred layer. RME. made into TAGs then chylomicrons.

36

ligaments of liver

see book
triangular, coronary, falciform

37

biliary tree

see book
R L hepatic, common hepatic, common bile, cystic, pancreatic, sphincter of oddi

38

pancreas artery

splenic

39

pancreatic drainage

head - superior mesenteric
tail - splenic

40

adaptive and innate GI defences

adaptive - GALT
innate - acid, enzymes, mucus, peristalsis

41

achlorhydra symptoms

anemia (impaired iron absorption). increase infection from salmonella, shigella, cholera, H pylori

42

liver failure symptoms

hepatic encephalopathy, portal hypertension in cirrhosis

43

symptoms of portal hypertension and cirrhosis

caput medusa, varices, shunting, splenomegaly, palmar erthyema, dupuytrens, jaundice, anemia, flapping tremor,, spider naevi, ascites

44

investigations for hepatitis

jaundice, increase ALT (and AST), clotting increased

45

which is specifc to liver ALT or AST

ALT. L for liver

46

test for cholecystitis

bilirubin (conjugated) and ALP

47

prehepatic signs and causes

unconj bilirubin, increase LDH, anaemia
immune cause, infection (malaria), spherocytosis

48

hepatic jaundice signs and causes

increase ALT and AST, increase conj and unconj, clotting abnormal.
cirrhosis, hepatitis B virus, alcohol, paracetemol

49

post hepatic signs and causes

increase conj, and ALP
gall stones, cancer, pancreatitis

50

alcohol disease on liver

fatty liver due to increase NADH leading to FA and TAG deposits. THEN hepatitis due to acetaldehyde. then cirrhosis and wernickes encephalopathy

51

causes of cirrhosis

wilsons, alcohol, hep B, autoimune

52

portal system anastamosis

oesophageal, rectal, caput medusae (para umbilical veins)

53

pancreatitis symptoms

shock, pain, vomiting, sepsis, increase insulin
chronic - malabsorption, decrease weight, DM, jaundice

54

glucose into cell

SGLT1 and then into ECF via GLUT2

55

what does large intestine absorb

vitamins and water

56

how calcium absorbed and taken into guts

absorbed by PTH via Vit D activation. Via facilitated diffusion into cell and then Ca-ATPase into ECF

57

explain how iron absorbed

iron + gastric acid then to transferrin and then RME

58

what does oral rehydration contain

glucose and na

59

how segmenting in intestine works

pacemakers fire quicker at stomach end than at large intestine end.

60

features of jejunum and ileum

jejunum - dark red, thick wall, no peyers
ileum - pink, thin, peyers

61

which one does smoking help with UC or CD?

UC

62

features of UC

continous, rectal involvement, gross bleeding, mucosal ffriability, pseudopolyps

63

CD and UC treatment

CD - corticosteroids, methotrexate, azathioprine
UC - same and colectomy

64

why baxcteria in gut good

vitamins, kill pathogens, MALT stimulate

65

what bacteria cause gastroentiritis

campylobacter, salmonella, listeria

66

what causes gingivitis and travellers diarrhoea

gingivitis - strep mutans
travellers diarrhoea - e coli

67

gastric cancer symptoms and appearances and spread

epigastric pain, vomiting, weight loss
appearance - fungating, ulcerative, infiltrative
spread - local, trans-coelemic (liver, peritoneum, ovaries), lymph

68

large intestine cancer cause

familial adenomatous polyposis, DCC gene

69

what is ileus, toxic megacolon and lead pipe colon

ileus - loss of peristalsis
toxic megacolon - v dilated colon (IBS deterioratioN)
lead pipe - severe UC. no haustra

70

small bowel colic symptoms and cuases

vomiting, distention, constipation, pain 2-3 mins
cause - adhesions, hernia, tumour, inflamm

71

large bowel colic symptoms and cuases

symptoms - vomit faeces, distention, consitpation,. pain 10-15 mins
cause - hernia, cancer, volvulus