Term
| Consists of upper and lower GI segments with separate functions |
|
Definition
|
|
Term
| What all does the upper GI tract include? |
|
Definition
Mouth
Esophagus
Stomach
Duodenum |
|
|
Term
| Purpose is to ingest and digest food |
|
Definition
|
|
Term
| What all does the lower GI tract include? |
|
Definition
|
|
Term
| Performs both digestion and absorption of nutrients |
|
Definition
|
|
Term
| Absorbs water and electrolytes, and stores feces until time for elimination. |
|
Definition
|
|
Term
| What are some signs and symptoms of GI problems? |
|
Definition
Dyspepsia
Nausea and vomiting
Anorexia
Diarrhea
Constipation
Dysphagia
Achalasia
Heartburn
Abdominal Pain
GI bleeding
Bowel or fecal incontinence |
|
|
Term
| Hematemesis, melena, hematochezia |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Failure to relax the smooth muscle fibers of the GI tract, especially at the esophageal spinchter, resulting in obstruction to the passage of food thru the terminal esophagus. Results ina feeling of fullness in the sternal region and progressive dysphagia |
|
Definition
|
|
Term
| A burning sensation in the esophagus usually felt in the midline below the sternum, often the symptoms of gastroesophageal reflux |
|
Definition
|
|
Term
| Passage of tarry stools, due to the presence of blood altered by the intestinal juices |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Pain in the left shoulder caused by free air or blood in the abdominal cavity |
|
Definition
|
|
Term
| Strenuous exercise can induce GI symptoms. Name 7 |
|
Definition
Heartburn
Belching
N&V
Abdominal cramps
Diarrhea
Fecal urgency |
|
|
Term
| Name 4 causes of abdominal pain |
|
Definition
Mechanical
Inflammatory
Ischemic
Referred Pain |
|
|
Term
| Name 2 sites of pain that can be caused by GI bleeding, perforation associated with an ulcer, or a ruptured spleen. |
|
Definition
|
|
Term
| GI system pain should be ruled out for what other 2 types of pain |
|
Definition
Musculoskeletal
CV disorder related |
|
|
Term
| Pain from __ or __ pain also can be referred to the abdomen; usually associated with hyperesthesia over the involved spinal dermatomes and the pain is intensified by motions such as coughing, sneezing, or straining. |
|
Definition
| Spine or neuromusculoskeletal |
|
|
Term
| Pain caused by __ diseases as such ischemic cardiac angina and aneurysm; these causes need to be ruled out. |
|
Definition
|
|
Term
| Erosive gastritis is common in: (5) |
|
Definition
1. Severely ill ppl with major trauma or systemic illness, burns, or head injury
2. Patients with peptic ulcers
3. NSAIDs users: aspirin or ibuprofen
4. Chronic alcohol user
5. Pts using anticoagulants: warfarin, heparin and aspirin used in the treatment of pulmonary emboli, venous thrombus or vavular abnormalities |
|
|
Term
| In developed countries, what are 5 common causes for vitamin deficiencies? |
|
Definition
1. Chronic alcohol use
2. Medication misuse
3. Imbalanced diet
4. Foot faddism
5. Long term parenteral nutrition |
|
|
Term
| How are most vitamin deficiencies treated? |
|
Definition
| Vitamin replacement from diet to supplementation |
|
|
Term
| What is a common Vitamin A |
|
Definition
|
|
Term
| A component of photoreceptor pigments int he retina and helps to maintain normal epithelium |
|
Definition
|
|
Term
| Found in egg yold, butter, cream, liver, and fish liver oil. Also formed by the body from beta-carotene, which is found in yellow, orange, or leafy green vegetables. |
|
Definition
|
|
Term
| Name 3 ways in which a person might develop a Vitamin A deficiency. |
|
Definition
1. Night blindness, conjunctival dryness, and corneal keratinization, which may result in perforation.
2. Other signs include dry skin and keratinization of lung, GI, and urinary epithelium
3. Severe deficiency predisposes to increased infections. Deficiency is noted only after liver stores are depleted. |
|
|
Term
| What is a common Vitamin D |
|
Definition
|
|
Term
| Enhances calcium and phosphate absorption and helps maintain their appropriate levels in the blood |
|
Definition
|
|
Term
| Found in yeast, fish liver oils, egg yolds, and supplemented dairy products: however, ourmajor source of this vitamin is its formation in the skin with sun exposure. |
|
Definition
|
|
Term
| 2 things that Vitamin D deficiency leads to. |
|
Definition
1. Rickets in children and osteomalacia in adults
2. X-rays show several characteristic deformities, including long-bone bowing in children and demineralization in adults |
|
|
Term
| This vitamin maintains cell membrane integrity by protecting lipids from oxidation. |
|
Definition
|
|
Term
| Found in vegetable oils, eggs, butter, and whole grains. |
|
Definition
|
|
Term
| Deficiency of this vitamin is rare in a human. |
|
Definition
|
|
Term
| There are 3 specific situations when a Vitamin E deficiency is likely to occur. |
|
Definition
1. In persons who cannot absorb dietary fat - malabsorption syndroms with steatorrhea
2. In premature, very low birth weight infants (birth weights less than 1500 grams, or 3.5 pounds)
3. In individuals with rare disorders of fat metabolism |
|
|
Term
| Vitamin E deficiency can cause what 2 things? |
|
Definition
1. Hemolysis, which may lead to anemia
2. Neurologic problems due to poor nerve conduction. These include neuromuscular problems such as spinocerebellar ataxia and myopathies |
|
|
Term
| This is a cofactor in the synthesis of clotting factors |
|
Definition
|
|
Term
| This vitamin is supplied by leafy green vegetables and is also produced by normal intestinal bacteria |
|
Definition
|
|
Term
| Deficiency of Vitamin K results in what 2 things? |
|
Definition
1. Spontaneous bleeding or prolonged oozing
2. Prothrombin time (PT) is increased more than partial thromboplastin time (PTT), although both may be affected. |
|
|
Term
| What is the treatment for Vitamin K deficiency? |
|
Definition
| Injections of Vitamin K may be given if rapid correction of the deficiency is needed |
|
|
Term
| Name 4 fat soluble vitamins |
|
Definition
|
|
Term
| Name 7 fat soluble vitamins. |
|
Definition
| B1, B2 Folate, B3, B6, B12, Folate, Vitamin C |
|
|
Term
| What is a common Vitamin B1? |
|
Definition
|
|
Term
| What is a common vitamin B3? |
|
Definition
|
|
Term
| What is a common vitamin B6 |
|
Definition
|
|
Term
| What is a common vitamin B12? |
|
Definition
|
|
Term
| What is a common vitamin C? |
|
Definition
|
|
Term
| This vitamin contributes to carbohydrate metabolism as a coenzyme. |
|
Definition
|
|
Term
| This vitamin is found in grains, but it is removed in the production of highly polished rice. |
|
Definition
|
|
Term
| Name 2 causes of Vitamin B1 deficiency |
|
Definition
-Dietary deficiency of thiamine
-Certain conditions, including pregnancy and hyperthyroidism, increase the need for thiamine and can cause secondary deficiency |
|
|
Term
| Vitamin B1 deficiency can be manifested as: (3) |
|
Definition
1. Painful bilateral, symmetric peripheral polyneuritis; called dry beriberi
2. Edema resulting from a high-output form of heart failure; called wet beriberi
3. The Wernicke-Korsakoff syndrome: also called cerebral beriberi |
|
|
Term
| Results in nystagmus, confusion, and confabulation may progress to coma and death. Occurs when chronic thiamine deficiency is exacerbated by acute defieiency. This condition is particularly common in alcoholics. |
|
Definition
| Wernicke-Korsakoff's Syndrome |
|
|
Term
| A componenet of the coenzymes flavin adenine dinucleotide (FAD) and flavin mononucleotide (FMN) |
|
Definition
|
|
Term
| Deficiency of riboflavin occurs with insufficient milk or animal protein consumption |
|
Definition
|
|
Term
| Vitamin B2 Folate defiency can manifest into what 4 things? |
|
Definition
Cheilosis (swollen, cracked, bright red lips)
Angular stomatitis (fissuring at the angles of the mouth)
Cutaneous lesion (as dry and scaling skin, fluid retention in the mucus membranes)
Ocular lesions (eyes may become bloodshot, itchy, watery, and sensitive to bright light |
|
|
Term
| A coenzyme of carbohydrate metabolism |
|
Definition
|
|
Term
| Primary deficiency of this vitamin occurs when maize (milled corn) is a diet staple and secondary deficiency occurs with diarrhea, cirrhosis, alcoholism, and isoniazid (INH) use. |
|
Definition
|
|
Term
| Vitamin B3 deficiency can lead to what 2 things? |
|
Definition
1. Pellagra, which is characterized by the "4 D's": diarrhea, dermatitis, dementia, and death
2. Symmetric cutaneous lesions, stomatitis, and glossitis |
|
|
Term
| Inflammation of the tongue |
|
Definition
|
|
Term
| This vitamin is active in blood, the CNS, and skin metabolism |
|
Definition
|
|
Term
| This vitamin is found in many foods, so deficiency is rare but may occur due to malabsorption or increased metabolism. |
|
Definition
|
|
Term
| Manifestations of Vitamin B6 deficiency include: (4) |
|
Definition
-Seborrheic dermatosis, cheilosis, glossitis
-Peripheral neuropathy
-Lymphopenia, anemia
-May cause seizures in infants |
|
|
Term
| This vitamin is important for DNA synthesis and myelin formation. |
|
Definition
|
|
Term
| This vitamin is found in meat, eggs, and milk. Once ingested, it binds to intrinsic factor from the parietal cells, and the complex is absorbed. |
|
Definition
|
|
Term
| What are 2 causes of Vitamin B12 deficiency? |
|
Definition
-Lack of B12 in diet
-Pernicious anemia, in which the destruction of parietal cells results in insufficient amounts of intrinsic factor |
|
|
Term
| What are 3 deficiency manifestations of vitamin B12? |
|
Definition
Megaloblastic anemia
Neurologic disturbances
Ataxia |
|
|
Term
| What is the treatment for vitamin B12 deficiency? |
|
Definition
| Intramuscular injections of vitamin B12 for patients with pernicious anemia |
|
|
Term
| This is used in DNA synthesis and is found in leafy green vegetables and citrus fruits. |
|
Definition
|
|
Term
| Deficiency of this vitamin results from inadequate folic acid in diet, seen often in the elderly, alcoholics, and the poor. |
|
Definition
|
|
Term
| Signs of deficiency of this vitamin are often subtle. Megaloblastic anemia without neurologic changes suggests this diagnosis. |
|
Definition
|
|
Term
| Women with this deficiency who become pregnant are more likely to give birth to a low birth weight or premature infant, or an infant with neural tube defects. |
|
Definition
|
|
Term
| This vitamin is needed for the formation of collaged and the maintenance of connective tissue, bones, and teeth. |
|
Definition
|
|
Term
| Deficiency of this vitamin, scurvy, is often due to dietary insufficiency and appears up to 1 year after the deficiency state starts |
|
Definition
|
|
Term
| Name 3 deficiency manifestations of Vitamin C |
|
Definition
1. Splinter hemorrhages, swollen, friable gums
2. Myalgias, and hemarthralgias
3. In more advanced conditions: tooth loss, secondary infections, gangrene, and spontaneous hemorrhages |
|
|
Term
| What does GERD stand for? |
|
Definition
| Gastroesophageal Reflux Disease |
|
|
Term
| Inflammation of the esophagus; due to reflux of acid gastric juice into the lower esophagus |
|
Definition
|
|
Term
| This results from malfunction of the lower esophageal sphincter and disordered gastric motility; may lead to peptic esophagitis, ulceration, stricture, or Barrett esophagus. Can be caused by bacteria, a virus, chemicals, dust, gas, or food/water aspiration. |
|
Definition
|
|
Term
| What are some clinical manifestations of GERD? |
|
Definition
| heartburn (chronic or recurrent epigastric or retrosternal pain), reflux, dysphagia, and painful swallowing |
|
|
Term
| What is the treatment for GERD? |
|
Definition
| Acid-suppressants, antacids, lifestyle modification, surgery |
|
|
Term
| What should a PT be aware of in a pt wit GERD? |
|
Definition
-Exercise might make symptoms worse
-GERD is induced by strenuous exercise is common among athletes
-Intervention requiring a supine position should be scheduled before meals and avoided just after eating
-May need modify towards a more upright posture if symptoms persist during therapy |
|
|
Term
| Usually a squamous cell carcinoma |
|
Definition
|
|
Term
| What are 2 major risk factors for esophageal cancer. |
|
Definition
| Heavy alcohol and tobacco use |
|
|
Term
| Most patients with this have metastases to the lymph nodes at the time of presentation, and local extension with invasion of nearby structures is also common. |
|
Definition
|
|
Term
| Occurs in 5-10% of cases and is usually related to Barrett's epithelium (columnar metaplasia of the lower esophagea lining) |
|
Definition
|
|
Term
| The intitial symptoms are dysphagia, leading to weight loss. Patients first experience difficulty swallowing solids, which gradually progresses to difficulty swallowing liquids as well. Weakness, anemia, pain, regurgitation, and aspiration are also noted. Coughing or hoarseness may be present if the laryngeal nerves involved. |
|
Definition
|
|
Term
| What are the treatments for esophageal cancer? |
|
Definition
| Surgery, radiation, chemotherapy. Prognosis is poor |
|
|
Term
| What should a PT be aware of with a pt with esophageal cancer? |
|
Definition
| Consider side effects of medications |
|
|
Term
| Inflammation of the gastric mucosa, can be acute or chronic. |
|
Definition
|
|
Term
| Etiology for this is varied and includes alcohol use, nonsteroidal anti-inflammatory drugs (NSAIDs), inflammatory bowel disease, viral infection or severe stress. |
|
Definition
|
|
Term
| __ gastritis involved superficial, rapidly developing lesions and occurs with severe stress, such as major trauma, burn, head injury, or hemorrhage. |
|
Definition
|
|
Term
| __ gastritis becomes increasingly common with advanced age |
|
Definition
|
|
Term
| Mild dyspepsia is the presenting complaint. Blood in the nasogastric aspirate is the first sign in hospitalized patients. |
|
Definition
|
|
Term
| What are the treatments for Gastritis |
|
Definition
| H2-blockers, antacids, and avoidance of troublesome foods are the best treatment options for chronic disease. |
|
|
Term
| What should a PT be aware of for a patient with Gastritis |
|
Definition
| Monitor S&S of GI bleeding with elderly patients and patients on NSAIDs |
|
|
Term
| Ulcerative corrosion of the epithelium can occur anywhere in the esophagus, stomach, or duodenum. |
|
Definition
|
|
Term
| H. pylori infection is the most important risk factor. It may be complicated by bleeding, perforation, or obstruction. |
|
Definition
|
|
Term
| S&S may include burning or gnawing epigastric pain; may be alleviated by food or antacids; Nausea, vomiting, and epigastric tenderness is common. |
|
Definition
|
|
Term
| What are the treatments for peptic ulcer disease? |
|
Definition
| Antibiotics for H. pylori infections, acid suppressants, and antacids |
|
|
Term
| What should a PT be aware of in a person with peptic ulcer disease. |
|
Definition
-Monitor S&S of GI bleeding with elderly patients or patients on NSAIDs
-Perforated ulcr can cause back or right shoulder pain |
|
|
Term
| Ischemia of small or large bowel, caused either by intrinsic vascular disease or by extrinsic compression of intestinal blood vessels. Atherosclerosis is a common cause. Acute ischemia is caused by emboli occlusion. |
|
Definition
|
|
Term
| Might result in a significant decrease in blood flow or occlusion of the visceral branches of abdominal aorta resulting inflammation and necrosis (infarct) of the intestine segment lacking blood supply |
|
Definition
|
|
Term
| Might result in a rapid onset of abdominal pain or in chronic ischemia, abdominal cramping after eating; bloody diarrhea, a tender abdomen, and systemic symptoms |
|
Definition
|
|
Term
| What should a PT be aware of in a patient with Intestinal Ischemia? |
|
Definition
-Intestinal ischemia pain can results in intermittent back pain with exertion
-Clinical presentation combined with medical history, CAD risk factor, and PVD are the red flags; need for a medical referral if patient is not diagnosed. |
|
|
Term
| IBD (inflammatory bowel disease) may affect any part of the GI tract; refer to 2 diseases |
|
Definition
Crohn's
Ulcerative Colitis |
|
|
Term
| Can occur in any age but 10-30 years is the most common. 20-25% might show up in family history. Occurs equally in both men and women. Cancer risk with this is increased so early detection is the best means of prevention. |
|
Definition
|
|
Term
| Can occur with any age, but 10-40 years old is the most common. 20% of the time it will show up in family history. Occurs equally in men and women. Risk of cancer is increased but preventable with bowel resection. |
|
Definition
|
|
Term
| Can occur in any segment of the body but small or large intestines are the most common. Skip lesions are common. The entire intestinal wall is involved and may be inflammed. Granulomas, thickened bowel wall, and a narrowed lumen and obstruction are all typical. Fissures and fistulas are also common. |
|
Definition
|
|
Term
| Usually the lesions are located in the large intestin and rectum. Skip lesions are absent. Mucosal and submucosa layers may be inflammed. Granulomas, thickened bowel wall,a nd narrowed lumen and obstruction are all very uncommon. Fissures and fistulas are absent here. |
|
Definition
|
|
Term
| Ab pain is common and can be mild to severe. Diarrhea may be absent to moderate. Bloody stools are unommon but abdominal masses are common in the right lower quadrant. Anorexia and weight loss can be severe. |
|
Definition
|
|
Term
| Ab pain is less frequent but can be mild to severe. Diarrhea is typical and is often chronic and severe. Bloody stools are typical but abdominal masses are uncommon. Anorexia and weight loss is usually mild to moderate. |
|
Definition
|
|
Term
| Skin rashes are common but mild. Joint pain is common but mild to moderate. Growth retardationis often marked. Pt can go thru remissions and exacerbations. |
|
Definition
|
|
Term
| Skin rashes are common but mild. Joint pain is common but usually mild to moderate. Growth retardation is usually very mild. Pt can go thru remissions and exacerbations. |
|
Definition
|
|
Term
| Experienced by abdominal pain, especially in the lower right quadrant; cramping, diarrhea, and pain at the anus is noted. |
|
Definition
|
|
Term
| What all should a PT be aware of in a pt with IBD? |
|
Definition
-CD in terminal ileum may produce referred pain to the corresponding low back, lower right quadrant
-CD associated abscess or inflammation mass may cause hip, thigh, or knee pain, often with an antalgic gait (ambulation pattern characterized by a shortened stance phase on the affected side)
-25% IBD patients may present with joint problems as migratory arthralgias, monarthritis, polyarthritis, or sacroilitis
-IBD is associated with low bone mineral content and a high prevalence of osteoporosis |
|
|
Term
| A common disorder involving chronic GI complaints, often associated with psychiatric symptoms. Patients with this complain of chronic, crampy ab pain, bloating, flatulence, and diarrhea or constipation. |
|
Definition
|
|
Term
| A diagnosis of exclusion, and lactose intolerance must be ruled out. Presumptive diagnosis may be made in the context of chronic symptoms without weight change. |
|
Definition
|
|
Term
| What are the treatments for IBS? |
|
Definition
| Dietary bulk supplements, anticholinergics, and antidiarrheals are generally sufficient and tricyclic antidepressants may be helpful |
|
|
Term
| An acquired conition that refers to the presence of outpouchings in the wall of the colon or small intestine |
|
Definition
|
|
Term
| Contains feces but without infection |
|
Definition
|
|
Term
| Especiallycommon in developed nations due ot a low-fiber diet, resulting in increased intraluminal pressures |
|
Definition
|
|
Term
| Generally asymptomatic. Symptoms arise from a lower GI bleed or from diverticulitis. |
|
Definition
|
|
Term
| What is the treatment for diverticulosis? |
|
Definition
| It usually resolves spontaneously but a high-fiber diet is recommended |
|
|
Term
| A complication of diverticulosis, occurs when a diverticulum becomes infected or perforates, causing an abscess or peritonitis |
|
Definition
|
|
Term
| May be further complicated by formation of fistulas to the bladder, vagina, or skin or by the development of adhesions that cause small-bowel obstruction. |
|
Definition
|
|
Term
| Symptoms include acute ab pain, usually on the left side. Accompanied by fever, chills, altered bowel habit,and bloody stools. A lower abdominal mass may be present on the exam. |
|
Definition
|
|
Term
| Inflammation of the appendix |
|
Definition
|
|
Term
| Occurs as the appendix becomes distended and a compromise of blood supply develops. Gangrene and perforation become increasingly likely |
|
Definition
|
|
Term
| Vague periumilic ab pain with N&V are the first symptoms. Pain then localizes in the right lower quadrant. Pain over McBurney's point is typical. Temperature is only slighly elevated if no perforation has occurred. Fever and increased pain indicate possible performation. |
|
Definition
|
|
Term
| Leukocytosis with more than 75% polymorphonuclear leukocytes ismost seen and treatment includes a surgical resection. |
|
Definition
|
|
Term
| Small tissue masses projecting into the colonic lumen |
|
Definition
|
|
Term
| Most of these are adenomas. These malignant adenomas are probably the origin of most large-bowel adenocarcinomas. Adenomatous polyps are found in 50% of 70 year olds. |
|
Definition
|
|
Term
| A rare, autosomal dominant condition involving multiple polyps that eventually develop into colorectal cancer if untreated. |
|
Definition
| Familial Adenomatous Polyposis |
|
|
Term
| Are polyps generally symptomatic? |
|
Definition
|
|
Term
| Larger lesions can cause intermittent bleeding and changes in bowel habits, such as increased frequency, constipation, or tenesmus. |
|
Definition
|
|
Term
| A painful spasm of the anal sphincter with an urgent desire to evacuate the bowel or bladder, involuntary straining, and the passage of little fecal matter or urine. |
|
Definition
|
|
Term
| The 3rd most common site of cancer in Western countries |
|
Definition
|
|
Term
| The vast majority of colon cancers are __ |
|
Definition
|
|
Term
| Genetic predisposition is known with familial adenomatous polyposis and with two other disorders: cancer family syndrome and hereditary site-specific colon cancer. All of these are autosomal dominant. |
|
Definition
|
|
Term
| Other predisposing conditions include ulcerative colitis, schistosomal colitis, history of radiation exposure, and colonic polyps. Increased incidence is seen in higher socioeconomic classes and is probably related to high fat, high calorie, low fiber, and low calcium diets |
|
Definition
|
|
Term
| Spread most frequenctly to regional lymph nodes. May also spread by direct extension, as seen with the common circumferential growth pattern of left colon lesions, and it can invade nearby structures. |
|
Definition
|
|
Term
| __ __ commonly leads to metastases in the liver or lungs. "seeding" or transperitoneal metastasis, may cause local implants or generalized abdominal carcinomatosis. |
|
Definition
|
|
Term
| Adenocarcinoma that remains asymptomatic for about 5 years |
|
Definition
|
|
Term
| __ sided colon lesion typically cause weakness secondary to anemia, dyspepsia, and right sided-discomfort or fullness. |
|
Definition
|
|
Term
| __ sided colon cancer more often causes changes in bowel habits from occlusion of the lumen, with alternating constipation and increased frequency, blood-streaked stoo, and stook with decreased diameter. |
|
Definition
|
|
Term
| Metastatic nodes, called __ nodes or __ nodes, may be palpated in the supraclavicular region. |
|
Definition
|
|
Term
| In 70% of patients, __ __ is elevated in the serum, but this finding is not specific to colon cancer. It is not considered an appropriate screening tool, but it can be useful to detect recurrences. |
|
Definition
| CEA (Carcinoembryonic Antigen) |
|
|
