Pathophysiology - GI Patho
what is anorexia? - CORRECT ANSWER-•Lack of desire to eat despite physical
stimuli that would normally produce hunger
•Very nonspecific symptom = can be associated with nausea, abdominal pain,
diarrhea, psychological stress, weight loss. Often caused by medication side effect
what is emesis? - CORRECT ANSWER-•The forceful emptying of the stomach and
small intestine through the mouth --> vomiting
Where is the vomiting center located? - CORRECT ANSWER-medulla
what causes emesis? - CORRECT ANSWER-•Stimulation of vomiting reflex by pain,
distention of stomach or SI, motion sickness, etc
explain the process of emesis: - CORRECT ANSWER-•Begins with deep inspiration
•Glottis closes, intrathoracic pressure falls and esophagus becomes distended
•Abdominal muscles contract to create a pressure gradient from abdomen to thorax
(increases intrathoracic pressure)
•Forces diaphragm into thoracic cavity by these contractions
•Increased pressure opens the UES
•Duodenum and antrum of the stomach produce reverse peristalsis - pressure
gradient forces food up into esophagus
what are the sympathetic inputs of emesis? - CORRECT ANSWER-•Sympathetic
input causes tachycardia, tachypnea and diaphoresis
what are the parasympathetic inputs of emesis? - CORRECT ANSWER-•increases
salivation, increased gastric motility and relaxation of UES and LES
what is the normal frequency of BM? - CORRECT ANSWER-• 1 -3 BM's per day to 1
BM per week
what is primary constipation? - CORRECT ANSWER-•Normal transit - difficulty with
evacuation but normal stool passage (sedentary lifestyle, low fiber diet, low fluid
intake)
•Slow transit - impaired colonic motor activity with infrequent BM's, straining
what is secondary constipation? - CORRECT ANSWER-•caused by diet,
medications, or neurogenic disorders (stroke, MS, etc) in which colonic transit time is
delayed
what are the 3 major mechanisms of diarrhea? - CORRECT ANSWER-osmotic,
secretory, motility
, What is osmotic diarrhea? - CORRECT ANSWER-nonabsorbable substances in the
intestine draws excess water in and increases stool weight and volume
what causes osmotic diarrhea? - CORRECT ANSWER-lactase or pancreatic
enzyme deficiency, tube feedings, dumping syndrome
what is secretory diarrhea? - CORRECT ANSWER-Excessive mucosal secretion of
fluid and electrolytes
what causes secretory diarrhea? - CORRECT ANSWER-•Usually infectious causes
(rotavirus, E Coli, c diff)
what is motility diarrhea? - CORRECT ANSWER-decreased transit time and
absorption for fluids
what causes motility diarrhea? - CORRECT ANSWER-•Caused by resection or
surgical bypass of the small intestine, laxative abuse, hyperthyroidism
what causes dehydration and hypovolemia? - CORRECT ANSWER-digestive tract
disorders, vomiting and diarrhea
what can cause metabolic alkalosis? - CORRECT ANSWER-•Results from loss of
hydrochloric acid with vomiting
what can cause metabolic acidosis? - CORRECT ANSWER-•Diarrhea causes loss of
bicarbonate.
what causes parietal abdominal pain? - CORRECT ANSWER-irritation of fibers that
innervate the parietal peritoneum --> phrenic N. More localized --> usually one sided
what causes visceral abdominal pain? - CORRECT ANSWER-•Arises from a
stimulus acting on an abdominal organ (distention, inflammation, ischemia)
•Pain is usually poorly localized, diffuse or vague with a radiating pattern
•Innervation = vagus nerve
what can cause abnormal salivation? - CORRECT ANSWER-•↑ - inflammation (e.g.
tonsillitis), mechanical irritation
•↓ (xerostomy) - dehydration, Sjögren syndrome (autoimmune destruction),
medications
what can cause abnormal chewing? - CORRECT ANSWER-painful mandibular joint
(disease of the TMJ)
injury of tongue
what is anorexia? - CORRECT ANSWER-•Lack of desire to eat despite physical
stimuli that would normally produce hunger
•Very nonspecific symptom = can be associated with nausea, abdominal pain,
diarrhea, psychological stress, weight loss. Often caused by medication side effect
what is emesis? - CORRECT ANSWER-•The forceful emptying of the stomach and
small intestine through the mouth --> vomiting
Where is the vomiting center located? - CORRECT ANSWER-medulla
what causes emesis? - CORRECT ANSWER-•Stimulation of vomiting reflex by pain,
distention of stomach or SI, motion sickness, etc
explain the process of emesis: - CORRECT ANSWER-•Begins with deep inspiration
•Glottis closes, intrathoracic pressure falls and esophagus becomes distended
•Abdominal muscles contract to create a pressure gradient from abdomen to thorax
(increases intrathoracic pressure)
•Forces diaphragm into thoracic cavity by these contractions
•Increased pressure opens the UES
•Duodenum and antrum of the stomach produce reverse peristalsis - pressure
gradient forces food up into esophagus
what are the sympathetic inputs of emesis? - CORRECT ANSWER-•Sympathetic
input causes tachycardia, tachypnea and diaphoresis
what are the parasympathetic inputs of emesis? - CORRECT ANSWER-•increases
salivation, increased gastric motility and relaxation of UES and LES
what is the normal frequency of BM? - CORRECT ANSWER-• 1 -3 BM's per day to 1
BM per week
what is primary constipation? - CORRECT ANSWER-•Normal transit - difficulty with
evacuation but normal stool passage (sedentary lifestyle, low fiber diet, low fluid
intake)
•Slow transit - impaired colonic motor activity with infrequent BM's, straining
what is secondary constipation? - CORRECT ANSWER-•caused by diet,
medications, or neurogenic disorders (stroke, MS, etc) in which colonic transit time is
delayed
what are the 3 major mechanisms of diarrhea? - CORRECT ANSWER-osmotic,
secretory, motility
, What is osmotic diarrhea? - CORRECT ANSWER-nonabsorbable substances in the
intestine draws excess water in and increases stool weight and volume
what causes osmotic diarrhea? - CORRECT ANSWER-lactase or pancreatic
enzyme deficiency, tube feedings, dumping syndrome
what is secretory diarrhea? - CORRECT ANSWER-Excessive mucosal secretion of
fluid and electrolytes
what causes secretory diarrhea? - CORRECT ANSWER-•Usually infectious causes
(rotavirus, E Coli, c diff)
what is motility diarrhea? - CORRECT ANSWER-decreased transit time and
absorption for fluids
what causes motility diarrhea? - CORRECT ANSWER-•Caused by resection or
surgical bypass of the small intestine, laxative abuse, hyperthyroidism
what causes dehydration and hypovolemia? - CORRECT ANSWER-digestive tract
disorders, vomiting and diarrhea
what can cause metabolic alkalosis? - CORRECT ANSWER-•Results from loss of
hydrochloric acid with vomiting
what can cause metabolic acidosis? - CORRECT ANSWER-•Diarrhea causes loss of
bicarbonate.
what causes parietal abdominal pain? - CORRECT ANSWER-irritation of fibers that
innervate the parietal peritoneum --> phrenic N. More localized --> usually one sided
what causes visceral abdominal pain? - CORRECT ANSWER-•Arises from a
stimulus acting on an abdominal organ (distention, inflammation, ischemia)
•Pain is usually poorly localized, diffuse or vague with a radiating pattern
•Innervation = vagus nerve
what can cause abnormal salivation? - CORRECT ANSWER-•↑ - inflammation (e.g.
tonsillitis), mechanical irritation
•↓ (xerostomy) - dehydration, Sjögren syndrome (autoimmune destruction),
medications
what can cause abnormal chewing? - CORRECT ANSWER-painful mandibular joint
(disease of the TMJ)
injury of tongue
