NURS
5315
GI
Module
9,
exam
5
Upper
GI
organs
-
ANS
mouth,pharynx,
esophagus,
stomach,
and
duodenum
Lower
GI
organs
-
ANS
small
intestine,
large
intestine,
rectum
and
anus
Hepatoportal
circulation
-
ANS
hepatic
artery
receives
oxygenated
blood
from
the
inferior
mesenteric,
gastric,
and
cystic
veins.
The
hepatic
portal
vein
receives
deoxygenated
blood
from
the
inferior
and
superior
mesenteric
vein
and
splenic
vein
and
delivers
nutrients
that
have
been
absorbed
from
the
intestinal
system
Osmotic
diarrhea
-
ANS
Caused
by
the
presence
of
a
nonabsorbable
substance
in
the
intestines.
This
pulls
water
by
osmosis
into
the
intestinal
lumen
and
results
in
large
volume
diarrhea.
This
is
how
mag
citrate,
lactulose
and
miralax
work.
Causes
include:
excessive
ingestion
of
nonabsorbable
sugars,
tube
feedings,
dumping
syndrome,
malabsorption,
pancreatic
enzyme
deficiency,
bile
salt
deficiency,
small
intestine
bacterial
overgrowth
or
celiac
disease
Secretory
diarrhea
-
ANS
Results
in
large
volume
losses
secondary
to
infectious
causes
such
as
rotavirus,
bacterial
enterotoxins,
or
c-diff.
Motility
diarrhea
-
ANS
AKA
short
bowel
syndrome.
Results
from
resection
of
small
intestine
or
surgical
bypass
of
small
intestine,
IBS,
diabetic
neuropathy,
hyperthyroidism,
and
laxative
abuse.
Fatty
stools
and
bloating
are
common
in
malabsorption
syndrome.
Complications
include:
dehydration,
electrolyte
imbalance,
metabolic
acidosis,
weight
loss
and
malabsorption.
Upper
GI
bleed
-
ANS
bleeding
that
occurs
in
the
esophagus,
stomach
or
duodenum
commonly
caused
by
bleeding
varices,
peptic
ulcers
or
Mallory-Weiss
tear(tearing
of
esophagus
from
stomach)
Characterized
by
frank,
bright
red
or
coffee
ground
emesis.
Lower
GI
bleed
-
ANS
Bleeding
in
the
jejunum,
ileum,
colon
or
rectum
from
inflammatory
bowel
disease,
cancer,
diverticula
or
hemorrhoids.
Hematochezia,
or
the
presence
of
bright
red
blood
in
the
stools,
suggest
what
kind
of
bleed
Peptic
Ulcer
Disease
-
ANS
Is
a
break
in
the
integrity
of
the
mucosa
of
the
esophagus,
stomach
or
duodenum
resulting
in
exposure
of
the
tissue
to
gastric
acid.
Risk
factors
include
smoking,
advanced
age,
NSAID
use,
ETOH,
chronic
disease,
acute
pancreatitis,
COPD,
obesity,
socioeconomic
status,
gastrinoma,
and
infection
with
Helicobacter
pylori.
S&S:
Epigastric
pain
is
worse
with
eating,
melena
or
hematemesis
Duodenal
ulcers
-
ANS
most
common
and
tend
to
develop
in
younger
patients.
S&S:
epigastric
pain
that
is
relieved
by
food.
Patients
may
have
melena(black
and
tarry
stool)
or
hematemesis Ulcerative
colitis
(UC)
-
ANS
Inflammatory
disease
of
the
large
instestine
in
persons
20-40y/o.
Less
common
in
people
who
smoke.
Has
periods
of
remission
and
exacerbations.
Characterized
by
inflammation
and
ulcerations
that
remain
superficial
and
in
the
small
intestine.
UC
S&S
-
ANS
recurrent
diarrhea,
bloody
stools,
febrile,
polyarthritis,
uveitis,
sclerosing
cholangitis,
erythema
nodosum
and
pyoderma
gangrenosum
UC
complications
-
ANS
fissures,
hemorrhoids,
perirectal
abscess,
toxic
megacolon,
colon
perforation,
and
colorectal
adenocarcinoma.
Increased
risk
of
VTE
and
microthrombi,
and
colon
cancer
Crohn's
disease
-
ANS
Chronic
inflammatory
disorders
that
can
affect
any
portion
of
the
GI
tract
but
most
often
in
the
ileum
and
proximal
colon.
Affects
persons
in
their
20-30s
and
of
jewish
decent.
CARD15/NOD2
gene
mutation
commonly
associated.
Crohn's
disease
risk
factors
-
ANS
smoking,
family
history,
Jewish
decent,
age
less
than
40,
slight
predominance
in
women
and
altered
gut
microbiome.
Crohn's
disease
patho
-
ANS
includes
trasmural
involvement
of
the
affected
area(entire
wall
of
intestine
is
affected)
and
the
presence
of
skip
lesions.
Disease
progression
may
lead
to
abscess
formation
in
GI
tract.
Possible
causes
include
infectious
agents,
autoimmune,
psychosomatic,
impaired
T-cell
immunity
Crohn's
disease
S&S
-
ANS
abd
pain,
diarrhea,
dehydration,
bloody
stools,
malabsorption,
malnutrition,
weight
loss,
intestinal
obstruction
from
chronic
inflammation,
fistulas
and
perforation
of
the
intestine
Diverticular
disease
-
ANS
Characterized
as
the
presence
of
diverticula
in
the
large
intestine.
Risk
factors
include
older
age,
genetic
predisposition,
obesity,
smoking,
diet,
lack
of
exercise,
ASA
and
other
NSAIDS,
altered
DI
microbiome
and
abnormal
colonic
peristalsis
Diverticulosis/Diverticulitis
-
ANS
outpouchings
of
mucosa
from
the
muscle
layer
of
the
intestine
that
protrude
into
the
intestinal
lumen
most
commonly
in
the
sigmoid
colon.
Diverticulosis
is
the
presence
of
diverticula
in
an
asymptomatic
person.
Diverticulitis
is
an
inflammation
of
diverticula
and
cause
LLQ
pain.
Results
in
abscess
formation,
rupture
and
peritonitis
Appendicitis
-
ANS
Inflammation
of
the
appendix
usually
in
persons
10-19.
S&S:
periumbilical
pain,
RLQ
pain,
nvd,
anorexia.
Pain
may
initially
be
epigastric
or
periumbilical
then
settle
in
RLQ.
Perforation,
peritonitis
and
abscess
formation
are
all
potential
complications
Small
bowel
obstruction
-
ANS
Most
commonly
caused
by
postop
adhesions,
tumors,
Crohn's
disease,
hernias
and
intussusception.
Causes
distention
2ndary
to
impaired
absorption
and