OMS Ostomy Management Specialist Certification Exam

Four layers of the GI tract - answer-mucosa, submucosa, muscle, serosa Which nervous system controls the alimentary canal - answer-Autonomic nervous system Which nervous system causes increase in digestive activity - answer-parasympathetic nervous system What does the sympathetic nervous system control - answer-sphincter muscles and movement within the alimentary canal. This also assists with an inhibitory effect that provides the ability to remain continent by sphincter control Sphincter at end of esophagus to stomach - answer-LES- Lower esophageal sphincter Four regions of the stomach - answer-Cardia, fundus, body, and pyloric Sphincter from stomach to small intestine - answer-pyloric sphincter First section past esophagus in stomach - answer-Cardia Area in stomach where food is stored temporarily - answer-Fundus The main region in the stomach - answer-The body The area of stomach with large muscle that controls emptying into small intestine - answer-Pyloric region What cells secrete pepsinogen? - answer-Chief cells of the stomach What cells secrete hydrochloric acid in stomach? - answer-Parietal cells What mixes to form Pepsin in the stomach? - answer-Pepsinogen and hydrochloric acid How much gastic fluid is produced by the stomach daily? - answer-2-3L Measurements of small intestines - answer-18-20 feet, 2.5 cm in diameter Majority of what occurs in small intestines - answer-Chemical digestion, nutrient absorption sections of small intestine - answer-duodenum, jejunum, ileum What increases surface area of small intestines - answer-Intestinal villi What is the purpose of intestinal villi? - answer-increasing surface area to absorb more nutrients The shortest section of the small intestine. - answer-duodenum The longest section of the small intestines - answer-Ileum Section of small intestine with only receptors for Vit B12 and bile salts - answer-Ileum Junction from small intestine and large intestines - answer-Ileocecal valve Two movements of the small intestines - answer-Mixing and propulsive movement Mixing movement of small intestines - answer-Churns food but also slightly propels it Propulsive movements - answer-Primary push of the food through the alimentary canal towards the anus but also spreads it out for allowing the digestive enzymes to mix with it Mixing movements - answer-Also known as the segmental contractions Mixing movements main function - answer-To churn the chyme with intestinal enzymes and mechanically break down some particles Segmental contractions do what? - answer-Enhance the amount of time the chyme is exposed to the villi for absorption Peristaltic waves - answer-Wave-like motions with a movement from the upper to the lower GI system Large intestines - answer-AKA colon; begins at ileocecal valve and ends at anus measurements of the large intestine - answer-Colon is 5-6 ft in length, 2.5-5.5 cm in diameter, largest at the cecum Functions of the large intestines - answer-Fecal material formation, fluid absorption What makes up fecal waste - answer-Bile pigment, mucus, undigested fats, cellulose, protein, desquamated cells, electrolytes, water, undigested foods What exists in the colon and not in the small intestine and is responsible for odor of fecal materials - answer-bacteria sections of large intestine in order - answer-cecum, ascending colon, transverse colon, descending colon, sigmoid colon, rectum What makes up gas in body - answer-Swallowed air and bacteria in colon Types of movement of large intestines - answer-Peristaltic movement, segmental movement, and mass movement Peristaltic movement - answer-Pushes the fecal material through the colon Segmental movements - answer-Provides continuous motion that allows for continuous absorption of water and electrolytes Mass movement - answer-Occurs when the left side off the colon contracts and thrusts the fecal material into the rectum to be emptied through defecation, the evacuation of fecal movement of bowel movement. An urge to defecate occurs when the ingested food reaches the rectum, resulting in pressure changes and voluntary sphincter reflex action Stool consistency - ascending colon - answer-High volume and liquid-mushy (similar to ileostomy) Stool consistency-transverse colon - answer-semi-solid; mush or paste consistency Stool consistency- descending colon - answer-formed and solid Stool consistency- sigmoid colon/rectum - answer-hard, solid stool Functions of the GI system - answer-1. GI motility 2. Provide digestive enzymes 3. Digest nutrients 4. Absorb nutrients 5. Expel waste and nutrients that were unused/unneeded 6. Maintain balance of fluids and electrolytes Four stages of wound healing - answer-1. Hemostasis 2. Inflammation (Defensive) 3. Proliferation 4. Maturation Three types of wound closure - answer-1. Primary 2. Secondary 3. Tertiary (Delayed primary) GI ostomies are classified by what? - answer-1. The segment of the intestine or colon used to form the stoma 2. Continence status What is a cecostomy used for? - answer-Antegrade enema or cecal decompression Largest/widest segment of the colon - answer-Transverse What are the most common types of GI ostomies? - answer-Descending and sigmoid colostomy What section of colon can an ostomy start producing regulated evacuation? - answer-Descending and sigmoid colostomy Brooke ileostomy - answer-A permanent, end ileostomy Patients with ileostomies often require what supplement? - answer-Vitamin B12 What is an end stoma? - answer-1. Fecal evacuation occurs at this type of stoma 2. Distal portion of the remaining intestines either removed or sewn shut Hartmann's pouch - answer-1. A section of distal intestine whose proximal end is closed off and left within the peritoneal cavity, is contiguous with the rectum and anus 2. Can be used to reconnect to the proximal intestines at later date during ostomy "takedown" What continues to be produced and expelled from remaining intestines and colon beyond a stoma even if closed or not connected after surgery? - answer-Mucous loop stoma - answer-A segment or loop of intestines is used to form this stoma, therefore the intestine remains intact Loop stoma has what? - answer-A rod or support device sutured in place to hold the loop at surface or skin Loop stoma has what? - answer-Two openings- a proximal and distal What comes from the proximal opening of a loop stoma? - answer-Effluent (Proximal=poop) What comes from the distal opening of a loop stoma? - answer-Mucous Most loop stomas are considered what? - answer-Temporary procedures How long is a rod left in place in a loop stoma creation? - answer-1. As long as surgeon says so 2. Until the ostomy wall becomes adherent to the surrounding wall of abdomen Double-barrel stoma - answer-Both the proximal and distal ends of the intestines are pulled through the abdominal wall after the diseased intestines are removed Double-barrel stoma - answer-Two stomas side by side or apart: -Distal: mucous fistula -Proximal: stool Why is small amount of bleeding normal on a stoma? - answer-The mucous lining that is exposed is highly vascular and now exposed A pale pink stoma may indicate? - answer-Anemia or low HgB (GI stoma only, not urinary stoma) A dusky, d