Thema 4: Tractus Digestivus. Een complete samenvatting van alle tentamenstof!
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Grado
GNK 2.1 Thema 4 Tractus Digestivus
Institución
Rijksuniversiteit Groningen (RuG)
Op aanraden van mijn medestudenten verkoop ik nu mijn samenvattingen! In deze samenvatting maak ik veel gebruik van afbeeldingen, tabellen en opsommingen. Hierdoor hoef je geen lange lappen saaie en ingewikkelde tekst te lezen. In deze samenvatting staat alle stof van de boeken, colleges en leerdoe...
,Content
Week 12: Difficulty swallowing ............................................................................................................... 6
Anatomy .............................................................................................................................................. 6
The cranial nerves ........................................................................................................................... 6
The neck .......................................................................................................................................... 7
The nasal cavity ............................................................................................................................. 11
The oral cavity ............................................................................................................................... 11
The pharynx ................................................................................................................................... 13
The larynx ...................................................................................................................................... 16
Physiology.......................................................................................................................................... 18
Swallowing..................................................................................................................................... 18
Phonation ...................................................................................................................................... 19
Common disorders of the neck ......................................................................................................... 22
Pharynx .......................................................................................................................................... 22
Larynx ............................................................................................................................................ 23
Oesophagus ................................................................................................................................... 25
Malignancy of the upper digestive tract ........................................................................................... 28
Radiotherapy in head-and-neck cancer ............................................................................................ 29
Radiation ....................................................................................................................................... 29
Treatment ...................................................................................................................................... 29
Toxicity .......................................................................................................................................... 29
Prevention ..................................................................................................................................... 29
Nutrition ............................................................................................................................................ 31
Cachexia......................................................................................................................................... 32
Sarcopenia ..................................................................................................................................... 32
Sarcopenic obesity......................................................................................................................... 33
Nutritional screening tools ............................................................................................................ 34
Nutritional assessment .................................................................................................................. 35
Treatment ...................................................................................................................................... 35
Week 13: Heartburn .............................................................................................................................. 36
Gastroesophageal reflux ................................................................................................................... 36
Stomach pain ................................................................................................................................. 36
Disorders of the oesophagus............................................................................................................. 37
GORD ............................................................................................................................................. 38
Hiatus hernia ................................................................................................................................. 38
Barrett oesophagus ....................................................................................................................... 38
2
, Candida oesophagitis .................................................................................................................... 40
Achalasia ........................................................................................................................................ 40
Haemorrhage................................................................................................................................. 40
Oesophageal tumours ................................................................................................................... 41
Disorders of the stomach .................................................................................................................. 42
Dyspepsia....................................................................................................................................... 42
Helicobacter pylori ........................................................................................................................ 42
Bleeding in the stomach ................................................................................................................ 44
Gastric tumours ............................................................................................................................. 44
Disorders of the pancreas ................................................................................................................. 46
Pancreatitis .................................................................................................................................... 46
Disorders of the small intestine ........................................................................................................ 47
Coeliac disease .............................................................................................................................. 47
Irritatable bowel syndrome ........................................................................................................... 47
Short intestine disease .................................................................................................................. 48
Embryology........................................................................................................................................ 49
The foregut .................................................................................................................................... 52
Anatomy ............................................................................................................................................ 56
Peritoneal cavity ............................................................................................................................ 56
The stomach .................................................................................................................................. 57
The duodenum .............................................................................................................................. 57
Pancreas ........................................................................................................................................ 58
Spleen ............................................................................................................................................ 58
Arterial supply to the abdominal viscera ...................................................................................... 60
Venous drainage ............................................................................................................................ 62
Veins of the abdomen ................................................................................................................... 63
Hepatic portal system of veins ...................................................................................................... 64
Pharmacology .................................................................................................................................... 65
The stomach wall........................................................................................................................... 65
Cytochrome P450 enzymes (CYP450) ........................................................................................... 65
Drugs to treat gastric problems..................................................................................................... 66
Gastric protective therapy............................................................................................................. 69
Week 14: Jaundice................................................................................................................................. 70
Anatomy ............................................................................................................................................ 70
Histology ............................................................................................................................................ 71
The liver ......................................................................................................................................... 71
3
, Vasculature of the liver ................................................................................................................. 71
Histological structure of the liver .................................................................................................. 73
The hepatocyte and vascular sinus ............................................................................................... 75
Bile ducts ....................................................................................................................................... 76
Physiology.......................................................................................................................................... 78
The liver ......................................................................................................................................... 78
The gall bladder ............................................................................................................................. 81
Bilirubin ......................................................................................................................................... 82
Diagnostics in liver problems ............................................................................................................ 84
Physical examination ..................................................................................................................... 84
Imaging for the hepatobiliary and pancreatic region.................................................................... 85
Disorders of the liver and bile ducts.................................................................................................. 86
Hepatitis ........................................................................................................................................ 86
Cirrhosis ......................................................................................................................................... 87
Liver failure .................................................................................................................................... 89
Alcoholic liver disease and non-alcoholic steatohepatitis (NASH) ................................................ 90
Cholecystolithiasis and choledocholithiasis .................................................................................. 91
Cholangitis ..................................................................................................................................... 92
Primary sclerosing cholangitis ....................................................................................................... 93
Primary biliary cirrhosis ................................................................................................................. 94
Carcinoma of the pancreas............................................................................................................ 95
Week 14: Blood in the stool .................................................................................................................. 97
Architecture and function ................................................................................................................. 97
Layers of the digestive tract .......................................................................................................... 97
Digestive enzymes and juices ............................................................................................................ 98
Absorption of nutrients: in small intestine by enterocytes............................................................... 99
Regulation of the gastrointestinal tract .......................................................................................... 101
Digestive hormones ..................................................................................................................... 101
Digestive organs and their function ................................................................................................ 102
Small intestine ............................................................................................................................. 102
Large intestine ............................................................................................................................. 103
Disorders of the gut ......................................................................................................................... 104
Inflammatory bowel disease (IBD) .............................................................................................. 104
Haemorrhoids .............................................................................................................................. 104
Perianal abcess ............................................................................................................................ 105
Perianal fistula ............................................................................................................................. 106
4
, Anal fissure .................................................................................................................................. 106
Sinus pilonidalis ........................................................................................................................... 106
Anal carcinoma ............................................................................................................................ 107
Colorectal polyps ......................................................................................................................... 108
Colorectal adenocarcinoma ........................................................................................................ 109
Diverticulosis vs diverticulitis ...................................................................................................... 112
Diarrhoea ..................................................................................................................................... 112
Stoma............................................................................................................................................... 114
Complications .............................................................................................................................. 115
Secondary prevention ..................................................................................................................... 116
Test properties ............................................................................................................................ 116
Advantages and disadvantages of screening .............................................................................. 117
Criteria for introducing a screening program .............................................................................. 118
Screening programs in the Netherlands...................................................................................... 118
5
,Week 12: Difficulty swallowing
Anatomy
The cranial nerves
Number Nerve
I Olfactory
II Optic
III Oculomotor
IV Trochlear
V Trigeminal
VI Abducens
VII Facial
VIII Vestibulocochlear
IX Glossopharyngeal
X Vagus
XI Accessory
XII Hypoglossal
6
,The neck
Anterior cervical region
Sternocleidomastoid region
Lateral cervical region
Posterior cervical region
Muscles of the neck
Suprahyoid muscles: raise hyoid bone towards a stabilised mandible during swallowing
Infrahyoid muscles: depress the hyoid bone and larynx during swallowing and vocalisation
➔ Extrinsic muscles of the larynx →
7
, Nerves
8
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