What are the clinical manifestations of GI dysfunctions?
Anorexia Vomiting Constipation Diarrhea Abdominal Pain GI bleeding
What is anorexia?
lack of desire to eat despite physiological need or stimuli; accompanies other disorders
What is anorexia often associated with?
- nausea
- abdominal pain
- indigestion
- diarrhea
What is involved in the process of vomiting?
Vomiting is the result of REVERSE PERISTALSIS
- Somatomotore signals from vomiting centre are sent causing abdominal PRESSURE, RESPIRATION to STOP, LES (lower esophageal sphincter) RELAXATION, and CLOSURE of the GLOTTIS and SOFT PALATE
What is vomiting initiated by?
- various drugs
- trauma or torsion of the ovaries, testes, uterus, bladder, kidney, GI, brain
- activations of the medullary centre
What part of the brain initiates vomiting?
Medullary centre
What can cause infrequent defecation or constipation?
personal habits various disorders drugs inadequate fluid intake muscle weakness
What is most often the main concern about prolonged diarrhea?
DEHYDRATION
What are some kinds of abdominal pain?
- mechanical (stretching) from inflammation or ishemic causes
- parietal pain more localize, intense
visceral pain usually diffus, vague - referred pain usually well localized felt in skin or deep tissue that share afferent nervous pathways
What is visceral pain?
usually diffuse, vague
closely connected to ANS; thus associated with pallor, sweating, nausea, vomiting
What is parietal pain?
more localized, intense pain
What is referred pain?
usually well localized, felt in skin or deeper tissues (that share afferent nervous pathway)
Define hematemesis.
bloody vomit- fresh bright red or coffee-ground (digested) appearence
Define melena.
tarry, foul-smelling stool (due to digested blood)
Define hematochezia.
fresh, bright red blood (Frank) from rectum
Define occult blood.
trace amounts in stool or gastric secretions (detected in a lab)
Are GI bleeds life threatening?
ACUTE SEVERE GI bleeds can be life threatening
When there is massive amount of blood loss due to GI bleeds what does it effect?
- HR & BP changes
What happens when blood accumulates in the GI tract?
vomiting and diarrhea
Define deglutiition.
swallowing
When you swallow what happens?
The soft palate and uvula block the nasal passages
The epiglottis protects the airway
What are the layers of the esophagus?
starting from the outside... ADVENTITIA MUSCULARIS EXTERNA SUBMUCOSA MUCOSA
Define DYSPHAGIA.
DIFFICULTY SWALLOWING
- commonly described as food sticking or lodging in the chest
-
What CAUSES dysphagia?
- lack of salivary secretions (dehydration)
- esophageal obstruction
- impaired esophageal motility
- neural or muscular disorders
Define achalasia.
severely impaired lower esophageal peristalsis and sphincter function (impairs food and fluid movement)
- Loss of inhibitory neurons that mediate the lower esophageal sphincter, preventing relaxation. Leads to pain after swallowing and regurgitation.
Define stricture.
limit or constriction
What causes achalasia?
Loss of inhibitory neurons that mediate the lower esophageal sphincter, preventing relaxation.
What are symptoms of achalasia?
Leads to pain after swallowing and regurgitation.
What is a hiatal hernia?
Protrusion of upper part of stomach into thoracic cavity through esophageal hiatus
What is the esophageal hiatus?
the opening of the diaphram
What are the symptoms of hiatal hernias?
Often asymptomatic but can lead to: GER, esophagitis, dysphagia, regurgitation
What is GERD?
Gastroesophageal reflux disease (GERD) is when there is regurgitation of chyme to esophagus
What are the symptoms of GERD?
- regurgitation of chyme to esophagus causing heart burn, upper abdominal pain within 1hour after eating
- symptoms worsen when lying down or with increased intra-abdominal pressure
What are some rare complications of GER?
esophagitis, cancer, trigger asthmatic attach, strictures, esophageal spasm, decrease esophageal motility
How does reflux esophagitis present?
- lots of eosinophils in superficial portion of the mucosa
- stratified squamous epithelium has not under gone complete maturation due to ongoing inflammatory damage
What is the max capacity of the stomach?
4L
start on slide 40