Motility Disorders of the GI Tract Flashcards Preview

MS2 - Digestive, Endocrine, and Metabolic Systems > Motility Disorders of the GI Tract > Flashcards

Flashcards in Motility Disorders of the GI Tract Deck (30)
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1
Q

Broadly, what causes motility disorder?

A
  • Missing enteric nervous input
  • Disease GI muscles (can be genetic defect or progressive sclerosis)
  • Abnormal pacemaker cells (the interstitial cells of Cajal)
  • CNS disorders
2
Q

Achalasia is __________________.

A

absence of esophageal peristalsis

3
Q

Progressive systemic sclerosis presents with what GI findings?

A

Smooth muscle atrophy (leading to weak peristalsis , GERD, and dysphagia) and gut wall fibrosis

––– predominantly a myopathic process

4
Q

Where are the interstitial cells of Cajal?

A

In the proximal body along the greater curvature of the stomach

5
Q

What is the role of the fundus?

A

It relaxes in response to food intake, thus allowing you to eat a big meal.

6
Q

Which part of the stomach does the processing?

A

The distal stomach, near the antrum

7
Q

What nerve mediates receptive relaxation and distal grinding?

A

The vagus nerve (in response to LES relaxation); hence, patients with vagotomies often have failure of gastric accommodation.

8
Q

Define gastroparesis.

A

(n.) stomach paralysis; can be caused by muscle weakness or obstructive disorders

9
Q

What percent of radiolabeled EggBeaters is considered abnormal retention?

A
  • Greater than 60% at two hours

- Greater than 10% at four hours (greater than 35% is considered severe)

10
Q

What is the hallmark of GI motility disorders?

A

Intestinal pseudo-obstruction – signs/symptoms of intestinal obstruction without a lesion obstructing flow of intestinal contents

11
Q

What major small intestine complication should you worry about in someone with chronic intestinal pseudo obstruction?

A

Stasis can lead to bacterial overgrowth, which can lead to malabsorption, fermentation

12
Q

CIPO has a ___________ prognosis in children. What usually causes it?

A

poor (1/3 die before age 1!); it is generally congenital

13
Q

Low-amplitude contractions in the colon produce ________________.

A

mixing

14
Q

High-amplitude contractions in the colon produce _______________.

A

propulsion

15
Q

Describe the process of Sitz markers.

A

You give someone a capsule containing 24 radio opaque capsules and then x-ray their abdomen five days later; less than five markers is considered normal. It is used to evaluate colonic transit.

16
Q

What causes Hirschsprung’s?

A

Congenital absence of the myenteric neurons of the distal colon, resulting in absence of the inner-anal sphincter reflex. (It’s normally supposed to relax in response to arrival of feces.)

17
Q

Small frequent meals low in insoluble fiber and fats is a treatment for ________________.

A

gastroparesis

18
Q

Describe the setup for recording esophageal manometry.

A

It is a nasogastric catheter placed down the esophagus that records pressure every one centimeter while the patient swallows water.

19
Q

Achalasia results from ________________.

A

inflammatory destruction of the myenteric nerve plexus of the esophagus – predominantly the nitric-oxide-producing inhibitory neurons (sparing the cholinergic excitatory)

20
Q

True or false: achalasia usually presents suddenly.

A

False. The progression is gradual, with many patients not seeking treatment until years of symptoms.

21
Q

What percent of patients with scleroderma have GI involvement?

A

90

22
Q

How can you resolve scleroderma and achalasia?

A

Those with scleroderma usually have a weak LES pressure, while those with achalasia have a normal or even overactive LES pressure.

23
Q

Contrast the roles of the proximal and distal portions of the stomach.

A

Proximal: relaxes in response to filling so as to accommodate meals

Distal: contracts to mechanically grind food; empties into the duodenum

24
Q

What are some classic causes of gastroparesis?

A
  • Vagotomy
  • Diabetes (autonomic neuropathy)
  • Medications
  • Neurologic disorders (MS, Parkinson’s, stroke)
25
Q

True or false: the MMC phases occur in transplanted small bowel.

A

True. Only the enteric nervous system is needed; extrinsic innervation (i.e., the vagus nerve) is not needed

26
Q

Chagas disease (Trypanosoma infection) can lead to what bowel problem?

A

Chronic intestinal pseudo-obstruction

27
Q

Most of the colonic contractions are which type of movement?

A

Segmental (95%)

Peristaltic (5%)

28
Q

The _____________ reflex is lost in those with Hirschsprung’s.

A

internal anal sphincter relaxation

29
Q

What is the characteristic pattern of neuropathic small-bowel disorders?

A

Normal amplitude contractions, but uncoordinated

Increased frequency of MMC

30
Q

Biofeedback therapy is helpful for ____________.

A

dyssynergia

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