Oral cancer can occur where?
Lips, gums, inside structures of the mouth
Risk factors for oral cancer
Smoking, chewing tobacco, HPV infection
Pathophysiology of Oral Cancer
Leukoplakia (white plaque under tongue or on cheek, often precancerous lesion)
Malignant transformation (in about 20%)
Erythroplasia (red mucousal plaque, no signs of inflammation)
Cleft Lip and Palate
Congenital splitting or defect in integrity of lip; with or without splitting of the plane
Pathophysiology of Cleft Lip
Disfigurement causes varying degrees of impairment
Risk of aspiration increased
Clinical Manifestations of Cleft Lip
Facial deformity, difficult feeding
Delayed development of teeth and speech
Types of Esophageal Alterations
GERD
Esophageal cancer
Achalasia
Esophageal Atresia
GERD
Gastroesophageal Reflux Disease:
Regurgitation of gastric contents into the esophagus
Pathophysiology of GERD?
Incompetent lower esophageal sphincter (cardiac) causes Hiatal hernia (stomach protrudes back into esophagus)
Esophageal mucosa injury
Risk Factors for Esophageal Cancer
Alcohol, tobacco, males over age 50
Barrett esophagus
Esophageal adenocarcinoma
Normal esophageal lining replaced by abnormal epithelium
Clinical Manifestations of Esophageal Cancer
Dysphagia
Weight loss, pain, fatigue
Achalasia
Inability of the cardiac sphincter to relax
Abscence of esphageal peristalsis
Food is retained
Hypertrophy and dilation of lower esophagus
Symptoms of Achalasia
Dysphagia
Vomiting
Pain
Esophageal Atresia
Congenital concurrent abnormality of trachea
Esophagus ends in blind pouch or fistula from trachea to stomach
Clinical Manifestations of Esophageal Atresia
Aspiration of gastric contents into respiratory system
Abdominal distension
Coughing and cyanosis with feeding
Recurrent pneumonia
Alterations in the Stomach and Duodenum
Gastritis
Peptic Ulcer Disease
Stomach Cancer
Hypertrophic pyloric stenosis
Gastritis
Inflammation of gastric mucosa
Risk Factors for Gastritis
Cigarettes, alcohol, spicy foods, caffeine, aspiring, NSAIDs
Pathophysiology of Gastritis
Increased acid and pepsinogen
Superficial erosion of surface epithelium (usually regenerates)
Manifestations of Gastritis
Heart burn, hematemesis (blood in vomit), scarring (risk for cancer)
Peptic Ulcer Disease
Chronic inflammatory disorder causes by erosion by acid and pepsin
Risk Factors for Peptic Ulcer Disease
Helicobacter pylori (H. pylori)
Chronic use of aspirin or NSAIDS
Zollinger-Ellison syndrome
Effects of H. pylori
Increases gastric acid production and produces cellular injury
Ulcerative lesions
Blood vessel erosion
Pathophysiology of Peptic Ulcer Disease
Inflammatory damage to mucosa
May cause peritonitis
What is peritonitis?
Perforation of the bowel, bacteria enter abdominal cavity
Stomach Cancer Risk Factors
Dietary preservatives, recurrent gastritis, genetics
Hypertrophic pyloric stenosis
Genetic in infants
Obstruction of gastric outlet resulting from hypertrophy of musculature surrounding pylorus
Symptoms of Hypertrophic pyloric stenosis
Projectile vomiting within 3-10 weeks of birth
No bile in emesis
Inflammation Disorders of SI and LI
Gastroenteritis
Inflammatory Bowel Disease
Ulcerative colitis
Irritable Bowel Syndrome
Diverticular Disease
Gastroenteritis (Infectious Enterocolitis) is also known as...
The "stomach flu
Gastroenteritis is caused by...
Bacterial toxins or irritants in food
Clostridium difficile
Loss of normal flora due to antibiotic therapy. C. diff flourishes and overtakes GI
Inflammatory Bowel Disease
Crohn's diease
Cobblestone appearance
Ulcerative colitis
Starts lower in rectum, ascends to colon
Inflammatory lesions become necrotic and fill with exudate
Irritable Bowel Syndrome
Combination of chronic and recurrent intestinal symptoms not explained by structural or chemical problems
Clinical Manifestations of Irritable Bowel Syndrome
Increased motility and intestinal contractions cause uncontrollable diarrhea
Persistent and recurrent abdominal pain relieved by defecation
2 types of Diverticular disease
Diverticula: out-pouching or ballooned segments of colon, caused by pressure of bowel movement
Diverticulitis: inflamed pouches
Hemorrhoids
Dilations of venous plexus, varicose veins of rectum
Types of Obstructive Disorders
Paralytic Ileus
Hirschprung's Disease
Mechanical Obstruction
Intestinal Ischemia or Infarction
Paralytic ileus
Functional bowel obstruction
Lack of neural stimuli (d/t anesthesia) leads to mechanical obstruction (stool build-up)
Hirschprung's Disease
Congenital lack of colonical innervations
2 Types of Mechanical Obstruction
Intussesception: bowel folds over on itself
Volvulus: bowel twists around itself, cuts of blood supply
Intestinal Ischemia or Infarction
Lack of oxygen supply to intestine d/t clot, obstruction
Hernia
Abdominal wall defect, protrusion of stomach or intestinal wall through defect/weakened area
2 types of hernias
Intermittent: can be reduced by pushing back in
Strangulated: tight section of bowel can't be pushed back in
Disorders of Intestinal Absorption
Celiac Disease
Malabsorption Syndromes
Celiac Disease
Inappropriate T-cell response against gluten (wheat, rye, barley)
Intense inflammatory reaction results in loss of absorptive villi
Impaired nutrient absorption
Main type of malabsorption syndrome
Lactose Intolerance (congenital or secondary)
Pathophysiology of lactose intolerance
-Carbs malabsorption results in lack of carbs in blood
-Carbs accumulate in lumen of bowel
-Excess carbs act as osmotic gradient to pull water into bowel
-Watery Diarrhea results
Colorectal Cancer
Dietary: High fat, low fiber intake
Polyps: growth protruding into intestine
Hormone effects of Anorexia nervosa
Female: decreased estrogen (d/t depleted fat stores) may lead to absence of menstruation
Male: fluctuating testosterone levels
Other manifestations of Anorexia nervosa
-Reduced thyroid function causes dry skin and hair
-Electrolyte imbalances (low potassium) causes cardiac rhythm problems
-Ketoacidosis from increased breakdown of fat as fuel
-Renal failure due to BUN elevation
-Anemia
Complications of Bulimia nervosa
Dental Disorders
Esophagitis
Hypokalemia
Metabolic Alkalosis
Pancreatitis
Acute or chronic inflammation of pancreas
Causes of Pancreatitis
Obstruction of pancreatic ducts
Often alcohol related