The ____ functions primarily as a conduit for passage of food and liquid from the pharynx to the stomach.
esophagus
____ anomalies of the esophagus require early detection and correction because they are incompatible with life.
Congenital
____ can result from disorders that produce narrowing of the esophagus, lack of salivary secretion, weakness of the muscular structures that propel the food bolus, or neural networks coordinating the swallowing mechanism.
Dysphagia
____ is characterized by a protrusion of the stomach through the esophageal hiatus of the diaphragm.
Hiatal hernia
The most frequent symptom of _____ is heartburn.
GERD
There is considerable evidence linking gastroesophageal reflux with _____.
asthma
_____ involves mucosal injury to the esophagus, hyperemia, and inflammation.
Reflux esophagitis
Symptoms of the reflux esophagitis in an ____ include evidence of pain when swallowing, hematemesis, and anemia due to esophageal bleeding, heartburn, irritability, and sudden or inconsolable crying.
infant
Most squamous cell esophageal carcinomas are attributable to ____ and _____ use.
alcohol, tobacco
The stomach lining usually is ____ to the acid it secretes, a property that allows the stomach to contain acid and pepsin without having its wall digested.
impermeable
The ____ are thought to exert their effects through improved mucosal blood flow, decreased acid secretion, increased bicarbonate ion secretion, and enhanced mucus production.
prostaglandins
_____ refers to inflammation of the gastric mucosa.
Gastritis
____ is the most commonly associated with local irritants such as aspirin or other nonsteroidal anti-inflammatory agents, alcohol, or bacterial toxins.
Acute gastritis
_____ is denoted by the absence of grossly visible erosions and the presence of chronic inflammatory changes leading eventually to atrophy of the glandular epithelium of the stomach.
Chronic gastritis
Autoimmune gastritis results from the presence of ____ to components of gastric gland parietal cells and intrinsic factor.
autoantibodies
_____ is a term used to describe a group of ulcerative disorders that occur in areas of the upper gastrointestinal tract that are exposed to acid-pepsin secretions.
Peptic ulcer
The most common complications of peptic ulcer are ____, perforation and penetration, and gastric outlet ____.
hemorrhage, obstruction
Laboratory findings of hypochromic anemia and occult blood in the stools indicate _____.
bleeding ulcers
_____ is the major physiologic mediator for hydrochloric acid secretion.
Histamine
Persons at high risk for development of _____ include those with large-surface area burns, trauma, sepsis, acute respiratory distress syndrome, severe liver failure, and major surgical procedures.
stress ulcers
Gastric ____ is the second most common tumor in the world.
carcinoma
____ is a functional gastrointestinal disorder characterized by a variable combination of chronic and recurrent intestinal symptoms not explained by structural or biochemical abnormalities.
Irritable bowel syndrome
The term inflammatory bowel disease is used to designated two related inflammatory intestinal disorders: _____ disease and _____.
Crohn, ulcerative colitis
_____ disease is a recurrent, granulomatous type of inflammatory response that can affect any area of the gastrointestinal tract.
Crohn
Ulcerative colitis is confined to _____ and _____.
colon, rectum
_____ deficiencies are common in Crohn disease because of diarrhea, steatorrhea, and other malabsorption problems.
Nutritional
Characteristic of ulcerative colitis are the lesions that form in the crypts of ____ in the base of the mucosal layer.
Lieberkuhn
_____ of the colon is one of the feared complications of ulcerative colitis.
Cancer
The complications of ____ result from massive fluid loss or destruction of intestinal mucosa.
bacterial enterocolitis
____ is a condition in which the mucosal layer of the colon herniated through the muscularis layer.
Diverticulosis
____ is a complication of diverticulosis in which there is inflammation and gross or microscopic perforation of the diverticulum.
Diverticulitis
The pain associated with _____ is caused by stretching of the appendix during the early inflammatory process.
appendicitis
The usual definition of _____ is excessively frequent passage of stools.
diarrhea
Toxin-producing bacteria or other agents that disrupt the normal absorption or secretory process in the small bowel commonly cause _____.
noninflammatory diarrhea
____ diarrhea is often associated with conditions such as inflammatory bowel disease, irritable bowel syndrome, malabsorption syndrome, endocrine disorders, or radiation colitis.
Chronic
_____ commonly is associated with acute or chronic inflammation or intrinsic disease of the colon, such as ulcerative colitis or Crohn disease.
Inflammatory diarrhea
____ can be defined as the infrequent and/or difficult passage of stools.
Constipation
____ is the retention of hardened or puttylike stool in the rectum and colon, which interferes with normal passage of feces.
Fecal impaction
Intestinal obstruction designates an impairment of movement of intestinal contents in a _____ direction.
cephalocaudal
_____ obstruction results from neurogenic and muscular impairment of peristalsis.
Paralytic
Peritonitis is an inflammatory response of the _____ that lines the abdominal cavity and covers the visceral organs.
serous membrane
Celiac disease is an immune-mediated disorder triggered by ingestion of _____ containing grains.
gluten
_____ provides a means for direct visualization of the rectum and colon.
Colonoscopy
Define achalasia
Difficulty passing food into the stomach
Define esophageal atresia
The upper esophagus ends in a blind pouch
Define odynophagia
Swallowing is painful
Define Gastroesophageal reflux
Backward movement of gastric contents into the esophagus
Define dysphagia
Difficulty in swallowing
Define Barrett esophagus
Squamous mucosa that lines the esophagus gradually is reduced by columnar epithelium
Define tracheoesophageal fistulae
Esophagus is connected to the trachea
Define Mallory-Weiss syndrome
Tears in the esophagus at the esophagogastric junction
Define perforation
An ulcer erodes through all the layers of the stomach
Define Helicobacter pylori
Most common cause of chronic gastritis in the United States
Define Fistulas
Tubelike pasages that form connections between different sites in the gastrointestinal tract.
Define Zollinger-Ellison Syndrome
Gastrin-secreting tumor
Define Celiac disease
Immune-mediated disorder triggered by ingestion of gluten-containing grains
Define osmotic diarrhea
Water is pulled into the bowel by hyperosmotic nature of its contents
Define hypergastrinemia
Presence of an excess of gastrin in the blood
Define steatorrheic
Stools contain excess fat
Define cobblestone appearance
Hallmark symptom of Crohn disease
Define penetration
Ulcer crater erodes into adjacent organs
Define adenomatous polyps
Benign neoplasms that arise from the mucosal epithelium of the intestine
Define Rotavirus
Causes diarrhea in children
What is GERD? What is the mechanism of damage?
GERD is Gastroesophageal reflux disease. It is thought to be associated with a weak or incompetent lower esophageal sphincter that allows reflux to occur, the irritant effects of the refluxate, and decreased clearance of the refluxed acid from the esophag
Describe how the gastric mucosal barrier functions to protect the stomach from its own secretions.
Several factors contribute to the protection of the gastric mucosa, including an impermeable epithelial cell surface covering, mechanisms for the selective transport of hydrogen and bicarbonate ions, and the characteristics of gastric mucus. The gastric e
Describe the progression and remission of peptic ulcers.
A peptic ulcer can affect one or all layers of the stomach or duodenum. The ulcer may penetrate smooth muscle layers. Occasionally, an ulcer penetrates the outer wall of the stomach or duodenum. Spontaneous remissions and exacerbations are common. Healing
What is the relationship between Helicobacter pylori infection and the development of stomach cancer?
Chronic infection with Helicobacter pylori appears to serve as a cofactor in some types of gastric carcinomas. The bacterial infection causes gastritis, followed by atrophy, intestinal metaplasia, and carcinoma. This sequence of cellular events depends on
What are the typical characteristics of irritable bowel syndrome?
The condition is believed to result from deregulation of intestinal motor and sensory functions modulated by the central nervous system. Irritable bowel disease is characterized by persistent or recurrent symptoms of abdominal pain, altered bowel function
What is hypothesized to be a cause of inflammatory bowel disease (ulcerative colitis and Crohn disease)?
According to the currently accepted hypothesis, this normal state of homeostasis is disrupted in inflammatory bowel disease leading to unregulated and exaggerated immune responses against bacteria in the normal intestinal flora of genetically susceptible
What is the mechanism of diverticulosis formation?
In a manner similar to the small intestine, bands of circular muscle constrict the large intestine. As the circular muscle contracts at each of these points (approximately every 2.5 cm), the lumen of the bowel becomes constricted, so that it is almost occ
What is the pathophysiologic of constipation?
The pathophysiology of constipation can be classified into three broad categories: normal-transit constipation, slow-transit constipation, and disorders of defecator or rectal evacuation. Normal-transit constipation (or functional constipation) is charact
How does diet expose a patient to colon cancer?
The cause of colon cancer is unknown, but attention has focused on dietary fat intake, refined sugar intake, fiber intake, and the adequacy of such protective micronutrients such as vitamin A, C, and E in the diet. It has been hypothesized that a high lev
Hiatal hernias can cause severe pain if the hernia is large. Gastroesophageal reflux is a common comorbidity of a hiatal hernia, and when this occurs, what might the hernia do?
Retard esophageal acid clearance. Esophageal acid clearance can be retarded in cases of severe erosive esophagitis where Gastroesophageal reflux and a large hiatal hernia coexist.
Infants and children commonly have Gastroesophageal reflux. Many times it is asymptomatic and resolves on its down. What are the signs and symptoms of Gastroesophageal reflux in infants with severe disease?
Tilting of the head to one side and arching of the back may be noted in children with severe reflux. Early satiety is another indication of Gastroesophageal reflux, but not coupled with consolable crying.
The stomach secretes acid to begin the digestive process on the food that we eat. The gastric mucosal barrier works to prevent acids secreted by the stomach from actually damaging the wall of the stomach. What are the factors that make up the gastric muco
An impermeable epithelial cell surface covering, characteristics of gastric mucus, mechanisms for selective transport of hydrogen and bicarbonate ions. The stomach lining usually is impermeable to the acid it secretes, a property that allows the stomach t
Helicobacter pylori gastritis has a prevelance of over 50% of American adults over the age of 50, which is thought to be caused by a previous infection when the client was younger. What can chronic gastritis caused by H.pylori cause?
Gastric atrophy. Helicobacter pylori gastritis can be a chronic infection that can lead to gastric atrophy, peptic ulcer, and is associated with increased risk of gastric adenocarcinoma and a low-grade B-cell gastric lymphoma (mucosa-associated lymphoid t
A 39-year-old white woman presents at the clinic with complaints of epigastric pain that is cramplike, rhythmic, and just below the xiphoid. She states that it wakes her up around 1 am, and she is not sleeping well because of it. She further states that t
Schedule client for a complete metabolic panel and a complete blood count. Diagnostic procedures for peptic ulcer include history taking, laboratory tests, radiologic imaging, and endoscopic examination.
A client in a nursing home complains to her nurse that she is not feeling well. When asked to describe how she feels, the client states that she really is not hungry anymore and seems to have indigestion a lot. The nurse checks the client's chart and find
Schedule a barium radiograph and an endoscopy and order cytologic studies to be done during the endoscopy. Diagnosis of gastric cancer is accomplished by means of a variety of techniques, including barium radiographic studies, endoscopic studies with biop
Irritable bowel syndrome is thought to be present in 10% to 15% of the population in the United States. What is its hallmark symptom?
Abdominal pain relieved by defection with a change in consistency or frequency of stools. A hallmark of irritable bowel syndrome is abdominal pain that is relieved by defecation and associated with a change in consistency or frequency of stools. Nausea, a
Crohn disease is a recurrent inflammatory disease that can affect any area of the bowel. Characteristic of Crohn disease is granulomatous lesions that are sharply demarcated from the surrounding tissue. As the nurse caring for a client with newly diagnose
Information on sulfasalazine including dosage, route, frequency, and side effects of the drug. A characteristic feature of Crohn disease is the sharply, demarcated, granulomatous lesions that are surrounded by normal-appearing mucosal tissue. When the les
Rotavirus is a common infection in children younger than 5 years of age. Like other diseases, rotavirus is most severe in children under 24 months of age. What is a symptom of a rotavirus infection?
Vomiting that disappears around the second day. Rotavirus infection typically beings after an incubation period of less than 24 hours, with mild to moderate fever, and vomiting, followed by onset of frequent, watery, stools. The fever and vomiting usually
Diverticulitis is a herniation of tissue of the large intestine through the muscularis layer of the colon. It is often asymptomatic and is found in approximately 80% of people over the age of 85. Diverticulitis is often asymptomatic, but when symptoms do
Lower left quadrant pain with nausea and vomiting. One of the most common complains of diverticulitis is pain in the lower left quadrant, accompanied by nausea and vomiting, tenderness in the lower left quadrant, a slight fever, and an elevated white bloo
Diarrhea is described as a change in frequency of stool passage to a point where it is excessively frequent. Diarrhea can be acute or chronic, inflammatory, or noninflammatory. What are the symptoms of noninflammatory diarrhea?
Nonbloody stools, periumbilical cramps, and nausea and/or vomiting. Noninflammatory diarrhea is associated with large-volume watery and nonbloody stools, periumbilical cramps, bloating, and nausea and/or vomiting.
Peritonitis is an inflammatory condition of the lining of the abdominal cavity. What is one of the most important signs of peritonitis?
The translocation of extracellular fluid into the peritoneal cavity. One of the most important manifestations of peritonitis is the translocation of extracellular fluid into the peritoneal cavity (through weeping or serous fluid from the inflamed peritone
Celiac disease commonly presents in infancy as failure to thrive. It is an inappropriate T-cell-mediated immune response and there is no cure for it. What is the treatment of choice for celiac disease?
Removal of gluten from the diet. The primary treatment of celiac disease consists of removal of gluten and related proteins from the diet.
One of the accepted methods of screening for colorectal cancer is testing for occult blood in the stool. Because it is possible to get a false-positive result on these test, you would instruct the client to do what?
Avoid nonsteroidal anti-inflammatory drugs for 1 week prior to testing. To reduce the likelihood of false-positive tests, persons are instructed to avoid nonsteroidal anti-inflammatory drugs such as ibuprofen and aspirin for 7 days prior to testing, to av