2-17-12 Friday

PHYS/PATH

Bladder Cancer: development of malignant cells in bladder
risk smoking; median age: 73 (so older people get this not likely in younger)
alcohol, dyes, environment
Prognosis: usually found earlier, better odds, slow moving
blood in urine

Interstitial Cystitis (IC): something irritate bladder
dysuria: pain with peeing
W>M
worse thing you can do is drink cranberry juice (unsweetened)
**Hunner ulcers; pathoneumonia, pinpoint hemorrahages
protective shield isn't working
S&S: chronic pelvic pain, pain and burning
Dx: rule out UTI, ggenital herpes, cancer
Tx: find irritant

Urinary Tract Infection (UTI): anywhere lower urinary system
W>M (shorter urethra) men more likely to have STD
microorganism in urethra
90% from Escherichia coli (E. coli)- fecal matter
irritation (honeymoon cystitis) pee after sex please
risk: soaps, spermicide, diaphragm use, diabetes, color toilet paper
S&S: cloudy/bloody urine, pain urination, pelvic/ab/LB pain
worry about it getting to kidneys
Tx: hydration, blueberry/cranberry juice (unsweetened), antibiotics
prevention: hydration
M: contra due to active infection

Phys chap 17 digestive system

chief function: digest, absorb, eliminate
organs: digestive tract, accessory organs
starts 15-20 min before eating

80% of immune system

Wall digest syst.
mucous membrane (mucosa)
-digestive juice, secreting cells
-mucus secreting (goblet) cells
submucosa
-connective tissue
-contains blood vessels and nerves help regulate digest
smooth mm
*-inner layer-circular
*-outer layer-longitudinal
*-peristalsis-action potential and mm contractions (food moved through)
serous membrane
-epithelium
-loose connective tissue

Peritoneum: membrane that lines the ab cavity
-perietal peritoneum
-visceral peritoneum
-mesentery-fascia holding around everything
-mesocolon
-greater omentum
-lesser omentum
peritoneal cavity; space b/w 2 layers

Alimentary tract or GI tract
mouth, pharynx, esophagus, stomach, small/large intestine

Mouth: ingestion, mastication, mixing with saliva amalates deglutition
deciduous teeth are baby teeth

Pharynx: throat
Esophagus: muscular tube, no digestion, joins with stomach, esophageal hiatus

Stomach: structure
fundus: top
lesser/greater curvature
*oblique, circular, longitudinal mm
*rugae in stomach not intestine- folds in stomach increase surface area
*pyloric sphincter: junction b/w stomach and small intestine

Function: store food and liquid
secrete gastric juice (hydrochhloric acid: and pepsin * digesting proteins(in stomach)
secrete mucus
chyme: highly acidic mixture of gastric juice and food that leaves the stomach for the small intestine

parietal cells
-HCl
-intrinsic factors to digest b12
chief cells
-pepsinogen--pepsin

Small intestine: struct
duodenum: pyloric sphincter, not too long
Jejunum: majority of absorption of nutrients
ileum: b12, calcium
-connects with large intestine via ileocecal valve
Function: secrete mucus
secrete enzymes
absorb digested food
-villi
-microvilli
-blood vessels
-specialised lymphatic capillaries (lacteal)

Large intestine struct
-cecum
-ileocecal valve
-vermiform appendix
-colon: ascending, transverse, descending, sigmoid
-rectum
-anal canal
-anus

function
secrete mucus
reabsorb water (main function)
defecation (main function)
form feces (stool)

Accessory organs
salivary glands to mouth
all other organs to duodenum

bile-absorb fat soluable vitamin

The liver
right, left, (middle) lobes, portal vein, hepatic artery
function: manufacture bile, store glucagen, convert to glucose, modify fats, store vitamins, iron, etc

Gallbladder: store bile, flow through cystic duct

Pancreas: enzymes are released from here, insulin, glucagon

Enzymes: speed things up (reaction), specific, not used up, are protein

water: dilute fluid
absorption
-fats-lacteals
-vits and mins

control digestion
parasympathetic keeps it going
sympathetic
hormonal
-cholecystokonin (CCK): stop eating H., release enzymes
Hunger (hypothalaic) vs appetite (no relation to need)

Path

Celiac Disease: villi are flattened, destroyed due to gluten
gluten sensitive enteropathy (in b/w - milder symptoms)
whites 1:133
autoimmune reaction: wheat, barley, rye
malabsorption; inflam response
S&S: GI pain, gas, bloating, diarrhea
complication: anemia, folic acid deficiency, osteoporosis, delayed growth
Dx: antibody test
irritable bowel syndrome, crohn
Tx: no gluten

Crohn disease: part of IBS; intestines are swelling in/ limiting space; can cause fistula (tunnel to get poop out)
disconnected patches of inflam and damage along GI tract
can be anywhere in body from mouth to anus; **ileum most common place**
type A: m=w, whites, young and old
**swelling; fistulas-tunnels
S&S: flares/remission; ab pain, cramping, weight loss, fever
Tx: steroids, immunosuppressant

Esophageal Cancer: malignant cell; squamous cell (proximal end) carcinoma/ adenocarinoma (distal end)
hot fluids, smoking, GERD-heartburn
S&S: swallowing problems
Dx: Barium, swallowing

Gastroenteritis (aka stomach flu): inflam stomach/ small intestine infection
most dangerous with young and old
etiology: pathogens, invaders
absorption of H2o disrupted
causes: viruses: hep a,b,c; norwalk 50-70% of cases
bacteria: salmonella, E. coli, H pylori (peptic ulcer)
parasites: *giardia- contaminated water - fecal oral
others: *funis (candidiasis)* in intestines
oral fecal, contaminated water/ice; food prep.
S&S: ab pain, nausea, vomiting, bloating, cramp
comp: *dehydration, guillian-barre
prog: most resolve 2-3 days

Gastroesophageal Reflux Disease (GERD): problem with lower esophageal sphincter
4 problems: LES to relaxed, doesn't allow clear out etc.
acid reflux
respiratory injury, decay teeth, ulcers, stricture, barrett esoph.
risk: prego, obesity, smoke, diet, tumor
S&S: heartburn, angina, pain in chest

Peptic Ulcers: erosion in esophagus, stomach, duodenum; open sore invitation for infect; hole in stuff
Factors:
stress, h Pylori, NSAIDs-asprin, ibuprotfen
S&S: Gnawing burning pain in chest
comp: bleeding, hemorrhage, peritonitis

Stomach cancer
M>W; alcohol, H. pylori, preservatives, diet, tobacco
S&S: ab pain, ascites (swell ab), unitentional weight loss
Dx: seldom found before tour

Colorectral Cancer: large intestine
over cooked meat
#2 cause of death from cancer
polyps
causes: high fat foods, fiber something:
risk: sedentary life, weight, IBDs, age
*S&S: silent early, change in bowel mvmt, older, unintentional weight loss
prevention: diet

Diverticular Disease: bulge in colon form diverticulum
diverticulosis: presence of bulges
diverticulitis: infection of bulges
S&S: left side appendicitis, older folks, may be silent, fever, cramp, pain


Irritable Bowel Syndrome: digestive dysfunction
w/o structural changes
w>M
imbalances
S&S: ab pain, no structural changes in colon
M=+

Ulcerative colitis: inflam, ulcers in large intestine (opposite crohns)
lining been eroded/thining
gluten
stop bleeding!
nutritional disease; arthritis, skin stuff
S&S: anemia
M: no deep tissue

cirrhosis: replacement of healthy hepatocytes with nofunctioning scar tissue
shorten life span 22 years
chronic inflam state
causes: alcohol, hepatitis b,c,d
*hep A (a ok) doesn't lead to cirrhosis or liver cancer
NAFLD: nonalcoholic fatty liver disease
NASH: nonalcoholic steatohepatitis
S&S: silent/subtel, vomit, weight loss
comp: splenomegaly
jaundice
Tx: don't drink
M; careful no swedish/deep work

Gallstones: **most gallsones made of cholesterol in our society
fair
forty
fertile
fat
female
can be life threatening if blocks pancreas

Hepatitis: inflammation liver; viral; lead to jaundice
A: short term; fecal oral
B: long term; 6 month=chronic phase
transmit from body fluids; can last a long time outside body
C: more likely develop cirrhosis, liver cancer, alcoholism more common with sex
D: have to have B or C

Liver Cancer: hepatocellular carcinoma
hep B, C, alcohol too much iron, grain and peanuts

pancreatic cnacer
**more common in men
"what's digesting us?"
very aggressive; 1% survival, aggressive
risk: age, m, black, smoke, type 2, no vegs

Pancreatitis: acute inflammation
**gallstones and alcohol most common cause; 12 out of 10 pain
S&S: fat in smelly stool

Candidiasis: fungus in intestinal tract

Peritonitis: life threatening infect parientneal layer