Oral Cavity
- Mouth
- Mechanical Digestion
- Salivary Amylase Begins Carbohydrate Breakdown
- Lingual Lipase Begins Lipid Breakdown
- Esophagus
- Bolus
- Peristalsis
Stomach Digestion
- Chief Cells Secrete Pepsinogen
- Pepsinogen Turned to Pepsin By H+
- Protein Breakdown Begins
- Mucous Cells Secrete Mucus and Bicarbonate
- G Cells Secrete Gastrin
- Gastrin Stimulates Parietal Cell HCl Release
- Parietal Cells Secrete Intrinsic Factor
GI Absorption
- Stomach
- Alcohol
- Duodenum
- Iron
- Jejunum
- Folate
- Terminal Ileum
- Vitamin B12
- Bile Resorption
Large Intestine
- Colon
- Electrolyte Reabsorption
- Water Reabsorption
- Microflora Produce Vitamins
- Rectum Stores Feces
Small Intestine Absorption
- Carbohydrates Undergo Active Transport
- Amino Acids Undergo Active Transport
- Small Lipids Undergo Passive Diffusion
- Epithelial Cells
- Intestinal Capillaries
- Hepatic Portal Transports Nutrients
- Liver
- Large Lipids Transported as Chylomicrons
- Lacteals Transport Chylomicrons
Small Intestine Digestion
- Brush border enzymes
- Pancreatic Enzymes are secreted via a Duct
- Pancreas secretes bicarbonate
- Brush Border activates Pancreatic Trypsin
- Trypsin activates Chymotrypsin
- Trypsin and Chymotrypsin digest Proteins
- Gallbladder Releases Bile
- Pancreatic Lipase breaks down Lipids
- Goblet cells secrete mucus
- Pancreatic Amylase breaks down Carbohydrates
- Pancreatic Nucleases breakdown DNA/RNA
- Digestion occurs in the Duodenum
Acute Abdomen Differential Diagnosis: Lower Quadrants
- Appendicitis
- Salpingitis
- Sigmoid Volvulus
- Sigmoid Diverticulitis
- Ectopic Pregnancy
- Ovarian Torsion
- Renal Calculi
- Pyelonephritis
Acute Abdomen Differential Diagnosis: Midepigastrium and Diffuse
- Peptic Ulcer Disease
- Pancreatitis
- Aortic Dissection
- Myocardial Infarction
- Peritonitis
- Hemorrhage or Perforation
- Bowel Obstruction
- Strangulation
- Acute Hepatitis
Acute Abdomen Differential Diagnosis: Upper Quadrants
- Cholecystitis
- Biliary Colic
- Cholangitis
- Perforated Duodenal Ulcer
- Acute Hepatitis
- Splenic Rupture
- IBS (Splenic Flexure Syndrome)
Acute Gastritis
- Erosive
- Disruption of Mucosal Barrier
- Caused by Stress
- NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
- Alcohol
- Uremia
- Burns
- Curling's Ulcer
- Brain Injury
- Cushing Ulcer
- Increase H+ Production
Acute Pancreatitis Disease
- Autodigestion of Pancreas by Pancreatic Enzymes
- Epigastric Abdominal Pain Radiating to Back
- Anorexia
- Nausea
- Increased Amylase and Lipase
- Disseminated Intravascular Coagulation (DIC)
- Infection
- Hypocalcemia
- Systemic Inflammatory Response Syndrome (SIRS)
- Acute Respiratory Distress Syndrome (ARDS)
- Pancreatic Pseudocyst
- Hemorrhage
Acute Pancreatitis Causes
- "GET SMASHHED" Mnemonic
- Gallstones
- (Ethanol) Alcohol
- Trauma
- Steroids
- Mumps
- Autoimmune
- Scorpion Sting
- Hypercalcemia
- Hypertriglyceridemia > 1000
- ERCP
- Drugs
Acute Pancreatitis Assessment
- Heavy Alcohol Use and Gallstones
- Abdominal Pain
- Nausea/Vomiting/Anorexia
- Abdominal Rigidity/Guarding
- Decreased or Absent Bowel Sounds
- Hypotension and Tachycardia
- Jaundice
- Increased White Blood Cells
Acute Pancreatitis Interventions
- NPO with NG Tube to Suction
- Pain Management
- Albumin
- Lactated Ringers Solution
- Proton Pump Inhibitor (PPI)
- Antibiotics
- Surgery
- Nutrition
Chronic Gastritis
- Type A
- Fundus and Body
- Autoimmune
- Autoantibodies to Parietal Cells
- Pernicious Anemia
- Achlorhydria
- Type B
- Most Common Type
- Helicobacter pylori
- Antrum
- Increased Risk of MALT Lymphoma
- HIV/AIDS
- Crohn's Disease
Gastroesophageal Reflux Disease (GERD) Assessment
- Relaxed Lower Esophageal Sphincter
- Dyspepsia (Indigestion)
- Belching
- Nighttime Coughing
- Dysphagia
- Epigastric Pain
- Regurgitation
- Heartburn (Pyrosis)
- Globus
Peptic Ulcer Disease Assessment
- Helicobacter Pylori
- NSAIDs
- Increased Stomach Acid
- Abdominal Pain
- Heartburn (Pyrosis)
- Melena
- Weight Changes
- GI Distress
- Most Commonly in Duodenum
- Duodenal: Pain Relieved by Eating
- Gastric: Pain Caused by Eating
Peptic Ulcer Disease Interventions
- Combination Drug Therapy
- Two Antibiotics
- Proton Pump Inhibitor (PPI)
- Decrease Acid Secretion
- Avoid NSAIDs
- Diet and Lifestyle Changes
Barrett's Esophagus
- Metaplasia in Lower Esophagus
- Columnar Epithelium
- Gastroesophageal Reflux Disease (GERD)
- Esophagitis
- Esophageal Ulcers
- Increased Risk of Esophageal Adenocarcinoma
Mallory-Weiss
- Bleeding From Tears in Mucosa
- Forceful Vomiting
- Alcoholism
- Eating Disorders (Bulimia)
- Painful Hematemesis
- Endoscopy
- Observation
Types of Intestinal Obstruction
- Adhesions
- Hernia
- Volvulus
- Intussusception
- Tumor
- Mesenteric Artery Occlusion
- Spinal Injury
- Paralytic Ileus
Intestinal Obstruction
- Severe Abdominal Pain
- Vomiting
- High Pitched Bowel Sounds
- Abdominal Distention
- Increased Peristalsis
- Absent Bowel Sounds
- Paralytic Ileus
Types of Hernias
- Hiatal
- Gastroesophageal Reflux Disease (GERD)
- Inguinal
- Men
- Femoral
- Women
- Incisional
- Umbilical
- Strangulation
Hernia Interventions
- Reduce Intra Abdominal Pressure
- Avoid Straining and Lifting
- Open Mouth Sneezing
- Excision
- Herniorrhaphy
- Hernioplasty
- Scrotal Support
Mesenteric Ischemia
- Severe Abdominal Pain
- Bloody Diarrhea
- Metabolic Acidosis
- Increased WBC
- Increased Lactate (Lactic Acid)
- X-ray
- Air Within Bowel Wall
- CT Angiography
- Bowel Wall Edema
- Antibiotics
- Emergent Surgical Intervention
Cholecystitis Causes
- Gallbladder Inflammation
- Female
- Fair (Caucasian)
- Fat (Obese)
- Fertile (Pregnant)
- Forty (Advanced Age Over 40)
- Flatulence
Cholecystitis Assessment
- RUQ Pain
- Referred Shoulder Pain
- Clay Colored Stools
- Jaundice
- Nausea and Vomiting
- Dyspepsia (Indigestion)
- Fever
- Increased WBCs
- Fatty or Spicy Foods
- Ultrasound
Cholecystitis Interventions
- Supportive Therapy
- Antibiotics
- Low Fat Diet
- NG Tube
- Analgesics
- Lithotripsy
- Cholecystectomy
- T Tube
Diverticulosis and Diverticulitis Assessment
- Outpouching
- Inflamed Diverticula
- Abdominal Pain
- Abdominal Distention
- Flatulence
- Fever
- Rectal Bleeding
- Alternating Constipation and Diarrhea
- Peritonitis
Diverticulosis and Diverticulitis Interventions
- High Fiber Diet
- Reduce Intra-abdominal Pressure
- Stool Softeners
- Exercise
- Anticholinergics
- Antibiotics
- Bowel Resection
Irritable Bowel Syndrome (IBS) Assessment
- Abdominal Pain
- Relieved by Defecation
- Alternating Diarrhea and Constipation
- Fatigue
- Excessive Flatulence
- Sensation of Incomplete Evacuation
- Stressors
- Food Intolerances
- More Common in Women
- Rule Out Other Disorders
Irritable Bowel Syndrome (IBS) Interventions
- Identify Triggers
- Increase Fiber Intake
- Probiotics
- Anticholinergics
- Tricyclic Antidepressants (TCAs)
- Loperamide
- Linaclotide
- Tegaserod (Zelnorm)
- Lubiprostone (Amitiza)
- Alosetron (Lotronex)
Celiac Disease
- Intestinal Mucosa Damage
- Ingestion Wheat, Barley, Rye
- GI Distress
- Steatorrhea
- Weight Loss
- Dermatitis Herpetiformis
- Gluten-free Diet
- Screening
Celiac Disease Characteristics
- European Descent
- HLA-DQ2
- HLA-DQ8
- Autoimmune-mediated Intolerance of Gliadin
- Dermatitis Herpetiformis
- Weight Loss
- Failure to Thrive
- Decreased Bone Density
- Steatorrhea
- Anemia
Crohn's Disease Assessment
- Diarrhea
- 5-6 per day
- Cramping Abdominal Pain
- Fever
- Weight Loss
- Malabsorption
- Anemia
- Obstruction
- Fistulas
Ulcerative Colitis Assessment
- Cramping Abdominal Pain
- Tenesmus
- Bloody Diarrhea
- Up to 10-20 / Day
- Fever
- Hemorrhage
Complications of Cirrhosis
- Portal Hypertension
- Ascites
- Esophageal Varices
- Coagulation Defects
- Portal-Systemic Encephalopathy
- Hepatorenal Syndrome
Cirrhosis Assessment
- Degeneration and Destruction of Liver Cells
- Jaundice
- Fatigue
- Palmar Erythema
- Spider Angiomas
- Hepatosplenomegaly
- Edema
- Gynecomastia
- Change in LOC
Cirrhosis Interventions
- Maintain Nutrition
- Paracentesis
- Drug Therapy
- Endoscopic Band Ligation or Sclerotherapy
- Balloon Tamponade
- Transjugular Intrahepatic Portosystemic Shunt (TIPS)
- Lactulose
- Antibiotics
Colorectal Cancer Assessment
- 3rd Most Common Cancer
- Change in Bowel Habits
- Bowel Obstruction
- Rectal Bleeding
- Anemia
- Weight Loss
- Ascites
- Colonoscopy
- FOBT and FIT
Bilirubin Lab Value
- 0.2-1.2 mg/dL
- Increased Bilirubin Causes Jaundice
Budd-Chiari Syndrome
- Pregnancy and Postpartum
- Hematologic Disorders
- Tumors
- Chronic Infections
- Thrombosis of Major Hepatic Veins
- Centrilobular Congestion and Necrosis
- Abdominal Pain
- Ascites
- Hepatomegaly
- Nutmeg Liver
Tracheoesophageal Fistula (TEF)
- Esophageal Atresia
- Ends in Blind Pouch
- Coughing
- Choking
- Cyanosis
- Drooling
- NPO
- Surgical Emergency
- Aspiration Pneumonia