Week 6: Gastrointestinal Tract and Assessment
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Questions and Answers

What is the primary function of the oral cavity in the gastrointestinal tract?

  • Temporary storage of food
  • Mastication and initiation of a bolus (correct)
  • Final breakdown and absorption
  • Production of digestive enzymes
  • Which area of the abdomen is commonly associated with gastric ulcers?

  • Right lower quadrant
  • Right upper quadrant
  • Left lower quadrant
  • Mid upper quadrant (correct)
  • Which gastrointestinal function occurs in the small and large intestine?

  • Temporary storage of food
  • Production of enzymes
  • Digestion and absorption (correct)
  • Mastication of food
  • Which of the following signs is used in the special tests for appendicitis?

    <p>McBurney's point</p> Signup and view all the answers

    What symptom might indicate early appendicitis?

    <p>Right mid abdomen pain</p> Signup and view all the answers

    What does rebound tenderness indicate during an abdominal examination?

    <p>Pain upon releasing pressure</p> Signup and view all the answers

    Which condition is associated with changes in bowel function such as constipation or diarrhea?

    <p>Irritable bowel syndrome</p> Signup and view all the answers

    What does auscultation of the abdominal quadrants check for?

    <p>Bowel sounds presence</p> Signup and view all the answers

    What physical assessment finding is indicative of potential kidney issues?

    <p>Flank swelling or bruising</p> Signup and view all the answers

    Which hormone is produced by the kidneys that is crucial for regulating blood pressure?

    <p>Renin</p> Signup and view all the answers

    What sign is characterized by bruising around the umbilicus, and indicates serious underlying pathology?

    <p>Cullen Sign</p> Signup and view all the answers

    What symptom is commonly associated with renal issues and can manifest as dependent swelling?

    <p>Edema</p> Signup and view all the answers

    Which assessment technique is used to detect tenderness in the costovertebral angle (CVA)?

    <p>Percussion</p> Signup and view all the answers

    What primary function is compromised if the liver is unable to produce albumin effectively?

    <p>Fluid regulation</p> Signup and view all the answers

    Which symptom is most closely associated with elevated bile salts due to liver dysfunction?

    <p>Skin pruritus</p> Signup and view all the answers

    Which assessment finding may indicate liver disease when present as upper right quadrant pain?

    <p>Right shoulder pain</p> Signup and view all the answers

    How does liver dysfunction directly affect the body’s clotting mechanism?

    <p>Decreases the synthesis of clotting factors</p> Signup and view all the answers

    What is ascites and how is it related to liver function?

    <p>Fluid accumulation in the abdominal cavity due to low albumin levels</p> Signup and view all the answers

    In a physical examination for liver assessment, which technique is used to estimate the liver span?

    <p>Percussion</p> Signup and view all the answers

    Which of the following medications would require careful monitoring of hepatic dosing due to liver function?

    <p>Anticoagulants</p> Signup and view all the answers

    What is a common symptom of infection related to liver dysfunction?

    <p>Increased white blood cell count</p> Signup and view all the answers

    What indicates potential liver damage during patient assessment?

    <p>Presence of spider angioma</p> Signup and view all the answers

    What factor primarily contributes to cognitive issues in patients with liver disease?

    <p>Increase in ammonia levels</p> Signup and view all the answers

    What is a primary function of the gall bladder?

    <p>Stores and concentrates bile</p> Signup and view all the answers

    What symptoms may indicate an infection in the gall bladder?

    <p>Nausea and vomiting</p> Signup and view all the answers

    Where does the gall bladder excrete bile?

    <p>Duodenum via the cystic duct</p> Signup and view all the answers

    What is a possible result of gall stones?

    <p>Cholecystitis</p> Signup and view all the answers

    Which area of the body is typically associated with upper right abdominal pain due to gall bladder issues?

    <p>Central abdomen</p> Signup and view all the answers

    Which symptom may indicate a lack of bile salts in the digestive tract?

    <p>Grey-colored stools</p> Signup and view all the answers

    Which of the following assessments would show tenderness related to gall bladder issues?

    <p>Palpation of the right upper quadrant</p> Signup and view all the answers

    Which of the following might indicate peritoneal irritation when assessing gall bladder conditions?

    <p>Guarding</p> Signup and view all the answers

    What is a common referred pain location related to gall bladder problems after eating a fatty meal?

    <p>Mid back</p> Signup and view all the answers

    What common complication arises from cholelithiasis?

    <p>Pancreatitis</p> Signup and view all the answers

    What is one of the main functions of the spleen?

    <p>Removal of old or damaged red blood cells</p> Signup and view all the answers

    Which type of blood cell does the spleen produce?

    <p>Both B and T cells</p> Signup and view all the answers

    What abnormal finding might you note upon percussion during a spleen assessment?

    <p>Dullness in the upper left quadrant at the costal margin</p> Signup and view all the answers

    What is the primary exocrine function of the pancreas?

    <p>Production and release of digestive enzymes</p> Signup and view all the answers

    What symptom may be observed during the assessment of a patient with pancreatic issues?

    <p>Nausea and vomiting</p> Signup and view all the answers

    Which statement regarding the spleen is accurate?

    <p>It serves as a reservoir for blood in case of trauma.</p> Signup and view all the answers

    What is the endocrine function of the pancreas?

    <p>Production of hormones like insulin and glucagon</p> Signup and view all the answers

    In the assessment of the spleen, which of the following is not typically expected?

    <p>A palpable organ in a healthy individual</p> Signup and view all the answers

    What might indicate splenic enlargement during an inspection?

    <p>A bulge or misshapen abdomen in the left upper quadrant</p> Signup and view all the answers

    Which condition could lead to fever and tachycardia in a patient presenting with pancreatic problems?

    <p>Acute pancreatitis</p> Signup and view all the answers

    Study Notes

    Gastrointestinal Tract

    • The gastrointestinal tract includes the oral cavity, stomach, small intestine and large intestine.
    • The oral cavity is responsible for mastication and the initiation of a bolus, it also introduces the first digestive enzymes.
    • The stomach temporarily stores food and further breaks it down mechanically.
    • The stomach also produces enzymes and specialized cells to break down food.
    • The small and large intestines are responsible for further breakdown, digestion, absorption, and elimination of wastes.

    Gastrointestinal Assessment

    • History
      • Nausea or vomiting
      • Appetite changes
      • Pain or heartburn
      • Diarrhea or constipation
      • Blood or mucous in stools
      • Cramping
    • Inspection
      • Contour, symmetry, and discolouration
    • Auscultation
      • Presence of bowel sounds in 4 quadrants
    • Percussion
      • Dullness vs. general tympany
    • Palpation
      • Lumps, bumps, or masses

    Appendicitis Assessment

    • Special Tests
      • McBurney’s point: Right abdomen between the umbilicus and the iliac crest – increased pain with pressure at this point
      • Rovsing’s sign: Palpation of LLQ causes pain in the RLQ
      • Rebound tenderness: Removal of pressure rather than the application of pressure causes tenderness.

    Liver

    • Primary Functions
      • Cognition
      • Skin
      • Medication toxicities
      • Signs and symptoms of infection
      • Ascites and third spacing of fluids
      • Nutritional status
      • Abnormal bleeding

    Liver Assessment

    • Assessment
      • Upper right quadrant pain
      • Right shoulder pain (referred pain)
    • Special Tests
      • Inspection: Ascites, spider angioma, contour of abdomen related to ascites
      • Auscultation: Of abdomen in general
      • Percussion: To find the liver span (ask me about the scratch test)
      • Palpation: Gentle palpation from umbilicus up with flat hand.
      • Ask about the fluid wave test.

    Gallbladder

    • Primary Functions
      • Stores and concentrates bile from the liver.
      • Excretes bile into the duodenum via the cystic duct.
      • Bile is required for the breakdown and absorption of fats.
      • Some involvement in the removal of waste from the liver to the intestine (biliary system rather than gall bladder itself).

    Gallbladder Assessment

    • Common issues
      • Stones (cholelithiasis)
      • Infections (cholecystitis)
    • History
      • Nausea/vomiting
      • Fever/chills
      • Jaundice
      • Changes in colour of stools (usually to grey – no bile salts to colour them)
    • Pain and referred pain
      • Upper right or mid abdomen.
      • Radiation to right shoulder or mid back especially after eating a fatty meal.
    • Assessment
      • Inspection
      • Auscultation
      • Percussion
      • Palpation: Tenderness to RUQ
    • Special tests
      • Signs of peritoneal irritation: Guarding, rigidity and tenderness.

    Spleen

    • Primary Functions
      • Production of lymphocytes both B and T cells.
      • Removal of old or damaged red blood cells.
      • Can be a reservoir for blood in trauma or hemorrhage.
      • Retains iron which is needed for the production of hemoglobin.

    Spleen Assessment

    • History
      • Left upper quadrant abdominal pain.
      • Bloating or early satiety
      • Nausea or vomiting
      • Problems with either diarrhea or constipation
    • Inspection
      • Can you see a bulge or is the abdomen misshapen.
    • Auscultation
      • Cannot normally hear anything
    • Percussion
      • Look for abnormal dullness ULQ at costal margin.
    • Palpation
      • Palpate laterally to identify abnormal bulge – follow edge along until you feel the ledge – normally not palpable.

    Pancreas

    • Primary Functions
      • Exocrine function: Production and release of enzymes that aid in the digestion of food.
      • Endocrine function: Regulation of blood glucose through the production and excretion of insulin and glucagon.

    Pancreas Assessment

    • History
      • Pain – upper left of mid abdominal pain with radiation to mid back or chest
        • May be reduced by leaning forward.
        • Exacerbated by cough, movement or even deep breathing.
      • Nausea/vomiting
      • Flatulence, diarrhea, steatorrhea.
      • Abdominal distension.
      • Undernutrition, weight loss.
      • Fatigue
    • Inspection
      • Pt. may be diaphoretic, febrile tachycardia and tachypneic
    • Auscultation
      • Decreased bowel sounds
    • Percussion
    • Palpation
    • Special Test
      • Grey Turner Sign: Bruising to flanks.
      • Cullen Sign: Bruising around umbilicus.
      • These signs are rare and have a poor prognosis.

    Kidneys

    • Primary Functions
      • Regulation of electrolyte and fluid balance.
      • Regulation of blood pH.
      • Production of hormones important for red blood cell production and calcium regulation as well as blood pressure regulation.
      • Excretion of waste products from the blood.

    Kidneys Assessment

    • History
      • Urinary history – volume, changes in patterns, hematuria, pyuria, colour and odour, retention or no voiding.
      • History of illness related to renal/urinary disease – infections (including recent strep infections), cancers, BPH, renal calculi.
      • Pain assessment – normally flank pain.
      • Edema (usually dependent edema).
      • Blood pressure changes.
    • Physical Assessment
      • Inspection: Flank areas, look for swelling, bruising.
      • Auscultation: Listen as CVA for bruits and at upper abdomen for renal arteries.
      • Percussion: CVA tenderness.
      • Palpation: Kidneys are deep palpation so you don’t have to do this, palpation of the bladder.

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    Description

    This quiz covers the anatomy and functions of the gastrointestinal tract, including the oral cavity, stomach, and intestines. It also examines the assessment techniques used for gastrointestinal issues, such as inspection, auscultation, percussion, and palpation. Test your knowledge on gastrointestinal health and assessment methods.

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