NU 545
Unit 6 Study Guide
Advanced Pathophysiology
University of South Alabama.
This document provides a focused
study guide
It summarizes key concepts, lecture highlights, and
exam-relevant material to support efficient last-minute
review. The guide is structured to help students
reinforce understanding, identify weak areas, and prepare
confidently for the assessment.
,Unit 6: The Digestive and
Musculoskeletal Systems
NU545: Physio-Pathological Basis of Advanced Nursing
Study Guide: Chapters 40 – 45, McCance and Huether,
7th edition
Edited by: Jessica L. Santos
,SECTION I: STUDY GUIDE
1. Anatomy and function of the GI system components;
normal intestinal flora. (pp.1393-97, 1400, 1409; key search term:
“except for chewing”)
The digestive system breaks down ingested food, prepares it for uptake by the
body’s cells, provides body water, and eliminates wastes.
The functions of the GI system are ingestion of food; propulsion of food and
wastes from mouth to anus; secretion of mucus, water, and enzymes;
mechanical digestion of food particles; chemical digestion of food particles;
absorption of digested food; and elimination of waste products by defecation.
Consists of GI tract and accessory organs—liver, gallbladder, and exocrine
pancreas.
(p. 1393) The GI tract consists of mouth, esophagus, stomach, small intestine,
large intestines, rectum, and anus. Has 4 layers of tissue: mucosa,
submucosa, muscularis, and serosa/adventitia (esophagus).
Enteric nervous system within GI tract controlled by local and autonomic nervous
system—3 nerve plexus: submucosal plexus (located muscularis), myenteric
plexus (between the inner circular and outer longitudinal mucsle layers in
the muscularis), and subserosal plexus (beneath the serosa). The enteric plexus
neurons regulate motility reflexes, blood flow, absorption, secretions, and
immune responses.
(p. 1395) Mouth is reservoir for chewing and mixing food with saliva. 3 pairs
salivary glands (submandibular, sublingual, and parotid). Saliva consist mostly of
water that contains mucus, sodium, bicarb, chloride, potassium, and salivary a-
amylase (ptylain), an enzyme that initates carb digestion in the mouth and
stomach.
The esophagus is a hollow muscular tube that controls swallowing substances
from oropharynx to stomach. Each end of the esophagus has a sphincter:
cricopharyngeal muscle and cardiac sphincter.
2
, (p. 1397) The stomach is a hollow muscular organ that stores food during
eating, secretes digestive juices, mixes food with juices, and propels partially
digested food (chyme) into the duodenum of small intestine.
(p. 1400) The small intestine is about 5 to 6 m long and is functionally divided
into three segments: the duodenum, jejunum, and ileum.
The duodenum: essential role in mixing food with digestive juices from the liver
and pancreas. The jejunum and ileum facilitate intestinal motility and support
blood vessels, nerves, and lymphatics. The peritoneum is the serous membrane
surrounding the organs of the abdomen and lining the abdominopelvic cavity.
(p. 1407) The large intestine is approximately 1.5 m long and consists of the
cecum, appendix, colon, rectum, and anal canal. The cecum is a pouch that
receives chyme from the ileum. Attached to the cecum is the vermiform
appendix, has little or no physiologic function. From the cecum, chyme enters
the colon, four-parts that descends to the anal canal: ascending colon,
transverse colon, descending colon, and sigmoid colon. Most of the water is
absorbed in the colon by diffusion and active transport. By the time the fecal
mass enters the sigmoid colon, the mass consists entirely of wastes and is called
the feces. The movement of feces into the sigmoid colon and rectum stimulates
the defecation reflex (rectosphincteric reflex). Defecation is facilitated by
squatting or sitting because these positions straighten the angle between the
rectum and anal canal and increase the efficiency of straining.
(p.1409) Bacteria from stomach to distal colon. Stomach is relatively sterile due
to acid production. Bile acid secretion, intestinal motility, and antibody
production suppress bacterial growth in the duodenum, and in the duodenum
and jejunum there is a low concentration of aerobes: streptococci, lactobacilli,
staphylococci, enterobacteria, and Bacteroides. Anaerobes are found distal to
ileocecal valve and consists 95% of fecal flora and 1/3 of the solid bulk of
feces: Bacteroides, clostridia, anaerobic lactobacilli, and coliforms are the most
common microorganisms from the ileum to the cecum.
(p. 1409) The liver, gallbladder, and exocrine pancreas all secrete
substances necessary for the digestion of chyme. These secretions are delivered
to the duodenum through ducts. The liver produces bile, which contains salts
necessary for fat digestion and absorption. Between meals bile is stored in the
gallbladder. The exocrine pancreas produces enzymes needed for the complete
digestion of carbohydrates, proteins, and fats. The exocrine pancreas also
produces an alkaline fluid that neutralizes chyme, creating a duodenal pH that
supports enzymatic action. The liver receives nutrients absorbed by the small
intestine and metabolizes or synthesizes these nutrients into forms that can be
absorbed by the body’s cells. It then releases the nutrients into the bloodstream
or stores them for later use.
2. Know disorders of GI tract and accessory organs of digestion:
pathophysiology, etiology, prevention, clinical manifestations,
diagnostics, treatment and complications. (pp. 1428 – 1474; key
search term: “from mechanical obstruction”)
Disorders of Motility:
Dysphagia (p. 1428) is difficulty swallowing and can result from
mechanical obstruction of esophagus (within the walls of esophagus or
outside esophageal lumen—narrow esophagus) or functional disorder
impairing esophageal motility (neural or muscular disorders).
Gastroesophageal Reflux Disease (p. 1429) is the reflux of acid and pepsin
from the stomach to the esophagus that causes esophagitis.
3
Unit 6 Study Guide
Advanced Pathophysiology
University of South Alabama.
This document provides a focused
study guide
It summarizes key concepts, lecture highlights, and
exam-relevant material to support efficient last-minute
review. The guide is structured to help students
reinforce understanding, identify weak areas, and prepare
confidently for the assessment.
,Unit 6: The Digestive and
Musculoskeletal Systems
NU545: Physio-Pathological Basis of Advanced Nursing
Study Guide: Chapters 40 – 45, McCance and Huether,
7th edition
Edited by: Jessica L. Santos
,SECTION I: STUDY GUIDE
1. Anatomy and function of the GI system components;
normal intestinal flora. (pp.1393-97, 1400, 1409; key search term:
“except for chewing”)
The digestive system breaks down ingested food, prepares it for uptake by the
body’s cells, provides body water, and eliminates wastes.
The functions of the GI system are ingestion of food; propulsion of food and
wastes from mouth to anus; secretion of mucus, water, and enzymes;
mechanical digestion of food particles; chemical digestion of food particles;
absorption of digested food; and elimination of waste products by defecation.
Consists of GI tract and accessory organs—liver, gallbladder, and exocrine
pancreas.
(p. 1393) The GI tract consists of mouth, esophagus, stomach, small intestine,
large intestines, rectum, and anus. Has 4 layers of tissue: mucosa,
submucosa, muscularis, and serosa/adventitia (esophagus).
Enteric nervous system within GI tract controlled by local and autonomic nervous
system—3 nerve plexus: submucosal plexus (located muscularis), myenteric
plexus (between the inner circular and outer longitudinal mucsle layers in
the muscularis), and subserosal plexus (beneath the serosa). The enteric plexus
neurons regulate motility reflexes, blood flow, absorption, secretions, and
immune responses.
(p. 1395) Mouth is reservoir for chewing and mixing food with saliva. 3 pairs
salivary glands (submandibular, sublingual, and parotid). Saliva consist mostly of
water that contains mucus, sodium, bicarb, chloride, potassium, and salivary a-
amylase (ptylain), an enzyme that initates carb digestion in the mouth and
stomach.
The esophagus is a hollow muscular tube that controls swallowing substances
from oropharynx to stomach. Each end of the esophagus has a sphincter:
cricopharyngeal muscle and cardiac sphincter.
2
, (p. 1397) The stomach is a hollow muscular organ that stores food during
eating, secretes digestive juices, mixes food with juices, and propels partially
digested food (chyme) into the duodenum of small intestine.
(p. 1400) The small intestine is about 5 to 6 m long and is functionally divided
into three segments: the duodenum, jejunum, and ileum.
The duodenum: essential role in mixing food with digestive juices from the liver
and pancreas. The jejunum and ileum facilitate intestinal motility and support
blood vessels, nerves, and lymphatics. The peritoneum is the serous membrane
surrounding the organs of the abdomen and lining the abdominopelvic cavity.
(p. 1407) The large intestine is approximately 1.5 m long and consists of the
cecum, appendix, colon, rectum, and anal canal. The cecum is a pouch that
receives chyme from the ileum. Attached to the cecum is the vermiform
appendix, has little or no physiologic function. From the cecum, chyme enters
the colon, four-parts that descends to the anal canal: ascending colon,
transverse colon, descending colon, and sigmoid colon. Most of the water is
absorbed in the colon by diffusion and active transport. By the time the fecal
mass enters the sigmoid colon, the mass consists entirely of wastes and is called
the feces. The movement of feces into the sigmoid colon and rectum stimulates
the defecation reflex (rectosphincteric reflex). Defecation is facilitated by
squatting or sitting because these positions straighten the angle between the
rectum and anal canal and increase the efficiency of straining.
(p.1409) Bacteria from stomach to distal colon. Stomach is relatively sterile due
to acid production. Bile acid secretion, intestinal motility, and antibody
production suppress bacterial growth in the duodenum, and in the duodenum
and jejunum there is a low concentration of aerobes: streptococci, lactobacilli,
staphylococci, enterobacteria, and Bacteroides. Anaerobes are found distal to
ileocecal valve and consists 95% of fecal flora and 1/3 of the solid bulk of
feces: Bacteroides, clostridia, anaerobic lactobacilli, and coliforms are the most
common microorganisms from the ileum to the cecum.
(p. 1409) The liver, gallbladder, and exocrine pancreas all secrete
substances necessary for the digestion of chyme. These secretions are delivered
to the duodenum through ducts. The liver produces bile, which contains salts
necessary for fat digestion and absorption. Between meals bile is stored in the
gallbladder. The exocrine pancreas produces enzymes needed for the complete
digestion of carbohydrates, proteins, and fats. The exocrine pancreas also
produces an alkaline fluid that neutralizes chyme, creating a duodenal pH that
supports enzymatic action. The liver receives nutrients absorbed by the small
intestine and metabolizes or synthesizes these nutrients into forms that can be
absorbed by the body’s cells. It then releases the nutrients into the bloodstream
or stores them for later use.
2. Know disorders of GI tract and accessory organs of digestion:
pathophysiology, etiology, prevention, clinical manifestations,
diagnostics, treatment and complications. (pp. 1428 – 1474; key
search term: “from mechanical obstruction”)
Disorders of Motility:
Dysphagia (p. 1428) is difficulty swallowing and can result from
mechanical obstruction of esophagus (within the walls of esophagus or
outside esophageal lumen—narrow esophagus) or functional disorder
impairing esophageal motility (neural or muscular disorders).
Gastroesophageal Reflux Disease (p. 1429) is the reflux of acid and pepsin
from the stomach to the esophagus that causes esophagitis.
3
