NU Patho Study Guide Unit 6 Exam With
Complete Solutions
1. ANATOMY OF GI SYSTEM Anatomy and function of the GI system
components; normal intestinal flora. (P.1393-97, 1400, 1409) - ANSWER
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, myenteric plexus,
and subserosal plexus.
(P. 1395) Mouth - ANSWER reservoir for chewing and mixing food with
saliva. 3 pairs salivary glands (submandibular, sublingual, and parotid).
The esophagus and Stomach - ANSWER 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. (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 - ANSWER 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.
A central lacteal, or lymphatic capillary is contained within each villus and is
important for the absorption & transport of fat molecules. A person who has
problems with lacteals will have alterations in fat absorption. Digested fats
move into the lacteals and eventually reach the liver through the systemic
circulation.
(P. 1408) The large intestine - ANSWER 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 gastrocolic reflex initiates
propulsion in the entire colon, usually during or immediately after eating,
when chyme enters from the ileum. This reflex causes the fecal mass to
pass rapidly into the sigmoid colon and rectum, stimulating defecation
(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 - ANSWER 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.
Kupffer cells (macrophages) in the sinusoids of the liver remove bacteria
and foreign particles from blood in the hepatic circulation.
ANKYLOSING SPONDYLITIS Know Ankylosing spondylitis:
pathophysiology, etiology, prevention, clinical manifestations, diagnostics,
treatment and complications (pg. 1572-1574) - ANSWER is the most
common of a group of inflammatory arthropathies known as
spondyloarthropathies. It is a chronic inflammatory joint disease
characterized by stiffening and fusion (ankylosis) of the spine and sacroiliac
joints.
Patho: The exact cause of AS is unknown but its high association with the
histocompatibility antigen human leukocyte antigen (HLAB27) has been
known for decades. New research has shown that misfolding of HLA-B27
occurs in the endoplasmic reticulum (ER). As misfolded proteins
accumulate, it results in a stress response of the ER and increased
production of interleukin-23 (IL-23), a potent cytokine that may also act on
T-helper 17 cells, promoting their survival. Th17 cells, in turn, produce the
inflammatory cytokine. In AS, the primary pathological problem is
uncontrolled bone formation rather than bone destruction seen with most
other types of arthritis. The end results of AS are fibrosis, ossification, and
fusion of the joint, primarily the sacroiliac joints and the vertebral column.
In the early phases of AS, T cells and macrophages invade and cause
erosion of the cartilage at different sites. AS involves inflammation of
fibrocartilage in cartilaginous joints, primarily the vertebrae. The fibrous
tissue of the joint, capsule, the cartilage that surrounds intervertebral disks,
the enthuses, and periosteum are infiltrated by inflammatory cells. As
inflammatory cells (chiefly macrophages) and lymphocytes infiltrate and
erode bode and fibrocartilage in joint structures, repair begins. Fibroblasts
Complete Solutions
1. ANATOMY OF GI SYSTEM Anatomy and function of the GI system
components; normal intestinal flora. (P.1393-97, 1400, 1409) - ANSWER
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, myenteric plexus,
and subserosal plexus.
(P. 1395) Mouth - ANSWER reservoir for chewing and mixing food with
saliva. 3 pairs salivary glands (submandibular, sublingual, and parotid).
The esophagus and Stomach - ANSWER 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. (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 - ANSWER 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.
A central lacteal, or lymphatic capillary is contained within each villus and is
important for the absorption & transport of fat molecules. A person who has
problems with lacteals will have alterations in fat absorption. Digested fats
move into the lacteals and eventually reach the liver through the systemic
circulation.
(P. 1408) The large intestine - ANSWER 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 gastrocolic reflex initiates
propulsion in the entire colon, usually during or immediately after eating,
when chyme enters from the ileum. This reflex causes the fecal mass to
pass rapidly into the sigmoid colon and rectum, stimulating defecation
(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 - ANSWER 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.
Kupffer cells (macrophages) in the sinusoids of the liver remove bacteria
and foreign particles from blood in the hepatic circulation.
ANKYLOSING SPONDYLITIS Know Ankylosing spondylitis:
pathophysiology, etiology, prevention, clinical manifestations, diagnostics,
treatment and complications (pg. 1572-1574) - ANSWER is the most
common of a group of inflammatory arthropathies known as
spondyloarthropathies. It is a chronic inflammatory joint disease
characterized by stiffening and fusion (ankylosis) of the spine and sacroiliac
joints.
Patho: The exact cause of AS is unknown but its high association with the
histocompatibility antigen human leukocyte antigen (HLAB27) has been
known for decades. New research has shown that misfolding of HLA-B27
occurs in the endoplasmic reticulum (ER). As misfolded proteins
accumulate, it results in a stress response of the ER and increased
production of interleukin-23 (IL-23), a potent cytokine that may also act on
T-helper 17 cells, promoting their survival. Th17 cells, in turn, produce the
inflammatory cytokine. In AS, the primary pathological problem is
uncontrolled bone formation rather than bone destruction seen with most
other types of arthritis. The end results of AS are fibrosis, ossification, and
fusion of the joint, primarily the sacroiliac joints and the vertebral column.
In the early phases of AS, T cells and macrophages invade and cause
erosion of the cartilage at different sites. AS involves inflammation of
fibrocartilage in cartilaginous joints, primarily the vertebrae. The fibrous
tissue of the joint, capsule, the cartilage that surrounds intervertebral disks,
the enthuses, and periosteum are infiltrated by inflammatory cells. As
inflammatory cells (chiefly macrophages) and lymphocytes infiltrate and
erode bode and fibrocartilage in joint structures, repair begins. Fibroblasts
