You are on page 1of 4

NURS 3103 Pathophysiology Teri L.

Hernandez, PhD, RN

GI Notes
Gastrointestinal Tract: function is to provide nutrients for the body Lower Esophageal Sphincter (LES) Principle components: 1. GI motility 2. Secretion of digestive juices 3. Digestion of nutrients 4. Absorption of nutrients Fundus Pyloric Sphincter Duodenum Organs Involved: Mouth, esophagus, stomach, small intestine, large intestine, exocrine pancreas, liver, gallbladder, anus and rectum Pathophysiologic Principles related to the GI tract 1. The function of the normal gastrointestinal tract depends on the normal development of anatomic structures and the functional differentiation of their components. Structural and functional development If structural defects occur, GI pathophysiology occurs. Example: cleft palate, Hirschsprungs Disease (congential/intramural ganglia of the rectum do not develop. Leads to spasmodic constriction of the aganglionic segment of the large intestine/dilatation of the intestine above the obstruction). If functional defects occur, GI pathophysiology occurs. Example: inborn errors of metabolism in which key digestive enzymes are deficient. Abetalipoproteinemia is an enzymatic defect in the small intestinal cells prevents the absorption of fats from food, causing steatorrhea (one example) 2. The gastrointestinal tract is open-ended and thus is readily accessible to bacteria and other pathogens and allergens. Unlike many organ systems that are sterile, the GI tract is NOT sterile. It is colonized with bacteria and normal flora. 3. The intestinal mucosa is an interface and a barrier between the external and the internal milieu that requires energy to be maintained actively.

The mucosa of the GI tract is like skin and its integrity must be maintained. Even small defects are sites of bacterial infection. Examples: ulcers, cancher sores, breaks in gingiva around teeth 4. The gastrointestinal tract is a tube that can dilate or become obstructed. 5. Gastrointestinal diseases may disturb one or more of the basic functions of the gastrointestinal tract. Examples: loss of teeth affects chewing. Malabsorption issues affect vitamin and nutrient absorption. 6. Movement of the intestines depends on the autonomic contraction of smooth muscles, which is under neural and hormonal control. The GI system is under control of the autonomic NS PSNS: stimulation GI activity through the intrinsic NS (Rest and Digest) -Ach promotes stimulatory response SNS: stimulation GI activity through the intrinsic NS (Fight or Flight) -NorEpi promotes inhibitory response Intrinsic NS
Myenteric Plexus Control of GI movement

Submucosal Plexus Control of GI secretion

7. Abundant blood flow through the gastrointestinal tract and the superficial location of the blood vessels in the mucosa make it prone to hemorrhage or ischemia. The gastrointestinal tract receives a large amount of blood through large-caliber arteries that originate directly from the aorta. These arteries are prone to atherosclerosis; therefore, with advancing age, the blood supply to the intestine diminishes. This is one of the reasons why elderly people often have problems with digestion and constipation. They often develop ulcerations and ischemic atrophy of the mucosa.

8. The gastrointestinal tract is an important source of enzymes, hormones, and biologically active polypeptides.


Mouth, stomach Small intestine lumen Intestinal Epithelium (brush borders) Liver makes bile, stores it in Gallbladder Fats emulsified in Small Intestine Stomach, small intestine lumen, brush borders of small intestine Sites of Digestion Carbohydrates Lipids Proteins

The Liver: Normal Function


Digestive: 1. Bile salt excretion for fat digestion 2. Processing/storage of fat, CHO, PRO absorbed by intestine 3. Processing/storage of vitamins/minerals Endocrine: 1. Metabolism of glucocorticoids, mineralocorticoids, sex hormones 2. Regulation of CHO, fat, PRO metabolism


Hematologic: 1. Temporary storage of blood 2. Bilirubin synthesis from blood breakdown products 3. Hematopoesis (certain diseases) 4. Synthesis of clotting factors Excretory: 1. Excretion of bile pigment 2. Excretion of cholesterol via bile 3. UREA synthesis 4. Detoxification: drugs, foreign substances

Gallbladder: Bile storage tank. Bile assists in lipid digestion Exocrine Pancreas: Digestive Enzymes (amylase, lipase) 9. The gastrointestinal tract is exposed to environmental carcinogens in food Carcinomas of the gastrointestinal tract are among the most common human malignant diseases. It is believed that carcinogens in food play an important pathogenetic role and are directly responsible for most of these malignant diseases Sources: Damjanov, Ivan. Pathology for the Health Professions, 3rd Edition. W.B. Saunders Company, 102005. p. 242). Copstead-Kirkhorn, Lee-Ellen C. Pathophysiology, 4th Edition. W.B. Saunders Company, 022009. p. 822).

You might also like