CHAPTER 9: GASTROINTESTINAL SYSTEM − The palate contributes to the process of swallowing.

− The palatine tonsils, which are lymphoid tissue, are located

INTRODUCTION: laterally in the palate.
− The digestive system is also known as the gastrointestinal − The uvula is a hanging fold of tissue found in the middle of
system or the alimentary canal. the soft palate.
− The digestive system is approximately 10m long and travels
through the thoracic, abdominal, and pelvic cavities, ending
at the anus. Teeth
− The main function of the digestive system is to convert food - Temporary teeth are also known as deciduous teeth or milk
from the diet into a form that can be used by the cells of the teeth
body. - Temporary teeth begin to appear at about 6 months old
- There are 20 temporary teeth, which are replaced by
Five Processes of Digestive System permanent teeth from about age 6
1. Ingestion: taking food into the digestive system. - Canines and incisors are cutting and tearing teeth, while
2. Propulsion: moving the food along the length of the premolars and molars are used for grinding and chewing food
digestive system. - The structure of each tooth is the same, with a crown, pulp
3. Digestion: breaking down food. This can be achieved cavity, dentine, and enamel
mechanically as food is chewed or moved through the - The crown is the visible part of the tooth above the gum or
digestive system, or chemically by the action of enzymes gingiva
mixed with the food as it moves through the digestive - The pulp cavity contains blood vessels, lymph vessels, and
system. nerves, providing nutrients and sensations to the tooth
4. Absorption: the products of digestion exit the digestive - Surrounding the pulp is dentine, and surrounding the dentine is
system and enter the blood or lymph capillaries for enamel, a hard protective material
distribution to where they are required. - The teeth are anchored in sockets with a bone-like material
5. Elimination: the waste products of digestion are excreted called cementum
from the body as feces. - The function of the teeth is to chew (masticate) food.

The mouth (oral cavity)

− The oral cavity is where the process of digestion begins.
− Food enters the oral cavity through ingestion.
− The lips and cheeks help move food mixed with saliva
around the mouth for mechanical digestion.
− The teeth contribute to mechanical digestion by grinding and
tearing food.
− Chewing and mixing food with saliva is called mastication.
− The oral cavity is lined with mucus-secreting, stratified
squamous epithelial cells that provide protection against
abrasion and the effects of heat.
− The lips and cheeks are also involved in speech and facial
expression.

Tongue
− The tongue is a large, voluntary muscular structure in the
oral cavity. Salivary Glands
− The tongue is attached to the hyoid bone posteriorly and 1. There are three pairs of salivary glands: parotid glands,
inferiorly by the frenulum. submandibular glands, and sublingual glands.
− The superior surface of the tongue is covered in stratified 2. Saliva is continuously secreted to keep the oral cavity moist.
squamous epithelium for protection. 3. Parasympathetic fibers innervate the salivary glands and
− The tongue contains little projections called papillae or taste increase saliva production in response to the sight, smell, or
buds. taste of food.
− Taste buds are responsible for the sense of taste and 4. Sympathetic fibers decrease saliva secretion.
contribute to our enjoyment of food. 5. Approximately 1-1.5L of saliva are secreted daily.
− The tongue also plays a role in swallowing, holding and 6. Saliva consists of water, salivary amylase, mucus, mineral
moving food in the oral cavity, and speech. salts, lysozyme, immunoglobulins, and blood clotting factors.
7. Saliva has several important functions, including:
a. Salivary amylase begins the breakdown of carbohydrates.
b. Saliva helps to moisten and lubricate food, making it easier
to hold and swallow.
c. Saliva cleanses the oral cavity and maintains moisture,
preventing infections and mouth ulcers.
d. Saliva contains lysozyme, immunoglobulins, and clotting
factors to protect against pathogens.
e. Saliva is necessary for taste, as food substances need to be
moist for taste receptors to function.

Palate
− The palate is divided into two parts: the hard palate at the
front and the soft palate at the back.
− The hard palate is made up of bone, while the soft palate
consists of skeletal muscle and connective tissue.
1 – ANATOMY AND PHYSIOLOGY (LEC)
 - The muscle layer of the esophagus consists of skeletal
(voluntary) muscle in the superior portion and smooth
(involuntary) muscle in the inferior portion.
- Breathing and swallowing cannot occur simultaneously.

Clinical Consideration (Mouth Care)

1. Dehydration in ill patients leads to reduced production of
saliva, increasing the risk of oral infections.
2. Reduced saliva levels result in less washing away of
pathogens, allowing them to enter the respiratory tract.
3. Good oral hygiene practices can help prevent respiratory
infections in vulnerable patients. The Structure of the Digestive System
4. A lack of saliva affects the taste of food and makes it − The digestive system is composed of four layers of tissue.
difficult to form a bolus for swallowing. − The innermost layer, the mucosa, is involved in secretion
5. Patients may lose their appetite and experience delayed and absorption.
healing due to a lack of saliva. − The submucosa contains blood vessels, lymphatic vessels,
and glands.
Pharynx − The muscularis consists of circular and longitudinal smooth
- The pharynx consists of three parts: oropharynx, nasopharynx, muscles responsible for peristalsis.
and laryngopharynx. − The outermost layer is the serosa, protecting the digestive
- The nasopharynx is a part of the respiratory system, while the organs.
oropharynx and laryngopharynx are passages for both food and − The peritoneum, a type of serosa, covers the abdominal and
respiratory gases. pelvic organs and contains lymph nodes and vessels.
- The epiglottis prevents food from entering the larynx during − The peritoneum acts as a barrier and can isolate areas of
swallowing. infection.
- Swallowing (deglutition) occurs in three phases: voluntary
phase, pharyngeal phase, and esophageal phase.
- In the voluntary phase, the food bolus is manipulated into the
oropharynx through voluntary muscles.
- In the pharyngeal phase, a reflex action coordinated by the
swallowing center in the medulla oblongata causes muscle
contractions in the pharynx to prevent food from entering the
respiratory passages.
- In the esophageal phase, waves of muscle contraction, known
as peristalsis, move the food bolus down the esophagus and into
the stomach.

Stomach
Three regions: cardiac, fundus, body, and pyloric
- Lower esophageal sphincter controls entrance from the
esophagus, pyloric sphincter controls exit to small intestine
- Vagus nerve stimulates gastric motility and secretion of
gastric juice, sympathetic fibers reduce gastric activity
- Stomach has three layers of smooth muscle for churning
Esophagus and mixing food
- The esophagus is a thick-walled structure that extends from - Mucosa of stomach has rugae when empty, gastric glands
the laryngopharynx to the stomach. secrete various substances
- Its main function is to transport the food bolus from the mouth - Surface mucous cells produce protective mucus, mucous
to the stomach. neck cells secrete a different type of mucus
- The mucosa of the esophagus secretes thick mucus to aid - Parietal cells produce hydrochloric acid and intrinsic factor,
the passage of the food bolus and protect the esophagus from necessary for absorption of vitamin B12 and denaturing
abrasion. dietary protein
- The upper esophageal sphincter regulates the movement of - Chief cells produce pepsinogen, which converts to pepsin
substances into the esophagus, while the lower esophageal for protein digestion
sphincter regulates the movement of substances from the - Enteroendocrine cells produce hormones, including
esophagus to the stomach. gastrin, to regulate gastric motility
- Gastric juice is a mixture of secretions, water, and mineral
salts, produced daily
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 - Proteins are denatured by hydrochloric acid in the stomach and
further broken down by enzymes in the small intestine.
- Intestinal juice, produced by the small intestine, helps protect
the mucosa and increase pH.
- The small intestine has anatomical adaptations, such as
circular folds, villi, and microvilli, to facilitate absorption of water
and nutrients.
- Nutrients are absorbed through diffusion or active transport,
with some going into the blood capillary and others into the
lacteal.

Function of Small Intestine

1. Production of mucus to protect the duodenum from acidic
chyme.
2. Secretion of intestinal juice and pancreatic juice to
increase pH and facilitate enzyme action.
3. Bile enters to emulsify fat for further breakdown by lipase.
Regulation of Gastric Juice Secretion 4. Enzymes are secreted for complete chemical digestion of
carbohydrates, proteins, and fats.
Three phases: cephalic, gastric, and intestinal. 5. Mechanical digestion occurs through peristalsis and
segmentation to allow mixing and absorption.
1. The cephalic phase is stimulated by the sight, taste, or 6. Large surface area for maximum absorption of digestion
smell of food. products.
2. The gastric phase is triggered when food enters the 7. Majority of nutrients, electrolytes, and water are absorbed
stomach and the hormone gastrin is secreted. in the small intestine.
3. The intestinal phase occurs when the acidic contents of the
stomach enter the duodenum and the hormones secretin The Pancreas
and cholecystokinin are secreted. - The pancreas is composed of exocrine and endocrine
tissue
Gastric emptying rate depends on the size and content of the meal, - The endocrine hormones insulin and glucagon are
with liquids passing through the stomach quickly and solids requiring produced by the islet cells of the pancreas and control
more time. carbohydrate metabolism
The functions of the stomach include storing food, producing mucus - The exocrine glands of the pancreas produce pancreatic
for protection, mechanically digesting food, mixing food with juice, which helps with digestion
hydrochloric acid, producing chyme, and producing intrinsic factor. - Pancreatic juice consists of water, mineral salts, amylase,
lipase, and protein-digesting enzymes
Small Intestine - The secretion of pancreatic juice is regulated by hormones
1. The small intestine is approximately 6 meters long and is such as secretin and CKK, as well as parasympathetic
responsible for further breaking down food through mechanical vagus nerve stimulation
and chemical digestion. - The exocrine function of the pancreas is to secrete
2. The small intestine is divided into three parts: the duodenum, pancreatic juice for the breakdown of carbohydrates, fats,
the jejunum, and the ileum. and proteins.
3. The small intestine is innervated by both parasympathetic and
sympathetic nerves and receives its arterial blood supply from
the superior mesenteric artery.
4. There are four types of cells present in the mucosa of the small
intestine: absorptive cells, goblet cells, enteroendocrine cells,
and Paneth cells.
5. Partially digested food spends 3-6 hours in the small intestine,
where it undergoes mechanical digestion through segmental
contractions and peristalsis.
6. Chemical digestion in the small intestine is completed through
the actions of pancreatic juice, bile, and intestinal juice.

The Liver and the Production of Bile

1. The liver is the body's largest gland and is located under

the diaphragm and protected by the ribs.
2. The liver is composed of hexagonal-shaped lobules that
Chemical Digestion contain hepatocytes (liver cells) and Kupffer cells (hepatic
- Within the small intestine, carbohydrates are broken down by macrophages).
pancreatic amylase. 3. The liver receives oxygenated arterial blood from the
- Bile emulsifies fat and fatty acids, making it easier for lipase to hepatic artery and nutrient-rich deoxygenated blood from the
break down fats. hepatic portal vein.
3 – ANATOMY AND PHYSIOLOGY (LEC)
 4. Hepatocytes filter, detoxify, and process nutrients from the 5. Food residue enters the caecum and travels through the
digestive tract, which can be used for energy, stored, or used ascending, transverse, and descending colon before being
to make new molecules. excreted out of the body.
5. Processed blood is drained into the central vein and then 6. The caecum is a sac-like opening into the large intestine,
into the hepatic vein, which leads to the inferior vena cava. and the vermiform appendix is a narrow tube-like structure
6. Bile, a yellow/green alkaline fluid, is produced by the attached to it.
hepatocytes as a metabolic by-product. 7. The vermiform appendix is composed of lymphoid tissue
7. Bile emulsifies fats, allowing fat-digesting enzymes to and plays a role in immunity.
have a larger surface area to work on. 8. Exit from the anus is controlled by two sphincter muscles:
8. Bile is stored and concentrated in the gallbladder before the internal anal sphincter (controlled by the
being released into the small intestine. parasympathetic nervous system) and the external anal
sphincter (controlled voluntarily).
Function of the Liver
1. Production of bile and metabolism of carbohydrates, fats, o The large intestine mucosa contains goblet cells that secrete
and proteins. mucus to ease passage of feces and protect the walls.
2. Detoxification of drugs and elimination of toxins. o The anal canal changes from simple columnar to stratified
3. Recycling of erythrocytes (red blood cells). squamous epithelium.
4. Deactivation of hormones, including sex hormones and o Anal sinuses secrete mucus in response to fecal
insulin. compression to protect the anal canal.
5. Production of clotting proteins. o The taeniae coli are bands of longitudinal muscle that give
6. Storage of vitamins, minerals, and glycogen. the large intestine its gathered appearance.
7. Synthesis of vitamin A. o The sac created by the gathering of taeniae coli is called a
8. Heat production. haustrum.
o The primary function of the large intestine is to absorb water
The Gallbladder and turn food residue into semi-solid feces.
1. The gallbladder is a small, green, muscular sac located o The large intestine also absorbs some vitamins, minerals,
behind the liver. electrolytes, and drugs.
2. It functions as a reservoir for bile and concentrates bile by o Food residue takes 24-48 hours to pass through the large
absorbing water. intestine.
3. The mucosa of the gallbladder contains folds that allow it o The stretching of rectal walls initiates the defecation reflex.
to stretch to accommodate varying volumes of bile. o Acquired voluntary control of the defecation reflex occurs
4. When the gallbladder contracts, bile is expelled into the between the ages of 2 and 3 years.
cystic duct and down into the common bile duct, eventually o The external anal sphincter is under voluntary control and
entering the duodenum. allows defecation to occur if appropriate.
5. Gallbladder contraction is stimulated by the hormone o The Valsalva maneuver, involving contraction of abdominal
CCK, which is produced in response to the presence of fatty muscles and diaphragm, helps in the process of defecation.
chyme in the duodenum. o Defecation can be postponed if it is not appropriate to do so.
6. CCK also stimulates the secretion of pancreatic juice and o Feces is a brown, semi-solid material that contains fiber,
the relaxation of the hepatopancreatic sphincter. stercobilin, water, fatty acids, shed epithelial cells, and
7. When the sphincter is relaxed, both bile and pancreatic microbes.
juice can enter the duodenum. o Diarrhea occurs when there is excess water in feces due to
too quick passage through the large intestine.
The Large Intestine o Constipation occurs when food residue spends too long in
the large intestine.

REVIEW OF NUTRIENTS

Sources of Energy
A. Carbohydrates (4 calories per 1 g): sugars (simple) and
starches (complex); help provide basic fuel for energy; food
sources: sugars, honey, fruit, milk, syrups, potatoes, rice,
legumes, and products made with flour from grain (e.g.,
bread, cereal, pasta, crackers, cake, and cookies)
B. Proteins (4 calories per g): basically, composed of amino
acids; necessary for body growth, development, and healthy
functioning; maintains nitrogen balance; food sources: meat,
fish, poultry, dry beans, eggs, nuts, milk, and cheese
C. Fats (9 calories per 1 g): include neutral fats, oils, fatty
acids, cholesterol, and phospholipids; contribute to cellular
transport; dietary source of fuel and fuel reserve; vitamin
absorption and transport; insulation and protection afforded
by adipose tissue; food sources: animal fat, coconut and
1. The large intestine is responsible for the slow movement palm oil, dairy products, whole milk, vegetable oils, butter,
and absorption of contents from the small intestine. margarine, mayonnaise, salad dressings, and baked goods
2. Entry to the large intestine is regulated by the ileocecal and snacks that contain significant fat
sphincter, which opens in response to increased activity in
the stomach and the hormone gastrin. VITAMINS
3. Once food residue reaches the large intestine, it cannot
flow back into the ileum. 1. Vitamin A: fat-soluble vitamin needed for night vision, healthy
4. The large intestine measures 1.5 m in length and 7 cm in epithelium, skeletal and tooth development, and energy regulation
diameter, and it is continuous with the small intestine. a. Sources: carrots, cantaloupe, sweet potatoes, apricots,
squash, broccoli, cabbage, spinach and collards, fortified
milk products, egg yolk, liver, and kidney
4 – ANATOMY AND PHYSIOLOGY (LEC)
 b. Deficiency: slow accommodation to dim light, sinus (+) Chvostek’s sign – contraction of
problems, sore throat, epithelial thickening of tissue over the the facial muscles with a light tap
eye over the facial nerve.
c. Excess: yellow discoloration of skin (carotenemia) Think C for Cheesy smile
Risk Factors: Risk Factors:
2. Vitamin D: fat-soluble vitamin that enhances bone mineralization - ↑ calcium absorption - issues absorbing calcium from the
promoting absorption of calcium, muscle contraction - ↓ calcium excretion GIT
a. Sources: sunlight, cod liver oil, fortified milk, most dairy - kidney dse - Too much calcium leaving the
products - use of thiazide diuretics body from excretion
b. Deficiency: rickets (soft, fragile bones; skeletal - Hyperparathyroidism & > Kidney dse (↑ phosphorus & ↓
deformities), osteomalacia (softening of bone, causing hyperthyroidism vitamin D = hypocalcemia)
flexible, brittle bones; skeletal deformities), tetany resulting - Bone breakdown from > Diuretics
from low serum calcium level (vitamin D necessary for metastatic cancer > Diarrhea
calcium absorption) - Highly concentrated blood > Drainage from wounds
(hemoconcentration)
3. Vitamin E: fat-soluble vitamin that is an antioxidant
a. Sources: vegetable and peanut oils, whole grains, wheat Tx: Tx:
germ, milk, eggs, meats, fish, and leafy vegetables - stop calcium intake (IV or - ↑ calcium intake in diet
b. Deficiency: muscle weakness, anemia; rarely occurs PO) > Calcium supplements
- administer medications to > Vitamin D
4. Vitamin K: fat-soluble vitamin associated with blood clotting and lower down calcium levels > Calcium gluconate
bone metabolism; majority is produced by intestinal bacteria > Phosphorus - initiate seizure precautions (have
a. Sources: liver; green, leafy vegetables (e.g., lettuce, > Calcitonin high risk for seizures)
spinach, cabbage, kale, broccoli, Brussels sprouts), “calcitonin helps tone down
cauliflower, asparagus calcium levels in the blood”
b. Deficiency: prolonged antibiotic therapy and fat
absorption problems, which contribute to prolonged blood
clotting time 2. Sodium
a. Major role in fluid balance, transmission of
5. Vitamin C: water-soluble vitamin; antioxidant; associated with electrochemical impulses along nerve and muscle
wound and fracture healing, adrenal gland function, iron absorption, membrane
and folic acid conversion b. Sources: table salt, processed foods, milk and milk
Sources: citrus fruits, tomatoes, green and red peppers, products.
white potatoes, cabbage, broccoli, kale, asparagus, chard,
turnip greens, berries, melons, pineapple, and guavas Hypernatremia > Hyponatremia <135mEq/L
Deficiency (scurvy): tender, sore, bleeding gums; loose 145mEq/L
teeth; small skin hemorrhages and bleeding around joints,
stomach, and heart; ends of long bones soften; delayed S/Sx: “FRIED SALT” S/Sx: “SALT LOSS”
wound healing Flushed skin Stupor/coma
Restless, anxious, Anorexia (N&V)
6. B-complex vitamins: B1 (thiamine), B2 (riboflavin), B3 (niacin), B6 confused, irritable Lethargy (weakness or fatigue)
(pyridoxine), folic acid, B12 (cyanocobalamin), B5 (pantothenic acid), Increased BP & fluid Tachycardia (thready pulse)
and biotin; function as coenzymes retention Limp muscles (muscle weakness)
a. Sources: enriched grains; each has its own source (e.g., Edema (pitting) Orthostatic hypotension
B1—pork, wheat germ; B2—milk; B3— legumes; B6—organ Decreased UO Seizures; headache h/a
meats; folic acid—orange juice, green leafy vegetables; Skin is dry Stomach cramping (hyperactive
biotin—egg yolks, liver) Agitation bowels)
b. Deficiency: each has its own clinical findings; often seen Low-grade fever
in clients who drink an excessive amount of alcohol, Thirst (dry mucous Na+ imbalance can lead to neuro
experience weight loss, consume excessive sugar; may turn membrane) changes
urine bright yellow
Risk Factors: Risk Factors:
MINERALS - increased Na+ intake - loss of Na+
> Oral ingestion > Diaphoresis
1. Calcium > adm. Of IVF with NA+ > Diarrhea and vomiting
a. Needed for bone and tooth growth, coagulation, nerve (hypertonic IVF) > Drains (NGT suction)
conduction, and muscle contraction - loss of fluids from: > Diuretics
b. Sources: milk and dairy products, leafy green vegetables, > Burn > siaDh (dilution)
whole grains, nuts, legumes, and seafood > Fever - high water = low salt (all the water
> Diabetes insipidus (DI) dilutes the Na+ = hemodilution)
Hypercalcemia >11 mg/dL Hypocalcemia <9 mg/dL *low water = high salt
S/Sx “backme” S/Sx “CATS GO NUMB” (hemoconcentration) Hypovelemic hyponatremia – low
levels of fluid & Na+
Bone pain Convulsion Hypervolemic hyponatremia – high
Arrythmias Arrythmias levels of water in the body which
Cardiac Arrest (bounding Tetany dilutes Na+
pulses) Spasms and stridor
Kidney stones GO NUMB numbers in fingers, Tx: Tx:
Muscle weakness face, limbs - restrict Na+ intake - Adm. IVF (hypertonic solution)
Excessive urination - Adm. IVF if due to fluid loss - place pt. on seizure precaution
(+) Trousseau – carpal spasm (isotonic or hypotonic - place the pt. on fluid restriction if
caused by inflating a BP cuff solution) due to SIADH (they are in fluid vol.
overload)
5 – ANATOMY AND PHYSIOLOGY (LEC)
 - place pt. on airway precaution 6. Fluoride (ionized form of fluorine)
(NPO) > never give food or water to a. Maintains bone structure and strengthens tooth enamel
a pt. who is lethargic, confused, or b. Sources: added to water, toothpaste, mouthwashes, and
in a comatose state > risk for provided with supplements
aspiration
7. Magnesium
Hypertonic sol’n contain high Source: Nuts, milk, legumes, cereal
amounts of salt Function: Constituent of coenzymes. Muscle and nerve
TREAT underlying cause! irritability
Deficiency:
− neuromuscular problems, irregular heartbeat
3. Potassium − diarrhea

a. Function: Regulates fluid balance, conduction of nerve Hypermagnesemia Hypomagnesemia <1.5mg/dL

impulses, and muscle contraction, especially the heart >2.5 mg/dL
b. Sources: oranges, bananas, dried apricots or peaches, S/Sx: S/Sx:
cantaloupe, prune juice, baked potato with skins, sweet - ↓ DTRs - everything ↑ = not sedated
potato, raisins, pinto beans, winter squash, lima beans, - ↓ energy - ↑ HR
broccoli - ↓ HR (bradycardia) - ↑ BP (HPN)
- ↓ BP (hypotension) - shallow respirations
Hyperkalemia >5 mEq/L Hypokalemia <3.5 mEq/L - ↓ RR (bradypnea) - twitches, paresthesia
S/Sx: “MURDER” S/Sx: - ↓ resp. shallow - tetany & seizures
Muscle cramps & weakness - weak muscles & less contraction - ↓ bowel sounds - irritability & confusion
Urine abnormalities - ↓ reflexes - (+) trousseau
Respiratory distress - shallow breathing - (+) Chvostek’s sign
Decreased cardiac - slowing of GI system
contractility = low HR, low (constipation) Risk Factors: Risk Factors:
BP - ↓ BP (esp. orthostatic) - ↑ magnesium intake - insufficient Mg intake
EKG changes - N&V, bloating > (magnesium-containing > malnutrition, vomiting, diarrhea
Reflexes = low deep tendon - EKG changes *flattened T wave or antacids and laxatives) > Malabsorption syndrome
reflex (DTR) inversion of the T-wave > excessive adm. of > Celiac & Chron’s dse.
- ↑ levels of K+ = tall, peaked Generalized weakness in the magnesium IV - ↑ Mg excretion
T waves muscles = smooth muscle in - renal insufficiency > Diuretics or chronic alcoholism
bronchi, GI system. ↓ renal excretion of Mg = ↑ Mg - intracellular mov’t of Mg
* Muscles contract for in the bld. > Hyperglycemia & insulin adm.
TOO long = tight & - diabetic ketoacidosis (DKA) > sepsis
contracted
Tx: Tx:
Risk Factors: Risk Factors: - adm. loop diuretics - adm. MgSO4 IV or PO
- intake of too much K+ (IVF - ↓ K+ intake (not eating, NPO diet) - IV adm. of calcium chloride & - place pt. on seizure precautions
with K+) - vomiting & diarrhea calcium gluconate - instruct pt. to ↑ intake of Mg-
- adrenal gland issues - gastric suction - restrict dietary intake of containing foods
(insufficiency) - alkalosis magnesium-containing foods *nuts & seeds, legumes, whole
- ↑ levels of acid in the blood - potassium-wasting diuretics (loop - avoid the use of laxatives & grain, milk
(acidosis) or thiazide) antacids containing Mg
- NSAIDs *non-steroidal - use of hemodialysis in
anti-inflammatory drugs severe cases
(ibuprofen, naproxen)
- Potassium-sparing
diuretics (spironolactone)

Tx: Tx:
- stop K+ intake (IV or PO) - replace K+
- Adm. Medications: > Oral K+ supplement
> IV sodium bicarbonate > IV K+
> IV calcium gluconate *always dilute in fluid
*K+ can burn the vein, therefore
infuses slowly!
*never adm. K+ via IV push

4. Iron
a. Essential to hemoglobin and myoglobin formation,
constituent of enzyme systems
b. Sources: liver, lean meat, eggs, spinach, fortified cereals,
dried beans

5. Iodine
a. Component of thyroid hormones, which help regulate
metabolism, cell function and growth
b. Sources: saltwater fish, shellfish and seaweed, table salt
fortified with iodine
6 – ANATOMY AND PHYSIOLOGY (LEC)
8. Chloride
Source: Table salt
Function: Works with sodium to maintain osmotic pressure of extracellular fluid
Deficiency:
− alkalosis, muscle cramps
− vomiting

Hyperchloremia >105 mEq/L Hypochloremia <95 mEq/L

S/Sx: S/Sx:
- HPN *fluid retention - hypotension & tachycardia
- generalized swelling - mental status change
- peripheral edema - muscle weakness
- cardiac arrythmias - fatigue
*Similar S/Sx of hyponatremia

Risk Factors: Risk Factors:

- hypernatremia - DHN r/t large fluid vol. loss through:
- overuse of IV NaCl > Vomiting & diarrhea
- metabolic acidosis > SIADH
- renal damage > Overuse of diuretics
*kidneys are not able to filter & excrete excess chloride = ↑ Cl in the > Addison’s dse.
body > Metabolic alkalosis
- DHN = ↓ water = ↑ concentration of Cl in the body > Excessive suctioning of gastric contents
- uncontrolled glucose levels > K+ imbalance
- Diabetes insipidus (DI)

Tx: Tx:
- diet modifications - diet modifications
> Na+ restriction > ↑ salt intake with meals
> ↑ fluid to flush salt - adm. IV potassium
> Oral or IV fluids - adm. IV sodium chloride
- start bld. glucose mgmt or insulin - rehydration
- use dialysis in patients with renal dse. - limit or reduce diuretic use

GASTRO SUFFIXES

SUFFIX MEANING EXAMPLE

Cellulase - an enzyme that breaks down cellulose into smaller sugar molecules.
Lactase - an enzyme that breaks down lactose into smaller sugar molecules.
Amylase - an enzyme that breaks down starch into smaller sugar molecules.
ase enzyme
Lipase - an enzyme that breaks down fats into fatty acids and glycerol.
Maltase - an enzyme that breaks down maltose into glucose molecules.
Sucrase - an enzyme that breaks down sucrose into glucose and fructose.
itis Inflammation Appendicitis – inflammation of the appendix.
cholecystolithiasis (gallstones)
nephrolithiasis (kidney stones)
lithiasis Calculus or stone ureterolithiasis (stones in the ureter)
salivary gland lithiasis (stones in the salivary glands)
cholesterol lithiasis (cholesterol stones)
lysis Destruction or breakdown Hemolysis – breakdown of red blood cells.
pepsia Digestion Dyspepsia – indigestion or impaired digestion.
prandial Meal Postprandial – occurring after a meal.
orrhaphy Surgical fixation or suturing Herniorrhaphy – surgical repair of a hernia.
ostomy Creation of an artificial opening Colostomy – surgically created opening between the colon and the abdominal wall.
tresia Opening Atresia – absence or closure of a normal body opening.
tripsy Crushing Lithotripsy – a procedure used to break up kidney stones.

7 – ANATOMY AND PHYSIOLOGY (LEC)