Quiz 34: Introduction to the Endocrine System

Nursing

Functions of the gastrointestinal tract are food ingestion, absorption and digestion. During digestion the nutrients are absorbed by the colon or large intestine. Carbohydrate and protein fermentation in colon by the bacteria produces vitamin K. In the large intestine water and minerals get removed from the residual waste which is then compressed in the feces for defection through the rectum. Intestinal contents move by the rhythmic contraction in small intestine known as peristalsis through the bowel. Rectal pressure increases due to the fecal movement in the empty rectum which trigger the defecation reflux. The whole process is under the parasympathetic control. Propulsion of feces through anus caused due to the relaxation of internal anal sphincter. When the external anal sphincter relaxes which is under the voluntary control then defecation of feces occurs. Straining and evacuation can also initiate the defecation. The process is under the control of autonomic nervous system. The parasympathetic nervous system stimulation increases the intestinal motility and sympathetic nervous system stimulation decreases the intestinal motility. Bowel movement is very sensitive to an emotional stress or changes in the nervous system. Cholinergic i.e. parasympathetic stimulation leads to increase intestinal motility and adrenergic i.e. sympathetic stimulation decreases the intestinal motility. Impaired bowel syndrome is characterized by the decreased motility of intestine or increased motility of the intestine. Increased bowel movement causes decrease in transit time so the rapid movement of fecal mass through the intestine to the rectum. Decreased bowel movement causes increase in transit time so the facal mass remain in the colon for longer time. Increased bowel movement leads to diarrhea while decrease in bowel movement leads to constipation.

Functions of the gastrointestinal tract are food ingestion, absorption and digestion. During digestion the nutrients are absorbed by the colon or large intestine. Carbohydrate and protein fermentation in colon by the bacteria produces vitamin K. Intestinal contents move by the rhythmic contraction in small intestine known as peristalsis through the bowel. In the large intestine water and minerals get removed from the residual waste which is then compressed in the feces while defection through rectum. The process is under the control of autonomic nervous system. The parasympathetic nervous system stimulation increases the intestinal motility and sympathetic nervous system stimulation decreases the intestinal motility. Impaired bowel syndrome is characterized by the decreased motility of intestine or increased motility of the intestine. Increased bowel movement leads to diarrhea while decrease in bowel movement leads to constipation. Diarrhea leads to loss of water along with salts such as potassium, and chloride which results into dehydration. Diarrhea is caused due to increased intestinal motility and can be acute or chronic. There are certain types of diarrhea such as increased motility, secretory, inflammatory and osmotic. According to the cause of diarrhea, appropriate drug therapy can be determined. Microorganisms that invade the GI tissues leads to local inflammation and irritation may cause diarrhea. Patient A should be provided with the proper antibiotic or anti-viral drug. Adsorbent administration will also work in this case. An adsorbent will form a complex with bacteria or irritant in the stomach for the treatment of diarrhea caused due to spoiled food. Patient B is suffering from traveller's diarrhea and thus should be provided with the adsorbent like Pepto-Bismol and an antibiotic like Rifaximin. This type of diarrhea is caused due to consumption of the endemic contaminated water. Patient C is already suffering from urinary tract infection which is caused due to bacterial infection. Thus, diarrhea should be treated with the proper antibiotic. Patient D is suffering from the irritable bowel syndrome and thus should be prescribed the Loperamide. This drug is used for non-specific diarrhea, acute and chronic diarrhea related to irritating bowel syndrome.

The sympathetic nervous system acts to increase the heart rate, widens the bronchial passages and decrease motility of the large intestine. The internal as well as external anal sphincter contracts when the rectum is empty. The contraction of puborectalis muscles produces anorectal angulation. The large intestine propels feces towards the intestine for elimination. The distention of the intestine is an indication for the formation of the contractile ring and this initiates the process of peristalsis. Hence the incorrect options are b, c, d and e. The defecation means removing waste products from the body like passing stool or urine. Thus, process of eliminating stool from the body requires simulation of defecation reflex. It is a voluntary process. Hence the correct option is img .

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