ASSIGNMENT ON:

STOMACH AND ITS DISEASES.

SUBMITTED BY:

MADIHA SHAH

SUBMITTED TO:

SYED BAHAR

PROGRAMME:

BS NURSING

DATED: 12TH JULY 2023

STOMACH:

Your stomach is a muscular organ that digests food. It is part of your gastrointestinal (GI)

tract. When your stomach receives food, it contracts and produces acids and enzymes that

break down food. When your stomach has broken down food, it passes it to your small

intestine.

STOMAC
H

The stomach is a J-shaped organ that digests food. It produces

enzymes (substances that create chemical reactions) and acids
(digestive juices). This mix of enzymes and digestive juices breaks
down food so it can pass to your small intestine.

Your stomach is part of the gastrointestinal (GI) tract. The GI tract is

a long tube that starts at your mouth. It runs to your anus, where
stool (poop) leaves your body. The GI tract is a key part of your
digestive system.

STOMACH’S FUNCTION

Your stomach’s purpose is to digest food and send it to your small

intestine. It has three functions:

Temporarily store food.

Contract and relax to mix and break down food.

Produce enzymes and other specialized cells to digest food.

Stomach work with the rest of the GI
tract:

Each part of your GI tract breaks down food and liquid and carries
it through your body. During the digestive process, your body
absorbs nutrients and water. Then, you expel the waste products
of digestion through your large intestine.

Food moves through your GI tract in a few steps:

1. Mouth: As you chew and swallow, your tongue pushes food into
your throat. A small piece of tissue called the epiglottis covers your
windpipe The epiglottis prevents choking.

2. Esophagus: Food travels down a hollow tube called the

esophagus. At the bottom, your esophageal sphincter relaxes to
let food pass to your stomach.

(A sphincter is a ring-shaped muscle that tightens and loosens.)

3. Stomach: Your stomach creates digestive juices and breaks

down food. It holds food until it is ready to empty into your small
intestine.

4. Small intestine: Food mixes with the digestive juices from your
intestine, liver and pancreas. Your intestinal walls absorb nutrients
and water from food and send waste products to the large
intestine

5. Large intestine: Your large intestine turns waste products into

stool. It pushes the stool into your rectum

6. Rectum: The rectum is the lower portion of your large intestine.

ANATOMY:
STOMACH POSITION:
Your stomach sits in your upper abdomen on the left side of your
body. The top of your stomach connects to a valve called the
esophageal sphincter (a muscle at the end of your esophagus).
The bottom of your stomach connects to your small intestine.

Stomach Size:

The size of the stomach varies from person to person. Your

stomach expands when full and deflates when empty. Because of
this, your stomach size can vary depending on how recently and
how much you have eaten.

Parts of the stomach's anatomy:

Your stomach has five distinct sections:

• The cardia is the top part of your stomach. It contains the cardiac
sphincter, which prevents food from traveling back up your
esophagus.

• The fundus is a rounded section next to the cardia. It's below

your diaphragm (the dome-shaped muscle that helps you breathe)
• The body (corpus) is the largest section of your stomach. In the
body, your stomach contracts and begins to mix food.

The antrum lies below the body. It holds food until your stomach is
ready to

send it to your small intestine.

The pylorus is the bottom part of your stomach. It includes the

pyloric

sphincter. This ring of tissue controls when and how your stomach
contents move to your small intestine.

Stomach's structure:

Several layers of muscle and other tissues make up your stomach:

• Mucosa is your stomach's inner lining. When your stomach is

empty, the mucosa has small ridges (rugae). When your stomach is
full, the mucosa expands, and the ridges flatten.

• Submucosa contains connective tissue, blood vessels, lymph

vessels (part of your lymphatic system) and nerve cells. It covers
and protects the mucosa.

• Muscularis externa is the primary muscle of your stomach. It has

three layers that contract and relax to break down food.

• Serosa is a layer of membrane that covers your stomach.

CONDITIONS AND DISORDERS

Conditions and disorders that affect stomach:

• Gastrointestinal diseases may affect your stomach. You may have

gastrointestinal symptoms only under specific circumstances, such
as getting heartburn during pregnancy. Or you may have a chronic
(long-lasting) condition.

• Common conditions that affect your stomach include:

• Gastric ulcers: Erosion in your stomach's lining that can lead to
pain and bleeding

Gastritis: Stomach inflammation.

• Gastroesophageal reflux disease (GERD): When stomach

contents travel up to your esophagus, causing heartburn or
coughing

• Gastroparesis: Nerve damage that affects your stomach's muscle

contractions.

• Indigestion (dyspepsia): Discomfort, pain or burning in your

upper stomach

Peptic ulcer disease: Ulcers (sores) in either your stomach or the

first portion of your small intestine (duodenum).

• Stomach cancer: When cancerous cells grow uncontrollably in

your stomach.

CARE

Healthy Stomach:
• You can make lifestyle changes to keep your stomach
and digestive system healthy. You may:

• Drink alcohol only in moderation.

Drink at least 50 ounces of water daily, depending on your activity

level and size

• Eat 25 to 35 grams of fiber daily, depending on your age

and sex.

• Exercise regularly.

Limit your intake of processed foods.

Manage stress with healthy coping strategies, such as meditation.

Quit smoking or using tobacco products.

Carcinoma in Stomach MCQS

1) : The stomach lining is consists of following layers.

a) Serious layer

b) Muscular layer

c) Mucous layer

d) All of them
2) : Which of the following diets are risky or responsible for the
Stomach cancer?

a) Salted fish

b) Meat in large amount

c) Pickles

d) Vegetables

3) : Type of blood group is at high risk of developing

stomach cancer.

a) A Blood group

b) B Blood group

c) AB Blood group

d) O Blood group

4) : How many stages are there in the gastric cancer?

a) One Stage

b) Two Stage

c) Three Stage

d) Four Stage
5) : In the stomach carcinoma pathology, in which of the
following type shows lesions are with necrotic base and
heaped-up margins?

a) Intestinal type

b) Diffuse type

c) Cancer type

d) Ulcer type

6) : The people who are having B12 vitamin deficiency

will affect the body's ability to make new

a) WBCs

b) RBCs

c) DNA

d) RNA

7) : Which of the following technique helps in assessing local

invasion, ascitis and thickening of gastric wall?

a) Endoscopy

b) CT scan

c) Ultrasonography

8). Is the lower portion of the stomach where the food gets
mixed with gastric juice?
a) Cardia

b) Pylorus

c) Fundus

d) Antrum

9) : Which of the following are included in the signs of the

stomach carcinoma?

a) Cachexia

b) Virchows node

c) Irish node

d) All of them

10) : Which of the following will be primary treatment in the

stomach carcinoma?

a) By improving nutrition if needed

b) Surgery

c) Chemotherapy d) Radiotherapy

11) Which of the following tumor types is most common in

patients with gastric cancer?

a. Gastrointestinal stromal tumor

b. Adenocarcinoma

c. Carcinoid tumor

D.Lymphoma

12) Helicobacter pylori infection may be a strong risk factor for

gastric cancer.

A. True

B. False

13) Other risk factors for gastric cancer include:

a. Type A blood

b. Lynch syndrome

c. All of the above

14) Which of the following are symptoms of gastric cancer?

Severe, persistent heartburn

A. Fatigue
B. Vomiting

c.All of the above

15) A small percentage of gastric cancers are known to

be caused by hereditary diffuse gastric cancer
syndrome.

A. True

B.False

16) what is helicobactor pylori associated with

A.brain cancer

B. Prostate cancer

C. Gastric cancer

17) Stomach cancer may happen to be asymptomatic for a

long time before diagnosis.

A. True

B. False

18. Stomach cancer early symptoms are

A. Indigestion

B. loss of appetite

C.tiredness

D. All of the above

18) Stomach cancer risk factor are

A. Pickled or salty food access intake

B. Cigarettes

C. Advanced age

D. All of the above

19) The symptoms that show stomach drainage by enlarging

cancer is

A. Severe nausea and vomiting

B. Weight gain

C. C. Abdominal pain

PEPTIC ULCER MCQS

1. In the stomach lining, the parietal cells

Release-------------and the chief

cells release--------which both play

a role in peptic ulcer disease.

• A. pepsin, hydrochloric acid

• B. pepsinogen, pepsin

• C. pepsinogen, gastric acid

• D. hydrochloric acid, and pepsinogen

2. A patient has developed a duodenal ulcer. As the nurse, you
know that which of the following plays a role in peptic ulcer
formation. Select ALL that apply:

• A. Spicy foods X

• B. Helicobacter pylori v

• C. NSAIDs ~

• D. Milk

• E. Zollinger-Ellison Syndrome v.

3. This bacterium has a unique shape which allows it to

penetrate the stomach mucosa. You know this bacterium is:

• A. Rod shaped X

• B. Spherical shaped

• C. Spiral shaped

• D. Filamentous shaped

4. Helicobacter pylori can live in the stomach's acidic

conditions because it secretes which neutralizes the acid.

• A. ammonia

• B. urease

• C. carbon dioxide X

• D. bicarbonate
5. The physician orders a patient with a duodenal ulcer to take
a UREA breath test. Which lab value will the test measure to
determine if h. pylori is present?

• A. Ammonia

• B. Urea

• C. Hydrochloric acid X

• D. Carbon dioxide

6. A patient arrives to the clinic for evaluation of epigastric

pain. The patient describes the pain to be relieved by food
intake. In addition, the patient reports awaking in the middle
of the night with a gnawing pain in the stomach. Based on the
patient's description this appears to be what type of peptic
ulcer?

• A. Duodenal

• B. Gastric X

• C. Esophageal

• D. Refractory

7. patient with chronic peptic ulcer disease underwent a

gastric resection 1 month ago and is reporting nausea,
bloating, and diarrhea 30 minutes after eating. What condition
is this patient most likely experiencing?

• A. Gastroparesis X

• B. Fascia dehiscence
• C. Dumping Syndrome

• D. Somogyi effect

8. Thhinking back to the patient in question 8, select ALL the

correct statements on how to educate this patient about
decreasing their symptoms:

• A. "It is best to eat 3 large meals a day rather than small frequent
meals."

• B. "After eating a meal lie down for 30 minutes." X

• C. "Eat a diet high in protein, fiber, and low in carbs." v

• D. "Be sure to drink at least 16 oz. of milk with meals."

9. A patient is recovering from discomfort from a peptic ulcer.

The doctor has ordered to advance the patient's diet to solid
foods. The patient's lunch tray arrives. Which food should the
patient avoid eating?

• A. Orange

• B. Milk X

• C. White rice

• D. Banana

10. Which statement is INCORRECT about Histamine-receptor

blockers?
• A. "H2 blockers block histamine which causes the chief cells
to decrease the secretion of hydrochloric acid."

• B. "Ranitidine and Famotidine are two types of histamine-

receptor blocker medications."

• C. "Antacids and H2 blockers should not be given together." X

• D. All the statements are

11. ou are providing discharge teaching to a patient taking

Sucralfate (Carafate). Which statement by the patient
demonstrates they understand how to take this medication?

• A. "I will take this medication at the same time I take Ranitidine."

• B. "I will always take this medication on an empty stomach"

• C. "It is best to take this medication with antacids."

• D. "I will take this medication once a week." X

12. select all the medications a physician may order to treat a

H.

Pylori infection that is causing a peptic ulcer?

• A. Proton-Pump Inhibitors X

• B. Antacids

• C. Anticholinergics

• D. 5-Aminosalicylates

• E. Antibiotics X
• F. H2 Blockers v

• G. Bismuth Subsalicylates X

13. A physician prescribes a Proton-Pump Inhibitor to a

patient with a gastric ulcer. Which medication is considered a
PPI?

• A. Pantoprazole

• B. Famotidine

• C. Magnesium Hydroxide X

• D. Metronidazole

14. A patient with a peptic ulcer is suddenly vomiting dark

coffee ground emesis. On assessment of the abdomen you
find bloating and an epigastric mass in the abdomen.

Which complication may this patient be experiencing?

• A. Obstruction of pylorus

• B. Upper gastrointestinal bleeding

• C. Perforation

• D. Peritonitis ×

15. Nurse is discussing with a 56-year-old male client causative

factors that have led to his development of PUD.
The nurse realizes that there is need for further teaching when the
patient makes which of the incorrect statement?

A. I will take my prescribed triple therapy with antibiotics, ppi

and nsaids to eliminate H, pylori

B. Infection for 2 months

C. I should engage in relaxation techniques

16. Duodenal and gastric ulcers have similar as well as

differenfeatures. Which of the following characteristics Is/are
unique to tiating duodenal ulcers?

a. Stomach pain Is worsened by food

b. Cramp-like gnawing pain Interrupts sleep in the middie of

the night

c. Relieved by voriting

d. Vomiting of blood is more common

e. There is hx of passage of black, tarry stools

f. More common in men

17. Following Billroth 11(gastrojejunastomy) procedure, a

patient develops dumping syndrame. The nurse should
explain that the symptoms associated with this problem is
caused by:

a. Movement of fluid into the small bowel from concentrated

food and fluids moving rapidly into the Intestine

b. Hyperglycemia caused by uncontrolled gastric emptying

Into the small intestine

C.Irritation of the stomach lining by reflux of bile salts because the
pylorus has been remaved c Distention of the smaller stomach by
too much food and fluid intake

18. A client is admitted to the hospital after vomiting bright

red blood and is diagnosed with a bleeding duodenal ulcer.
The client develops a sudden, sharp pain in the midepigastric
region along with a rigid, boardlike abdomen.These clinical
manifestations most kely indicate which of the following?

a. Ulcer has perforated

b. Additional ulcers have

develoged c.Esophagus has

become inflamed

d. Intestinal obstruction occurred

19. What are the complications of peptic ulcer?

A. Perforation

B. GI bleeding

C. Dysphagia

D. Both a and b

20. Which of the following is not a causative agent for a peptic ulcer

A. Augumentin

B. Ansaids

C. Stress