This topic contains a solution. Click here to go to the answer

Author Question: What type of adaptation can the small intestine make after surgical resection? What will be an ... (Read 11 times)

APUS57

  • Hero Member
  • *****
  • Posts: 571
What type of adaptation can the small intestine make after surgical resection?
 
  What will be an ideal response?

Question 2

Burns are often described as one of the most metabolically stressful injuries. Discuss the effects of a burn on metabolism and how this will affect nutritional requirements.
 
  What will be an ideal response?



Related Topics

Need homework help now?

Ask unlimited questions for free

Ask a Question
Marked as best answer by a Subject Expert

pikon

  • Sr. Member
  • ****
  • Posts: 361
Answer to Question 1

The small bowel is remarkably adaptive (villi height and crypt depth can increase to accommodate for lost surface area).
Usually, when less than 50 of the small intestine is resected, normal digestion and absorption can be expected.
Success of adaptation is related directly to the health of the remaining small intestine.
Mr. Page has had extensive Crohn's disease for several years so it may prove difficult to predict his tolerance to this extensive surgery.

Answer to Question 2

Burns, as a type of severe injury or trauma, initiate the stress metabolic response. There is progression through three phases: the ebb phase, acute flow phase, and recovery phase or adaptive flow phase. The ebb phase occurs within the first 24-48 hours and it characterized by hemodynamic instability. This is a period of severe shock with depression of enzymatic activity and oxygen consumption, resulting in decreased cardiac output, decreased core temperature, and increased lactic acidosis. It is critical during this time to conduct fluid resuscitation and oxygen delivery. Thus, feeding this patient while he/she is still hemodynamically unstable is not a top priority for this stage.
During the acute flow phase, which occurs from 3 to 10 days after the initial stress event, the body is hypermetabolic with increased cardiac and oxygen consumption. Other changes include increased glucose production via gluconeogenesis, variable lipolysis, and increased protein breakdown to supply a gluconeogenic substrate. The body also uses amino acids from this muscle breakdown to create precursors for acute-phase proteins and glutamine for gut metabolism. This causes an increase in protein mobilization, increased urinary nitrogen excretion, and lean body mass wasting (weight loss). During this second phase, the body is activating its survival mechanisms to maintain organ systems and promote healing. Unfortunately, this also increases the risk for malnutrition and further complications to the initial event if not treated properly. The goal of this stage is to maintain nitrogen balance to prevent catabolism and the patient will require high levels of protein and energy with nutrition support.
During the last stage, the recovery/adaptive flow phase, the acute flow phase subsides and the initiation of recovery and the repair processes begin. This results in a decrease in energy and protein needs due to the decrease in inflammation and catabolism as anabolism begins to occur. This third phase can last up to two years after initial injury in extreme cases.




APUS57

  • Member
  • Posts: 571
Reply 2 on: Aug 21, 2018
Great answer, keep it coming :)


parshano

  • Member
  • Posts: 333
Reply 3 on: Yesterday
Wow, this really help

 

Did you know?

The National Institutes of Health have supported research into acupuncture. This has shown that acupuncture significantly reduced pain associated with osteoarthritis of the knee, when used as a complement to conventional therapies.

Did you know?

Pope Sylvester II tried to introduce Arabic numbers into Europe between the years 999 and 1003, but their use did not catch on for a few more centuries, and Roman numerals continued to be the primary number system.

Did you know?

On average, the stomach produces 2 L of hydrochloric acid per day.

Did you know?

Children of people with alcoholism are more inclined to drink alcohol or use hard drugs. In fact, they are 400 times more likely to use hard drugs than those who do not have a family history of alcohol addiction.

Did you know?

Acetaminophen (Tylenol) in overdose can seriously damage the liver. It should never be taken by people who use alcohol heavily; it can result in severe liver damage and even a condition requiring a liver transplant.

For a complete list of videos, visit our video library