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CHAPTER 12
Digestive System
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Digestive System Overview
• Digestive System
– Known as gastrointestinal tract
• Also known as digestive tract or alimentary canal
– Approximately 30 feet long
• Begins with mouth (oral cavity), ends with anus
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Digestive System Overview
• Digestive System
– Functions
• Prepare foods for absorption into the bloodstream
• Prepare foods for use by the body cells
• Responsible for elimination of solid wastes from the body
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Digestive System Structures
• Oral cavity (buccal cavity)
– Lips
– Cheeks
– Hard palate
• Rugae
– Soft palate
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Digestive System Structures
• Oral cavity (buccal cavity)
– Uvula
– Tongue
• Principle organ of the sense of taste
• Also assists in process of chewing (mastication) and swallowing
(deglutition)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Digestive System Structures
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Digestive System Structures
• Salivary glands
– Three pairs
• Parotids
• Submandibulars
• Sublinguals
– Secrete saliva
• Mostly water, but contains mucus and digestive enzymes that
aid in digestive process
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Digestive System Structures
• Salivary glands
– Digestive enzymes contained in saliva
• Amylase – aids in digestion of carbohydrates
• Lipase – aids in digestion of fats
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Digestive System Structures
• Pharynx
– Known as the throat
– Serves as passageway for both respiratory and digestive
systems
– Oropharynx
• Section leading away from oral cavity
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Digestive System Structures
• Pharynx
– Nasopharynx
• Behind nasal cavity
– Laryngopharynx
• Lower portion – opens into esophagus and larynx
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Digestive System Structures
• Esophagus
– Receives food from pharynx and propels it to stomach
– Cardiac sphincter (lower esophageal sphincter) controls
passage of food from esophagus into the stomach
• Relaxes = food enters stomach
• Contracts = stomach contents prevented from reentering the
esophagus
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Digestive System Structures
• Stomach
– Fundus
• Upper rounded portion
– Body
• Central part
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Digestive System Structures
• Stomach
– Pylorus
• Lower tubular part (also called the gastric antrum)
• Pyloric sphincter regulates passage of food from stomach into
the duodenum
– Folds in mucous membranes of stomach = rugae
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Digestive System Structures
• Stomach
– Gastric juices break down food in stomach
– Muscular action of stomach causes churning of food
• Mixes food with the secretions
• Chyme = liquid-like mixture of partially digested food and
digestive secretions
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Digestive System Structures
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Digestive System Structures
• Small intestine
– Approximately 20 feet long
– Also known as the small bowel
– Divided into three parts
• Duodenum
• Jejunum
• Ileum
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Digestive System Structures
• Large intestine
– Cecum
• Appendix hangs from lower portion of cecum
– Ascending colon
• Hepatic flexure
– Transverse colon
• Splenic flexure
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Digestive System Structures
• Large intestine
–
–
–
–
Descending colon
Sigmoid colon
Rectum
Anus
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Digestive System Structures
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Digestive System Structures
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Question
True or False: Basically, this 30-foot digestive
system from mouth to anus breaks down
food into what the body can use and gets rid
of what it cannot.
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Answer
True. Food must be broken down to a cellular
level.
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Accessory Organs of Digestion
• Liver
– Located immediately under diaphragm, slightly to the right
– Only one digestive function
• Production of bile for emulsification of fats in small intestine
– Additional functions of liver
• Excretion of bile pigments into bile
• Synthesis of vitamin K-dependent plasma proteins
• Amino acid metabolism
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Accessory Organs of Digestion
• Liver
– Additional functions of liver
•
•
•
•
•
Carbohydrate metabolism
Fat metabolism
Phagocytosis
Detoxification
Storage of vital nutrients
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Accessory Organs of Digestion
• Gallbladder
– Pear-shaped sac, located under surface of liver
– Main function:
• To store and concentrate bile produced by the liver
• Releases bile in response to presence of fatty content of food
present in duodenum
• Emulsifies fats
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Accessory Organs of Digestion
• Pancreas
– Located in upper left quadrant of abdomen, behind stomach
– Functions as exocrine gland to manufacture digestive juices
•
•
•
•
Trypsin – breaks down proteins
Pancreatic lipase – breaks down fats
Pancreatic amylase – breaks down carbohydrates
Sodium bicarbonate – neutralizes acidic stomach contents
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Accessory Organs of Digestion
• Pancreas
– Functions as endocrine gland to manufacture insulin and
glucagon
• Insulin – hormone that makes it possible for glucose to pass from
blood through cell membranes to be used for energy
• Insulin also promotes conversion of excess glucose into glycogen
• Glucagon – hormone that stimulates the liver to convert glycogen
into glucose in time of need
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Animation
Click Here to Play Pancreas Animation
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Accessory Organs of Digestion
• Teeth
– Primary responsibility
• Chewing (mastication)
• Food is ground by teeth and softened by saliva
– Primary teeth = deciduous teeth
• Set of 20 teeth – appears around age 6 months
– Secondary teeth = permanent teeth
• Begin to appear around age 6
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Accessory Organs of Digestion
• Teeth
– Incisors
• Chisel shape with sharp edges for biting food
– Canine or cuspid teeth
• Useful for grasping and tearing food
– Bicuspids (premolars) and molars
• Flat surfaces, multiple projections for crushing and grinding food
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Accessory Organs of Digestion
• Teeth
– Crown
• Visible part of the tooth
• Covered with enamel – hardest substance in body
– Neck
• Lies just beneath the gum line
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Accessory Organs of Digestion
• Teeth
– Root
• Embedded in bony socket of the jaw bone
– Root canal = pulp cavity
• Central core of the tooth
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Question
The ducts from the liver, gallbladder, and
pancreas all converge to empty into what
part of the digestive tract?
a.
b.
c.
d.
stomach
colon
duodenum
esophagus
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Answer
c. The duodenum is the first part of the small
intestine, where digestion is completed and
nutrients can be passed to the bloodstream.
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Accessory Organs of Digestion
Layers of Teeth
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Animation
Click Here to Play Digestion Animation
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Common Signs and Symptoms
• Achlorhydria
– Abnormal condition characterized by the absence of
hydrochloric acid in the gastric juice
• Anorexia
– Lack or loss of appetite, resulting in the inability to eat
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Common Signs and Symptoms
• Aphagia
– Condition characterized by the loss of the ability to
swallow as a result of organic or psychologic causes
• Ascites
– Abnormal accumulation of fluid within the peritoneal
cavity
• Fluid contains large amounts of protein and electrolytes
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Common Signs and Symptoms
• Borborygmus
– An audible abdominal sound produced by hyperactive
intestinal peristalsis
• Borborygmi are rumbling, gurgling, and tinkling noises heard
when listening with a stethoscope
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Common Signs and Symptoms
• Constipation
– Difficulty in passing stools, or an incomplete or
infrequent passage of hard stools
• Diarrhea
– Frequent passage of loose, watery stools
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Common Signs and Symptoms
• Dyspepsia
– Vague feeling of epigastric discomfort after eating
– Involves an uncomfortable feeling of fullness, heartburn,
bloating, and nausea
• Dysphagia
– Difficulty in swallowing, commonly associated with
obstructive or motor disorders of the esophagus
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Question
This symptom may be relieved with Tums or
Prilosec OTC.
a.
b.
c.
d.
aphagia
dyspepsia
dysphagia
borborygmus
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Answer
b. Otherwise known as heartburn.
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Common Signs and Symptoms
• Emaciation
– Excessive leanness caused by disease or lack of nutrition
• Emesis
– Material expelled from the stomach during vomiting
– Vomitus
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Common Signs and Symptoms
• Eructation
– Act of bringing up air from the stomach with a
characteristic sound through the mouth
– Belching
• Flatus; flatulence
– Air or gas in the intestine that is passed through the rectum
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Common Signs and Symptoms
• Gastroesophageal reflux
– Backflow of contents of stomach into esophagus
– Often result of incompetence of the lower esophageal
sphincter
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Common Signs and Symptoms
• Icterus
– A yellowish discoloration of the skin, mucous
membranes, and sclera of the eyes, caused by greater
than normal amounts of bilirubin in the blood
– Also called jaundice
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Common Signs and Symptoms
• Melena
– An abnormal, black, tarry stool containing digested blood
• Nausea
– Unpleasant sensation often leading to the urge to vomit
• Pruritus ani
– A common chronic condition of itching of the skin
around the anus
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Common Signs and Symptoms
• Steatorrhea
– Greater than normal amounts of fat in the feces
• Characterized by frothy, foul-smelling fecal matter that floats
• Vomit
– To expel the contents of the stomach through the
esophagus and out of the mouth
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Question
True or False: Nausea can lead to eructation
and vomiting, which produces icterus.
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Answer
False. Vomitus, or more commonly emesis, is
the result of vomiting.
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PATHOLOGICAL CONDITIONS
Digestive System
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Achalasia
• Pronounced
– (ak-al-LAY-zee-ah)
• Defined
– Decreased mobility of the lower two-thirds of the
esophagus along with constriction of the lower esophageal
sphincter
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Anal Fistula
• Pronounced
– (AY-nal FISS-too-lah)
• Defined
– Abnormal passageway in the skin surface near the anus,
usually connecting with the rectum
• May occur as the result of a draining abscess
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Aphthous Stomatitis
• Pronounced
– (AFF-thus stoh-mah-TYE-tis)
• Defined
– Small, inflammatory, noninfectious, ulcerated lesions
occurring in the lips, tongue, and inside the cheeks of the
mouth
– Also called canker sores
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Appendicitis
• Pronounced
– (ap-pen-dih-SIGH-tis)
• Defined
– Inflammation of the vermiform appendix
• Usually an acute condition that can lead to rupture (perforation)
with resultant inflammation of the peritoneum (peritonitis)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Celiac Disease
• Pronounced
– (SEE-lee-ak dih-ZEEZ)
• Defined
– Nutrient malabsorption due to damaged small bowel
mucosa
• Gluten-sensitive disease
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Cirrhosis
• Pronounced
– (sih-ROH-sis)
• Defined
– Disease of the liver that is chronic and degenerative,
causing injury to the hepatocytes (liver’s functional cells)
• Fat infiltrates lobules of the liver, causing tissue covering the
lobes to become fibrous
• Functions of liver eventually deteriorate
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Question
If appendicitis is not caught in time, the
appendix ruptures and spills its contents into
the abdominal cavity. This causes
inflammation of its lining, which is called
the _____________.
a.
b.
c.
d.
peritoneum
pleura
meninges
perineum
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Answer
a. Peritonitis is inflammation of the peritoneum.
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Colorectal Cancer
• Pronounced
– (koh-loh-REK-tal KAN-sir)
• Defined
– Presence of a malignant neoplasm in the large intestine
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Constipation
• Pronounced
– (kon-stih-PAY-shun)
• Defined
– A state in which the individual’s pattern of bowel
elimination is characterized by a decrease in the frequency
of bowel movements and the passage of hard, dry stools
• Individual experiences difficult defecation
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Crohn’s Disease
• Pronounced
– (KROHNZ dih-ZEEZ)
• Defined
– Digestive tract inflammation of a chronic nature causing
fever, cramping, diarrhea, weight loss, and anorexia
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Dental Caries
• Pronounced
– (DEN-tal KAIR-eez)
• Defined
– Tooth decay caused by acid-forming microorganisms
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Diverticular Disease
• Pronounced
– (dye-ver-TIK-yoo-lar dih-ZEEZ)
• Defined
– Expression used to characterize both diverticulosis and
diverticulitis
• Diverticulosis = non-inflamed outpouchings or herniations of the
muscular layer of the intestines, typically the sigmoid colon
• Diverticulitis = inflammation of these outpouchings
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Diverticular Disease
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Dysentery
• Pronounced
– (DISS-en-ter-ee)
• Defined
– A term used to describe painful intestinal inflammation
typically caused by ingesting water or food containing
bacteria, protozoa, parasites, or chemical irritants
• Person has frequent stools that often contain blood
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Question
True or False: Diverticular disease is a
collective way of saying a person has
diverticulosis with episodes of diverticulitis.
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Answer
True. Diverticulosis must exist in order to have
diverticulitis.
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Esophageal Varices
• Pronounced
– (eh-soff-ah-JEE-al VAIR-ih-seez)
• Defined
– Swollen, twisted (tortuous) veins located in the distal end
of the esophagus
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Gallstones (Cholelithiasis)
• Pronounced
– (koh-lee-lih-THIGH-ah-sis)
• Defined
– Pigmented or hardened cholesterol stones formed as a
result of bile crystallization
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Hemorrhoids
• Pronounced
– (HEM-oh-roydz)
• Defined
– Hemorrhoid is an unnaturally distended or swollen vein
(varicosity) in distal rectum or anus
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Hepatitis
• Pronounced
– (hep-ah-TYE-tis)
• Defined
– Acute or chronic inflammation of the liver due to a viral
or bacterial infection, drugs, alcohol, toxins, or parasites
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Hernia
• Pronounced
– (HER-nee-ah)
• Defined
– Irregular protrusion of tissue, organ, or a portion of an
organ through an abnormal break in the surrounding
cavity’s muscular wall
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Hernia
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Herpetic Stomatitis
• Pronounced
– (her-PEH-tik stoh-mah-TYE-tis)
• Defined
– Inflammatory infectious lesions in or on the oral cavity
occurring as a primary or a secondary viral infection
caused by herpes simplex
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Question
In the picture of a hernia (Figure 12-9), what
muscle is the stomach protruding through?
a.
b.
c.
d.
abdominal muscle
diaphragm
intercostal muscle
the stomach's own muscle
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Answer
b. The cardiac sphincter is enlarged, which
causes part of the stomach to protrude
through the opening.
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Hirschsprung’s Disease (Congenital
Megacolon)
• Pronounced
– (HIRSH-sprungz dih-ZEEZ)
– (kon-JEN-ih-tal meg-ah-KOH-lon)
• Defined
– Absence at birth of the autonomic ganglia in a segment
of the intestinal smooth muscle wall that normally
stimulates peristalsis
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Ileus
• Pronounced
– (ILL-ee-us)
• Defined
– Obstruction of the intestine
• May occur due to twisting of the bowel, absence of peristalsis,
or presence of adhesions or tumor
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Intestinal Obstruction
• Pronounced
– (in-TESS-tin-al ob-STRUCK-shun)
• Defined
– Complete or partial alteration in the forward flow of the
contents in the small or large intestine
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Intussusception
• Pronounced
– (in-tuh-suh-SEP-shun)
• Defined
– Telescoping of a portion of proximal intestine into distal
intestine usually in the ileocecal region, causing an
obstruction
• Typically occurs in infants and young children
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Intussusception
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Irritable Bowel Syndrome (Spastic
Colon)
• Pronounced
– (EAR-it-ah-b’l BOW-el SIN-drohm)
– (SPAS-tik KOH-lon)
• Defined
– Increased motility of the small or large intestinal wall
resulting in abdominal pain, flatulence, nausea, anorexia,
and the trapping of gas throughout the intestines
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Oral Leukoplakia
• Pronounced
– (OR-al loo-koh-PLAY-kee-ah)
• Defined
– Precancerous lesion occurring anywhere in the mouth
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Question
True or False: Ileus or intestinal obstruction is
not an imminent threat, so it is best to let
nature take its course.
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Answer
False. It must be diagnosed and treated within
24 hours, or death could result.
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Pancreatitis
• Pronounced
– (pan-kree-ah-TYE-tis)
• Defined
– Destructive inflammatory condition of the pancreas
• May be acute or chronic
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Peptic Ulcers (Gastric, Duodenal,
Perforated)
• Pronounced
– (PEP-tik ULL-sirz)
– (GAS-tric, doo-OD-en-al, PER-foh-ray-ted)
• Defined
– Break in the continuity of the mucous membrane lining
of the gastrointestinal tract as a result of hyperacidity or
the bacterium Helicobacter pylori (H. pylori)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Peptic Ulcers
• Peptic ulcer descriptions
– Acute or chronic
– Singular or clustered
– Shallow or deep
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Peptic Ulcers
• Symptoms of an ulcer
–
–
–
–
Gnawing epigastric pain
Heartburn or indigestion
Nausea and vomiting
Bloated feeling after eating
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Periodontal Disease
• Pronounced
– (pair-ee-oh-DON-tal dih-ZEEZ)
• Defined
– Group of inflammatory gum disorders (gingivitis)
– May lead to degeneration of teeth, gums, and sometimes
surrounding bones
• Purulent inflammation of gums (pyorrhea) in late stages
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Polyps, Colorectal
• Pronounced
– (PALL-ips, koh-loh-REK-tal)
• Defined
– Small growths projecting from the mucous membrane of
the colon or rectum
• May be sessile (attached by a base) or pedunculated (attached by
a stalk)
• May vary in size and may be benign or pre-cancerous
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Thrush
• Pronounced
– (THRUSH)
• Defined
– Fungal infection in the mouth and throat producing sore,
creamy white, slightly raised curdlike patches on the
tongue and other oral mucosal surfaces
• Caused by Candida albicans
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Thrush
(Image courtesy of Dr. Joseph Konzelman,
School of Dentistry, Medical College of
Georgia)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Ulcerative Colitis
• Pronounced
– (ULL-sir-ah-tiv koh-LYE-tis)
• Defined
– Chronic inflammatory condition resulting in a break in
the continuity of the mucous membrane lining of the
colon in the form of ulcers
• Characterized by large, watery, diarrheal stools containing
mucus, pus, or blood
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Volvulus
• Pronounced
– (VOL-vyoo-lus)
• Defined
– Rotation of loops of bowel causing a twisting on itself
that results in an intestinal obstruction
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Volvulus
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Question
Peptic ulcers and ulcerative colitis are a break
in what lining?
a.
b.
c.
d.
muscular lining
serosal membrane
mucous membrane
epithelial membrane
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Answer
c. The mucous coating is needed to protect
underlying structures in a highly acidic
environment.
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
DIAGNOSTIC TECHNIQUES, TREATMENTS,
AND PROCEDURES
Digestive System
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diagnostic Techniques, Treatments,
and Procedures
• Abdominal ultrasound
– Use of very high-frequency sound waves to provide
visualization of the internal organs of the abdomen
(liver, gallbladder, bile ducts, pancreas, kidneys, bladder,
and ureters)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diagnostic Techniques, Treatments,
and Procedures
• Abdominocentesis (paracentesis)
– Insertion of a needle or trocar into abdominal cavity to
remove excess fluid
• Person is in a sitting position
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diagnostic Techniques, Treatments,
and Procedures
• Alanine aminotransferase (ALT)
– Hepatocellular enzyme released in elevated amounts due
to liver dysfunction
– Also known as serum glutamic pyruvic transaminase
(SGPT)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diagnostic Techniques, Treatments,
and Procedures
• Alkaline phosphatase (ALP)
– Enzyme found in highest concentrations in liver, biliary
tract, and bone
• Amylase
– Enzyme secreted normally from pancreatic cells that
travels to the duodenum by way of pancreatic duct
– Aids in digestion
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diagnostic Techniques, Treatments,
and Procedures
• Appendectomy
– Surgical removal of an inflamed appendix
– May be removed via laparoscope if no rupture has
occurred
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diagnostic Techniques, Treatments,
and Procedures
• Barium enema (BE)
– Infusion of a radiopaque contrast medium, barium
sulfate, into the rectum and held in the lower intestinal
tract while x-ray films are obtained of the lower GI tract
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diagnostic Techniques, Treatments,
and Procedures
• Barium swallow (upper GI series [UGI])
– Involves oral administration of a radiopaque contrast
medium, barium sulfate, which flows into the esophagus
as the person swallows
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diagnostic Techniques, Treatments,
and Procedures
• Capsule endoscopy
– Process of viewing entire length of small intestine using
an ingestible video camera with a light source, enclosed
in a capsule
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Diagnostic Techniques, Treatments,
and Procedures
• Capsule endoscopy
– Camera pill produces digital images of entire length of
small intestine, visualizing areas other diagnostic
techniques cannot
• No disruption to digestive tract
• Also known as wireless endoscopy
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diagnostic Techniques, Treatments,
and Procedures
• Cheiloplasty
– Surgically correcting a defect of the lip
• Cholecystectomy
– Surgical removal of the gallbladder
• Cholecystography (oral)
– Visualization of the gallbladder through X-ray following
the oral ingestion of pills containing a radiopaque
iodinated dye
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diagnostic Techniques, Treatments,
and Procedures
• Colonoscopy
– Visualization of the lining of the large intestine using a
fiberoptic colonoscope
• Colostomy
– Surgical creation of a new opening on the abdominal
wall through which the feces will be expelled, by
bringing the incised colon out to the abdominal surface
• Abdominal-wall anus
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Question
True or False: Appendectomy and
cholecystectomy remove body parts that
have little effect on bodily function.
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Answer
True. The appendix aids in fighting infection,
and the gallbladder aids in digestion of fatty
material. The diet may need to be adjusted,
but otherwise a person can live just fine
without them.
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diagnostic Techniques, Treatments,
and Procedures
• CT of the abdomen
– Painless, noninvasive X-ray procedure
– Produces an image created by the computer representing
a detailed cross section of the tissue structure within the
abdomen
• Example: computerized tomography (CT) of the abdomen
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diagnostic Techniques, Treatments,
and Procedures
• CT colonography (virtual colonoscopy)
– Uses CT scanning (or MRI) to obtain interior view of
colon that is usually seen with endoscope
– Noninvasive, painless procedure provides
2- to 3-dimensional images that can show polyps and
other lesions as clearly as with direct visual colonoscopy
• Allows growths to be detected in early stages
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diagnostic Techniques, Treatments,
and Procedures
• Endoscopic retrograde
cholangiopancreatography (ERCP)
– Examines the size of and filling of the pancreatic and
biliary ducts through direct radiographic visualization
with a fiberoptic endoscope
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diagnostic Techniques, Treatments,
and Procedures
• Esophagogastroduodenoscopy (EGD)
– Process of direct visualization of the esophagus, stomach,
and duodenum using a lighted, fiberoptic endoscope
• Also known as an upper endoscopy
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diagnostic Techniques, Treatments,
and Procedures
• Extracorporeal shock wave lithotripsy
(ESWL)
– Alternative treatment for gallstones by using ultrasound
to align the computerized lithotripter and source of shock
waves with the stones
– To crush the gallstones and thus enable the contraction
of the gallbladder to remove stone fragments
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diagnostic Techniques, Treatments,
and Procedures
• Fluoroscopy
– Radiological technique used to examine the function of
an organ or a body part using a fluoroscope
• Gastric analysis
– Study of the stomach contents to determine the acid
content and to detect the presence of blood, bacteria,
bile, and abnormal cells
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diagnostic Techniques, Treatments,
and Procedures
• Gastric lavage
– Irrigation, or washing out, of the stomach with sterile
water or a saline solution
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Diagnostic Techniques, Treatments,
and Procedures
• Herniorrhaphy
– Surgical repair of a hernia by closing the defect using
sutures, mesh, or wire
• Liver biopsy
– Piece of liver tissue obtained for examination by
inserting a specially designed needle into the liver
through the abdominal wall
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Question
A colonoscopy evaluates the lower portion of
the digestive tract with a scope, while a(n)
___________ evaluates the upper portion.
a.
b.
c.
d.
EGD
CT colonography
capsule endoscopy
fluoroscopy
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Answer
a. The abbreviation EGD stands for
esophagogastroduodenoscopy. The majority
of the small intestine cannot be not reached
with either test, however.
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Diagnostic Techniques, Treatments,
and Procedures
• Liver scan
– Noninvasive scanning technique
– Enables visualization of shape, size, and consistency of
liver after IV injection of a radioactive compound
• Magnetic resonance imaging (MRI)
– Noninvasive scanning procedure that provides
visualization of fluid, soft tissue, and bony structures
without the use of radiation
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diagnostic Techniques, Treatments,
and Procedures
• Nasogastric intubation
– Placement of a tube through the nose into the stomach
– To relieve gastric distension by removing gastric
secretions, gas, or food
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Diagnostic Techniques, Treatments,
and Procedures
• Percutaneous transhepatic cholangiography
(PTC) or (PTHC)
– Examination of bile duct structure using a needle to pass
directly into an intrahepatic bile duct to inject a contrast
medium
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Diagnostic Techniques, Treatments,
and Procedures
• 48-hour pH study
– Measures and monitors amount of gastric acid reflux into
the esophagus during specified period
– Monitoring system determines how often stomach
contents reflux into esophagus, how long acid stays in
esophagus, and how much reflux occurs at night
– Used to determine presence of and severity of
gastroesophageal reflux disease (GERD)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diagnostic Techniques, Treatments,
and Procedures
• Serum bilirubin
– Measurement of bilirubin level in serum
• Serum bilirubin levels are a result of the breakdown of red blood
cells
• Serum glutamic-oxaloacetic transaminase
(SGOT)
– Enzyme that has very high concentrations in liver cells
• Also known as aspartate aminotransferase (AST)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diagnostic Techniques, Treatments,
and Procedures
• Small bowel follow-through
– Oral administration of a radiopaque contrast medium,
barium sulfate
– Flows through the GI system
– X-ray films are obtained at timed intervals to observe the
progression of the barium through the small intestine
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Diagnostic Techniques, Treatments,
and Procedures
• Stool analysis for occult blood
– Analysis of a stool sample to determine presence of
blood not visible to naked eye
• Stool culture
– Collection of a stool specimen placed on one or more
culture mediums
– Allowed to grow colonies of microorganisms to identify
specific pathogen(s)
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Diagnostic Techniques, Treatments,
and Procedures
• Stool guaiac
– Test on a stool specimen using guaiac as a reagent
– Identifies presence of blood in stool
• Urinary bilirubin
– Tests for conjugated or direct bilirubin in a urine specimen
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Question
True or False: An elevated serum bilirubin
gives babies their yellowish appearance after
birth, which is quite common.
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Answer
True. Usually, a few sessions of phototherapy
(special blue light) will correct this.
Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.