Digestive System - Chapter 9 PDF

**CHAPTER 9** **DIGESTIVE SYSTEM** This Chapter discusses the different terms related both on the normal and clinical aspects of the digestive system that may help the learner to enable to communicate with the allied health care workers in taking care of the patients holistically. **Duration:** [...

**CHAPTER 9** **DIGESTIVE SYSTEM** This Chapter discusses the different terms related both on the normal and clinical aspects of the digestive system that may help the learner to enable to communicate with the allied health care workers in taking care of the patients holistically. **Duration:** [ **1.5** hours] +-----------------------------------------------------------------------+ | **MAJOR TOPICS** | +=======================================================================+ | 1. **Normal Structure and general functions of the digestive | | system** | | | | 2. Roots pertaining to the digestive system | | | | 3. Clinical symptoms and disorders of the digestive system | | | | 4. Common abbreviations and medical terminologies related to the | | digestive system | +-----------------------------------------------------------------------+ The digestive system is used in the human body for the process of digestion. It consists primarily of the digestive tract, or the series of structures and organs through which food and liquids pass during their processing into forms absorbable into the bloodstream. The system also consists of the structures through which wastes pass in the process of elimination and other organs that contribute juices for the digestive process. digestive system I. **[ORGANS OF THE DIGESTIVE TRACT]** **ORGAN** **DIGESTIVE ACTIONS** ----------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Mouth Used to bite and chew food. Mixes food with saliva, which contains salivary amylase, an enzyme that begins the digestion of starch. Shapes food into small portions, which the tongue pushes into the pharynx. Pharynx Swallows food by reflex action and moves it into the esophagus Esophagus Moves food into the stomach by peristalsis Stomach Stores food; churns to mix food with water and digestive juices. Secretes protein-digesting hydrochloric acid (HCl) and the enzyme pepsin Small Intestine Secretes enzymes. Receives secretions from the accessory organs, which digest and neutralize food. Site of most digestion and absorption of nutrients into the circulation Large Intestine Forms, stores, and eliminates undigested waste material - ***[The Accessory Organs]*** **ORGAN** **DIGESTIVE ACTIONS** ----------------- ------------------------------------------------------------------------------------------------------------------------ Salivary glands Secrete saliva, which moistens food and contains salivary amylase, an enzyme that begins the digestion of starch Liver Secretes bile salts that break down (emulsify) fats Gallbladder Stores bile and releases it into the digestive tract when needed Pancreas Secretes a variety of digestive enzymes. Also secretes bicarbonate to neutralize stomach acid and water to dilute food  II. **[NORMAL STRUCTURE AND FUNCTION]** +-----------------------------------+-----------------------------------+ | **TERMS** | **MEANING** | +===================================+===================================+ | anus | The distal opening of the | | | digestive tract (root: an/o) | +-----------------------------------+-----------------------------------+ | appendix | An appendage usually means the | | | narrow tube of lymphatic tissue | | | attached to the cecum, the | | | vermiform (worm-like) appendix | +-----------------------------------+-----------------------------------+ | bile | the fluid secreted by the liver | | | that emulsifies fats and aids in | | | their absorption (roots: chole/, | | | bili) | +-----------------------------------+-----------------------------------+ | cecum | A blind pouch at the beginning of | | | the large intestine (root: cec/o) | +-----------------------------------+-----------------------------------+ | colon | The major portion of the large | | | intestine; extends from the cecum | | | to the rectum and is formed by | | | ascending, transverse, and | | | descending portions (roots: | | | col/o, colon/o) | +-----------------------------------+-----------------------------------+ | common bile duct | The duct that carries bile into | | | the duodenum, formed by the union | | | of the cystic duct and the common | | | hepatic duct (root: choledoch/o) | +-----------------------------------+-----------------------------------+ | duodenum | The first portion of the small | | | intestine (root: duoden/o). Also | | | pronounced da-OD-e-mum | +-----------------------------------+-----------------------------------+ | enzyme | An organic catalyst; speeds the | | | rate of chemical reactions | +-----------------------------------+-----------------------------------+ | esophagus | The muscular tube that carries | | | food from the pharynx to the | | | stomach | +-----------------------------------+-----------------------------------+ | feces | The waste material eliminated | | | from the intestine (adjective | | | fecal); stool | +-----------------------------------+-----------------------------------+ | gallbladder | A sac on the under surface of the | | | liver that stores bile (root: | | | cholecyst/o) | +-----------------------------------+-----------------------------------+ | hepatic portal system | A special circulatory pathway | | | that brings blood directly from | | | the abdominal organs to the liver | | | for processing (also called | | | simply the portal system). The | | | vessel that enters the liver is | | | the hepatic portal vein (portal | | | vein) | +-----------------------------------+-----------------------------------+ | ileum | The terminal portion of the small | | | intestine (root: ile/o) | +-----------------------------------+-----------------------------------+ | intestine | The portion of the digestive | | | tract between the stomach and the | | | anus. Ir consists of the small | | | and large intestines. It | | | functions in digestion, | | | absorption, and elimination of | | | waste (root: enter/o). | +-----------------------------------+-----------------------------------+ | jejunum | The middle portion of the small | | | intestine (root: jejun/o) | +-----------------------------------+-----------------------------------+ | lacteal | A lymphatic capillary in a villus | | | of the small intestine. Lacteals | | | absorb digested fats intothe | | | lymph | +-----------------------------------+-----------------------------------+ | large intestine | The terminal portion of the | | | digestive tract, consisting of | | | the cecum, colon, rectum, and | | | anus. It stores and eliminates | | | undigested waste material (feces) | +-----------------------------------+-----------------------------------+ | liver | The large gland in the upper | | | right abdomen. In addition to | | | many other functions, it secretes | | | bile needed for digestion and | | | absorption of fats (root: | | | hepat/o) | +-----------------------------------+-----------------------------------+ | lower esophagus sphincter (LES) | Muscle tissue at the distal end | | | of the esophagus | | | (gastroesophageal junction) that | | | prevents stomach contents from | | | refluxing into the esophagus. | | | Also called the cardiac sphincter | +-----------------------------------+-----------------------------------+ | mastication | Chewing | +-----------------------------------+-----------------------------------+ | mouth | The oral cavity; contains the | | | tongue and teeth. Used to take in | | | and | | | | | | mix it with saliva, and move it | | | toward the throat to be swallowed | | | | | | food | +-----------------------------------+-----------------------------------+ | palate | The roof of the mouth; the | | | partition between the mouth and | | | nasal cavity. Consists of an | | | anterior portion formed by bone, | | | the hard palate, and a posterior | | | portion formed of tissue, the | | | soft palate (root palat/o) | +-----------------------------------+-----------------------------------+ | pancreas | A large, elongated gland | | | posterior to the stomach. It | | | produces hormones that regulate | | | sugar metabolism and also | | | produces digestive enzymes (root | | | pancreat/o) | +-----------------------------------+-----------------------------------+ | peristalsis | Wave-like contractions of an | | | organ\'s walls; moves material | | | through an organ or duct | +-----------------------------------+-----------------------------------+ | peritoneum | The large serous membrane that | | | lines the abdominal cavity and | | | supports the abdominal | +-----------------------------------+-----------------------------------+ | pharynx | The throat; a common passageway | | | for food entering the esophagus | | | and air entering the larynx | | | (root: pharyng/o) | +-----------------------------------+-----------------------------------+ | pylorus | The stomach\'s distal opening | | | into the duodenum (root: | | | pylor/o). The opening is | | | controlled by a ring of muscle, | | | the pyloric sphincter | +-----------------------------------+-----------------------------------+ | rectum | The distal portion of the large | | | intestine. It stores and | | | eliminates undigested waste | | | (roots: rect/o, proct/o) | +-----------------------------------+-----------------------------------+ | saliva | The clear secretion released into | | | the mouth that moistens food and | | | contains a starch-digesting | | | enzyme (root: sial/o). Saliva is | | | produced by three pairs of | | | glands: the parotid, | | | submandibular, and sublingual | | | glands | +-----------------------------------+-----------------------------------+ | sigmoid colon | Distal S-shaped portion of the | | | large intestine located between | | | the descending colon and the | | | rectum | +-----------------------------------+-----------------------------------+ | small intestine | The portion of the intestine | | | between the stomach and the large | | | intestine; comprises the | | | duodenum, jejunum, and ileum. | | | Accessory organs secrete into the | | | small intestine, and almost all | | | digestion and absorption occur | | | there | +-----------------------------------+-----------------------------------+ | stomach | A muscular sac-like organ below | | | the diaphragm that stores food | | | and secretes juices the digest | | | proteins (root: gastr/o) | +-----------------------------------+-----------------------------------+ | uvula | The fleshy mass that hangs from | | | the soft palate; aids in speech | | | production (literally \"little | | | grape\") (root: uvul/o) | +-----------------------------------+-----------------------------------+ | villi | Tiny projections in the lining of | | | the small intestine that absorb | | | digested foods into the | | | circulation (singular: villus) | +-----------------------------------+-----------------------------------+ III. **[ROOTS]** - **[Roots for the Mouth]** +-----------------+-----------------+-----------------+-----------------+ | Root | Meaning | Example | Definition of | | | | | Example | +=================+=================+=================+=================+ | bucc/o | Cheek | buccoversion | Turning toward | | | | | the cheek | +-----------------+-----------------+-----------------+-----------------+ | dent/o,dent/i | Tooth, teeth | edentulous | Without teeth | +-----------------+-----------------+-----------------+-----------------+ | odont/o | Tooth, teeth | periodontics | Dental | | | | | speciality that | | | | | deals with the | | | | | study and | | | | | treatment of | | | | | the tissues | | | | | around the | | | | | teeth | +-----------------+-----------------+-----------------+-----------------+ | gingiv/o | Gum (gingiva) | gingivectomy | Excision of the | | | | | gum tissue | +-----------------+-----------------+-----------------+-----------------+ | gloss/o | tongue | glossoplegia | Paralysis | | | | | (-plegia of the | | | | | tongue) | +-----------------+-----------------+-----------------+-----------------+ | lingu/o | tongue | orolingual | Pertaining to | | | | | the mouth and | | | | | tongue | +-----------------+-----------------+-----------------+-----------------+ | or/o | Mouth | circumoral | Around the | | | | | mouth | +-----------------+-----------------+-----------------+-----------------+ | stoma, stomat/o | mouth | xerostomia | Dryness (-xero) | | | | | of the mouth | | palat/o | | | | +-----------------+-----------------+-----------------+-----------------+ | sial/o | Saliva, | sialogram | Radiograph of | | | salivary gland, | | the salivary | | | salivary duct | | gland and ducts | +-----------------+-----------------+-----------------+-----------------+ | uvul/o | uvula | uvulotome | Instrument | | | | | (-tome) for | | | | | incising the | | | | | ovula | +-----------------+-----------------+-----------------+-----------------+ - **[Roots for the Digestive Tract (except the mouth)]** Root Meaning Example Definition of Example ---------------- --------------- --------------- --------------------------------------------------- esophag/o Esophagus esophageal Pertaining to the esophagus gastr/o stomach gastroparesis Partial paralysis (paresis) of the stomach pylor/o pylorus pyloroplasty Plastic repair of the pylorus enter/o Intestine dysentery Infection disease of the intestine duoden/o duodenum duodenostomy Surgical creation of an opening into the duodenum jejun/o jejunum jejunectomy Excision of the jejunum ile/o ileum ileitis Inflammation of the ileum cec/o cecum cecoptosis Downward displacement of the cecum col/o, colon/o Colon colonlysis Irrigation (-clysis) of the colon sigmoid/o sigmoid colon sigmoidscope An endoscope for examining the sigmoid colon rect/o rectum rectocele Hernia of the rectum proct/o Rectum proctoplexy Surgical fixation of the rectum - **[Roots for the Accessory Organs]** Root Meaning Example Definition of Example ---------------- ------------------ ----------------- ------------------------------------- hepat/o Liver hepatocyte A liver cell bili Bile biliary Pertaining to the bile or bile duct chol/e, chol/o Bile, gall Cholestasis Stoppage of the bile flow cholecyst/o Gallbladder Cholecystogram Radiograph of the gallbladder cholangi/o Bile duct chalangioma Cancer of the bile duct choledoch/o Common bile duct Choledochal Pertaining o the common bilr duct pancreat/o pancreas pancreatotropic Acting on the pancreas IV. **TERMS** **MEANING** ------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- appendicitis Inflammation of the appendix ascites Accumulation of fluid in the abdominal cavity; a form of edema. May be caused by heart disease, lymphatic or venous obstruction, cirrhosis, or changes in blood plasma composition Barrett syndrome Condition resulting from chronic esophagitis, as caused by gastroesophageal reflux disease. Inflammatory injury Can lead to esophageal spasms, scarring, strictures, and increased risk of cancer. Also called Barrett esophagus biliary colic Acute abdominal pain caused by gallstones in the bile ducts bilirubin A pigment released in the breakdown of hemoglobin from red blood cells; mainly excreted by the liver in bile caries Tooth decay celiac disease Inability to absorb foods containing gluten, a protein found in wheat and some other grains; caused by an excess immune response to gluten cholencystitis Inflammation of the gallbladder cholelithiasis The condition of having stones in the gallbladder; also used to refer to stones in the common bile duct cirrhosis Chronic liver disease with degeneration of liver tissue Crohn disease A chronic inflammatory disease of the gastrointestinal tract usually involving the ileum and colon diarrhea The frequent passage of watery bowel movements diverticulitis Inflammation of diverticula (small pouches) in the wall of the digestive tract, especially in the colon diverticulosis The presence of diverticula, especially in the colon dysphagia Difficulty in swallowing emesis Vomiting fistula An abnormal passageway between two organs or from an organ to the body surface, such as between the rectum and anus (anorectal fistula) gastroenteritis Inflammation of the stomach and intestine Gastroesophageal reflux disease (GERD) Condition caused by reflux of gastric juices into the esophagus resulting in heartburn regurgitation, inflammation, and possible damage to the esophagus; caused by weakness of the lower esophageal sphincter (LES) heartburn A warm or burning sensation felt behind the sternum and radiating upward. Commonly associated with gastroesophageal reflux. Medical name is pyrosis (pyrlo means \"heat\") hemorrhoids Varicose veins in the rectum associated with pain, bleeding, and sometimes rectal prolapse; piles hepatitis Inflammation of the liver; commonly caused by a viral infection hepatomegaly Enlargement of the liver hiatal hernia A protrusion of the stomach through the opening (hiatus) in the diaphragm through which the esophagus passes icterus jaundice ileus Intestinal obstruction. May be caused by lack of peristalsis (adynamic, paralytic ileus) or by contraction (dynamic ileus). Intestinal matter and gas may be relieved by insertion of a drainage tube intussusception Slipping of one intestinal segment into another part below it. Occurs mainly in male infants in the ileocecal region. May be fatal if untreated for more than one day jaundice A yellowish color of the skin, mucous membranes, and whites of the eye caused by bile pigments in the blood (from French jaune meaning \"yellow\"), The main pigment is bilirubin, a byproduct of erythrocyte destruction leukoplakia White patches on mucous membranes, as on the tongue or cheeks, often resulting from smoking or other irritants; may be precancerous nausea An unpleasant sensation in the upper abdomen that often precedes vomiting. Typically occurs in digestive upset, motion sickness, and sometimes early pregnancy occult blood Blood present in such small amounts that it can be detected only microscopically chemically; in the feces, a sign of intestinal bleeding (occult means \"hidden\") pancreatitis Inflammation of the pancreas peptic ulcer A lesion in the mucous membrane of the esophagus, stomach, or duodenum caused by the action of gastric juice perotinitis Inflammation of the peritoneum, the membrane that lines the abdominal cavity and covers the abdominal organs. May result from perforation of an ulcer, ruptured appendix, or reproductive tract infection, among other causes polyp A tumor that grows on a stalk and bleeds easily portal hypertension An abnormal pressure increases in the hepatic portal system, May be caused by cirrhosis, infection, thrombosis, or a tumor pyloric stenosis Narrowing of the opening between the stomach and the duodenum; pylorostenosis regurgitation A backward flowing, such as the backflow of undigested food spienomegaly Enlargement of the spleen ulcerative collitis Chronic ulceration of the rectum and colon; the cause is unknown, but may involve autoimmunity volvulus Twisting of the intestine resulting in obstruction. Usually involves the sigmoid colon and occurs most often in children and in the elderly. May be caused by congenital malformation, a foreign body, or adhesion, Failure to treat immediately may result in death Diagnosis and Treatment anastomosis A passage or communication between two vessels or organs. May be normal or pathologic or may be created surgically Barium study Use of barium sulfate as a liquid contrast medium for fluoroscopic or radiographic study of the digestive tract. Can show obstruction, tumors, ulcers, hiatal hernia, and motility disorders, among other conditions cholecystectomy Surgical removal of the gallbladder Dukes classification A system for staging colorectal cancer based on degree of bowel wall penetration and lymph node involvement; severity is graded from A to C endoscopic retrograde cholangiopancreatography (ERCP) A technique for viewing, the pancreatic and bile ducts and for performing certain techniques to relieve obstructions. Contrast medium is injected into the biliary system from the duodenum before radiographs are taken endoscopy Use of a fiberoptic endoscope for direct visual examination. GI studies include esophagogastroduodenoscopy, proctosigmoidoscopy (rectum and distal colon), and colonoscopy (all regions of the colon) ostomy An opening into the body; generally refers to an opening created for elimination of body waste. Also refers to the operation done to create such an opening (see stoma) stoma A surgically created opening to the body surface or between two organs (literally \"mouth\") V. **SUPPLEMENTARY TERMS:** - **[Normal Structure and Function]** **Terms** **Meaning** ------------------ -------------------------------------------------------------------------------------------------------------- bolus A mass, such as the rounded mass of food that is swallowed cardia The part of the stomach near the esophagus, named for its closeness to the heart chyme The semi-liquid partially digested food that moves from the stomach into the small intestine defecation The evacuation of feces from the rectum deglutition Swallowing duodenal bulb The part of the duodenum near the pylorus; the first bend (flexure) of the duodenum duodenal papilla The raised area where the common bile duct and pancreatic duct enter the duodenum; papilla of Vater (FA-ter) greater omentum A fold of the peritoneum that extends from the stomach over the abdominal organs hepatic flexure The right bend of the colon, forming the junction between the ascending colon and the transverse colon ileocecal valve A valve-like structure between the ileum of the small intestine and the cecum of the large intestine messentery The portion of the peritoneum that folds over and supports the intestine mesocolon The portion of the peritoneum that folds over and supports the colon papilla of Vater See duodenal papilla rugae The large folds in the stomach\'s lining seen when the stomach is empty sphinter of Oddi The muscular ring at the opening of the common bile duct into the duodenum splenic flexure The left bend of the colon, forming the junction between the transverse colon and the descending colon - **[Disorders]** **Terms** **Meaning** -------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------- achalasia Failure of a smooth muscle to relax, especially the lower esophageal sphincter so that food is retained in the esophagus achlorhydria Lack of hydrochloric acid in the stomach; opposite is hyperchlorhydria anorexia Loss of appetite. Anorexia nervosa is a psychologically induced refusal or inability to eat (adjectives: anorectic, anorexic) aphagia Inability to swallow or difficulty in swallowing, refusal or inability to eat aphthous ulcer An ulcer in a mucous membrane, as in the mouth bruxism Clenching and grinding of the teeth, usually during sleep bulimia Excessive, insatiable appetite. A disorder characterized by overeating followed by induced vomiting, diarrhea, or fasting cachexia Profound ill health, malnutrition, and wasting cheilosis Cracking at the corners of the mouth, often caused by B vitamin deficiency (root cheil/o means \"lip cholestasis Stoppage of bile flow. Also pronounced ko-LES-ta-sis constipation Infrequency or difficulty in defecation and the passage of hard, dry feces dyspepsia Poor or painful digestion eructation Belching familial adenomatous polyposis (FAP) A heredity condition in which multiple polyps form in the colon and rectum, predisposing to colorectal cancer Flatulence Condition of having gas or air in the Gl tract flatus Gas or air in the gastrointestinal tract; gas or air expelled through the anus hematemesis Vomiting of blood irritable bowel syndrome (IBS) A chronic stress-related disease characterized by diarrhea, constipation, and pain associated with rhythmic intestinal contractions. Mucous colitis, spastic colon megacolon An extremely dilated colon. Usually congenital but may occur in acute ulcerative colitis melena Black tarry feces resulting from blood in the intestines. Common in new borns. May alsobe a sign of gastrointestinal bleeding obstipation Extreme constipation pernicious anemia A form of anemia caused by the stomach\'s failure to secrete intrinsic factor, a substance needed for the absorption of vitamin B12 pilonidal cyst A dermal cyst in the sacral region, usually at the top of the cleft between the buttocks. May become infected and begin to drain thrush Fungal infection of the mouth and/or throat caused by Candida; appears as mucosal white patches or ulcers Vincent disease Severe gingivitis with necrosis associated with the bacterium. Treponema vincenti, necrotizing ulcerative gingivitis; trench mouth - **[Diagnosis and Treatment]** +-----------------------------------+-----------------------------------+ | **Terms** | **Meaning** | +===================================+===================================+ | appendectomy | Surgical removal of the appendix | +-----------------------------------+-----------------------------------+ | bariatrics | The branch of medicine concerned | | | with prevention and control of | | | obesity and associated | +-----------------------------------+-----------------------------------+ | bariatic surgery | Surgery to reduce the size of the | | | stomach and reduce nutrient | | | absorption in the treatment of | | | morbid obesity. Most common is | | | gastric bypass surgery, which | | | involves division of the stomach | | | and anastomosis of its upper part | | | to the small intestine | | | (jejunum)Other methods are | | | gastric stapling, partitioning of | | | the stomach with rows of staples, | | | and | | | | | | gastric banding, which involves | | | laparoscopic placement of an | | | adjustable loop (Lap-Band) that | | | reduces stomach capacity | +-----------------------------------+-----------------------------------+ | Billroth operation | Gastrectomy which anastomosis of | | | the stomach to the duodenum | | | (Bullroth 1) or to the jejunum | | | (Ballroch II) | +-----------------------------------+-----------------------------------+ | gavage | Process of feeding through a | | | nasogastric tube into the stomach | +-----------------------------------+-----------------------------------+ | lavage | Washing out of a cavity; | | | irrigation | +-----------------------------------+-----------------------------------+ | manometry | Measurement of pressure; | | | pertaining to the GI tract, | | | measurement of pressure in the | | | portal system as a sign of | | | obstruction | +-----------------------------------+-----------------------------------+ | Murphy sign | Inability to take a deep breath | | | when fingers are pressed firmly | | | below the right arch of the ribs | | | (below the liver). Signifies | | | gallbladder disease | +-----------------------------------+-----------------------------------+ | nasogastric (NG) tube | Tube that is passed through the | | | nose into the stomach May be used | | | for emptying the stomach, | | | administering medication, giving | | | liquids, or sampling stomach | | | contents | +-----------------------------------+-----------------------------------+ | parenteral hyperalimentation | Complete intravenous feeding for | | | one who cannot take in food. | | | Total parenteral nutrition (TPN) | +-----------------------------------+-----------------------------------+ | percutaneous endoscopic | Tube inserted into the stomach | | gastrostomy (PEG) tube | for long-term feeding | +-----------------------------------+-----------------------------------+ | vagotomy | Interruption of vagal nerve | | | impulses to reduce stomach | | | secretions in the treatment of a | | | gastric ulcer. Originally done | | | surgically but may also be done | | | with drugs | +-----------------------------------+-----------------------------------+ - **[Drugs ]** **Terms** **Meaning** ------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- antacid Agent that counteracts acidity, usually gastric acidity antidiarrheal Drug that treats or prevents diarrhea by reducing intestinal motility or absorbing irritants and soothing the intestinal lining antiemetic Agent that relieves or prevents nausea and vomiting antiflatulent Agent that prevents or relieves flatulence emetic Agent that relieves spasm, usually of smooth muscle histamine H2 antagonist An agent that causes vomiting laxative Drug that decreases secretion of stomach acid by interfering with the action of histamine at H, receptors. Used to treat ulcers and other gastroiritestinal problems. Hy-receptor blocking agent proton pump inhibitor Agent that promotes elimination from the large intestine. Types include stimulants, substances that retain water