Four functions of the gastrointestinal tract
Ingestion, digestion, absorption, and elimination
Deglutition
swallowing
the epiglottis of the pharynx covers the trachea so food cannot enter and become logged in the windpipe
papillae
small raised areas on the tongue, contain taste buds that are sensitive to the chemical nature of foods and allow discrimination of different tastes such as food moves across the tongue
Tonsils
masses of lymphatic tissue in depressions of the mucous membranes
lie on both side of the oropharynx
they are filters to protect the body from the invasion of microorganisms and produce lymphocytes
Name the 8 types of teeth
central incisor
lateral incisor
canine teeth
1st premolar
2nd premolar
1st molar
2nd molar
3rd molar (wisdom teeth)
Labial surface
labi/o = lip
for incisor and canine teeth, is nearest the lips
Buccal surface
bucc/o = cheek
for premolar and molar teeth, lies adjacent to the cheek
Facial surface
Faci/o = face
Contains Labial and Buccal surface
Lingual Surface
On the side of the tooth directly opposite the facial surface
Mesial Surface
lies nearer to the medial line
Distal surface
lies farther from the medial line
Occlusal surface
applies to premolar and molar surfaces
Where tooth comes into contact with corresponding tooth in the opposing arch.
Incisal edge
Both incisors and canines have this shape edge
A tooth consists of 5 parts
crown
root
enamel
dentin
pulp
Crown
above gum line
root
lies within the bony tooth socket
enamel
Outer most protective layer of the crown
it is dense, hard, and white
Hardest substance in the body
Dentin
the main substance of the tooth, lies beneath the enamel and extends throughout the crown
Cementum
covers, protects, and supports dentin in the root
Periodontal membrane
surrounds the cementum and holds the tooth in place in the tooth socket
Pulp
lies underneath the dentin
soft and delicate tissue that fills the center of the tooth
blood vessels, nerve endings, CT, and lymphatic vessels are withing the pump canal (root canal)
Root canal
necessary when disease or abces occurs in pulp canal
dentist opens the tooth from above and cleans the canal of infected tissue, nerves, and blood vessels
The canal is then disinfected and filled with material to prevent the entrance of microorganisms tha
Salivary glands
surround and empty into the oral cavity
They are exocrine glands that produce saliva, which lubricates the mouth
3 types: Parotid gland, submandibular gland, and sublingual gland
All 3 are on both sides of the mouth, narrow ducts carry saliva into the ora
saliva
lubricates the mouth and contains important digestive enzymes as well as healing growth factors such as CYTOKINES
released from the Parotid gland, submandibular gland, and sublingual gland
Pharynx
(throat)
muscular tube, about 5 inches long, luned with a mucous membrane
serves as a passageway both for air (nose -> trachea) and for food (mouth -> esophagus)
Esophagus
9-10" long muscular tube extending from the pharynx to the stomach
Uses PERISTALSIS to propel a BOLUS down toward the stomach
Peristalsis
involuntary, progressive, rhythmic contraction of muscles of esophageal wall and other gastrointestinal organs to propel a bolus
Stomach (3 parts)
fundus, body, and antrum
Contains 2 sphincters: Lower esophageal Spincter & Pyloric sphincter
Lined with RUGAE (folds in the mucous membrane of stomach) which contain pepsin and HCl
the stomach controls passage of foods into the first part of the small in
Lower esophageal Sphincter
relaxes and contracts to move food from the esophagus into the stomach
Pyloric Sphincter
allows food to leave the stomach when it is ready
Rugae
folds in the mucous membrane lining the stomach
contain digestive glands that produce pepsin (begin digest protein) and HCl
Small intestine (small Bowel)
20 feet
duodenum (1') , jejunum (8'), ileum (11')
Millions of tiny VILLI line the walls. Tiny capillaries in villi absorb the digested nutrients into the bloodstream and lymph vessels
Duodenum
1 foot long
receives bolus from stomach, bile from liver & gallbladder, and pancreatic juices from pancreas
large Intestine
3 main parts: cecum, colon, and rectum
It receives the fluid waste products of digestion (material unable to be absorbed into the bloodstream) and stores them until they can be released from the body
Cecum
a pouch on the right side of the body that connects ileum at the ileocecal valve (sphincter)
contains the appendix
Colon
5 feet in length
Ascending colon, hepatic flexure, transverse colon, splenic flexure, decending colon, sigmoid colon, rectum, anus
Liver
Located URQ
continually releases bile
maintains normal glucose. It removes excess glucose from bloodstream and stores it as glycogen. When the body needs glucose, the liver uses GLYCOGENOLYSIS to break down stored glycogen into glucose. The liver also use
Bile
made by the liver, orange-black, greenish thick fluid
contains choesterol, bile acids, and several bile pigments including bilirubin.
Bile emulsifies fats, which breaks apart large fat globules, creating more surface area so that enzymes from the pancreas
Liver -> Storage of bile -> duodenum
When bile is released from the liver it travels thru the HEPATIC DUCT into the CYSTIC DUCT -> gallbladder where it is stored
In response to food in the stomach and duodenum, the gallbladder contracts to release bile into the cystic duct -> COMMON BILE DUC
Bilirubin
a pigment in bile that is produced from the breakdown of hemoglobin during RBC destruction
It travels in the bloodstream to the lover, where it is conjugated into a water soluble form and added to bile --> duodenum
Bacteria in the colon degrade bilirubin
Jaundice (hyperbilirubinemia)
If the bile duct is blocked or the liver is damaged and unable to excrete bilirubin into bile, bilirubin remains in the bloodstream causing jaundice
Yellow discoloration of the skin, whites of the eyes, and mucous membranes
Portal vein
brings blood to the liver from the intestines
Digested foods pass into the portal vein directly after being absorbed into the capillaries of the small intestine, thus giving the liver the first chance to use the nutrients
pancreas
both an exocrine and endocrine organ
as an exocrine organ, it produces enzymes to digest starch (amylase), fat (lipase), and protein (protease). These pass form the pancreatic duct to the common bile duct into the duodenum.
as an endocrine organ (secretin
an/o
anus
perianal
append/o
appendix
appendectomy
appendic/o
appendix
appendicitis
bucc/o
cheek
buccal mucosa
cec/o
cecum
cecal
celi/o
belly, abdomen
celiac
cheil/o
lip
cheilosis
cholecyst/o
gallbladder
cholecystectomy
choledoch/o
common bile duct
Choledochotomy
col/o
colon, large intestine
colostomy
colon/o
colon
colonic, colonoscopy
dent/i
tooth
dentibuccal
duoden/o
duodenum
duodenal
enter/o
intestines, usually small intestine
enterocolitis, enteroenterostomy, mesentery, parenteral
esophag/o
esophagus
faci/o
face
facial
gastr/o
stomach
gingiv/o
gums
gingivitis
gloss/o
tongue
hepat/o
liver
ile/o
ileum
ileocecal sphincter
jejun/o
jejunum
choledochojejunostomy
labi/o
lip
lapar/o
abdomen
laparoscopy
lingu/o
tongue
mandibul/o
lower jaw, mandible
odont/o
tooth
or/o
mouth
palat/o
palate
palatoplasty
pancreat/o
pancreas
peritone/o
peritoneum
peritonitis (no e)
pharyng/o
throat
proct/o
anus and rectum
proctologist
pylor/o
pyloric sphincter
pyloroplasty
rect/o
rectum
rectocele
sialaden/o
salivary gland
sialadenitis
sigmoid/o
sigmoid colon
stomat/o
mouth
uvul/o
uvula
uvulectomy
amyl/o
starch
bil/i
gall, bile
biliary
bilirubin/o
bilirubin
hyperbilirubinemia
chol/e
gall, bile
cholelithiasis
chlorhydro/o
hydrochoric acid
achlorhydria
gluc/o glyc/o
sugar
glycogen/o
glycogen
lip/o
fat, lipid
lith/o
stone
lithogenesis
prote/o
protein
protease
sial/o
saliva, salivary
sialolith
steat/o
fat
steatorrhea
-ase
enzyme
-chezia
defecation, elimination of wastes
hematochezia
-iasis
abnormal condition
choledocholithiasis
-prandial
meal
postprandial
anorexia
lack of appetite
-sign of malignancy or liver disease
Anorexia nervousa is loss of apetite associated with emotional problems. Eating disorder.
ascities
abnormal accumulation of fluid in the abdomen
-occurs when fluid passes from the bloodstream and collects in the peritoneal cavity.
-Can be a sign of of neoplasm or inflammatory disorders in the abdomen, venous hypertension caused by liver disease, or hea
borborygmus (plural: borborygmi)
Rumbling or gurgling noise produced by the movement of gas, fluid, or both in the gastrointestinal tract
- a sign of hyperactive intestinal peristalsis, often are present during gastoenteritis or diarrhea
constipation
difficulty in passing stool
Occurs when peristalsis is slow and stools become dry/hard.
*diet of fruit, vegetables, and water is helpful. As well as laxatives and cathartics
diarrhea
frequent passage of loose, watery stools
-abrupt onset of diarrhea immediately after eating suggests acute infection or toxin in the gastrointestinal tract.
-may lead to dehydration
*Treatment: Antidiarrheal drugs
Dysphagia
difficulty in swallowing
-this sensation feels like a "lump in the throat" when a swallowed bolus fails to progress, either because of a physical obstruction or because of a motor disorder in which esophageal peristalsis is not coordinated
Obstructive or
eructation
gas expelled from the stomach through the mouth
also called belching
flatus
gas expelled through the anus
flatulence is presence of excessive gas in the stomach and intestines
Hematochezia
passage of fresh, bright red blood from the rectum
-the cause is usually bleeding due to colitis or from ulcers or polyps in the colon or rectum
Jaundice (icterus)
Yellow-orange coloration of the skin and whites of the eyes caused by high levels of bilirubin in the blood (hyperbilirubinemia)
-Can occur when
1. excessive destruction of erythrocytes, as in hemolysis, causes excess bilirubin in blood
2. malfunction of
melena
Black, tarry stools; feces containing digested blood
-usually reflects a condition in which blood has had time to be digested and results from bleeding in the upper gastrointestinal tracts (duodenal ulcer)
-shows a positive stool guaiac test
nausea
unpleasent sensation in the stomach associated with a tendency to vomit
-sea and motion sickness and early pregnancy
-nausea and vomiting might be symptomatic of a perforation of an abdominal organ; obstruction of a bile duct, stomach, or intestine; toxin
Steatorrhea
fat in the feces; frothy, foul-smelling fecal matter
-improper digestion or absorption of fat can cause fat to remain in the intestine. This may occur with disease of the pancreas (pancreatitis) when enzymes are not excreted.
-It is also a sign of intesti
Aphthous stomatitis
inflammation of the mouth with small, painful ulcers
-commonly called canker sores
dental caries
tooth decay
-dental plaque on the tooth enamel. bacteria frows in the plawue and causes production of acid which dissolves the enamel resulting in a cavity
herpetic stomatitis
Inflammation of the mouth caused by infection with the herpesvirus
-painful fluid-filled blisters on the lips, palate, gums, and tonue, commonly called fever blisters or cold sores
Oral leukoplakia
White plaques or patches on the mucosa of the mouth
- precancerous lesion resulting from tobacco use
-malignant potential is test thru a microscope
Periodontal disease
Inflammation and degeneration of gums, teeth, and bone
- gingivitis occurs from plaque, dental calculus, and tartar
*gingivectomy and antibiotics
Achalasia
Failure of the lower esophagus sphincter (LES) muscle to relax
- results from the loss of peristaltic motion so food cannot pass easily thru the esophagus.
- both the failure of LES and peristalsis leads to the esophagus dilating above constriction
*bland
Esophageal cancer
Malignant tumor of the esophagus
- most common symptom is difficulty swallowing (dysphagia)
- cause: smoking and alcohol, and excessive gastric reflex (Barrett esophagus)
*surgery, radiation, chemotherapy
Esophageal varices
Swollen, varicose veins at the lower end of the esophagus
- liver disease causes increased pressure in veins near and around liver (portal hypertension)
*drug therapy to lower portal hypertension and banding or tying off the swollen esophageal veins
Gastric cancer
Malignant tumor of the stomach
- chronis gastritis associated with bacterial infection is a major risk
-gastric endoscopy and biopsy diagnose
* cure depends on treatment and surgical removal
Gastroesophageal reflux disease (GERD)
Solids and fluids return to the mouth from the stomach
- heartburn is caused from HCl and pepsin regurgitating from stomach into esophagus
- chronic exposure of these acids on the esophageal mucosa leads to reflux esophagitis
* anacids agents and medicati
Hernia
Protrusion of an organ or part thru the muscle normally containing it
-HIATAL HERNIA when upper part of stomach protrudes upward thru the diaphragm. This can lead to GERD
-INGUINAL HERNIA when a small loop of bowel protrudes thru a weak area of lower abdo
Peptic ulcer
Open sore in the lining of the stomach or duodenum
- a bacterium heliobacter pylori, hyperacidity, and gastric juices damage epithelial linings and cause ulcer
* antibiotics, anacids
Anal fistula
Abnormal tube- like passageway near the anus
- results from a break or fissure in the anus or from and absces
Colonic polyps
Polyps (benign growths) protrude from the mucous membrane of the colon
- PEDUNCULATED attached to the membrane by a stalk
SESSILE sitting dire fly on the mucus
*polypectomy and biopsy to prevent malignancy
Colorectal cancer
Adenocarcinoma of the colon or rectum, or both
- can rise from polyps
- diagnosis is determined thru detecting melon (blood in stool) and colonoscopy
- prognosis depends on stage of tumor
* surgical treatment, chemotherapy, and radiotherapy
Crohn disease
Chronic inflammation of the intestinal tract ( terminal ileum and colon)
- symptoms include diarrhea, severe abdominal pain, fever, anorexia, weakness, weightless
- both crohns and ulcerative colitis are forms of IBD
* drugs to control symptoms or surgica
Diverticulitis
Abnormal outpouchings in the intestinal wall
- diverticula ae pouch-like herniations thru the muscular wall of the colon. When fecal matter be ones trapped in -> diverticulitis
Dysentery
Painful, inflamed intestines commonly caused by bacterial infection
- occurring in the colon, occurs from ingestion of food or water containing bacteria
- symptoms bloody stool and abdominal pain
Hemorrhoids
Swollen, twisted, varicose veins in the rectal region
- varicoseveins can be internal or external (outside anal sphincter)
Ileus
Loss Of peristalsis with resulting obstruction of the intestines
- surgery, trauma, or bacterial injury to the peritoneum can lead to paralytic ileus
Intussusception
Telescoping of the intestines
- one segment of bowel collapses into the opening of another segment
- it occurs in children at the oleocecal region
-* surgicAl removal of affected segment with anastamosis
Irritable bowel syndrome (IBS)
Group of gastrointestinal symptoms associated with stress and tension
- diarrhea, constipation, bloating, and/or abdominal pain
- the intestines appear normal but symptoms persist
*symptomatic with a diet high in bran and fiber
Ulcerative colitis
chronic inflammation of the colon with presents of ulcers
- idiopathic, chronic, recurrent diarrheal disease (type of IBS) with rectal bleeding and pain
- beginning in the colon and spreads proximally into the entire colon
* resection of the bowel with il
Volvulus
Twisting of the intestine on itself
- causes intestinal obstruction. Severe pain, nausea, vomiting, and absence of bowel sounds
* surgical correction is necessary to prevent necrosis
Cholelithiasis
Gallstones in the bladder
- calculi (stones) prevent bile from leaving the gallbladder and bile ducts
-many patients are asymptomatic, but if patient has episodes of biliary colic, treatment is required
* laparoscopic cholecystectomy
Cirrhosis
Chronic degenerative disease of the liver
- commonly the result of chronic alcoholism, or viral hepatitis
- lobes of the liver become covered with fibrous tissue, hepatic cells degenerate, and the liver is infiltrated with fat
- cirrh/o means yellow-orang
Pancreatic cancer
Malignant tumor of the pancreas
- occurs more often in men
-cause is unknown
- more common in smokers and obese
- symptoms are abdominal pain, fatigue, jaundice, and anorexia
* pancreatoduodenectomy (whipple procedure)
Pancreatitis
Inflammation of the pancrease
- digestive enzymes attack pancreatic tissue and damage the gland. Others: alcoholism, drugs, gallstones, and viral infections
* meds for epigastric pain, intravenous fluids
Viral hepatitis
Inflammation of the liver caused by A virus
- hep A, B, C
- liver enzyme levels may be elevated, indicating damage to liver cells
-signs and symptoms include malaise, anorexia, hepatomegalgy, jaundice, and abdominal pain
-estasis, -ectasia
stretching, dilation, dilatation, widening
bronchiectasis
lymphangiectasia
-emesis
vomiting
hematemesis
-lysis
destruction, breakdown, separation
-pepsia
digestion
dyspepsia
-phagia
eating, swallowing
polyphagia (excessive appetite)
dysphagia (difficulty swallowing)
-plasty
surgical repair
-ptosis
drooping; sagging; protruding
proptosis (protrusion of the eye)
-ptysis
spitting
hemoptysis (from lungs and respiratory tract)
-rrhage, -rrhagia
bursting forth (of blood)
hemorrhage
menorrhagia
-rrhaphy
suture
herniorrhaphy (stitching up a hernia)
-rrhea
flow, discharge
dysmenorrhea
-spasm
involuntary contraction of mm
-stasis
stopping, controlling
cholestasis (flow of bile from liver is interrupted)
-stenosis
tightening, stricture, narrowing
pyloric stenosis (newborns displaying a blockage in the small intestine)
-tresia
opening
atresia (absense of normal opening)
biliary atresia
Liver function tests (LFTs)
Tests for the presence of enzymes and bilirubin in blood
-ALT: alanine transaminase
-AST: aspartate transaminase
Both AST and ALT are present in many tissue of the body but high levels of both of them indicate damage to liver cells
-Alkaline phosphatase
-
Stool culture
Test for microorganisms present in feces
stool guaiac test or hemoccult test
test to detect occult (hidden) blood in feces
Guaiac is a chemical from the wood of trees and when put in a stool it reacts with any blood present in the feces
Lower gastrointestinal series (barium enema)
x-ray images of the colon and rectum obtained after injection of barium into the rectum
Upper gastrointestinal series
x-ray images of the esophagus, stomach, and small intestine obtained after administering barium by mouth
Cholangiography
x-ray examination of the biliary system performed after injection of contrast into the bile ducts
computed tomography (CT)
a series of x-ray images are taken in multiple views (especially cross section)
Abdominal ultrasonography
sound waves beamed into the abdomen produce an image of abdominal viscera
endoscopic ultrasonography (EUS)
use of an endoscope combined with ultrasound to examine the organs of the gastrointestinal tract
Magnetic resonance imagine (MRI)
Magnetic waves produce images of organs and tissues in all 3 planes of the body
Gastric bypass or bariatric surgery
Reducing the size of the stomach and diverting food to the jejunum (gastrojejunostomy)
Gastrointestinal endoscopy
visual examination of the gastrointestinal tract using an endoscope
Laparoscopy
visual (endoscopic) examination of the abdomen with a laparoscope inserted thru small incisions in the abdomen
Liver biopsy
Removal of liver tissue for microscopic examination
Nasogastic intubation
insertion of a tube through the nose into the stomach
Paracentesis (abdominocentesis)
Surgical puncture to remove fluid from the abdomen
BE
Barium enema
BM
bowel movement
BRBPR
Bright red blood per rectum
Hematochezia
CT
computed tomography
EGD
esophagogastroduodenoscopy
ERCP
endoscopic retrograde cholandiopancreatography
EUS
endoscopic ultrasonography
FOBT
fecal occult blood test
G tube
gastrostomy tube
GB
Gallbladder
GERD
gastroesophageal reflux disease
LAC
laparoscopic-assisted colectomy
LFTs
liver function tests- alk phos, bilirubin, AST, ALT
MRI
magnetic resonance imaging
NG tube
nasograstric tube
NPO
nothing by mouth (nil per os)
PEG tube
percutaneous endoscopic gastrostomy tube (feeding tube)
PEJ tube
percutaneous endoscopic jejunostomy
PTHC
Percutaneous transhepatic cholangiography
PUD
Peptic ulcer disease
TPN
Total parenteral nutrition
T tube
Tube placed in the bile duct for drainage into a small pouch (bile bag) on the outside of the body