Chapter Five DIGESTIVE SYSTEM.

Chapter Five DIGESTIVE SYSTEM

Digestive System Gastrointestinal (GI) system or tract Word Parts
Be Careful! The combining form gastr/o refers only to the stomach. Word Parts gastr/o = stomach intestin/o = intestine aliment/o = nutrition This is one system that has a variety of names. And each of them is used with a fair amount of regularity! We’ll start with the gastrointestinal system (gastr/o + intestin/o + -al). Two important organs of the system, the stomach and the intestines, are named perhaps for their important roles. Notice the abbreviation GI, because that, too, is commonly used. The term tract (not track!) refers to the organs collectively, while the use of the term system adds the connotation of an interactive structure. Be Careful! The combining form gastr/o refers only to the stomach.

Functions Intake of food Physical and chemical breakdown of food
Ingestion Intake of food Digestion Physical and chemical breakdown of food Absorption Extraction of nutrients Elimination Excretion of waste products The functions of the GI system include 1. ingestion: the intake of food, 2. digestion: the physical and chemical breakdown of food, 3. absorption: the extraction of nutrients, 4. elimination: the excretion of waste products. The medical term for the waste products of the GI system is feces. The process of releasing feces from the body is defecation. You may have heard the abbreviation BM referring to bowel movements. This is another term for feces. Ask students if they can think of any disorders related to these functions.

General Description of the GI System: The Route Through the Body
Oral cavity Mediastinal cavity Abdominopelvic cavity Peritoneal cavity The digestive system begins with the mouth and ends with the anus. On its route through the body, it travels through a number of body cavities. Because these cavities share organs and functions with other systems, the location of the digestive organs can sometimes cause confusion with symptoms of pain, for example. Heartburn is a digestive disorder, not a cardiovascular one. Here we can see that the system begins with the first bite of food entering the oral cavity, proceeding down the throat to the esophagus through the mediastinal cavity, and on to the abdominopelvic cavity. The stomach and intestines lie within the peritoneal cavity and are attached to the wall of the body by a vascular network of tissue called the mesentery. The extensive blood supply is necessary to absorb nutrients and route them to the cells.

General Description of the Digestive System: Layers
Tunics/Coats-layers of the GI tract Tunica mucosa- inner layer that secrets gastric juices, absorbs nutrients and protects the system through mucus production Submucosa-middle layer that holds blood, lymphatic and nervous tissue. Tunica muscularis-deepest layer that moves food through the system with contraction and relaxation around the digestive tube. Serosa: Visceral peritoneum- think layer of cells that secretes lubricating fluid Adventitia- outer layer when the digestive tube passes through a body wall. Mesentery- visceral and parietal folds of tissue that hold organs in place Peristalsis- wavelike movement to move food through Word Parts sub- = under viscer/o = organ, viscera peri- = surrounding -stalsis = contraction The digestive tract is composed of three layers, termed tunics. A tunic or coat is a layer of the digestive tract. It’s important to be aware of this because the severity of certain diseases (ulcers and cancer, for example) is judged by the damage it does to a particular layer. The inner layer is termed the tunica mucosa. It secretes gastric juices, absorbs nutrients, and protects the tissues of the system through the production of mucus. The middle layer is called the submucosa (remember that sub- means under). This layer holds the blood, lymphatic, and nervous tissue. Finally, the deepest or outside layer is called the tunica muscularis. Its function is to move the food through the system through coordinated continual contraction and relaxation around the digestive tube. The tunica muscularis is attached to the serosa (the visceral peritoneum), which is a thin layer of cells that secretes a lubricating fluid. The adventitia is the name used for this outer layer when the digestive tube passes through a body wall; otherwise it is referred to as the serosa. The mesentery is both folds (visceral and parietal) of the tissue that holds the organs in place. The wavelike movement referred to earlier is called peristalsis (peri- around, surrounding) and -stalsis (contraction).

Wall of the Gastrointestinal Tract
Use this diagram to explain the terms on the previous slide.

Oral Cavity Mastication, deglutition- chewing and swallowing Lips Vermilion borders- margins between lip and surrounding skin Frenulum-small fold of tissue inside that restricts movement Philtrum- vertical depression aboe the upper lip Teeth Incisors and cuspids-for tearing Bicuspids and molars-for chewing Word Parts or/o, stom/o, stomat/o = mouth, oral cavity labi/o, cheil/o = lip dent/i, odont/o = teeth cusp/o = point bi- = two in- = in cis/o = to cut mol/o = molar The oral cavity is responsible for the functions of mastication (chewing) and deglutition (swallowing). The combining forms stom/o and stomat/o refer literally to a mouth or an opening. Notice the similarity to the suffix –stomy (making a new opening) and a stoma, which is an opening to the surface of the body. Review the combining forms for the oral cavity, naming the lips and teeth. The upper lip is the labium superioris, while the lower lip is the labium inferioris. The vermilion borders are the dark red margins between the lips and the skin. The frenulum of each lip is the small fold of skin that attaches it to the upper and lower jaw. The philtrum is the small indentation between the nose and the upper lip. Be Careful! with stom/o and stomat/o vs. stomach. The incisors and cuspids are the teeth that are located in the anterior (front) of the mouth, while the bicuspids and molars are located in the posterior (back) of the mouth. The incisors and cuspids serve to tear and break apart food, while the bicuspids and molars function to chew (masticate) the food. The word part cusp/o refers to a point. In this case, the cuspids have a single “point,” while the bicuspids have two. Note that the combining form mol/o used to describe the molars, the back teeth, has an etymology in Latin meaning “grinding.”

The Tooth in Detail Word Parts
Enamel- hardest substance in the body. Outermost layer of protection for the tooth Dentin- calcified 2nd layer Cementum- bonelike substance that covers the part of the tooth below the gums. Pulp- center of the tooth Crown- part visible above the gums Word Parts amel/o = enamel alveol/o = small cavity, alveolus dent/i = tooth -in = substance Note the different parts of a tooth with their respective combining forms. The thin outer covering of the tooth is the enamel, while the second layer is the calcified dentin. Dentin literally means the “tooth substance.” The cementum is a bonelike substance that is below the gums, while the enamel is above the gums. The dentin is continuous above and below the gums. The pulp is the center area of the tooth where the nerves and blood supply reside. The crown of the tooth is the area above the gums that is covered by the enamel. The term “alveol/o” literally means a small cavity, which describes the “socket” where the tooth is seated in the jaw bones.

Oral Cavity Word Parts Cheeks Mucous glands Buccal- cheek
Molar-inside lips surrounding mouth Labial- lips Palatine- roof of mouth Tongue Papillae- tiny projections on the tongue that hold taste buds Taste buds Palate Hard-roof and soft- behind Uvula- hangs in back mouth Word Parts bucc/o = cheek muc/o = mucus mol/o = molar, grinding labi/o = lip gloss/o, lingu/o = tongue palat/o = palate uvul/o = uvula The fleshy structures on either side of the oral cavity are the cheeks. The mucous glands that lubricate the oral cavity are located throughout the inner cheek walls (buccal), near the back teeth (molar), inside the lips and surrounding the mouth (labial), and surrounding the soft palate (palate) of the roof of the mouth. The tongue is covered with thousands of tiny projections termed papillae that have nerve-like cells called taste buds between them. The taste buds have receptors for five basic tastes: sour, sweet, salty, bitter, and savory (umami). Note that students can feel the difference between the hard and soft palates by sliding their tongue to the roof of their mouth right behind their teeth (the hard palate) and farther back (the soft palate). The term uvula comes from the Latin meaning literally “little grape.” Perhaps the uvula does appear to be a small grape that hangs from the back of the soft palate, but our best meaning for uvul/o is the uvula.

Oral Cavity Word Parts Maxilla- upper jaw Mandible- lower jaw
Gums –fleshy tissue that coats alveolar ridges Salivary glands and saliva Parotid- near the ear Sublingual –under the tongue Submandibular- under the lower jawbone maxill/o = upper jaw mandibul/o = lower jaw dent/i, odont/o = teeth gingiv/o = gums peri- = surrounding sialoaden/o = salivary gland sial/o, ptyal/o = saliva par- = near sub- = under The upper jaw is the maxilla, while the lower jaw is the mandible. The gums are the fleshy tissue that coats the alveolar ridges of these bones. Note that a specialist in the gums is a periodontist, not a gingivologist (don’t shoot the messenger!). There are three salivary glands, each named for its location. The parotid gland is near (par-) the ear (ot/o), the sublingual gland is under (sub-) the tongue (lingu/o), and the submandibular gland is under (sub-) the lower jawbone (mandibul/o).

Throat and Esophagus Word Parts Pharynx
Nasopharynx-1st section of the throat, behind nose Oropharynx – behind oral cavity Hypopharynx- below oropharynx Esophagus Bolus- chewed food Lower esophageal sphincter (LES)/- muscle that opens and close to allow food in the stomach cardiac sphincter/- close to the heart gastroesophageal sphincter- the muscle at the stomach and esophagus pharyng/o = pharynx, throat nas/o = nose or/o = mouth hypo- = below, under esophag/o = esophagus After chewing and swallowing a mouthful of food, the food enters the pharynx (the throat). There are three sections of the throat: the first, the nasopharynx, is behind the nasal cavity; the second, the oropharynx, is behind the oral cavity; and the third, the hypopharynx, is the area of the throat that is below the oropharynx. Another term that is sometimes used for the hypopharynx is the laryngopharynx because it is near the larynx, the voice box. The esophagus is a muscular tube, about 12 inches long, that extends from the throat to the stomach. The masticated lump of food that is swallowed is termed the bolus. If you’ve ever swallowed a piece of meat that is too big, you may have experienced the peristaltic motion of this bolus being pushed toward the stomach. The sphincter muscle (a round muscle) that opens and closes to allow the food into the stomach is called the lower esophageal sphincter, abbreviated LES, the cardiac sphincter, and the gastroesophageal sphincter. The first and last terms are understandable, but what about “cardiac sphincter”? It gets its name from its proximity to the heart.

Word Parts Peritoneum Peritoneum- lining of abdominal cavity
Visceral- faces organs of the abdomen Parietal- faces the body wall Retroperitoneum- behind the peritoneal cavity and is the location of kidneys, duodenum, pancreas, ureters and aorta. Mesentery- extensions of the visceral peritoneum that serve to support the organs within the body cavity, and may be named for organs they support Mesoappendix=appendix and mesocolon Mesocolon= large intestine Ligaments- Folds Greater and lesser sacs- two main regions of the peritoneum Epiploic foramen- join the greater and lesser sacs Omenta: greater- curves the abdomen coering the intestines and merging into the parietal peritoneum and lesser- extends from the lesser curvature of the stomach and connects to the liver. Word Parts periotone/o = peritoneum retro- = behind oment/o, epiplo/o = omentum The lining of the abdominal cavity is the peritoneum. It is a double-folded membrane with two surfaces: The visceral peritoneum faces the organs of the abdomen, while the parietal peritoneum faces the body wall. Remember that the visceral peritoneum is the same as the serosal layer of the abdominal organs. The term retroperitoneum is the area behind the peritoneal cavity and is the location of the kidneys, duodenum, pancreas, ureters, and aorta. The mesenteries are extensions of the visceral peritoneum that serve to support the organs within the body cavity. Some of the mesenteries are named for the organs they support (Examples: mesoappendix = appendix and mesocolon = colon, large intestine). Other names for the mesenteries are visceral ligaments and folds. The two main regions within the peritoneum are the greater and lesser sacs. These two are joined by the epiploic foramen, also called the foramen of Winslow. The greater sac is the main area of the peritoneum, while the lesser sac is formed by two separate folds termed omenta (singular: omentum). The omenta are the sites of fat deposition and provide protection from infection and trauma. The greater omentum extends from the greater curve of the abdomen, covering the intestines and merging into the parietal peritoneum. The lesser omentum, also called the omental bursa, extends from the lesser curvature of the stomach and connects to the liver.

The Stomach Cardia – bolus enters, name for its proximity to the heart Fundus- most superior part Body – main part of the stomach Pylorus – end of the stomach where food exits Rugae – folds that increase its surface area as the stomach fills Chyme- mix of food and gastric juices Word Parts gastr/o = stomach cardi/o = heart fund/o = fundus corpor/o = body pylor/o = pylorus From the esophagus, the bolus enters the stomach in the area of the cardia (again, named thusly because it is near the heart). The main part of the stomach is called the body, or corporis. The gastric fundus is the most superior part of the body of the stomach. The end of the stomach where the food exits is called the pylorus (also referred to as the gastric antrum). Digestion continues its chemical breakdown of the masticated food by mixing it with gastric juices and hydrochloric acid. The mixture of the food with the gastric juices and acid is termed chyme. The stomach is lined with ridges or wrinkles called rugae (s. ruga) that increase its surface area as the stomach fills. Note the curvatures of the stomach: the greater and lesser, which were previously mentioned as sites of attachment for the omenta. The stomach

Small Intestine Word Parts Duodenum- first section of small intestine
Jejunum – second section Ileum- third section Plicae – series of folds that contain thousands of tiny projections Villi- tiny projections that line the plicae that contain blood capillaries that absorb carbs and protein digestion Lacteals Enzymes- help break down food Word Parts enter/o = small intestines duoden/o = duodenum jejun/o = jejunum ile/o = ileum plic/o = fold, plica vill/o = villus -ase = enzyme Small intestines From Mosby’s dictionary, ed 8, Mosby The main function of the small intestine is the absorption of nutrients from the chyme. The structure of the intestines is a series of folds (plicae) that contain thousands of tiny projections termed villi (s. villus), which contain blood capillaries that absorb the products of carbohydrate and protein digestion. The three sections of the small intestines in order are the duodenum, the jejunum, and the ileum. Be Careful! Don’t confuse ileum with ilium (part of the hip). Emphasize the importance of learning the order of the three parts of the small intestine.

Large Intestine Word Parts Cecum – first part of large intestine
Ileocecal sphincter- between the ileum and cecum Vermiform appendix – hangs from the cecum Ascending colon- feces travels here from the cecum Transverse colon- moves through from ascending colon Descending colon- moves across from transerse colon Sigmoid colon Rectum Anus Internal and external sphincters Proct/o is for anus and rectum Defecation Feces, bowel movement: BM Word Parts col/o, colon/o = large intestine, colon cec/o = cecum append/o, appendic/o = appendix fec/a = feces sigmoid/o = sigmoid colon rect/o = rectum an/o = anus proct/o = rectum and anus The large intestine, also called the bowels, is much shorter in length (5 feet) than the small intestines. The adjective “large” comes from the diameter, not the length. The main function of the large intestines is the elimination of waste products and the synthesis of vitamins. The waste that is in the intestines at this point is no longer chyme but is now called feces. The first part of the large intestine is the cecum. The sphincter between the ileum and the cecum is the ileocecal sphincter. The vermiform appendix hangs from the cecum. Although it has no function in the digestive system, it may have a function in the lymphatic system. From the cecum, the feces travels up the ascending colon, across the transverse colon, down the descending colon, through the sigmoid colon (sigmoid/ literally means “S” like), and finally through the rectum and out the anal sphincters. The internal sphincter is involuntary, while the external sphincter is voluntary. Again, emphasize the order of the parts of the large intestine. Review the combining forms for anus, rectum, and anus + rectum. Be careful not to confuse an/o, ana-, and an-.

Accessory Organs: Adnexa Liver Gallbladder Pancreas
Word Parts adnex/o = accessory hepat/o = liver cholecyst/o = gallbladder pancreat/o = pancreas The accessory organs of the digestive system are referred to as the adnexa. They consist of the liver, gallbladder, and pancreas.

The liver functions to produce bile
Location/lobes -4 Right, left, quadrate, caudate The liver functions to produce bile Bile serves to emulsify fats Bile is composed of bilirubin and cholesterol Bile in liver  bile ducts  hepatic duct  joins with cystic duct from the gallbladder to form the common bile duct  empties bile into the duodenum Word Parts lob/o = lobe chol/e, bil/i = bile choledoch/o = common bile duct The liver is composed of four lobes and is located mostly in the upper right quadrant of the abdominal cavity. Liver produces bile that emulsifies (breaks down) fats. Bile is composed of bilirubin, the waste product formed by the normal breakdown of hemoglobin in red blood cells at the end of their life spans, and cholesterol, a fatty substance found only in animal tissues.

Anterior and Posterior View of Liver

Location/description under right lobe of the liver
Gallbladder Location/description under right lobe of the liver Stores bile from the liver until needed for digestion cholecystokinin in bile secretion to help with fatty substances. Travels to Cystic duct , and then Common bile duct. Word Parts chol/e, bil/i = bile cholesterol/o = cholesterol choledoch/o = common bile duct cholangi/o = bile vessel cholecyst/o = gallbladder -kinin = movement substance The gallbladder is a small sac that is found on the underside of the right lobe of the liver. Its function is to store bile until needed in digestion. When fatty food enters the duodenum, cholecystokinin is secreted, which causes the gallbladder to contract and release bile into the cystic duct. Note that –kinin is a suffix for a substance that moves, making cholecystokinin a substance that moves the gallbladder. From the cystic duct it travels to the common bile duct and then on to the duodenum.

Location: ULQ of stomach
Pancreas Location: ULQ of stomach Exocrine function of the pancreas is key in the digestion of: Carbohydrates, proteins, lipids Pancreatic enzymes enter the duodenum through the pancreatic duct that empties into the common bile duct Word Parts pancreat/o = pancreas The pancreas is located in the upper left quadrant behind the stomach. It is involved in the digestion of carbohydrates, proteins, and fats (lipids). Pancreatic involvement in the digestive function is considered exocrine (meaning to secrete out) because it is through a duct. Later we will discuss the endocrine function of the pancreas, where it secretes within the bloodstream (endocrine).

Symptoms and Signs Involving the Digestive System and Abdomen (R10-R19)
Dysphagia- difficulty swallowing Hepatomegaly- enlargement of the liver Jaundice- yellowing of the skin and eyes caused by increased bilirubin from the liver Pyrosis- heartburn Gastralgia- stomach pain Diarrhea- watery stool Word Parts dys- = difficult, bad -phagia = condition of swallowing, eating hepat/o = liver -megaly = enlargement pyr/o = fire -osis = abnormal condition dia- = through -rrhea = discharge, flow For each of these terms, use their word parts when given to help define the terms. Dysphagia is difficulty with swallowing. Hepatomegaly is an enlargement of the liver. Jaundice is a yellowing the skin and sclerae caused by elevated levels of bilirubin. A synonym is icterus. Pyrosis is a painful burning sensation in the esophagus, commonly known as “heartburn.” Gastralgia is pain in the stomach or abdominal pain. A synonym is gastrodynia. Diarrhea is an abnormal discharge of watery, semisolid stools. Jaundice

Congenital Conditions (Q00-Q99)
Anklyoglossia- inability to move the tongue freely (tongue tied) Esophageal atresia- esophagus ending in a blind pouch and therefore lacking an opening to the stomach. Word Parts ankyl/o = stiffening gloss/o = tongue -ia = condition esophag/o = esophagus -eal = pertaining to a- = no, not, without -tresia = condition of an opening Use the word parts in the terms listed to help define them. Anklyoglossia is an inability to move the tongue freely--a condition that may be termed “tongue tied.” Esophageal atresia (a- = without + -tresia = condition of an opening) is a condition of the esophagus ending in a blind pouch and therefore lacking an opening into the stomach. Discuss how esophageal atresia is often not diagnosed immediately after birth and what this means for patient care. Esophageal atresia

Gastroschisis- congenital opening in the anterior abdominal wall. Omphalocele- congenital herniation at the umbilicus. Pyloric stenosis- narrowing of the pyloric sphincter muscle. Word Parts gastr/o = stomach -schisis = split omphal/o = umbilicus -cele = herniation, protrusion pylor/o = pylorus -ic = pertaining to stenosis = narrowing Use the word parts in the terms listed to help define them. Gastroschisis is a congenital opening in the anterior abdominal wall. Note that the suffix -schisis is related to the word schism and the combining form schiz/o meaning a split. An omphalocele is a congenital herniation at the umbilicus. It is also referred to as an exomphalos. Occasionally, an umbilical hernia can be acquired – in this case it would not be coded with the congenital conditions. Pyloric stenosis is a narrowing of the pyloric sphincter muscle, which prevents partially digested food from passing into the duodenum. Omphalocele

Cleft palate- failure of the roof of the mouth to close during development in the embryo. A cleft palate is a failure of the roof of the mouth to close during embryonic development, resulting in an opening of the roof of the mouth. Hirschsprung’s disease is a congenital absence of normal nervous function in part of the colon, resulting in an absence of peristaltic movement, accumulation of feces, and an enlarged colon. A synonym is congenital megacolon (mega- = large). Cleft palate and lip

Hirschsprung’s disease- Congenital absence of normal nervous function in part of the colon resulting in an absence of peristalsis, accumulation of feces and enlarged colon.

Diseases of Oral Cavity and Salivary Glands (K00-K14)
Amelogenesis imperfecta Anodontia- no teeth OR Edentulous Word Parts amel/o = enamel -genesis = production, origin an- = no, no, without odont/o = teeth -ia = condition Amelogenesis imperfecta is an abnormal formation of the tooth enamel that causes a separation from the underlying dentin. Anodontia is either a complete or partial lack of teeth. A synonym for a complete lack of teeth is edentulous.

Aphthous stomatitis- inflammation of the mouth with small ulcer like sores. Cheilitis- inflammation of the lips Word Parts aphth/o = ulceration -ous = pertaining to stomat/o = mouth -itis = inflammation cheil/o = lip Aphthous stomatitis is an inflammation of the mouth with the presence of small ulcers (aphth/o = ulceration). These erosions appear on the mucous membranes of the mouth. A synonym is canker sores. Cheilitis is an inflammation of the lips, while cheilosis is an abnormal condition of the lips that is present with riboflavin deficiency. Aphthous stomatitis

Dental caries- cavity Gingivitis- gum inflammation Periodontal disease- dz of tissues surrounding teeth Glossitis- inflammation of tongue. Word Parts gingiv/o = gums -itis = inflammation gloss/o = tongue Dental caries are commonly known as cavities. The caries are caused by an interaction between food and bacteria in the mouth. Gingivitis (gingiv/o + -itis) is an inflammation of the gums. Periodontal (peri- + odont/o + -al) disease is disease of the tissues surrounding the teeth. It can include gingivitis and pyorrhea. Glossitis (gloss/o + -itis) is an inflammation of the tongue. Gingivitis

Oral mucositis- inflammation of mucous membranes. Oral leukoplakia- white patches on the lips or cheek mucosa, can be caused by tobacco Ptyalism- excessive salivation Sialoadenitis- inflammation of salivary gland Sialolithiasis- condition of stone or stones in a salivary gland Word Parts mucos/o = mucus -itis = inflammation leuk/o = white -plakia = condition of patches ptyal/o = saliva -ism = condition sialoaden/o = salivary gland sial/o = saliva lith/o = stone -iasis = presence of, condition Use word parts wherever possible in the following terms to help define them. Oral mucositis is an inflammation of the mucous membranes of the mouth. Gastrointestinal muscositis may be an adverse effect of chemotherapy. Oral leukoplakia (leuk/o + -plakia) is a condition of white patches on the lips and/or the buccal mucosa. This condition is often associated with tobacco use (chewed or smoked) and may be precancerous. Ptyalism is a condition of excessive salivation. Sialoadenitis is an inflammation of a salivary gland. Sialolithiasis is a condition of a stone or stones in a salivary gland or duct. Oral leukoplakia

Diseases of Esophagus, Stomach, and Duodenum (K20-K31)
Achalasia- impairment of peristaltic movement in the esophagus, which will not allow a bolus into the stomach. Dyspepsia- abnormal digestion or indigestion Esophagitis- inflammation of the esophagus Gastroesophageal reflux disease(GERD)- backflow of stomach contents into the esophagus Barrett’s esophagus- complication of GERD, causing tissue changes to the esophagus. Word Parts a- = without -chalasia = condition of relaxation dys- = abnormal, bad -pepsia = digestion condition gastr/o = stomach esophag/o = esphagus -eal = pertaining to re- = back -flux = flow Achalasia (a- + -chalasia) is a condition of being without relaxation. It is an impairment of the normal peristaltic movement of the esophagus, along with an inability of the lower esophageal sphincter to relax and allow a bolus of food into the stomach. Dyspepsia, literally a condition of bad or abnormal digestion, is what we would normally call indigestion. It is a feeling of epigastric discomfort that occurs shortly after eating. It may include sensations of nausea, fullness, bloating, and/or heartburn. Esophagitis is an inflammation of the esophagus. Gastroesophageal reflux disease (GERD – pronounced as an acronym “gird”) is a “flowing back” of the contents of the stomach to the esophagus. Barrett’s esophagus is a condition caused by chronic reflux from the stomach. It is associated with an increased risk of cancer. GERD

Diseases of Esophagus, Stomach, and Duodenum (K20-K31)
Gastritis- inflammation of the stomach Peptic ulcer disease (PUD)- Gastritis is an inflammation of the stomach. Peptic ulcer disease gets its name peptic, meaning pertaining to digestion. This is a type of erosion of the mucosal lining of the GI system. It occurs most often in the stomach or duodenum. Chronic peptic ulcer

Diseases of the Appendix (K35-K38)
Appendicitis- inflammation of the appendix Peritonitis- inflammation of the lining of the abdominal cavity. Acute- rapid, sudden onset vs. chronic- long term . Appendicitis (appendic/o + -itis) is an inflammation of the appendix. You might want to mention a complication of untreated appendicitis – peritonitis. Peritonitis is an inflammation of the peritoneum, the lining of the abdominal cavity. It can occur if the appendicitis is not treated and the appendix bursts. What does acute mean? What is the opposite? (chronic) Be Careful! not to confuse peritone/o (membrane that lines the abdominal cavity), perone/o (fibula), and perine/o (space between the anus and external reproductive organs). Ask if students can identify the therapeutic intervention to treat appendicitis. (appendectomy)

Hernias (K40-K46) Complications
Incarcerated hernia- loop of bowel becomes blocked or closed and nothing can bass Irreducible – another name for incarcerated hernia Strangulated hernia- hernia that is caused by narrowing, and blood flow is shut off. Both these hernias are medical emergencies. Why? Gangrene- dead tissue that results from lack of blood flow. An incarcerated hernia occurs when a loop of bowel becomes occluded (blocked or closed) so that solids cannot pass. It is also called an irreducible hernia. It is a reducible hernia if the contents of the protrusion can be returned to its original location manually or spontaneously. Strangulation is the constriction (narrowing) of a tubular structure. A strangulated hernia is one in which the blood flow is shut off. Ask the students why incarcerated and strangulated hernias are medical emergencies. Gangrene is dead (necrotic) tissue that results from a lack of blood flow.

Hernias (K40-K46) Umbilical hernia Hiatal hernia
Umbilical hernia (omphalocele) – protrusion of intestines through a weakness in the abdominal wall at the navel Femoral (crural) hernia- protrusion of a loop of intestine through the femoral canal into the groin. Hiatal hernia (diaphragmatocele)- protrusion of a portion of the stomach through the diaphragm. Inguinal hernia- protrusion of a loop of intestine into the inguinal canal. Ventral hernia- protrusion of intestines through abdominal wall except at the umbilicus. An umbilical hernias is a protrusion of the intestines and omentum through a weakness in the abdominal wall at the navel. A femoral hernia is a protrusion of a loop of intestine through the femoral canal into the groin. A hiatal hernia is a protrusion of a portion of the stomach through the diaphragm. Note that congenital hiatal hernias are coded separately. An inguinal hernia is a protrusion of a loop of intestine into the inguinal canal. A direct inguinal hernia is through a muscle wall, while an indirect inguinal hernia is through a normal intestinal passage. A ventral hernia is a protrusion of the intestines and omentum through the abdominal wall except at the umbilicus. An epigastric hernia is above the stomach, while an incisional hernia is at the site of previous abdominal surgery. Umbilical hernia Hiatal hernia From Zitelli: Atlas of pediatric physical diagnosis, ed 4, Mosby

Noninfective Enteritis and Colitis (K50-K52)
Colitis- inflammation of the colon. Inflammatory bowel disease (IBD)- chronic inflammation of the lining of the colon. Crohn’s disease (regional or granulomatous enteritis)- chronic inflammation of the ileum or the colon. Ulcerative colitis- inflammation of the colon and rectum. Colitis is an inflammation of the colon. Inflammatory bowel disease (IBD) is a chronic inflammation of the lining of the intestine characterized by bleeding and diarrhea. Crohn’s disease and ulcerative colitis are both forms of IBD. Crohn’s disease is an inflammation of the ileum or the colon that is of idiopathic origin. Also called regional or granulomatous enteritis. Ulcerative colitis is a chronic inflammation of the colon and rectum manifested by bouts of profuse watery diarrhea.

Other Diseases of the Intestines (K55-K63)
Anal fissure- crack like lesion of the skin around anus. Anorectal abscess- pus filled area of inflammation in the anus and rectum. Anorectal fistula- abnormal opening between organs or to the outside of the body. Constipation- infrequent, incomplete or delayed bowel movements. Obstipation- intractable or difficult to manage constipation. An anal fissure is a crack-like lesion of the skin around the anus. An anorectal abscess is a circumscribed purulent (pus-filled) area of inflammation in the anus and rectum. An anorectal fistula is an abnormal opening between organs (internal) or to the outside of the body (external). This occurs as the result of a disease process, not a surgical intervention. Constipation is infrequent, incomplete, or delayed bowel movements. Obstipation is intractable (difficult to manage) constipation.

Ileus- obstruction of the digestive system Intussusception- inward telescoping of the intestines Volvulus- twisting of the intestines Irritable bowel syndrome (IBS)- grouping of diarrhea, gas, constipation that results from stress. An ileus is a general term for an obstruction in the digestive system. A paralytic ileus is a lack of peristaltic movement that is also referred to as an adynamic ileus. Intussusception is an inward telescoping of the intestines. A volvulus is a twisting of the intestines. Irritable bowel syndrome (IBS) is a grouping of symptoms that occur together (diarrhea, gas, constipation) that results from stress with no underlying disease. A. Intussusception, B. Volvulus From Damjanov: Pathology for the health professions, ed 3, Saunders Intussusception

Diverticulitis- inflammation of the diverticula Diverticulosis- abnormal condition of the presence of pouches in the lining of the Colon. Word Parts diverticul/o = diverticulum -itis = inflammation -osis = abnormal condition Diverticula are pouches in the lining of the colon. Diverticulosis is the abnormal condition of the presence of these pouches. Diverticulitis is an inflammation of the diverticula. Diverticulosis

Word Parts Other Diseases of the Intestines (K55-K63) Polyp of colon- benign growths on the mucous membrane Proctitis- inflammation of the rectum and anus Proctoptosis- prolapse of the rectum to the outside of the anus. proct/o = rectum and anus -itis = inflammation -ptosis = drooping, prolapse Polyps of the colon are benign growths on the mucous membrane. Proctitis is an inflammation of the rectum and anus. Proctoptosis is a prolapse of the rectum to the outside of the anus. proctitis

Word Parts Normal liver Cirrhosis of the liver
Diseases of Peritoneum and Retroperitoneum (K65-K68) and Diseases of Liver (K70-K77) Cirrhosis- degenerative disease of the liver many times associated to alcohol abuse, chronic liver disease, and biliary tract disorders. Peritonitis- inflammation of the peritoneum, lining of the abdominal cavity. Word Parts cirrh/o = orange-yellow -osis = abnormal condition peritone/o = peritoneum -itis = inflammation Normal liver Cirrhosis of the liver Cirrhosis is a chronic degenerative disease of the liver that is often associated with alcohol abuse, chronic liver disease, and biliary tract disorders. Peritonitis is an inflammation of the peritoneum, the lining of the abdominal cavity. Although this was mentioned with appendicitis, it is classified as a disease of the peritoneum, not of the appendix.

Diseases of Gallbladder, Biliary Tract, and Pancreas (K80-K87)
Cholangitis- inflammation of the bile vessels Cholecystitis – inflammation of the gallbladder Choledocholithiasis- gall stones in the common bile duct Cholelithiasis- presence of stones in the gall bladder Pancreatitis – inflammation of the pancreas Word Parts cholang/o = bile vessel -itis = inflammation cholecyst/o = gallbladder choledoch/o = common bile duct -lith/o = stone -iasis = presence of chol/e = bile pancreat/o = pancreas Cholangitis is an inflammation of the bile vessels. Cholecystitis is an inflammation of the gallbladder. Choledocholithiasis is the presence of stones (-lithiasis) in the common bile duct. Cholelithiasis is the presence of stones in the gallbladder. Here, cholecyst/o, which would normally indicate the gallbladder, is contracted to chol/e. Pancreatitis is an inflammation of the pancreas. Cholelithiasis

Other Diseases of Digestive System (K90-K94)
Celiac disease (celiac sprue)- disorder of the intestines in which they are unable to absorb wheat proteins. Hematemesis- vomiting blood Melena- blood in the stool, black, tarry and the presence of partially digested food. Word Parts celi/o = abdomen hemat/o = blood -emesis = vomiting melan/o = black, dark Celiac disease is a disorder of the intestines in which they are unable to absorb wheat proteins. Also referred to as celiac sprue. Hematemesis is the vomiting of blood. Melena is black, tarry stools caused by the presence of partially digested blood. Discuss the differences in disorders between those that manifest with hematemesis and those with melena.

Viral Infections Characterized by Skin and Mucous Membranes (B00-B09) and Viral Hepatitis (B15-B19)
Herpetic stomatitis (cold sore, fever blister) inflammation of the mouth due to HSV. Hepatitis- inflammation of the liver caused by a type of virus Hepatitis A (HAV)- direct contact with fecally contaminated food or water Hepatitis B (HBV)- contaminated blood or sexual contact Hepatitis C (HCV)- blood transfusions, percutaneous inoculation or sharing of infected needles. Word Parts stomat/o = mouth -itis = inflammation hepat/o = liver Herpetic stomatitis (stomat/o + -itis) is an inflammation of the mouth due to the herpes simplex virus (HSV). This is also called a cold sore or a fever blister. Don’t confuse it with aphthous stomatitis, which is a canker sore. Hepatitis is an inflammation of the liver that is caused by a variety of viruses. Hepatitis A is transmitted through direct contact with fecally contaminated food or water. Hepatitis B is transmitted through contaminated blood or sexual contact. Hepatitis C is transmitted through blood transfusions, percutaneous inoculation, or through the sharing of infected needles.

Benign Neoplasms (D10-D36)
Cystadenoma- benign glandular tumor filled with fluid filled sacs found in the pancreas Odontogenic tumor- one that arises around the teeth and jaw Word Parts cyst/o = cyst aden/o = gland -oma = tumor, mass odont/o = teeth -genic = pertaining to produced by A cystadenoma is a benign glandular tumor filled with fluid-filled sacs that is most commonly found in the pancreas. An odontogenic tumor is one that arises around the teeth and jaw. Polyps are benign growths that arise from a mucous membrane. They may be adenomatous, arising from glandular tissue, or hyperplastic, smaller tumors. The adenomatous tumors have the potential to become malignant, while the hyperplastic tumors do not.

Benign Neoplasms (D10-D36)
Polyps, adenomatous or hyperplastic- small growths that generally do not become malignant Sessile- flat versus pedunculated- on a stalk with a little foot Polyps are usually benign growths that occur on mucous membranes throughout the body, although most commonly in the colon. Adenomatous polyps are those that develop from glandular (aden/o) tissue and have the potential to become malignant. Hyperplastic (hyper- = excessive + -plastic = pertaining to formation) polyps are smaller growths that usually do not become malignant. The shape of the tumors may be sessile (flat) or peduculated (on a stalk [“little foot”]). Both of these polyps may appear as either sessile (flat) or pedunculated (with a stalk). Adenomatous polyps- develop from glandular tissue and have the ability to become malignant

Adenocarcinoma of the esophagus
Malignant Neoplasms (C00-C96) Adenocarcinoma – malignant tumor of glandular tissue Hepatocellular- malignant tumor that originates in the cells of the liver Squamous cell carcinoma- any cancer of epithelial origin that has a scale-like appearance. Word Parts aden/o = gland -carcinoma = cancerous tumor of epithelial origin hepat/o = liver cellul/o = cell -ar = pertaining to squam/o = scaly -ous = pertaining to An adenocarcinoma is a malignant tumor of epithelial origin that either originates from glandular tissue or has a glandular appearance. A hepatocellular carcinoma, also called a hepatoma, is a malignant epithelial tumor that originates in the cells of the liver. A squamous cell carcinoma is any cancer of epithelial origin that has a scale-like appearance. Adenocarcinoma of the esophagus

Laboratory Tests Gamma-glutamyl transferase (GGT)- blood test that detects increased enzymes that can indicate cirrhosis, hepatitis, acute pancreatitis, or cholecystitis and nephrosis or H-Pylori Stool culture- examination of a fecal sample to test for worms, amoebae, bacteria or protozoa Stool guaiac/hemoccult test- tests for hidden blood in feces Total bilirubin- test to detect cirrhosis, hepatitis, or jaundice A gamma-glutamyl transferase (GGT) is a blood test that detects increased enzymes that can indicate cirrhosis, hepatitis, acute pancreatitis or cholecystitis, and nephrosis or that tests for Helicobacter pylori antibodies. A stool culture is an examination of a fecal sample to test for microorganisms such as worms, amoebae, bacteria, or protozoa. A stool guaiac (also called a hemoccult ) tests for hidden blood in the feces. A total bilirubin test is a blood test to detect cirrhosis, hepatitis, or jaundice.

Laboratory Tests Albumin- decreased measurement of the protein formed by the liver. If low, it may signal liver disease. Alkaline phosphatase (ALP)- liver emzyme that may be high in liver or gallbladder disease, and low in malnutrition Alanine transaminase (ALT)- liver enzyme that is high in cirrhosis or pancreatitis Aspartate transaminase (AST) liver enzyme that may be high in lier disease or pancreatitis, and low in diabetes with ketoacidosis Gastric analysis- examination of the stomach contents to determine the blood, bile, bacterial, and hydrochloric acid in the stomach. If it is low, it can be a sign of stomach cancer. Measuring albumin in the blood reveals decreased measurement of the this protein formed by the liver. It will be low when liver disease is present. ALP is a liver enzyme that may be increased in liver or gallbladder disease. It may be decreased in the condition of malnutrition. ALT is a liver enzyme that is increased in cases of cirrhosis or pancreatitis. It has been referred to as SGPT (serum glutamic pyruvic transaminase) in the past. AST is a liver enzyme that is increased in liver disease or pancreatitis. A decreased amount may indicate uncontrolled diabetes mellitus with ketoacidosis. It had been referred to as SGOT (serum glutamic oxaloacetic acid transaminase) in the past. A gastric analysis is an examination of the stomach contents to determine the amount of blood, bile, bacteria, and hydrochloric acid in the stomach. Decreased hydrochloric acid may indicate stomach cancer.

Laboratory Tests Hepatitis-associated antigen (HAA)- blood test used to detect hepatitis B virus. Liver function tests (LFTs)- collection of tests to determine the health of the liver. Prothrombin time (PT) blood test that leasures the amount of time that it takes the blood to clot. Liver disease can decrease prothrombin which can lead to an increased clotting time. Rapid urease test- detects Hpylori. HAA is a blood test used to detect the hepatitis B virus. LFTs are a collection of tests to determine the health of the liver. The collection includes albumin, total bilirubin, prothrombin time, ALP, ALT, and GGT. A PT is a blood test that measures the amount of time that it takes the blood to clot. Liver disease can decrease the production of prothrombin, which can lead to an increased clotting time. A rapid urease test is used to detect Helicobacter pylori (H. pylori). It is also termed a CLO test (Campylobacter-like organism test)

Upper GI Procedures Word Parts
Barium swallow- imaging procedure to detect abnormalities of the esophagus and stomach Frentomy, frenulotomy- cutting of the frenulum to treat ankyloglossia Esophagoesophagostomy- rejoining of the two ends of the esophagus, usually done after a procedure to remove part of the esophagus to correct a defect. Fundoplication, - folding of the fundus of the stomach around the distal end of the esophagus to treat GERD Gingivectomy- removal of the gums, usually to correct periodontal disease. Word Parts fren/o , frenul/o = frenulum -tomy = cutting esophag/o = esophagus -stomy = making a new opening fund/o = fundus -plication = folding gingiv/o = gums -ectomy = cutting out A barium swallow (BS) is a radiologic imaging procedure to detect abnormalities of the esophagus and stomach. A frenotomy (frenulotomy) is a cutting of the frenulum to treat ankyloglossia. An esophagoesophagostomy is a rejoining of the two ends of the esophagus, usually done after a procedure to remove part of the esophagus to correct a defect. A gastroesophageal fundoplication is a folding of the fundus of the stomach around the distal end of the esophagus in order to treat GERD. A gingivectomy is the surgical removal of the gums, usually in order to correct periodontal disease. Barium swallow

Gastroduodenostomy- anastomosis of the stomach and duodenum Gastroplasty- surgical forming of the stomach for the purpose of repair or reshaping, possibly as part of a procedure for bariatric surgery. Gastrostomy- new opening of the stomach to the wall of the abdomen. Percutaneous endoscopic gastrostomy (PEG)- to place a tube for feeding Hyperalimentation- use of nutritional supplements that exceed recommended requirements Esophageal manometry- test that measures muscle pressure of the esophagus Pyloromyotomy- cutting of the pyloric sphincter in order to correct an obstruction. Word Parts gastr/o = stomach duoden/o = duodenum -stomy = making a new opening -plasty = surgically forming hyper- = excessive aliment/o = nutrition -ation = process of pylor/o = pylorus my/o = myscle -tomy = cutting A gastroduodenostomy is an anastomosis of the stomach and duodenum. A gastroplasty is a surgical forming of the stomach for the purpose of repair or reshaping, possibly as part of a procedure for bariatric surgery. A gastrostomy is a new opening of the stomach to the wall of the abdomen. A percutaneous endoscopic gastrostomy is an opening for the purpose of placing a tube for enteral feeding if a patient is unable to take food through his/her mouth. Hyperalimentation is the use of nutritional supplements that exceed recommended requirements. Manometry of the esophagus is a test that measures the motor function (muscle pressure) of the esophagus. A pyloromyotomy is a cutting of the pyloric sphincter in order to correct an obstruction such as pyloric stenosis. Gastroduodenostomy

Procedures Anastomoses vs. -stomy
Definition of anastomosis- joining or rejoining of two hollow tubes or organs. Rules for building terms for anastomoses Terms using a single structure with “-stomy” An anastomosis is the joining (or rejoining) of two hollow tubes or organs. Because the digestive system is basically one long tube, any removal of a section requires an anastomosis to rejoin the cut ends or a new opening to the surface of the body. When building a term to signify an anastomosis, the two combining forms are joined in the order of the normal direction of the organs in the system. For example, if the jejunum is removed, an anastomosis of the remaining sections of the small intestines would be a duodenoileostomy. If a term ends with -stomy, it signifies a new opening. In the digestive system, it would signify a new opening to the outside of the body. For example, a colostomy would be a new opening of the colon to the surface of the abdomen. The opening itself would be termed a “stoma.” Have students give examples of each.

Glossorrhaphy- suturing of the tongue to repair a wound or remove a lesion. Odontectomy- removal of a tooth Palatoplasty- surgical correction of the roof of the mouth as in the case of a cleft palate or to treat snoring. Sialodochoplasty- surgical correction of a salivary gland after removal of a stone Stomatoplasty-surgical reconstruction of the mouth to correct a malformation due to trauma, disease, or congenital causes. Uvulectomy- removal of all or part of the uvula, usually to correct snoring. Word Parts gloss/o = tongue -rrhaphy = suturing odont/o = teeth -ectomy = cutting out palat/o = palate -plasty = surgically forming sialodoch/o = salivary duct stomat/o = mouth uvul/o = uvula A glossorrhaphy is a suturing of the tongue, usually to repair a wound or remove a lesion. An odontectomy is the removal of a tooth. A palatoplasty is the surgical correction of the roof of the mouth, as in the case of a cleft palate or to treat snoring. A sialodochoplasty is the surgical correction of a salivary gland after the removal of a stone or other surgery. A stomatoplasty is the surgical reconstruction of the mouth to correct a malformation due to trauma, disease, or congenital causes. A uvulectomy is a removal of all or part of the uvula, usually to correct snoring.

Lower GI Procedures Word Parts Appendectomy- removal of the appendix.
Barium enema- introduction of barium sulfate suspension through the rectum for imaging of the lower digestive tract to detect obstructions, tumors, and other abnormalities. Cecopexy-fixation of the cecum to prevent or correct twisting of the cecum. Colonoscopy- diagnostic procedure to view the lining of the large intestine to detect cancer, diverticulities, or other abnormalities Colostomy-new opening of the colon called a stoma Stoma Word Parts append/o = appendix -ectomy = cutting out cec/o = cecum -pexy = suspension colon/o = colon -scopy = viewing col/o = colon -stomy = making a new opening Appendectomy is a cutting out of the appendix. An incidental appendectomy is the removal of the appendix secondary to another surgery, for example, during a hysterectomy. A barium enema is the introduction of barium sulfate suspension through the rectum for imaging of the lower digestive tract to detect obstructions, tumors, and other abnormalities. A cecopexy is a fixation of the cecum to prevent or correct a volvulus (twisting) of the cecum. A colonoscopy is a diagnostic procedure to view the lining of the large intestine to detect cancer, diverticulitis, or other abnormalities. A colostomy is a new opening of the colon. The opening itself is a stoma, using the combining form for a mouth or an opening. Discuss the reasons for the types of interventions noted. Colostomy and stoma

Lower GI Procedures Word Parts
Diverticulectomy- cutting out of a diverticulum Enteral nutrition – nutrition that is introduced through a structure when a patient is unable to eat normally Herniorrhaphy- suturing Of a hernia. Word Parts diverticul/o = diverticulum -ectomy = cutting out enter/o = small intestine -al = pertaining to herni/o = hernia -rrhaphy = suturing A diverticulectomy is cutting out of a diverticulum. Enteral nutrition is nutrition that is introduced through a digestive structure when a patient is unable to eat normally. A herniorrhaphy is a suturing of a hernia or a hernia repair. The procedure may be done through an open incision or laparoscopically, may be simply sutured, or may include reinforcing mesh. Enteral nutrition

Ileoureterostomy- new opening between the ileum and ureters. Jejunostomy-new opening of the second part of the small intestine to the surface of the abdomen for the placement of a feeding tube. Omentectomy, omentumectomy-is cutting out part or all of the omentum, usually as part of the treatment for ovarian cancer. Peritoneocentesis-a surgical puncture of the peritoneum to removal fluid and is a treatment for ascites Polypectomy, GI- removal of a polyp. Word Parts ile/o = ileum ureter/o = ureter -stomy = making a new opening jejun/o = jejunum oment/o = omentum -tomy = cutting -ectomy = cutting out peritone/o = peritoneum -centesis = surgical puncture An ileoureterostomy is a new opening between the ileum and ureters. A jejunostomy is a new opening of the second part of the small intestine to the surface of the abdomen for the placement of a feeding tube. An omentectomy (omentumectomy) is cutting out part or all of the omentum, usually as part of the treatment for ovarian cancer. A peritoneocentesis is a surgical puncture of the peritoneum to removal fluid and is a treatment for ascites.

Proctoclysis-is a cleansing of the rectum and anus or an enema Proctoscopy-is a viewing of the rectum and anus used to examine hemorrhoids or rectal polyps Pyloromyotomy-is an incision of the pyloric sphincter to correct an obstruction. Sigmoidoscopy-is a viewing of the sigmoid colon Total parenteral nutrition (TPN)-TPN is nutrition that is introduced outside of the alimentary canal (as opposed to enteral nutrition), usually done because the digestive tract is nonfunctional Word Parts proct/o = rectum and anus -clysis = washing -scopy = viewing pylor/o = pylorus my/o = muscle -tomy = cutting sigmoid/o = sigmoid colon par- = near, beside enter/o = small intestine -al = pertaining to A proctoclysis is a cleansing of the rectum and anus or an enema. A proctoscopy is a viewing of the rectum and anus used to examine hemorrhoids or rectal polyps. A pyloromyotomy is an incision of the pyloric sphincter to correct an obstruction. A sigmoidoscopy is a viewing of the sigmoid colon. TPN is nutrition that is introduced outside of the alimentary canal (as opposed to enteral nutrition), usually done because the digestive tract is nonfunctional.

Procedures of the Adnexa
Cholangiography -TPN is nutrition that is introduced outside of the alimentary canal (as opposed to enteral nutrition), usually done because the digestive tract is nonfunctional Cholecystectomy -removal of the gallbladder, either laparoscopically or through an open incision Choledochectomy-a removal of part or all of the common bile duct, usually as part of a procedure to treat cancer of the proximal duodenum Choledocholithotomy-is the removal of a stone from the common bile duct. A cholangiography is an imaging of the bile vessels using a contrast medium. A cholecystectomy is the removal of the gallbladder, either laparoscopically or through an open incision. A choledochectomy is a removal of part or all of the common bile duct, usually as part of a procedure to treat cancer of the proximal duodenum. A choledocholithotomy is the removal of a stone from the common bile duct. Laparoscopic cholecystectomy

Procedures of the Adnexa
Endoscopic retrograde cholangiopancreatography (ERCP)- an imaging of the bile vessels and the pancreas using a contrast medium in order to diagnose stones, strictures, and neoplasms. Hepatectomy-removal of all or part of the liver Word Parts endo- = below -scopic = pertaining to viewing cholangi/o = bile vessel pancreat/o = pancreas -graphy = recording hepat/o = liver -ectomy = cutting out An ERCP is an imaging of the bile vessels and the pancreas using a contrast medium in order to diagnose stones, strictures, and neoplasms. A hepatectomy is the removal of part or all of the liver. ERCP

Pharmacology Anorexiants- appetite suppressants designed to aid in weight control, often in an attempt to treat morbid obesity Antacids-a buffer (neutralizer) of hydrochloric acid in the stomach to temporarily relieve symptoms of GERD, pyrosis, and ulcers Antidiarrhealsprovide relief from diarrhea by reducing intestinal motility, inflammation, or loss of fluids and nutrients Antiemetics: prevent or alleviate nausea and vomiting Cathartics: cause evacuation of the bowel by stimulating peristalsis, increasing the fluidity or bulk of intestinal contents, softening the feces, or lubricating the intestine. Cathartics can be classified as either mild (laxatives) or severe (purgatives). Histamine-2 receptor antagonists (h2ras): prevent a portion of the hydrochloric acid production in the stomach for moderate-lasting acid suppression Laxatives: cause mild evacuation of the bowel by increasing the bulk of the feces, softening the stool, or lubricating the intestinal wall Proton pump inhibitors: block production of hydrochloric acid in the stomach for long-lasting acid suppression of disorders like GERD Anorexiants: appetite suppressants designed to aid in weight control, often in an attempt to treat morbid obesity Antacids: a buffer (neutralizer) of hydrochloric acid in the stomach to temporarily relieve symptoms of GERD, pyrosis, and ulcers Antidiarrheals: provide relief from diarrhea by reducing intestinal motility, inflammation, or loss of fluids and nutrients Antiemetics: prevent or alleviate nausea and vomiting Cathartics: cause evacuation of the bowel by stimulating peristalsis, increasing the fluidity or bulk of intestinal contents, softening the feces, or lubricating the intestine. Cathartics can be classified as either mild (laxatives) or severe (purgatives). Histamine-2 receptor antagonists (h2ras): prevent a portion of the hydrochloric acid production in the stomach for moderate-lasting acid suppression Laxatives: cause mild evacuation of the bowel by increasing the bulk of the feces, softening the stool, or lubricating the intestinal wall Proton pump inhibitors: block production of hydrochloric acid in the stomach for long-lasting acid suppression of disorders like GERD

Chapter Five DIGESTIVE SYSTEM.

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Chapter Five DIGESTIVE SYSTEM.

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