Chapter 8 Digestive System

Chapter 8 Digestive System
Ehrlich/Schroeder/Ehrlich/Schroeder, Medical Terminology for Health Professions, 8th Edition. © 2018 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Related Combining Forms
Structure Related Combining Forms Mouth or/o, stomat/o Pharynx pharyng/o Esophagus esophag/o Stomach gastr/o Small intestine enter/o Large intestine c o l/o, colon/o Rectum and anus an/o, proct/o, r e c t/o Liver hepat/o Gallbladder cholecyst/o Pancreas pancreat/o

Structures of Digestive System (1 of 2)
Gastrointestinal tract (gastr/o: stomach; intestin: intestine) Upper G I tract Mouth, pharynx, esophagus, stomach Lower G I tract Small and large intestines, rectum, anus Accessory organs Liver, gallbladder, pancreas

Structures of Digestive System (2 of 2)

Oral Cavity (1 of 2) Also known as the mouth Major structures Lips
Lips, hard and soft palates, salivary glands, tongue, teeth, periodontium Lips Surround the opening to oral cavity Play a role in eating, breathing, speaking, and expression of emotions

Oral Cavity (2 of 2)

Palate Hard palate Soft palate Uvula
Anterior portion of the palate; covered with specialized mucous membrane Soft palate Flexible posterior portion of the palate; closes off nasal passage during swallowing preventing upward movement of food/liquid Uvula Plays role in swallowing, snoring, and speech

Tongue Very strong, flexible, and muscular in nature
Important in chewing, speaking, and swallowing Upper surface: dorsum; contains taste buds Sublingual surface: under the tongue Lingual frenum: attaches tongue to the floor of the mouth

Soft Tissues of Oral Cavity (1 of 2)
Periodontium Surround, support, and attach to teeth (peri-: surrounding; odonti: teeth; -um: noun ending) Gingiva Specialized mucous membrane covering bone of dental arches and surrounding neck of the teeth Also known as Gum

Soft Tissues of Oral Cavity (2 of 2)
Sulcus Space between a tooth and surrounding gingiva Infection can result from buildup of food debris and bacteria

Dental Arches Bony structures of oral cavity Maxillary arch
Upper jaw; does not move Mandibular arch Lower jaw; movable Temporomandibular joint Formed at the back of mouth where maxillary and mandibular arches come together

Teeth (1 of 2) Dentition Natural teeth arranged in upper and lower jaws Incisors and canines (cuspids) Used for biting and tearing Premolars (bicuspids) and molars Used for chewing and grinding

Teeth (2 of 2)

Primary and Permanent Dentition
Primary dentition Deciduous dentition; baby teeth 20 teeth Erupt in early childhood Permanent dentition 32 teeth 20 replace primary teeth; 12 erupt at the back of the mouth

Structures and Tissues of Teeth (1 of 3)
Crown Portion visible in the mouth Covered with enamel–the hardest substance in the body Roots Hold teeth securely within the dental arch Cervix Neck of the tooth where crown and root meet

Dentin Bulk of a tooth Pulp cavity Within the crown and roots of a tooth Pulp Consists of rich supply of blood vessels and nerves providing nutrients and innervation to a tooth

Saliva and Salivary Glands (1 of 3)
Colorless liquid that maintains moisture in the mouth Begins the digestive process by lubricating food during chewing and swallowing Contains amylase, the first step in chemical digestion

Parotid glands Located slightly in front of each ear Sublingual glands Located on floor of the mouth under the tongue Submandibular glands Located on floor of the mouth near the mandible

Pharynx Common passageway for respiration and digestion
Important role in deglutition (swallowing) Epiglottis closes entrance to trachea to prevent food and liquid from moving from pharynx during swallowing

Esophagus (1 of 5) Muscular tube for the passage of ingested food from pharynx to stomach Lower esophageal sphincter Muscular ring between esophagus and stomach; relaxes to allow food to enter the stomach and contracts to prevent stomach contents from regurgitating into the esophagus

Stomach (1 of 9) Consists of fundus (upper, rounded part), body (main portion), and antrum (lower part) Rugae Folds in mucosa lining allowing the stomach to increase and decrease in size Gastric juices Enzymes and hydrochloric acid that aid in food digestion

Stomach (2 of 9)

Stomach (3 of 9) Pyloric sphincter Pylorus
Ring-like muscle at base of stomach controlling flow of partially digested food from stomach to the duodenum Pylorus Narrow passage connecting stomach with the small intestine

Small Intestine Extends from pyloric sphincter to the first part of the large intestine Three sections Duodenum: first portion Jejunum: middle portion Ileum: longest portion

Large Intestine (1 of 2) Extends from end of small intestine to the anus Site of preparation of waste products of digestion for excretion Major parts of the large intestine Cecum, colon, rectum, anus

Large Intestine (2 of 2)

Cecum Lies on the right side of the abdomen Ileocecal sphincter
Controls flow from ileum into cecum Vermiform appendix Appendix Hangs from the lower portion of the cecum Made up of lymphoid tissue

Colon Four parts Ascending colon: travels upward from cecum to the undersurface of the liver Transverse colon: lies horizontal across the abdominal cavity from right to left Descending colon: travels down the left side of the abdominal cavity Sigmoid colon: continues from descending colon and joins rectum

Rectum and Anus (1 of 2) Rectum Anus
Widest division of large intestine; ends at anus Anus Lower opening of digestive tract Internal and external anal sphincters control the flow of waste

Accessory Digestive Organs (1 of 2)
Play role in digestive process, but are not the part of the G I tract Liver Largest organ in the body Many functions, such as removing toxins from blood and turning food into fuel/nutrients Bilirubin causes yellow–green color of bile Bile secreted by liver and aids in fat digestion

Accessory Digestive Organs (2 of 2)

Biliary Tree Provides channels for transportation of bile from liver to small intestine

Gallbladder (1 of 5) Located under the liver
Stores and concentrates bile Cholecystic: pertaining to the gallbladder

Pancreas Located behind the stomach
Plays roles in digestive and endocrine system Secretes pancreatic juices aid in digestion and sodium bicarbonate that aid in neutralization of stomach acids

Digestion (1 of 2) Process by which complex food is broken down into nutrients to be used by the body Digestive enzymes Responsible for chemical changes in food

Digestion (2 of 2) Nutrient
Substance necessary for normal functioning of the body Primary (macronutrients) Carbohydrates, fats, proteins Essential micronutrients Vitamins, minerals

Metabolism Chemical reactions involved in body's use of nutrients
(metabol: change) Two parts Anabolism Builds up cells/substances by use of nutrients Catabolism Breaks down cells/substances releasing energy and carbon dioxide

Absorption Complete digestion of nutrients and their transportation to cells Villi Finger-like projections covering mucosa of small intestine Lacteals Lymphatic structures absorbing fats and fat-soluble vitamins that cannot be transported directly by the bloodstream

Role of Mouth, Salivary Glands, and Esophagus
Mastication Chewing Bolus Mass of food ready to be swallowed Peristalsis Wave-like contractions moving food forward into the digestive system

Role of Stomach Continued breakdown of food by gastric juices and digestive enzymes Chyme Semifluid mass of partly digested food that passes out of the stomach through pyloric sphincter into the small intestine

Role of Small Intestine
Duodenum Site of mixing of chyme with pancreatic juice and bile Jejunum Continues process of digestion using large amounts of digestive enzymes Ileum Site of absorption of nutrients

Role of Large Intestine (1 of 2)
Receives and stores waste products of digestion Feces Solid body wastes Defecation Bowel movement Gut microflora Bacteria in large intestine; fight infections

Role of Large Intestine (2 of 2)
Borborygmus Rumbling noise caused by the movement of gas in the intestine Flatulence (flatus) Passage of gas out of the body through the rectum

Medical Specialties Related to Digestive System (1 of 4)
Bariatrics Branch of medicine related to prevention and control of obesity Dentist Specializes in diagnosing/treating diseases/disorders of teeth and tissues of the oral cavity

Gastroenterologist Specializes in diagnosing/treating diseases/disorders of stomach and intestines (gastr/o: stomach; enter: small intestine) Oral or maxillofacial surgeon Specializes in surgery of face and jaws to correct deformities, treat diseases, or repair injuries

Orthodontist Specializes in prevention/correction of malocclusion of teeth and related facial structures (orth: straight or normal; odont: teeth) Periodontist Specializes in prevention/treatment of disorders of tissue surrounding the teeth (peri-: surrounding: odont: teeth; -ist: specialist)

Proctologist Specializes in disorders of colon, rectum, and anus (proct: anus and rectum; -ologist: specialist) Registered dietitian Specialist in food and nutrition; counsels patients on improving dietary intake

Pathology of Digestive System
Tissues of the oral cavity Aphthous ulcers Gray–white pits with red border in soft tissues lining the mouth Cheilosis Crack-like sores at the corners of the mouth (cheil: lips; -osis: abnormal condition or disease)

Tissues of Oral Cavity (1 of 3)
Herpes labialis Blister-like sores on lips and adjacent facial tissue Caused by oral herpes simplex virus type 1 Leukoplakia White precancerous lesion developing on tongue and inside of the cheek (leuk/o: white; -plakia: plaque)

Stomatitis Inflammation of mucosa of the mouth (stomat: mouth or oral cavity) Stomatomycosis Disease of the mouth due to fungus (stomat/o: mouth or oral cavity; myc: fungus) Oral thrush Due to Candida albicans

Trismus Restriction of opening of the mouth Caused by trauma, surgery, or radiation of oral cancer Xerostomia Lack of adequate saliva due to diminished secretions by salivary glands (xer/o: dry; stom: mouth or oral cavity; -ia: pertaining to)

Cleft Lip and Cleft Palate
Deep groove of the lip upward to the nose as a result of portion of the lip failing to close during prenatal development Cleft palate Failure of palate to close during early development of the fetus Cleft lip/palate may occur singly or together; corrected by surgery

Dental Diseases and Conditions (1 of 4)
Bruxism Grinding/clenching of teeth Dental caries Infectious disease caused by bacterial destruction of enamel and dentin of the teeth Dental plaque Formed in sheltered areas near gums/teeth Consists of bacteria and bacterial by-products

Edentulous Without teeth Halitosis Unpleasant odor coming from the mouth (halit: breath; -osis: abnormal condition or disease) Malocclusion Any deviation from normal position of upper teeth against lower teeth

Peridontal disease Inflammation of tissues surrounding and supporting the teeth Dental calculus (tartar) Hardened dental plaque Gingivitis Earliest state of periodontal disease and affects only the gums (gingiv: gums)

Acute necrotizing ulcerative gingivitis Due to abnormal growth of bacteria in the mouth Can lead to inflammation, bleeding, deep ulceration, and death of gum tissues

Esophagus (2 of 5) Dysphagia Eosionophilic esophagitis
Difficulty in swallowing Eosionophilic esophagitis Chronic immune system disease in which eosinophils build up in the esophagus, usually as result of allergy to certain foods (esophagi: esophagus; -itis: inflammation)

Esophagus (3 of 5) Gastroesophageal reflux disease Barrett’s esophagus
Upward flow of acid from the stomach into the esophagus (gastr/o: stomach; esophag: esophagus; -eal: pertaining to) Barrett’s esophagus Occurs when chronic acid exposure causes damage of cells in the epithelial tissue of the esophagus

Esophagus (4 of 5) Stricture Pyrosis
Abnormal narrowing of the esophagus due to scar tissue or other damage May result in swallowing difficulties Pyrosis Burning sensation due to acid reflux (pyr: fever or fire; -osis: abnormal condition or disease)

Esophagus (5 of 5) Esophageal varices Hiatal hernia
Enlarged, swollen veins at the lower end of the esophagus Hiatal hernia Portion of the stomach protrudes upward through an opening in the diaphragm (hiat: opening; -al: pertaining to)

Stomach (4 of 9) Gastritis Gastroparesis
Inflammation of stomach lining Often caused by Helibactor pylori Gastroparesis (gastr/o: stomach; -paresis: partial paralysis) Improper functioning of stomach muscles preventing normal emptying of contents Gastrorrhea (gastr/o: stomach; -rrhea: flow or discharge) Excessive secretion of gastric juice/mucus

Peptic Ulcers Peptic (pept: digestion; -ic: pertaining to)
Gastric ulcers Occur in the stomach Duodenal ulcers Occur in the upper part of the small intestine Perforating ulcer Erosion through entire thickness of organ wall Complication of peptic ulcer

Nutritional Disorders (1 of 3)
Anorexia Loss of appetite Cachexia Physical wasting away with loss of weight and muscle mass due to inability of body to properly absorb nutrients Dehydration Fluid loss exceeds fluid intake (de-: removal; hydra: water; -tion: the process of)

Malnutrition Lack of proper food/nutrients in body due to shortage of food, poor eating habits, or inability of body to digest, absorb, and distribute these nutrients (mal-: bad or poor) Malabsorption Inability of small intestine to absorb nutrients

Obesity Excessive accumulation of fat in the body More than 20%–30% over the established weight standards for height, age, and gender Morbid obesity Weighing two times or more than ideal weight Body mass index (B M I) greater than 40 B M I: body weight adjusted for height

Indigestion and Vomiting (1 of 4)
Aerophagia Excessive swallowing of air while eating or drinking (a e r/o: air; -phagia: swallowing) Dyspepsia Indigestion (d y s-: painful; -pepsia: digestion)

Emesis Reflex ejection of the stomach contents (emesis or -emesis: vomiting) Eructation Belching

Hematemesis Vomiting of blood (hemat: blood; -emisis: vomiting) Hyperemesis Extreme, persistent vomiting resulting in dehydration (hyper-: excessive; -emesis: vomiting)

Nausea Urge to vomit Regurgitation Return of swallowed food into the mouth

Intestinal Disorders (1 of 11)
Celiac disease Inherited autoimmune disorder characterized by severe reaction to food containing gluten Damages villi of small intestine leading to malabsorption Gluten intolerance Digestive distress due to the response to gluten Does not cause intestinal tissue damage

Food allergy Immune system reaction occurring after eating of certain foods Lactose intolerance Inability to digest dairy products Due to absence of the enzyme lactase Colorectal carcinoma Colon cancer

Polyp Mushroom-like growth from the surface of the mucous membrane May be benign or malignant Diverticulosis Chronic presence of abnormal number of diverticula Often asymptomatic (diverticul: diverticulum; -osis: abnormal condition or disease)

Diverticulum Small pouch in the lining or wall of a tubular organ Diverticulitis Inflammation or infection of the diverticula Enteritis Inflammation of the small intestine May be viral or bacterial (enter: small intestine; -itis: inflammation)

Ischemic colitis Deprivation of blood supply to the large intestine Ileus Partial or complete blockage of the small or large intestine Due to decrease in peristalsis May occur temporarily after abdominal surgery (postoperative ileus)

Irritable bowel syndrome Intermittent cramping and abdominal pain accompanied by constipation or diarrhea Unknown cause Inflammatory bowel diseases General term for diseases that cause inflammation and swelling in intestines Most common are ulcerative colitis and Crohn’s disease

Ulcerative colitis Chronic, repeated episodes of inflammation in the innermost lining of the rectum and large intestine causing ulcers and irritation (col: colon; -itis: inflammation) Crohn’s disease Chronic, autoimmune disorder occurring anywhere in the digestive tract Permeates every layer of affected tissue

Intestinal obstruction Partial or complete blockage of small or large intestine Adhesions join parts of the intestine which otherwise should be separated Strangulating obstruction blocks blood flow to the intestine leading to gangrene or perforation

Volvulus Twisting of the intestine on itself Intussusception Telescoping of one part of the small intestine into the opening of the adjacent part (intussuscept: to take up or to receive within; -ion: condition)

Inguinal hernia Protrusion of loop of bowel through weak place in lower abdominal wall (inguin: groin; -al: pertaining to) Strangulated hernia Constriction of portion of intestine inside hernia Decreased blood supply causes ischemia in this tissue

Infectious Diseases of Intestines (1 of 2)
Clostridium difficile Bacterial infection typically occurs following the use of antibiotics that wipe out competing bacteria Common in hospitals or long-term care facilities Prevention: infection control measures Dysentery Bacterial infection spreads through food/water contaminated with human feces

Infectious Diseases of Intestines (2 of 2)
Escherichia coli (E.coli) Transmitted through improper cooking of contaminated food Salmonellosis Transmitted by feces through direct contact with animals or eating contaminated foods, unpasteurized milk, and cheese products

Anorectal Disorders (1 of 3)
Anal fissure Crack-like sore in the skin of anus Bowel incontinence Inability to control the excretion of feces Constipation Difficulty in emptying the bowel due to hardened and dry feces

Diarrhea Frequent flow of loose or watery stools (dia-: through; -rrhea: flow or discharge) Hemorrhoids Cluster of veins, muscles, and tissues which slip near or through the anal opening

Rectocele Bulging of front wall of rectum into vagina May be the result of childbirth or pregnancy (rect/o: rectum; -cele: hernia)

Abnormal Stools (1 of 2) Hematochezia Melena
Flow of bright red blood in stool Usually indicates bleeding from lower part of G I tract Melena Black, tarry, foul-smelling feces Usually indicates bleeding in upper part of G I tract

Abnormal Stools (2 of 2) Steatorrhea Presence of excess fat in stool
Frothy, foul-smelling stool Usually caused by pancreatic disease, removal of gallbladder, or malabsorption disorders (steat/o: fat; -rrhea: flow or discharge)

Liver (1 of 5) Ascites Hepatomegaly
Abnormal accumulation of serous fluid in peritoneal cavity May be the result of severe liver disease Hepatomegaly Abnormal enlargement of liver (hepat/o: liver; -megaly: enlargement)

Liver (2 of 5) Jaundice Hepatitis
Yellow discoloration of skin, mucous membranes, and eyes Due to increased bilirubin in the blood Hepatitis Inflammation of liver Usually caused by viral infection (hepat: liver; -itis: inflammation)

Liver (3 of 5) Cirrhosis Nonalcoholic fatty liver disease
Chronic degenerative disease of liver May be due to alcohol abuse or viral hepatitis B or C (cirrh: yellow or orange; -osis: abnormal condition or disease) Nonalcoholic fatty liver disease Accumulation of fat in liver of the people who drink small amount or no alcohol

Liver (4 of 5) Nonalcoholic steatohepatitis
Fatty accumulations plus liver-damaging inflammation May progress to cirrhosis, irreversible liver scarring, or liver cancer

Gallbladder (2 of 5) Cholangitis Cholecystitis
Acute inflammation of bile duct Usually caused by bacterial infection (cholang: bile duct; -itis: inflammation) Cholecystitis Inflammation of gallbladder Often associated with gallstones (cholecyst: gallbladder)

Gallbladder (3 of 5) Gallstone Cholelithiasis
Hard deposit in gallbladder and bile ducts due to concretion of bile components Cholelithiasis Presence of gallstones in gallbladder or bile ducts (chole: bile or gall; -lithiasis: presence of stones)

Diagnostic Procedures of Digestive System (1 of 4)
Abdominal computed tomography Radiographic procedure showing cross-section of tissue structure within abdomen Abdominal ultrasound Noninvasive test using very-high-frequency sound waves to visualize internal organs

Cholangiography Radiographic examination of bile ducts with the use of contrast medium (cholangi/o: bile duct; -graphy: the process of recording)

Enema Placement of solution into rectum/colon to empty the lower intestine Esophagogastroduodenoscopy Allows direct visualization of upper G I tract (esophag/o: esophagus; gastr/o: stomach; duoden/o: duodenum; -scopy: visual examination)

Upper G I series and lower G I series Radiographic studies to examine digestive system Require contrast medium Stool samples Specimens of feces that are examined for content/characteristics

Endoscopic Procedures
Require instrument for visual examination of internal structures Anoscopy Visual examination of anal canal/lower rectum Capsule endoscopy Use of tiny video camera that is swallowed by patient Camera transmits images of small intestine; transmitted to data recorder worn by patient

Screening for Colorectal Carcinoma (1 of 2)
Colonoscopy Direct visual examination of inner surface of the entire colon from rectum to cecum (colon/o: colon; -scopy: visual examination) Sigmoidoscopy Endoscopic examination of the interior of the rectum, sigmoid colon, and possibly a portion of the descending colon (sigmoid/o: sigmoid colon)

Screening for Colorectal Carcinoma (2 of 2)
Hemoccult® test Laboratory test for hidden blood in stool (hem: blood; -occult: hidden) Cologuard® Noninvasive stool test using D N A testing along with screening for hidden blood

Treatment Procedures of Digestive System (1 of 4)
Antioxidants Chemicals, such as vitamins, that may prevent or delay cell damage Present in fruits, beans, berries, nuts, and dark chocolate Probiotics Living microorganisms that aid digestion and protection of body from harmful bacteria (pro: supporting)

Medications Antacids Neutralize acids in the stomach Proton pump inhibitors Decrease the amount of acid produced by the stomach

Medications Antiemetic Prevents or relieves nausea/vomiting (anti-: against; emet: vomit; -ic: pertaining to) Laxatives Medications/foods that stimulate bowel movements

Medications Intravenous fluids Administered to combat dehydration (intra-: within; ven/o: vein; -us: noun ending) Oral rehydration therapy Liquid preparation of electrolytes administered to counteract dehydration, especially in young children

Oral Cavity and Esophagus (1 of 2)
Dental prophylaxis Professional cleaning of teeth Dental implant Crown, bridge or denture that may or may not be anchored to the jaw Root canal Removal of diseased or damaged pulp

Oral Cavity and Esophagus (2 of 2)
Gingivectomy Surgical removal of the diseased gingival tissue (gingiv: gingival tissue; -ectomy: surgical removal) Palatoplasty Surgical repair of cleft palate, or cleft lip (palat/o: palate; -plasty: surgical repair)

Stomach (5 of 9) Gastrectomy Nasogastric intubation
Surgical removal of all or part of the stomach (gastr: stomach; -ectomy: surgical removal) Nasogastric intubation Placement of feeding tube through nose into the stomach to provide nutrition (nas/o: nose; gastr: stomach; -ic: pertaining to)

Stomach (6 of 9) Gastrostomy tube
Surgically placed feeding tube from exterior of body directly into stomach to provide nutrition (gastr: stomach; -ostomy: surgically creating an opening)

Stomach (7 of 9) Total parenteral nutrition Bariatric surgery
Specialized intravenous solution administered to patients who cannot or should not get nutrition through eating Bariatric surgery Treats morbid obesity Restricts amount of food entering the stomach for digestion

Stomach (8 of 9) Gastric bypass surgery
Stapling of a section of stomach to make a small pouch Causes food to bypass first part of small intestine Lap-band adjustable gastric banding Places inflatable band around the exterior of the stomach restricting food intake

Stomach (9 of 9) Endoscopic sleeve gastroplasty
Suturing of stomach to make it a small tube, reducing its capacity Endoscopic option for bariatric surgeries requiring general anesthesia

Intestines (1 of 3) Colectomy Colotomy
Surgical removal of all or part of the colon (c o l: colon; -ectomy: surgical removal) Colotomy Surgical incision into the colon (c o l: colon; -otomy: surgical incision)

Intestines (2 of 3) Diverticulectomy Gastroduodenostomy
Surgical removal of diverticulum (diverticul: diverticulum; -ectomy: surgical removal) Gastroduodenostomy Anastomosis between upper portion of stomach and duodenum (gastr/o: stomach; duoden: first part of the small intestine; -ostomy: surgically creating an opening)

Intestines (3 of 3) Anastomosis Ileectomy
Surgical connection between two hollow structures Ileectomy Surgical removal of the ileum (ile: ileum; -ectomy: surgical removal)

Ostomies Ileostomy Colostomy
Surgical creation of artificial excretory opening between ileum and outside of abdominal wall (ile: small intestine) Colostomy Surgical creation of artificial excretory opening between the colon and the body surface May be temporary or permanent

Rectum and Anus (2 of 2) Hemorrhoidectomy Proctopexy
Surgical removal of hemorrhoids (hemorrhoid: hemorrhoid) Proctopexy Surgical fixation of prolapsed rectum to an adjacent tissue/organ (proct/o: rectum; -pexy: surgical fixation)

Liver (5 of 5) Hepatectomy Liver transplant
Surgical removal of all or part of the liver (hepat: liver; -ectomy: surgical removal) Liver transplant Option for the patient whose liver is not functioning properly for a reason other than liver cancer

Gallbladder (4 of 5) Choledocholithotomy
Incision into common bile duct for the removal of gallstones (choledoch/o: common bile duct; lith: stone; -otomy: surgical incision)

Gallbladder (5 of 5) Cholecystectomy
Surgical removal of the gallbladder (cholecyst: gallbladder; -ectomy: surgical removal)

Chapter 8 Digestive System

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