1. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 12: The Digestive System

2. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter Objectives  Function of the digestive system.  Digestive tract, functions of each part.  Accessory organs and their role in digestion.  Roots pertaining to the digestive system.  Major disorders of the digestive system.  Medical terms used in reference to the digestive system.  Abbreviations used in referring to the gastrointestinal system.

3. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Term Normal Structure and Function anusThe distal opening of the digestive tract (root: an/o) appendixAn appendage; usually means the narrow tube of lymphatic tissue attached to the cecum, the vermiform (wormlike) appendix bileThe fluid secreted by the liver that emulsified fats and aids in their absorption (roots: chol/e, bili) cecumA blind pouch at the beginning of the large intestine (root: cec/o) colonThe major portion of the large intestine; extends from the cecum to the rectum and is formed by ascending, transverse, and descending portions (root: col/o, colon/o) common bile ductThe duct that carries bile into the duodenum; formed by the union of the cystic duct and the common hepatic duct (root: choledoch/o) duodenumThe first portion of the small intestine (root: duoden/o) enzymeAn organic catalyst; speeds the rate of chemical reactions

4. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Normal Structure and Function (cont’d) esophagusThe muscular tube that carries food from the pharynx to the stomach. fecesThe waste material eliminated from the intestine (adjective: fecal); stool gallbladderA sac on the undersurface of the liver that stores bile (root: cholecyst/o) hepatic portal system A special pathway of the circulation that brings blood directly from the abdominal organs to the liver for processing (also called simply the portal system). The vessel that enters the liver is the hepatic portal vein (portal vein). ileumThe terminal portion of the small intestine (root: ile/o) intestineThe portion of the digestive tract between the stomach and the anus. It consists of the small intestine and large intestine. It functions in digestion, absorption, and elimination of waste (root: enter/o). The bowel (BOW-el)

5. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Normal Structure and Function (cont’d) jejunumThe middle portion of the small intestine (root: jejun/o) lactealA lymphatic capillary in a villus of the small intestine. Lacteals absorb digested fats into the lymph large intestineThe terminal portion of the digestive tract, consisting of the cecum, colon, rectum, and anus. It stores and eliminates undigested waste material (feces) liverThe large gland in the upper right part of the abdomen. In addition to many other functions, it secretes bile needed for digestion and absorption of fats (root: hepat/o) lower esophageal sphincter (LES) Muscle tissue at the distal end of the esophagus (gastroesophageal junction) that prevents stomach contents from refluxing into the esophagus. Also called the cardiac sphincter masticationChewing mouthThe oral cavity; contains the tongue and teeth. Used to take in and chew food, mix it with saliva, and move it toward the throat to be swallowed

6. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Normal Structure and Function (cont’d) palateThe roof of the mouth; the partition between the mouth and nasal cavity; consists of an anterior portion formed by bone, the hard palate, and a posterior portion formed of tissue, the soft palate (root: palat/o) pancreasA large, elongated gland behind the stomach. It produces hormones that regulate sugar metabolism and also produces digestive enzymes (root: pancreat/o) peristalsisWavelike contractions of an organ's walls; moves material through an organ or duct pharynxThe throat; a common passageway for food entering the esophagus and air entering the larynx (root: pharyng/o) pylorusThe stomach's distal opening into the duodenum. The opening is controlled by a ring of muscle, the pyloric sphincter (root: pylor/o) rectumThe distal portion of the large intestine. It stores and eliminates undigested waste (root: rect/o, proct/o)

7. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Normal Structure and Function (cont’d) salivaThe clear secretion released into the mouth that moistens food and contains a starch-digesting enzyme (root: sial/o). Saliva is produced by three pairs of glands: the parotid, submandibular, and sublingual glands sigmoid colonDistal S-shaped portion of the large intestine located between the descending colon and the rectum small intestineThe portion of the intestine between the stomach and the large intestine; comprised of the duodenum, jejunum, and ileum. Accessory organs secrete into the small intestine, and almost all digestion and absorption occur there stomachA muscular saclike organ below the diaphragm that stores food and secretes juices that digest proteins (root: gastr/o) uvulaThe fleshy mass that hangs from the soft palate; aids in speech production (literally “little grape”) (root: uvul/o) villiTiny projections in the lining of the small intestine that absorb digested foods into the circulation (singular: villus)

8. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Disorders appendicitisInflammation of the appendix ascitesAccumulation of fluid in the abdominal cavity; a form of edema. May be caused by heart disease, lymphatic or venous obstruction, cirrhosis, or changes in plasma composition. biliary colicAcute abdominal pain caused by gallstones in the bile ducts bilirubinA pigment released in the breakdown of hemoglobin from red blood cells; mainly excreted by the liver in bile cariesTooth decay celiac diseaseInability to absorb foods containing gluten, a protein found in wheat and some other grains; caused by an excess immune response to gluten cholecystitisInflammation of the gallbladder cholelithiasisThe condition of having stones in the gallbladder; also used to refer to stones in the common bile duct

9. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Disorders (cont’d) cirrhosisChronic liver disease with degeneration of liver tissue Crohn diseaseA chronic inflammatory disease of the gastrointestinal tract usually involving the ileum and colon diarrheaThe frequent passage of watery bowel movements diverticulitisInflammation of diverticula (small pouches) in the wall of the digestive tract, especially in the colon diverticulosisThe presence of diverticula, especially in the colon dysphagiaDifficulty in swallowing emesisVomiting fistulaAn abnormal passageway between two organs or from an organ to the body surface, such as between the rectum and anus (anorectal fistula)

10. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Disorders (cont’d) gastroenteritisInflammation of the stomach and intestine gastroesophageal reflux disease (GERD) Condition caused by reflux of gastric juices into the esophagus resulting in heartburn, regurgitation, inflammation, and possible damage to the esophagus; caused by weakness of the lower esophageal sphincter (LES) heartburnA warm or burning sensation felt behind the sternum and radiating upward. Commonly associated with gastroesophageal reflux. Medical name is pyrosis (pyr/o means “heat”) hemorrhoidsVaricose veins in the rectum associated with pain, bleeding, and sometimes prolapse of the rectum hepatitisInflammation of the liver; commonly caused by a viral infection hepatomegalyEnlargement of the liver hiatal herniaA protrusion of the stomach through the opening (hiatus) in the diaphragm through which the esophagus passes

11. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Disorders (cont’d) icterusJaundice ileusIntestinal obstruction. May be caused by lack of peristalsis (adynamic, paralytic ileus) or by contraction (dynamic ileus). Intestinal matter and gas may be relieved by insertion of a drainage tube intussusceptionSlipping of one part of the intestine into another part below it. Occurs mainly in male infants in the ileocecal region). May be fatal if untreated for more than 1 day jaundiceA yellowish color of the skin, mucous membranes, and whites of the eye caused by bile pigments in the blood (from French jaune meaning “yellow”). The main pigment is bilirubin, a byproduct of erythrocyte destruction leukoplakiaWhite patches on mucous membranes, as on the tongue or cheeks, often resulting from smoking or other irritants; may be precancerous nauseaAn unpleasant sensation in the upper abdomen that often precedes vomiting. Typically occurs in digestive upset, motion sickness, and sometimes early pregnancy

12. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Disorders (cont’d) occult bloodBlood present in such small amounts that it can be detected only microscopically or chemically; in the feces, a sign of intestinal bleeding (occult means “hidden”) pancreatitisInflammation of the pancreas peptic ulcerA lesion in the mucous membrane of the esophagus, stomach, or duodenum caused by the action of gastric juice peritonitisInflammation of the peritoneum, the membrane that lines the abdominal cavity and covers the abdominal organs. May result from perforation of an ulcer, rupture of the appendix, or infection of the reproductive tract, among other causes. polypA tumor that grows on a stalk and bleeds easily

13. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Disorders (cont’d) portal hypertensionAn abnormal pressure increase in the hepatic portal system. May be caused by cirrhosis, infection, thrombosis, or tumors pyloric stenosisNarrowing of the opening between the stomach and the duodenum; pylorostenosis regurgitationA backward flowing, such as the backflow of undigested food splenomegalyEnlargement of the spleen ulcerative colitisChronic ulceration of the rectum and colon; the cause is unknown, but may involve autoimmunity volvulusTwisting of the intestine resulting in obstruction. Usually involves the sigmoid colon and occurs most often in children and in the elderly. May be caused by congenital malformation, a foreign body, or adhesion. Failure to treat immediately may result in death

14. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Diagnosis and Treatment anastomosisA passage or communication between two vessels or organs. May be normal or pathologic, or may be created surgically barium studyUse of barium sulfate as a liquid contrast medium for fluoroscopic or radiographic study of the digestive tract. Can show obstruction, tumors, ulcers, hiatal hernia, and motility disorders, among other things cholecystectomySurgical removal of the gallbladder Dukes classificationA system for staging colorectal cancer based on degree of penetration of the bowel wall and lymph node involvement; severity is graded from A to C endoscopyUse of a fiberoptic endoscope for direct visual examination. GI studies include esophagogastroduodenoscopy, proctosigmoidoscopy (rectum and distal colon), and colonoscopy (all regions of the colon)

15. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Diagnosis and Treatment (cont’d) ERCPEndoscopic retrograde cholangiopancreatography; a technique for viewing the pancreatic and bile ducts and for performing certain techniques to relieve obstructions. Contrast medium is injected into the biliary system from the duodenum and radiographs are taken ostomyAn opening into the body; generally refers to an opening created for elimination of body waste. Also refers to the operation done to create such an opening (see stoma). stomaA surgically created opening to the body surface or between two organs (literally “mouth”)

16. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary terms Normal Structure and Function bolusA mass, such as the rounded mass of food that is swallowed cardiaThe part of the stomach near the esophagus, named for its closeness to the heart chymeThe semiliquid partially digested food that moves from the stomach into the small intestine defecationThe evacuation of feces from the rectum deglutitionSwallowing duodenal bulbThe part of the duodenum near the pylorus; the first bend (flexure) of the duodenum duodenal papillaThe raised area where the common bile duct and pancreatic duct enter the duodenum; papilla of Vater (FA-ter) greater omentumA fold of the peritoneum that extends from the stomach over the abdominal organs hepatic flexureThe right bend of the colon, forming the junction between the ascending colon and the transverse colon

17. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Normal Structure and Function (cont’d) ileocecal valveA valvelike structure between the ileum of the small intestine and the cecum of the large intestine mesenteryThe portion of the peritoneum that folds over and supports the intestine mesocolonThe portion of the peritoneum that folds over and supports the colon papilla of VaterSee duodenal papilla peritoneumThe serous membrane that lines the abdominal cavity and supports the abdominal organs rugaeThe large folds in the lining of the stomach seen when the stomach is empty sphincter of OddiThe ring of muscle at the opening of the common bile duct into the duodenum splenic flexureThe left bend of the colon, forming the junction between the transverse colon and the descending colon

18. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Disorders achalasiaFailure of a smooth muscle to relax, especially the lower esophageal sphincter, so that food is retained in the esophagus achlorhydriaLack of hydrochloric acid in the stomach; opposite is hyperchlorhydria anorexiaLoss of appetite. Anorexia nervosa is a psychologically induced refusal or inability to eat (adjectives: anorectic, anorexic) aphagiaRefusal or inability to eat; inability to swallow or difficulty in swallowing aphthous ulcerAn ulcer in a mucous membrane, as in the mouth Barrett syndromeLower esophageal ulcer resulting from chronic esophagitis, often with constriction caused by mucosal changes; may be premalignant. Also called Barrett esophagus bruxismClenching and grinding of the teeth, usually during sleep bulimiaExcessive, insatiable appetite. A disorder characterized by overeating followed by induced vomiting, diarrhea, or fasting

19. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Disorders (cont’d) cachexiaProfound ill health, malnutrition, and wasting cheilosisCracking at the corners of the mouth, often caused by B vitamin deficiency (root cheil/o means “lip”) cholestasisStoppage of bile flow constipationInfrequency or difficulty in defecation and the passage of hard, dry feces dyspepsiaPoor or painful digestion eructationBelching familial adenomatous polyposis (FAP) A heredity condition in which multiple polyps form in the colon and rectum, predisposing to colorectal cancer flatulenceCondition of having gas or air in the GI tract

20. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Disorders (cont’d) flatusGas or air in the gastrointestinal tract; gas or air expelled through the anus hematemesisVomiting of blood irritable bowel syndrome (IBS) A chronic stress-related disease characterized by diarrhea, constipation, and pain associated with rhythmic contractions of the intestine. Mucous colitis; spastic colon. megacolonAn extremely dilated colon. Usually congenital but may occur in acute ulcerative colitis. melenaBlack tarry feces resulting from blood in the intestines. Common in newborns. May also be a sign of gastrointestinal bleeding. obstipationExtreme constipation pernicious anemiaA form of anemia caused by the stomach’s failure to secrete intrinsic factor, a substance needed for the absorption of vitamin B 12

21. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Disorders (cont’d) pilonidal cystA dermal cyst in the sacral region, usually at the top of the cleft between the buttocks. May become infected and begin to drain. thrushFungal infection of the mouth and/or throat caused by Candida; appears as mucosal white patches or ulcers Vincent diseaseSevere gingivitis with necrosis associated with the bacterium Treponema vincentii; necrotizing ulcerative gingivitis; trench mouth

22. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Diagnosis and Treatment appendectomySurgical removal of the appendix bariatricsThe branch of medicine concerned with prevention and control of obesity and associated diseases (from Greek baros, meaning “weight”) Billroth operationsGastrectomy with anastomosis of the stomach to the duodenum (Billroth I) or to the jejunum (Billroth II) gastric bypass surgery Division of the stomach and anastomosis of its upper part to the small intestine (jejunum) to reduce nutrient absorption; used to treat morbid obesity. Other surgical methods are used for this purpose, including partition of the stomach with rows of staples (gastric stapling) gavageProcess of feeding through a nasogastric tube into the stomach lavageWashing out of a cavity; irrigation manometryMeasurement of pressure; pertaining to the GI tract, measurement of pressure in the portal system as a sign of obstruction

23. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Diagnosis and Treatment (cont’d) Murphy signInability to take a deep breath when fingers are pressed firmly below the right arch of the ribs (below the liver). Signifies gallbladder disease. nasogastric (NG) tube Tube that is passed through the nose into the stomach. May be used for emptying the stomach, administering medication, giving liquids, or sampling stomach contents. parenteral hyperalimentation Complete intravenous feeding for one who cannot take in food. Total parenteral nutrition (TPN). percutaneous endoscopic gastrostomy (PEG) tube Tube inserted into the stomach for long-term feeding vagotomyInterruption of impulses from the vagus nerve to reduce stomach secretions in the treatment of gastric ulcer. Originally done surgically but may also be done with drugs.

24. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Drugs antacidAgent that counteracts acidity, usually gastric acidity antidiarrhealTreats or prevents diarrhea by reducing intestinal motility or absorbing irritants and soothing the intestinal lining antiemeticAgent that relieves or prevents nausea and vomiting antiflatulentAgent that prevents or relieves flatulence antispasmodicAgent that relieves spasm, usually of smooth muscle emeticAn agent that causes vomiting

25. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Drugs (cont’d) histamine H 2 antagonistDrug that decreases secretion of stomach acid by interfering with the action of histamine at H 2 receptors. Used to treat ulcers and other gastrointestinal problems. H 2 -receptor-blocking agent laxativePromotes elimination from the large intestine. Types include stimulants, substances that retain water (hyperosmotics), stool softeners, and bulk-forming agents proton-pump inhibitor (PPI) Agent that inhibits secretion of stomach acid by blocking the transport of hydrogen ions (protons) into the stomach.

26. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Abbreviations BEBarium enema (for radiographic study of the colon) BMBowel movement CBDCommon bile duct ERCPEndoscopic retrograde cholangiopancreatography FAPFamilial adenomatous polyposis GERDGastroesophageal reflux disease GIGastrointestinal HAVHepatitis A virus HBVHepatitis B virus HCVHepatitis C virus HDVHepatitis D virus

27. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Abbreviations (cont’d) HEVHepatitis E virus HClHydrochloric acid IBDInflammatory bowel disease IBSIrritable bowel syndrome LESLower esophageal sphincter NGNasogastric (tube) N & VNausea and vomiting N/V/DNausea, vomiting, and diarrhea PONVPostoperative nausea and vomiting PPIProton pump inhibitor TPNTotal parenteral nutrition UGIUpper gastrointestinal (radiograph series)

28. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Digestion Prepares food for cellular intake –Nutrients must be small enough to be absorbed –Nutrients broken down by mechanical and chemical means Occurs in digestive tract Food moved by peristalsis

29. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Digestive System

30. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins The Mouth to the Stomach Digestion begins in mouth –Mastication breaks up food –Tongue, lips, cheek, and palate break up food and mix in saliva –Moistened food passed: Into pharynx → through esophagus → into stomach Churning of stomach further breaks down food by: –Mixing with enzyme pepsin and HCl

31. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins The Mouth

32. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Roots for the Mouth RootMeaningExampleDefinition of Example bucc/ocheekbuccoversionturning toward the cheek dent/o, dent/itooth, teethedentulouswithout teeth odont/otooth, teethperiodonticsdental specialty that deals with the study and treatment of the tissues around the teeth gingiv/ogum (gingiva)gingivectomyexcision of gum tissue gloss/otongueglossoplegiaparalysis (-plegia) of the tongue lingu/otongueorolingualpertaining to the mouth and tongue

33. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Roots for the Mouth (cont’d) RootMeaningExampleDefinition of Example gnath/ojawprognathoushaving a projecting jaw labi/oliplabiumlip or liplike structure or/omouthcircumoralaround the mouth stoma, stomat/o mouthxerostomiadryness (xero-) of the mouth palat/opalatepalatinepertaining to the palate (also palatal) sial/osaliva, salivary gland, salivary duct sialogramradiograph of the salivary glands and ducts uvul/ouvulauvulotomeinstrument (-tome) for incising the uvula

34. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Roots for the Digestive Tract (Except for the Mouth) RootMeaningExampleDefinition of Example esophag/oesophagusesophageal*pertaining to the esophagus gastr/ostomachgastroparesispartial paralysis (paresis) of the stomach pylor/opyloruspyloroplastyplastic repair of the pylorus enter/ointestinedysenteryinfectious disease of the intestine duoden/oduodenumduodenostomysurgical creation of an opening into the duodenum * Note addition of e before –al.

35. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Roots for the Digestive Tract (Except for the Mouth) RootMeaningExampleDefinition of Example jejun/ojejunumjejunectomyexcision of the jejunum ile/oileumileitisinflammation of the ileum cec/ocecumcecoptosisdownward displacement of the cecum col/o, colon/o coloncoloclysisirrigation (-clysis) of the colon sigmoid/osigmoid colon sigmoidoscopean endoscope for examining the sigmoid colon rect/orectumrectocelehernia of the rectum proct/orectumproctopexysurgical fixation of the rectum an/oanusperianalaround the anus

36. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins The Small Intestine Partially digested food passes through pylorus into duodenum Digestion completed after passing through other parts of small intestine (jejunum and ileum) Digested nutrients absorbed into circulation –Aided by villi

37. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins The Large Intestine Undigested food, water, digestive juices Begins with cecum Colon twists and turns: –Ascending colon –Transverse colon –Descending colon Water reabsorbed, feces formed Waste material passes into sigmoid colon Waste stored in rectum; eliminated through anus

38. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Accessory Organs Salivary glands –Secretes enzyme that begins digestion of starch Liver –Secretes bile to break down fats Gallbladder –Bile stored here until needed Pancreas –Produces mixture of digestive enzymes

39. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Accessory Organs

40. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Roots for the Accessory Organs RootMeaningExampleDefinition of Example hepat/oliverhepatocytea liver cell bilibilebiliarypertaining to the bile or bile ducts chol/e, chol/obile, gallcholestasisstoppage of bile flow cholecyst/ogallbladdercholecystogramradiograph of the gallbladder cholangi/obile ductcholangiomacancer of the bile ducts choledoch/ocommon bile duct choledochalpertaining to the common bile duct pancreat/opancreaspancreatotropicacting on the pancreas

41. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Clinical Aspects of the Digestive System Infection –Can be caused by variety of organisms Ulcers –Lesion of skin or mucous membrane –Marked by inflammation or tissue damage –Can be diagnosed by: Endoscopy Barium study (Radiography with contrast medium)

42. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Cancer Colon and rectum most likely affected area Risk factors: –Diet low in fiber, high in fat –Heredity –Chronic inflammation of colon (colitis) Polyps often become cancerous Symptom: bleeding into intestine

43. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Cancer (cont’d) Internal observations performed with endoscopes Treatment may require surgical removal of portion of GI tract –May create a stoma for waste elimination –Surgery is called –ostomy, with root named for involved organ (e.g. colostomy)

44. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Obstructions Hernia –Protrusion of organ through abnormal opening Pyloric stenosis –Opening between stomach and small intestine too narrow Intussusception –Slipping of part of intestine into part below

45. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Obstructions (cont’d) Volvulus –Intestinal twisting Ileus –Intestinal obstruction caused by lack of peristalsis Hemorrhoids –Varicose veins in the rectum

46. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Gastroesophageal Reflux Disease Reflux of gastric juices caused by weakness at gastroesophageal junction Heartburn likely to occur after meals, when lying down, with hiatal hernia, and pregnancy Treatment: –Weight loss –Elevate head –Avoidance of irritating foods –Drugs –Surgery

47. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Inflammatory Intestinal Disease Crohn disease –Chronic inflammation of intestinal wall segments, usually ileum –May causes, pain, diarrhea, abscess, formation of fistula Ulcerative colitis –Continuous inflammation of colon lining, usually rectum

48. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Inflammatory Intestinal Disease (cont’d) Celiac disease –Inability to absorb gluten Diverticulitis –Many small pouches in wall of intestine –Attributed to diet low in fiber –If pouches collect waste and bacteria, leads to diverticulitis –Treated with diet improvement, stool softeners, drugs to reduce motility

49. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Hepatitis Inflammation of the liver More than six types of viral infections –Hepatitis A Spread by fecal-oral contamination –Hepatitis B Spread by blood and other body fluids –Hepatitis C Spread through blood or close contact to infected person

50. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Hepatitis (cont’d) –Hepatitis D Highly pathogenic, only affects those with Hepatitis B –Hepatitis E Spread by contaminated food and water –Hepatitis G Spread through contact with blood of infected person –Vaccines available for Hepatitis A and B

51. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Cirrhosis Chronic liver disease mainly caused by excess consumption of alcohol Characterized by: –Hepatomegaly –Edema –Ascites –Jaundice As it progresses: –Splenomegaly –Internal bleeding –Brain damage

52. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Gallstones Cholecystitis –Inflammation of gallbladder Cholelithiasis –Presence of stones in gallbladder –Usually associated with cholecystitis

53. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Gallstones (cont’d) Diagnosed by: –Ultrasonography –Radiography –Endoscopic retrograde cholangiopancreatography Treatment may involve: –Drugs to dissolve stones –Cholecystectomy

54. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pancreatitis Inflammation of pancreas May result from: –Alcohol abuse –Drug toxicity –Bile obstruction –Infections –Other causes Disease often subsides with only treatment of symptoms

55. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 1.An organic catalyst is a(n) : (a) sugar (b) nucleic acid (c) saliva (d) enzyme

56. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 1.An organic catalyst is a(n) : (a) sugar (b) nucleic acid (c) saliva (d) enzyme

57. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 2.The organ that carries food from the pharynx to the stomach is the : (a) trachea (b) larynx (c) esophagus (d) intestine

58. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 2.The organ that carries food from the pharynx to the stomach is the : (a) trachea (b) larynx (c) esophagus (d) intestine

59. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 3.The word root for the stomach is : (a) gastr/o (b) hepat/o (c) ren/o (d) cardi/o

60. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 3.The word root for the stomach is : (a) gastr/o (b) hepat/o (c) ren/o (d) cardi/o

61. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 4.The main portion of the large intestine is the: (a) stomach (b) appendix (c) colon (d) rectum

62. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 4.The main portion of the large intestine is the: (a) stomach (b) appendix (c) colon (d) rectum

63. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 5.The word root enter/o refers to the: (a) intestine (b) heart (c) kidney (d) gallbladder

64. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 5.The word root enter/o refers to the: (a) intestine (b) heart (c) kidney (d) gallbladder

65. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 6.The wavelike action that moves substances through an organ is called: (a) pulmonary (b) peristalsis (c) parotid (d) mastication

66. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 6.The wavelike action that moves substances through an organ is called: (a) pulmonary (b) peristalsis (c) parotid (d) mastication

67. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 7.The process of moving digested nutrients from the intestine into the circulation is called: (a) digestion (b) egestion (c) absorption (d) lymphedema

68. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 7.The process of moving digested nutrients from the intestine into the circulation is called: (a) digestion (b) egestion (c) absorption (d) lymphedema

69. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 8.The organ that secretes bile is the: (a) kidney (b) spleen (c) liver (d) stomach

70. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 8.The organ that secretes bile is the: (a) kidney (b) spleen (c) liver (d) stomach

71. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 9.Cholecystitis is inflammation of the: (a) gallbladder (b) throat (c) diaphragm (d) small intestine

72. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 9.Cholecystitis is inflammation of the: (a) gallbladder (b) throat (c) diaphragm (d) small intestine