Medical Terminology FOR HEALTH CARE PROFESSIONALS CHAPTER 8th edition Medical Terminology for Health...

Medical TerminologyMedical TerminologyFOR HEALTH CARE PROFESSIONALSFOR HEALTH CARE PROFESSIONALS

CHAPTER

8th edition

Medical Terminology for Health Care Professionals, 8eJane Rice

Copyright © 2015 by Pearson Education, Inc.All Rights Reserved

Digestive System

8



Learning OutcomesLearning Outcomes

1. Describe the digestive system.2. Explain the primary functions of the

organs of the digestive system.3. Describe the two sets of teeth found in

humans.4. Identify the three main portions of a

tooth.




5. Discuss the accessory organs of the digestive system and state their functions.

6. Analyze, build, spell, and pronounce medical words.

7. Comprehend the drugs highlighted in this chapter.

8. Describe diagnostic and laboratory tests related to the digestive system.




9. Identify and define selected abbreviations.



Multimedia DirectoryMultimedia Directory

Slide 9Digestive System AnimationSlide 22Digestion AnimationSlide 63Anorexia Video 1Slide 64Anorexia Video 2Slide 67Appendicitis AnimationSlide 90GERD VideoSlide 108Sigmoidscopy VideoSlide 128Ultrasound Video



Anatomy and Physiology OverviewAnatomy and Physiology Overview

• General description of the digestive or gastrointestinal system: a continuous tube beginning with the mouth and ending at the anus.

• This tube is known as the alimentary canal and/or gastrointestinal tract and is about 30 feet long in adults.




• Digestive system contains both primary and accessory organs for the conversion of food and fluids into a semiliquid that can be absorbed for the body to use.

• Three main functions:– Digestion– Absorption– Elimination




• Digestion changes food by means of digestive enzymes in the mouth, stomach, and intestines so the body can absorb the food.

• Absorption takes nutrients into the bloodstream or lymph.

• Elimination is excretion of solid waste end products of digestion.



Digestive System AnimationDigestive System Animation

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Figure 8.1Digestive system.



TABLE 8.1 Digestive System at-a-Glance



FYIFYI

With aging:• Digestive system becomes less motile.• Glandular secretions decrease:

– Drier mouth– Less gastric juices

• Nutrient absorption is mildly reduced.• Teeth are mechanically worn down.• Gums begin to recede.



FYIFYI

• Loss of taste buds, and food preferences change.

• Gastric motor activity slows:– Gastric emptying is delayed.– Hunger contractions diminish.



MouthMouth

• The mouth or oral cavity is formed by:– The hard and soft palates at the top or roof– The cheeks on the sides– The tongue at the floor– The lips that frame the opening to the

cavity

• Contains the teeth and salivary glands



MouthMouth

• The gingivae (gums) surround the necks of the teeth.

• The lingual frenulum is a thin fold of mucous membrane that connects the free portion of the tongue to the underlying epithelium.



Figure 8.2Oral cavity: (A) sagittal section.



Figure 8.2 (continued)Oral cavity: (B) anterior view as seen through the open mouth.



MouthMouth

• Tongue:– Made of skeletal muscle and covered with

mucous membrane– Can be divided into:

Root Pointed tip Central body

• Papillae (elevations) and taste buds (sweet, salt, sour, and bitter) are located on the tongue's surface.



MouthMouth

• Three pairs of salivary glands secrete saliva into the oral cavity.

• Posterior margin of soft palate supports:– Dangling uvula– Two pairs of muscular pharyngeal arches, which

contain the palatine tonsils

• The passageway between the oral cavity and the pharynx is bounded by the fauces.



MouthMouth

• Digestion begins as food is broken apart by the action of the teeth, moistened and lubricated by saliva, and formed into a bolus.



Figure 8.3Movement of a bolus of food from the mouth to the esophagus. The bolus then

travels to the stomach.



Digestion AnimationDigestion Animation

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TeethTeeth

• Two Sets– 20 deciduous teeth, also referred to as milk

teeth or baby teeth– 32 permanent teeth

8 incisors 4 canines 8 premolars 12 molars



TeethTeeth

• Incisors: the four front teeth in each dental arch.

• Canine or cuspid teeth: larger and stronger than the incisors.

• Premolars or bicuspid teeth: lateral to and behind the canine teeth.

• Molar teeth: largest of the permanent set; broad crowns are adapted for grinding food.



TeethTeeth

• Each tooth consists of three main portions:– Crown– Neck– Root



Figure 8.4Teeth. (A) Diagrammatic section through a typical adult tooth.



Figure 8.4 (continued)Teeth. (B) The adult teeth.



TeethTeeth

• The pulp cavity– Found in the interior of the crown and the

center of each root– Receives blood vessels and nerves, which

enter the root canal through an opening called the apical foramen



TeethTeeth

• Root– Sits in a bony socket called an alveolus.– Collagen fibers of the periodontal ligament

extend from the dentin of the root to the bone of the alveolus, creating a strong articulation known as a gomphosis.

– A layer of cementum (a thin layer of bone) covers the dentin of the root, firmly anchoring the periodontal ligament.



TeethTeeth

• Dentin– The solid portion of the tooth, which forms

the bulk of the tooth

• Enamel– Covers the exposed part of the crown– Is the hardest and most compact part of

the tooth



TeethTeeth

• Neck– Marks the boundary between the root and

the crown.– The gingival sulcus is a shallow groove that

surrounds the neck of each tooth.



PharynxPharynx

• Pharynx– A chamber that extends between the

internal nares and the entrance to the larynx and esophagus



PharynxPharynx

• Nasopharynx: the upper portion of the pharynx, above the soft palate

• Oropharynx: the middle portion, which lies between the palate and the hyoid bone and has an opening to the oral cavity

• Laryngopharynx: the lowest portion of the pharynx



PharynxPharynx

• The pharynx is a common passageway for both respiration and digestion.

• Both the larynx, or voice box, and the esophagus begin in the pharynx.

• The epiglottis (a flap of tissue) blocks the opening of the larynx, preventing food from entering the airway leading to the trachea (windpipe).



EsophagusEsophagus

• A muscular tube about 10 inches long that leads from the pharynx to the stomach.

• The lower esophageal or cardiac sphincter is at the junction with the stomach.

• This sphincter:– relaxes to permit passage of food.– contracts to prevent the backup of stomach

contents.



EsophagusEsophagus

• Food is carried along the esophagus by a series of wavelike muscular contractions called peristalsis.



StomachStomach

• A muscular, distensible saclike portion of the alimentary canal between the esophagus and duodenum.

• Fundus: upper region of the stomach.• Body: the main portion.• Antrum: the lower region.• Rugae: folds in the mucous membrane

lining the stomach that contain glands that produce digestive juices.



Figure 8.5Stomach.



StomachStomach

• Gastric juices help convert the food to a semiliquid state called chyme, which passes through the pyloric sphincter into the small intestine.



Small IntestineSmall Intestine

• About 21 feet long and 1 inch in diameter.

• Extends from pyloric sphincter at base of stomach to entrance of large intestine.

• Divided into three parts:– Duodenum– Jejunum– Ileum



Figure 8.6Small intestine.



Small IntestineSmall Intestine

• Chyme is mixed with bile and pancreatic juice.

• Digestion and absorption take place chiefly in the small intestine.

• Tiny capillaries and lymph vessels absorb nutrients, which are transferred to body cells by the circulatory system.



TABLE 8.2 Components of Chemical Digestion



Large IntestineLarge Intestine

• About 5 feet long and 2.5 inches in diameter.

• Divided into:– Cecum– Colon– Rectum– Anal canal



Figure 8.7Large intestine.



FYIFYI

• Meconium, the first stool, is:– a mixture of amniotic fluid and secretions

of the intestinal glands.– thick and sticky, dark green in color.– usually passed 8 to 24 hours following

birth.



FYIFYI

• Stool during the first week is loose and greenish-yellow.

• Stool of a breast-fed baby is bright yellow, soft, and pasty.

• Stool of a bottle-fed baby is more solid, and color varies from yellow to brown.



Accessory OrgansAccessory Organs

• These organs are not actually part of the digestive tube but are closely related to the digestive process:– Salivary glands– Liver– Gallbladder– Pancreas




• Salivary Glands– Located in or near the mouth.– Secrete saliva in response to sight, smell,

taste, or mental image of food.




• Salivary Glands– Parotid– Submandibular– Sublingual



Figure 8.8Salivary glands, salivary ducts and the tongue.




• Liver– The largest glandular organ in the body.– Weighs about 3 ½ lbs.– Located in the upper right part of the

abdomen.– Plays an essential role in the normal

metabolism of carbohydrates, fats, and proteins.




• Carbohydrate Metabolism– Changes glucose to glycogen and stores it

until needed by body cells.– When required, glycogen is converted back

to glucose.

• Fat Metabolism– The liver serves as a storage place and acts

to desaturate fats before releasing them into the bloodstream.




• Protein Metabolism– The liver acts as a storage place and

assists in both protein anabolism and catabolism.



Figure 8.9Liver.




• The liver manufactures the following important substances:– Bile– Fibrinogen and prothrombin– Heparin– Blood proteins




• The liver stores iron and vitamins B12, A, D, E, and K.

• Detoxifies many harmful substances (toxins), such as drugs and alcohol.




• Gallbladder– A small, pear-shaped sac attached to the

liver in which excess bile is stored and concentrated.

– Concentration is accomplished by reabsorption of water.




• Pancreas– A large, elongated gland situated behind

the stomach and secreting pancreatic juice into the small intestine.

– Contains cells that produce digestive enzymes.

– Other specialized cells secrete the hormones insulin and glucagon directly into the bloodstream.



Figure 8.10Pancreas.



FYIFYI

• Newborns produce very little saliva until 3 months of age, and swallowing is a reflex action.

• The infant's stomach is small and empties rapidly.

• The liver of the newborn is often immature, thereby causing jaundice.

• Fat absorption is poor because of a decreased level of bile production.



Audio PronunciationsAudio Pronunciations

• Absorption• Amylase• Anabolism• Anorexia• Appendectomy• Appendicitis• Ascites• Biliary



Anorexia Video 1Anorexia Video 1

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Anorexia Video 2Anorexia Video 2

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Figure 8.11Appendectomy. The appendix and cecum are brought through the incision to the surface of the abdomen. The base of the appendix is clamped and ligated,

and the appendix is then removed.



Figure 8.12McBurney's point is the common location of pain in children and adolescents

with appendicitis.



Appendicitis AnimationAppendicitis Animation

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• Bilirubin• Black hairy tongue• Bowel• Buccal



Figure 8.13Black hairy tongue.




• Catabolism• Celiac• Cheilosis• Cholecystectomy

chol/e

cyst

-ectomy

= gall, bile

= bladder

= surgical excision



Figure 8.14Gallbladder with gallstones. Note the stones in the hepatic duct, gallbladder,

and common bile duct.




• Cholecystitis• Choledochotomy• Chyle• Cirrhosis



Figure 8.15The liver in this photograph was from a deceased patient with an advanced

state of cirrhosis.




• Colectomy• Colon cancer• Colonic• Colonoscope



Figure 8.16Common sites of colorectal cancer.



Figure 8.17Note the tumor visualized with the use of a colonoscope.




• Colonoscopy• Colostomy• Constipation• Crohn disease



Figure 8.18Alternate sites that can be used to create a new opening (-ostomy) in the

colon.



Figure 8.19Note the thickening of the intestinal wall and the erosion of the inner lining of

the ileum, often seen in Crohn disease.



FYIFYI

• Constipation– Frequent problem among older adults.– Not believed to be a normal age-related

change.



FYIFYI

• Constipation– Caused by:

Low fluid intake Dehydration Lack of dietary fiber Inactivity Medicines Depression Other health-related conditions




• Defecation• Deglutition• Dentalgia• Dentist• Dentition




• Diarrhea• Digestion• Diverticulitis• Duodenal

dia-

-rrhea

= through

= flow



Figure 8.20Diverticulitis.




• Dysentery• Dyspepsia• Dysphagia• Emesis• Enteric• Enteritis• Enzyme




• Epigastric• Eructation• Esophageal• Feces• Fibroma• Flatus




• Gastrectomy• Gastric• Gastroenterology• Gastroesophageal




• Gastroesophageal reflux disease (GERD)

• Gavage• Gingivitis• Glossectomy

gloss/o

-ectomy

= tongue

= excision



Figure 8.21Mechanisms of gastroesophageal reflux.



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• Glycogenesis• Halitosis• Hematemesis• Hematochezia




• Hemorrhoid• Hepatitis• Hepatoma• Hernia



FYIFYI

• Hepatitis refers to a group of viral infections that affect the liver.

• Most common types in US are hepatitis A (HAV), hepatitis B (HAB), and hepatitis C (HAC).– Vaccines exist for all but hepatitis C.



FYIFYI

• HAV primarily transmitted by fecal–oral route; HAB by blood transfusion, sexual contact, or use of contaminated needles or instruments; and HAC through exposure to infected blood.

• Other forms not common in the U.S. are hepatitis D and hepatitis E.



Figure 8.22Location of internal and external hemorrhoids.



Figure 8.23Hernias.



Figure 8.23 (continued)Hernias.




• Herniorrhaphy• Hyperalimentation• Hyperemesis• Hypogastric




• Ileitis• Ileostomy• Irritable bowel syndrome• Labial



Figure 8.24Ileostomy. Note that the cecum and colon have been surgically removed.




• Laparotomy• Lavage• Laxative• Lingual• Lipolysis

lip/o

-lysis

= fat

= destruction; to separate




• Liver transplant• Malabsorption• Mastication• Melena• Mesentery• Nausea




• Pancreas transplant• Pancreatitis• Paralytic ileus• Peptic• Peptic ulcer disease (PUD)• Periodontal



Figure 8.25Peptic ulcer disease (PUD).




• Periodontal disease• Peristalsis• Pharyngeal• Pilonidal cyst• Postprandial




• Proctologist• Proctoscope• Pyloric• Rectocele

rect/o

-cele

= rectum

= hernia




• Sialadenitis• Sigmoidoscope• Splenomegaly• Stomatitis• Sublingual• Ulcer• Ulcerative colitis



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Figure 8.26Sublingual drug administration.




• Vermiform • Volvulus• Vomit



Figure 8.27Volvulus.



Drug HighlightsDrug Highlights

• Antacids• Antacid Mixtures

• Histamine H2-Receptor Antagonists




• Mucosal Protective Medications• Gastric Acid Pump Inhibitors (Proton-

Pump Inhibitor) (PPI)




• Other Ulcer Medications– Treatment regimen for active duodenal

ulcers associated with H. pylori can involve a two- or three-drug program.

• Laxatives• Antidiarrheal Agents




• Antiemetics• Emetics



Diagnostic and Lab TestsDiagnostic and Lab Tests

• Alcohol Toxicology (ethanol & ethyl)– Test performed on blood serum or plasma

to determine levels of alcohol.

• Ammonia (NH4)– Test performed on blood plasma to

determine the level of ammonia (end product of protein breakdown).




• Barium Enema (BE)– Test performed by administering barium

via the rectum to determine the condition of the colon.

• Bilirubin Blood Test (total)– Test done on blood serum to determine

whether bilirubin is conjugated and excreted in the bile.




• Bravo pH Monitor– Test to diagnose causes of heartburn and

provide specific information about GERD.

• Carcinoembryonic Antigen (CEA)– Test performed on whole blood or plasma

to monitor the course of cancer therapy.

• Cholangiography– X-ray examination of the common bile

duct, cystic duct, and hepatic ducts after radiopaque dye is ingested.




• Cholecystography– X-ray examination of the gallbladder, in

which radiopaque dye is injected.

• Colonoscopy– Direct visual examination of the colon via a

colonoscope.

• Fiberoptic colonoscopy– Direct visual examination of the colon via a

flexible colonoscope.




• Endoscopic Retrograde Cholangiopancreatography (ERCP)– X-ray examination of the biliary and

pancreatic ducts by injecting a contrast medium.

• Esophagogastroduodenal endoscopy– Endoscopic examination of the esophagus,

stomach, and small intestine.




• Gamma-Glutamyl Transferase (GGT)– Test performed on blood serum to

determine the level of GGT enzyme.

• Gastric Analysis– Test performed to determine quality of

secretion, amount of free and combined HCl, and absence or presence of blood, bacteria, bile, and fatty acids.




• Gastrointestinal (GI) Series– Fluoroscopic examination of the

esophagus, stomach, and small intestine, in which barium is given orally and is observed as it flows through the GI system.



Figure 8.28Upper GI series. Courtesy of Teresa Resch.




• Hepatitis B Surface Antigen (HBsAg)– Test performed to determine the presence

of the hepatitis B virus.




• Liver Biopsy– Microscopic examination of liver tissue to

diagnose cirrhosis, hepatitis, and tumors.

• Occult Blood– Test performed on feces to determine

gastrointestinal bleeding that is not visible.

• Ova and Parasites (O&P)– Test performed on stool to identify ova and

parasites.




• Stool Culture– Test performed on stool to identify the

presence of organisms.

• Ultrasonography, Gallbladder– Test to visualize the gallbladder by using

high-frequency sound waves.

• Ultrasonography, Liver– Test to visualize the liver by using high-

frequency sound waves.



Figure 8.29Gallbladder ultrasound. Courtesy of Teresa Resch



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• Upper Gastrointestinal Fiberoscopy– Direct visual examination of the gastric

mucosa via a flexible fiberscope when gastric neoplasm is suspected.



Abbreviations



Combining Form Match Up QuizCombining Form Match Up Quiz

1. aden/o a. tongue2. amyl/o b. starch3. gloss/o c. gland4. halit/o d. breath5. labi/o e. lip

Medical Terminology FOR HEALTH CARE PROFESSIONALS CHAPTER 8th edition Medical Terminology for Health...

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