RO23 Understanding Body Systems and...
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RO23 Understanding Body Systems and Disorders Cardiac, respiratory and digestive
Transcript of RO23 Understanding Body Systems and...
RO23 Understanding Body Systems and Disorders Cardiac, respiratory and digestive
Objectives
• LO1: Know how body systems work
• LO2: Understand disorders that affect body systems
• LO3: Be able to interpret data obtained from measuring body rates with reference to the functioning of healthy body systems
Objectives
• Respiratory anatomy and physiology review
• Respiratory Conditions
• Peak Flow
• Charting peak flow observations
• Cardiac anatomy and physiology review
• Cardiac conditions and illnesses
• Cardiac observations
• Digestive anatomy and physiology overview
• Disorders of the digestive system
• BMI
• charting BMI
Functions of the respiratory systemThe primary organs of the respiratory system are the lungsActive respiration occurs in the alveoli
Functions of the respiratory system are:• Intake of oxygen • Expel carbon dioxide and waste products
Respiratory system
Respiratory System
• Parts of the respiratory system include:
• Nose, Nasal Cavity and Mouth
• Trachea
• Bronchi
• Lungs
• Bronchioles
• Alveoli
• Diaphram
Structures of the respiratory system
Trachea
• Trachea is also known as the windpipe
• Connects the nose and mouth to the lungs
• The trachea is a tube of bone
• Have rings of 'c' shaped cartilage to stop the tube collapsing.
Lungs
• There is one lung each side of the thorax (chest cavity)
• The lungs are cone shaped.
• The right lung is larger than the left lung. The left lung has to share room with the heart.
Inhalation (moving air in....)
• During inspiration (inhalation), the diaphragm and intercostal muscles contract.
• The diaphragm contracts and moves downwards.
• The intercostal muscles contract and move the ribs upwards and outwards.
• This increases the size of the chest and decreases the air pressure inside it which sucks air into the lungs.
• Air is moved into the lungs
• Oxygen is inhaled
Exhalation (moving air out....)
• During exhalation, the diaphragm and intercostal muscles muscles relax.
• The diaphragm relaxes and moves back to its domed shape.
• The intercostal muscles relax so the ribs move inwards and downwards under their own weight.
• This decreases the size of the chest and increases the air pressure in the chest so air is forced out of the lungs.
• Carbon dioxide is exhaled
Passage of air into the lungs...
• Air enters the body and is warmed as it travels through the mouth and nose.
• It then enters the trachea. • The trachea divides into two bronchi. One
bronchus enters each lung.• Each bronchus branches out into smaller tubes
called bronchioles. Air travels through these bronchioles.
• At the end of the bronchioles, the air enters one of the many millions of alveoli where gaseous exchange takes place.
Nasal Cavity
Trachea
Bronchi
Bronchioles
Alveoli
Alveoli
• At the end of the bronchioles are the microscopic alveoli
• Arrange in clusters in the lungs
• Alveoli are bunched together
Alveoli gas exchange
• Oxygen diffuses through the alveolus and capillary linings, and attaches to red blood cells.
• At the same time, carbon dioxide diffuses from the blood intothe alveolus.
Anatomical parts of the system…respiratory
1. Nose/nasal cavity
2. Mouth
3. Larynx
4. Lung
5. Right bronchus
6. Diaphragm
7. Pharynx
8. Trachea
11. alveoli
10. Bronchiole
9. Left bronchus
Disorders of the respiratory system
Asthma
• Asthma is a narrowing of the bronchioles due to some irritant (dust mite, pollen, cold virus) and so the sufferer finds it difficult to inhale enough oxygen.
• Removing the offending agent can prevent it and treatment is by use of inhalers that dilate the tubes again.
Asthma Video• https://www.youtube.com/watch?v=vI_VXehIxls
Asthma Causes...
CAUSES
▪Genetics▪ Pollen▪ Animals▪ Smoke▪ Dust mites▪ Chemicals▪ Excercise
WHOS AT RISK?
A number of things can increase chances of getting asthma. These include:
▪ having an allergy-related condition, such as eczema, a food allergy or hay fever
▪ a family history of asthma
▪ having had childhood bronchiolitis
▪ Exposure to tobacco smoke as a child
▪ Maternal smoking during pregnancy
▪ Being born prematurely (before 37 weeks) or with a low birthweight
▪ Some people may be at risk of developing asthma through their job.
Asthma Symptoms
SYMPTOMS
▪ Most children and adults with asthma have times when their breathing becomes more difficult.
▪ Some people with severe asthma may have breathing problems most of the time.
▪ The most common symptoms of asthma are:
▪ Wheezing (a whistling sound when breathing)
▪ Breathlessness
▪ A tight chest – it may feel like a band is tightening around it
▪ Coughing
Asthma Diagnosis....
Asthma can usually be diagnosed from the symptoms and some simple tests:
• FeNO test – you breathe into a machine that measures the level of nitric oxide in the exhalated breath, which is a sign of inflammation in the lungs
• Spirometry – you blow into a machine that measures how fast you can breathe out and how much air can be held in the lungs
• Peak flow test – you blow into a handheld device that measures how fast you can breathe out, and this may be done several times over a few weeks to see if it changes over time
After you're diagnosed with asthma, you may also have allergy tests to see if your symptoms might be triggered by an allergy.
Asthma treatment....
Prevention and treatment
• Identify triggers• Avoid or remove - these can prevent asthma flare ups
• Inhalers• Inhalers help relieve symptoms when they occur (reliever inhalers) and stop symptoms developing
(preventer inhalers). Some people need an inhaler that combines both. • Inhalers reduce the inflammation and sensitivity of the airways, which stops symptoms occurring
• Steroid tablets• Steroid tablets may be recommended if other treatments are not helping to control symptoms.• They can be taken either as an immediate treatment or every day as a long-term treatment to prevent
symptoms.
• Injections• For some people with severe asthma, injections given every few weeks can help control the symptoms.
• Surgery• A procedure called bronchial thermoplasty may be offered as a treatment for severe asthma.
What is Pneumonia? • Pneumonia is swelling
(inflammation) of the tissue in one or both lungs. It's usually caused by a bacterial infection.
• At the end of the bronchioles (tubes in the lungs) are clusters of tiny alveoli. If you have pneumonia, these alveoli become inflamed and fill up with fluid.
Video• https://youtu.be/1wqa9UQzing
Pneumonia Causes....
Pneumonia is usually the result of a pneumococcal infection, caused by bacteria called Streptococcus pneumoniae.As well as bacterial pneumonia, other types include:
▪ Viral Pneumonia
▪ A common cause of pneumonia in young children
▪ Most commonly caused by the respiratory syncytial virus (RSV) and sometimes influenza type A or B; viruses
▪ Aspiration Pneumonia : caused by breathing in vomit, a foreign object, such as a peanut, or a harmful substance, such as smoke or a chemical
▪ Fungal Pneumonia – rare in the UK and more likely to affect people with a weakened immune system
▪ Hospital-acquired pneumonia – pneumonia that develops in hospital while being treated for another condition or having an operation; people in intensive care on breathing machines are particularly at risk of developing ventilator-associated pneumonia.
Risk groups:• The following groups have an increased risk of developing
pneumonia:
• Babies and very young children
• Elderly people
• People who smoke
• People with additional health conditions including asthma, cystic fibrosis, or a heart, kidney or liver condition
• People with a weakened immune system
Pneumonia Symptoms....
Common symptoms of pneumonia include:
• Cough – may be dry, produce thick yellow/green/brown or blood-stained mucus.
• Difficulty breathing – breathing may be rapid, shallow, and breathless (even when resting).
• Rapid heartbeat
• High temperature
• Feeling generally unwell
• Sweating and shivering
• Chest pain – which increases when breathing or coughing
Less common symptoms include:
• Coughing up blood (haemoptysis)
• Headaches
• Fatigue
• Nasea/vommiting
• Wheezing
• Joint and muscle pain
• Confusion/disorientation, particularly in elderly people
The symptoms of pneumonia can develop suddenly over 24 to 48 hours, or they may come on more slowly over several days.
Pneumonia Symptoms....
Pneumonia Diagnosis....
• Pneumonia can be difficult to diagnose because it shares many symptoms with other conditions, such as the common cold, bronchitis and asthma.
• Chest Auscaltation: • A health professional may listen to the chest and back with a
stethoscope to check for any crackling or rattling sounds. • They may also listen to the chest by tapping it. Lungs filled
with fluid produce a different sound from normal healthy lungs.
• Chest X-ray
• Sputum (mucus) sample
Pneumonia Treatment
• Medication
• Oral Antibiotics
• IV Antibiotics
• Self Help whilst at home
• stop smoking
• drink fluids
• rest
• regular movement to help fluid moving around within the lungs
• Hospital treatment
• In hospital, medical staff may recommend the administration of two antibiotics rather than one. These may be given directly into a vein with a drip.
• Oxygen saturation monitoring will be used whilst in hospital and oxygen will be delivered via facemask
• If the illness is severe enough, breathing will be assisted using a ventilator (an artificial breathing
machine).
What is the cardiovascular system?
The cardiovascularsystem, also known asthe circulatory system, istransport system of body
It comprises blood, heartand blood vessels.
The system suppliesnutrients to and removewaste products fromvarious tissue of body.
The conveying media isliquid in form of bloodwhich flows in closetubular system.
Cardiovascular System
Functions of the cardiovascular system....
Transport nutrients, hormones
Remove waste products and removal of metabolic wastes (carbon dioxide,nitrogenous wastes).
Immunity (antibodies)
Blood vessels transport blood◦ Carries oxygenated blood away from the heart◦ Carries deoxygenated blood (containing carbon dioxide) back towards the
lungs for reoxygenation◦ Also carries nutrients and wastes
Components of the cardiovascular system...
HEART BLOOD VESSELSArteries
Veins
Capillaries
BLOOD
The Blood
•The Blood▪ Blood cells (45%)▪ Plasma (55%)
•Blood cells▪ Erythrocytes (Red Blood Cells) used in gas exchange▪ Leucocytes (white blood cells) help fight infection. ▪ Thrombocytes (platelets) are used for clotting
•Plasma is fluid portion•Carries everything
The Blood Vessels
ARTERIES▪ Carries OXYGENATED
blood AWAY from the heart to all of the body's tissues
▪ All except the pulmonary artery, carry oxygenatedblood
CAPILLARIES▪ Most numerous vessels
▪ Connects the arteries to veins
VEINS▪ Carries blood towards the
heart
▪ Contain valves
▪ Closer to the body surface than the arteries
▪ All except the pulmonary vein carry deoxygenated blood
Blood vessels
ARTERY▪ Have thicker smooth
muscle and connective tissue to accommodate the higher pressure and speed of freshly-pumped blood
▪ No valves
▪ Lumen is small
CAPPILARY▪ The smallest blood vessels
are capillaries and they connect the arteries and veins.
▪ microscopic, one cell thick walls.
▪ This is where the exchange of nutrients and gases occurs.
VEIN▪ Thinner, less muscular and
elastic than arteries
▪ Contain one way valves to prevent blood backflow
Arteries & Veins...
Arteries▪ Blood is carried away from the
heart
▪ Blood carried is oxygenated
▪ Blood flows under high pressure
▪ Blood flows in pulses.
▪ Artery walls are thick, elastic and muscular
▪ Arteries do not have valves
▪ Internal diameter is small
Veins▪ Blood is carried towards the
heart
▪ Blood carried is deoxygenated
▪ Blood flows under low pressure
▪ Blood flows smoothly with a squeezing action
▪ walls are thin with little muscle
▪ veins have valves
▪ Large internal diameter
The Heart
• The heart is the organthat helps supplyblood and oxygen toall parts of the body
• Heart is a four chambered, hollowmuscular organ approximately thesize of your fist
• The heart is made fromspecialised cardiac muscle thatdoes not tire like other musclesaround the body.
The Heart
• It is divided by a partition (or septum) into two halves, and the halves are in turn divided into four chambers.
• The heart is made up of four chambers:
• Atria: upper two chambers of the heart.
• Ventricles: lower two chambers of the heart.
The Heart
The heart is a 'double pump'
Right Hand Side:
Pumps deoxygenated blood from the veins to the lungs for oxygenation.
Left Hand Side:
Pumps oxygenated blood from the lungs to the body
Atria and Ventricles
Atria
• The atria are the upper chamber through which blood enters the ventricles of the heart.
• There are two atria, both of which have thin walls.
• Atria are separated by an interatrial septum into the left atrium and the right atrium.
• The left atrium receives blood from the pulmonary circulation, and the right atrium receives blood from the vena cava.
• The atria receive blood while relaxed (diastole), then contract (systole) to move blood to the ventricles.
Ventricles
The ventricles of the heart function to pump blood around the entire body
Due to the force needed to pump blood to the body, ventricles have thicker walls than the atria. The left ventricle wall is the thickest of the heart walls.
Right ventricle receives blood from the right atrium and pumps it to the main pulmonary artery. These arteries extend to the lungs. Oxygen-poor blood picks up oxygen and is returned to the heart via the pulmonary veins.
Left ventricle receives blood from the left atrium and pumps it to the aorta. The aorta carries and distributes oxygen-rich blood to the rest of the body.
Other main Parts Of The Heart....
Aorta
Is the main artery of the body. It leaves the heart from the left ventricle.
Pulmonary Artery
Carries deoxygenated blood from the heart to the lungs
Superior Vena Cava
Is one of the largest veins in the body. Carries blood from the head arms and upper body into the heart
Inferior Vena Cava
Carries blood from the lower body into the heart.
Pulmonary Vein
Carries oxygenated blood from the lungs to the left atrium of the heart
A heartbeat ....
• The atria and ventricles contract and relax in turn, producing a rhythmical heartbeat
• Each heartbeat can be split into two parts:▪ Diastole: the atria and
ventricles relax and fill with blood.
▪ Systole: the atria contract (atrial systole) and push blood into the ventricles; then, as the atria start to relax, the ventricles contract (ventricular systole) and pump blood out of the heart.
The heart valves...
• The heart has four valves that help ensure that blood only flows in one direction:▪ Aortic valve: between the left ventricle and the aorta.
▪ Mitral valve: between the left atrium and the left ventricle.
▪ Pulmonary valve: between the right ventricle and the pulmonary artery.
▪ Tricuspid valve: between the right atrium and right ventricle.
Blood flow through the heart…
• First, blood flows into the right atrium, passes through the tricuspid valve, and into the right ventricle.
• It then moves through the pulmonic valve, into the pulmonary artery to the lungs.
• After picking up oxygen in the lungs, the blood moves out of the lungs into the pulmonary vein, into the left atrium, through the mitral valve, and into the left ventricle that pushes blood to the body through the aortic valve.
• Once blood leaves the heart it is in the aorta where it flows to various parts of the body.
Summary
• https://youtu.be/f9ONXd_-anM
• https://youtu.be/U2WG4gRt1yE
Disorders of the heart...
HEART FAILURE
Heart Attack
• A heart attack (myocardial infarction or MI) is a serious medical emergency in which the supply of blood to the heart is suddenly blocked, usually by a blood clot.
• A lack of blood to the heart may seriously damage the heart muscle and can be life threatening.
https://youtu.be/_WXxET_DzE4
Video
Heart Attack Causes....
• Heart attacks are caused by the blood supply to the heart being suddenly interrupted. This causes heart muscles to become damaged and die. This causes irreversible damage. If a large portion of the heart is damaged, the heart stops beating (known as a cardiac arrest), resulting in death.
• Coronary heart disease (CHD) is a significant cause of heart attacks. CHD causes the coronary arteries to become clogged with cholesterol deposits called plaques. One of the plaques ruptures, causing a blood clot to develop at the site of the rupture. The clot may block the supply of blood to the heart, triggering a heart attack. Your risk of developing CHD is increased by:
▪ smoking
▪ a high-fat diet
▪ diabetes
▪ high cholesterol / high blood pressure
▪ being overweight or obese
• Some less common causes of heart attack are described below:
▪ Drug misuse can cause coronary arteries to narrow, restricting blood supply and triggering a heart attack.
▪ Lack of oxygen in the blood (hypoxia)
Heart Attack Symptoms....
• Symptoms of a heart attack can include:▪ Chest pain – a sensation of pressure, tightness or squeezing in
the centre of the chest (pain can be severe or minor)▪ Pain in other body parts – it can feel as if the pain is travelling
from the chest to arms (usually the left arm is affected, but it can affect both), jaw, neck, back and abdomen
▪ Feeling lightheaded or dizzy ▪ Sweating ▪ Shortness of breath▪ Nausea or vomiting ▪ An overwhelming sense of anxiety (similar to having a panic
attack) ▪ Coughing or wheezing
Heart Attack Symptoms....
Heart Attack Diagnosis....
Electrocardiography
• An ECG measures the hearts electrical activity, allowing identification of heart function. It helps confirm the diagnosis of and type of heart attack, which will help determine the most effective treatment.
Blood tests
• Damage from a heart attack causes an increase in certain proteins (cardiac markers). Blood will be taken to observe protein levels.
Chest X-ray
• A chest X-ray is used if a heart attack is uncertain and there are other possible causes for symptoms. A chest X-ray is used to check whether complications have arisen from the heart attack including pulmonary oedema (fluid in the lungs).
Echocardiogram
• An echocardiogram uses sound waves to build an internal picture of the heart. This identifies which areas of the heart have been damage, damage severity and its affect on heart's function.
Coronary angiography
• Coronary angiography can help determine whether a blockage or narrowing has occurred in the coronary arteries and, if so, to locate the exact location of the blockage or narrowing.
Heart Attack treatment....
The treatment options depend on if a person has had an ST segment elevation myocardial infarction (STEMI) - the most severe type, or another type of heart attack.
Surgery▪ Primary percutaneous coronary intervention (PCI) is an
emergency treatment of STEMI, using a procedure to widen the coronary artery.
▪ Coronary angioplasty A stent is usually inserted into the artery to help keep it open.
Medication▪ Medications are used to break down blood clots (usually given
by injection) or prevent blood clots from getting bigger.
Heart Failure
• Heart failure means that the heart is unable to pump blood around the body properly. It usually occurs because the heart has become too weak or stiff.
• Heart failure is a long-term condition that tends to get gradually worse over time.
• It cannot usually be cured, but the symptoms can often be controlled for many years
Heart Failure....
Heart Failure Stages
• The stage describes how severe your heart failure is: • Class 1 – No symptoms during normal physical activity
• Class 2 – Comfortable at rest, but normal physical activity triggers symptoms
• Class 3 – Comfortable at rest, but minor physical activity triggers symptoms
• Class 4 – Unable to carry out any physical activity without discomfort and may have symptoms even when resting
Heart Failure Causes....
• Heart failure is often the result of a number of problems at the same time.
• Conditions that can lead to heart failure include:▪ Coronary Heart Disease ▪ High blood pressure – this can put strain on the heart, which over time can lead to
heart failure ▪ Cardiomyopathy – conditions affecting the heart muscle ▪ Arrhythmias such as atrial fibrillation▪ Damage or other problems with the heart valves▪ Congenital heart disease – birth defects that affect the normal workings of the heart▪ A viral infection affecting the heart muscle▪ Some cancer treatments such as chemotherapy
• Sometimes anaemia, excessive alcohol consumption, an overactive thyroid or high pressure in the lungs (pulmonary hypertension) can lead to heart failure.
Heart Failure Symptoms
• The most common symptoms of heart failure are:▪ Breathlessness – this may occur after activity or at rest ▪ Fatigue – you may feel tired most of the time and find exercise exhausting ▪ Swollen ankles and legs – this is caused by a build-up of fluid (oedema)
• Less common symptoms▪ a persistent cough▪ wheezing ▪ a bloated tummy ▪ loss of appetite ▪ weight gain or weight loss▪ dizziness and fainting▪ a fast heart rate ▪ a pounding, fluttering or irregular heartbeat (palpitations)
Heart Failure Symptoms....
Heart Failure Diagnosis
• Blood tests – to check whether there's anything that might indicate heart failure or another illness
• Electrocardiogram (ECG) – this records the electrical activity of the heart to check for problems
• Echocardiogram – a type of ultrasound scan where sound waves are used to examine the heart
• Breathing tests – used to check if a lung problem is contributing to breathlessness; common tests include spirometry and a peak flow test
• Chest X-ray – to check whether the heart's bigger than it should be, whether there's fluid in the lungs, or whether a lung condition could be causing symptoms.
Heart Failure Treatment....
• While there isn't a cure for heart failure, the treatments available help control symptoms. The main treatments are:
• healthy lifestyle changes • medication
▪ ACE inhibitors▪ angiotensin receptor blockers (ARBs)▪ beta blockers▪ mineralocorticoid receptor antagonists▪ diuretics
• Surgery• •heart valve surgery• •a coronary angioplasty or bypass• •left ventricular assist devices• •heart transplant
Digestive System
What is digestion?
Digestion is the breakdown of food into small molecules,
which are then small enough to be absorbed into the body
Nutrition....
Process by which organisms obtain and utilize their food.
There are two parts to Nutrition:
1. Ingestion- process of taking food into the digestive system so that it may be hydrolized or digested.
2. Digestion- the breakdown of food (either chemically or mechanically) in order to utilize nutrients
Phases of digestion....
Physical Digestion Begins in the mouth, when the food is chewed.
Chemical DigestionOccurs in the mouth and in the stomach
What is the Digestive System..?
• The digestive system is made up of the gastrointestinal tract (GI tract or digestive tract), the liver, pancreas, and gallbladder.
• The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus.
• The hollow organs that make up the GI tract are the mouth, esophagus, stomach, small intestine, large intestine, and anus.
• The liver, pancreas, and gallbladder are the solid organs of the digestive system.
Digestive System....
Functions of the digestive system...• The main functions of the
digestive system: ▪ Breaks down food into
simple sugars, amino acids, and carbohydrates. This is fuel for the human body.
▪ Absorption of molecules (minerals/water) into the blood
▪ waste removal from the blood
Stages Of Digestion....
• Ingestion: Food taken into mouth
• Digestion: Food broken down by teeth and digestive enzymes
• Absorption: into bloodstream
• Egestion/defication: Undigested material egested/deficated through anus.
The Structures Of The Digestive System....
Ingestion - Via the mouth
• The first stage of the digestive system is via the mouth and teeth.
• The teeth grid up the food, food is chewed (masticated) mechanically = mechanical digestion
• Saliva is mixed with the food to break the food down = Chemical digestion.
• Saliva contains:
• The enzyme amylase which digests starch
• Mucin
• slippery protein (mucus)
• protects soft lining of digestive system
• lubricates food for easier swallowing
• Buffers
• neutralizes acid to prevent tooth decay
• Anti-bacterial chemicals
• kills bacteria that enter mouth with food
Swallowing & Peristalsis
• Swallowing
• The epiglottis (flap of cartilage) closes trachea (windpipe) when swallowing and food travels down esophagus
• Peristalsis
• Involuntary muscle contractions which occur and push food along the digestive tract
The Oesophagus
• Approximately 25 cm long.
• Functions include:
1.Secrete mucus2.Moves food and fluid
from the throat to the stomach using muscle movement called peristalsis
• No absorption of nutrients takes place in the oesophagus
• If acid from the stomach gets in here that’s heartburn
Stomach
• J-shaped muscular bag that temporarily stores the food you eat, and breaks it down into tiny pieces.
• The stomach can stretch to fit approx. 2 litres of food
• Gastric juices that contain enzymes to break down Proteins and Lipids, are secreted which chemically break down the ingested food.
• The stomach has layers of muscle that line the inside.The walls of the stomach squeeze in and allows the semi digested food to be mixed with gastric juices, producing a substance called chyme.
• The stomach mechanically and chemically breaks down food.
Small Intestine....
The small intestine is the major organ of digestion & absorption
• Chemical digestion
▪ Most of the chemical digestion takes place here.
• Absorption through lining
▪ The small intestine is lined with villi, these are small folds which are 1 cell thick. These increase the surface area and maximises oppertunity for digestion and absorption.
▪ The small intestine has huge surface area = 300m2
▪ Simple sugars and proteins are absorbed into the inner lining.
▪ Fatty acids and glycerol go to lymphatic system.
• Structure
▪ 3 sections
▪ Duodenum = most digestion
▪ Jejunum = absorption of nutrients & water
▪ Ileum = absorption of nutrients & water
Duodenum...
• The first part of the small intestine is called the duodenum.
• Receives partially digested food from the stomach and begins the absorption of nutrients.
• The duodenum produces a range of digestive enzymes to break down starch, proteins and fats that are in food. It also mixes with bile from the gallbladder and digestive juices from the pancreas.
Jejunum....
• The jejunum is the middle portion of the small intestine, connecting the duodenum and the ileum.
• The jejunum makes up approximatly two-fifths of the small intestine
• It is responsible for absorbing nutrients from digested food into the bloodstream.
• Peristalsis, the involuntary smooth muscle contractions that move nutrients through the digestive system, is vigorous and quick in the jejunum.
Ileum....
• The Ileum is the final and longest segment of the small intestine.
• It is specifically responsible for the absorption of vitamin B12 and the reabsorption of conjugated bile salts.
Large Intestine....
• Its main role is to absorb water from the waste food, solidifying the faeces.
• Solid materials pass through the large intestine
• Water absorbtion occurs in the large intestine. With 90% of water reabsorbed:
▪ Not enough water absorbed = Diarrhea
▪ Too much water absorbed = constipation
• Vitamins K and B are reabsorbed with the water.
The Rectum....
• The rectum is the the concluding part of the large intestine that terminates in the anus.
• The rectum is a continuation of the sigmoid colon, and connects to the anus.
• It stores fecal matter produced in the colon until the body is ready to eliminate the waste through the process of defecation.
The process of defecation
The defecation reflex is triggered when:
• When stool moves to the rectum, the amount of stool causes the tissues in the rectum to stretch. Receptors designed to signal to the brain when they are stretched, cause a defecation reflex.
• The defecation reflex occurs when the internal anal sphincter relaxes and the external anal sphincter contracts.
• After the defecation reflex is triggered, you can either delay or defecate. Delay is when a person doesn’t defecate immediately. Anal sphincter muscles cause the stool to move backward and reduces the urge to defecate. If you choose to defecate, your brain activates voluntary and involuntary muscles to move stool forward and out of your body.
• Defecation can be totally involuntary, or it may be under voluntary control.
Disorders of the digestive system....
ULCERS
What is heart burn ?• The esophagus and stomach are connected by muscle
fibers called the lower esophageal sphincter (LES).
• The LES works like a valve, opening to allow food to pass into the stomach and closing to keep food and digestive juices from flowing back into the esophagus.
• If the LES relaxes when it shouldn't, or becomes weak, stomach acid can flow backward into the esophagus causing heartburn.
• If it keeps happening, it's called gastro-oesophageal reflux disease (GORD).
Heart Burn
Symptoms are usually worse after eating, when lying down and when bending over.
Heart Burn Symptoms....
The main symptoms of acid reflux are:
• Heartburn – a burning sensation in the middle of your chest
• An unpleasant sour taste in the mouth (caused by the stomach acid)
You may also have:
• A cough or hiccups that keep coming back
• A hoarse voice
• Bad breath
• Bloating and feeling sick
Causes of Heart Burn....
Esophageal Irritation
• Certain foods, drink, smoking, and medications can directly irritate the lining of the esophagus causing heartburn.
Lower Esophageal Sphincter (LES) Dysfunction
• If the LES is weak or loses tone, it will not close fully after food passes into the stomach. Stomach acid can migrate into the esophagus. Certain foods and beverages, alcohol, drugs, and nervous system factors can weaken LES and impair its function.
Motility Disorders (Slow Stomach Emptying)
• Some motility disorders cause abnormal perestalsis movements. This abnormality can be due to a problem within the muscle, or with the nerves or hormones that control the muscle's contractions. The combination of food left in the stomach and increased stomach pressure due to the delayed emptying increases the risk for stomach acid to leak back up into the esophagus.
Causes of heartburn....
Hiatal hernia
• Hiatal Hernia s often found in patients with GERD. It is believed that a hiatal hernia can weaken the LES and cause reflux.
Pressure on the Abdomen
• Excessive pressure on the abdomen can put pressure on the LES, allowing stomach acid to enter the esophagus or even the mouth. Pregnant women and overweight people are especially prone to heartburn for this reason.
Other Medical Conditions
• Other medical conditions that may contribute to GERD include asthma and diabetes.
Genetic Factors
• Studies have suggested there is an inherited risk for GERD. This could be because of inherited muscular or structural problems in the esophagus or stomach.
Lifestyle Risk Factors....
Alcohol
Alcohol relaxes the LES, allowing the reflux of stomach contents into the esophagus. It also increases the production of stomach acid and makes your esophagus more sensitive to stomach acid.
Smoking Tobacco
The chemicals in cigarette smoke weaken the LES. Cigarette smoking slows saliva production; one of the body's defenses against damage to the esophagus. Smoking stimulates stomach acid production and changes stomach acid by promoting the movement of bile salts from the intestine into the stomach. Digestion is slowed during smoking, thus the stomach takes longer to empty.
Diagnosis of heart burn....
X-ray
• This allows the shape and condition of your esophagus and stomach to be anaylised.
Endoscopy
• This allows for abnormalities in your esophagus to be identified. A tissue sample (biopsy) may be taken for analysis.
Ambulatory acid probe tests
• This identifed when, and for how long, stomach acid backs up into your esophagus. An acid monitor that is placed in your esophagus connects to a small computer that you wear around your waist or on a strap over your shoulder.
Esophageal motility testing
• To measure movement and pressure in your esophagus.
Treatment of heart burn....
To eleveate symptoms of acid reflux, a GP may prescribe medicine that reduces how much acid your stomach makes, such as:
• Omeprazole
• Lansoprazole
• Ranitidine
If medicines do not help or the symptoms are severe, a GP may refer to a specialist for:
• Gastroscopy - to identify what's causing the symptoms
• Laparoscopic fundoplication - a surgical intervention to stop acid reflux
Definition
• Ulcer: Erosion of the surface of the alimentary canal generally associated with some kind of irritant
Stomach Ulcers
What is a Stomach Ulcer?
• Stomach ulcers, also known as gastric ulcers, are open sores that develop on the lining of the stomach. Ulcers occur in part of the intestine just beyond the stomach. These are known as duodenal ulcers.
• Both stomach and duodenal ulcers are referred to as peptic ulcers. Throughout this presentation, the term stomach ulcer will be used, however the information applies equally to duodenal ulcers.
Symptoms of a Stomach Ulcer....
• Burning or gnawing pain in the abdomen ▪ Most common symptom
• Bleeding from the ulcer▪ Blood in the stools.• Indigestion
• Heartburn
• Loss of appetite
• Feeling and being sick
• Weight loss
• Some people also find they burp or become bloated after eating fatty foods.
Causes of a Stomach Ulcer....
H. Pylori bacteria
• These can break down the stomach's defence against the acid it produces to digest food, allowing the stomach lining to become damaged and an ulcer to form.
• H. pylori infections are common.
Non-steroidal anti-inflammatory drugs (NSAIDs).
• NSAIDs are medicines used to treat pain, high temperatures and inflammation.
• Commonly used NSAIDs include:▪ ibuprofen▪ Aspirin▪ Naproxen ▪ Diclofenac
• Many individuals take NSAIDs without side effects, however if taken for a long time or at high doses stomach ulcers can occur.
Diagnosis of a Stomach Ulcer....
Testing for H. pylori infection
If the GP thinks symptoms may be caused by an H. pylori infection, one of following tests may occur:
• Urea Breath Test
▪ A drink containing a chemical that's broken down by H. pylori is given; expelled breath is then analysed to see whether or not H. pylori infection is present by determining if the chemical is still present.
• Stool Antigen Test
▪ A small stool sample is tested for the bacteria.
• Blood Test
▪ A sample of blood is tested for antibodies to the H. pylori bacteria
If you test positive for H. pylori, you'll need treatment to clear the infection, which can heal the ulcer and prevent it returning.
Gastroscopy
In some cases, individuals may be referred for a gastroscopy to look inside the stomach directly and see whether a stomach ulcer was present.
• The images taken by the camera will confirm or rule out an ulcer. A small tissue sample may be taken from the stomach or duodenum so it can be tested for the H. pylori bacteria.
Stomach Ulcer Treatment....
Cause = Helicobacter Pylori
Course of antibiotics and a medication called a proton pump inhibitor (PPI) is recommended
Cause = Non-steroidal anti-inflammatory drugs (NSAIDs).
If the stomach ulcer is caused by taking NSAIDs, a course of proton pump inhibitormedication is recommended.
Your use of NSAIDs will be reviewed, and taking an alternative painkiller may be advised.
The treatment for a stomach would depend on what caused it. With treatment, most ulcers heal in a month or two.
H2-receptor antagonists
• Like PPIs, H2-receptor antagonists work by reducing the amount of acid your stomach produces.
• Ranitidine is the most widely used H2-receptor antagonist for treating stomach ulcers.
Stomach Ulcer Treatment....
LO3: Be able to interpret data obtained from measuring body
rates with reference to the functioning of healthy body
systems
PEAK FLOW....
Peak Flow
• Peak flow is a simple measurement of how quickly you can blow air out of your lungs. It's often used to help diagnose and monitor asthma.
• By measuring how fast you're able to breathe out, your peak flow score can indicate whether your airways are narrowed
• Exercise can increase an individual’s peak flow reading. This is because exercise makes the lungs stronger and this increases the lungs’ ability to take in oxygen.
https://www.youtube.com/watch?v=055fSYXgNKU
Practical session - measure peak flow...
• To measure your peak flow:
• Find a comfortable position, either sitting or standing
• Reset your peak flow meter so the pointer is pushed back to the first line of the scale – this is usually 60
• Hold the peak flow meter so it's horizontal and make sure that your fingers are not obstructing the measurement scale
• Breathe in as deeply as you can and place your lips tightly around the mouthpiece
• Breathe out as quickly and as hard as you can
• When you've finished breathing out, make a note of your reading
This should be repeated 3 times, and the highest of the 3 measurements should be recorded as your peak flow score.
Heart Rate
Heart Rate
• Heart rate, also known as pulse, is the number of times a person's heart beats per minute. Normal heart rate varies from person to person, but a normal range for adults is 60 to 100 beats per minute
• However, a normal heart rate depends on the individual, age, body size, heart conditions, whether the person is sitting or moving, medication use and even air temperature. Emotions can affect heart rate; for example, getting excited or scared can increase the heart rate.
Finding your pulse...
• You can find your pulse in your wrist or neck:
To find your pulse in your wrist:
▪ Hold out one of your hands, with your palm facing upwards
▪ Press the first (index) finger and middle finger of your other hand on the inside of your wrist, at the base of your thumb – don't use your thumb as it has its own pulse
▪ Press your skin lightly until you can feel your pulse – if you can't find it, try pressing a little harder or move your fingers around
To find your pulse in your neck:
▪ Press your first finger and middle finger to the side of your neck, just under your jaw and beside your windpipe – don't use your thumb
▪ Press your skin lightly to feel your pulse – if you can't find it, try pressing a bit harder or move your fingers around
Checking your pulse...
When you find your pulse, either:
• Count the number of beats you feel for 60 seconds
• This gives you your heart rate – the number of times your heart beats per minute (bpm).
Heart Rate Parameters (adult)
Normal heart rate is between 60-100 beats/min
Tachycardia (significantly raised heart rate) is considered a heart rate above 100 beats/min
Bradycardia (significantly low heart rate) is considered a heart rate below 60 beats/min
WHAT IS BMI?
• The body mass index (BMI) is a measure that uses your height and weight to work out if your weight is healthy.
• The BMI calculation divides an adult's weight in kilograms by their height in metres squared. For example, A BMI of 25 means 25kg/m2.
RANGES OF BMI...
• For most adults, an ideal BMI is in the 18.5 to 24.9 range.
• For children and young people aged 2 to 18, the BMI calculation takes into account age and gender as well as height and weight.
• If your BMI is:▪ Below 18.5 – you're in the underweight
range ▪ Between 18.5 and 24.9 – you're in the
healthy weight range ▪ Between 25 and 29.9 – you're in the
overweight range ▪ Between 30 and 39.9 – you're in the obese
range
ACCURACY OF THE BMI...
• BMI takes into account natural variations in body shape, giving a healthy weight range for a particular height.
• As well as measuring your BMI, healthcare professionals may take other factors into account when assessing if you're a healthy weight.
• Muscle is much denser than fat, so very muscular people, such as heavyweight boxers, weight trainers and athletes, may be a healthy weight even though their BMI is classed as obese.
• Your ethnic group can also affect your risk of some health conditions. For example, adults of Asian origin may have a higher risk of health problems at BMI levels below 25.
HOW TO CALCULATE BMI...
Metric BMI Formula
• BMI = weight (kg) / [height (m)]2
Imperial BMI Formula
• BMI = 703 × weight (lbs) / [height (in)]2
BMI....
