copyright ©2011 by pearson education, inc. upper saddle river, new jersey 07458 all rights...

Copyright ©2011 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.

Medical Language, Second Edition Susan Turley

CHAPTERCHAPTER

Medical LanguageMedical LanguageSecond Edition

Gastroenterology

3




Learning Objectives

1. Identify the structures of the gastrointestinal system.

2. Describe the process of digestion.

3. Describe common gastrointestinal diseases and conditions, laboratory and diagnostic procedures, medical and surgical procedures, and drug categories.




Learning Objectives

4. Give the medical meaning of word parts related to the gastrointestinal system.

5. Build gastrointestinal words from word parts and divide and define gastrointestinal words.

6. Spell and pronounce gastrointestinal words.




Learning Objectives

7. Analyze the medical content and meaning of a gastroenterology report.

8. Dive deeper into gastroenterology by reviewing the activities at the end of this chapter and online at Medical Terminology Interactive.




Multimedia Directory

Slide 10Digestive System Animation

Slide 45Digestive System Animation

Slide 51GERD Video

Slide 57Appendicitis Animation

Slide 91Ultrasound Video

Slide 93MRI Video

Slide 103Sigmoidscopy Video

Slide 110Medical Assisting Video




Gastroenterology

• The medical specialty that studies the anatomy and physiology of the gastrointestinal system and uses diagnostic tests, medical and surgical procedures, and drugs to treat gastrointestinal diseases.




Anatomy and Physiology

• Gastrointestinal System – Begins at the mouth, continues through the

thoracic cavity, and fills most of the abdominal cavity

– Upper gastrointestinal system includes the structures from the mouth through the stomach




Anatomy and Physiology (con’t)

• Gastrointestinal System (con’t)– Lower gastrointestinal system includes the

small and large intestines– Purpose is to digest food, absorb nutrients,

and remove undigested material (waste) from the body




Figure 3-1 Gastrointestinal system




Digestive System Animation

Click on the screenshot to view an animation showing a tour of the digestive system.The animation may take a few seconds to start playing.

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Anatomy of the Gastrointestinal System

• Oral Cavity and Pharynx– Begins in the mouth, or oral cavity– Oral cavity contains the teeth; tongue; hard

palate; and soft palate with its fleshy, hanging uvula.

– Receptors on the tongue perceive taste and send this information to the gustatory cortex in the brain.




Anatomy of the Gastrointestinal System (con't)

• Oral Cavity and Pharynx (con’t)– Lined with mucosa, a mucous membrane that

produces thin mucus.– The sight, smell, and taste of food cause the

salivary glands to release saliva into the mouth; this moistens foods as they are chewed and swallowed.

– Saliva also contains an enzyme that begins the process of digestion.





• Oral Cavity and Pharynx (con’t)– There are three pairs of salivary glands: the

parotid glands, the sublingual glands, and the submandibular glands.

– The teeth tear, chew, and grind the food during the process of mastication.

– The tongue moves food toward the teeth and mixes food with saliva.





• Oral Cavity and Pharynx (con’t)– Swallowing or deglutition moves food into the

throat or pharynx.– When food is swallowed, the epiglottis closes

the entrance to the larynx, so that food in the back of the throat, pressing on the uvula, does not initiate the gag reflex.




Figure 3-2 Oral cavity and pharynx




Figure 3-3 Salivary glands





• Esophagus– A flexible, muscular tube that connects the

pharynx to the stomach. – Lined with mucosa that produces mucus. – By coordinated contractions of its wall—the

process of peristalsis—food moves toward the stomach.





• Stomach– A large, elongated sac in the upper abdominal

cavity that receives food from the esophagus.– Divided into four areas: the cardia, fundus,

body, and pylorus.– The gastric mucosa is arranged in thick, deep

folds known as rugae which expand as the stomach fills with food.





• Stomach (con’t)– The mucosa produces mucus that protects

the lining of the stomach from the acid the stomach produces.

– Two sphincters (muscular rings) keep food in the stomach.

– The lower esophageal sphincter is located in the distal esophagus.





• Stomach (con’t)– The pyloric sphincter is located in the distal

end of the stomach. – Chyme is a semisolid mixture of partially

digested food, saliva, and digestive juices in the stomach.




Figure 3-4 Stomach





• Small Intestine– The small intestine is a long, hollow tube that

receives chyme from the stomach.– It is divided into three parts: the duodenum,

jejunum, and ileum.




Figure 3-5 Small and large intestines





• Large Intestine– A larger, hollow tube that receives undigested

material and water from the small intestine.– Consists of the cecum, colon, rectum, and

anus.– The walls contain haustra (puckered pouches)

that can greatly expand, as needed.





• Large Intestine (con’t)– Waves of peristalsis slowly move undigested

material through the large intestine as water is absorbed through the intestinal wall and into the blood.

– The colon is the longest part. – It travels through all four quadrants of the

abdomen as the ascending colon, transverse colon, descending colon, and sigmoid colon.





• Large Intestine (con’t)– The sigmoid colon bends toward the midline

in an S-shaped curve that joins the rectum. – The rectum is a short, straight segment that

connects to the outside of the body. – The anus, the external opening of the rectum,

is located between the buttocks. – The anal sphincter is a muscular ring whose

opening and closing is under conscious, voluntary control.





• Abdomen and Abdominopelvic Cavity– Contains the largest organs of the

gastrointestinal system. – The walls of the abdominopelvic cavity are

lined by peritoneum, a membrane that secretes peritoneal fluid.

– This watery fluid fills the spaces between the organs and allows them to slide past each other during the movements of digestion.





• Abdomen and Abdominopelvic Cavity (con’t)– The peritoneum extends into the center of the

abdominopelvic cavity as the omentum. – The omentum supports the stomach and hangs

down as a fatty apron to cover and protect the small intestine.

– The peritoneum also extends as the mesentery, a thick, fan-shaped sheet that supports the jejunum and ileum.





• The blood supply to the stomach, small intestine, liver, gallbladder, and pancreas comes from the celiac trunk of the aorta, the largest artery in the body.





• Liver– The liver is the largest solid organ in the body,

located in the upper right abdominal cavity. – An accessory organ of digestion that

contributes to, but is not physically involved in, the process of digestion.

– Liver cells (hepatocytes) continuously produce bile, a yellow-green, bitter-tasting, thick fluid.





• Liver (con’t)– Bile produced by the liver flows through the

hepatic ducts, through the common hepatic duct, and then into either the cystic duct to the gallbladder or the common bile duct.

– All of the ducts that carry bile are collectively known as the biliary tree.




Figure 3-6 Biliary tree





• Gallbladder– An accessory organ of digestion posterior to

the liver. – Concentrates and stores bile from the liver.– The presence of fatty chyme in the duodenum

causes the gallbladder to contract, sending bile into the common bile duct and duodenum to digest fats.





• Pancreas– An accessory organ of digestion posterior to

the stomach.– Presence of food in the duodenum causes the

pancreas to secrete digestive enzymes into the pancreatic duct to the duodenum.

– Also functions as an organ of the endocrine system.




Physiology of Digestion

• There are two parts to digestion: – Mechanical – Chemical

• Mechanical digestion uses mastication, deglutition, and peristalsis to break down foods.

• Mechanical digestion also involves breaking apart fats in the duodenum.




Physiology of Digestion (con't)

• Fatty chyme stimulates the duodenum to secrete the hormone cholecystokinin, which stimulates the gallbladder to contract and release bile.

• Bile breaks apart large globules of fat during the process of emulsification.

• Chemical digestion uses enzymes and acid to break down foods.





• The enzyme amylase in saliva begins to break down carbohydrate foods in the mouth.

• The stomach secretes the following substances that continue the process of chemical digestion:– Hydrochloric acid– Pepsinogen – Gastrin





• The stomach secretes a substance known as intrinsic factor, which helps vitamin B12 be absorbed from the intestine into the blood.

• When the stomach does not produce enough intrinsic factor, vitamin B12 is not absorbed.




• Chemical digestion is completed in the small intestine.

• Cholecystokinin stimulates the pancreas to secrete four digestive enzymes into the duodenum: – Amylase – Lipase– Other enzymes that break down proteins





• The villi of the small intestine produce the digestive enzymes such as lactase to break down sugars.





• Absorption of nutrients and water through the intestinal wall into the blood takes place mainly in the duodenum and jejunum.

• Absorption of water continues in the large intestine.

• Absorbed nutrients are carried by blood in the portal vein to the liver.





• The liver plays an important role in regulating nutrients such as glucose and amino acids.

• Excess glucose in the blood is stored in the liver as glycogen and released when the blood glucose level is low.

• The liver uses amino acids to build plasma proteins and clotting factors for the blood.





• Elimination occurs when undigested materials and water are eliminated from the body in a solid waste form of feces or stool.

• The process of elimination is a bowel movement or defecation.





Figure 3-7 Gastrointestinal system.(Robert W. Ginn/PhotoEdit Inc.)




Digestive System Animation

Click on the screenshot to view an animation showing the digestive system.

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Diseases and Conditions

• Eating– Anorexia– Dysphagia– Polyphagia




Diseases and Conditions (con't)

• Mouth and Lips– Cheilitis– Sialolithiasis– Stomatitis– Glossitis




Figure 3-8 Glossitis(Centers for Disease Control and Prevention [CDC])





• Esophagus and Stomach– Dyspepsia– Esophageal varices– Gastritis– Gastroenteritis– Gastroesophageal reflux disease (GERD)




Figure 3-9 Esophageal varix(David M. Martin, M.D./Photo Researchers, Inc.)




GERD Video

Click on the screenshot to view a video on the topic of GERD.

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• Esophagus and Stomach (con't)– Heartburn– Hematemesis– Nausea and vomiting (N&V)– Peptic ulcer disease (PUD)– Stomach cancer




Figure 3-10 Gastric ulcer (David M. Martin, M.D./Photo Researchers, Inc.)





• Duodenum, Jejunum, Ileum– Ileus– Intussusception– Volvulus




Figure 3-11 Intussusception of the intestine





• Cecum and Colon– Appendicitis– Colic– Colon cancer– Diverticulum– Dysentery




Appendicitis Animation

Click on the screenshot to view an animation showing appendicitis.

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Figure 3-12 Diverticula(David M. Martin, M.D./Photo Researchers, Inc.)




Figure 3-13 Diverticulitis and polyposis





• Cecum and Colon (con’t)– Gluten enteropathy– Inflammatory bowel disease (IBD)– Irritable bowel syndrome (IBS) – Polyp




Figure 3-14 Crohn’s disease




Figure 3-15 Colonic polyps (Staats/Custom Medical Stock Photo, Inc.)





• Rectum and Anus– Hemorrhoids– Proctitis– Rectocele





• Defecation and Feces– Constipation– Diarrhea– Flatulence– Hematochezia– Incontinence– Steatorrhea





• Abdominal Wall and Abdominal Cavity– Adhesions– Hernia– Peritonitis




Figure 3-16 Hernia(From Rudolph, A.M., Hoffman, J.I.E., & Rudolph, C.D. (Eds.) 1991. Rudolph’s Pediatrics. (19th

ed., p. 1040))




Figure 3-17 Peritonitis(Custom Medical Stock Photo, Inc.)





• Liver– Ascites– Cirrhosis– Hepatitis




Figure 3-18 Fatty liver disease and cirrhosis of the liver(Arthur Glauberman/Photo Researchers, Inc.)





• Hepatitis is the most common chronic liver disease.– Hepatitis A– Hepatitis B– Hepatitis C– Hepatitis D– Hepatitis E





• Hepatitis A is an acute but short-lived infection caused by exposure to water or food that is contaminated with feces from a person who is infected with the hepatitis A virus (HAV).




• Hepatitis B is an acute infection caused by exposure to the blood of a person who is already infected with the hepatitis B virus (HBV); it is also known as serum hepatitis.

• It is also spread during sexual activity by contact with saliva and vaginal secretions.

• An infected mother can pass hepatitis B to her fetus before birth or when breastfeeding.





Figure 3-19 Blood transfusion(PhotoDisc/Getty Images)




• Hepatitis C is an acute infection caused by exposure to the blood of a person who is already infected with the hepatitis C virus (HCV).

• Hepatitis C is not readily transmitted by sexual activity or from a mother to her fetus.





• Chronic hepatitis C is the main cause of chronic liver disease, cirrhosis, and liver cancer.

• Hepatitis D is a secondary infection caused by a mutated (changed) hepatitis virus.





• Hepatitis D only develops in patients who already have hepatitis B; it is also known as delta hepatitis.

• Hepatitis E is similar to hepatitis A but rarely occurs in the United States.





• Hepatomegaly• Jaundice• Liver Cancer





Figure 3-20 Jaundice(Dr. M.A. Ansary/Photo Researchers, Inc.)




Figure 3-21 Liver cancer(Gca/Photo Researchers, Inc.)





• Gallbladder and Bile Ducts– Cholangitis– Cholecystitis– Cholelithiasis




Figure 3-22 Cholelithiasis(Custom Medical Stock Photo, Inc.)




Figure 3-23 Gallstones in the biliary and pancreatic ducts





• Pancreas– Pancreatic cancer– Pancreatitis




Laboratory and Diagnostic Procedures

• Blood Tests– Albumin – Alkaline phosphatase (ALP) – ALT and AST – Bilirubin




Laboratory and Diagnostic Procedures (con't)

• Blood Tests (con’t)– GGT – Liver function tests (LFTs)





• Gastric and Feces Specimen Tests– CLO test– Culture and sensitivity (C&S)– Fecal occult blood test – Gastric analysis– Ova and parasites (O&P)




• Radiologic Procedures– Barium enema – Cholangiography





Figure 3-24 Barium enema(Custom Medical Stock Photo, Inc.)




Figure 3-25 Endoscopic retrograde cholangiopancreatography




• Radiologic Procedures (con’t)– Computerized axial tomography (CAT, CT

scan) – Flat plate of the abdomen – Gallbladder ultrasound





Ultrasound Video

Click on the screenshot to view a video on the topic of ultrasounds.

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• Radiologic Procedures (con’t)– Magnetic resonance imaging (MRI) scan– Oral cholecystography (OCG)





MRI Video

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• Radiologic Procedures (con’t)– Upper gastrointestinal series (UGI)





Medical and Surgical Procedures

• Medical Procedures– Insertion of nasogastric tube




Figure 3-26 Nasogastric tube(Pearson Education/PH College)




Medical and Surgical Procedures (con't)

• Surgical Procedures– Abdominocentesis– Appendectomy – Biopsy– Bowel resection and anastomosis– Cholecystectomy– Choledocholithotomy




Figure 3-27 Laparoscopic cholecystectomy(Geoff Tompkinson/Photo Researchers, Inc.)





• Surgical Procedures (con’t)– Colostomy – Endoscopy – Exploratory laparotomy




Figure 3-28 Colostomy and stoma(Pearson Education/PH College)





• Endoscopic Procedures– Esophagoscopy– Gastroscopy– Esophagogastroduodenoscopy (EGD) – Sigmoidoscopy– Colonoscopy




Figure 3-29 Colonoscopy(BSIP/Phototake NYC)




Sigmoidoscopy Video

Click on the screenshot to view a video on the topic of sigmoidoscopy.

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• Surgical Procedures (con’t)– Gastrectomy – Gastroplasty – Gastrostomy – Hemorrhoidectomy




Figure 3-30 PEG tube





• Surgical Procedures (con’t)– Herniorrhaphy– Jejunostomy – Liver transplantation – Polypectomy




Drug Categories

• These categories of drugs are used to treat gastrointestinal diseases and conditions:– Antacid drugs– Antibiotic drugs– Antidiarrheal drugs– Antiemetic drugs




Drug Categories (con’t)

• These categories of drugs are used to treat gastrointestinal diseases and conditions:– H2 blocker drugs– Laxative drugs– Proton pump inhibitor drugs




Abbreviations




Medical Assisting Video

Click on the screenshot to view a video on the topic of careers in medical assisting.

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