Lecture Notes 6Digestive

System

Classroom Activity to Accompany Medical Terminology Systems, Sixth Edition Barbara A. Gylys ∙ Mary Ellen Wedding

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Structure•Oral cavity• Teeth• Salivary glands

•Pharynx•Esophagus•Stomach •Small intestine•Large intestine

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Structure •Accessory organs•Liver•Gallbladder•Pancreas

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Function•Organs of digestion break down food physically and chemically• Prepare food for absorption by cells of the body

•Digestive system eliminates waste substances

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Structure and Function ExerciseQ: What is the oral cavity and what is its function?A: The mouth and the first part of the digestive tract. It is

where the chemical and mechanical process of digestion begins with teeth and salivary glands.

Q: Name the three parts of the small intestine and describe their locations.

A: First segment, the duodenum, is about 10 inches long. Second segment, the jejunum, is approximately 8 feet long. Third segment, the ileum, is about 12 feet long.

Q: Name the first four sections of the colon.A: Ascending colon, transverse colon, descending colon,

and sigmoid colon.

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Structure and Function Exercise

(continued)Q: Describe the shape and location of the

pancreas.A: Elongated, somewhat flattened organ

that lies posterior and slightly inferior to the stomach.

Q: Describe the location and main function of the gallbladder.

A: It is located on the inferior surface of the liver and stores bile.

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AppendicitisSigns and Symptoms• Inflammation of appendix, usually due to

obstruction or infection caused by a fecalith, foreign body, or bacteria.• Onset of symptoms include generalized abdominal

pain followed by localized pain in upper right quadrant (URQ), nausea, vomiting, and anorexia.• Pain eventually settles over the appendix in the

right lower abdomen (RLQ) with “board-like” rigidity, increased tenderness, and abdominal spasms.

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Appendicitis Signs and Symptoms (continued)• Fever, malaise, diarrhea, or constipation

and tachycardia are among the later signs and symptoms.• Sudden spontaneous relief of pain suggests

a ruptured appendix.

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AppendicitisTreatment• Appendectomy.• Surgery within 24 to 48 hours of first symptoms.

Delay can result in rupture and peritonitis as fecal matter is released into the peritoneal cavity.

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Clinically Related ExerciseQ: A 35-year-old man presents to the ED with RLQ

pain, rigid abdomen with increased tenderness and abdominal cramping. The physician suspects he is suffering from an inflammation of the appendage located off the cecum. An inflammation of the appendix is known as _________________.

A: appendicitis

Q: The physician recommends appendectomy and explains that a delay in surgery may result in rupture of the appendix. This can cause a serious infection of the abdominal cavity or peritoneum called ________________________.

A: peritonitis

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Clinically Related Exercise (continued)Q: Dr. G charts removal of the appendix as

an __________________.A: appendectomyQ: Dr. J informs Joan that her appendicitis

may be due to an obstruction or infection caused by a hard mass of fecal matter. This type of mass is known as a _______________.

A: fecalith

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Diverticulitis Signs and Symptoms• Acute inflammation of diverticula

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Diverticulitis Signs and Symptoms (continued)• Tenderness and pain in LLQ of abdomen.• Intensity of pain can fluctuate.• Cramping, nausea, vomiting, fever, chills, or a change in bowel habits may also be experienced.• Eventually abscess may form in tissues surrounding the colon.

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Diverticulitis Treatment • Focuses on clearing up the inflammation

and infection, resting the colon, and preventing or minimizing complications.• Severe cases with acute pain and

complications require a hospital stay. Most cases of severe diverticulitis are treated with IV antibiotics and a few days without food or drink to help the colon rest. • Some cases may require colon resection

with a temporary colostomy while the colon heals.

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Clinically Related Exercise Q: Dr. X tells Ann that she has small, blister-like

pockets in the inner lining of her large intestine. He tells her that these pockets are known as ____________________.

A: diverticulaQ: The nurse charts the Mr. J’s complaint of extreme

constipation as ________________.A: obstipationQ: Mr. F is diagnosed for the third time with a severe

case of diverticulitis. The physician explains that surgery is needed to remove the diverticula. This surgical procedure is called ____________________.

A: diverticulectomy

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CholelithiasisSigns and Symptoms• Cholelithiasis and choledocholithiasis• Formation or presence of gallstones within the gallbladder or bile ducts.

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CholelithiasisSigns and Symptoms (continued) • Individuals with gallstones may remain

asymptomatic.• Bile duct obstruction may result in a classic

“gallbladder attack”; commonly referred to as biliary colic.• Acute onset of URQ abdominal pain that

radiates to the shoulder and back.• Nausea and vomiting may accompany the

attack.• Attacks typically tend to follow ingestion of

large meals or fatty foods.

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CholelithiasisTreatment• Cholecystectomy is the treatment of choice for

symptomatic cholelithiasis.• If condition is asymptomatic, treatment is

nonsurgical, unless symptoms reappear or unless there is a history of previous gallstones with complications.• Extracorporeal shock-wave lithotripsy, a non-

surgical treatment.

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CholelithiasisTreatment (continued)• Insertion of a flexible catheter, guided by

fluoroscopy, directly to the stone. A Dormia (stone) basket is threaded through the catheter, opened, and twirled to entrap the stone. It is then closed and withdrawn.• Dissolving cholesterol-based stones by bile acid

therapy. Existing stones may be decreased in size or dissolved completely.

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Clinically Related Exercise Q: Ms. G presents with an acute onset of URQ abdominal pain that radiates to the shoulder and back, and complains of nausea and vomiting. Dr. J suspects a formation of gallstones in the gallbladder. The medical term for an abnormal condition of gallbladder stones is __________________________.

A: cholecystolithiasisQ: The doctor explains that removal of the gallbladder is the treatment of choice for symptomatic cholelithiasis. The surgical procedure for excision of the gallbladder is ___________________.A: cholecystectomy

Q: Mr. F is scheduled for ultrasound to pulverize his gallstones. This nonsurgical treatment, which is abbreviated ESWL, is defined as ________________________________________________.A: extracorporeal shock wave lithotripsy

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Medical Vocabulary•ascites•borborygmus•dysentery•dyspepsia•dysphagia•enterologist•esophagogastroduodenoscopy

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Medical Vocabulary(continued)• hyperemesis• jaundice• laparoscopic• proctologist• ptyalism• sublingual• volvulus

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Diagnostic Procedures•Endoscopy•Visual examination of the interior of organs and cavities with a specialized lighted instrument called an endoscope.

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Diagnostic Procedures(continued)• Sigmoidoscopy and colonoscopy• Sigmoidoscopy is an examination of only the lower third of the colon.•Colonoscopy is an examination of the entire length of the colon.

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Diagnostic Procedures(continued) • Barium enema (BE)• Barium swallow• Magnetic resonance imaging (MRI)• Ultrasound (US)

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Word Building ExerciseQ: Visual examination of the sigmoid colon:A: sigmoidoscopyQ: Instrument for examining interior organs and cavities:A: endoscopeQ: Visual examination of the colon:A: colonoscopyQ: Visual examination of within interior organs and cavities:A: endoscopyQ: Visual examination of the rectosigmoid colon:A: proctosigmoidoscopy

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Medical and Surgical Procedures

•Bariatric surgery •A. Vertical banded gastroplasty

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Medical and Surgical Procedures

(continued)• Bariatric surgery•B. Roux-en-Y gastric bypass(RGB)

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Medical and Surgical Procedures

(continued)

• Colostomy• Creation of an

opening into the colon (through the surface of the abdomen).

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Medical and Surgical Procedures

Colostomy (continued)• May be permanent or temporary.• Performed as treatment for cancer or diverticulitis.• Colostomy allows elimination of feces into a bag attached through the skin.

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Medical and Surgical Procedures

(continued)• Polypectomy• Excision of small tumorlike, benign growths (polyps) that project from a mucous membrane surface.

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Clinically Related ExerciseQ: Ms. K is diagnosed with colorectal CA. The physician explains

that an opening of the colon through the abdominal wall to the outside surface will be created. This enables fecal mater to be collected in an attached pouch. The surgical procedure to create an opening (mouth) of the colon is called a _______________.

A: colostomyQ: Dr. Jones discovers polyps during a colonoscopy. What

surgical procedure does the doctor perform to remove the polyps?

A: polypectomyQ: The nurse explains to the weight-loss group that surgical

procedures are available to treat morbid obesity. The surgical specialty that treats morbid obesity is called ___________ _____________.

A: bariatric surgery

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Clinically Related Exercise(continued)Q: The nurse explains to the bariatric surgical patient

the procedure for a Roux-en-Y gastric bypass. What is the abbreviation for this weight-loss surgery?

A: RGBQ: The doctor explains one option to treat morbid

obesity. The surgeon staples the upper stomach near the esophagus to reduce it to a small pouch followed by the insertion of a band to restrict food consumption. This is known as __________________________________.

A: vertical banded gastroplasty

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Pharmacology•Antacids•Antidiarrheals•Antiemetics•Laxatives

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Clinically Related ExerciseQ: Mrs. J complains of nausea and vomiting for the past 3 days. The

medication prescribed will control nausea and vomiting by blocking nerve impulses to the vomiting center of the brain. This medication is known as a/an (antacid, antidiarrheal, antiemetic).

A: antiemeticQ: Mrs. S is diagnosed with irritable bowel syndrome. She is

instructed to increase fluid intake and is prescribed a drug that will control her loose bowel movements. The drug is known as a/an (antacid, antidiarrheal, antiemetic).

A: antidiarrhealQ: A patient diagnosed with excessive stomach acid is treated with

a/an (antacid, laxative, antiemetic).A: antacid

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