Digestive System

Terms
 Enter/o

refers to the small intestine  Gastr/o refers to the combining form for Gastr/o stomach

Functions
 Ingestion

of food (process of eating)  Digestion or breakdown of food  Absorption of digested food into the bloodstream (carried out by the small intestine)  Elimination of solid waste materials that are not absorbed

The alimentary/food canal



 

Continuous canal that carries food through the digestive system Begins at the mouth, and ends at the anus WaveWave-like muscular contractions (peristalsis) advance contents through the canal after swallowing

Mouth
  

 

Lips-Cheil/o(cheilitis) Lips-Cheil/o(cheilitis) Mastication: chewing Chemical digestion starts in the mouth with the addition of saliva Salivary glands deglutitiondeglutition-swallowing sends food into the esophagus

Teeth


 

4 types (incisor, canines, premolars & molars) Primary dentition/decidous dentition consists of 20 teeth Adult/permanent are 32 GingivaGingiva-gums

Tongue


Tongue contain taste buds detect salty, sweet, sour and bitter

Salivary glands


Functions include lubricating food, cleansing the mouth and aiding in digestion Parotid, sublingual and submandibular (label)

Pharynx
  

Aka throat Appx. 5 long Serves as a passageway for both food and air

Epiglottis
   

Located at the base of tongue Soft piece of tissue Caps off the larynx Function is to close airway to prevent aspiration

Esophagus
  

Peristalsis begins here Appx. 9Appx. 9-10 long Peristalsis contractions push food to the stomach, it goes through the cardiac sphincter first

Stomach


 

Digestive pouch where food is further mechanically and chemically digested Secretes enzymes and HCl for chemical digestion Food is turned into chyme The term gastr/o gastr/o refers to the stomach

3 parts
  

FundusFundus-upper portion BodyBody-middle section AntrumAntrum-lower portion

Stomach rugae

Cardiac sphincter


Circular muscle located at the entrance of the stomach Relaxes to allow food to enter the stomach from the esophagus

Pyloric sphincter


Allows digested food (chyme) into the chyme) duodenum

Small intestine


 

Extends from the pyloric sphincter to the first part of the large intestine Appx. 20Appx. 20-23 ft. long Contains villi with capillaries for absorption of nutrients Alcohol and some drugs are absorbed directly into the blood through the sm. Intestine The medical term that refers to the small intestine is enter/o

Duodenum
About 1 ft. long  Receives food from the stomach  Receives bile from the liver and gall bladder to help digest fats  Receives pancreatic juice from the pancreas


Jejunum
 

About 10 ft. long Identify and label

Ileum
 

About 11 ft. long Junctions with the first part of lg. intestine Identify and label

Large intestine
 

Extends from ileum to the anus Eliminates waste by absorbing water, making liquid waste a solid and store feces in the rectum until released from body 6 sections

Cecum
  

First part of the lg. intestines Dead end pouch Appendix hangs from the cecum but serves no function

Ascending colon
  

Ascending colon Transverse colon Descending colon

Sigmoid colon

Toxins and dead foods lead to poor digestion, constipation, diarrhea, weight gain, low energy and toxic colon build-up. These buildcommon symptoms are more than just inconvenient; they can lead to long-term health problems and serious or terminal longdisease. Autopsies often reveal colons that are plugged up to 80% with waste material. Vegetarian Times, March, 1998 The waste material in the human body is home to a sinister world of monstrous creatures that feed on living flesh: parasites . The combination of environmental toxins, an unhealthy diet and parasites poses a grave danger to humans. In fact, parasites have killed more humans than all the wars in history .

Rectum
 

 

The storage pouch for stool Has a strong anal sphincter that controls opening Rect/o Rect/o is the combining form meaning rectum The end portion of the large intestine is the rectum Excretion is the elimination of digested food

Accessory organs of the digestive system

Liver
  

 

RUQ Exocrine gland Function is fat & carb metabolism and detoxification of blood Converts glucose to glycogen Produces proteins for blood clotting

Gallbladder
Located under the liver  Receives bile from liver through the hepatic and cystic ducts  Stores and concentrates bile  Helps breakdown fat globules in aid of digestion


Pancreas
   

Located behind stomach Exocrine/endocrine functions Digestive juice neutralizes acid Produces glucagon and insulin

Indigestion

Hemorrhoid

diverticulosis

hernia

hepatitis

Toxic Hepatitis
 Toxic

hepatitis is a toxic reaction to chemical toxicants, certain medications and to alcohol

Cirrhosis

cholelithiasis
 The

formation of gallstones made of cholesterol and bilirubin

volvulus

Intestinal blockage

Emesis

melena

Esophageal reflux

Guaiac
 Test

to detect hidden blood in the stool

colostomy

colonoscopy

GI questionnaire


Identify exactly the location of the pain!!

It is important to know what structures are under each quadrant because it gives an idea of what may be wrong with our patient and help us anticipate the Dr. s needs

General abdominal pain

     

Gastroenteritis Constipation Small bowel obstruction Large bowel obstruction Peritonitis Sickle cell crisis

Upper Quadrant Pain

Common causes:  Hepatitis  Biliary colic  Peptic ulcer disease  Pyelonephritis  Acute cholecystitis

Right lower quadrant pain

      

Appendicitis Inflammatory bowel disease Salpingitis Rectus abdominus muscle strain Ureteral calculus Ruptured ectopic pregnancy Ovarian torsion

Left upper quadrant pain

   

Pancreatitis Splenic infarction Pyelonephritis Myocardial infarction

       

Inflammatory bowel disease Diverticulitis Salpingitis Rectus abdominus muscle strain Ureteral calculus Ovarian torsion Ruptured ectopic pregnancy Sigmoid volvulus

 How

long have you had this pain?  Does you pain stay in the same place or does it radiate?  Let s take a look at how referred pain works:

Abdominal Pain radiation

          

Does anything make the pain worse or better? Have you taken anything for it? If so, what, how much? And, did it work? Does staying in one position help or worsen the pain? Can you stretch your legs out? If there is any vomiting and diarrhea, how much, how often, what color? Can you hold any fluids down? Travel to any foreign countries? Ate at any new or unusual places? Bowel movements? Distention? Any relative hx?

A female with lower abdominal pain?



Ask the patient to point to where it hurts? Ask GI questions, if not related to any obvious GI complaintcomplaintGo to your GYN interview skills

Umbilical hernia

Abdominal pathologies/emergencies

Gastroenteritis


acute syndrome characterized by inflammation of the stomach and intestinal tract. Usually caused by a viral organism. Nausea, vomiting and diarrhea. Fever headache and abdominal cramps.Fever under 102 F. Minimal abdominal tenderness. Dehydrated with orthostatic hypotension "positive tilts"

Ulcers
 

 

Ulceration of the lining of the stomach or duodenum as a result of hyperacidity. Precipitated by stress, diet alcohol and coffee, drugs ASA etc., infection, with heredity playing a role also Epigastric distress 45 60 minutes after meals. Pain is frequently burning or gnawing in quality, and may be nocturnal becoming most severe between midnight and 0200 hrs. Pain is relieved by food or antacids. Epigastric tenderness Get a hemoccult ready

Constipation
defecation is delayed for days beyond the patients normal, or if the stools are unusually hard, dry, and difficult to move.  occasionally with abdominal distention or cramps. Usually no severe pain, nausea, vomiting or blood in stools  Minimal abdominal tenderness, usually LLQ


Hemorrhoids
mass of dialated, tortuous veins in the anal area  Caused by straining at stool, constipation prolonged sitting and a diet poor in fiber.  Itching, irritation and bleeding with bowel movements.  Prep patient, ask them to remove their bottoms and have an anoscope ready


Cholelithiasis


Nausea, vomiting, abdominal pain RUQ, and fever RUQ tenderness, may have jaundice 3 Fs!

 

Appendicitis: The most frequent cause of abdomen emergency

  

  

Initially anorexia and pain in the epigastric or periumbilical area of the abdomen. Nausea, diarrhea, and vomiting " may" accompany pain. The pain is moderately severe and after several hours moves to the RLQ and becomes sharper. Fever may be present. Fever if present usually below 101 F. Tenderness in epigastric area, but classically localized to the RLQ. Pain in the RLQ will increase on straight leg raising, or jarring of the right leg with heeltap.

PERFERATION
 

sudden severe pain Epigastric pain radiating to the Back

OBSTRUCTION
   

severe pain coming in waves Vomiting Elimination problems Bloating

Upper GI Bleeding
      

Chronic Renal Failure Esophagitis Duodenitis Pancreatitis Blood dyscrasias and hemostatic disorders Leukemias Thrombocytopenia associated disorders

Lower GI Bleeding


Anorectal Lesions Hemorrhoids, Fissures, Proctitis, Rectal trauma, Fistulas Colonic Lesions, Diverticular Disease, Angiodysplasias, UC, Crohn s disease, Ischemic colitis, Infectious colitis, Polyps, Carcinoma, Upper GI Site with rapid blood loss (usually PUD) tumors of Large and Small Bowel

22 y/o female c/o RLQ pain x 2d. Denies any N/V/D, but has had a fever (101 @ home) on and off. She has taken OTC pain relievers s relief. Cannot stretch out her legs. Hcg (neg) dip UA +sm. Leuks

49 y/o female c/o intermittent epigastric pain. Sxs worse after eating, taking OTC antacids s relief. Pain radiates to her L arm. Has a family hx of cholelithiasis ECG complete