Chapter Five
DIGESTIVE SYSTEM
Copyright © 2012 by Mosby, an imprint of Elsevier Inc.
Digestive System
Word Parts
 Gastrointestinal (GI) system or tract
 Alimentary canal
Gastr/o = stomach
Intestin/o = intestine
aliment/o = nutrition
Be Careful! The
combining form
gastr/o refers only
to the stomach.
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2
Did You Know?
 The alimentary canal acquires its name from the
Latin term alimentum, which refers to food or
nourishment. Its influence is currently seen in
contemporary words, such as adult, meaning grown
up or nourished, alimony, meaning an allowance for
sustenance, and alma mater, meaning a nourishing
mother.
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3
Functions
Ingestion
Digestion
Absorption
Elimination
• Intake of food
• Physical and chemical breakdown
of food
• Extraction of nutrients
• Excretion of waste products
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4
General Description of the GI System: The Route
Through the Body
 Route
 Oral cavity
 Mediastinal cavity
 Abdominopelvic cavity

Peritoneal cavity
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Word Parts
sub- = under
viscer/o = organ,
viscera
General Description of the
Digestive System: Layers
 Tunics/Coats


peri- = surrounding

-stalsis = contraction

Tunica mucosa
Submucosa
Tunica muscularis
Serosa:
Visceral peritoneum
 Adventitia

 Mesentery
 Peristalsis
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Wall of the Gastrointestinal Tract
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Review Question
 Which process of the GI system refers to the
breakdown of food?
A.
B.
C.
D.
ingestion
digestion
absorption
elimination
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8
Word Parts
or/o, stom/o, stomat/o
= mouth, oral cavity
Oral Cavity
 Mastication, deglutition
 Lips

labi/o, cheil/o = lip
dent/i, odont/o = teeth
cusp/o = point
bi- = two
in- = in
cis/o = to cut
mol/o = molar


Vermilion
borders
Frenulum
Philtrum
 Teeth
 Incisors and cuspids
 Bicuspids and molars
Be Careful! Don’t confuse stom/o
and stomat/o, meaning mouth or
oral cavity with stomach.
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Word Parts
amel/o = enamel
alveol/o = small cavity,
alveolus
dent/i = tooth
-in = substance
The Tooth in Detail
 Enamel
 Dentin
 Cementum
 Pulp
 Crown
 Alveolar ridge
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Word Parts
bucc/o = cheek
Oral Cavity
 Cheeks
 Mucous glands
Muc/o = mucus

Mol/o = molar,
grinding

Labi/o = lip
gloss/o, lingu/o =
tongue
palat/o = palate
uvul/o = uvula


Buccal
Molar
Labial
Palatine
 Tongue
 Papillae
 Taste buds
 Palate
 Hard and soft
 Uvula
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Word Parts
maxill/o = upper jaw
mandibul/o = lower
jaw
Oral Cavity
 Maxilla
 Mandible
 Gums
dent/i, odont/o = teeth
gingiv/o = gums
peri- = surrounding
sialoaden/o = salivary
gland
sial/o, ptyal/o = saliva
par- = near
Sub- = under
 Salivary glands and saliva
 Parotid
 Sublingual
 Submandibular
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Word Parts
pharyng/o = pharynx,
throat
nas/o = nose
Throat and Esophagus
 Pharynx



Nasopharynx
Oropharynx
Hypopharynx
or/o = mouth
hypo- = below, under
esophag/o = esophagus
 Esophagus
 Bolus
 Lower esophageal sphincter (LES)/
cardiac sphincter/
gastroesophageal sphincter
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Did You Know?
 A sphincter is a ringlike muscle: sphincters appear in
other parts of the body as well, for example, in the
urinary system and the eye.
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Review Question
 The parotid gland is a salivary gland located:
A. under the tongue
B. under the jaw
C. near the ear
D. around the teeth
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Word Parts
periotone/o =
peritoneum
Peritoneum
 Peritoneum


Visceral
Parietal
retro- = behind
 Retroperitoneum
oment/o, epiplo/o =
omentum
 Mesentery
 Mesoappendix
 Mesocolon
 Ligaments
 Folds
 Greater and lesser sacs
 Epiploic foramen
 Omenta: greater and lesser
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Word Parts
gastr/o = stomach
cardi/o = heart
fund/o = fundus
corpor/o = body
pylor/o = pylorus
The Stomach
 Cardia
 Fundus
 Body
 Pylorus
 Rugae
 Chyme
The stomach
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Word Parts
enter/o = small
intestines
duoden/o = duodenum
jejun/o = jejunum
ile/o = ileum
plic/o = fold, plica
vill/o = villus
-ase = enzyme
Small Intestine
 Duodenum
 Jejunum
 Ileum
 Plicae
 Villi

Lacteals
 Enzymes
Small intestines
From Mosby’s dictionary, ed 8, Mosby
Be Careful! Don’t confuse ileum with ilium
(part of the hip).
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Review Question
 The cardiac sphincter is the same as the:
A. lower esophageal sphincter
B. gastroesophageal sphincter
C. pyloric sphincter
D. A&B
E. all of the above
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Word Parts
Large Intestine
 Cecum


Ileocecal sphincter
Vermiform appendix
col/o, colon/o = large
intestine, colon
 Ascending colon
cec/o = cecum
 Transverse colon
append/o, appendic/o
= appendix
 Descending colon
fec/a = feces
 Rectum
sigmoid/o = sigmoid
colon
rect/o = rectum
an/o = anus
proct/o = rectum and
anus
 Sigmoid colon
 Anus

Internal and external sphincters
 Proct/o is for anus and rectum
 Defecation

Feces, bowel movement: BM
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Be Careful!
 gastr/o vs. abdomin/o, lapar/o, and celi/o
Gastr/o refers only to the stomach, while abdomen/o, lapar/o, and celi/o refer to
the abdomen.
 -cele vs. celi/o
Don’t confuse –cele, the suffix meaning herniation with celi/o, a combining form
for abdomen.
 an/o vs. ana- vs. anAn/o is the combining form for anus; ana-, the prefix meaning up or apart; and
an-, the prefix meaning no, not, or without.
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Word Parts
adnex/o = accessory
hepat/o = liver
Accessory Organs: Adnexa
 Liver
 Gallbladder
 Pancreas
cholecyst/o = gallbladder
pancreat/o = pancreas
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Word Parts
lob/o = lobe
chol/e, bil/i = bile
choledoch/o = common
bile duct/
The Liver
 Location/lobes

Right, left, quadrate, caudate
 The liver functions to produce bile
 Bile serves to emulsify fats


Bile is composed of bilirubin and
cholesterol
Bile in liver  bile ducts  hepatic
duct  joins with cystic duct from the
gallbladder to form the common bile
duct  empties bile into the duodenum
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Anterior and Posterior View of Liver
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Word Parts
chol/e, bil/i = bile
cholesterol/o =
cholesterol =
choledoch/o = common
bile duct
cholangi/o = bile vessel
Gallbladder
 Location/description
 Stores bile from the liver
 Role of cholecystokinin in bile
secretion
 Cystic duct
 Common bile duct
cholecyst/o =
gallbladder
-kinin = movement
substance
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Word Parts
pancreat/o = pancreas
Pancreas
 Location
 Exocrine function of the
pancreas is key in the
digestion of:

Carbohydrates, proteins, lipids
 Pancreatic enzymes enter the
duodenum through the pancreatic
duct that empties into the common
bile duct
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Review Question
 A combining form for the gallbladder is:
A. choledoch/o
B. cholecyst/o
C. cholangi/o
D. hepat/o
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Symptoms and Signs Involving the Digestive System
and Abdomen (R10-R19)
 Halitosis
 Eructation
 Flatulence
 Ascites
 Nausea
 Vomiting
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Word Parts
dys- = difficult, bad
-phagia = condition of
swallowing, eating
hepat/o = liver
Symptoms and Signs Involving
the Digestive System and
Abdomen (R10-R19)
 Dysphagia
 Hepatomegaly
 Jaundice
-megaly = enlargement
pyr/o = fire
-osis = abnormal
condition
 Pyrosis
 Gastralgia
dia- = difficult, bad
-rrhea = discharge, flow
 Diarrhea
Jaundice
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Did You Know?
 Nausea derives its name from the Greek word for
seasickness. Notice the similarity between the words
nausea and nautical.
 Heartburn is a misnomer. This burning sensation is
experienced in the chest near the heart, not the heart itself.
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Word Parts
ankyl/o = stiffening
gloss/o = tongue
Congenital Conditions (Q00Q99)
 Anklyoglossia
 Esophageal atresia
-ia = condition
esophag/o = esophagus
-eal = pertaining to
a- = no, not, without
-tresia = condition of an
opening
Esophageal atresia
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Word Parts
gastr/o = stomach
-schisis = split
omphal/o = umbilicus
Congenital Conditions (Q00Q99)
 Gastroschisis
 Omphalocele
 Pyloric stenosis
-cele = herniation,
protrusion
pylor/o = pylorus
-ic = pertaining to
stenosis = narrowing
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Congenital Conditions (Q00-Q99)
 Cleft palate
 Hirschsprung’s disease
Cleft palate and lip
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Review Question
 The medical term/word part for “no opening” is:
A. stenosis
B. atresia
C. -schisis
D. ankyl/o
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Word Parts
amel/o = enamel
-genesis = production,
origin
an- = no, no, without
Diseases of Oral Cavity and
Salivary Glands (K00-K14)
 Amelogenesis imperfecta
 Anodontia

Edentulous
odont/o = teeth
-ia = condition
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Word Parts
aphth/o = ulceration
-ous = pertaining to
Diseases of Oral Cavity and
Salivary Glands (K00-K14)
 Aphthous stomatitis
 Cheilitis
stomat/o = mouth
-itis = inflammation
cheil/o = lip
Aphthous stomatitis
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Word Parts
gingiv/o = gums
-itis = inflammation
gloss/o = tongue
Diseases of Oral Cavity and
Salivary Glands (K00-K14)
 Dental caries
 Gingivitis
 Periodontal disease
 Glossitis
Gingivitis
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Word Parts
mucos/o = mucus
-itis = inflammation
leuk/o = white
-plakia = condition of
patches
ptyal/o = saliva
-ism = condition
sialoaden/o = salivary
gland
Diseases of Oral Cavity and
Salivary Glands (K00-K14)
 Oral mucositis
 Oral leukoplakia
 Ptyalism
 Sialoadenitis
 Sialolithiasis
sial/o = saliva
lith/o = stone
-iasis = presence of,
condition
Oral leukoplakia
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Review Question
 Ptyalism is a condition of:
A. the saliva
B. the gallbladder
C. the esophagus
D. the gums
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Word Parts
a- = without
-chalasia = condition of
relaxation
dys- = abnormal, bad
-pepsia = digestion
condition
gastr/o = stomach
esophag/o = esphagus
-eal = pertaining to
Diseases of Esophagus,
Stomach, and Duodenum
(K20-K31)
 Achalasia
 Dyspepsia
 Esophagitis
 Gastroesophageal
reflux disease
(GERD)

Barrett’s esophagus
GERD
re- = back
-flux = flow
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Diseases of Esophagus, Stomach, and
Duodenum (K20-K31)
 Gastritis
 Peptic ulcer disease (PUD)
Chronic peptic ulcer
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Diseases of the Appendix (K35-K38)
 Appendicitis
 Peritonitis
 Acute vs. chronic
Be Careful! Don’t confuse peritone/o, which means the membrane that
lines the abdominal cavity, with perone/o, which is a combining form for
the fibula; and perine/o, which means the space between the anus and
external reproductive organs.
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Hernias (K40-K46)
 Complications
 Incarcerated hernia



Irreducible
Strangulated hernia
Gangrene
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Hernias (K40-K46)
 Umbilical hernia (omphalocele)
 Femoral (crural) hernia
 Hiatal hernia (diaphragmatocele)
 Inguinal hernia
 Ventral hernia
Umbilical hernia
Hiatal hernia
From Zitelli: Atlas of pediatric physical diagnosis, ed 4, Mosby
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Noninfective Enteritis and Colitis (K50-K52)
 Colitis
 Inflammatory bowel disease (IBD)
 Crohn’s disease (regional or granulomatous enteritis)
 Ulcerative colitis
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Other Diseases of the Intestines (K55-K63)
 Anal fissure
 Anorectal abscess
 Anorectal fistula
 Constipation
 Obstipation
Anorectal fistula
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Other Diseases of the Intestines (K55-K63)
 Ileus
 Intussusception
 Volvulus
 Irritable bowel
syndrome (IBS)
A. Intussusception, B. Volvulus
From Damjanov: Pathology for the health professions, ed 3, Saunders
Intussusception
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Word Parts
diverticul/o =
diverticulum
Other Diseases of the
Intestines (K55-K63)
 Diverticulitis
 Diverticulosis
-itis = inflammation
-osis = abnormal
condition
Diverticulosis
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Word Parts
proct/o = rectum and
anus
-itis = inflammation
-ptosis = drooping,
prolapse
Other Diseases of the
Intestines (K55-K63)
 Polyp of colon
 Proctitis
 Proctoptosis
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Review Question
 A twisting of the intestines:
A. anastomosis
B. paralytic ileus
C. intussusception
D. volvulus
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Review Question
 A hiatal hernia is the same as a/n:
A. omphalocele
B. diaphragmatocele
C. crural hernia
D. inguinal hernia
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Word Parts
cirrh/o = orange-yellow
-osis = abnormal
condition
peritone/o =
peritoneum
Diseases of Peritoneum and
Retroperitoneum (K65K68) and Diseases of Liver
(K70-K77)
 Cirrhosis
 Peritonitis
-itis = inflammation
Normal liver
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Cirrhosis of the liver
52
Special Note
 Liver disease often requires additional codes like
alcoholic liver diseases that need codes to describe
alcohol abuse and dependence. Toxic liver disease
requires a code to identify what type of drug or toxic
agent caused the disease.
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cholang/o = bile vessel
Diseases of Gallbladder,
Biliary Tract, and
Pancreas (K80-K87)
-itis = inflammation
 Cholangitis
Word Parts
cholecyst/o =
gallbladder
choledoch/o = common
bile duct
-lith/o = stone
-iasis = presence of
 Cholecystitis
 Choledocholithiasis
 Cholelithiasis
 Pancreatitis
chol/e = bile
pancreat/o = pancreas
Cholelithiasis
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Review Question
 Which of the following disorders involves the
presence of stones?
A.
B.
C.
D.
cholangitis
cholecystitis
choledocholithiasis
cirrhosis
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Word Parts
celi/o = abdomen
hemat/o = blood
-emesis = vomiting
Other Diseases of Digestive
System (K90-K94)
 Celiac disease (celiac sprue)
 Hematemesis
 Melena
melan/o = black, dark
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Word Parts
stomat/o = mouth
-itis = inflammation
hepat/o = liver
Viral Infections
Characterized by Skin and
Mucous Membranes (B00B09) and Viral Hepatitis
(B15-B19)
 Herpetic stomatitis (cold sore,
fever blister)
 Hepatitis



Hepatitis A (HAV)
Hepatitis B (HBV)
Hepatitis C (HCV)
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Word Parts
cyst/o = cyst
Benign Neoplasms (D10-D36)
 Cystadenoma
 Odontogenic tumor
aden/o = gland
-oma = tumor, mass
odont/o = teeth
-genic = pertaining to
produced by
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Benign Neoplasms (D10-D36)
 Polyps, adenomatous or hyperplastic
 Sessile versus pedunculated
Adenomatous polyps
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Word Parts
aden/o = gland
-carcinoma = cancerous
tumor of epithelial
origin
hepat/o = liver
Malignant Neoplasms (C00C96)
 Adenocarcinoma
 Hepatocellular
carcinoma/hepatoma
 Squamous cell
carcinoma
cellul/o = cell
-ar = pertaining to
squam/o = scaly
-ous = pertaining to
Adenocarcinoma of the esophagus
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Review Question
 Which of the following tumors begins in the teeth?
A. odontogenic
B. leiomyoma
C. cystadenoma
D. hemangioma
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Laboratory Tests
 Gamma-glutamyl transferase (GGT)
 Stool culture
 Stool guaiac/hemoccult test
 Total bilirubin
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Laboratory Tests
 Albumin
 Alkaline phosphatase (ALP)
 Alanine transaminase (ALT)
 Aspartate transaminase (AST)
 Gastric analysis
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Laboratory Tests
 Hepatitis-associated antigen (HAA)
 Liver function tests (LFTs)
 Prothrombin time (PT)
 Rapid urease test
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Review Question
 Which diagnostic procedure would be used to
determine if blood was present in the stool?
A.
B.
C.
D.
total bilirubin
stool guaiac
manometry
fluoroscopy
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Word Parts
fren/o , frenul/o =
frenulum
-tomy = cutting
esophag/o = esophagus
-stomy = making a new
opening
Upper GI Procedures
 Barium swallow
 Frentomy, frenulotomy
 Esophagoesophagostomy
 Fundoplication,
gastroesophageal
fund/o = fundus
-plication = folding
 Gingivectomy
gingiv/o = gums
-ectomy = cutting out
Barium swallow
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Word Parts
gastr/o = stomach
duoden/o = duodenum
-stomy = making a new
opening
-plasty = surgically
forming
hyper- = excessive
aliment/o = nutrition
Upper GI Procedures
 Gastroduodenostomy
 Gastroplasty
 Gastrostomy

Percutaneous endoscopic gastrostomy
(PEG)
 Hyperalimentation
 Pyloromyotomy
-ation = process of
pylor/o = pylorus
my/o = myscle
-tomy = cutting
Gastroduodenostomy
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Procedures
 anastomoses vs. -stomy
 Definition of anastomosis
 Rules for building terms for anastomoses
 Terms using a single structure with “-stomy”
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Word Parts
gloss/o = tongue
-rrhaphy = suturing
odont/o = teeth
-ectomy = cutting out
palat/o = palate
-plasty = surgically
forming
Upper GI Procedures
 Glossorrhaphy
 Odontectomy
 Palatoplasty
 Sialodochoplasty
 Stomatoplasty
 Uvulectomy
sialodoch/o = salivary
duct
stomat/o = mouth
uvul/o = uvula
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Guideline Alert
 Bypass procedures are coded by identifying the body
part bypassed “from” and the body part bypassed
“to”. The fourth character body part specifies the
body part bypassed from, and the qualifier specifies
the body part bypassed to.
Example: Bypass from stomach to jejunum,
stomach is the body part and jejunum is the
qualifier.
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PCS Guideline Alert
 PCS contains specific body parts for anatomical
subdivisions of a body part, such as lobes of the
lungs or liver and regions of the intestines.
Resection of the specific body part is coded whenever
all of the body part is cut out or off, rather than
coding Excision of a less specific body part.
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Review Question
 A sialoadenectomy is a cutting out of:
A. a salivary gland
B. the gums
C. the roof of the mouth
D. a tooth
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Word Parts
append/o = appendix
-ectomy = cutting out
cec/o = cecum
-pexy = suspension
colon/o = colon
-scopy = viewing
Lower GI Procedures
 Appendectomy
 Barium enema
 Cecopexy
 Colonoscopy
 Colostomy

Stoma
col/o = colon
-stomy = making a new
opening
Colostomy and stoma
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Word Parts
diverticul/o =
diverticulum
Lower GI Procedures
 Diverticulectomy
 Enteral nutrition
 Herniorrhaphy
-ectomy = cutting out
enter/o = small intestine
-al = pertaining to
herni/o = hernia
-rrhaphy = suturing
Enteral nutrition
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Word Parts
ile/o = ileum
ureter/o = ureter
-stomy = making a new
opening
jejun/o = jejunum
Lower GI Procedures
 Ileoureterostomy
 Jejunostomy
 Omentectomy, omentumectomy
 Peritoneocentesis
 Polypectomy, GI
oment/o = omentum
-tomy = cutting
-ectomy = cutting out
peritone/o =
peritoneum
-centesis = surgical
puncture
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Word Parts
proct/o = rectum and
anus
-clysis = washing
-scopy = viewing
Lower GI Procedures
 Proctoclysis
 Proctoscopy
 Sigmoidoscopy
 Total parenteral nutrition (TPN)
sigmoid/o = sigmoid
colon
par- = near, beside
enter/o = small
intestine
-al = pertaining to
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Review Question
 Surgical puncture of fluid from the abdominal cavity
is:
A.
B.
C.
D.
peritoneocentesis
ileoureterostomy
TPN
cecopexy
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Procedures of the Adnexa
 Cholangiography
 Cholecystectomy
 Choledochectomy
 Choledocholithotomy
Laparoscopic cholecystectomy
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Word Parts
cholangi/o = bile vessel
pancreat/o = pancreas
-graphy = recording
Procedures of the Adnexa
 Endoscopic retrograde
cholangiopancreatography
(ERCP)
 Hepatectomy
hepat/o = liver
-ectomy = cutting out
ERCP
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Review Question
 What does the suffix –lithotomy indicate in a
choledocholithotomy?
A.
B.
C.
D.
folding
Cutting out a stone
washing
making a new opening
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Suffixes and Root Operations for the Digestive
System
 -centesis
 -ectomy
 -lithotomy
 -pexy
 -plasty
 -plication
 -rrhaphy
 -scopy
 -stomy
 -tomy
drainage
excision, resection
extirpation
repair, reposition
repair, supplement, replacement
restriction
repair, supplement
inspection
bypass, drainage
drainage, release, division
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Sort these terms into their correct categories
Terms
1. esophagoesophagostomy
2. peristalsis
3. stool guaiac
4. diverticulitis
5. hepatitis
Categories
__ A + P
__ Pathology
__ Procedures
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