Chapter 12: The Digestive System Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter Objectives Function of the digestive system. Digestive tract, functions of each part. Accessory organs and their role in digestion. Roots pertaining to the digestive system. Major disorders of the digestive system. Medical terms used in reference to the digestive system. Abbreviations used in referring to the gastrointestinal system. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Term Normal Structure and Function anus The distal opening of the digestive tract (root: an/o) appendix An appendage; usually means the narrow tube of lymphatic tissue attached to the cecum, the vermiform (wormlike) appendix bile The fluid secreted by the liver that emulsified fats and aids in their absorption (roots: chol/e, bili) cecum A blind pouch at the beginning of the large intestine (root: cec/o) colon The major portion of the large intestine; extends from the cecum to the rectum and is formed by ascending, transverse, and descending portions (root: col/o, colon/o) common bile duct The duct that carries bile into the duodenum; formed by the union of the cystic duct and the common hepatic duct (root: choledoch/o) duodenum The first portion of the small intestine (root: duoden/o) enzyme An organic catalyst; speeds the rate of chemical reactions Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Normal Structure and Function (cont’d) esophagus The muscular tube that carries food from the pharynx to the stomach. feces The waste material eliminated from the intestine (adjective: fecal); stool gallbladder A sac on the undersurface of the liver that stores bile (root: cholecyst/o) hepatic portal system A special pathway of the circulation that brings blood directly from the abdominal organs to the liver for processing (also called simply the portal system). The vessel that enters the liver is the hepatic portal vein (portal vein). ileum The terminal portion of the small intestine (root: ile/o) intestine The portion of the digestive tract between the stomach and the anus. It consists of the small intestine and large intestine. It functions in digestion, absorption, and elimination of waste (root: enter/o). The bowel (BOW-el) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Normal Structure and Function (cont’d) jejunum The middle portion of the small intestine (root: jejun/o) lacteal A lymphatic capillary in a villus of the small intestine. Lacteals absorb digested fats into the lymph large intestine The terminal portion of the digestive tract, consisting of the cecum, colon, rectum, and anus. It stores and eliminates undigested waste material (feces) liver The large gland in the upper right part of the abdomen. In addition to many other functions, it secretes bile needed for digestion and absorption of fats (root: hepat/o) lower esophageal sphincter (LES) Muscle tissue at the distal end of the esophagus (gastroesophageal junction) that prevents stomach contents from refluxing into the esophagus. Also called the cardiac sphincter mastication Chewing mouth The oral cavity; contains the tongue and teeth. Used to take in and chew food, mix it with saliva, and move it toward the throat to be swallowed Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Normal Structure and Function (cont’d) palate The roof of the mouth; the partition between the mouth and nasal cavity; consists of an anterior portion formed by bone, the hard palate, and a posterior portion formed of tissue, the soft palate (root: palat/o) pancreas A large, elongated gland behind the stomach. It produces hormones that regulate sugar metabolism and also produces digestive enzymes (root: pancreat/o) peristalsis Wavelike contractions of an organ's walls; moves material through an organ or duct pharynx The throat; a common passageway for food entering the esophagus and air entering the larynx (root: pharyng/o) pylorus The stomach's distal opening into the duodenum. The opening is controlled by a ring of muscle, the pyloric sphincter (root: pylor/o) rectum The distal portion of the large intestine. It stores and eliminates undigested waste (root: rect/o, proct/o) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Normal Structure and Function (cont’d) saliva The clear secretion released into the mouth that moistens food and contains a starch-digesting enzyme (root: sial/o). Saliva is produced by three pairs of glands: the parotid, submandibular, and sublingual glands sigmoid colon Distal S-shaped portion of the large intestine located between the descending colon and the rectum small intestine The portion of the intestine between the stomach and the large intestine; comprised of the duodenum, jejunum, and ileum. Accessory organs secrete into the small intestine, and almost all digestion and absorption occur there stomach A muscular saclike organ below the diaphragm that stores food and secretes juices that digest proteins (root: gastr/o) uvula The fleshy mass that hangs from the soft palate; aids in speech production (literally “little grape”) (root: uvul/o) villi Tiny projections in the lining of the small intestine that absorb digested foods into the circulation (singular: villus) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Disorders appendicitis Inflammation of the appendix ascites Accumulation of fluid in the abdominal cavity; a form of edema. May be caused by heart disease, lymphatic or venous obstruction, cirrhosis, or changes in plasma composition. biliary colic Acute abdominal pain caused by gallstones in the bile ducts bilirubin A pigment released in the breakdown of hemoglobin from red blood cells; mainly excreted by the liver in bile caries Tooth decay celiac disease Inability to absorb foods containing gluten, a protein found in wheat and some other grains; caused by an excess immune response to gluten cholecystitis Inflammation of the gallbladder cholelithiasis The condition of having stones in the gallbladder; also used to refer to stones in the common bile duct Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Disorders (cont’d) cirrhosis Chronic liver disease with degeneration of liver tissue Crohn disease A chronic inflammatory disease of the gastrointestinal tract usually involving the ileum and colon diarrhea The frequent passage of watery bowel movements diverticulitis Inflammation of diverticula (small pouches) in the wall of the digestive tract, especially in the colon diverticulosis The presence of diverticula, especially in the colon dysphagia Difficulty in swallowing emesis Vomiting fistula An abnormal passageway between two organs or from an organ to the body surface, such as between the rectum and anus (anorectal fistula) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Disorders (cont’d) gastroenteritis Inflammation of the stomach and intestine gastroesophageal reflux disease (GERD) Condition caused by reflux of gastric juices into the esophagus resulting in heartburn, regurgitation, inflammation, and possible damage to the esophagus; caused by weakness of the lower esophageal sphincter (LES) heartburn A warm or burning sensation felt behind the sternum and radiating upward. Commonly associated with gastroesophageal reflux. Medical name is pyrosis (pyr/o means “heat”) hemorrhoids Varicose veins in the rectum associated with pain, bleeding, and sometimes prolapse of the rectum hepatitis Inflammation of the liver; commonly caused by a viral infection hepatomegaly Enlargement of the liver hiatal hernia A protrusion of the stomach through the opening (hiatus) in the diaphragm through which the esophagus passes Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Disorders (cont’d) icterus Jaundice ileus Intestinal obstruction. May be caused by lack of peristalsis (adynamic, paralytic ileus) or by contraction (dynamic ileus). Intestinal matter and gas may be relieved by insertion of a drainage tube intussusception Slipping of one part of the intestine into another part below it. Occurs mainly in male infants in the ileocecal region). May be fatal if untreated for more than 1 day jaundice A yellowish color of the skin, mucous membranes, and whites of the eye caused by bile pigments in the blood (from French jaune meaning “yellow”). The main pigment is bilirubin, a byproduct of erythrocyte destruction leukoplakia White patches on mucous membranes, as on the tongue or cheeks, often resulting from smoking or other irritants; may be precancerous nausea An unpleasant sensation in the upper abdomen that often precedes vomiting. Typically occurs in digestive upset, motion sickness, and sometimes early pregnancy Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Disorders (cont’d) occult blood Blood present in such small amounts that it can be detected only microscopically or chemically; in the feces, a sign of intestinal bleeding (occult means “hidden”) pancreatitis Inflammation of the pancreas peptic ulcer A lesion in the mucous membrane of the esophagus, stomach, or duodenum caused by the action of gastric juice peritonitis Inflammation of the peritoneum, the membrane that lines the abdominal cavity and covers the abdominal organs. May result from perforation of an ulcer, rupture of the appendix, or infection of the reproductive tract, among other causes. polyp A tumor that grows on a stalk and bleeds easily Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Disorders (cont’d) portal hypertension An abnormal pressure increase in the hepatic portal system. May be caused by cirrhosis, infection, thrombosis, or tumors pyloric stenosis Narrowing of the opening between the stomach and the duodenum; pylorostenosis regurgitation A backward flowing, such as the backflow of undigested food splenomegaly Enlargement of the spleen ulcerative colitis Chronic ulceration of the rectum and colon; the cause is unknown, but may involve autoimmunity volvulus Twisting of the intestine resulting in obstruction. Usually involves the sigmoid colon and occurs most often in children and in the elderly. May be caused by congenital malformation, a foreign body, or adhesion. Failure to treat immediately may result in death Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Diagnosis and Treatment anastomosis A passage or communication between two vessels or organs. May be normal or pathologic, or may be created surgically barium study Use of barium sulfate as a liquid contrast medium for fluoroscopic or radiographic study of the digestive tract. Can show obstruction, tumors, ulcers, hiatal hernia, and motility disorders, among other things cholecystectomy Surgical removal of the gallbladder Dukes classification A system for staging colorectal cancer based on degree of penetration of the bowel wall and lymph node involvement; severity is graded from A to C endoscopy Use of a fiberoptic endoscope for direct visual examination. GI studies include esophagogastroduodenoscopy, proctosigmoidoscopy (rectum and distal colon), and colonoscopy (all regions of the colon) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Key Terms Diagnosis and Treatment (cont’d) ERCP Endoscopic retrograde cholangiopancreatography; a technique for viewing the pancreatic and bile ducts and for performing certain techniques to relieve obstructions. Contrast medium is injected into the biliary system from the duodenum and radiographs are taken ostomy An opening into the body; generally refers to an opening created for elimination of body waste. Also refers to the operation done to create such an opening (see stoma). stoma A surgically created opening to the body surface or between two organs (literally “mouth”) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary terms Normal Structure and Function bolus A mass, such as the rounded mass of food that is swallowed cardia The part of the stomach near the esophagus, named for its closeness to the heart chyme The semiliquid partially digested food that moves from the stomach into the small intestine defecation The evacuation of feces from the rectum deglutition Swallowing duodenal bulb The part of the duodenum near the pylorus; the first bend (flexure) of the duodenum duodenal papilla The raised area where the common bile duct and pancreatic duct enter the duodenum; papilla of Vater (FA-ter) greater omentum A fold of the peritoneum that extends from the stomach over the abdominal organs hepatic flexure The right bend of the colon, forming the junction between the ascending colon and the transverse colon Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Normal Structure and Function (cont’d) ileocecal valve A valvelike structure between the ileum of the small intestine and the cecum of the large intestine mesentery The portion of the peritoneum that folds over and supports the intestine mesocolon The portion of the peritoneum that folds over and supports the colon papilla of Vater See duodenal papilla peritoneum The serous membrane that lines the abdominal cavity and supports the abdominal organs rugae The large folds in the lining of the stomach seen when the stomach is empty sphincter of Oddi The ring of muscle at the opening of the common bile duct into the duodenum splenic flexure The left bend of the colon, forming the junction between the transverse colon and the descending colon Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Disorders achalasia Failure of a smooth muscle to relax, especially the lower esophageal sphincter, so that food is retained in the esophagus achlorhydria Lack of hydrochloric acid in the stomach; opposite is hyperchlorhydria anorexia Loss of appetite. Anorexia nervosa is a psychologically induced refusal or inability to eat (adjectives: anorectic, anorexic) aphagia Refusal or inability to eat; inability to swallow or difficulty in swallowing aphthous ulcer An ulcer in a mucous membrane, as in the mouth Barrett syndrome Lower esophageal ulcer resulting from chronic esophagitis, often with constriction caused by mucosal changes; may be premalignant. Also called Barrett esophagus bruxism Clenching and grinding of the teeth, usually during sleep bulimia Excessive, insatiable appetite. A disorder characterized by overeating followed by induced vomiting, diarrhea, or fasting Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Disorders (cont’d) cachexia Profound ill health, malnutrition, and wasting cheilosis Cracking at the corners of the mouth, often caused by B vitamin deficiency (root cheil/o means “lip”) cholestasis Stoppage of bile flow constipation Infrequency or difficulty in defecation and the passage of hard, dry feces dyspepsia Poor or painful digestion eructation Belching familial adenomatous polyposis (FAP) A heredity condition in which multiple polyps form in the colon and rectum, predisposing to colorectal cancer flatulence Condition of having gas or air in the GI tract Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Disorders (cont’d) flatus Gas or air in the gastrointestinal tract; gas or air expelled through the anus hematemesis Vomiting of blood irritable bowel syndrome (IBS) A chronic stress-related disease characterized by diarrhea, constipation, and pain associated with rhythmic contractions of the intestine. Mucous colitis; spastic colon. megacolon An extremely dilated colon. Usually congenital but may occur in acute ulcerative colitis. melena Black tarry feces resulting from blood in the intestines. Common in newborns. May also be a sign of gastrointestinal bleeding. obstipation Extreme constipation pernicious anemia A form of anemia caused by the stomach’s failure to secrete intrinsic factor, a substance needed for the absorption of vitamin B12 Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Disorders (cont’d) pilonidal cyst A dermal cyst in the sacral region, usually at the top of the cleft between the buttocks. May become infected and begin to drain. thrush Fungal infection of the mouth and/or throat caused by Candida; appears as mucosal white patches or ulcers Vincent disease Severe gingivitis with necrosis associated with the bacterium Treponema vincentii; necrotizing ulcerative gingivitis; trench mouth Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Diagnosis and Treatment appendectomy Surgical removal of the appendix bariatrics The branch of medicine concerned with prevention and control of obesity and associated diseases (from Greek baros, meaning “weight”) Billroth operations Gastrectomy with anastomosis of the stomach to the duodenum (Billroth I) or to the jejunum (Billroth II) gastric bypass surgery Division of the stomach and anastomosis of its upper part to the small intestine (jejunum) to reduce nutrient absorption; used to treat morbid obesity. Other surgical methods are used for this purpose, including partition of the stomach with rows of staples (gastric stapling) gavage Process of feeding through a nasogastric tube into the stomach lavage Washing out of a cavity; irrigation manometry Measurement of pressure; pertaining to the GI tract, measurement of pressure in the portal system as a sign of obstruction Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Diagnosis and Treatment (cont’d) Murphy sign Inability to take a deep breath when fingers are pressed firmly below the right arch of the ribs (below the liver). Signifies gallbladder disease. nasogastric (NG) tube Tube that is passed through the nose into the stomach. May be used for emptying the stomach, administering medication, giving liquids, or sampling stomach contents. parenteral hyperalimentation Complete intravenous feeding for one who cannot take in food. Total parenteral nutrition (TPN). Tube inserted into the stomach for long-term feeding percutaneous endoscopic gastrostomy (PEG) tube vagotomy Interruption of impulses from the vagus nerve to reduce stomach secretions in the treatment of gastric ulcer. Originally done surgically but may also be done with drugs. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Drugs antacid Agent that counteracts acidity, usually gastric acidity antidiarrheal Treats or prevents diarrhea by reducing intestinal motility or absorbing irritants and soothing the intestinal lining antiemetic Agent that relieves or prevents nausea and vomiting antiflatulent Agent that prevents or relieves flatulence antispasmodic Agent that relieves spasm, usually of smooth muscle emetic An agent that causes vomiting Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Supplementary Terms Drugs (cont’d) histamine H2 antagonist Drug that decreases secretion of stomach acid by interfering with the action of histamine at H2 receptors. Used to treat ulcers and other gastrointestinal problems. H2-receptor-blocking agent laxative Promotes elimination from the large intestine. Types include stimulants, substances that retain water (hyperosmotics), stool softeners, and bulk-forming agents proton-pump inhibitor (PPI) Agent that inhibits secretion of stomach acid by blocking the transport of hydrogen ions (protons) into the stomach. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Abbreviations BE Barium enema (for radiographic study of the colon) BM Bowel movement CBD Common bile duct ERCP Endoscopic retrograde cholangiopancreatography FAP Familial adenomatous polyposis GERD Gastroesophageal reflux disease GI Gastrointestinal HAV Hepatitis A virus HBV Hepatitis B virus HCV Hepatitis C virus HDV Hepatitis D virus Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Abbreviations (cont’d) HEV Hepatitis E virus HCl Hydrochloric acid IBD Inflammatory bowel disease IBS Irritable bowel syndrome LES Lower esophageal sphincter NG Nasogastric (tube) N&V Nausea and vomiting N/V/D Nausea, vomiting, and diarrhea PONV Postoperative nausea and vomiting PPI Proton pump inhibitor TPN Total parenteral nutrition UGI Upper gastrointestinal (radiograph series) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Digestion • Prepares food for cellular intake – Nutrients must be small enough to be absorbed – Nutrients broken down by mechanical and chemical means • Occurs in digestive tract • Food moved by peristalsis Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Digestive System Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins The Mouth to the Stomach • Digestion begins in mouth – Mastication breaks up food – Tongue, lips, cheek, and palate break up food and mix in saliva – Moistened food passed: • Into pharynx → through esophagus →into stomach • Churning of stomach further breaks down food by: – Mixing with enzyme pepsin and HCl Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins The Mouth Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Roots for the Mouth Root Meaning Example Definition of Example bucc/o cheek buccoversion turning toward the cheek dent/o, dent/i tooth, teeth edentulous without teeth odont/o tooth, teeth periodontics dental specialty that deals with the study and treatment of the tissues around the teeth gingiv/o gum (gingiva) gingivectomy excision of gum tissue gloss/o tongue glossoplegia paralysis (-plegia) of the tongue lingu/o tongue orolingual pertaining to the mouth and tongue Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Roots for the Mouth (cont’d) Root Meaning Example Definition of Example gnath/o jaw prognathous having a projecting jaw labi/o lip labium lip or liplike structure or/o mouth circumoral around the mouth stoma, stomat/o mouth xerostomia dryness (xero-) of the mouth palat/o palate palatine pertaining to the palate (also palatal) sial/o saliva, salivary gland, salivary duct sialogram radiograph of the salivary glands and ducts uvul/o uvula uvulotome instrument (-tome) for incising the uvula Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Roots for the Digestive Tract (Except for the Mouth) Root Meaning Example Definition of Example esophag/o esophagus esophageal* pertaining to the esophagus gastr/o stomach gastroparesis partial paralysis (paresis) of the stomach pylor/o pylorus pyloroplasty plastic repair of the pylorus enter/o intestine dysentery infectious disease of the intestine duoden/o duodenum duodenostomy surgical creation of an opening into the duodenum * Note addition of e before –al. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Roots for the Digestive Tract (Except for the Mouth) Root Meaning Example Definition of Example jejun/o jejunum jejunectomy excision of the jejunum ile/o ileum ileitis inflammation of the ileum cec/o cecum cecoptosis downward displacement of the cecum col/o, colon/o colon coloclysis irrigation (-clysis) of the colon sigmoid/o sigmoid colon sigmoidoscope an endoscope for examining the sigmoid colon rect/o rectum rectocele hernia of the rectum proct/o rectum proctopexy surgical fixation of the rectum an/o anus perianal around the anus Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins The Small Intestine • Partially digested food passes through pylorus into duodenum • Digestion completed after passing through other parts of small intestine (jejunum and ileum) • Digested nutrients absorbed into circulation – Aided by villi Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins The Large Intestine • Undigested food, water, digestive juices • Begins with cecum • Colon twists and turns: – Ascending colon – Transverse colon – Descending colon • Water reabsorbed, feces formed • Waste material passes into sigmoid colon • Waste stored in rectum; eliminated through anus Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Accessory Organs • Salivary glands – Secretes enzyme that begins digestion of starch • Liver – Secretes bile to break down fats • Gallbladder – Bile stored here until needed • Pancreas – Produces mixture of digestive enzymes Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Accessory Organs Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Roots for the Accessory Organs Root Meaning Example Definition of Example hepat/o liver hepatocyte a liver cell bili bile biliary pertaining to the bile or bile ducts chol/e, chol/o bile, gall cholestasis stoppage of bile flow cholecyst/o gallbladder cholecystogram radiograph of the gallbladder cholangi/o bile duct cholangioma cancer of the bile ducts choledoch/o common bile duct choledochal pertaining to the common bile duct pancreat/o pancreas pancreatotropic acting on the pancreas Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Clinical Aspects of the Digestive System • Infection – Can be caused by variety of organisms • Ulcers – Lesion of skin or mucous membrane – Marked by inflammation or tissue damage – Can be diagnosed by: • Endoscopy • Barium study (Radiography with contrast medium) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Cancer • Colon and rectum most likely affected area • Risk factors: – Diet low in fiber, high in fat – Heredity – Chronic inflammation of colon (colitis) • Polyps often become cancerous • Symptom: bleeding into intestine Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Cancer (cont’d) • Internal observations performed with endoscopes • Treatment may require surgical removal of portion of GI tract – May create a stoma for waste elimination – Surgery is called –ostomy, with root named for involved organ (e.g. colostomy) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Obstructions • Hernia – Protrusion of organ through abnormal opening • Pyloric stenosis – Opening between stomach and small intestine too narrow • Intussusception – Slipping of part of intestine into part below Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Obstructions (cont’d) • Volvulus – Intestinal twisting • Ileus – Intestinal obstruction caused by lack of peristalsis • Hemorrhoids – Varicose veins in the rectum Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Gastroesophageal Reflux Disease • Reflux of gastric juices caused by weakness at gastroesophageal junction • Heartburn likely to occur after meals, when lying down, with hiatal hernia, and pregnancy • Treatment: – Weight loss – Elevate head – Avoidance of irritating foods – Drugs – Surgery Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Inflammatory Intestinal Disease • Crohn disease – Chronic inflammation of intestinal wall segments, usually ileum – May causes, pain, diarrhea, abscess, formation of fistula • Ulcerative colitis – Continuous inflammation of colon lining, usually rectum Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Inflammatory Intestinal Disease (cont’d) • Celiac disease – Inability to absorb gluten • Diverticulitis – Many small pouches in wall of intestine – Attributed to diet low in fiber – If pouches collect waste and bacteria, leads to diverticulitis – Treated with diet improvement, stool softeners, drugs to reduce motility Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Hepatitis • Inflammation of the liver • More than six types of viral infections – Hepatitis A • Spread by fecal-oral contamination – Hepatitis B • Spread by blood and other body fluids – Hepatitis C • Spread through blood or close contact to infected person Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Hepatitis (cont’d) – Hepatitis D • Highly pathogenic, only affects those with Hepatitis B – Hepatitis E • Spread by contaminated food and water – Hepatitis G • Spread through contact with blood of infected person – Vaccines available for Hepatitis A and B Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Cirrhosis • Chronic liver disease mainly caused by excess consumption of alcohol • Characterized by: – Hepatomegaly – Edema – Ascites – Jaundice • As it progresses: – Splenomegaly – Internal bleeding – Brain damage Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Gallstones • Cholecystitis – Inflammation of gallbladder • Cholelithiasis – Presence of stones in gallbladder – Usually associated with cholecystitis Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Gallstones (cont’d) • Diagnosed by: – Ultrasonography – Radiography – Endoscopic retrograde cholangiopancreatography • Treatment may involve: – Drugs to dissolve stones – Cholecystectomy Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pancreatitis • Inflammation of pancreas • May result from: – Alcohol abuse – Drug toxicity – Bile obstruction – Infections – Other causes • Disease often subsides with only treatment of symptoms Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 1. An organic catalyst is a(n): (a) sugar (b) nucleic acid (c) saliva (d) enzyme Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 1. An organic catalyst is a(n): (a) sugar (b) nucleic acid (c) saliva (d) enzyme Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 2. The organ that carries food from the pharynx to the stomach is the: (a) trachea (b) larynx (c) esophagus (d) intestine Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 2. The organ that carries food from the pharynx to the stomach is the: (a) trachea (b) larynx (c) esophagus (d) intestine Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 3. The word root for the stomach is: (a) gastr/o (b) hepat/o (c) ren/o (d) cardi/o Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 3. The word root for the stomach is: (a) gastr/o (b) hepat/o (c) ren/o (d) cardi/o Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 4. The main portion of the large intestine is the: (a) stomach (b) appendix (c) colon (d) rectum Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 4. The main portion of the large intestine is the: (a) stomach (b) appendix (c) colon (d) rectum Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 5. The word root enter/o refers to the: (a) intestine (b) heart (c) kidney (d) gallbladder Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 5. The word root enter/o refers to the: (a) intestine (b) heart (c) kidney (d) gallbladder Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 6. The wavelike action that moves substances through an organ is called: (a) pulmonary (b) peristalsis (c) parotid (d) mastication Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 6. The wavelike action that moves substances through an organ is called: (a) pulmonary (b) peristalsis (c) parotid (d) mastication Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 7. The process of moving digested nutrients from the intestine into the circulation is called: (a) digestion (b) egestion (c) absorption (d) lymphedema Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 7. The process of moving digested nutrients from the intestine into the circulation is called: (a) digestion (b) egestion (c) absorption (d) lymphedema Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 8. The organ that secretes bile is the: (a) kidney (b) spleen (c) liver (d) stomach Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 8. The organ that secretes bile is the: (a) kidney (b) spleen (c) liver (d) stomach Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 9. Cholecystitis is inflammation of the: (a) gallbladder (b) throat (c) diaphragm (d) small intestine Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pretest 9. Cholecystitis is inflammation of the: (a) gallbladder (b) throat (c) diaphragm (d) small intestine Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins