Week 3 presentation

The Language Of
Medicine
10 edition
th

Davi-Ellen Chabner
Copyright © 2014, 2011, 2007 by Saunders, an imprint of Elsevier Inc.

1

Chapter 5
Digestive System


2

Chapter Goals
• Name the organs of the digestive system and
describe their locations and functions.
• Define combining forms for organs and know
the meaning of related terminology.
• Describe signs, symptoms, and disease
conditions affecting the digestive system.


3

Chapter 5
Lesson 5.1


4

Introduction
The digestive or gastrointestinal system
performs four main functions:
• ingestion
• digestion
• absorption
• elimination


5

Introduction:
Ingestion and Digestion
• Ingestion—food material taken into mouth

• Digestion—food is broken down, mechanically and
chemically, as it travels through the gastrointestinal
tract.
 Digestive enzymes aid the breakdown of complex nutrients.
•
•
•

Proteins → amino acids
Sugars → glucose
Fats
→ fatty acids or triglycerides


6

Introduction:
Absorption passes into the bloodstream through
• Digested food

Digested food passes into the bloodstream through
lining cells of the small intestine.

• Nutrients travel to all cells of the body.
• Cells burn nutrients to release the energy stored in
food.


7

Introduction:
Elimination
• The body eliminates solid waste materials that

The body eliminates solid waste materials that
cannot be absorbed into bloodstream.
• The large intestine concentrates feces.
• The wastes pass out of the body through the anus.


8

Organs of the Digestive System
• The gastrointestinal tract begins with the oral
cavity.


9

Oral Cavity
Major parts of the oral cavity


10

Oral Cavity (cont’d)
Major parts of the oral cavity


11

Upper permanent teeth within the dental arch

→


12

Upper permanent teeth within the dental arch


13

Anatomy of a tooth


14

Anatomy of a tooth


15

Salivary glands


16

Pharynx
Deglutition


17

Pharynx (cont’d)
Deglutition


18

Esophagus/Stomach
Parts of the stomach


19

Esophagus/Stomach (cont’d)
Parts of the stomach


20

The Digestive Tract


21

The Digestive Tract (cont’d)


22

Small Intestine
Villi in the lining of the small intestine


23

Large Intestine
Parts of the large intestine


24

Large Intestine (cont’d)
Parts of the large intestine


25

Liver, Gallbladder, and Pancreas
Parts of the liver, gallbladder, and pancreas


26

Liver, Gallbladder, and
Pancreas (cont’d)
Parts of the liver, gallbladder, and pancreas


27

(cont’d)
Besides producing bile, the liver:
• Helps maintain normal blood glucose levels
• Manufactures blood proteins necessary for clotting
• Releases bilirubin, a pigment in bile
• Removes toxins and poisons from the blood


28

QUICK QUIZ:

1. What happens if bilirubin cannot leave the
body and remains in the bloodstream?

A. Gluconeogenesis
B. Emulsification
C. Hyperbilirubinemia
D. Glycogenolysis


29

The pancreas and its functions


30

Food Pathway through the GI Tract
Food enters
through the oral
cavity and exits
through the anus


31

Food Pathway through the GI Tract
(cont’d)
Food enters
through the oral
cavity and exits
through the anus


32

QUICK QUIZ:

2. Which term is the first part of the large
intestine?

A. Cecum
B. Duodenum
C. Jejunum
D. Pylorus


33

QUICK QUIZ: (cont’d)

3. Which term means swallowing?

A. Mastication
B. Deglutition
C. Emulsification
D. Peristalsis


34

Vocabulary
• absorption

Passage of materials through the walls of
the small intestine into the bloodstream

Small building blocks of proteins;
• amino acids released when proteins are digested

• amylase

• anus

Enzyme secreted by the pancreas and
salivary glands to digest starch
Terminal end or opening of the digestive
tract to the outside of body


35

Vocabulary (cont’d)
• appendix

Blind pouch hanging from the cecum

• bile

Digestive juice made in the liver and stored
in the gallbladder; breaks up large fat
globules; composed of bile pigments,
cholesterol, and bile salts

• bilirubin
• bowel

Pigment released by the liver in bile
Intestine


36

• canine teeth

• cecum
• colon

• common
bile duct

Pointed, dog-like teeth next to the
incisors; also called cuspids or eyeteeth
First part of the large intestine
Consists of the ascending, transverse,
descending, and sigmoid segments
Carries bile from the liver and
gallbladder to the duodenum; also
called the choledochus


37

• defecation

Elimination of feces from the digestive
tract through the anus

• deglutition

Swallowing

• dentin

Primary material found in teeth; covered
by the enamel in the crown and a
protective layer of cementum in the root

• digestion

Breakdown of complex foods to simpler
forms

38

• duodenum

First part of the small intestine;
measures 12 inches long
Act of removal of materials from the
body

• elimination
• emulsification
• enamel

Physical process of breaking up large
fat globules into smaller globules
Hard, outermost layer of a tooth


39

• enzyme

Chemical that speeds up reactions
between substances; enzyme names end
in –ase

• esophagus

Tube connecting the throat to the
stomach

• fatty acids
Substances produced when fats are
digested; a category of lipids
• feces

Solid wastes; stool


40

• gallbladder

Small sac under the liver; stores
bile

• glucose

Simple sugar

• glycogen

Starch; glucose is stored in the form
of glycogen in liver cells

• hydrochloric acid

Substance produced by the
stomach; necessary for digestion of
food


41

• ileum

Third part of the small intestine

• incisor

One of four front teeth in the dental arch

• insulin

Hormone produced by endocrine cells of the
pancreas; transports sugar from the blood
into cells and stimulates glycogen formation
by the liver
Second part of the small intestine

• jejunum

42

Pancreatic enzyme needed to digest
fats

• lipase
• liver

Large organ located in the RUQ of the
abdomen; secretes bile; stores sugar,
iron, and vitamins; produces blood
proteins; destroys worn-out RBCs;
filters out toxins; normal adult liver
weighs about 2 ½ to 3 pounds

• lower esophageal
sphincter (LES)

Ring of muscles between the
esophagus and stomach; cardiac
sphincter


43

• mastication

Chewing

• molar teeth

Sixth, seventh, and eighth teeth from
the middle on either side of the dental
arch

• palate
• pancreas

Roof of the mouth
Organ under the stomach; produces
insulin and enzymes


44

• papillae (singular:
papilla)
• parotid gland
• peristalsis

Small, nipple-like elevations on the tongue

Salivary gland within the cheek, just
anterior to the ear
Rhythmic contractions of the tubular
organs

• pharynx
Throat, the common passageway for food
from the mouth and for air from the nose


45

• portal vein

Large vein bringing blood to the liver
from the intestines

• protease

Enzyme that digests protein

• pulp

Soft tissue within a tooth, containing
nerves and blood vessels

• pyloric sphincter

Ring of muscle at the end of the
stomach, near the duodenum; opens
when a wave of peristalsis passes over
it


46

• pylorus

Distal region of the stomach, opening to the
duodenum

• rectum

Last section of the large intestine, connecting
the end of the colon and the anus

• rugae

Ridges on the hard palate and the wall of the
stomach

• saliva

Digestive juice produced by salivary glands;
contains the enzyme amylase

47

• salivary glands

Parotid, sublingual, and submandibular
glands

• sigmoid colon

• sphincter

• stomach

Fourth and last, S-shaped segment of the
colon, just before the rectum; empties
into the rectum
Circular ring of muscle that constricts a
passage or closes a natural opening
Muscular organ that receives food from
the esophagus


48

• triglycerides

Fat molecules composed of three parts
fatty acids and one part glycerol;
subgroup of lipids
Soft tissue hanging from the middle of
the soft palate

• uvula

• villi (singular:
villus)

Microscopic projections in the wall of
the small intestine that absorb
nutrients into the bloodstream


49

Terminology – Combining Forms
Parts of the Body
Combining Form

•
•
•
•
•
•
•
•

an/o
append/o, appendic/o
bucc/o
cec/o
celi/o
cheil/o
cholecyst/o
choledoch/o

Meaning

anus
appendix
cheek
cecum
belly,abdomen
lip
gallbladder
common bile duct


50


Parts of the Body (cont’d)
Combining Form

Meaning

•
•
•
•
•
•
•
•
•

colon
colon
tooth
duodenum
intestines, usually small intestine
esophagus
face
stomach
gums

col/o
colon/o
dent/i
duoden/o
enter/o
esophag/o
faci/o
gastr/o
gingiv/o


51


Combining Form

•
•
•
•
•
•
•
•
•

Meaning

gloss/o
hepat/o
ile/o
ileum
jejun/o
labi/o
lapar/o
lingu/o
mandibul/o
odont/o

tongue
liver
jejunum
lip
abdomen
tongue
lower jaw, mandible
tooth


52


Combining Form

Meaning

•
•
•
•
•
•
•
•
•

mouth
palate
pancreas
peritoneum
throat
anus and rectum
pyloric sphincter
rectum
salivary gland

or/o
palat/o
pancreat/o
peritone/o
pharyng/o
proct/o
pylor/o
rect/o
sialaden/o


53


Combining Form

• sigmoid/o
• stomat/o
• uvul/o

Meaning

sigmoid colon
mouth
uvula


54


Substances
Combining Form

•
•
•
•
•
•
•

Meaning

amyl/o
starch
bil/i
gall, bile
bilirubin/o bilirubin (bile pigment)
chol/e
gall or bile
chlorhydr/o
hydrochloric acid
gluc/o
sugar
glyc/o
sugar


55


Substances (cont’d)
Combining Form

•
•
•
•
•
•
•

Meaning

glycogen/o glycogen, animal starch
lip/o
fat
lith/o
stone
prote/o
protein
py/o
pus
sial/o
saliva, salivary
steat/o
fat


56

Terminology – Suffixes
Suffix

• -ase
• -chezia
• -iasis
• -prandial

Meaning

enzyme
defecation, elimination of
wastes
abnormal condition
meal


57

Combining Forms, Suffixes,
and Terminology (cont’d)
Three types of anastomoses


58

QUICK QUIZ:

4. Which term means inflammation of the lip?

A. Cholecystitis
B. Celiac
C. Appendicitis
D. Cheilitis


59

Chapter 5
Lesson 5.2


60

Pathology
of the Digestive System
Signs and symptoms
• Anorexia – lack of appetite
• Ascites – abnormal accumulation of fluid in the
abdomen
• Borborygmus (plural: borborygmi) – rumbling or
gurgling noise produced by the movement of gas,
fluid, or both in the GI tract
• Constipation – difficulty in passing stools
• Diarrhea – frequent passage of loose, watery stools


61

Pathology
of the Digestive System (cont’d)
• Dysphagia – difficulty in swallowing
• Eructation – gas expelled from the stomach
through the mouth
• Flatus – gas expelled through the anus
• Hematochezia – passage of fresh, bright red
blood from the rectum
• Jaundice (icterus) – yellow-orange coloration
of the skin and whites of the eyes caused by
high levels of bilirubin in the blood

62

Pathology
of the Digestive System (cont’d)
• Melena – black, tarry stools; feces containing
digested blood
• Nausea – unpleasant sensation in the stomach
associated with a tendency to vomit
• Steatorrhea – fat in the feces; frothy, foulsmelling fecal matter


63

Pathologic Conditions
Oral Cavity and Teeth
• Aphthous stomatitis – inflammation of the
mouth with small, painful ulcers
• Dental caries – tooth decay
• Herpetic stomatitis – inflammation of the
mouth by infection with the herpes virus
• Oral leukoplakia – white plaques or patches
• Periodontal disease – inflammation and
degeneration of the gums, teeth and
surrounding bone

64

Upper Gastrointestinal Tract
• Achalasia – failure of the lower esophagus
sphincter (LES) muscle to relax


65

• Esophageal cancer – malignant tumor of the
esophagus
• Esophageal varices – swollen, varicose veins at
the lower end of the esophagus
• Gastric carcinoma – malignant tumor of the
stomach


66



67

Upper Gastrointestinal Tract (cont’d)
• Gastroesophageal reflux disease (GERD) –
solids and fluids return to the mouth from
the stomach
• Peptic ulcer – open sore or lesion of the
mucous membrane of the stomach or
duodenum


68

Upper Gastrointestinal Tract (cont’d)
• Hernia – protrusion of an organ or part
through the muscle normally containing it


69

Lower Gastrointestinal Tract
Small and Large Intestines

• Anal fistula – abnormal tube-like passageway
near the anus
• Colonic polyposis – polyps protrude from the
mucous membrane of the colon


70

Small and Large Intestines (cont’d)

• Colorectal cancer – adenocarcinoma of the colon
or rectum or both


71


• Crohn disease – chronic inflammation of
the intestinal tract
• Diverticulosis – abnormal side pockets
(outpouchings) in the intestinal wall


72


• Dysentery – painful, inflamed intestines
• Hemorrhoids – swollen, twisted, varicose veins in
the rectal region
• Ileus – failure of peristalsis with resulting
obstruction of the intestines
• Inflammatory bowel disease (IBD) – inflammation
of the colon and small intestine


73


• Intussusception – telescoping of the intestines
• IBS – irritable bowel syndrome – group of
gastrointestinal symptoms associated with stress
and tension
• Ulcerative colitis – chronic inflammation of the
colon with the presence of ulcers
• Volvulus – twisting of the intestines on itself


74

•
•
•
•

Cirrhosis – chronic degenerative disease of the liver
Pancreatic cancer – malignant tumor of the pancreas
Pancreatitis – inflammation of the pancreas
Viral hepatitis – inflammation of the liver caused by
a virus


75

Liver Gallbladder, and Pancreas (cont’d)
• Cholelithiasis – gallstones in the gallbladder


76

Suffixes
Suffix

•
•
•
•
•
•

Meaning

-ectasis, -ectasia __________
-emesis
__________
-pepsia
__________
-phagia
__________
-plasty
__________
-ptysis
__________


77

Suffixes
Suffix

•
•
•
•
•
•

Meaning

-ectasis, -ectasia dilation, widening
-emesis
vomiting
-pepsia
digestion
-phagia
eating, swallowing
-plasty
surgical repair
-ptysis
spitting


78

Suffixes (cont’d)
Suffix

•
•
•
•
•
•
•

Meaning

-rrhage, -rrhagia __________
-rrhaphy
__________
-rrhea
__________
-spasm
__________
-stasis
__________
-stenosis
__________
-tresia
__________


79

Suffixes (cont’d)
Suffix

Meaning

•
•
•
•

-rrhage, -rrhagia bursting forth (of blood)
-rrhaphy
suture
-rrhea
flow, discharge
-spasm
involuntary contraction
of muscles
• -stasis
stopping; controlling
• -stenosis
narrowing, tightening
• -tresia
opening


80

Suffixes (cont’d)
• Suffixes that are also used alone as separate
terms:
 Emesis (emetic)
 Spasm
 Stasis
 Stenosis


81

QUICK QUIZ:

1. Which term means difficulty in swallowing?

A. Dysphasia
B. Dysphagia
C. Dysplasia
D. Polyphagia


82

QUICK QUIZ: (cont’d)

2. Which term means to control or stop
bleeding?

A. Hemostasis
B. Hematoma
C. Hemoptysis
D. Cholestasis


83

Combining Forms
and Terminology
Combining Form
Meaning
•
•
•
•
•
•
•
•

bucc/o
__________
cec/o
__________
celi/o
__________
cheil/o
__________
chol/e
__________
cholangi/o __________
cholecyst/o
__________
choledoch/o
__________


84

Combining Forms
and Terminology
Combining Form
Meaning
•
•
•
•
•
•
•
•

bucc/o
cheek
cec/o
cecum
celi/o
abdomen
cheil/o
lip
chol/e
gall, bile
cholangi/o bile duct (vessel)
cholecyst/o
gallbladder
choledoch/o
common bile duct


85

Combining Forms and
Terminology (cont’d)
Combining Form

•
•
•
•
•
•
•
•

Meaning

col/o
__________
colon/o
__________
dent/i
__________
duoden/o __________
enter/o
__________
esophag/o __________
gastr/o
__________
gingiv/o
__________


86

Combining Forms and
Combining Form

•
•
•
•
•
•
•
•

Meaning

col/o
colon
colon/o
colon
dent/i
tooth
duoden/o duodenum
enter/o
intestines
esophag/o esophagus
gastr/o
stomach
gingiv/o
gums


87

Combining Forms and
Combining Form

•
•
•
•
•
•
•
•

gloss/o
gluc/o
glyc/o
hepat/o
herni/o
ile/o
jejun/o
labi/o

Meaning

__________
__________
__________
__________
__________
__________
__________
__________


88

Combining Forms and
Combining Form

Meaning

•
•
•
•
•
•
•
•

tongue
sugar
sugar
liver
hernia

gloss/o
gluc/o
glyc/o
hepat/o
herni/o
ile/o
jejun/o
labi/o

ileum
jejunum
lip


89

Combining Forms and
Combining Form
Meaning
•
•
•
•
•
•
•

lingu/o
__________
lip/o
__________
lith/o
__________
odont/o
__________
or/o
__________
palat/o
__________
pancreat/o __________


90

Combining Forms and
Combining Form
Meaning
•
•
•
•
•
•
•

lingu/o
tongue
lip/o
fat
lith/o
stone
odont/o
tooth
or/o
mouth
palat/o
palate
pancreat/o pancreas


91

Combining Forms and
Combining Form
Meaning
Combining Form

•
•
•
•
•
•
•

Meaning

proct/o
__________
pylor/o
__________
rect/o
__________
sialaden/o __________
splen/o
__________
steat/o
__________
stomat/o __________


92

Combining Forms and
Combining Form
Meaning
Combining Form

•
•
•
•
•
•
•

Meaning

proct/o
anus and rectum
pylor/o
pyloric sphincter
rect/o
rectum
sialaden/o salivary gland
splen/o
spleen
steat/o
fat
stomat/o mouth


93

QUICK QUIZ:

3. Which term means enlarged liver?

A. Acromegaly
B. Cardiomegaly
C. Hepatomegaly
D. Hepatitis


94

Laboratory Tests and
Clinical Procedures
• Laboratory tests
 Liver function tests (LFTs): tests for enzymes and
bilirubin in blood
 Stool culture: test for microorganisms in stool
 Stool guaiac test or Hemoccult test: test to detect
blood in feces


95

QUICK QUIZ:

4. Which of the following tests for the clear
fluid that remains after blood has clotted
(serum)?

A. Stool guaiac
B. Hemoccult
C. Stool culture
D. LFTs


96

Clinical Procedures
• Clinical procedures
 X-rays

• Lower gastrointestinal series
(barium enema)
• Upper gastrointestinal series
• Cholangiography
• Computed tomography (CT scan)


97

Clinical Procedures (cont’d)
• Clinical procedures
 Ultrasound examination

• Abdominal ultrasonography
• Endoscopic ultrasonography (EUS)

 Magnetic resonance techniques

• Magnetic resonance imaging (MRI)

 Nuclear medicine test

• Hepatobiliary iminodiacetic acid
scan (HIDA scan)

98

Clinical Procedures (cont’d)
• Other procedures

Gastric bypass or bariatric surgery: reduces
stomach size
Gastrointestinal endoscopy: visual
examination of the GI tract
Laparoscopy: visual examination of the
abdomen
Liver biopsy: removal of liver tissue for
microscopic examination
Nasogastric intubation: insertion of a tube
through the nose into the stomach
Paracentesis (abdominocentesis): puncture to
remove fluid from abdomen

99

QUICK QUIZ:

5. Which procedure is a surgical puncture to
remove fluid from the abdomen?

A. Laparoscopy
B. Laparotomy
C. Abdominectomy
D. Abdominocentesis


100

Abbreviations
•
•
•
•
•
•
•
•
•

alk phos
ALT, AST
BE
BM
BRBPR
CD
CT
EGD
ERCP

__________
__________
__________
__________
__________
__________
__________
__________
__________


101

Abbreviations
•
•
•
•
•
•
•
•
•

alk phos
ALT, AST
BE
BM
BRBPR
CD
CT
EGD
ERCP

Alkaline phosphatase
Alanine transaminase, aspartate transaminase
Barium enema
Bowel movement
Bright red blood per rectum
Celiac disease
Computed tomography
Esophagogastroduodenoscopy
Endoscopic retrograde
cholangiopancreatography

102

Abbreviations (cont’d)
•
•
•
•
•
•
•
•
•
•

EUS
FOBT
G tube
GB
GERD
GI
HBV
IBD
LAC
LFTs

__________
__________
__________
__________
__________
__________
__________
__________
__________
__________


103

•
•
•
•
•
•
•
•
•
•

EUS
FOBT
G tube
GB
GERD
GI
HBV
IBD
LAC
LFTs

Endoscopic ultrasonography
Fecal occult blood test
Gastrostomy tube; also stomach tube, PEG tube
Gallbladder
Gastroesophageal reflux disease
Gastrointestinal
Hepatitis B virus
Inflammatory bowel disease
Laparoscopic-assisted colectomy
Liver function tests


104

•
•
•
•
•
•
•
•
•

MRI
NG tube
NPO
PEG tube
PEJ tube
PTHC
PUD
TPN
T tube

__________
__________
__________
__________
__________
__________
__________
__________
__________


105

•
•
•
•
•
•
•
•
•

MRI
NG tube
NPO
PEG tube
PEJ tube
PTHC
PUD
TPN
T tube

Magnetic resonance imaging
Nasogastric tube
Nothing by mouth
Percutaneous endoscopic gastrostomy tube
Percutaneous endoscopic jejunostomy tube
Percutaneous transhepatic cholangiography
Peptic ulcer disease
Total parenteral nutrition
Tube placed in the bile duct for drainage into
a small pouch on the outside of the body


106

Review Suffixes
-ase
-centesis
-chezia
-ectasia
-ectasis
-ectomy
-emesis
-emia
-genesis

_____________
_____________
_____________
_____________
_____________
_____________
_____________
_____________
_____________

107

Review Suffixes (cont’d)
• -ase
• -centesis
fluid
• -chezia
wastes
• -ectasia
expansion
• -ectasis
expansion
• -ectomy
• -emesis

enzyme
surgical puncture to remove
defecation; elimination of
stretching; dilation;
stretching; dilation;
removal; excision; resection
vomiting


108

-graphy
-iasis
-lysis
-megaly
-orexia
-pathy
-pepsia
-phagia

_____________
_____________
_____________
_____________
_____________
_____________
_____________
_____________

109

• -graphy
• -iasis
• -lysis
• -megaly
• -orexia
• -pathy
• -pepsia
• -phagia

process of recording
abnormal condition
breakdown; separation;
destruction; loosening
enlargement
appetite
disease; emotion
digestion
eating; swallowing

110

-prandial
-plasty
-ptosis
-ptysis
-rrhage
-rrhagia
-rrhaphy
-rrhea

_____________
_____________
_____________
_____________
_____________
_____________
_____________
_____________

111


•
•
•
•
•
•
•
•

-prandial
-plasty
-ptosis
-ptysis
-rrhage
-rrhagia
-rrhaphy
-rrhea

meal
surgical repair
droop; sag; prolapse; fall
spitting
bursting forth (of blood)
bursting forth (of blood)
suture
flow; discharge

112

-scopy
-spasm
-stasis
-stenosis
-stomy
-tomy
-tresia

_____________
_____________
_____________
_____________
_____________
_____________
_____________


113

• -scopy
• -spasm
• -stasis
• -stenosis
• -stomy
mouth)
• -tomy
• -tresia

visual examination
sudden contraction of muscles
stop; control; place
tightening; stricture
new opening (to form a
process of cutting
opening


114

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