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6. Digestive System. Lecture Notes. Classroom Activity to Accompany Medical Terminology Systems, Sixth Edition Barbara A. Gylys ∙ Mary Ellen Wedding. 6. DIGESTIVE SYSTEM. Structure. Oral cavity Teeth Salivary glands Pharynx Esophagus Stomach Small intestine Large intestine. 6.

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Lecture Notes

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Lecture notes

6

Digestive System

Lecture Notes

Classroom Activity to Accompany Medical Terminology Systems, Sixth Edition

Barbara A. Gylys ∙Mary Ellen Wedding


Lecture notes

6

DIGESTIVE SYSTEM

Structure

  • Oral cavity

    • Teeth

    • Salivary glands

  • Pharynx

  • Esophagus

  • Stomach

  • Small intestine

  • Large intestine


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DIGESTIVE SYSTEM

Structure

  • Accessory organs

    • Liver

    • Gallbladder

    • Pancreas


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DIGESTIVE SYSTEM

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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DIGESTIVE SYSTEM

Structure and Function Exercise

Q: 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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DIGESTIVE SYSTEM

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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6

DIGESTIVE SYSTEM

Appendicitis

Signs 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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DIGESTIVE SYSTEM

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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DIGESTIVE SYSTEM

Appendicitis

Treatment

  • 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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DIGESTIVE SYSTEM

Clinically Related Exercise

Q: 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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DIGESTIVE SYSTEM

Clinically Related Exercise

(continued)

Q: Dr. G charts removal of the appendix as an __________________.

A: appendectomy

Q: 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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DIGESTIVE SYSTEM

Diverticulitis

Signs and Symptoms

  • Acute inflammation of diverticula


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DIGESTIVE SYSTEM

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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DIGESTIVE SYSTEM

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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6

DIGESTIVE SYSTEM

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: diverticula

Q: The nurse charts the Mr. J’s complaint of extreme constipation as ________________.

A: obstipation

Q: 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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DIGESTIVE SYSTEM

Cholelithiasis

Signs and Symptoms

  • Cholelithiasis and choledocholithiasis

    • Formation or presence of gallstones within the gallbladder or bile ducts.


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DIGESTIVE SYSTEM

Cholelithiasis

Signs 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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DIGESTIVE SYSTEM

Cholelithiasis

Treatment

  • 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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6

DIGESTIVE SYSTEM

Cholelithiasis

Treatment (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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6

DIGESTIVE SYSTEM

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: cholecystolithiasis

Q: 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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6

DIGESTIVE SYSTEM

Medical Vocabulary

  • ascites

  • borborygmus

  • dysentery

  • dyspepsia

  • dysphagia

  • enterologist

  • esophagogastroduodenoscopy


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DIGESTIVE SYSTEM

Medical Vocabulary

(continued)

  • hyperemesis

  • jaundice

  • laparoscopic

  • proctologist

  • ptyalism

  • sublingual

  • volvulus


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DIGESTIVE SYSTEM

Diagnostic Procedures

  • Endoscopy

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


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DIGESTIVE SYSTEM

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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6

DIGESTIVE SYSTEM

Diagnostic Procedures

(continued)

  • Barium enema (BE)

  • Barium swallow

  • Magnetic resonance imaging (MRI)

  • Ultrasound (US)


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DIGESTIVE SYSTEM

Word Building Exercise

Q: Visual examination of the sigmoid colon:

A: sigmoidoscopy

Q: Instrument for examining interior organs and cavities:

A: endoscope

Q: Visual examination of the colon:

A: colonoscopy

Q: Visual examination of within interior organs and cavities:

A: endoscopy

Q: Visual examination of the rectosigmoid colon:

A: proctosigmoidoscopy


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6

DIGESTIVE SYSTEM

Medical and Surgical Procedures

  • Bariatric surgery

    • A. Vertical banded gastroplasty


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6

DIGESTIVE SYSTEM

Medical and Surgical Procedures

(continued)

  • Bariatric surgery

    • B. Roux-en-Y gastric bypass

      (RGB)


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6

DIGESTIVE SYSTEM

Medical and Surgical Procedures

(continued)

  • Colostomy

    • Creation of an opening into the colon (through the surface of the abdomen).


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DIGESTIVE SYSTEM

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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DIGESTIVE SYSTEM

Medical and Surgical Procedures

(continued)

  • Polypectomy

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


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DIGESTIVE SYSTEM

Clinically Related Exercise

Q: 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: colostomy

Q: Dr. Jones discovers polyps during a colonoscopy. What surgical procedure does the doctor perform to remove the polyps?

A: polypectomy

Q: 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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DIGESTIVE SYSTEM

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: RGB

Q: 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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6

DIGESTIVE SYSTEM

Pharmacology

  • Antacids

  • Antidiarrheals

  • Antiemetics

  • Laxatives


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6

DIGESTIVE SYSTEM

Clinically Related Exercise

Q: 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: antiemetic

Q: 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: antidiarrheal

Q: A patient diagnosed with excessive stomach acid is treated with a/an (antacid, laxative, antiemetic).

A: antacid


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