Chapter 5 Notes Digestive System

CHAPTER 5 Chapter 5 is titled “Digestive System” in The Language of Medicine textbook. Introduction: Starting with the introduction section, I just want to remind you from anatomy that the GI tract or digestive system has 4 different functions including ingestion, digestion, absorption, and elimination. Anatomy & Physiology: Oral Cavity   You want to review your anatomy beginning with the oral cavity, and be mindful what the combining forms are for each of the body parts o For example, the cheeks, the combining form is bucc/o o Lips have 2 combining forms cheil/o and labi/o o The hard palate and the soft palate, palat/o o Rugae are ridges in the hard palate o The uvula is soft tissue that hangs from the hard palate o Gloss/o and lingu/o are combing forms for tongue o Mastication means chewing o Deglutition means swallowing o Papillae are the small raised areas on the tongue, and that is plural, remember papilla is singular, papillae is plural, the “a” becomes “ae” o Tonsil/o means tonsils o Gingiv/o is the combining form for gums o Dent/i means teeth There is a diagram in your textbook that shows the upper permanent teeth within the dental arch. o You need to know each of the teeth with the median line being in the center of the 2 front teeth, and if we work our way from the front to the back, the two front teeth are referred to as the central incisor, this makes sense because central, they are right in the center of the dental arch, then to the side of the central incisor, side also known as lateral, is your lateral incisor, the third tooth from the median line is referred to as the canine, it’s the pointed tooth. o The fourth tooth is the first pre-molar, pre meaning before, so it is before the molar o Then your second pre-molar, then your first molar, your second molar, and your third molar which is also referred to as your wisdom tooth Pharynx  The pharynx is also referred to as the throat, which serves as a passageway for air traveling from the nose to the trachea and for food traveling from the mouth to the esophagus o When swallowing occurs, a flap of tissue called the epiglottis covers the trachea so food cannot enter and become lodged there o The epiglottis opens as the bolus moves down the esophagus o So our epiglottis knows when to open and close to the trachea and the esophagus o So if we were breathing, not eating or drinking, the epiglottis is open to our trachea to allow air into our lungs to breathe o The minute we would start to drink or eat something, the epiglottis would open so the food could enter the esophagus o So sometimes when our epiglottis gets confused when you actually choke Esophagus  Again reviewing your anatomy and physiology, we go from the esophagus, which is a tube that extends from the pharynx to the stomach o The medical term peristalsis is the involuntary, rhythmic contraction of muscles in the wall of the esophagus that propels food down toward the stomach o It is involuntary, meaning we don’t think about it, it just happens Stomach  In regards to the stomach, you need to know the 3 parts of the stomach o There is a diagram in your textbook that shows the different parts of the stomach o The upper portion of the stomach is called the fundus o The middle portion is called the body, and the lower portion is called the antrum o You can correlate this with the 3 parts of the uterus, the upper portion of the uterus was called the fundus, the middle portion of the uterus is not called the body, but a word that means body, the corpus, and the lower portion of the uterus which actually becomes narrow or neck like is the cervix. So just some similarities there  The medical term sphincter is a ring of muscles o We have sphincters throughout our body o So here you have a sphincter at both ends, proximal and distal, of the stomach o The proximal sphincter is called the lower esophageal sphincter or LES, and that is between the esophagus and the stomach o The distal sphincter is called the pyloric sphincter because it is between the pylorus in the stomach Small Intestine   We then move from the stomach to the small intestine, and you want to remember the 3 parts of the small intestine, and I just remember DJI, duodenum, jejunum, and ileum in that order. o So the first part of the small intestine is the duodenum o The second part of the small intestine is the jejunum o And the third part of the small intestine is the ileum, and that is ileum with an “e” and the way I remember this is I think of my combing form enter/o which means small intestine, and ileum with an “e” is the small intestine. Ilium with an “I” is part of your pelvic bon Part of our digestive system includes the gallbladder, pancreas, and liver, although we don’t have food going through the gallbladder, pancreas, and liver, they do secrete substances that help us with the digestion of food Large Intestine  Beyond the small intestine we have the large intestine, or the large bowel, or the colon, and it has 3 major components: the cecum, the colon, and the rectum o The cecum is on the right side and connects to the ileum at a sphincter called the ileocecal valve o The appendix hangs from the cecum on the right side o Then we have the ascending colon which means it is going up, then the transverse colon which trans- means across, and the descending colon which means it is going down o Then we have the sigmoid colon because it is shaped like a “S”, and then we have the rectum, and then the terminal end of the GI tract is the anus o We refer to stools as feces, and the term defecation is the expulsion or passage of feces from the body through the anus Liver, Gallbladder, and Pancreas    The liver is located in the right upper quadrant of the abdomen, and the liver manufactures a substance called bile Then you have the gallbladder, and the combining form for gallbladder is cholecyst/o, and then we have the pancreas, which secretes pancreatic juices and pancreat/o is the combining form for pancreas In your textbook, there is a great visual diagram of the pathway of food through the GI tract o So you can see starting with the oral cavity, then the pharynx, esophagus, stomach, then the duodenum where you have contribution of bile and enzymes from the pancreas, liver, and gallbladder, then the 3 parts of the small intestine DJI duodenum, jejunum, and ileum, and then the cecum, ascending colon, transverse colon, descending colon, sigmoid colon, rectum, and lastly the anus o You should recall the pathway of food in the digestive tract from anatomy. Vocabulary: We are going to skip some of the vocabulary terms in this chapter. That’s why it is important review these notes so you don’t study the entire chapter. If I don’t mention it in these notes, it will not be on an exam. You may want to highlight the terms in your textbook as I go through the vocabulary at this point. You do not need to know the terms I skip over.                            Absorption Anus Appendix Bile Bilirubin Bowel Canine teeth Cecum Colon Common Bile Duct Defecation Deglutition Esophagus Feces Gallbladder Ileum Incisor Insulin Jejunum Lipase Liver Lower Esophageal Sphincter (LES) Mastication Molar teeth Palate Pancreas Papillae   Peristalsis Pharynx   Pyloric sphincter Pylorus        Rectum Rugae Saliva Sigmoid colon Sphincter Stomach Uvula Combining Forms – Parts of the Body: For the terminology regarding the combining forms for the parts of the body for the digestive system, you need to know all of them listed in your textbook:              an/o means anus append/o and appendic/o mean appendix bucc/o means cheek cec/o means cecum celi/o means belly, abdomen o In previous chapters we covered abdomin/o and lapar/o both means abdomen cheil/o means lip o We will learn later in this chapter that labi/o also means lip cholecyst/o means gallbladder o chol/e means bile or gall and cyst/o means bladder, so gallbladder o We learned previously cyst/o means urinary bladder, but in this case it is not referring to urinary bladder, it is just bladder, and along with chol/e it is gall bladder, so cholecyst/o is gallbladder. o If someone had their gallbladder removed it would be a cholecystectomy choledoch/o means common bile duct o chol/e means gall or bile, in this case it is referring to bile, and doch/o means common duct, so choledoch/o is common bile duct o For example, choledochotomy, now this is not removal of the common bile duct, because it would have to be –ectomy, so –otomy is just making an incision or the process of cutting into the common bile duct, but not removing it col/o means colon o Now the term colostomy, -ostomy is creating an artificial mouth or opening, what you are doing here is removing a section of the colon and reconnecting the two ends, and creating a different opening to the outside of the body, that is a stoma or opening colon/o means colon dent/i means tooth  We will learn later that odont/o also means tooth duoden/o means duodenum enter/o means intestines, usually small intestine                          o Your textbook has a diagram of different types of anastomoses o It shows examples of how we can reconnect these new openings throughout the body o An end to end, shows you the two ends are connected. o An end to side shows that the end of one connected to the side of another o Or a side to side shows that the side of one is connected to the side of another esophag/o means esophagus faci/o means face gastr/o means stomach gingiv/o means gums gloss/o means tongue hepat/o means liver ile/o means ileum jejun/o means jejunum labi/o means lip lapar/o means abdomen o So we have learned 3 combining forms for abdomen: celi/o, abdomin/o and lapar/o lingu/o means tongue mandibul/o means lower jaw; mandible odont/o means tooth o We previously learned that dent/i also means tooth or/o means mouth palat/o means palate pancreat/o means pancreas peritone/o means peritoneum pharyng/o means throat proct/o means anus and rectum o Note proct/o does not mean anus, that is an/o o Proct/o does not mean rectum, that’s recto/o o Proct/o means both anus and rectum. Be cautious about that. pylor/o means pyloric sphincter rect/o means recturm sialaden/o means salivary gland o aden/o is gland, sial/o is salivary, so salivary gland sigmoid/o means sigmoid colon stomat/o means mouth uvul/o means the uvula Combining Form – Substances: For the terminology regarding the combining forms for substances pertaining to the digestive system, you need to know all of them listed in your textbook:     amyl/o means starch bil/i means gall, bile bilirubin/o means bilirubin chol/e means gall or bile depending on how it is use o You have the medical term cholelithiasis, -iasis is abnormal condition, lith/o is a stone, chol/e means gal, so cholelithiasis is an abnormal condition of stones in the gallbladder     chlorhydr/o means hydrochloric acid gluc/o and glyc/o which both mean sugar glycogen/o means glycogen, animal starch lip/o means fat o Remember we already learned steat/o and adip/o also mean fat lith/o means stone prote/o means protein py/o means pus sial/o means saliva, salivary steat/o means fat o Remember we already learned lip/o and adip/o also mean fat      Suffixes: For the terminology regarding the suffixes for the digestive system, you need to know all of them listed in your textbook:     -ase means enzyme -chezia means defecation, elimination of wastes o For example, hematochezia, -chezia is elimination of waste and hemat/o is blood, so bright red blood in the feces -iasis means an abnormal condition o So choledocholithiasis is abnormal condition of stones in the common bile duct -prandial means meal Pathology of the Digestive System: In regards to pathology of the digestive system, I will go over the terms you need to know. You need to know the definition of the terms in bold to the right, you do not have to know all the detail unless I specifically list it. Signs and Symptoms In regards to the signs and symptoms of the digestive system, you need to know the following terms:  Anorexia, that means lack of appetite. The term anorexia nervosa it is lack of appetite, but because we have the term nervosa, it is associated with emotional problems.             Ascites is an abnormal accumulation of fluid in the abdomen. You don’t have to know any of the other information in the paragraph below, just the bolded definition Borborygmus is rumbling or gurgling noises produced by the movement of gas, fluid, or both in the gastrointestinal tract Constipation is difficulty passing stools Diarrhea is frequent passage of loose, watery stools Dysphagia is difficulty in swallowing Eructation produces a sound and it is also called belching, so you could say the medical term for belching is eructation Flatus is gas expelled through the anus, and flatulence is the presence of gas in the stomach and the intestines Hematochezia you want to remember that it is bright red blood, when you have bright red blood coming out of the rectum, you can assume the blood is coming from the terminal end of the colon o If the blood is dark red, it is coming from up higher in the digestive track because it has been digested. Jaundice or icterus, it means the same thing as jaundice Malena is the term used when feces contain blood, but it is not bright red. So hematochezia is bright red blood, melena is black dark tarry stools Nausea is unpleasant sensation in the stomach with a tendency to vomit Steatorrhea is fat in the feces Pathologic Conditions: In regards to pathologic conditions of the digestive system, I will go over the terms you need to know. You need to know the definition of the terms in bold to the right, you do not have to know all the detail unless I specifically list it. Oral Cavity and Teeth In regards to pathologic conditions of the oral cavity and teeth, you need to know the following terms:  Aphthous stomatitis is an inflammation of the mouth with small painful ulcers, the ulcers are associated with a condition called canker sores. Dental caries is the medical term for tooth decay or rotten teeth Herpetic stomatitis, so stomatitis is inflammation of the mouth that is caused by the herpes virus. You will find blisters that are referred to as fever blisters or cold sores Oral leukoplakia is white plaques or patches on the mucosa of the mouth  Periodontal disease is inflammation and degeneration of gums, teeth, and surrounding bone    Upper Gastrointestinal Tract In regards to pathologic conditions of the upper gastrointestinal tract, you need to know the following terms:  Achalasia is failure of the lower esophageal sphincter (LES) muscle to relax Esophageal cancer is malignant tumor of the esophagus Esophageal varices are swollen, varicose veins at the lower end of the esophagus Gastric cancer is a malignant tumor of the stomach GERD which stands for gastroesophageal reflux disease, which is when solids and fluids return to the mouth from the stomach Hernia is a protrusion of an organ or part through the tissue and muscles normally containing it  Peptic ulcer is an open sore in the lining of the stomach or duodenum      Lower Gastrointestinal Tract In regards to pathologic conditions of the lower gastrointestinal tract including the small and large intestines, you need to know the following terms:              Anal fistula is an abnormal tube-like passageway near the anus Colonic polyps are polyps that protrude from the mucous membrane of the colon Colorectal cancer is adenocarcinoma of the colon or rectum, or both Crohn disease: o Crohn’s disease is an example of an eponym. This is a disease, diagnosis, procedure, or surgery that was named after a person. It’s a person’s first or last name. o It is chronic inflammation of the intestinal tract Diverticulosis is an abnormal outpunching in the intestinal wall of the colon Dysentery is painful inflammation of the intestines commonly caused by a bacterial infection Hemorrhoids are swollen, twisted, varicose veins in the rectal region. Ileus is loss of peristalsis with resulting obstruction of the intestines Inflammatory bowel disease. o (And you also want to make sure you know these abbreviations because on an exam I could have you tell me what does the abbreviation IBD stand for, and in this case it is inflammatory bowel disease) o (Also remember that on your second, third, fourth, and fifth exams, you will be tested on spelling, so you want to be mindful of the correct spelling of these terms as you are going through them) o IBD is inflammation of the colon and small intestine Intussusception is telescoping of the intestines Irritable Bowel Syndrome (also known as IBS) is a group of GI symptoms that include abdominal pain, bloating, diarrhea, and constipation, but without defined abnormalities in the intestines Ulcerative colitis is a chronic inflammation of the colon with presences of ulcers Volvulus is twisting of the intestine on itself Liver, Gallbladder, and Pancreas In regards to pathologic conditions of the liver, gallbladder, and pancreas, you need to know the following terms:      Cholelithiasis is gallstones in the gallbladder Cirrhosis is a chronic degenerative disease of the liver Pancreatic cancer is a malignant tumor of the pancreas. Pancreatitis is inflammation of the pancreas Viral hepatitis is inflammation of the liver caused by a virus. This concludes the material for this chapter. Again I want to encourage you to work through all the exercises on the following pages after the chapter including the Practical Applications, Exercises, and Review Sheet. The Practical Applications section provides an opportunity for you to use your skill in understanding medical terms and to increase your knowledge of new terms. The Exercises section is designed to help you learn the terms presented in the chapter. Writing terms over and over again is a good way to study this new language. Your textbook also includes the answers for the Practical Applications and Exercises. The Pronunciation of Terms section is very helpful in that you are able to look at the pronunciation and try to make sure that you pronouncing the medical terms correctly, so hopefully you will be able to spell the terms correctly, and be able to communicate and converse with other allied health professionals. The Review Sheet is complete lists of the word elements contained in the chapter. They are designed to pull together the terminology and to reinforce your learning by giving you the opportunity to write the meanings of each word part in the spaces provided and to test yourself. All of these exercises will be very beneficial in helping you with your retention.