Lecture Notes A PowerPoint Presentation 6 Lecture Notes A PowerPoint Presentation Digestive System Classroom Activity to Accompany Medical Terminology Systems, Seventh Edition Barbara A. Gylys ∙ Mary Ellen Wedding

Structure and Function 6 DIGESTIVE SYSTEM Structure and Function Oral cavity Teeth Salivary glands Pharynx Esophagus Stomach Small intestine Large intestine 2

Structure and Function 6 DIGESTIVE SYSTEM Structure and Function Accessory organs Liver Gallbladder Pancreas Pedagogical Note: For instructors who prefer extensive anatomy and physiology coverage, refer to the Respiratory System presentation for an example of a comprehensive coverage of anatomy and physiology. It can be used as a framework to help you lengthen other chapters if needed. In addition, you may encourage students to complete TermPlus, the powerful interactive multimedia program with which they can concentrate on reinforcing anatomy and physiology.   3

Structure and Function 6 DIGESTIVE SYSTEM Structure and Function Breaks down food physically and chemically Prepares food for absorption by cells of the body Eliminates waste substances 4

Structure and Function Exercise 6 DIGESTIVE SYSTEM Structure and Function Exercise What is the oral cavity and what is its function? Name the three parts of the small intestine and describe their locations. Pedagogical Note: Questions only are presented on the first slide. Questions with answers (in red) are presented on the following slide. For testing purposes, you may wish to use only the question slides.   5

Structure and Function Exercise 6 DIGESTIVE SYSTEM Structure and Function Exercise What is the oral cavity and what is its function? First part of the digestive tract, where the mechanical process of chewing and chemical breakdown of food by salivary secretions initiates the digestive process Name the three parts of the small intestine and describe their locations. Duodenum, first segment, about 10 long; jejunum, second segment, about 8 long; ileum, third segment, about 12 long Pedagogical Note: Questions only are presented on the first slide. Questions with answers (in red) are presented on the following slide. For testing purposes, you may wish to use only the question slides.   6 6

Structure and Function Exercise 6 DIGESTIVE SYSTEM Structure and Function Exercise Name the first four sections of the colon. Describe the shape, location, and function of the pancreas. Describe the location and main function of the gallbladder.   7 7

Structure and Function Exercise 6 DIGESTIVE SYSTEM Structure and Function Exercise Name the first four sections of the colon. Ascending, transverse, descending, and sigmoid Describe the shape, location, and function of the pancreas. Elongated, flattened organ posterior and slightly inferior to the stomach that produces digestive enzymes and insulin Describe the location and main function of the gallbladder. Organ on the inferior surface of the liver that stores bile   8 8

Combining Forms Exercise DIGESTIVE SYSTEM 6 Combining Forms Exercise List the CF(s) for: esophagus: salivary glands: pharynx: stomach: pancreas:

Combining Forms Exercise DIGESTIVE SYSTEM 6 Combining Forms Exercise esophagus: esophag/o salivary glands: sial/o pharynx: pharyng/o stomach: gastr/o pancreas: pancreat/o

Combining Forms Exercise DIGESTIVE SYSTEM 6 Combining Forms Exercise 6. spleen: 7. tongue: 8. liver: 9. ileum: 10. gallbladder:

Combining Forms Exercise DIGESTIVE SYSTEM 6 Combining Forms Exercise 6. spleen: splen/o 7. tongue: gloss/o, lingu/o 8. liver: hepat/o 9. ileum: ile/o 10. gallbladder: cholecyst/o

Combining Forms Exercise DIGESTIVE SYSTEM 6 Combining Forms Exercise rectum: anus: anus, rectum: duodenum: colon:

Combining Forms Exercise DIGESTIVE SYSTEM 6 rectum: rect/o anus: an/o anus, rectum: proct/o duodenum: duoden/o colon: col/o, colon/o

Combining Forms Exercise DIGESTIVE SYSTEM 6 Combining Forms Exercise sigmoid colon: mouth: gum(s): bile, gall: bile duct:

Combining Forms Exercise DIGESTIVE SYSTEM 6 Combining Forms Exercise sigmoid colon: sigmoid/o mouth: or/o, stomat/o gum(s): gingiv/o bile, gall: chol/e bile duct: choledoch/o Pedagogical Note: Encourage your students to enhance and reinforce their study of word elements for this chapter by visiting the DavisPlus web site and completing the flash-card activities.

Complete the Medical Word Exercise DIGESTIVE SYSTEM 6 Complete the Medical Word Exercise discharge or flow through: dia/ without an appetite: an/ swallowing, eating (that is) painful or difficult: /phagia 17

Complete the Medical Word Exercise DIGESTIVE SYSTEM 6 Complete the Medical Word Exercise discharge or flow through: dia/rrhea without an appetite: an/orexia swallowing, eating (that is) painful or difficult: dys/phagia 18

Complete the Medical Word Exercise DIGESTIVE SYSTEM 6 Complete the Medical Word Exercise after a meal: post/ pertaining to under or below the tongue: /lingu/ visual examination within or in (an organ): /scopy 19

Complete the Medical Word Exercise DIGESTIVE SYSTEM 6 Complete the Medical Word Exercise after a meal: post/prandial pertaining to under or below the tongue: sub/lingu/al visual examination within or in (an organ): endo/scopy Pedagogical Note: Encourage your students to enhance and reinforce their study of word elements for this chapter by visiting the DavisPlus web site and completing the flash-card activities. 20

Build Medical Words Exercise DIGESTIVE SYSTEM 6 Build Medical Words Exercise vomiting blood: tumor of the pancreas: instrument for examining the stomach: 21

Build Medical Words Exercise DIGESTIVE SYSTEM 6 Build Medical Words Exercise vomiting blood: hemat/emesis Tumor of the pancreas: pancreat/oma instrument for examining the stomach: gastro/scope 22

Build Medical Words Exercise DIGESTIVE SYSTEM 6 Build Medical Words Exercise enlargement of the liver: disease of the intestine (usually small intestine): inflammation of the gum(s): 23

Build Medical Words Exercise DIGESTIVE SYSTEM 6 Build Medical Words Exercise enlargement of the liver: hepat/o/megaly disease of the intestine (usually small intestine): enter/o/pathy inflammation of the gum(s): gingiv/itis 24

Diseases and Conditions DIGESTIVE SYSTEM 6 Diseases and Conditions Appendicitis Inflammation of the appendix Usually due to obstruction or infection caused by a fecalith, foreign body, or bacteria

Diseases and Conditions (continued) DIGESTIVE SYSTEM 6 Diseases and Conditions (continued) Appendicitis (continued) Signs and symptoms Pain, usually becoming localized to right lower quadrant at McBurney point (see illustration) Sudden spontaneous relief of pain indicating a ruptured appendix Fever, malaise, diarrhea, or constipation, and tachycardia (later signs and symptoms)

Diseases and Conditions (continued) DIGESTIVE SYSTEM 6 Diseases and Conditions (continued) Appendicitis (continued) Treatment Appendectomy (see illustration) Surgery within 48 hours of first symptoms to avoid delay, which could result in rupture and peritonitis as fecal matter is released into the peritoneal cavity

Clinically Related Exercise DIGESTIVE SYSTEM 6 Clinically Related Exercise Mr. Q. presents to the ED with RLQ pain, a rigid abdomen with increased tenderness, and abdominal cramping. The physician suspects he is suffering from an inflammation of the appendix. His diagnosis is . Mr. R., a smoker and heavy drinker, complains of dysphagia for the past 4 months. After various tests, he is diagnosed with cancer of the (esophagus, mouth, stomach). 28

Clinically Related Exercise DIGESTIVE SYSTEM 6 Clinically Related Exercise Mr. Q. presents to the ED with RLQ pain, a rigid abdomen with increased tenderness, and abdominal cramping. The physician suspects he is suffering from an inflammation of the appendix. His diagnosis is appendicits. Mr. R., a smoker and heavy drinker, complains of dysphagia for the past 4 months. After various tests, he is diagnosed with cancer of the (esophagus, mouth, stomach). 29

Clinically Related Exercise DIGESTIVE SYSTEM 6 Clinically Related Exercise The abbreviation RLQ means the patient’s pain is located in the . The physician informs Ms. J. that her appendicitis may be due to an obstruction or infection caused by a hard mass of fecal matter. This type of mass is diagnosed as a (fecalith, fecaloid, fecundation). Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or web site resources to tailor these sections to your course objectives. 30

Clinically Related Exercise DIGESTIVE SYSTEM 6 Clinically Related Exercise The abbreviation RLQ means the patient’s pain is located in the right lower quadrant. The physician informs Ms. J. that her appendicitis may be due to an obstruction or infection caused by a hard mass of fecal matter. This type of mass is diagnosed as a (fecalith, fecaloid, fecundation). Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or web site resources to tailor these sections to your course objectives. 31

Diseases and Conditions (continued) DIGESTIVE SYSTEM 6 Diseases and Conditions (continued) Diverticulitis Acute inflammation of diverticulae Diverticulosis — presence of diverticulae without inflammation (see illustration)

Diseases and Conditions (continued) DIGESTIVE SYSTEM 6 Diseases and Conditions (continued) Diverticulitis (continued) Signs and symptoms Symptoms varied from case-to-case in intensity and duration Bowel changes, possibly alternating between constipation and diarrhea Tenderness and pain in LLQ of abdomen Possible bleeding as condition worsens, along with weakness, fever, fatigue, and anemia Possible rupture (if an abscess develops), leading to peritonitis

Diseases and Conditions (continued) DIGESTIVE SYSTEM 6 Diseases and Conditions (continued) Diverticulitis (continued) Treatment Focus on clearing up inflammation and infection, resting the colon, and preventing or minimizing complications Hospital stay required for severe cases with acute pain and complications IV antibiotics and a few days without food or drink (for most severe cases) to help the colon rest Colon resection required for some cases with a temporary colostomy while the colon heals Pedagogical note: A colostomy animation is available in the Student Resources section of the DavisPlus web site.

Clinically Related Exercise DIGESTIVE SYSTEM 6 Clinically Related Exercise Ms. O.’s radiograph shows pouchlike herniations through the muscular layer of her colon. These small, blisterlike pockets are diagnosed as (diverticula, diverticulitis, diverticuloma). The nurse charts Mr. J.’s complaint of extreme constipation as (diarrhea, obstipation, colopathy). Mr. F. is diagnosed with a severe case of diverticulitis. His symptoms include LLQ tenderness and pain. LLQ means the pain is located in the of his abdomen. Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or web site resources to tailor these sections to your course objectives. 35

Clinically Related Exercise DIGESTIVE SYSTEM 6 Clinically Related Exercise Ms. O.’s radiograph shows pouchlike herniations through the muscular layer of her colon. These small, blisterlike pockets are diagnosed as (diverticula, diverticulitis, diverticuloma). The nurse charts Mr. J.’s complaint of extreme constipation as (diarrhea, obstipation, colopathy). Mr. F. is diagnosed with a severe case of diverticulitis. His symptoms include LLQ tenderness and pain. LLQ means the pain is located in the left lower quadrant of his abdomen. Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or web site resources to tailor these sections to your course objectives. 36

Diseases and Conditions (continued) DIGESTIVE SYSTEM 6 Diseases and Conditions (continued) Cholelithiasis and Choledocholithiasis Formation or presence of gallstones within the gallbladder or bile ducts

Diseases and Conditions (continued) DIGESTIVE SYSTEM 6 Diseases and Conditions (continued) Cholelithiasis and Choledocholithiasis (continued) Signs and symptoms Patients with gallstones, possibly asymptomatic Classic "attack," called biliary colic, from bile duct obstruction Acute onset of URQ abdominal pain that radiates to the shoulder and back Possible nausea and vomiting Typically following ingestion of large or fatty meals

Diseases and Conditions (continued) DIGESTIVE SYSTEM 6 Diseases and Conditions (continued) Cholelithiasis and Choledocholithiasis (continued) Nonsurgical treatment If asymptomatic, unless symptoms reappear or there is a history of previous gallstones with complications Extracorporeal shock-wave lithotripsy Dissolving cholesterol-based stones through bile acid therapy Inhibits synthesis and secretion of cholesterol within the liver, altering the composition of the bile. Existing stones may be decreased in size or dissolved entirely

Diseases and Conditions (continued) DIGESTIVE SYSTEM 6 Diseases and Conditions (continued) Cholelithiasis and Choledocholithiasis (continued) Surgical treatment Laparoscopic cholecystectomy (for cholelithiasis), a minimally invasive procedure Most common procedure performed Laparoscope inserted through several small incisions in the abdomen with patient usually discharged in 24 hours or less Choledocholithotomy (for choledocholithiasis) Incision into the common bile duct to remove the stone(s)

Clinically Related Exercise DIGESTIVE SYSTEM 6 Clinically Related Exercise Ms. G. presents with an acute onset of URQ abdominal pain that radiates to the shoulder and back, and complains of nausea and vomiting. The physician suspects gallstone formation in the gallbladder. He charts an abnormal condition of gallbladder stones as . 41

Clinically Related Exercise DIGESTIVE SYSTEM 6 Clinically Related Exercise Ms. G. presents with an acute onset of URQ abdominal pain that radiates to the shoulder and back, and complains of nausea and vomiting. The physician suspects gallstone formation in the gallbladder. He charts an abnormal condition of gallbladder stones as cholecystolithiasis. 42

Clinically Related Exercise DIGESTIVE SYSTEM 6 Clinically Related Exercise The physician explains that removal of the gallbladder is the treatment of choice for symptomatic cholelithiasis. The procedure for excision of the gallbladder is . Mr. F. is scheduled for ultrasound treatment to pulverize his gallstones. This nonsurgical procedure, abbreviated ESWL, is called . 43

Clinically Related Exercise DIGESTIVE SYSTEM 6 Clinically Related Exercise The physician explains that removal of the gallbladder is the treatment of choice for symptomatic cholelithiasis. The procedure for excision of the gallbladder is cholecystectomy. Mr. F. is scheduled for ultrasound treatment to pulverize his gallstones. This nonsurgical procedure, abbreviated ESWL, is called extracorporeal shock-wave lithotripsy. 44

Vocabulary Challenge Exercise DIGESTIVE SYSTEM 6 Vocabulary Challenge Exercise anastomosis: ascites: borborygmus: 45

Vocabulary Challenge Exercise DIGESTIVE SYSTEM 6 Vocabulary Challenge Exercise anastomosis: connection between two vessels; surgical joining of two ducts, blood vessels, or bowel segments to allow flow from one to the other ascites: abnormal accumulation of fluid in the peritoneal cavity borborygmus: audible abdominal sound caused by passage of gas through the liquid contents of the intestine 46

Vocabulary Challenge Exercise DIGESTIVE SYSTEM 6 Vocabulary Challenge Exercise cachexia: dysentery: volvulus: Pedagogical note: To customize or add other disorders to your presentation, you can access numerous images from the image bank. You may also wish to use these types of slides in a group project activity during class. 47

Vocabulary Challenge Exercise DIGESTIVE SYSTEM 6 Vocabulary Challenge Exercise cachexia: state of ill health, malnutrition, and wasting that may occur in many chronic diseases, malignancies, and infections dysentery: diarrhea containing blood and mucus, resulting from inflammation of the walls of the gastrointestinal tract, especially the colon volvulus: twisting of the bowel on itself, causing obstruction 48

Medical and Surgical Procedures DIGESTIVE SYSTEM 6 Medical and Surgical Procedures Bariatric surgery Surgical alteration of the stomach as a treatment for morbid obesity Illustration: (A) Vertical banded gastroplasty. (B) Roux-en-Y gastric bypass (RGB).

Medical and Surgical Procedures (continued) DIGESTIVE SYSTEM 6 Medical and Surgical Procedures (continued) Colostomy Excision of a diseased part of the colon and creation of a new opening in the abdominal wall where fecal flow is diverted to a colostomy bag Permanent or temporary Performed as treatment for cancer or diverticulitis Illustration: Colon is brought out through the abdominal wall to form a mouth (stoma) Pedagogical note: A colostomy animation is available in the Student Resources section of the DavisPlus web site.

Medical and Surgical Procedures (continued) DIGESTIVE SYSTEM 6 Medical and Surgical Procedures (continued) Polypectomy Excision of small, tumorlike, benign growths (polyps) that project from a mucous membrane surface Illustration: Snare removing a polyp from the colon

Clinically Related Exercise DIGESTIVE SYSTEM 6 Clinically Related Exercise Ms. K is diagnosed with colorectal CA. The surgeon will create an opening in the colon through the abdominal wall to the outside surface to enable diversion of fecal matter into an attached pouch. The surgical procedure to create an opening (mouth) of the colon is called a(n) . The physician discovers polyps during a colonoscopy. What surgical procedure does the doctor perform to remove the polyps? 52

Clinically Related Exercise DIGESTIVE SYSTEM 6 Clinically Related Exercise Ms. K is diagnosed with colorectal CA. The surgeon will create an opening in the colon through the abdominal wall to the outside surface to enable diversion of fecal matter into an attached pouch. The surgical procedure to create an opening (mouth) of the colon is called a colostomy. The physician discovers polyps during a colonoscopy. What surgical procedure does the doctor perform to remove the polyps? polypectomy 53

Clinically Related Exercise DIGESTIVE SYSTEM 6 Clinically Related Exercise The nurse explains that surgical procedures are available to treat morbid obesity. The surgical procedure that treats morbid obesity is called surgery. The physician explains a surgical procedure to treat morbid obesity in which he staples the upper stomach near the esophagus to reduce it to a small pouch and inserts a band to restrict food consumption. This bariatric procedure is known as vertical . 54

Clinically Related Exercise DIGESTIVE SYSTEM 6 Clinically Related Exercise The nurse explains that surgical procedures are available to treat morbid obesity. The surgical procedure that treats morbid obesity is called bariatric surgery. The physician explains a surgical procedure to treat morbid obesity in which he staples the upper stomach near the esophagus to reduce it to a small pouch and inserts a band to restrict food consumption. This bariatric procedure is known as vertical banded gastroplasty. 55

Diagnostic Procedures DIGESTIVE SYSTEM 6 Diagnostic Procedures Endoscopy Visual examination of the interior of organs and cavities with a specialized lighted instrument called an endoscope Illustration: Esophago- gastroduodenoscopy

Diagnostic Procedures (continued) DIGESTIVE SYSTEM 6 Diagnostic Procedures (continued) Colonoscopy Examination of the entire length of the colon Examination of only the lower third of the colon known as sigmoidoscopy Illustration: Colonoscopy and sigmoidoscopy

Diagnostic Procedures (continued) DIGESTIVE SYSTEM 6 Diagnostic Procedures (continued) Barium enema (BE) Barium swallow Magnetic resonance imaging (MRI) Ultrasound (US) Pedagogical Note: You may want to bring a few diagnostic instruments or laboratory set-ups for students to examine. Various images of medical instruments are available on web sites if you do not have the actual instruments. In addition, other diagnostic procedures can be included to suit individual classroom needs.

Build a Medical Word Exercise DIGESTIVE SYSTEM 6 Build a Medical Word Exercise Visual examination of the sigmoid colon: Instrument for examining interior organs and cavities: Process of recording (x-ray) the gallbladder: 59

Build a Medical Word Exercise DIGESTIVE SYSTEM 6 Build a Medical Word Exercise Visual examination of the sigmoid colon: sigmoid/o/scopy Instrument for examining interior organs and cavities: endo/scope Process of recording (x-ray) the gallbladder: cholecyst/o/graphy or chol/e/cyst/o/graphy 60

Build a Medical Word Exercise DIGESTIVE SYSTEM 6 Build a Medical Word Exercise Visual examination of the colon: Instrument for examining the rectum and sigmoid colon: Process of recording (x-ray) a bile vessel: 61

Build a Medical Word Exercise DIGESTIVE SYSTEM 6 Build a Medical Word Exercise Visual examination of the colon: colon/o/scopy Instrument for examining the rectum and sigmoid colon: proct/o/sigmoid/o/scope Process of recording (x-ray) a bile vessel: cholangi/o/graphy or chol/angi/o/graphy 62

Pharmacology Antacids Antidiarrheals Antiemetics Laxatives 6 DIGESTIVE SYSTEM 6 Pharmacology Antacids Antidiarrheals Antiemetics Laxatives

Clinically Related Exercise DIGESTIVE SYSTEM 6 Clinically Related Exercise Mrs. J. complains of nausea and vomiting for the past 3 days. The prescribed medication, which will control nausea and vomiting by blocking nerve impulses to the vomiting center of the brain, is called an (antacid, antidiarrheal, antiemetic). 64

Clinically Related Exercise DIGESTIVE SYSTEM 6 Clinically Related Exercise Mrs. J. complains of nausea and vomiting for the past 3 days. The prescribed medication, which will control nausea and vomiting by blocking nerve impulses to the vomiting center of the brain, is called an (antacid, antidiarrheal, antiemetic). 65

Clinically Related Exercise DIGESTIVE SYSTEM 6 Clinically Related Exercise Mrs. S. is diagnosed with irritable bowel syndrome. The physician instructs her to increase her fluid intake and prescribes a drug that will control her loose bowel movements. The drug is known as an (antacid, antidiarrheal, antiemetic). A patient diagnosed with excessive stomach acid is treated with a(n) (antacid, laxative, antiemetic). 66

Clinically Related Exercise DIGESTIVE SYSTEM 6 Clinically Related Exercise Mrs. S. is diagnosed with irritable bowel syndrome. The physician instructs her to increase her fluid intake and prescribes a drug that will control her loose bowel movements. The drug is known as an (antacid, antidiarrheal, antiemetic). A patient diagnosed with excessive stomach acid is treated with an (antacid, laxative, antiemetic). 67

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