2. Assessment Techniques Physical exam: Visualization- looking Auscultation- listening Palpatation- feeling Gastric analysis: hemoccult, pH Fecal analysis: hemoccult, cultures, O&P

3. Radiography Abdominal CT Scan Radiographic procedure Detailed cross sectional view within the abdomen (detects tumors and obstruction) Abdominal ultrasound Noninvasive procedure using sound waves Upper GI Series/Barium Swallow Lower GI Series/Barium Enema

4. Endoscopy Colonoscopy visualizes the colon, from rectum to cecum

5. Endoscopy (continued) Gastrointestinal endoscopy visualizes esophagus, stomach and duodenum Protoscopy Visualizes rectum and anus Sigmoidoscopy Visualizes the entire rectum, sigmoid colon, and possibly a portion of the descending colon

6. Pathology of the Digestive System Examples of symptoms: Anorexia - lack of appetite Eructation - gas expelled from the stomach through the mouth Steatorrhea - fat in the feces; frothy, foul-smelling fecal matter Ascites - abnormal accumulation of fluid in the abdomen Flatus – gas expelled through the rectum

7. Disorders of the Digestive System Anorexia Lack of appetite Anorexia nervosa Compulsive dieting and excessive exercise Can become emaciated and have electrolyte/cardiac disorders Abdominal distention, swollen joints Bulimia Nervosa Binge eating and purging of food (vomiting, laxatives) May cause: chronic gastric reflux after eating, dehydration, electrolyte imbalance, which can lead to cardiac arrhythmia, cardiac arrest, and even death, dental erosion, swollen salivary glands Difficult to detect Q: Why might Bulimia nervosa be more difficult to detect than Anorexia Nervosa

8. Pathological Conditions (cont’d.) Upper Gastrointestinal Tract achalasia - failure of the lower esophagus sphincter (LES) muscle to relax Symptoms: difficulty swallowing, regurgitation, and sometimes chest pain

9. Disorders of the Digestive System (continued) Anal fistula almost always the result of a previous abscess a small tunnel connecting the anal gland from which the abscess arose to the skin of the buttocks outside the anus.

10. A blind sac attached to the cecum and has no known function. When appendix becomes inflamed If it ruptures, bacteria from appendix can spread to peritoneal cavity. Symptoms- RLQ pain, rebound tenderness, fever, nausea, and vomiting RX - appendectomy Appendicitis Disorders of the Digestive System (continued)

11. Cleft Lip and Cleft Palate Incomplete closure or fusion of the embryotic structure, specifically the maxillary processes and the nasal elevation during the second month of gestation.

12. Disorders of the Digestive System (continued) Cholelithiasis Chole = bile or Gall; lithiasis – means presence of stones Gallstones Can block the bile duct causing pain in the shoulder blades and digestive disorders and jaundice Small ones may pass on their own, large ones are surgically removed Chloecyystectomy

13. Disorders of the Digestive System (continued) Colitis Inflammation of the colon Colon cancer An abnormal growth in the large intestine Constipation When defecation is delayed, feces becomes dry and hard RX: diet with cereals, fruits, vegetables, drinking plenty of fluids, exercise, and avoiding tension Diarrhea Loose, watery, frequent bowel movements when feces pass along colon too rapidly Caused by infection, poor diet, nervousness, toxic substances or irritants in food

14. Cirrhosis A chronic degenerative condition of the liver accompanied by the formation of scar tissue Normal tissue replaced by fibrous connective tissue 75% caused by excessive alcohol consumption

15. Disorders of the Digestive System (continued) Celiac disease; usually symptoms develop 2 to 4 months after solid foods are introduced. Children are unable to digest gliadin, which is a component of gluten – a protein found in wheat, rye, barely, and oats. Thought to be related to IgA deficiency and early introduction of protein solids. Crohn’s disease Inflammation and ulceration, usually affecting the ileum and colon, or both Symptoms include chronic diarrhea, abdominal pain, fever, anorexia, wt. loss, FTT, enlarged regional lymph nodes, RLQ mass or fullness.

16. Disorders of the Digestive System (continued) Diverticulitis The weakening of the colon wall, leading to formation of a pouch causing infection or abscesses if fecal material trapped

17. Disorders of the Digestive System (continued) Gastroenteritis – vomiting (emesis) and diarrhea Inflammation of mucous membrane lining of stomach and intestine Acute caused by: Infections (bacterial, viruses) - Rotavirus Toxins Antibiotic therapy Diet conditions Chronic caused by: Malabsorption disorders (such as Crohns, celiac) Structural defects Allergic disorders Can cause dehydration

18. Disorders of the Digestive System (continued) Food Poisoning Botulism Characterized by paralysis and is often fatal E. Coli Watery bloody diarrhea that is often accompanied by a high fever Salmonella Severe diarrhea, nausea and vomiting accompanied by a high fever

19. Disorders of the Digestive System (continued) Gastritis Inflammation of the stomach lining Gastroesophageal reflux disease Frequent heartburn or chest pain, bitter taste in the mouth, difficulty swallowing, frequent hoarseness or coughing due to regurgitation Halitosis Or bad breath, is caused by anaerobic bacteria

20. Disorders of the Digestive System (continued) Heartburn A painful burning sensation in the esophagus caused by the backflow of acidic chyme from the stomach Hemorrhoid A painful dilated vein in the lower rectum or anus Hepatitis A viral infection of the liver Jaundice (icterus) – yellow discoloration of skin caused by excessive bilirubin in the blood

21. Hepatitis Hepatitis A passed by fecal-oral route, most commonly by poor sanitation or poor hand washing in day-care centers Also caused by contaminated food or water symptoms generally mild Hepatitis B transmitted via blood and body fluids as well as vertically from mother to fetus Can result in long-term sequelae of cirrhosis, liver cancer, fulminating hepatitis, and hepatocellular carcinoma.

22. Hepatitis continued Hepatitis C transmitted through the blood -predominantly parenterally spread; often thru blood transfusion Most cases are subclinical but can lead to cirrhosis and hepatocellular carcinoma Hepatitis D only occurs in children infected with HBV Hepatitis E waterborne and is responsible for outbreaks in developing countries. Infection may be severe but it does not become chronic. Hepatitis G relatively new virus transmitted through blood. individuals with HGB may be asymptomatic, and most infections are chronic

23. Disorders of the Digestive System (continued) Ileus Temporary stoppage of intestinal peristalsis Intestinal obstruction (bowel obstruction) Complete stoppage to the passage of intestinal contents Intussusception Telescoping of the bowel onto itself Inguinal hernia Protrusion of a small loop of bowel thru a weak place in lower abdominal wall or groin

24. Disorders of the Digestive System (continued) Pancreatitis A mild acute or chronic condition resulting from gallbladder stone blockage, disease, injury, or alcoholism Peptic ulcer Ulcer of the stomach Peritonitis An inflammation of the abdominal cavity caused by bacteria

25. Disorders of the Digestive System (continued) Phenylketonuria Inherited disease that can lead to brain damage if not detected Phenyl Pyloric stenosis A birth defect in which a constricted pyloric sphincter does not allow food to pass easily into the small intestine

26. Disorders of the Digestive System (continued) Tay-Sachs A recessive genetic disorder in which fat cells accumulate in the body and cause damage to normal cells Ulcer Sore or lesion that forms in the mucosal lining of the stomach Gastric ulcers in the stomach and duodenal ulcer in the duodenum Cause – H. pylori (bacteria) is primary cause Lifestyle factors that contribute: cigarette smoking, alcohol, stress, certain drugs. Symptoms – burning pain in abdomen, between meals and early morning, may be relieved by eating or taking antacids. Diagnosis – x-ray, presence of bacteria Rx – H 2 blockers ( drugs) that block release of histamine

28. Teeth There are 4 different types of teeth -incisors -canines -premolars -molars These different teeth have different jobs!

29. Incisors These are cutting teeth used for cutting and biting off pieces of food

30. Canines These are long and sharp teeth that are used to hold and tear at food

31. Teeth and Animals! Different animals have different sets of teeth depending on the type of food that they eat - What is a herbivore? Name a specific animal. - What is a carnivore? Name a specific animal. - What is a omnivore? Name a specific animal.

32. Think…. Do you think a herbivore will a different set of teeth compared to a carnivore? Why? What types of teeth does an ominovore have?

33. What kind of teeth does a sheep have?

35. What kind of teeth does a lion have?

37. What kind of teeth do we have?