Understanding CF Cholangi/o in Digestive Terms
Understanding CF Cholangi/o in Digestive Terms
Seventh Edition
Chapter 8
Digestive System
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Digestive System at a Glance (1 of 2)
• The digestive system mechanically and chemically breaks down food and absorbs
nutrients into the body.
• Food that is not digested or absorbed passes out of the digestive system in the form of
solid waste.
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Digestive System at a Glance (2 of 2)
• Organs and accessory structures of the digestive system include:
– Mouth
– Oral cavity
– Salivary glands
– Pharynx
– Esophagus
– Stomach
– Liver
– Pancreas
– Gallbladder
– Small intestine
– Large intestine
– Anus
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Digestive System Illustrated
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Anatomy and Physiology of the Digestive
System (1 of 4)
• The digestive system is also known as the gastrointestinal (GI) system.
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Anatomy and Physiology of the Digestive
System (2 of 4)
• Most digestive organs are actually distinct sections of the gut tube.
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Anatomy and Physiology of the Digestive
System (3 of 4)
• Accessory organs are involved in the digestive process but not part of the continuous
gut tube.
• The salivary glands, pancreas, liver, and gallbladder are all accessory organs.
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Anatomy and Physiology of the Digestive
System (4 of 4)
• The digestive system has three main functions:
– Digestion is the physical and chemical breakdown of food into smaller nutrient
molecules.
– Absorption is the process by which nutrients pass into the bloodstream.
– Elimination is the expulsion of any food that is not digested or absorbed.
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Oral Cavity (1 of 3)
• The oral cavity is the first portion of the continuous gut tube.
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Oral Cavity (2 of 3)
• The palate is the roof of the oral cavity.
– The bony anterior portion is the hard palate.
– The flexible posterior portion is the soft palate.
– The uvula hangs from the soft palate, where it is involved in speech production and
the gag reflex.
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Oral Cavity (3 of 3)
• The cheeks are the lateral walls of the oral cavity.
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Figure 8-1
Anatomy of structures of the oral cavity.
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Figure 8-2
Structures of the oral cavity, pharynx, and esophagus.
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Teeth (1 of 3)
• The teeth in the front of the mouth bite, tear, and cut food.
– Incisors
– Cuspids (canines)
• The teeth toward the back of the mouth grind and crush food into finer pieces.
– Bicuspids (premolars)
– Molars
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Figure 8-3A
The name and shape of the adult teeth. These teeth represent those found in the
right side of the mouth. Those of the left side would be a mirror image. The incisors
and cuspids are cutting teeth. The bicuspids and molars are grinding teeth.
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Figure 8-3B
X-ray scan of all teeth. Note the four wisdom teeth (third molars) that have not
erupted.
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Teeth (2 of 3)
• All teeth consist of two main parts:
– The crown lies above the gum line.
– The root lies below the gum line.
• The hollow interior is the pulp cavity in the crown and the root canal in the root.
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Figure 8-4
Longitudinal view of an adult tooth showing the internal structures of the crown
and root.
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Teeth (3 of 3)
• Humans have two sets of teeth:
– The 20 deciduous (baby) teeth erupt between the ages of 6 and 28 months.
– Around age 6, the deciduous teeth begin to be replaced by the 32 permanent
teeth.
– Eruption of the permanent teeth continues until around ages 18–20.
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Pharynx
• After the oral cavity, the next portion of the digestive tract is the pharynx.
• Food first passes through the oropharynx, then progresses through the laryngopharynx.
• The epiglottis is a flap that prevents swallowed food from entering the respiratory tract.
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Esophagus
• The esophagus is a muscular tube that is about 10 inches long in most adults.
• It carries food through the thoracic cavity and into the abdominal cavity, where it enters
the stomach.
• Food is propelled through the esophagus (and the entire GI tract) by wavelike
contractions called peristalsis.
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Stomach (1 of 2)
• The stomach is a J-shaped, muscular organ.
• It churns food with hydrochloric acid and other gastric juices to form chyme.
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Stomach (2 of 2)
• Two muscular valves called sphincters control the flow of food through the stomach:
– The cardiac sphincter allows food to pass from the esophagus to the fundus.
– The pyloric sphincter regulates passage of chyme from the antrum to the small
intestine.
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Figure 8-5
The stomach, longitudinal view, showing regions and internal structures.
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Small Intestine (1 of 2)
• The small intestine is the longest part of the gut tube, extending from the pyloric
sphincter to the colon.
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Small Intestine (2 of 2)
• The small intestine has three sections:
– The duodenum is 10–12 inches long and begins at the pyloric sphincter.
– The jejunum is 8 feet long and extends from the duodenum to the ileum.
– The ileum is 12 feet long and connects to the colon via the ileocecal valve.
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Figure 8-6
Anterior view of the abdominopelvic cavity illustrating the three sections of the
small intestine: duodenum, jejunum, and ileum. Note that the sections are not
arranged in an orderly fashion.
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Large Intestine (1 of 4)
• From the small intestine, any remaining fluid enters the large intestine.
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Large Intestine (2 of 4)
• The large intestine is 5 feet long.
• The cecum is a saclike area in the first 2–3 inches of the large intestine.
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Large Intestine (3 of 4)
• The colon consists of four regions:
– The ascending colon extends upward on the right side of the abdomen.
– The transverse colon travels horizontally across the upper abdomen.
– The descending colon travels down the left side of the abdomen.
– The sigmoid colon curves in an S-shape to the midline of the body.
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Large Intestine (4 of 4)
• The next portion of the large intestine is the rectum, which stores feces.
• The rectum leads to the anal canal, which ends at the anal sphincter.
• The anal sphincter consists of rings of muscles that control the process of defecation.
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Figure 8-8
The regions of the colon.
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Accessory Organs of the Digestive System
• The accessory organs are not part of the continuous gut tube.
• These organs produce substances needed for the chemical breakdown of food.
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Salivary Glands (1 of 2)
• The salivary glands produce saliva.
• Saliva mixes with chewed food to form a bolus that is easier to swallow.
• Saliva also contains amylase, an enzyme that begins the breakdown of carbohydrates.
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Salivary Glands (2 of 2)
• There are three pairs of salivary glands:
– The parotid glands are in front of the ears.
– The sublingual glands are in the floor of the mouth.
– The submandibular glands are also in the floor of the mouth.
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Figure 8-9
The salivary glands: parotid, sublingual, and submandibular. This image shows the
position of each gland and its duct emptying into the oral cavity.
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Liver
• The liver is located in the right upper quadrant of abdomen.
• Bile assists in emulsification, or the breakdown of large fat molecules into smaller
droplets.
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Gallbladder
• The gallbladder lies under the liver and stores bile.
• Bile reaches the gallbladder by way of the hepatic and cystic ducts.
• Contraction of the gallbladder sends bile back down the cystic duct and into the common
bile duct.
• The bile then enters the duodenum, where it emulsifies fat in the chyme.
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Pancreas
• The pancreas connects to the duodenum via the pancreatic duct.
• The pancreas is also an exocrine gland that produces insulin and glucagon, which
regulate blood glucose levels.
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Figure 8-10
The liver, gallbladder, and pancreas. Image shows the relationship of these three
organs and their ducts to the duodenum.
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Additional Combining Forms (1 of 7)
Combining Form Definition
an/o
append/o
appendic/o
bar/o
bucc/o
carcin/o
cec/o
chol/e
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Additional Combining Forms (2 of 7)
Combining Form Definition
cholangi/o
cholecyst/o
choledoch/o
cirrh/o
col/o
colon/o
cutane/o
cyst/o
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Additional Combining Forms (3 of 7)
Combining Form Definition
dent/o
diverticul/o
duoden/o
enter/o
esophag/o
gastr/o
gingiv/o
gloss/o
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Additional Combining Forms (4 of 7)
Combining Form Definition
hem/o
hemat/o
hepat/o
ile/o
inguin/o
jejun/o
labi/o
lapar/o
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Additional Combining Forms (5 of 7)
Combining Form Definition
lingu/o
lith/o
mandibul/o
nas/o
odont/o
or/o
orth/o
palat/o
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Additional Combining Forms (6 of 7)
Combining Form Definition
pancreat/o
pharyng/o
polyp/o
proct/o
pylor/o
pyr/o
rect/o
sialaden/o
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Additional Combining Forms (7 of 7)
Combining Form Definition
sigmoid/o
ven/o
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Additional Suffixes (1 of 5)
Suffix Definition
-ac
-al
-algia
-ar
-centesis
-eal
-ectomy
-emesis
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Additional Suffixes (2 of 5)
Suffix Definition
-emetic
-gram
-graphy
-iatric
-ic
-istry
-itis
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Additional Suffixes (3 of 5)
Suffix Definition
-lithiasis
-logy
-oma
-orexia
-osis
-ostomy
-otomy
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Additional Suffixes (4 of 5)
Suffix Definition
-ous
-pepsia
-pexy
-phagia
-plasty
-plegia
-prandial
-ptosis
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Additional Suffixes (5 of 5)
Suffix Definition
-scope
-scopic
-scopy
-tripsy
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Additional Prefixes (1 of 3)
Prefix Definition
a-
an-
anti-
brady-
dys-
endo-
ex-
hyper-
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Additional Prefixes (2 of 3)
Prefix Definition
hypo-
in-
intra-
per-
peri-
poly-
post-
re-
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Additional Prefixes (3 of 3)
Prefix Definition
retro-
sub-
trans-
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Anatomical Terms (1 of 5)
Term Definition
anal
buccal
buccolabial
cecal
cholecystic
colonic
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Anatomical Terms (2 of 5)
Term Definition
colorectal
cystic
dental
duodenal
enteric
esophageal
gastric
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Anatomical Terms (3 of 5)
Term Definition
gastrointestinal (GI)
gingival
glossal
hepatic
hypoglossal
ileal
ileocecal
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Anatomical Terms (4 of 5)
Term Definition
jejunal
labial
lingual
nasogastric
oral
pancreatic
periodontal
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Anatomical Terms (5 of 5)
Term Definition
pharyngeal
pyloric
rectal
sigmoidal
sublingual
submandibular
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Medical Specialties (1 of 3)
Term Definition
Branch of healthcare involved with
the prevention, diagnosis, and
dentistry treatment of conditions involving the
teeth, jaw, and mouth. Practitioner
is a dentist.
Branch of medicine involved in the
diagnosis and treatment of diseases
gastroenterolog
and disorders of the digestive
y
system. Physician is a
gastroenterologist.
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Medical Specialties (2 of 3)
Term Definition
Branch of dentistry that uses surgical
oral surgery means to treat dental conditions.
Specialist is an oral surgeon.
Branch of dentistry concerned with
orthodonti
correction of tooth alignment problems.
cs
Specialist is an orthodontist.
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Medical Specialties (3 of 3)
Term Definition
Branch of dentistry concerned with
treating conditions involving the
periodontics
gums and tissues surrounding the
teeth. Specialist is a periodontist.
Branch of medicine involved in the
diagnosis and treatment of diseases
proctology
and disorders of the anus and
rectum. Physician is a proctologist.
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Signs and Symptoms (1 of 4)
Term Definition
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Signs and Symptoms (3 of 4)
Term Definition
presence of excess gas in the stomach or
flatulence
intestines
gastralgia stomach pain
hematemesi
vomiting blood
s
hematochezi
passing bright red blood in the stool
a
hyperemesis excessive vomiting
yellow cast to the skin, mucous membranes,
jaundice and whites of the eyes; caused by the deposit
of bile pigment
passage of dark tarry stool due to digested
melena
blood
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Signs and Symptoms (4 of 4)
Term Definition
nausea urge to vomit
having too much body fat leading to a body
obesity
weight that is above a healthy level
polyphagia excessive eating
postprandial after a meal
pain and burning sensation usually caused by
pyrosis stomach acid splashing into the esophagus;
heartburn
return of fluids and solids from the stomach
regurgitation
into the mouth
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Oral Cavity Pathology (1 of 2)
Term Definition
painful ulcers in the mouth of
aphthous ulcers unknown origin; commonly called
canker sores
congenital anomaly in which the
cleft lip upper lip and jawbone fail to fuse in
the midline, leaving a gap
congenital anomaly in which the roof
cleft palate
of the mouth has a split or fissure
decay and disintegration of teeth
dental caries
caused by bacteria; tooth cavity
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Oral Cavity Pathology (2 of 2)
Term Definition
gingivitis inflammation of the gums
infection of the lip by herpes simplex
herpes
virus type 1 (HSV-1); also called fever
labialis
blisters or cold sores
disease of the supporting structures of
periodontal the teeth, including the gums and
disease bones; most common cause of tooth
loss
sialadenitis inflammation of a salivary gland
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Pharynx and Esophagus
Term Definition
enlarged and swollen varicose veins
esophageal in the lower end of the esophagus;
varices rupture results in serious
hemorrhage
condition in which acid from the
gastroesophage
stomach flows backward into the
al reflux disease
esophagus, causing inflammation
(GERD)
and pain
pharyngoplegia paralysis of the throat muscles
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Stomach Pathology (1 of 2)
Term Definition
gastric
cancerous tumor in the stomach
carcinoma
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Figure 8-11
A hiatal hernia or diaphragmatocele. A portion of the stomach protrudes through
the diaphragm into the thoracic cavity.
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Stomach Pathology (2 of 2)
Term Definition
ulcer in the lower portion of the
esophagus, stomach, and/or
peptic ulcer duodenum; thought to be caused by
disease (PUD) the acid in gastric juices and may be
a result of Helicobacter pylori
infection
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Figure 8-12A
Figure illustrating the location and appearance of a peptic ulcer in both the stomach
and the duodenum.
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Figure 8-12B
Photomicrograph illustrating a gastric ulcer.
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Small Intestine and Large Intestine
Pathology (1 of 5)
Term Definition
abnormal tube-like passage from the surface
anal fistula
around the anal opening directly into the rectum
appendicitis inflammation of the appendix
bowel
inability to control defecation
incontinence
autoimmune condition affecting the small
intestine; caused by reaction to eating gluten;
celiac disease
symptoms include bloating, pain, diarrhea, and
nutritional deficiencies
colorectal
cancerous tumor originating in the colon or rectum
carcinoma
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Small Intestine and Large Intestine
Pathology (2 of 5)
Term Definition
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Figure 8-13
Diverticulosis and diverticulitis. Figure also illustrates external and internal
appearance of diverticula.
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Small Intestine and Large Intestine
Pathology (3 of 5)
Term Definition
disease characterized by diarrhea, often with
dysentery mucus and blood, severe abdominal pain, fever,
and dehydration
enteritis inflammation of the small intestine
hemorrhoids varicose veins in the rectum and anus
severe abdominal pain, inability to pass stool,
ileus vomiting, and abdominal distension as a result of
intestinal blockage
protrusion of a loop of small intestine into the
inguinal hernia inguinal (groin) region through a weak spot in the
abdominal wall
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Figure 8-14
An inguinal hernia. A portion of the small intestine is protruding through the
abdominal muscles into the groin region.
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Small Intestine and Large Intestine
Pathology (4 of 5)
Term Definition
result of the intestine slipping or
intussusception telescoping into another section of intestine
just below it
disturbance in the function of the intestine
irritable bowel from unknown causes; symptoms include
syndrome (IBS) abdominal discomfort and alteration in
bowel activity
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Figure 8-15
Intussusception. A short length of small intestine has telescoped into itself.
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Figure 8-16
Endoscopic view of a polyp in the colon. Note the mushroom-like shape, an enlarged
top growing at the end of a stem. It is being removed by means of a wire loop slipped
over the polyp and then tightened to cut it off.
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Small Intestine and Large Intestine
Pathology (5 of 5)
Term Definition
proctoptosi
prolapsed or drooping rectum and anus
s
chronic inflammatory condition resulting in
ulcerative numerous ulcers on the lining of the colon;
colitis also called inflammatory bowel disease
(IBD)
condition in which the bowel twists upon
volvulus
itself, causing an obstruction
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Figure 8-17
Volvulus. A length of small intestine has twisted around itself, cutting off blood
circulation to the twisted loop.
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Accessory Organ Pathology
Term Definition
inflammation of the gallbladder; most
cholecystitis
commonly caused by gallstones
presence of gallstones; may or may not
cholelithiasis
cause symptoms
chronic liver disease; associated with failure
cirrhosis
of the liver to function properly
inflammation of the liver, usually due to a
hepatitis
viral infection
hepatoma liver tumor
pancreatitis inflammation of the pancreas
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Figure 8-18A
Common sites for cholelithiasis.
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Figure 8-18B
A gallbladder specimen with multiple gallstones.
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Clinical Laboratory Tests (1 of 2)
Term Definition
alanine
enzyme normally present in the blood; levels are
transaminase
increased in persons with liver disease
(ALT)
aspartate
enzyme normally present in the blood; levels are
transaminase
increased in persons with liver disease
(AST)
laboratory test to determine whether microscopic
fecal occult blood
amounts of blood are present in feces; also called
test (FOBT)
hemoccult or stool guaiac test
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Clinical Laboratory Tests (2 of 2)
Term Definition
test to diagnose H. pylori infection
H. pylori antibody test
associated with peptic ulcer disease
examination of feces to detect the
ova and parasites (O&P)
presence of parasites or their eggs
test to determine the amount of bilirubin
serum bilirubin in bloodstream; elevated levels indicate
liver disease
test of feces to look for the presence of
stool culture
pathogenic bacteria
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Diagnostic Imaging (1 of 2)
Term Definition
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Figure 8-19
X-ray of the colon taken during a barium enema.
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Diagnostic Imaging (2 of 2)
Term Definition
percutaneous
X-ray of the liver and bile ducts after
transhepatic
injection of contrast medium directly
cholangiograp
into the liver
hy (PTC)
X-ray of the esophagus, stomach, and
upper
duodenum taken after oral
gastrointestinal
administration of barium contrast
(UGI) series
material; also called a barium swallow
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Endoscopic Procedures (1 of 3)
Term Definition
instrument used to view inside the
colonoscope
colon
process of visually examining the
colonoscopy colon by passing a colonoscope
through the anus and rectum
endoscopic
procedure used to visualize the
retrograde
hepatic duct, common bile duct, and
cholangiopan-
pancreatic duct; involves use of an
creatography
endoscope, X-rays, and contrast dye
(ERCP)
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Endoscopic Procedures (2 of 3)
Term Definition
esophagogastr
use of a flexible fiberoptic scope to
o-
visualize the esophagus, stomach,
duodenoscopy
and beginning of the duodenum
(EGD)
instrument used to view inside the
gastroscope
stomach
procedure in which a flexible
gastroscope is passed through the
gastroscopy
mouth and down the esophagus to
visualize inside the stomach
instrument used to view inside the
laparoscope
abdominal cavity
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Endoscopic Procedures (3 of 3)
Term Definition
procedure in which a lighted
laparoscope is passed through the
laparoscopy
abdominal wall and used to visually
examine the abdominal cavity
instrument used to view inside the
sigmoidoscope
sigmoid colon
procedure in which a flexible
sigmoidoscopy sigmoidoscope is used to visually
examine the sigmoid colon
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Additional Diagnostic Procedures
Term Definition
method of determining whether a
person’s weight is healthy; involves
body mass
dividing weight in kilograms by height in
index (BMI)
square meters, then comparing the
result to a predefined range of values
insertion of a needle into the abdominal
paracentesis
cavity to withdraw fluid
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Dental Procedures
Term Definition
dental appliance to replace missing teeth; is
bridge
attached to adjacent teeth for support
artificial covering for a tooth created to replace the
crown
original enamel
denture partial or complete set of artificial teeth
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Medical Procedures
Term Definition
injection of fluid through the rectum and into the
enema
large intestine
use of a nasogastric (NG) tube to place liquid
gavage
nourishment in the stomach
use of a nasogastric (NG) tube to wash out the
lavage
stomach
nasogastric
intubation insertion of a flexible catheter through the nose
and down the esophagus to the stomach
(NG tube)
total parenteral providing 100% of a patient’s nutrition
nutrition (TPN) intravenously
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Surgical Procedures (1 of 5)
Term Definition
surgical creation of a connection
anastomosis
between two organs or vessels
appendectomy surgical removal of the appendix
group of surgical procedures to
treat morbid obesity by reducing
bariatric surgery
stomach size or diverting food from
part of the alimentary canal
cholecystectomy surgical removal of the gallbladder
choledocholithotrip crushing of a gallstone in the
sy common bile duct
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Surgical Procedures (2 of 5)
Definition
colectomy surgical removal of the colon
surgical creation of an opening of
some portion of the colon through the
colostomy
abdominal wall to the outside surface
of the body
diverticulecto
surgical removal of a diverticulum
my
abdominal operation for the purpose of
exploratory examining the abdominal organs and
laparotomy tissues for signs of disease or
abnormalities
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Figure 8-20
A) The colon illustrating various ostomy sites. B) Colostomy in the descending colon,
illustrating functioning stoma and nonfunctioning distal sigmoid colon and rectum.
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Surgical Procedures (3 of 5)
Term Definition
fistulectomy surgical removal of an anal fistula
laparoscopic bariatric surgical
procedure that places a restrictive
gastric banding
band around the top portion of the
stomach
bariatric surgical procedure that
divides the stomach into two portions,
gastric bypass
then connects the upper portion
directly to the small intestine
gastrectomy surgical removal of the stomach
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Surgical Procedures (4 of 5)
Term Definition
procedure that closes off a large
gastric stapling
section of the stomach with staples
surgical procedure to create an
gastrostomy
opening in the stomach
hemorrhoidecto surgical removal of hemorrhoids
my from the anorectal area
surgical repair of a hernia; also
hernioplasty
called herniorrhaphy
surgical creation of an opening in
ileostomy
the ileum
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Surgical Procedures (5 of 5)
Term Definition
laparoscopic surgical removal of the gallbladder
cholecystectom through a small abdominal incision
y using a laparoscope
laparotomy surgical incision into the abdomen
liver transplant implantation of a donor liver
palatoplasty surgical repair of the palate
pharyngoplasty surgical repair of the throat
surgical fixation of the rectum and
proctopexy
anus
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Digestive System Pharmacology (1 of 2)
Drug Type Use Examples
suppresses appetite to
anorexiant Obezine, Adipex
treat obesity
Tums, Maalox,
antacid neutralizes stomach acid
Mylanta
Imodium,
antidiarrheal used to control diarrhea Lomotil,
Kaopectate
treats nausea, vomiting, Compazine,
antiemetic
and motion sickness Phenergan
herpes used to treat herpes
Valtrex, Zovirax
antivirals simplex infection
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Digestive System Pharmacology (2 of 2)
Drug Type Use Examples
blocks H2-receptors in the
H2-receptor Zantac, Tagamet,
stomach, reducing acid
antagonist Pepcid
production
treats constipation by
Senokot,
laxative stimulating a bowel
Metamucil
movement
proton pump blocks the stomach's
Nexium, Prilosec
inhibitor ability to secrete acid
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Digestive System Abbreviations (1 of 6)
Term Definition
ac before meals
ALT alanine transaminase
AST aspartate transaminase
Ba barium
BaE barium enema
BE barium enema
BM bowel movement
BMI body mass index
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Digestive System Abbreviations (2 of 6)
Term Definition
BS bowel sounds
CBD common bile duct
EGD esophagogastroduodenoscopy
endoscopic retrograde
ERCP
cholangiopancreatography
FOBT fecal occult blood test
GB gallbladder
GERD gastroesophageal reflux disease
GI gastrointestinal
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Digestive System Abbreviations (3 of 6)
Term Definition
H. pylori Helicobacter pylori
HAV hepatitis A virus
HBV hepatitis B virus
HCl hydrochloric acid
HCV hepatitis C virus
HDV hepatitis D virus
HEV hepatitis E virus
HSV-1 herpes simplex virus type 1
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Digestive System Abbreviations (4 of 6)
Term Definition
IBD inflammatory bowel disease
IBS irritable bowel syndrome
IVC intravenous cholangiography
N&V nausea and vomiting
NG nasogastric (tube)
NPO nothing by mouth
O&P ova and parasites
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Digestive System Abbreviations (5 of 6)
Term Definition
pc after meals
PO by mouth
pp postprandial
PTC percutaneous transhepatic cholangiography
PUD peptic ulcer disease
q every
qam every morning
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Digestive System Abbreviations (6 of 6)
Term Definition
qh every hour
TPN total parenteral nutrition
tTG tissue transglutaminase
UGI upper gastrointestinal series
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Copyright
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