KIN 2509 Ch 7

• the branch of medicine concerned with digestive diseases
• concentrates on the diagnosis and treatment of diseases involving the esophagus, stomach, small intestine, large intestine (colon), liver, gallbladder, and pancreas

• before or in front of
• in anatomical nomenclature, refers to the ventral or abdominal side of the body

the orange-yellow pigment of bile, formed principly by the breakdown of hemoglobin in red blood cells (RBCs) after termination of their normal lifespan

a hormone, produced by the mucosa of the upper intestine, that stimulates the contraction of the gallbladder and secretion of pancreatic enzymes

the semifluid, homogenous, creamy paste produced by gastric digestion of food

the elimination of feces from the digestive tract through the rectum

the state of being distended, swollen, or stretched out

• the breakdown of large fat globules into smaller, uniformly distributed particules
• accomplished mainly by bile acids in the small intestine
• first step in the preparation of fat for chemical digestion by specific enzymes

an acid that is normally present in gastric juice

any of a group of fats or fatlike substances that are insoluble in water (i.e. fats and cholesterol) but soluble in fat solvents such as alcohol, ether, and chloroform

• a type of epithelial tissue that lines body surfaces and excretes a thick substance
• Ex - the linings of the mouth, the digestive tube, the respiratory passages, and the genitourinary tract

• the principal digestive enzyme of gastric juice that begins protein digestion
• the gastric glands produce pepsin continuously but in different amounts, depending on the quantity of food absorbed

progressive, wavelike contractions that propel foodstuffs through the digestive tract, bile through the bile duct, and urine in the urinary system through the ureters

• food enters
• mouth
• pharynx
• esophagus
• stomach
• duodenum
• jejunum
• ileum
• cecum
• ascending colon
• transverse colon
• sigmoid colon
• rectum
• anus
• feces expelled

mouth

mouth

tongue

tongue

cheek

lip

lip

teeth

teeth

gum(s)

saliva, salivary gland

• any disease of the mouth
• synonymous with stomatosis

inflammation of the tongue

• abnormal condition of the lips
• characterized by scales & fissures caused by a deficiency of vitamin B complex (especially riboflavin) in the diet

inflammation of the gums

a calculus or stone formed in a salivary gland or duct

esophagus

pharynx (throat)

a hernia of the esophagus

inflammation of the pharynx (throat)

stomach

pylorus, pyloric sphincter

duodenenum

intestine (usually small intestine)

jejunum

ileum

partial or total removal of the stomach

surgical repair of the pyloric sphincter

visual examination of the duodenum (first part of the small intestine)

an intestinal disease

suture of the jejunum (second part of the small intestine)

inflammation of the ileum (third part of the small intestine)

appendix

appendix

colon

colon

sigmoid colon

rectum

anus, rectume

excision of the appendix (wormlike projection that hangs from the cecum)

inflammation of the appendix

surgical creation of an artificial opening on the abdominal wall by incising the colon and drawing it out to the surface

visual examination of the inner surface of the colon using a colonoscope

incision of the sigmoid colon

• herniation or protrusion of the rectum
• synonymous with proctocele

pain in the rectum or around the anus

liver

bile vessel

enlargement of the liver

radiographic record of the bile ducts obtained by cholangiography

bile, gall

gallbladder

bile duct

pancreas

formation or presence of calculi (bile stones) in the gallbladder or common duct

excision of the gallbladder

forming an opening into the common bile duct

without, not

through, across

painful, bad, difficult

excessive, above normal

around

loss of apetite; aversion to food

abnormally frequent discharge or flow of fluid fecal matter from the bowel

difficult digestion

excessive vomiting

• a specialist in peridontics
• branch of dentistry concerned with the treatment of abnormal conditions of the tissues around the teeth

after, behind

under, below

after a meal

pertaining to the area under the tongue

inflammation of the lip

• a plaque disease caused by the complex interaction of food, especially starches and sugars, with bacter that form dental plaque
• tooth decay

a precancerous, slowly developing change in the mucous membrane characterized by thickened, white, firmly attached patches that are slightly raised and sharply circumscribed

a disease of the supporting structures of the teeth (the periodontium) including the gums and bone structure to which the teeth are anchored

inflammation of a salivary gland

• any inflammatory condition of the mouth
• may result from infection by bacteria, viruses, or fungi; from exposure to certain chemicals or drugs; from vitamin deficiency; or from a systemic inflammatory disease

a recurring condition characterized by the eruption of painful ulcers (canker sores) on the mucous membranes of the mouth

a form of stomatitis caused by a herpes virus infection

an infection of the mouth or throat, especially in infants and young children, caused by Candida albicans

tortuous (twisted) dilatation of esophageal veins situated at the distal end of the esophagus, especially susceptible to ulceration and hemorrhage

• the most common throat disorder
• an acute or chronic inflammation of the pharynx

an abnormal condition characterized by inability of a muscle to relax, particularly the cardiac sphincter of the stomach

inflammation of the stomach and small intestine, accompanying numerous gastrointestinal disorders

a backflow of contents of the stomach into the esophagus; often the result of incompetence of the lower esophageal sphincter

narrowing of the pyloric sphincter at the outlet of the stomach, causing an obstruction that blocks the flow of food into the small intestine

• a lesion or erosion of the mucous membrane
• major forms - gastric & duodenal ulcers

an inborn error of metabolism characterized by the inability to hydrolyze peptides contained in gluten

a chronic inflammation, usually of the ileum, although it may affect any portion of the gastrointestinal tract

inflammation of the colon or large intestine; usually due to infection

a chronic inflammation and ulceration of the colon, often beginning in the rectum or sigmoid colon and extending upward into the entire colon

condition in which bulging pouches (diverticula) in the GI wall push the mucosal lining through the surrounding muscle

inflammation of one or more diverticula

the presence of pouchlike herniations through the muscular layer of the colon, particularly the sigmoid colon

inflammation of the intestine, especially of the colon, which may be caused by chemical irritants, bacteria, protozoa, or parasites

congenital absence of autonomic ganglia (groups of nerve cells) in the smooth muscle wall of the colon, which causes poor or absent peristalsis in the involved segment of the colon, accumulation of feces, and dilation of the bowl (megacolon)

partial or complete obstruction of the small or large bowel lumen

an obstruction that occurs when there is a blockage within the intestine from pressure on the intestinal walls

an obstruction that occurs when the intestinal peristalsis decreases or stops because of vascular or neuromuscular pathology

the sliding of the inner segment of intestine into another segment

chronic or periodic diarrhea alternating with constipation

a condition of multiple polyps in the large intestine

a twisting of the bowel on itself, causing intestinal obstruction

an abnormal tubelike passage from a normal cavity or tube to a free surface or to another cavity

a fistula near the anus that may open into the rectum

dilated, tortuous (twisted) veins in the mucous membrane

• hermorrhoids that involve veins outside the anal sphincter
• they are usually not painful
• bleeding does not occur unless a hemorrhoidal vein ruptures or thromboses

hemorrhoids that involve veins above the internal sphincter of the anus

• chronic liver disease characterized by the destruction of liver cells
• eventually leads to impaired liver function and jaundice

inflammatory condition of the liver, characterized by jaundice, hepatomegaly, anorexia, abdominal and gastric discomfort, abnormal liver function, clay-colored stools, and tea-colored urine

• inflammation of the liver caused by a virus
• marked by hepatic cells destruction, necrosis, and autolysis; leading to anorexia, jaundice, and hepatomegaly

• hepatitis caused by hepatitis A virus
• characterized by the slow onset of signs & symptoms

hepatitis caused by hepatitis B virus

• also known as non-A, non-B hepatitis
• transmitted largely by blood transfusion or percutaneous inoculation

• delta hepatitis
• a form of hepatitis that occurs only in patients infected with hepatitis B

• epidemic non-A, non-B hepatitis
• self-limited type of hepatitis, common in developing countries
• may occur after natural disasters because of fecally contaminated water or food

an inflammatory condition of the pancreas that may be acute or chronic

pancreatitis of sudden onset

pancreatitis of slow progression or frequent recurrence

the presence or formation of stones in the gallbladder, also known as gallstones

absence of hydrochloric acid in the gastric juice

lack or loss of appetite, resulting in the inability to eat

abnormal accumulation of fluid in the peritoneal cavity

an audible abdominal sound produced by hyperactive intestinal peristalsis

• a state of ill health, malnutrition, and wasting
• may occur in many chronic diseases, malignancies, and infections

• a change in normal bowel habits characterized by decreased infrequent, difficult defecation or passage of hard, dry stools
• sluggish action of the bowels

a change in bowel habits characterized by the frequent passage of loose, fluid, unformed stools

a vague feeling of epigastric discomfort, felt after eating

air or gas in the intestine that is passed through the rectum

a protrusion or projection of an organ or a part of an organ through the wall of the cavity that normally contains it

• a loop of intestine descends through the femoral canal into the groin
• surgical repair (herniorrhaphy) is the usual treatment

protrusion of a portion of the stomach upward through the diaphragm, commonly producing no symptoms

• a type of hernia in which a loop of intestine enters the inguinal canal
• in a man, it sometimes fills the entire scrotal sac

a soft, skin-covered protrusion of intestine and omentum through a weakness in the abdominal wall around the umbilicus

a yellow discoloration of the skin, mucous membranes, and sclerae of the eyes, caused by higher than normal amounts of bilirubin in the blood

abnormal black tarry stool that has a distinctive odor and contains digested blood

unpleasant wave-like sensation in the throat or abdomen, usually preceding vomiting

itching of varying intensity of the skin around the anus

• higher than normal amounts of fat in the feces
• any condition in which fats are poorly absorbed by the small intestine

• radiographic examination of the rectum and colon following administration of barium sulfate (radiopaque contrast medium) into the rectum
• this procedure is used for diagnosis of obstructions, tumors, or other abnormalities (i.e. ulcerative colitis)

radiographic examination of the esophagus, stomach, and small intestine following oral administration of barium sulfate (radiopaque contrast medium)

radiographic examination for outlining the major bile ducts by intravenous injection or direct instillation of a radiopaque contrast medium

in intravenous cholangiography, a contrast agent is injected slowly into the vein, and radiographs are taken of the region of the gallbladder

a radiographic examination of the structure of the bile ducts

a radiographic examination of the gallbladder after the ingestion of a contrast medium

• a radiographic imaging modality that is more sensitive than a conventional x-ray examination
• a scanner and detector circle the patient's body, sending images to a computer, which allows the radiographer and physician to view any part of the body
• the image produced represents a detailed cross secretion of tissue structure

provides visualization of the internal organs of the abdomen, such as the gallbladder, liver, bile ducts, pancreas, kidneys, ureters, and bladder

direct radiographic visualization with a fiberoptic endoscope, including radiographic fibroscopy, to examine the size and the filling of the pancreatic and biliary ducts

a radiographic technique for visually examining a part of the body or the function of an organ with a fluoroscope

imaging procedure that uses radiofrequency radiation as its source of energy

• used of sound waves (ultrasound) to produce an image of an organ or tissue
• ultrasonic echoes are recorded as they strike tissues of different densities

ultrasonographic visualization of the internal organs of the abdomen, such as the liver, gallbladder, bile ducts, pancreas, kidneys, bladder, and ureters

• visualization of the interior of organs and cavities of the body with an endoscope
• the organ being examined dictates the name of the endoscopic procedure

visual examination of the esophaus (esophagoscopy), stomach (gastroscopy), and duodenum (duodenoscopy), using a lighted, fiberoptic endoscope

visual examination of the colon (colonoscopy), sigmoid colon (sigmoidoscopy), rectum and anal canal (proctoscopy) using a lighted, fiberoptic endoscope

the plating of feces to one or more culture media to grow colonies of microorganisms for the purpose of identifying specific pathogen(s)

test performed on feces using the reagent gum guaiac to detect the presence of blood in the feces that is not apparent on visual inspection (obscure, hidden, or occult blood)

• a batter of tests used to determine liver cell dysfunction and liver disease
• alanine aminotransferase: blood test to measure the concentration of the enzyme ALT in the blood
• alkaline phosphatase: test to measure the concentration of the enzyme ALP in the blood; increased levels of ALP are found in liver disease
• aspartate aminotransferase: test to measure the concentration of the enzyme AST in the blood, which is released following damage to cells, particularly cardiac muscle and liver cells
• gamma glutamyltransferase: blood test to determine liver cell dysfunction and to detect alchol-induced liver disease
• bilirubin: test to measure the bilirubin concentration in the blood

removal of a small piece of living tissue for microscopic examination, usually to establish or confirm a diagnosis, estimate prognosis, or follow the course of a disease

removal of living tissue, for microscopic examination, by suction through a fine needle attached to a syringe

a special needle is introduced into the liver under local anesthesia to obtain a specimen for pathological examination

removal of tissue for microscopic examination by use of a needle, usually attached to a syringe

surgical connection between two vessels; surgical joining of two ducts, blood vessels, or bowel segments to allow flow from one to another

connection between the ileum and rectum after total colectomy as is sometimes performed in the treatment of ulcerative colitis

connection of two portions of the intestines, also called eneteroenterostomy

surgical procedure that sutures the lip, such as in the repair of a congenitally cleft lip or a lacterated lip

surgical creation of an artificial anus on the abdominal wall by incising the colon and drawing it out to the surface through which feces will be expelled into a disposable bag

excision of one or more hemorrhoids

surgical puncture of the peritoneal cavity (abdomen) to withdraw fluid

washing out of the stomach; used to empty the stomach when the contents are irritating, as in prolonged postanesthetic vomiting and some cases of regurgitant vomiting in acute intestinal obstruction

insertion of a nasogastric tube through the nose into the stomach to relieve gastric distension by removing gas, gastric secretions, or food; to instill medication, food, or fluids; or to obtain a specimen for laboratory analysis

drugs that exert a therapeutic effect by neutralizing acid, especially in the stomach and duodenum

drugs that relieve diarrhea either by absorbing the excess fluids that cause diarrhea or by lessening intestinal motility (slowing the movement of fecal material through the intestine), allowing more time for absorption of water

drugs that prevent or relieve nausea and vomiting, mainly by acting on brain control centers to stop nerve impulses

drugs that reduce the feeling of gaseousness and flatulences accompanying indigestion

agents that may be used for protective effects in ulcer disease and for mild to moderate diarrhea

agents that induce vomiting, especially in cases of poisoning

drugs used to treat ulcers and gastroesophageal reflux disease by blocking the release of acid in the gastric parietal cells, which line the stomach

agents that act topically on the ulcer surface and bind directly to necrotic areas, forming a protective layer over the ulcer, allowing it to heal

substances that inhibit acid secretion and stimulate the production of protective mucus bicarbonate

• specifically inhibit acid production
• used in the treatment of peptic ulcers and gastroesophageal reflux disease

bowel movement

diagnosis

gallbladder

gastroesophageal reflux

gastroesophageal reflux disease

gastrointestinal

hepatitis A virus

hepatitis B virus

hepatitis C virus

hepatitis D virus

hepatitis E virus

irritable bowel syndrome

intravenous

left lower quadrant

left upper quadrant

nasogastric

• physical examination
• pulmonary embolism

past medical history

right lower quadrant

right upper quadrant

aspiration biopsy cytology

• alanine aminotransferase (elevated in liver & heart disease)
• enzyme tests of liver function

• angiotensin sensitivity test
• aspartate aminotransferase

alkaline phosphatase

barium

barium enema

basal acid output

blood urea nitrogen

centimeter

computed tomography

computed tomography scan

x-ray images in a cross-sectional view

esophagogastroduodenoscopy

endoscopic retrograde cholangiopancreatography

endoscopic retrograde sphincterectomy

extracorporeal shock-wave lithotripsy

fasting blood sugar

gallbladder series

gamma glutamyltransferase

glucose tolerance test

intravenous cholangiography

liver function test(s)

maximal acid output

oral cholecystography

• postoperative
• period of onset

peptic ulcer disease

upper gastrointestinal tract (x-ray)

magnetic resonance imaging

ultrasound

before meals (ante cibum)

twice a day

at bedtime

nothing by mouth

after meals (postprandial)

by mouth (per os)

as required

every morning

every day

• every hour
• q#h - every # hrs

every 2 hours

four times a day

every other day

every night

immediately

three times a day