Gastrointestinal System

Gastrointestinal System
Chapter Five Gastrointestinal System Mastering Healthcare Terminology/Chapter 5

Quote “Anybody who believes that the way to a man’s
heart is through his stomach flunked geography.” Robert Byrne The order of the gastrointestinal system is extremely important in healthcare terminology, and the heart is most definitely not located anywhere in this system! Mastering Healthcare Terminology/Chapter 5

The Gastrointestinal (GI) System
Gastrointestinal system or tract Alimentary canal (aliment/o) Digestive system This is one system that has a variety of names. And each of them is used with a fair amount of regularity! We’ll start with the gastrointestinal system (gastr/o + intestin/o + -al). Two important organs of the system, the stomach and the intestines, are named perhaps for their important roles. Notice the abbreviation GI, because that, too, is commonly used. The term tract (not track!) refers to the organs collectively, while the use of the term system adds the connotation of an interactive structure. Be Careful! The combining form gastr/o refers only to the stomach. The alimentary canal is a more metaphorical way to describe the system. Alimentary refers to nutrition (aliment/o = nutrition) and certainly the word canal refers to the long tube that the food travels down on its route through the body. The digestive system is probably the term you are most familiar with, although the function of digestion is the process of breaking apart food. Let’s look at the functions of the digestive system in the next slide. Mastering Healthcare Terminology/Chapter 5

Did You Know? The alimentary canal acquires its name from the Latin term alimentum, which refers to food or nourishment. Its influence is currently seen in contemporary words, such as adult, meaning grown up or nourished, alimony, meaning an allowance for sustenance, and alma mater, meaning a nourishing mother.

Functions and Specialties
Ingestion Digestion Absorption Elimination (defecation/feces) Specialties Gastroenterology Specialists Gastroenterologist Dentist Exodontist Periodontist/pedodontist Proctologist The functions of the GI system include 1. ingestion: the intake of food 2. digestion: the physical and chemical breakdown of food 3. absorption: the extraction of nutrients 4. elimination: the excretion of waste products The medical term for the waste products of the GI system is feces. The process of releasing feces from the body is defecation. You may have heard the abbreviation BM referring to bowel movements. This is another term for feces. Ask students if they can think of any disorders related to these functions. Gastroenterologist treats disorders of the digestive system, exodontists remove teeth, periodontists treat the gums, pedodondists are children‘s dentists, protologists treat disorders of the anus and rectum. Mastering Healthcare Terminology/Chapter 5

General Description of the GI System: the Route through the Body
Oral cavity Mediastinal cavity Abdominopelvic cavity Peritoneal cavity Mesentery The digestive system begins with the mouth and ends with the anus. On its route through the body, it travels through a number of body cavities. Because these cavities share organs and functions with other systems, the location of the digestive organs can sometimes cause confusion with symptoms of pain, for example. Here we can see that the system begins with the first bite of food entering the oral cavity, proceeding down the throat to the esophagus through the mediastinal cavity, and on to the abdominopelvic cavity. The stomach and intestines lie within the periitoneal cavity and are attached to the wall of the body by a vascular network of tissue called the mesentery. The extensive blood supply is necessary to absorb nutrients and route them to the cells. Mastering Healthcare Terminology/Chapter 5

General Description of the GI System: Layers
Inner: tunica mucosa Middle: submucosa Outer: tunica muscularis Peristalsis The digestive tract is composed of three layers, termed tunics. It’s important to be aware of this because the severity of certain diseases (ulcers and cancer, for example) is judged by the damage it does to a particular layer. The inner layer is termed the tunica mucosa. It secretes gastric juices, absorbs nutrients, and protects the tissues of the system through the production of mucus. The middle layer is called the submucosa (remember that sub- means under). This layer holds the blood, lymphatic, and nervous tissue. Finally, the deepest or outside layer is called the tunica muscularis. Its function is to move the food through the system through coordinated continual contraction and relaxation around the digestive tube. This wavelike movement is called peristalsis (peri- around, surrounding) and –stalsis (contraction). Mastering Healthcare Terminology/Chapter 5

Clicker Question Which process of the GI system refers to the breakdown of food? A. ingestion B. digestion C. absorption D. elimination B. digestion Mastering Healthcare Terminology/Chapter 5

Oral Cavity (or/o, stom/o, stomat/o)
Mastication, deglutition Lips (labi/o, cheil/o) Cheeks (bucc/o) Tongue (gloss/o, lingu/o) Palate (palat/o) Teeth (dent/i, odont/o) Incisors and cuspids Bicuspids and molars The oral cavity is responsible for the function of mastication (chewing) and deglutition (swallowing). The combining forms stom/o and stomat/o refer literally to a mouth or an opening. Review the combining forms for the oral cavity, naming the lips, cheeks, tongue, palate and teeth. Note that students can feel the difference between the hard and soft palates by sliding their tongue to the roof of their mouth right behind their teeth (the hard palate) and farther back (the soft palate). Be Careful! with stom/o and stomat/o vs. stomach. Remind them of the use of these combining forms with the specialists named earlier. The incisors and cuspids are the teeth that are located in the anterior (front ) of the mouth, while the bicuspids and molars are located in the posterior (back) of the mouth. The incisors and cuspids serve to tear and break apart food, while the bicuspids and molars function to chew (masticate) the food. The word part cusp/o refers to a point. In this case, the cuspids have a single “point”, while the bicuspids have two. Oral cavity Mastering Healthcare Terminology/Chapter 5

Oral Cavity (cont’d) Gums (gingiv/o) Uvula (uvul/o)
Salivary glands (sialaden/o) and saliva (sial/o) Parotid Sublingual Submandibular Note that a specialist in the gums is a periodontist, not a gingivologist (don’t shoot the messenger!). The term uvula comes from the Latin meaning literally “little grape.” Perhaps the uvula does appear to be a small grape that hangs from the back of the soft palate, but our best meaning for uvul/o is the uvula. There are three salivary glands, each named for its location. The parotid gland is near (par-) the ear (ot/o), the sublinugal gland is under (sub-) the tongue (lingu/o), and the submandibular gland is under (sub-) the lower jawbone (mandibul/o). Mastering Healthcare Terminology/Chapter 5

Throat and Esophagus Pharynx (pharyng/o) Esophagus (esophag/o)
Nasopharynx Oropharynx Hypopharynx Esophagus (esophag/o) Bolus Lower esophageal sphincter (LES)/ cardiac sphincter/ gastroesophageal sphincter After chewing and swallowing a mouthful of food, the food enters the pharynx (the throat). There are three sections of the throat: the first, the nasopharynx, is behind the nasal cavity; the second, the oropharynx, is behind the oral cavity; and the third, the hypopharynx, is the area of the throat that is below the oropharynx. Another term that is sometimes used for the hypopharynx is the laryngopharynx because it is near the larynx, the voicebox. The esophagus is a muscular tube, about 12 inches long, that extends from the throat to the stomach. The masticated lump of food that is swallowed is termed the bolus. If you’ve ever swallowed a piece of meat that is too big, you may have experienced the peristaltic motion of this bolus being pushed toward the stomach. The sphincter muscle (a round muscle) that opens and closes to allow the food into the stomach is called the lower esophageal sphincter, abbreviated LES, the cardiac sphincter, and the gastroesophageal sphincter. The first and last terms are understandable, but what about “cardiac sphincter”? It gets its name from its proximity to the heart. Pharynx Mastering Healthcare Terminology/Chapter 5

Did You Know? A sphincter is a ringlike muscle: sphincters appear in other parts of the body as well, for example, in the urinary system and the eye.

The Stomach (gastr/o) Cardia (cardi/o) Fundus (fund/o) Body (corpor/o)
Pylorus (pylor/o) Rugae (rug/o) Chyme From the esophagus, the bolus enters the stomach in the area of the cardia (again, because it is near the heart). The main part of the stomach is called the body, or corporis. The gastric fundus is the most superior part of the body of the stomach. The end of the stomach where the food exits is called the pylorus (also referred to as the gastric antrum). Digestion continues its chemical breakdown of the masticated food by mixing it with gastric juices and hydrochloric acid. The mixture of the food with the gastric juices and acid is termed chyme. The stomach is lined with ridges called rugae (s. ruga) . The stomach Mastering Healthcare Terminology/Chapter 5

Small Intestines (enter/o)
Plicae (plic/o) Villi Duodenum (duoden/o) Jejunum (jejun/o) Ileum (ile/o) The main function of the small intestines is the absorption of nutrients from the chyme. The structure of the intestines is a series of folds (plicae) that contain thousands of tiny projections termed villi (s. villus), which contain blood capillaries that absorb the products of carbohydrate and protein digestion. The three sections of the small intestines in order are the duodenum, the jejunum, and the ileum. Be Careful! Don’t confuse ileum with ilium (part of the hip). Emphasize the importance of learning the order of the three parts of the small intestine. Small intestines From Mosby’s dictionary, ed 8, Mosby Mastering Healthcare Terminology/Chapter 5

Clicker Question Stomat/o is a combining form for the: A. saliva
B. abdomen C. stomach D. oral cavity, mouth D. Oral cavity, mouth Mastering Healthcare Terminology/Chapter 5

Large Intestines (col/o, colon/o)
Cecum (cec/o) Ileocecal sphincter Vermiform appendix (appendic/o, append/o) Ascending colon Transverse colon Descending colon Sigmoid colon (sigmoid/o) Rectum (rect/o) Anus (an/o) (proct/o is for anus and rectum) The large intestines, also called the bowels, are much shorter in length than the small intestines, about 5 feet. The adjective large comes from the diameter. The main function of the large intestines is the elimination of waste products and the synthesis of vitamins. The waste that is in the intestines at this point is no longer chyme, but is now called feces. The first part of the large intestine is the cecum. The sphincter between the ileum and the cecum is the ileocecal sphincter. The vermiform appendix hangs from the cecum. Although it has no function in the digestive system, it may have a function in the lymphatic system. From the cecum, the feces travel up the ascending colon, across the transverse colon, down the descending colon, through the sigmoid colon (sigmoid/ literally means “S” like), and finally through the rectum and out the anal sphincter. Again, emphasize the order of the parts of the large intestine. Review the combining forms for anus, rectum, and anus + rectum. Be careful not to confuse an/o, ana- and an-. The large intestine Mastering Healthcare Terminology/Chapter 5

Accessory Organs (Adnexa)
Liver Gallbladder Pancreas Accessory organs

The Liver (hepat/o) Location/lobes (lob/o)
The liver functions to produce bile Bile (bil/i, chol/e) serves to emulsify fats Bile is composed of bilirubin and cholesterol Bile in liver  bile ducts  hepatic duct  joins with cystic duct from the gallbladder to form the common bile duct (choledoch/o)  empties bile into the duodenum The liver is composed of two lobes and is located mostly in the upper right quadrant of the abdominal cavity. Liver produces bile that emulsifies (breaks down) fats. Bile is composed of bilirubin, the waste product formed by the normal breakdown of hemoglobin in red blood cells at the end of their life spans and cholesterol, a fatty substance found only in animal tissues. Mastering Healthcare Terminology/Chapter 5

Gallbladder (cholecyst/o)
Location/description Stores bile from the liver Role of cholecystokinin in bile secretion The gallbladder is a small sac that is found on the underside of the right lobe of the liver. Its function is to store bile until needed in digestion. When fatty food enters the duodenum, cholecystokinin is secreted, which causes the gallbladder to contract and release bile into the cystic duct. Note that –kinin is a suffix for a substance that moves, making cholecystokinin, a substance that moves the gallbladder. From the cystic duct it travels to the common bile duct and then on to the duodenum. Mastering Healthcare Terminology/Chapter 5

Pancreas (pancreat/o)
Location Exocrine function of the pancreas is key in the digestion of: Carbohydrates Proteins Lipids Pancreatic enzymes enter the duodenum through the pancreatic duct that empties into the common bile duct The pancreas is located in the upper left quadrant behind the stomach. It is involved in the digestion of carbohydrates, proteins, and fats (lipids). Pancreatic involvement in the digestive function is considered exocrine (meaning to secrete out) because it is through a duct. Later we will discuss the endocrine function of the pancreas, where it secretes within the bloodstream (endocrine). Mastering Healthcare Terminology/Chapter 5

Clicker Question A combining form for the gallbladder is:
A. choledoch/o B. cholecyst/o C. cholangi/o D. hepat/o B. Cholecyst/o Mastering Healthcare Terminology/Chapter 5

Terms Related to Upper Gastrointestinal Complaints
Dyspepsia Eructation Halitosis Pyrosis Hiccup/singultus Dyspepsia is the medical term for indigestion. Dys- means bad, difficult, or painful and the suffix –pepsia stands for digestion. Eructation is a medical term for the expulsion of air from the stomach through the mouth. You may recognize this as belching or burping. If air is swallowed, either intentionally or unintentionally, while eating, the term is aerophagia (aer/o = air + -phagia = condition of eating/swallowing). Halitosis is literally an abnormal condition of the breath, although it is generally considered to be bad breath. Pyrosis is a medical term for heartburn. It comes from the combining form for fire (pyr/o) and the suffix (-osis) for abnormal condition. Hiccups are involuntary contractions of the diaphragm, followed by a rapid closure of the glottis (the area where the vocal cords are located). Hiccup can also be spelled hiccough. Another synonym is singultus. Mastering Healthcare Terminology/Chapter 5

Terms Related to Upper Gastrointestinal Complaints (cont’d)
Nausea Regurgitation Vomiting (vomitus/emesis) Hematemesis N&V (nausea and vomiting) Nausea is a sensation that accompanies the urge to vomit. Its word derivation is related to the word nautical, having to do with the ocean. Hence, the term for sea sickness. Regurgitation is the return of swallowed food to the mouth. It can also be used to describe any backward flow (for example, mitral regurgitation in the cardiovascular system) elsewhere in the body. Vomiting is the forceful or involuntary emptying of the contents of the stomach through the mouth. The medical term for the product of vomiting is vomitus, also called emesis. Emesis is also used as a medical suffix. Hematemesis is the vomiting of blood (hemat/o = blood). A common abbreviation used in describing patient complaints is N&V, which stands for nausea and vomiting. Mastering Healthcare Terminology/Chapter 5

Did You Know? The term hiccup is a healthcare example of a word that was created to imitate the sound of the act. Nausea derives its name from the Greek word for seasickness. Notice the similarity between the words nausea and nautical. Heartburn is a misnomer. This burning sensation is experienced in the chest near the heart, not the heart itself.

Terms Related to Lower Gastrointestinal Complaints
Constipation vs. obstipation Diarrhea Flatus Hematochezia Melena Irritable bowel syndrome (IBS) Constipation is infrequent, incomplete, or delayed bowel movements (BM). Obstipation is extreme constipation or intestinal obstruction. Diarrhea is an abnormal discharge of watery, semisolid stools. Flatus is gas passed through the anus. Hematochezia is bright red (frank) blood in the stools (-chezia = condition of stools) Melena is black, tarry stools caused by the presence of partially digested blood (melan/o = black, dark). Irritable bowel syndrome is a group of symptoms marked by diarrhea/gas/constipation resulting from stress with no underlying disease. Mastering Healthcare Terminology/Chapter 5

Clicker Question Which of the following is a symptom of black, tarry stools? A. diarrhea B. flatus C. hematochezia D. melena D. melena

Terms Related to Congenital Disorders
Cleft palate Esophageal atresia A cleft palate is a failure of the roof of the mouth to close during embryonic development, resulting in an opening of the roof of the mouth. Esophageal atresia (a- = without + = tresia condition of an opening) is a condition of the esophagus ending in a blind pouch and therefore lacking an opening into the stomach. Discuss how esophageal atresia is often not diagnosed immediately after birth and what this means for patient care. Cleft palate and lip From Zitelli: Atlas of pediatric physical diagnosis, ed 5, Mosby Mastering Healthcare Terminology/Chapter 5

Terms Related to Congenital Disorders
Hirschsprung disease Megacolon Pyloric stenosis From Zitelli: Atlas of pediatric physical diagnosis, ed 4, Mosby Hirschsprung disease is a congenital absence of normal nervous function in part of the colon, resulting in an absence of peristaltic movement, accumulation of feces, and an enlarged colon. A synonym is congenital megacolon (mega- = large). Pyloric stenosis is a narrowing of the pyloric sphincter muscle, which prevents partially digested food from passing into the duodenum. Mastering Healthcare Terminology/Chapter 5

Terms Related to Oral Cavity Disorders
Aphthous stomatitis Cheilitis Cheilosis Aphthous stomatitis is an inflammation of the mouth with the presence of small ulcers (aphth/o = ulceration). These erosions appear on the mucous membranes of the mouth. A synonym is canker sores. Cheilitis is an inflammation of the lips, while cheilosis is an abnormal condition of the lips that is present with riboflavin deficiency. Cheilitis From Callen et al: Color atlas of dermatology, ed 2, Saunders Mastering Healthcare Terminology/Chapter 5

Terms Related to Oral Cavity Disorders (cont’d)
Malocclusion Dental caries Dental plaque Malocclusion (mal- + -occlusion) is misalignment of the upper and lower teeth. Dental caries are commonly known as cavities. The caries are caused by an interaction between food and bacteria in the mouth. Dental plaque is a film of material that coats the teeth and may lead to decay if not removed. Mastering Healthcare Terminology/Chapter 5

Herpetic stomatitis Leukoplakia Leukoplakia Herpetic stomatitis (stomat/o + -itis) is an inflammation of the mouth due to the herpes simplex virus (HSV). This is also called a cold sore or a fever blister. Don’t confuse it with aphthous stomatitis, which is a canker sore. Leukoplakia (leuk/o + -plakia) is a condition of white patches on the lips and/or the buccal mucosa. This condition is often associated with tobacco use (chewed or smoked) and may be precancerous. From Eisen and Lynch: The mouth: diagnosis and treatment, Mosby Mastering Healthcare Terminology/Chapter 5

Periodontal disease Gingivitis Pyorrhea Gingivitis From Eisen and Lynch: The mouth: diagnosis and treatment, Mosby Periodontal (peri- + odont/o + -al) disease is disease of the tissues surrounding the teeth. It can include gingivitis and pyorrhea. Gingivitis (gingiv/o + -itis) is an inflammation of the gums. Pyorrhea (py/o + -rrhea) is a discharge of pus from the tissue surrounding the teeth if the tissue becomes infected. Mastering Healthcare Terminology/Chapter 5

Clicker Question An inflammation of the gums is: A. gingivitis
B. cheilitis C. pyorrhea D. malocclusion A. gingivitis Mastering Healthcare Terminology/Chapter 5

Terms Related to Disorders of the Esophagus
Achalasia Cardiospasm Dysphagia Gastroesophageal reflux disease (GERD) Achalasia (a- + -chalasia) is a condition of being without relaxation. It is an impairment of the normal peristaltic movement of the esophagus, along with an inability of the lower esophageal sphincter to relax and allow a bolus of food into the stomach. Synonyms for achalasia include esophageal aperistalsis (again, notice the prefix a- meaning no, not, without), megaesophagus (mega- meaning large), and cardiospasm, meaning an involuntary contraction (-spasm) of the cardiac sphincter (cardi/o)–not the heart! Dysphagia means difficulty with swallowing. One of our acronyms, GERD, signifies a return of the contents of the stomach to the esophagus because of the LES’s inability to remain contracted. It is the opposite of achalasia! Symptoms may include pyrosis (heart burn) and regurgitation. Another disorder, Barrett esophagus, is a condition that is often associated with the chronic irritation of the esophagus by GERD. This disorder is associated with an increased risk of cancer. Discuss the “backwards” nature of the term gastroesophageal reflux disease. Why not esophageogastric reflux disease? GERD Mastering Healthcare Terminology/Chapter 5

Terms Related to Disorders of the Stomach
Gastralgia Gastritis Peptic ulcer disease (PUD) Define and decode (where appropriate) these terms related to disorders of the stomach. Gastralgia is pain of the stomach, stomach pain, or a stomachache. Gastritis is an inflammation of the stomach. Ask students if they can think of another term for gastralgia? (gastrodynia) Peptic ulcer disease gets its name peptic meaning pertaining to digestion (remember the suffix –pepsia?). So this is a type of erosion of the mucosal lining of the GI system. It occurs most often in the stomach or duodenum. Chronic peptic ulcer From Damjanov: Pathology, a color atlas, Mosby Mastering Healthcare Terminology/Chapter 5

Terms Related to Intestinal Disorders
Appendicitis Acute peritonitis Appendicitis (appendic/o + -itis) is an inflammation of the appendix. Peritonitis is an inflammation of the peritoneum, the lining of the abdominal cavity. It can occur if the appendicitis is not treated and the appendix bursts. What does acute mean? What is the opposite (chronic)? Be careful not to confuse peritone/o (membrane that lines the abdominal cavity), perone/o (fibula), and perine/o (space between the anus and external reproductive organs). Ask if students can identify the therapeutic intervention to treat appendicitis. (appendectomy) Appendicitis From Zitelli: Atlas of pediatric physical diagnosis, ed 4, Mosby Mastering Healthcare Terminology/Chapter 5

Terms Related to Intestinal Disorders (cont’d)
Anal fissure Anorectal abscess Hemorrhoid Proctitis Pruritus ani An anal fissure is a crack-like lesion of the skin around the anus. An anorectal abscess is a circumscribed purulent (pus-filled) area of inflammation in the anus and rectum. A hemorrhoid is a varicose vein (swollen, twisted) of the lower rectum and/or anus. Proctitis is an inflammation of the rectum and anus. Pruritus ani is an itching of the skin around the anus. Hemorrhoids From Lewis et al: Medical-surgical nursing, ed 7, Mosby Mastering Healthcare Terminology/Chapter 5

Colitis Crohn disease Inflammatory bowel disease (IBD) Ulcerative colitis Ulcerative colitis From Damjanov: Pathology for the health professions, ed 3, Saunders Colitis is an inflammation of the colon. Crohn disease is an inflammation of the ileum or the colon that is of idiopathic origin. Also called regional or granulomatous enteritis. Inflammatiory bowel disease (IBD) is a chronic inflammation of the lining of the intestine characterized by bleeding and diarrhea. Ulcerative colitis is a chronic inflammation of the colon and rectum manifested by bouts of profuse watery diarrhea. Mastering Healthcare Terminology/Chapter 5

Terms Related to Intestinal Disorders, (cont’d)
Diverticulosis Diverticulitis Fistula Internal External Diverticula are pouches in the lining of the colon. Diverticulosis is the abnormal condition of the presence of these pouches. Diverticulitis is an inflammation of the diverticula. A fistula is an abnormal opening between organs (internal) or to the outside of the body (external). This occurs as the result of a disease process, not a surgical intervention. A fistula is an abnormal opening between organs (internal)or to the outside of the body (external) . This occurs as the result of a disease process, not a surgical intervention. Diverticulosis From Damjanov: Pathology, a color atlas, Mosby Mastering Healthcare Terminology/Chapter 5

Ileus Intussusception Paralytic ileus Volvulus An ileus is an obstruction in the intestines. Discuss ways that students can remember the difference between an ileus and ileum. An intussusception is a telescoping of the intestines. A paralytic ileus is a blockage due to a lack of peristalsis of the intestines. A volvulus is a twisting of the intestines. The derivation of the term has to do with turning as in the word revolve, which literally means to turn again. A. Intussusception, B. Volvulus From Damjanov: Pathology for the health professions, ed 3, Saunders Mastering Healthcare Terminology/Chapter 5

Clicker Question A twisting of the intestines: A. anastomosis
B. paralytic ileus C. intussusception D. volvulus D. volvulus Mastering Healthcare Terminology/Chapter 5

Terms Related to GI Accessory Organ Disorders
Cirrhosis Hepatitis A B C Jaundice Pancreatitis Cirrhosis is a chronic degenerative disease of the liver, usually associated with alcohol abuse. Cirrh/o means an orange-yellow color, referring to the accompanying jaundice. Hepatitis is an inflammation of the liver that is caused by a variety of viruses. Hepatitis A is transmitted through direct contact with fecally contaminated food or water. Hepatitis B is transmitted through contaminated blood or sexual contact. Hepatitis C is transmitted through blood transfusions, percutaneous inoculation, or through the sharing of infected needles. Jaundice is a yellowing of the skin and sclerae. Pancreatitis is an inflammation of the pancreas. Cirrhosis From Damjanov: Pathology, a color atlas, Mosby Mastering Healthcare Terminology/Chapter 5

Terms Related to GI Accessory Organ Disorders
Cholangitis Cholecystitis Choledocholithiasis Cholelithiasis Cholangitis is an inflammation of the bile vessels. Cholecystitis is an inflammation of the gallbladder. Choledocholithiasis is the presence of stones (-lithiasis) in the common bile duct. Cholelithiasis is the presence of stones in the gallbladder. Here, cholecyst/o, which would normally indicate the gallbladder, is contracted to chol/e. Cholelithiasis From Damjanov: A color atlas, Mosby Mastering Healthcare Terminology/Chapter 5

Clicker Question Which of the following disorders involves the presence of stones? A. cholangitis B. cholecystitis C. choledocholithiasis D. cirrhosis C. Choledocholithiasis Mastering Healthcare Terminology/Chapter 5

Terms Related to Hernias
Femoral hernia Hiatal hernia Inguinal hernia Umbilical hernia Umbilical hernia Hiatal hernia A femoral hernia is the protrusion of a loop of intestine through the femoral canal into the groin. It is the same as a crural hernia. A hiatal hernia is a protrusion of part of the stomach through the diaphragm. It is also called a diaphragmatic hernia or a diaphragmatocele. (-cele meaning herniation or protrusion). Be careful! Do not confuse the suffix –cele, meaning herniation, with celi/o, meaning abdomen. An inguinal hernia is a protrusion of a loop of bowel through the inguinal canal. An umbilical hernia is a protrusion of the intestine and omentum (a fold of the peritoneum) through the abdominal wall. It is also called an omphalocele (omphal/o means umbilicus). From Zitelli: Atlas of pediatric physical diagnosis, ed 4, Mosby Mastering Healthcare Terminology/Chapter 5

Terms Related to Hernias (cont’d)
Complications Incarcerated hernia Strangulated hernia An incarcerated hernia occurs when a loop of bowel becomes occluded (blocked or closed) so that solids cannot pass. It is also called an irreducible hernia. Strangulation is the constriction (narrowing) of a tubular structure. A strangulated hernia is one in which the blood flow is shut off. Ask the students why incarcerate and strangulated hernias are medical emergencies. Mastering Healthcare Terminology/Chapter 5

Terms Related to Benign Neoplasms
Cystadenoma Hemangioma Leiomyoma Odontogenic tumor Cystadenoma (-oma means tumor or mass) are glandular tumors that are filled with cysts. These types of tumors most commonly appear in the pancreas. A hemangioma is a common type of tumor that occurs in blood vessels. A leiomyoma is a smooth muscle tumor that may occur throughout the digestive tract. An odontogenic tumor is a tumor that arises around the teeth and the jaw. Mastering Healthcare Terminology/Chapter 5

Terms Related to Benign Neoplasms
Polyps, adenomatous or hyperplastic sessile versus pedunculated Polyps are usually benign growths that occur on mucous membranes throughout the body, although most commonly in the colon. Adenomatous polyps are those that develop from glandular (aden/o) tissue and have the potential to become malignant. Hyperplastic (hyper- excessive + -plastic pertaining to formation) polyps are smaller growths that usually do not become malignant. Both of these polyps may appear as either sessile (flat) or pedunculated (with a stalk). Adenomatous polyps From Damjanov: Anderson’s pathology, ed 10, Mosby Mastering Healthcare Terminology/Chapter 5

Terms Related to Malignant Neoplasms
Adenocarcinoma Hepatocellular carcinoma/hepatoma Squamous cell carcinoma An adenocarcinoma is a malignant tumor of epithelial origin that either originates from glandular tissue or has a glandular appearance. A hepatocellular carcinoma, also called a hepatoma, is a malignant epithelial tumor that originates in the cells of the liver. A squamous cell carcinoma is any cancer of epithelial origin that has a scale-like appearance. Adenocarcinoma of the esphagus From Damjanov: Pathology for health-related professions, ed 3, Mosby Mastering Healthcare Terminology/Chapter 5

Age Matters Pediatric Geriatric Congenital disorders Gastroenteritis
Appendicitis Geriatric Neoplasms GERD Dysphagia Hemorrhoids Type 2 diabetes mellitus Discuss why children are more likely to be diagnosed with gastroenteritis and appendicitis, whereas the elderly more commonly experience neoplasms, GERD, dysphagia, hemorrhoids, and type 2 diabetes.

Clicker Question Which of the following tumors begins in the teeth?
A. odontogenic B. leiomyoma C. cystadenoma D. hemangioma A. odontogenic Odont/o = teeth

Terms Related to Imaging
Barium enema (BE) Barium swallow (BaS) Cholangiography Cholecystography Barium swallow A barium enema is an imaging of the lower digestive tract after the introduction of a barium sulfate solution through the anus. It is used to detect obstructions, tumors, and other abnormalities. A barium swallow is x-ray imaging of the upper GI tract after a patient swallows a barium sulfate solution. It is useful in detecting abnormalities of the esophagus and the stomach. Cholangiography is an imaging of the bile vessels after the injection of a contrast medium. Cholecystography is an x-ray of the gallbladder after the ingestion of iodine. Imaging is done over a series of time periods to assess the organ’s functioning. Cholangiography From Frank et al: Merrill’s Atlas, ed 11, Mosby Mastering Healthcare Terminology/Chapter 5

Terms Related to Imaging (cont’d)
Computed tomography scan (CT) Endoscopy Fluoroscopy Manometry Sonography Computed tomography is a radiographic technique that produces detailed images of cross sections of the body. In the digestive system, CT scans are used to detect tumors and abnormal accumulations of fluid. Endoscopy is the process of viewing within the body using an instrument called an endoscope. Examples of endoscopies in the digestive system are esophagoscopy, gastroscopy, colonoscopy, proctoscopy, sigmoidoscopy, and gastroesophagoduodenoscopy (EGD). Fluoroscopy is an x-ray procedure that allows visualization of structures in real time directly on a monitor screen. The combining form fluor/o means to flow, as this imaging procedure is a “flow” of images, not a static image. Manometry is a test that measure the motor function (muscle pressure) of the esophagus. Although the combining form man/o literally means thin, or scanty, it is used to denote the concept of pressure. Be careful not to confuse the combing form man/o meaning scanty with man/u meaning hand. Manometry gets its name from a device that measures a decreasing (scanty) amount of air pressure. Sonography is the use of high-frequency sound waves to image deep structures of the body. Formerly referred to as ultrasonography. Computed tomography From Frank, Long, and Smith: Merrill’s atlas, ed 10, Mosby Mastering Healthcare Terminology/Chapter 5

Terms Related to Laboratory Tests
Biopsy Gamma-Glutamyltransferase (GGT) Stool culture Stool guaiac/hemoccult test Total bilirubin A biopsy is a viewing of a piece of living tissue. It may be done for diagnostic and, sometimes, therapeutic reasons. A gamma-glutamyltransferase (GGT) is a blood test that detects increased enzymes that can indicate cirrhosis, hepatitis, acute pancreatitis or cholecystitis, and nephrosis or that tests for Helicobacter pylori antibodies. A stool culture is an examination of a fecal sample to test for microorganisms such as worms, amoebae, bacteria, or protozoa. A stool guaiac (also called a hemoccult ) tests for hidden blood in the feces. A total bilirubin test is a blood test to detect cirrhosis or hepatitis or jaundice. Mastering Healthcare Terminology/Chapter 5

Clicker Question Which diagnostic procedure would be used to determine if blood was present in the stool? A. biopsy B. stool guaiac C. manometry D. fluoroscopy B. Stool guaiac Mastering Healthcare Terminology/Chapter 5

Therapeutic Interventions
Anastomoses vs. -stomy Definition of anastomosis Rules for building terms for anastomoses Terms using a single structure with “-stomy” An anastomosis is the joining (or rejoining) of two hollow tubes or organs. Because the digestive system is basically one long tube, any removal of a section requires an anastomosis to rejoin the cut ends. When building a term to signify an anastomosis, the two combining forms are joined in the order of the normal direction of the organs in the system. For example, if the jejunum is removed, an anastomosis of the remaining sections of the small intestines would be a duodenoileostomy. If a term ends with –stomy, it signifies a new opening. In the digestive system, it would signify a new opening to the outside of the body. For example, a colostomy would be a new opening of the colon to the surface of the abdomen. The opening itself would be termed a “stoma.” Have students give examples of each. Mastering Healthcare Terminology/Chapter 5

Terms Related to Therapeutic Interventions
Bariatric surgery Colostomy Stoma Enema Gastrectomy Bar/o is a combining form that refers to weight or pressure. The suffix –iatric means pertaining to treatment. This is surgery done to correct morbid obesity, in which the amount of body fat threatens normal health. Discuss the types of bariatric surgery (lap bands, Roux-en-Y, etc). A colostomy is a new opening of the colon. The opening itself is a stoma, using the combining form for a mouth. Discuss the reasons for the types of interventions noted. The term gastrectomy indicates a removal of the stomach. Have students build terms for resections of various organs: esophagus, stomach, small and large intestines, and accessory organs. Check spelling! If time allows, have them follow up with the terms for anastomoses, where appropriate. Colostomy and stoma From Potter: Fundamentals of nursing, ed 7, Mosby Mastering Healthcare Terminology/Chapter 5

Terms Related to Therapeutic Interventions (cont’d)
Hemorrhoidectomy Herniorrhaphy Laparoscopic surgery A hemorrhoidectomy would be the removal of hemorrhoids. A herniorrhaphy is literally a suturing of a hernia, or a hernia repair. Laparoscopic surgery is surgery through several small incisions in the abdominal wall using a laparoscope. Laparoscopic cholecystectomy Mastering Healthcare Terminology/Chapter 5

Laparotomy Ligation Lysis of adhesions Decode and define the terms noted where appropriate. A laparotomy is a surgical incision of the abdominal wall as a surgical approach. Ligation is the tying of a vessel. Lysis of adhesions is the destruction/removal of adhesions to reopen a cavity. Lysis is one of those terms that can stand on its own as it does here, or can be used as a suffix. Mastering Healthcare Terminology/Chapter 5

Nasogastric intubation Paracentesis Pyloromyotomy Paracentesis of the abdominal cavity From Dorland’s illustrated dictionary, ed 31, Saunders Nasogastric intubation is a procedure in which a tube is placed through the nose, down the throat, and ending in the stomach. It is used to instill fluids as well as to remove them. Paracentesis is a surgical puncture to remove fluids from a body cavity. The prefix para- is used in the same sense as in the term parenteral. The removal is near the digestive system, but not through it. Both of these procedures are done through a needle. Pyloromyotomy is an incision of the pyloric sphincter (muscle) to correct pyloric stenosis, the abnormal narrowing of this muscle. Mastering Healthcare Terminology/Chapter 5

Odontectomy Polypectomy Stomatoplasty Odontectomy is the removal of a tooth, especially the surgical removal of teeth as in the removal of wisdom teeth. A polypectomy is the removal of a polyp. Stomatoplasty is the surgical repair of the mouth. Mastering Healthcare Terminology/Chapter 5

Gastric gavage Enteral nutrition PEG tube Parenteral nutrition Hyperalimentation Patients who cannot eat normally are given assistance in acquiring the necessary nutrition to live through two main methods. Gastric gavage/enteral feeding is accomplished through feeding tubes through a digestive structure . Here the term enter/o is used to refer to the digestive system in general. A PEG tube (percutaneous endoscopic gastrostomy) is a feeding tube that has been placed in the stomach by using endoscopic guidance. Parenteral nutrition is through a structure outside of the digestive system, usually through an intravenous needle. Hyperalimentation is the therapeutic use of nutritional supplements that exceed recommended daily requirements. Mastering Healthcare Terminology/Chapter 5

Pharmacology Anorexiants Antacids Antidiarrheals Antiemetics
Anorexiants are a class of appetite suppressants designed to aid in weight control, often in an attempt to treat morbid obesity. Examples include sibutramine (Meridia) and phentermine (Adipex-P). Antacids are a group of drugs or dietary substances that buffer (neutralize) or absorb hydrochloric acid in the stomach. Examples include calcium carbonate (Tums, Rolaids) and aluminum hydroxide with magnesium hydroxide (Maalox). Antidiarrheals are drugs that provide relief from diarrhea by reducing intestinal motility (movement). Examples include loperamide (Imodium), bismouth subsalicylate (Pepto Bismol), and diphenoxylate with atropine (Lomotil). Antiemetics are medications that prevent or alleviate nausea and vomiting. Examples include scopolamine (Scopace), ondansetron (Zofran), and promethazine (Phenergan). Mastering Healthcare Terminology/Chapter 5

Pharmacology (cont’d)
Cathartics Laxatives Purgatives Histamine-2 receptor antagonists (H2RAs) Proton pump inhibitors Cathartics are agents that cause an evacuation of the bowel by stimulating peristalsis; they can be classified as either mild (in which case they are called laxatives) or severe (in which case they are termed purgatives). Examples of laxatives are fiber, docusate (Colace), and bisacodul (Dulcolax). Senna (Seenacot) and mineral oil (Fleet Enema) are commonly used purgatives. H2RAs are drugs that prevent the production of a portion of the hydrochloric acid in the stomach for moderate-lasting acid suppression. Examples include famotidine (Pepcid) and ranitidine (Zantac). Proton pump inhibitors are drugs that prevent the production of hydrochloric acid in the stomach for long-lasting acid suppression. Examples include omeprazole (Prilosec) and pantoprazole (Protonix). Mastering Healthcare Terminology/Chapter 5

Clicker Question What is removed in an odontectomy? A. teeth B. polyps
C. a section of the stomach D. a section of the lining of the abdomen A. teeth Mastering Healthcare Terminology/Chapter 5

Sort these terms into their correct categories
1. anastomosis 2. peristalsis 3. stool guaiac 4. diverticulitis 5. hepatitis Categories __ A + P __ Pathology __ Diagnostic Procedures __ Therapeutic Interventions A+ P--peristalsis Pathology--diverticulitis, hepatitis Dx --stool guaiac Tx --anastomosis

Parting Thought “If you ever get a second chance in life for
something, you’ve got to go all the way.” –Lance Armstrong Is it always easy to recognize when a second chance appears? Mastering Healthcare Terminology/Chapter 5

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