Beruflich Dokumente
Kultur Dokumente
ASystemicApproach
SixthEdition
MaryLouMulvihill
MarkZelman
PaulHoldaway
ElaineTompary
JillRaymond
Chapter10
DiseasesoftheDigestiveSystem
Mulvihill,Zelman,Holdaway,Tompary,andRaymond
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Chapter 10
Diseases of the Digestive System
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Mouth
Salivary glands
Pharynx
Esophagus
Stomach
Liver
Gallbladder (GB)
Pancreas
Small intestine
Large intestine
Rectum
Anus
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Main Functions
Digesting food
Physical and chemical breakdown of large food into
molecules: glucose, triglycerides, amino acids
Absorbing nutrients
From intestines
Circulated through the body by cardiovascular system
Eliminating waste
Any food that cannot be digested or absorbed is
expelled
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Digestive Process
Begins when food enters
mouth
Mechanically broken up by
chewing
Digestive enzymes
Lubricates
surface
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palate is uvula
Pharynx
After the food leaves the mouth it enters
the oropharynx
Laryngopharynx
Epiglottis
Covers the larynx and trachea
Food is shunted away from the lungs into
esophagus
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Esophagus
Muscular tube
10 inches long in adults
Food enters from pharynx
Delivered to the stomach
Propelled along by wavelike muscular
movements
Peristalsis
Pushes food through the entire gut tube
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The Stomach
J-shaped muscular organ
Collects
Churns
Digests
Stores food
3 parts
Fundus (upper)
Body (main)
Antrum (lower)
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stomach lining
Hydrochloric acid is
secreted by glands
Mixes with food to form
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Sphincters
Muscular valves
Control flow of food in one direction only
Cardiac sphincter located near the heart
Lower esophageal sphincter keeps food
from backing up into the esophagus
Pyloric sphincter opens and closes
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colon)
Ileum (about 12 feet in length)
Jejunum (about 8 feet long)
Averages 20 feet of intestines
Longest portion of alimentary canal
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Colon
5 feet long
Extends from ileocecal
valve to anus
CecumAppendix
Ascending colon
Transverse colon
Descending colon
Sigmoid colon
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Salivary Glands
Three pairs
Parotid glands
Sublingual glands
Submandibular glands
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Produce saliva
Allow food to be
swallowed without
choking
Saliva + food = bolus
Contain amylase that
begins digestion of
carbohydrates
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Liver
Large organ
Located in right upper quadrant of
abdomen
Processes nutrients
Detoxifies harmful substances
Produces bile
Emulsification
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Gallbladder
Stores bile released from common bile
duct
Gallstones form when the bile contains too
much cholesterol.
Higher incidence in women
Obesity increases risk
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Pancreas
Produces pancreatic enzymes
Chemically digest:
Carbohydrates
Fats
Proteins
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Digestion
Mechanical breakdown of food, which begins in
the mouth
Passes through the pharynx, or throat, and into
the esophagus
Moves down the esophagus to the stomach,
where the digestion of proteins, large complex
molecules, begins
Sphincter muscle at the juncture of the
esophagus and stomach prevents regurgitation
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Digestion Stomach
The stomach secretes gastric juice that contains
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Digestion Liver
Bile, secreted by the liver and stored in the gallbladder,
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Esophageal Varices
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Esophagitis
Esophagitis, inflammation of the esophagus, causes
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Hiatal Hernia
A hernia is the protrusion of part of an organ through a
breath
Avoidance of irritants such as spicy foods and caffeine and
frequent small meals may be adequate treatment. If the person
is obese, weight loss is recommended.
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Gastritis
Acute gastritis is an inflammation of the stomach
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Peptic Ulcers
Ulcers are lesions of any body surface
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Peptic Ulcers
Caused in part by pepsin, a proteolytic enzyme secreted
by the stomach
Hydrochloric acid of the stomach and intestinal juice,
including bile, that is regurgitated through the pyloric
sphincter also irritate the gastric mucosa.
Irritated and inflamed mucous membrane may become
necrotic, leaving a hole.
Infection with the bacterium Helicobacter pylori is
associated with ulcers.
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intestines.
Symptoms include anorexia, nausea, vomiting, and
diarrhea.
The onset may be abrupt and violent with rapid loss of
fluid and electrolytes.
Possible causes are bacterial or viral infection, chemical
toxins, lactose intolerance, or other food allergy, although
the actual cause is not always clear. Treatment replaces
fluid and nutritional requirements including the lost salts.
Antispasmodic medications can control the vomiting and
diarrhea.
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Food Contaminants
Food contaminated with human or animal feces
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Appendicitis
Appendicitis is an acute inflammation of the
appendix.
The pain of appendicitis often begins in the
middle of the abdomen and shifts to the lower
right quadrant.
Nausea, vomiting, and fever are often symptoms. The
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Appendicitis (continued)
The pain of appendicitis often begins in the
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Malabsorption Syndrome
Inability to absorb fat or some other substance
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Complications
Defective mucosal cells can account for the
abnormal absorption.
Many other diseases cause secondary
malabsorption syndrome.
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Complications (continued)
One of the complications of the malabsorption
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Diverticulitis
Diverticula are little pouches or sacs formed when the
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Regional Enteritis
An inflammatory disease of the intestine that most
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disease
Corticosteroids are sometimes administered to
control autoimmunity.
Surgery may be necessary, occasionally
requiring a colostomy.
A colostomy is an artificial opening in the abdominal
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States
The mass is often felt by rectal examination or seen with
the protoscope or colonoscope, endoscopes used for
viewing the rectum and colon.
The symptoms vary according to the site of the
malignancy. A change in bowel habits, diarrhea or
constipation is symptomatic. As the tumor grows, there
may be abdominal discomfort and pressure. Blood often
appears in the stools, and continuous blood loss from
the malignant tumor causes anemia. The mass can
partially or completely obstruct the lumen of the colon.
As the tumor invades underlying tissue, the cancer cells
spread through the lymph vessels and veins.
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Intestinal Obstruction
Obstructions are classed as organic when there
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Intestinal Obstruction
(continued)
Adhesions, the linking together of two surfaces
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Symptoms of Obstruction
An acute organic obstruction causes severe pain. The
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Spastic Colon
Symptoms include diarrhea, constipation,
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Dysentery
Dysentery is an acute inflammation of the colon,
a colitis.
The major symptom of dysentery is diarrhea in
which the stools contain pus, blood, and mucus.
Severe abdominal pain accompanies the
diarrhea. Bacteria, parasitic worms, and other
microorganisms can cause dysentery. The
protozoan Entamoeba histolytica, which is
transmitted in feces-contaminated food and
water, causes amoebic dysentery.
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Dysentery (continued)
Organisms invade the wall of the colon and
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Vomiting
A protective mechanism, a response to the presence of
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Diarrhea
Diarrhea results when the fluid contents of the
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Constipation
Constipation results when feces remain in the colon too
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Hemorrhoids
Enlarged (varicose) veins in the lining of the
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Hemorrhoids (continued)
Straining to have a bowel movement can cause
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Occult Bleeding
Microscopic examination of stool may identify
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the liver. These cells engulf and digest bacteria and other foreign
substances, thus cleansing the blood.
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Gallbladder
A small sac-like structure on the underside of the
liver
Bile is secreted continuously by the liver into the
hepatic duct, which carries bile to the gallbladder
for storage and concentration.
The gallbladder releases the bile through the
cystic duct to the common hepatic duct, which
carries the bile to the duodenum. Release of bile
is coordinated with the appearance of fats in the
duodenum.
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anemias.
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Hepatitis
An inflammation of the liver caused by a
number of factors
Several viruses have been identified as
causing hepatitis.
Important causes are hepatitis A, hepatitis
B, hepatitis C, and hepatitis D. Hepatitis E
is uncommon in the United States.
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Hepatitis C
Hepatitis C is the leading viral cause of chronic liver
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Hepatitis A
Known as Infectious hepatitis, it is the least
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Hepatitis A (continued)
Contaminated water or food is the usual source of
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Hepatitis B
Formerly called serum hepatitis, it is a more
serious disease
Can lead to chronic hepatitis or cirrhosis of the
liver
The incubation period is long, lasting from 2 to 6
months.
The severity of the disease varies greatly.
Occasionally, a fulminating of hepatitis B
develops, and it is fatal. This form has a sudden
onset and progresses rapidly. The person
becomes delirious, then becomes comatose, and
dies.
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Hepatitis B (continued)
Can be transmitted by blood or serum transfusions in
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Hepatitis D
A defective virus that is incapable of
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Hepatitis E
Rare in the United States, but worldwide is the
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Cirrhosis
Chronic destruction of liver cells and tissues with
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Cirrhosis (continued)
A cirrhotic liver loses this organization and, as a
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Hepatocarcinoma
Cancer of the liver, is sometimes a complication
of cirrhosis
The symptoms of hepatocarcinoma vary
according to the site of the tumor. If the tumor is
obstructing the portal vein, ascites develops in
the abdominal cavity, as it does in cirrhosis. If
the fluid is found to contain blood, a malignancy
is indicated. A tumor blocking the bile duct will
cause jaundice. General symptoms may include
loss of weight, an abdominal mass, and pain in
the upper right quadrant of the abdomen.
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Hepatocarcinoma (continued)
More often, cancer detected in the liver is a result of
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Cholecystitis
An inflammation of the gallbladder
Symptoms include pain under the right rib cage
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Cholecystitis (continued)
Complications from cholecystitis include
Lack of blood flow due to the obstruction brought
about by the swelling can cause an infarction
Gangrene can set in. The acutely inflamed
gallbladder, like an inflamed appendix, may rupture,
causing peritonitis.
Necrosis and fibrosis of the liver cells lining the ducts
or biliary (bile) cirrhosis.
Cholecystitis is usually caused by an
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Copyright2006byPrenticeHall,Inc.
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Mulvihill,Zelman,Holdaway,Tompary,andRaymond
HumanDiseases:ASystemicApproach,6e
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UpperSaddleRiver,NewJersey07458
Allrightsreserved.
Mulvihill,Zelman,Holdaway,Tompary,andRaymond
HumanDiseases:ASystemicApproach,6e
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Pancreas
The pancreas is a fish-shaped organ extending
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Acute Pancreatitis
Steady abdominal pain of sudden onset followed
Mulvihill,Zelman,Holdaway,Tompary,andRaymond
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Mulvihill,Zelman,Holdaway,Tompary,andRaymond
HumanDiseases:ASystemicApproach,6e
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Diagnosis of Pancreatitis
Several factors can cause pancreatitis, but the most
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Copyright2006byPrenticeHall,Inc.
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Mulvihill,Zelman,Holdaway,Tompary,andRaymond
HumanDiseases:ASystemicApproach,6e
Copyright2006byPrenticeHall,Inc.
UpperSaddleRiver,NewJersey07458
Allrightsreserved.
Copyright2006byPrenticeHall,Inc.
UpperSaddleRiver,NewJersey07458
Allrightsreserved.
Copyright2006byPrenticeHall,Inc.
UpperSaddleRiver,NewJersey07458
Allrightsreserved.