Digestive System

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Notes on Gastrointestinal System

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Digestive System

  1. 1. Digestive system(gastrointestinal tract/alimentary canal) <ul><li>It consist of mouth, oral cavity,pharynx, esophagus, stomach , small & large intestine. Salivary glands, liver, gallbladder and pancreas which secrete digestive enzymes </li></ul><ul><li>Function: </li></ul><ul><li>Ingestion, peristalsis, digestion, absorption, elimination/defecation. </li></ul><ul><li>Hunger: craving for food </li></ul><ul><li>Starvation: decrease in food intake </li></ul><ul><li>Appetite: desire for specific food </li></ul><ul><li>Hypothalamus : control centre located in brain </li></ul><ul><li>Oral Cavity: cheeks, lips, hard palate, soft palate, rugae, tongue, tonsils, gums, teeth(32) i.e central incisor, lateral incisor, canine, first premolar, second premolar, first/second & third molar(wisdom tooth) </li></ul><ul><li>Surfaces of teeth: labial,buccal,occlusal, incisal </li></ul><ul><li>A tooth consist of Crown, root, enamel,dentin, cementum, pulp & periodontal membrane. </li></ul><ul><li>There are three pairs of salivary gland parotid, submandibular & sublingual gland, there function is to secrete saliva. </li></ul><ul><li>Pharynx or throat is a muscular tube located in the posterior part of mouth </li></ul>
  2. 2. mouth Oral cavity
  3. 3. Pathological conditions of oral cavity & teeth <ul><li>Ankyloglossia/ tongue tie: not able to protude tongue out of cavity </li></ul><ul><li>Apthous ulcer/stomatitis/canker: inflammation of mouth with small ulcer.types are major & minor apthaie </li></ul><ul><li>Gingivitis: inflammation of gums </li></ul><ul><li>Dental caries: tooth decay, because of acids, pulp infection, RCT </li></ul><ul><li>Periodonitis: acute inflammation of gums, teeth & bone </li></ul><ul><li>Leukoplakia:whitish coloration of mucous membrane, it is a precancerous condition </li></ul><ul><li>Erythroplakia:reddish coloration </li></ul><ul><li>Melanoplakia: blackish coloration </li></ul><ul><li>Herpetic stomatitis: HSV inflammation of the mouth </li></ul><ul><li>Oral Thrush/Candidiasis: Fungal infection of mouth. antifungal </li></ul><ul><li>Mucositis: infection of mouth by bacteria, virus, fungal, radiation </li></ul><ul><li>Treatment consist of oral care, control of pain with analgesics, antibiotics </li></ul>
  4. 4. Anatomy of esophagus/stomach/SI/LI (Bile) Function of pancreas: Pancreatic juices (amylase/lipase) Insulin
  5. 6. Duodenum: recives juice from pancreas & bile Jejunum Illeum Cecum Appendix
  6. 8. Pathology of Digestive system <ul><li>Achlorhydria: lack of HCL in stomach, e.g. chronic gastritis/gastric ca. </li></ul><ul><li>Anorexia: loss of apetite, e.g anorexia nervosa/liver disease </li></ul><ul><li>Ascites:abnormal collection of fluid in peritoneum due to cirrhosis,CCF </li></ul><ul><li>Belching: gas expelled thru mouth </li></ul><ul><li>Colic: acute abdominal pain because of aerophagia/lactose allergy </li></ul><ul><li>Constipation:unable to defecate due to dry & hard stools </li></ul><ul><li>Diarrhoea:loose watery stools </li></ul><ul><li>Dysphagia: painful/difficulty in swallowing </li></ul><ul><li>Flatus: gas expelled thru anus </li></ul><ul><li>Gastroesophageal reflux(GERD):regurgitation of stomach contents </li></ul><ul><li>Heartburn: substernal, midchest burning because of GERD </li></ul><ul><li>Haematochezia: bright red blood from rectum e.g piles, ulcerative colitis </li></ul><ul><li>Melena:Black dark brown stool containg blood </li></ul><ul><li>Nausea: discomfort preceding vomiting </li></ul><ul><li>Steatorrhea: fat in the feaces </li></ul><ul><li>Jaundice:yellow discoloration of skin & other tissues secondary to high bilrubin.Due to cirrhosis of liver, obstruction of bile/destruction of cells </li></ul>
  7. 9. Disease of GI tract <ul><li>Peptic ulcer </li></ul><ul><li>Achlasia;failure of lower spinchter to relax </li></ul><ul><li>Anal fistula: a tube like passage connected with rectum </li></ul><ul><li>Peritonitis </li></ul><ul><li>Appendicitis </li></ul><ul><li>Diverticulitis </li></ul><ul><li>Bulimia </li></ul><ul><li>Colitis/enteritis: infection of colon & rectum </li></ul><ul><li>Botulism: food poisioning due to clostridium botulinium </li></ul><ul><li>Dysentry:painful inflamed intestines </li></ul><ul><li>Esophageal varices: swollen, twisted vein at distal end </li></ul><ul><li>Colonic polyposis </li></ul><ul><li>Crohns disease:chronic inflammation of intestine </li></ul><ul><li>Hernia:protusion of organ or part thru the muscle normally containing it </li></ul><ul><li>Irritable bowel syndrome:constipation, lower abdominal pain & bloating </li></ul><ul><li>Volvulus:twisting of intestine upon itself </li></ul><ul><li>Intussusceptions: telescoping of intestine </li></ul>
  8. 10. Test for digestive system <ul><li>Stool analysis; stool culture, microscopy </li></ul><ul><li>Xray abdomen for gas under diaphram </li></ul><ul><li>Barium swallow </li></ul><ul><li>Barium meal </li></ul><ul><li>CT scan, MRI & PET abdomen </li></ul><ul><li>USG </li></ul><ul><li>Procedure: </li></ul><ul><li>Gastroscopy </li></ul><ul><li>Esophagoscopy </li></ul><ul><li>Duodenoscopy </li></ul><ul><li>Colonoscopy </li></ul><ul><li>Sigmoidscopy </li></ul><ul><li>Proctoscopy </li></ul><ul><li>Nasogastric intubation </li></ul><ul><li>Paracentesis </li></ul><ul><li>Colostomy </li></ul>
  9. 11. Liver <ul><li>Anatomy: </li></ul><ul><li>Site </li></ul><ul><li> division </li></ul><ul><li>Histology </li></ul><ul><li> lobules made up of hepatic cells </li></ul><ul><li> Bile juice </li></ul><ul><li>Function: </li></ul><ul><li>Formation of bile juice </li></ul><ul><li>Blood proteins used for blood clotting </li></ul><ul><li>Removal of RBC, WBC & some bacteria </li></ul><ul><li>Detoxification: removal of harmful products </li></ul><ul><li>Removal of glucose from blood and storage as glucagon in liver cells </li></ul><ul><li>Storage of vitamins and activation of vitamins </li></ul>
  10. 12. Pancreas & Gall Bladder <ul><li>Histology: </li></ul><ul><li>exocrine:pancreatic juice </li></ul><ul><li>endocrine: </li></ul><ul><li>glucagon, insulin & stomatostatin </li></ul>
  11. 13. Pathological conditions of pancreas, liver & GB <ul><li>Panreatitis: inflammation of pancreas </li></ul><ul><li>Cirrhosis:chronic degeneration of liver cells </li></ul><ul><li>Hepatitis:inflammation of liver caused by virus </li></ul><ul><li>Type A transmitted by food & infected water </li></ul><ul><li>Type B by blood, body fluids like tear, saliva </li></ul><ul><li>Type C by blood or blood products </li></ul><ul><li>Gallstones(cholelithaisis): hard collection of bile in gallbladder </li></ul><ul><li>Lab Test: </li></ul><ul><li>LFT: SGOT, SGPT, S. Bilrubin, Alkaline phosphatase </li></ul><ul><li>CT scan Abdomen </li></ul><ul><li>ERCP: endoscopic retrograde cholangiopancreatiography </li></ul><ul><li>Liver scan </li></ul><ul><li>Abbreviations: </li></ul><ul><li>BM: bowel movement </li></ul><ul><li>GI: gastrointestinal TPN: total parentral nutrition </li></ul><ul><li>IBD: inflammatory bowel disease PUD: peptic ulcer disease </li></ul><ul><li>NG Tube:nasogastric tube BE: barium enema </li></ul><ul><li>NBM:nil by mouth </li></ul>
  12. 14. Drugs associated with GIT <ul><li>Antacids </li></ul><ul><li>Antisecretories/PPI (proton pump inhibitor) omeparazole, esmeperazole, rabeprazole,pantaprozole, ranitidine, famotidine </li></ul><ul><li>Antispasmodics:diclomine, mefmanic acid,trenaxmic acid, atropine, belladona </li></ul><ul><li>Digestants:Pancreatic enzyme, lipase </li></ul><ul><li>Antiemitics: metachlorpramide, domperidon,odansteron, granisteron </li></ul><ul><li>Cathartics and laxatives:bisacodyl,phenolphalein,psyllium husk </li></ul>

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