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Gastroenterology - Learning Objectives
 

Gastroenterology - Learning Objectives

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    Gastroenterology - Learning Objectives Gastroenterology - Learning Objectives Presentation Transcript

    • Gastroenterology
      • The medical specialty that studies the anatomy and physiology of the gastrointestinal system and uses diagnostic tests, medical and surgical procedures, and drugs to treat gastrointestinal diseases.
    • Anatomy and Physiology
      • Gastrointestinal System
      Begins at the mouth, continues through the thoracic cavity, and fills most of the abdominal cavity
      Upper gastrointestinal system includes the structures from the mouth through the stomach
    • Anatomy and Physiology (con’t)
      • Gastrointestinal System (con’t)
      Lower gastrointestinal system includes the small and large intestines
      Purpose is to digest food, absorb nutrients, and remove undigested material (waste) from the body
    • Figure 3-1 Gastrointestinal system
    • Anatomy of the Gastrointestinal System
      • Oral Cavity and Pharynx
      Begins in the mouth, or oral cavity
      Oral cavity contains the teeth; tongue; hard palate; and soft palate with its fleshy, hanging uvula.
      Saliva also contains an enzyme that begins the process of digestion.
    • Anatomy of the Gastrointestinal System (con't)
      • Oral Cavity and Pharynx (con’t)
      There are three pairs of salivary glands: the parotid glands, the sublingual glands, and the submandibular glands.
      The teeth tear, chew, and grind the food during the process of mastication.
      The tongue moves food toward the teeth and mixes food with saliva.
    • Anatomy of the Gastrointestinal System (con't)
      • Oral Cavity and Pharynx (con’t)
      Swallowing or deglutition moves food into the throat or pharynx.
      When food is swallowed, the epiglottis closes the entrance to the larynx, so that food in the back of the throat, pressing on the uvula, does not initiate the gag reflex.
    • Figure 3-2 Oral cavity and pharynx
    • Figure 3-3 Salivary glands
    • Anatomy of the Gastrointestinal System (con't)
      • Esophagus
      A flexible, muscular tube that connects the pharynx to the stomach.
    • Anatomy of the Gastrointestinal System (con't)
      • Stomach
      Divided into four areas: the cardia, fundus, body, and pylorus.
      The gastric mucosa is arranged in thick, deep folds known as rugae which expand as the stomach fills with food.
    • Anatomy of the Gastrointestinal System (con't)
      • Stomach (con’t)
      Two sphincters (muscular rings) keep food in the stomach.
      The lower esophageal sphincter is located in the distal esophagus.
    • Figure 3-4 Stomach
    • Anatomy of the Gastrointestinal System (con't)
      • Small Intestine
      The small intestine is a long, hollow tube that receives chyme from the stomach.
      It is divided into three parts: the duodenum, jejunum, and ileum.
    • Figure 3-5 Small and large intestines
    • Anatomy of the Gastrointestinal System (con't)
      • Large Intestine
      A larger, hollow tube that receives undigested material and water from the small intestine.
      Consists of the cecum, colon, rectum, and anus.
    • Anatomy of the Gastrointestinal System (con't)
      • Large Intestine (con’t)
      Waves of peristalsis slowly move undigested material through the large intestine as water is absorbed through the intestinal wall and into the blood.
      The colon is the longest part.
      It travels through all four quadrants of the abdomen as the ascending colon, transverse colon, descending colon, and sigmoid colon.
    • Anatomy of the Gastrointestinal System (con't)
      • Abdomen and Abdominopelvic Cavity
      Contains the largest organs of the gastrointestinal system.
      The walls of the abdominopelvic cavity are lined by peritoneum, a membrane that secretes peritoneal fluid.
      This watery fluid fills the spaces between the organs and allows them to slide past each other during the movements of digestion.
    • Anatomy of the Gastrointestinal System (con't)
      • The blood supply to the stomach, small intestine, liver, gallbladder, and pancreas comes from the celiac trunk of the aorta, the largest artery in the body.
    • Anatomy of the Gastrointestinal System (con't)
      • Liver
      The liver is the largest solid organ in the body, located in the upper right abdominal cavity.
      An accessory organ of digestion that contributes to, but is not physically involved in, the process of digestion.
    • Figure 3-6 Biliary tree
    • Anatomy of the Gastrointestinal System (con't)
      • Gallbladder
      An accessory organ of digestion posterior to the liver.
      Concentrates and stores bile from the liver.
    • Anatomy of the Gastrointestinal System (con't)
      • Pancreas
      An accessory organ of digestion posterior to the stomach.
      Presence of food in the duodenum causes the pancreas to secrete digestive enzymes into the pancreatic duct to the duodenum.
      Also functions as an organ of the endocrine system.
    • Physiology of Digestion
      • There are two parts to digestion:
      Mechanical
      Chemical
      • Mechanical digestion uses mastication, deglutition, and peristalsis to break down foods.
      • Mechanical digestion also involves breaking apart fats in the duodenum.
    • Physiology of Digestion (con't)
      The enzyme amylase in saliva begins to break down carbohydrate foods in the mouth.
      The stomach secretes the following substances that continue the process of chemical digestion:
      Hydrochloric acid
      Pepsinogen
      Gastrin
      • Chemical digestion is completed in the small intestine.
      • Cholecystokinin stimulates the pancreas to secrete four digestive enzymes into the duodenum:
      Amylase
      Lipase
      Protease
      Other enzymes that break down proteins
      Physiology of Digestion (con't)
    • The liver plays an important role in regulating nutrients such as glucose and amino acids.
      Excess glucose in the blood is stored in the liver as glycogen and released when the blood glucose level is low.
      The liver uses amino acids to build plasma proteins and clotting factors for the blood.
      Physiology of Digestion (con't)
    • Alimentary Canal
      Accessory Structures
      Figure 3-7 Gastrointestinal system.
      (Robert W. Ginn/PhotoEdit Inc.)
    • Diseases and Conditions
      • Eating
      Anorexia
      Dysphagia
      Polyphagia
    • Diseases and Conditions (con't)
      • Mouth and Lips
      Cheilitis
      Sialolithiasis
      Stomatitis
      Glossitis
    • Figure 3-8 Glossitis
      (Centers for Disease Control and Prevention [CDC])
    • Diseases and Conditions (con't)
      • Esophagus and Stomach
      Dyspepsia
      Esophageal varices
      Gastritis
      Gastroenteritis
      Gastroesophageal reflux disease (GERD)
    • Figure 3-9 Esophageal varix
      (David M. Martin, M.D./Photo Researchers, Inc.)
    • Diseases and Conditions (con't)
      • Esophagus and Stomach (con't)
      Heartburn
      Hematemesis
      Nausea and vomiting (N&V)
      Peptic ulcer disease (PUD)
      Stomach cancer
    • Figure 3-10 Gastric ulcer
      (David M. Martin, M.D./Photo Researchers, Inc.)
    • Diseases and Conditions (con't)
      • Duodenum, Jejunum, Ileum
      Ileus
      Intussusception
      Volvulus
    • Figure 3-11 Intussusception of the intestine
    • Diseases and Conditions (con't)
      • Cecum and Colon
      Appendicitis
      Colic
      Colon cancer
      Diverticulum
      Dysentery
    • Figure 3-12 Diverticula
      (David M. Martin, M.D./Photo Researchers, Inc.)
    • Figure 3-13 Diverticulitis and polyposis
    • Diseases and Conditions (con't)
      • Cecum and Colon (con’t)
      Gluten enteropathy
      Inflammatory bowel disease (IBD)
      Irritable bowel syndrome (IBS)
      Polyp
    • Figure 3-14 Crohn’s disease
    • Figure 3-15 Colonic polyps
      (Staats/Custom Medical Stock Photo, Inc.)
    • Diseases and Conditions (con't)
      • Rectum and Anus
      Hemorrhoids
      Proctitis
      Rectocele
    • Diseases and Conditions (con't)
      • Defecation and Feces
      Constipation
      Diarrhea
      Flatulence
      Hematochezia
      Incontinence
      Steatorrhea
    • Diseases and Conditions (con't)
      • Abdominal Wall and Abdominal Cavity
      Adhesions
      Hernia
      Peritonitis
    • Figure 3-16 Hernia
      (From Rudolph, A.M., Hoffman, J.I.E., & Rudolph, C.D. (Eds.) 1991. Rudolph’s Pediatrics. (19th ed., p. 1040))
    • Figure 3-17 Peritonitis
      (Custom Medical Stock Photo, Inc.)
    • Diseases and Conditions (con't)
      • Liver
      Ascites
      Cirrhosis
      Hepatitis
    • Figure 3-18 Fatty liver disease and cirrhosis of the liver
      (Arthur Glauberman/Photo Researchers, Inc.)
    • Diseases and Conditions (con't)
      • Hepatitis is the most common chronic liver disease.
      Hepatitis A
      Hepatitis B
      Hepatitis C
      Hepatitis D
      Hepatitis E
    • Diseases and Conditions (con't)
      Hepatitis A is an acute but short-lived infection caused by exposure to water or food that is contaminated with feces from a person who is infected with the hepatitis A virus (HAV).
    • Hepatitis B is an acute infection caused by exposure to the blood of a person who is already infected with the hepatitis B virus (HBV); it is also known as serum hepatitis.
      It is also spread during sexual activity by contact with saliva and vaginal secretions.
      An infected mother can pass hepatitis B to her fetus before birth or when breastfeeding.
      Diseases and Conditions (con't)
    • Figure 3-19 Blood transfusion
      (PhotoDisc/Getty Images)
    • Hepatitis C is an acute infection caused by exposure to the blood of a person who is already infected with the hepatitis C virus (HCV).
      Hepatitis C is not readily transmitted by sexual activity or from a mother to her fetus.
      Diseases and Conditions (con't)
    • Chronic hepatitis C is the main cause of chronic liver disease, cirrhosis, and liver cancer.
      Hepatitis D is a secondary infection caused by a mutated (changed) hepatitis virus.
      Diseases and Conditions (con't)
    • Hepatitis D only develops in patients who already have hepatitis B; it is also known as delta hepatitis.
      Hepatitis E is similar to hepatitis A but rarely occurs in the United States.
      Diseases and Conditions (con't)
    • Hepatomegaly
      Jaundice
      Liver Cancer
      Diseases and Conditions (con't)
    • Figure 3-20 Jaundice
      (Dr. M.A. Ansary/Photo Researchers, Inc.)
    • Figure 3-21 Liver cancer
      (Gca/Photo Researchers, Inc.)
    • Diseases and Conditions (con't)
      • Gallbladder and Bile Ducts
      Cholangitis
      Cholecystitis
      Cholelithiasis
    • Figure 3-22 Cholelithiasis
      (Custom Medical Stock Photo, Inc.)
    • Figure 3-23 Gallstones in the biliary and pancreatic ducts
    • Diseases and Conditions (con't)
      • Pancreas
      Pancreatic cancer
      Pancreatitis
    • Laboratory and Diagnostic Procedures
      • Blood Tests
      Albumin
      Alkaline phosphatase (ALP)
      ALT and AST
      Bilirubin
    • Laboratory and Diagnostic Procedures (con't)
      • Blood Tests (con’t)
      GGT
      Liver function tests (LFTs)
    • Laboratory and Diagnostic Procedures (con't)
      • Gastric and Feces Specimen Tests
      CLO test
      Culture and sensitivity (C&S)
      Fecal occult blood test
      Gastric analysis
      Ova and parasites (O&P)
      • Radiologic Procedures
      Barium enema
      Cholangiography
      Laboratory and Diagnostic Procedures (con't)
    • Figure 3-24 Barium enema
      (Custom Medical Stock Photo, Inc.)
    • Figure 3-25 Endoscopic retrograde cholangiopancreatography
      • Radiologic Procedures (con’t)
      Computerized axial tomography (CAT, CT scan)
      Flat plate of the abdomen
      Gallbladder ultrasound
      Laboratory and Diagnostic Procedures (con't)
      • Radiologic Procedures (con’t)
      Magnetic resonance imaging (MRI) scan
      Oral cholecystography (OCG)
      Laboratory and Diagnostic Procedures (con't)
      • Radiologic Procedures (con’t)
      Upper gastrointestinal series (UGI)
      Laboratory and Diagnostic Procedures (con't)
    • Medical and Surgical Procedures
      • Medical Procedures
      Insertion of nasogastric tube
    • Figure 3-26 Nasogastric tube
      (Pearson Education/PH College)
    • Medical and Surgical Procedures (con't)
      • Surgical Procedures
      Abdominocentesis
      Appendectomy
      Biopsy
      Bowel resection and anastomosis
      Cholecystectomy
      Choledocholithotomy
    • Figure 3-27 Laparoscopic cholecystectomy
      (Geoff Tompkinson/Photo Researchers, Inc.)
    • Medical and Surgical Procedures (con't)
      • Surgical Procedures (con’t)
      Colostomy
      Endoscopy
      Exploratory laparotomy
    • Figure 3-28 Colostomy and stoma
      (Pearson Education/PH College)
    • Medical and Surgical Procedures (con't)
      • Endoscopic Procedures
      Esophagoscopy
      Gastroscopy
      Esophagogastroduodenoscopy (EGD)
      Sigmoidoscopy
      Colonoscopy
    • Figure 3-29 Colonoscopy
      (BSIP/Phototake NYC)
    • Medical and Surgical Procedures (con't)
      • Surgical Procedures (con’t)
      Gastrectomy
      Gastroplasty
      Gastrostomy
      Hemorrhoidectomy
    • Figure 3-30 PEG tube
    • Medical and Surgical Procedures (con't)
      • Surgical Procedures (con’t)
      Herniorrhaphy
      Jejunostomy
      Liver transplantation
      Polypectomy
    • Drug Categories
      • These categories of drugs are used to treat gastrointestinal diseases and conditions:
      Antacid drugs
      Antibiotic drugs
      Antidiarrheal drugs
      Antiemetic drugs
    • Drug Categories (con’t)
      • These categories of drugs are used to treat gastrointestinal diseases and conditions:
      H2 blocker drugs
      Laxative drugs
      Proton pump inhibitor drugs
    • Abbreviations