copyright © 2012 by mosby, an imprint of elsevier inc. digestive system chapter five

Copyright © 2012 by Mosby, an imprint of Elsevier Inc.

DIGESTIVE SYSTEM

Chapter Five

2Copyright © 2012 by Mosby, an imprint of Elsevier Inc.

Word Parts

Gastr/o = stomach

Intestin/o = intestine

aliment/o = nutrition

Digestive SystemGastrointestinal (GI) system or

tractAlimentary canal

Be Careful! The combining form gastr/o refers only to the stomach.


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


General Description of the GI System: The Route Through the Body

Route Oral cavity Mediastinal cavity Abdominopelvic cavity

Peritoneal cavity


Word Parts

sub- = under

viscer/o = organ, viscera

peri- = surrounding

-stalsis = contraction

General Description of the Digestive System: Layers

Tunics/Coats Tunica mucosa Submucosa Tunica muscularis Serosa:

Visceral peritoneum Adventitia

MesenteryPeristalsis


Wall of the Gastrointestinal Tract


Review Question

Which process of the GI system refers to the breakdown of food?A. ingestionB. digestionC. absorptionD. elimination


Word Parts

or/o, stom/o, stomat/o = mouth, oral cavity

labi/o, cheil/o = lip

dent/i, odont/o = teeth

cusp/o = point

bi- = two

in- = in

cis/o = to cut

mol/o = molar

Oral CavityMastication, deglutitionLips

Vermilion borders

Frenulum Philtrum

Teeth Incisors and cuspids Bicuspids and molars

Be Careful! Don’t confuse stom/o and stomat/o, meaning mouth or oral cavity with stomach.


Word Parts

amel/o = enamel

alveol/o = small cavity, alveolus

dent/i = tooth

-in = substance

The Tooth in DetailEnamelDentinCementumPulpCrownAlveolar ridge


Word Parts

bucc/o = cheek

Muc/o = mucus

Mol/o = molar, grinding

Labi/o = lip

gloss/o, lingu/o = tongue

palat/o = palate

uvul/o = uvula

Oral CavityCheeksMucous glands

Buccal Molar Labial Palatine

Tongue Papillae Taste buds

Palate Hard and soft

Uvula


Word Parts

maxill/o = upper jaw

mandibul/o = lower jaw

dent/i, odont/o = teeth

gingiv/o = gums

peri- = surrounding

sialoaden/o = salivary gland

sial/o, ptyal/o = saliva

par- = near

Sub- = under

Oral CavityMaxillaMandibleGums

Salivary glands and saliva Parotid Sublingual Submandibular


Word Parts

pharyng/o = pharynx, throat

nas/o = nose

or/o = mouth

hypo- = below, under

esophag/o = esophagus

Throat and EsophagusPharynx

Nasopharynx Oropharynx Hypopharynx

Esophagus Bolus Lower esophageal sphincter

(LES)/ cardiac sphincter/ gastroesophageal sphincter


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.


Review Question

The parotid gland is a salivary gland located:A. under the tongueB. under the jawC. near the earD. around the teeth


Word Parts

periotone/o = peritoneum

retro- = behind

oment/o, epiplo/o = omentum

PeritoneumPeritoneum

Visceral Parietal

RetroperitoneumMesentery

Mesoappendix Mesocolon

LigamentsFoldsGreater and lesser sacs

Epiploic foramen Omenta: greater and lesser


Word Parts

gastr/o = stomach

cardi/o = heart

fund/o = fundus

corpor/o = body

pylor/o = pylorus

The StomachCardia Fundus Body Pylorus Rugae Chyme

The stomach


Word Parts

enter/o = small intestines

duoden/o = duodenum

jejun/o = jejunum

ile/o = ileum

plic/o = fold, plica

vill/o = villus

-ase = enzyme

Small IntestineDuodenumJejunum IleumPlicae Villi

Lacteals

Enzymes

Be Careful! Don’t confuse ileum with ilium (part of the hip).

Small intestines From Mosby’s dictionary, ed 8, Mosby


Review Question

The cardiac sphincter is the same as the:A. lower esophageal sphincterB. gastroesophageal sphincterC. pyloric sphincterD. A&BE. all of the above


Word Parts

col/o, colon/o = large intestine, colon

cec/o = cecum

append/o, appendic/o = appendix

fec/a = feces

sigmoid/o = sigmoid colon

rect/o = rectum

an/o = anus

proct/o = rectum and anus

Large IntestineCecum

Ileocecal sphincter Vermiform appendix

Ascending colonTransverse colonDescending colonSigmoid colon Rectum Anus

Internal and external sphincters Proct/o is for anus and rectumDefecation

Feces, bowel movement: BM


Be Careful!

gastr/o vs. abdomin/o, lapar/o, and celi/oGastr/o refers only to the stomach, while abdomen/o, lapar/o, and

celi/o refer to the abdomen.

-cele vs. celi/oDon’t confuse –cele, the suffix meaning herniation with celi/o, a

combining form for abdomen.

an/o vs. ana- vs. an-An/o is the combining form for anus; ana-, the prefix meaning up or

apart; and an-, the prefix meaning no, not, or without.


Word Parts

adnex/o = accessory

hepat/o = liver

cholecyst/o = gallbladder

pancreat/o = pancreas

Accessory Organs: AdnexaLiverGallbladderPancreas


Word Parts

lob/o = lobe

chol/e, bil/i = bile

choledoch/o = common bile duct/

The LiverLocation/lobes

Right, left, quadrate, caudate

The liver functions to produce bile Bile 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 empties bile into the duodenum


Anterior and Posterior View of Liver


Word Parts

chol/e, bil/i = bile

cholesterol/o = cholesterol =

choledoch/o = common bile duct

cholangi/o = bile vessel


-kinin = movement substance

GallbladderLocation/descriptionStores bile from the liverRole of cholecystokinin in bile

secretionCystic duct Common bile duct


Word Parts


PancreasLocationExocrine 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


Review Question

A combining form for the gallbladder is:A. choledoch/oB. cholecyst/oC. cholangi/oD. hepat/o


Symptoms and Signs Involving the Digestive System and Abdomen (R10-R19)

HalitosisEructationFlatulence

Ascites

NauseaVomiting


Word Parts

dys- = difficult, bad

-phagia = condition of swallowing, eating

hepat/o = liver

-megaly = enlargement

pyr/o = fire

-osis = abnormal condition

dia- = difficult, bad

-rrhea = discharge, flow

Symptoms and Signs Involving the Digestive System and Abdomen (R10-R19)

DysphagiaHepatomegalyJaundice

PyrosisGastralgia

Diarrhea

Jaundice


Did You Know?

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.


Word Parts

ankyl/o = stiffening

gloss/o = tongue

-ia = condition


-eal = pertaining to

a- = no, not, without

-tresia = condition of an opening

Congenital Conditions (Q00-Q99)

AnklyoglossiaEsophageal atresia

Esophageal atresia


Word Parts

gastr/o = stomach

-schisis = split

omphal/o = umbilicus

-cele = herniation, protrusion

pylor/o = pylorus

-ic = pertaining to

stenosis = narrowing


GastroschisisOmphalocelePyloric stenosis



Cleft palateHirschsprung’s disease

Cleft palate and lip


Review Question

The medical term/word part for “no opening” is:A. stenosisB. atresiaC. -schisisD. ankyl/o


Word Parts

amel/o = enamel

-genesis = production, origin

an- = no, no, without

odont/o = teeth

-ia = condition

Diseases of Oral Cavity and Salivary Glands (K00-K14)

Amelogenesis imperfectaAnodontia

Edentulous


Word Parts

aphth/o = ulceration

-ous = pertaining to

stomat/o = mouth

-itis = inflammation

cheil/o = lip


Aphthous stomatitisCheilitis

Aphthous stomatitis


Word Parts

gingiv/o = gums


gloss/o = tongue


Dental cariesGingivitisPeriodontal diseaseGlossitis

Gingivitis


Word Parts

mucos/o = mucus


leuk/o = white

-plakia = condition of patches

ptyal/o = saliva

-ism = condition

sialoaden/o = salivary gland

sial/o = saliva

lith/o = stone

-iasis = presence of, condition


Oral mucositisOral leukoplakia

PtyalismSialoadenitisSialolithiasis

Oral leukoplakia


Review Question

Ptyalism is a condition of:A. the salivaB. the gallbladderC. the esophagusD. the gums


Word Parts

a- = without

-chalasia = condition of relaxation

dys- = abnormal, bad

-pepsia = digestion condition

gastr/o = stomach

esophag/o = esphagus

-eal = pertaining to

re- = back

-flux = flow

Diseases of Esophagus, Stomach, and Duodenum (K20-K31)

AchalasiaDyspepsiaEsophagitisGastroesophageal

reflux disease (GERD) Barrett’s esophagus

GERD


Diseases of Esophagus, Stomach, and Duodenum (K20-K31)

GastritisPeptic ulcer disease (PUD)

Chronic peptic ulcer


Diseases of the Appendix (K35-K38)

Appendicitis Peritonitis Acute vs. chronic

Be Careful! Don’t confuse peritone/o, which means the membrane that

lines the abdominal cavity, with perone/o, which is a combining form for the fibula; and perine/o, which means the space between the anus and external reproductive organs.


Hernias (K40-K46)

Complications Incarcerated hernia

Irreducible Strangulated hernia Gangrene


Hernias (K40-K46)

Umbilical hernia (omphalocele) Femoral (crural) herniaHiatal hernia (diaphragmatocele)Inguinal herniaVentral hernia

Umbilical hernia Hiatal herniaFrom Zitelli: Atlas of pediatric physical diagnosis, ed 4, MosbyFrom Zitelli: Atlas of pediatric physical diagnosis, ed 4, Mosby


Noninfective Enteritis and Colitis (K50-K52)

ColitisInflammatory bowel disease (IBD)

Crohn’s disease (regional or granulomatous enteritis) Ulcerative colitis


Other Diseases of the Intestines (K55-K63)

Anal fissureAnorectal abscessAnorectal fistulaConstipation

Obstipation

Anorectal fistula



IleusIntussusceptionVolvulusIrritable bowel

syndrome (IBS)

A. Intussusception, B. Volvulus

From Damjanov: Pathology for the health professions, ed 3, Saunders

Intussusception


Word Parts

diverticul/o = diverticulum




DiverticulitisDiverticulosis

Diverticulosis


Word Parts



-ptosis = drooping, prolapse


Polyp of colonProctitisProctoptosis


Review Question

A twisting of the intestines:A. anastomosisB. paralytic ileusC. intussusceptionD. volvulus


Review Question

A hiatal hernia is the same as a/n:A. omphaloceleB. diaphragmatoceleC. crural herniaD. inguinal hernia


Word Partscirrh/o = orange-yellow


peritone/o = peritoneum


Diseases of Peritoneum and Retroperitoneum (K65-K68) and Diseases of Liver (K70-K77)

CirrhosisPeritonitis

Normal liver Cirrhosis of the liver


Special Note

Liver disease often requires additional codes like alcoholic liver diseases that need codes to describe alcohol abuse and dependence. Toxic liver disease requires a code to identify what type of drug or toxic agent caused the disease.


Word Parts

cholang/o = bile vessel



choledoch/o = common bile duct

-lith/o = stone

-iasis = presence of

chol/e = bile


Diseases of Gallbladder, Biliary Tract, and Pancreas (K80-K87)

Cholangitis Cholecystitis CholedocholithiasisCholelithiasisPancreatitis

Cholelithiasis


Review Question

Which of the following disorders involves the presence of stones?A. cholangitisB. cholecystitisC. choledocholithiasisD. cirrhosis


Word Parts

celi/o = abdomen

hemat/o = blood

-emesis = vomiting

melan/o = black, dark

Other Diseases of Digestive System (K90-K94)

Celiac disease (celiac sprue)HematemesisMelena


Word Partsstomat/o = mouth


hepat/o = liver

Viral Infections Characterized by Skin and Mucous Membranes (B00-B09) and Viral Hepatitis (B15-B19)

Herpetic stomatitis (cold sore, fever blister)

Hepatitis Hepatitis A (HAV) Hepatitis B (HBV) Hepatitis C (HCV)


Word Parts

cyst/o = cyst

aden/o = gland

-oma = tumor, mass

odont/o = teeth

-genic = pertaining to produced by

Benign Neoplasms (D10-D36)

CystadenomaOdontogenic tumor


Benign Neoplasms (D10-D36)

Polyps, adenomatous or hyperplastic Sessile versus pedunculated

Adenomatous polypsAdenomatous polyps


Word Parts

aden/o = gland

-carcinoma = cancerous

tumor of epithelial

origin

hepat/o = liver

cellul/o = cell

-ar = pertaining to

squam/o = scaly

-ous = pertaining to

Malignant Neoplasms (C00-C96)

Adenocarcinoma Hepatocellular

carcinoma/hepatoma Squamous cell

carcinoma

Adenocarcinoma of the esophagus


Review Question

Which of the following tumors begins in the teeth?A. odontogenic B. leiomyoma C. cystadenoma D. hemangioma


Laboratory Tests

Gamma-glutamyl transferase (GGT)Stool cultureStool guaiac/hemoccult testTotal bilirubin


Laboratory Tests

AlbuminAlkaline phosphatase (ALP)Alanine transaminase (ALT)Aspartate transaminase (AST)Gastric analysis


Laboratory Tests

Hepatitis-associated antigen (HAA)Liver function tests (LFTs)Prothrombin time (PT)Rapid urease test


Review Question

Which diagnostic procedure would be used to determine if blood was present in the stool?A. total bilirubinB. stool guaiacC. manometryD. fluoroscopy


Word Parts

fren/o , frenul/o = frenulum

-tomy = cutting


-stomy = making a new opening

fund/o = fundus

-plication = folding

gingiv/o = gums

-ectomy = cutting out

Upper GI ProceduresBarium swallow Frentomy, frenulotomyEsophagoesophagostomyFundoplication, gastroesophageal

Gingivectomy

Barium swallow


Word Partsgastr/o = stomach

duoden/o = duodenum


-plasty = surgically forming

hyper- = excessive

aliment/o = nutrition

-ation = process of

pylor/o = pylorus

my/o = myscle

-tomy = cutting

Upper GI ProceduresGastroduodenostomy GastroplastyGastrostomy

Percutaneous endoscopic gastrostomy (PEG)

HyperalimentationPyloromyotomy

Gastroduodenostomy


Procedures

anastomoses vs. -stomy Definition of anastomosis Rules for building terms for anastomoses Terms using a single structure with “-stomy”


Word Partsgloss/o = tongue

-rrhaphy = suturing

odont/o = teeth


palat/o = palate

-plasty = surgically forming

sialodoch/o = salivary duct

stomat/o = mouth

uvul/o = uvula

Upper GI ProceduresGlossorrhaphyOdontectomyPalatoplastySialodochoplastyStomatoplastyUvulectomy


Guideline Alert

Bypass procedures are coded by identifying the body part bypassed “from” and the body part bypassed “to”. The fourth character body part specifies the body part bypassed from, and the qualifier specifies the body part bypassed to. Example: Bypass from stomach to jejunum,

stomach is the body part and jejunum is the qualifier.


PCS Guideline Alert

PCS contains specific body parts for anatomical subdivisions of a body part, such as lobes of the lungs or liver and regions of the intestines. Resection of the specific body part is coded whenever all of the body part is cut out or off, rather than coding Excision of a less specific body part.


Review Question

A sialoadenectomy is a cutting out of:A. a salivary glandB. the gumsC. the roof of the mouthD. a tooth


Word Parts

append/o = appendix


cec/o = cecum

-pexy = suspension

colon/o = colon

-scopy = viewing

col/o = colon


Lower GI ProceduresAppendectomyBarium enemaCecopexyColonoscopyColostomy

Stoma

Colostomy and stoma


Word Parts

diverticul/o = diverticulum


enter/o = small intestine

-al = pertaining to

herni/o = hernia

-rrhaphy = suturing

Lower GI ProceduresDiverticulectomyEnteral nutrition Herniorrhaphy

Enteral nutrition


Word Parts

ile/o = ileum

ureter/o = ureter


jejun/o = jejunum

oment/o = omentum

-tomy = cutting


peritone/o = peritoneum

-centesis = surgical puncture

Lower GI ProceduresIleoureterostomyJejunostomyOmentectomy,

omentumectomyPeritoneocentesisPolypectomy, GI


Word Parts


-clysis = washing

-scopy = viewing

sigmoid/o = sigmoid colon

par- = near, beside

enter/o = small intestine

-al = pertaining to

Lower GI ProceduresProctoclysisProctoscopySigmoidoscopyTotal parenteral nutrition

(TPN)


Review Question

Surgical puncture of fluid from the abdominal cavity is:

A. peritoneocentesisB. ileoureterostomyC. TPND. cecopexy


Procedures of the Adnexa

Cholangiography Cholecystectomy CholedochectomyCholedocholithotomy

Laparoscopic cholecystectomy


Word Parts

cholangi/o = bile vessel


-graphy = recording

hepat/o = liver


Procedures of the AdnexaEndoscopic retrograde

cholangiopancreatography (ERCP)

Hepatectomy

ERCP


Review Question

What does the suffix –lithotomy indicate in a choledocholithotomy?A. foldingB. Cutting out a stoneC. washingD. making a new opening


Suffixes and Root Operations for the Digestive System

-centesis drainage-ectomy excision, resection-lithotomy extirpation-pexy repair, reposition-plasty repair, supplement, replacement-plication restriction-rrhaphy repair, supplement-scopy inspection-stomy bypass, drainage-tomy drainage, release, division


Sort these terms into their correct categories

Terms1.

esophagoesophagostomy

2. peristalsis3. stool guaiac4. diverticulitis5. hepatitis

Categories__ A + P__ Pathology__ Procedures

copyright © 2012 by mosby, an imprint of elsevier inc. digestive system chapter five

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