Turley5e CH03 PPT Accessible

Medical Language: Immerse Yourself
Fifth Edition Susan M. Turley
Chapter 3
Gastroenterology
Gastrointestinal System
Copyright © 2020, 2017, 2014, 2011, 2007 Pearson Education, Inc. All Rights Reserved.
Learning Outcomes (1 of 2)
• Identify the structures of the gastrointestinal system.
• Describe the functions of the gastrointestinal system.
• Describe common gastrointestinal diseases.
Learning Outcomes (2 of 2)
• Describe common gastrointestinal laboratory tests, diagnostic procedures, and
radiologic procedures.
• Describe common gastrointestinal medical procedures, drugs, and surgical

procedures.
• Demonstrate proficiency in medical language.
Gastroenterology
• The medical specialty that studies the anatomy and physiology of the gastrointestinal
system.
• Gastroenterologists use diagnostic tests, medical and surgical procedures, and drugs
to treat gastrointestinal diseases.
Figure 3-1 Gastrointestinal system.
The gastrointestinal system consists of organs and glands connected in a pathway. Food enters the body, is digested,
nutrients are absorbed into the blood, and undigested wastes are eliminated from the body.
Anatomy of the Oral Cavity (1 of 4)
• The mouth is the first part of the GI tract.
– It is lined with mucosa, which produces thin mucus.
– It contains a number of important structures:
▪ Teeth
▪ Gums
▪ Tongue
▪ Hard palate
▪ Soft palate
Figure 3-2 Oral cavity and pharynx.
The oral cavity contains the teeth, tongue,

and the hard and soft palates. Food passes
from the oral cavity into the pharynx (throat)
and then into the esophagus.
For long description, see slide 94, Appendix A
• The tongue fills the oral cavity.
– Receptors on the tongue perceive taste and send the information to the gustatory
cortex.
▪ gustat/o- = sense of taste
▪ -ory = having the function of
– The tongue detects sweet, salty, sour, bitter, and umami tastes.
– Receptors on the tongue decrease with age.
• The sight, smell, and taste of food cause the three pairs of salivary glands to release
saliva.
– Parotid glands are located in front of the ear.
– Sublingual glands are located below the tongue.
– Submandibular glands are below the mandible, or lower jawbone.
Figure 3-3 Salivary glands.
The large, flat parotid glands are on either side

of the head in front of the ear. The sublingual
glands are under the tongue. The
submandibular glands are under the mandible
(lower jaw). Ducts from these glands bring
saliva into the oral cavity.
For long description, see slide 95, Appendix B
• The hard palate and soft palate form the roof of the mouth.
– The hard palate is the bony front portion behind the teeth.
– The soft palate is the fleshy back portion near the throat.
– The soft palate works with the uvula to sense food that is about to be swallowed.
Anatomy of the Pharynx (1 of 2)
• Swallowing moves food and saliva from the oral cavity into the pharynx.
– The pharynx is the common passageway for inhaled air, exhaled air, and food.
– It is divided into three parts.
▪ Nasopharynx
▪ Oropharynx
▪ Laryngopharynx
Anatomy of the Pharynx (2 of 2)
• Just inferior to the pharynx is the larynx.
– The larynx remains open during breathing and speaking.
– During swallowing, the larynx closes to prevent food entering the trachea and
lungs.
– The epiglottis seals the opening and diverts food to the esophagus and stomach.
Anatomy of the Esophagus
• The esophagus is a muscular tube that connects the pharynx to the stomach.
– The upper esophagus is in the neck.
– The lower esophagus is in the thoracic cavity.
– Coordinated peristalsis of the esophageal walls keeps food moving.
Anatomy of the Stomach (1 of 3)
• The stomach is an elongated sac.
– The cardia is where the stomach joins the esophagus.
– The fundus is the rounded, upper portion.
– The body is the main part.
– The pylorus is the narrow last part of the stomach that joins the duodenum.
• Gastric is the adjective form for stomach.

– gastr/o- = stomach
– -ic = pertaining to
• Gastric mucosa are rugae.
– Rugae form thick, deep folds that expand.
– They produce mucus that protects the stomach lining.
• The stomach produces hydrochloric acid, pepsinogen, and gastrin.
• Chyme is a mixture of food, saliva, and digestive enzymes that leaves the stomach.
• Two sphincters keep chyme in the stomach.
– The lower esophageal sphincter is located between the esophagus and stomach.
– The pyloric sphincter is located between the stomach and the small intestine.
• Chyme remains in the stomach for about an hour after a meal.
Figure 3-4 Stomach.
The stomach has four regions. The cardia is a

small area where the esophagus joins the
stomach. The fundus is the rounded top of the
stomach. The body is the large, curved part of
the stomach. The pylorus is where the stomach
narrows to join the first part of the small
intestine.
For long description, see slide 96, Appendix C
Anatomy of the Small Intestine (1 of 2)
• The small intestine runs from the stomach to the large intestine.
– The duodenum is the C-shaped first segment; approximately 10 inches long.
– The jejunum is the middle segment; approximately 8 feet long.
– The ileum is the third segment; approximately 12 feet long.
Anatomy of the Small Intestine (2 of 2)
• The small intestine produces digestive enzymes.
• Microscopic villi line the small intestine and increase absorptive surface area.
• It takes several hours for food to move through the small intestine.
Anatomy of the Large Intestine (1 of 2)
• The large intestine runs from the small intestine to the anus.
• Pouches called haustra line the walls of the large intestine.

– Haustra expand to receive large amounts of material from the small intestine.
Anatomy of the Large Intestine (2 of 2)
• The large intestine has three parts.
– Cecum
▪ It contains the ileocecal valve.
▪ The appendix is attached to the cecum.
– Colon
▪ Broken into ascending (upward), transverse (across), descending
(downward), and sigmoid (s-shaped) sections.
– Rectum
▪ This is the straight, final segment.
▪ It connects to the outside via the anus.
Figure 3-5 Small and large
intestines.
The small intestine consists of the duodenum,

jejunum, and ileum. The large intestine
consists of the cecum, colon, rectum, and
anus. The colon is divided into parts: the
ascending colon, transverse colon, descending
colon, and sigmoid colon. Each part is named
for the direction it is going or for its shape.
For long description, see slide 97, Appendix D
Anatomy of the Abdominopelvic
Cavity
• The small and large intestines lie in the abdominopelvic cavity.
– The cavity is lined with peritoneum.
– The peritoneum secretes peritoneal fluid.
– The peritoneum also forms two structures.
▪ Omentum supports the stomach.
▪ Mesentery supports the jejunum and ileum.
Anatomy of the Accessory Organs (1 of 4)
• The liver is the largest solid organ.
– It contains hepatocytes that continuously produce bile.
– Bile contains acids, bilirubin, and biliverdin.
– Bile flows from the liver through the hepatic duct into the common bile duct
(CBD).
– When the CBD is full, bile fills the cystic duct of the gallbladder and the
gallbladder itself.
Figure 3-6 Biliary tree.
Bile flows through hepatic ducts in the liver

that merge to form the common hepatic duct.
It joins the cystic duct from the gallbladder
and becomes the common bile duct.
Because of their branched appearance,
these ducts are known as the biliary tree.
The pancreatic duct joins the common bile
duct just before it enters the duodenum.
For long description, see slide 98, Appendix E
• bili/o- = bile
• chol/e- = bile
• cholecyst/o = gallbladder
– Built from chol/e- and cyst/o-.
• cholangi/o- = bile duct

– Built from chol/e- and angi/o-.
• choledoch/o- = common bile duct

– Built from chol/e- and doch/o-.
• The gallbladder is a dark green sac posterior to the liver.
– It concentrates and stores bile from the liver.
– Fatty chyme prompts gallbladder contractions.
– Contractions force bile through the CBD and into the duodenum.
• The pancreas is a yellow, triangular organ posterior to the stomach.
– It secretes several digestive enzymes into the duodenum via the pancreatic duct.
– The pancreas also secretes insulin as part of the endocrine system.
Physiology of Digestion (1 of 5)
• Mechanical digestion breaks up food with physical force and movement.
– Mastication is tearing, chewing, and grinding of food by the teeth.
– Deglutition is swallowing food.
– Peristalsis is movement of the food via muscular contractions.
• Chemical digestion breaks up food with enzymes, acids, and other substances.
• It begins in the mouth with amylase.
• It continues in the stomach as it secretes four substances.

– Hydrochloric acid breaks down food fibers.
– Pepsinogen breaks down proteins.
– Gastrin stimulates release of hydrochloric acid.
– Intrinsic factor aids in B12 absorption.
• The small intestine releases sugar-digesting enzymes like lactase.
• The duodenum releases cholecystokinin that stimulates release of pancreatic

enzymes.
– Amylase continues carbohydrate digestion.
– Lipase breaks fat globules into fatty acids.
– Protein-digesting enzymes break proteins into amino acids.
• Absorption is the process by which fluids and nutrients are absorbed into the blood.
– In the oral cavity, water and fluids are absorbed by vessels under the tongue.
– In the stomach, water, liquids, and drugs are absorbed into the blood.
– In the small intestine, water and nutrients enter the bloodstream.
• Some remaining water is absorbed in the large intestine.
• Elimination removes undigested fibers, waste, and water from the body.
– Solid waste is referred to as feces, stool, or a bowel movement (BM).
– The elimination process is known as defecation.
– Flatus is gas that sometimes accompanies feces.
Figure 3-7
Gastrointestinal
system.
Everyone enjoys eating! The gastrointestinal system

helps you taste and enjoy the food you eat and then
uses mechanical and chemical digestion processes
to break down that food into nutrients that nourish
your body.
For long description, see slide 99, Appendix F
Eating Diseases
Decreased appetite because of disease or the GI side

Anorexia effect of a drug.
Difficult or painful eating or swallowing.

Dysphagia • dys- = abnormal, difficult, painful
• phag/o- = eating or swallowing
• -ia = condition, state, thing
Excessive overeating due to overactive thyroid, DM, or

Polyphagia psychiatric illness.
• poly- = many, much
Oral Cavity and Salivary Gland
Diseases
Infection or inflammation of the tongue.

Glossitis • gloss/o- = tongue
• -itis = infection, inflammation
Presence of a stone in a salivary gland that blocks

Sialolithiasis saliva and causes swelling.
Inflammation of the oral mucosa.

Stomatitis
Esophagus and Stomach Diseases
(1 of 3)
Temporary epigastric pain; indigestion.
Dyspepsia • dys- = abnormal, difficult, painful
• peps/o- = digestion
• -ia = condition, state
Swollen, protruding vein in the esophageal mucosa.

Esophageal varix
Acute or chronic inflammation of the stomach.

Gastritis
Acute infection or inflammation of the stomach and

Gastroenteritis intestines.
Figure 3-10 Esophageal varices.
A varix is a dilated, swollen vein in the mucosa. There can be bleeding as swallowed food irritates a varix. Esophageal
varices can be seen when an endoscope with a light is passed through the mouth and into the esophagus.
(2 of 3)
Chronic irritation due to reflux of stomach acid into the
Gastroesophageal reflux esophagus.
disease (GERD) • Due to failure of esophageal sphincter.
• Can lead to ulcers or cancer.
Temporary irritation of the esophagus due to reflux of

Heartburn stomach acid.
Vomiting of blood.
Hematemesis • hemat/o- = blood
• -emesis = vomiting
Nausea is an unpleasant, queasy feeling in the

Nausea and vomiting stomach; vomiting is expulsion of stomach contents
(N&V) through the mouth.
(3 of 3)
Chronic irritation, burning pain, and erosion of the

Peptic ulcer disease mucosa due to an ulcer.
(PUD) • May be in the stomach, esophagus, or duodenum.
• Usually caused by H. pylori when it occurs in the
stomach.
• Can also be caused by hydrochloric acid, stress,
and drugs.
Cancerous tumor of the stomach that begins in gastric
Stomach cancer mucosal glands; often caused by H. pylori.
• aden/o- = gland
• carcin/o- = cancer
• -oma = tumor
Figure 3-11 Gastric ulcer.
This gastric mucosa is raw and irritated with a large central ulcer crater. The bright red blood indicates a recent episode
of bleeding from the ulcer.
Duodenum, Jejunum, and Ileum
Diseases
Absence of normal peristalsis.

Ileus • May be caused by mechanical obstruction,
infection, or trauma.
• May also occur as postoperative ileus.
Telescoping of one intestinal segment inside another.

Intussusception
Twisting or rotating of the small intestine around itself;

Volvulus malrotation.
• mal- = bad
• rotat/o- = rotate
• -ion = action, condition
Figure 3-12 Intussusception and volvulus of
the intestine.
A. In an intussusception, the intestine folds back on itself in the same way that one part of a telescope slides into the
other. B. In a volvulus, the intestine becomes twisted. Both of these conditions stop peristalsis and decrease blood flow
to the intestine.
Cecum and Colon Diseases (1 of 2)
Inflammation and infection of the appendix by waste
Appendicitis materials trapped inside it.
Cancerous tumor of the colon that develops when

Colon cancer colonic polyps or ulcerative colitis become cancerous.
Weakness in the colon wall forms a pouch.

Diverticulum
Autoimmune disorder and toxic reaction to gluten in

Gluten sensitivity certain grains; inflammatory response damages small
enteropathy intestine.
Figure 3-13 Diverticula.
These pouches in the wall of the colon are diverticular sacs where feces can become trapped.
Figure 3-14 Diverticulitis and
polyposis.
This diverticulum has become infected from trapped feces. These polyps (described later in this section) can be irritated
by the passage of feces and can become cancerous.
Cecum and Colon Diseases (2 of 2)
Chronic inflammation of parts of the small and large

Inflammatory bowel intestines.
disease (IBD) • Crohn disease = Affects the ileum and colon
• Ulcerative colitis = Affects the colon and rectum;
can cause ulcers
Condition with cramping, pain, diarrhea, bloating,
Irritable bowel syndrome constipation, and excessive mucus but no
(IBS) inflammation.
A condition of numerous polyps, which are fleshy

Polyposis benign growths in the mucosa.
Figure 3-15 Crohn disease.
A. This segment of normal intestine shows an open lumen throughout and an intestinal wall without thickening or ulcers.
B. Crohn disease shows thickening of the intestinal wall and ulcers. There is also a partial obstruction.
Figure 3-16 Colonic polyps.
This patient has two sessile polyps (in the front) and one pedunculated polyp on a stalk (in the rear) in the mucosal
folds in the wall of the colon.
Rectum and Anus Diseases
Swollen, protruding veins.

Hemorrhoids
Inflammation of the rectum due to radiation treatments

Proctitis for cancer.
A hernia in the wall of the rectum that causes the

Rectocele rectal wall to protrude into the vaginal wall.
• rect/o- = rectum
• -cele = hernia
Defecation and Feces Diseases (1 of 2)
Failure to have regular, soft bowel movements.

Constipation
Abnormally frequent, loose, and watery feces; involves

Diarrhea increased peristalsis that moves the feces through the
large intestine before water is absorbed.
Excessive amounts of gas in the stomach or

Flatulence intestines.
Defecation and Feces Diseases (2 of 2)
Blood in the feces; bright red blood indicates a lower

Hematochezia GI bleed and melena indicates a stomach or
esophagus bleed.
• hemat/o- = blood
• chez/o = pass feces
• -ia = condition, state
Feces that contains undigested fats due to a lack of
Steatorrhea the enzyme lipase.
Abdominal Wall and Abdominopelvic
Cavity Diseases (1 of 3)
A defect and weakness in the muscle of the diaphragm

Hernia or the abdominal wall that allows the intestine to bulge
through.
• May be named for ease of movement between
hernia sac and cavity.
‒ Sliding (reducible) hernia allows the
intestine to move freely.
‒ Incarcerated hernia traps the intestine.
‒ Strangulated hernia cuts off blood supply to
incarcerated intestine.
• May also be named according to location.

Hernia ‒ Hiatal hernia is bulging of the stomach
through the diaphragm.
‒ Ventral hernia occurs on the ventral
abdominal wall.
‒ Umbilical hernia occurs at the umbilicus.
‒ Omphalocele is an umbilical hernia present
at birth.
‒ Inguinal hernia occurs in the groin.
‒ Incisional hernia occurs along a suture line
from abdominal surgery.
Figure 3-17
Hernia.
A. In a sliding hernia, the intestine and peritoneum

move in and out of the hernia sac. B. In a
strangulated hernia, the intestine is trapped in the
hernia sac and its tissues begin to die. C. This
baby was born with an omphalocele, a hernia at
the umbilicus. The hernia sac is only a layer of
peritoneum with the intestine inside. This baby
needs to have immediate surgery to correct the
omphalocele and repair the abdominal wall defect.
For long description, see slide 100, Appendix G
Serious infection of the peritoneum that occurs when

Peritonitis the stomach or duodenal wall breaks or the appendix
ruptures.
• Contents of the stomach or appendix spill into the
abdominal cavity
• Surgery is necessary to clean out the abdominal
cavity.
Figure 3-18 Peritonitis.
The surgeon is holding a loop of duodenum, showing the mesentery attached to the small intestine. This patient
developed peritonitis when a duodenal ulcer perforated the intestinal wall and green bile from the gallbladder and
chyme from the stomach spilled into the abdominal cavity. The areas of white are white blood cells (pus) that are
fighting this infection.
Liver Diseases (1 of 3)
Accumulation of ascitic fluid in the abdominopelvic

Ascites cavity due to increased pressure in abdominal veins.
Chronic, progressive inflammation and irreversible

Cirrhosis degeneration of the liver.
Enlargement of the liver due to cirrhosis, hepatitis, or

Hepatomegaly cancer; enlargement is palpable on physical exam.
• hepat/o- = liver
• -megaly = enlargement
Figure 3-20 Liver disease.
The liver on the left is normal. The liver in the center has a yellow, fatty appearance that occurs in patients with
alcoholism, diabetes mellitus, or lipid disorders. The liver on the right shows cirrhosis with enlargement, nodules, and
scar tissue that decrease liver function.
Infection and inflammation of the liver by the hepatitis

Hepatitis virus; the most common chronic liver disease.
• Hepatitis A is caused by exposure to feces;
infection is acute.
• Hepatitis B is caused by exposure to blood, saliva,
or vaginal secretions; infection is acute but may
turn chronic.
• Hepatitis C is caused by exposure to blood;
infection is acute and turns chronic.
• Hepatitis D is secondary to hepatitis B.
Yellow discoloration of the skin and whites of the eyes

Jaundice due to unconjugated bilirubin in the blood.
• Liver may be too diseased or immature to
conjugate bilirubin.
• Large numbers of red blood cells may have been
destroyed.
• A gallstone may be obstructing the bile ducts.
Secondary cancer that began elsewhere in the body
Liver cancer and metastasized to the liver.
Figure 3-22 Jaundice.
Jaundice can be seen as a yellow discoloration of the white of the eye (sclera). This is known as scleral icterus. The
skin also has a slight yellow color.
Figure 3-23 Liver cancer.
This colorized computerized tomography (CT scan) of the abdomen shows an enlarged (tan) liver, nearly filling the
abdominal cavity, with many red-brown areas of cancer. A CT scan is read as if you were standing at the patient’s feet,
looking up. The white area in the center bottom is a vertebra of the spine, and the white areas around the edges are
ribs.
Gallbladder and Bile Duct Diseases
Cancer in the ducts of the gallbladder.
Gallbladder cancer
Inflammation of the bile ducts due to cirrhosis or

Cholangitis gallstones.
Inflammation of the gallbladder due to blockage of the

Cholecystitis cystic duct by a gallstone.
Condition of gallstones in the bladder; called

Cholelithiasis choledocholithiasis when stones are in the common
bile duct.
• lith/o- = stone
• -iasis = abnormal condition or process
Figure 3-24 Cholelithiasis.
This patient’s gallbladder was removed during surgery. It contained numerous small and large gallstones.
Figure 3-25 Gallstones in the biliary and
pancreatic ducts.
A gallstone in the cystic duct causes bile to back up into the gallbladder. A gallstone in the upper common bile duct
causes bile to back up into the gallbladder and liver. A gallstone in the lower common bile duct keeps pancreatic
digestive enzymes from entering the duodenum.
Pancreas Diseases
Cancer in the ducts of the pancreas; prognosis for

Pancreatic cancer most patients is poor because it is typically diagnosed
in the late stages.
Inflammation or infection of the pancreas.

Pancreatitis • Inflammation is caused by a gallstone in the ducts
or by chronic alcoholism.
• Infection is caused by bacteria or viruses.
Laboratory and Diagnostic
Procedures (1 of 2)
Major protein molecule in the blood, produced by the

Albumin liver; low level may indicate liver disease.
Rapid gastric mucosa screening for H. pylori that uses

CLO (Campylobacter-like urea containing pads.
organisms)
Fecal test in which bacterial colonies are grown in
Culture and sensitivity culture for identification and testing of antibiotics.
(C&S)
Fecal test to determine whether non-visible blood is
Fecal occult blood test present in feces.
Laboratory and Diagnostic
Procedures (2 of 2)
Test to measure the amount of hydrochloric acid in the

Gastric analysis stomach; uses a nasogastric tube to collect stomach
contents.
Panel of blood tests that gives a comprehensive

Liver function tests (LFTs) picture of liver function.
• Albumin
• Bilirubin
• ALP
• ALT
• AST
• GGT
• Prothrombin time
Fecal test to determine whether parasites are in the GI
Ova and parasites (O&P) system by checking for worms and their eggs in feces.
Radiology and Nuclear Medicine
Procedures (1 of 3)
X-rays taken after injection with the liquid contrast

Barium enema (BE) medium barium.
X-ray taken after injection with iodinated contrast dye

Cholangiography to outline bile ducts.
• Intravenous cholangiography = dye in the vein
• Percutaneous transhepatic cholangiography = dye
in the liver
• Endoscopic retrograde cholangiopancreatogaphy
= dye in the common bile and pancreatic ducts
Nuclear medicine procedure with a intravenous
Cholescintigraphy radioactive drug to measure uptake of bile with cystic
duct obstruction.
Figure 3-26 Barium enema.
Barium contrast medium inserted through the rectum fills the sigmoid colon, descending colon, transverse colon,
ascending colon, and cecum on this x-ray.
Figure 3-27 Endoscopic retrograde
cholangiopancreatography.
An endoscope is passed through the mouth,

esophagus, stomach, and into the duodenum. A
catheter is passed through the endoscope, and
then contrast dye is injected to visualize the
common bile duct and pancreatic duct.
Retrograde means the contrast dye is injected
in the opposite direction of the normal flow of
bile.
For long description, see slide 101, Appendix H
Procedures (2 of 3)
X-rays taken in successive slices to create images of

Computerized axial abdominal organs and structures.
tomography (CAT scan,
CT scan)
X-ray taken without contrast dye as the patient lies
Flat plate of the abdomen supine on the table.
Ultra high-frequency sound waves used to produce on

Gallbladder ultrasound image of the gallbladder to show wall thickening and
stones.
Images taken in successive slides using a strong
Magnetic resonance magnetic field that causes protons in the body’s atoms
imaging (MRI) to emit a signal.
Procedures (3 of 3)
X-ray taken after ingestion of iodinated contrast dye

Oral cholecystography tablets to outline bile ducts.
(OCG)
Continuous, moving x-ray taken after ingestion of
Upper gastrointestinal liquid barium; allows visualization of the upper GI tract.
series (UGI)
Medical Procedures
Placement of a flexible tube through the nose and into

Insertion of a nasogastric the stomach to remove stomach contents or give food
(NG) tube or drugs.
Insertion of water into the rectum to stimulate a bowel

Enema movement and relieve constipation.
Figure 3-30 Nasogastric tube.
This patient has a nasogastric (NG) tube. It was inserted into the nose and, as he swallowed, it was advanced through
the esophagus and into the stomach and then taped to the skin to hold it in position. Only liquid feedings or liquid drugs
can be given through an NG tube.
Drugs (1 of 2)
Neutralize acid in the stomach to treat heartburn.

Antacid drugs
Treat bacterial infections anywhere in the GI tract; not

Antibiotic drugs effective for viral infections.
Treat diarrhea by slowing down peristalsis to increase

Antidiarrheal drugs water absorption.
Treat nausea and vomiting and motion sickness.
Antiemetic drugs
Drugs (2 of 2)
Dissolve gallstones to eliminate the need for surgery.

Drugs for gallstones
Block histamine 2 (H2) receptors in the stomach to

H2 blocker drugs treat GERD and PUD.
Treat constipation by softening feces or adding dietary

Laxative drugs fiber.
• Suppositories are inserted into the rectum and
directly stimulate peristalsis.
Block production of hydrochloric acid in the stomach to
Proton pump inhibitor treat GERD and PUD.
drugs
Surgical Procedures (1 of 5)
Removal of fluid from the abdomen using a needle.
Abdominocentesis • abdomin/o- = abdomen
• -centesis = procedure to puncture
Removal of an infected appendix.

Appendectomy
Surgery for severe obesity that limits food intake and
Bariatric surgery nutrient absorption.
• Gastric balloon is swallowed then inflated.
• Adjustable gastric band is placed across the upper
stomach.
• Gastric sleeve removes 80% of the stomach.
Removal of a small piece of tissue from an ulcer,
Biopsy polyp, or growth; examined for cancerous cells.
Removal of a portion of diseased intestine (resection)

Bowel resection and and joining of the intestine back together
anastomosis (anastomosis).
Removal of the gallbladder; usually done

Cholecystectomy laparoscopically.
Surgery to make an incision in the common bile duct to
Choledocholithotomy remove a gallstone.
• lith/o- = stone
• -tomy = process of cutting into
Figure 3-31 Laparoscopic
cholecystectomy.
Carbon dioxide gas is used to inflate

the abdominal cavity and separate the
organs. A laparoscope is inserted
through one of several small incisions;
it is used to visualize the gallbladder
(on the computer screen), while other
instruments grasp and remove the
gallbladder.
For long description, see slide 102, Appendix I
Removal of a diseased part of the colon and creation

Colostomy of an opening in the abdominal wall for feces to pass
through.
Examination of the GI system with a flexible, lighted

Endoscopy endoscope.
Figure 3-32
Colostomy
and stoma.
A. This colostomy is performed on the sigmoid

colon. The red mucosa of the cut end of the
sigmoid colon was rolled back on itself to
create a stoma, which is sutured to the
abdominal wall. B. The patient wears a plastic
disposable colostomy bag that adheres to the
skin and collects feces.
For long description, see slide 103, Appendix J
Figure 3-33 Colonoscopy.
A colonoscope with a camera is passed through the patient’s anus to examine the rectum and colon. The images are
transmitted to a computer screen for viewing and are also recorded for the patient’s electronic medical record.
Exploration of the abdominopelvic cavity for evidence

Exploratory laparotomy of disease or trauma.
Removal of all or part of the stomach due to cancer.

Gastrectomy
Procedure to create a temporary or permanent
Gastrostomy opening in the abdominal wall in order to place a
feeding tube.
Removal of hemorrhoids from the rectum or from
Hemorrhoidectomy around the anus.
Figure 3-34 PEG tube.
This permanent feeding tube was inserted during a percutaneous endoscopic gastrostomy.
Closure of a defect in the abdominal muscle wall

Herniorrhaphy where there is a hernia.
• herni/o- = hernia
• -rrhaphy = procedure of suturing
Creation of an opening from the abdominal wall into
Jejunostomy the jejunum to insert a feeding tube.
Removal of a severely damaged liver and insertion of

Liver transplantation a donor liver in a patient with end-stage liver disease.
Removal of one or more polyps from the colon using
Polypectomy forceps or a wire snare.
Abbreviations (1 of 4)
Abbreviation Definition
ABD, abd abdomen
ALP alkaline phosphatase
ALT alanine aminotransferase; or alanine
transaminase
AST aspartate aminotransferase; or aspartate
transaminase
BE barium enema
BM bowel movement
C&S culture and sensitivity
CAT, CT computerized axial tomography
CBD common bile duct
CLO Campylobacter-like organism
EGD esophagogastroduodenoscopy
ERCP endoscopic retrograde
cholangiopancreatography
GERD gastroesophageal reflux disease
GGTP, GGT gamma-glutamyl transpeptidase
GI gastrointestinal
HAV hepatitis A virus
HBV hepatitis B virus
HCV hepatitis C virus
IBD inflammatory bowel disease
IBS irritable bowel syndrome
LFTs liver function tests
MRI magnetic resonance imaging
N&V nausea and vomiting
NG nasogastric
O&P ova and parasites
OCG oral cholecystogram; oral cholecystography
PEG percutaneous endoscopic gastrostomy
PEJ percutaneous endoscopic jejunostomy
PUD peptic ulcer disease
RLQ right lower quadrant (of the abdomen)
RUQ right upper quadrant (of the
abdomen)
UGI upper gastrointestinal (series)
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Appendix A
Long description for Figure 3-2
The image is a side profile of a face with lines pointing to the top hard
palate along the roof of the mouth. The soft palate is behind the hard
palate towards the back of the mouth. The Nasopharynx is behind the
soft palate. The soft palate ends at the Uvula. Below the Uvula is the
Oropharynx. Below the Oropharynx is the Epiglottis. Below the
Epiglottis is the Laryngopharynx. Mid throat and below the
laryngopharynx is the Larynx. Towards the back is the Esophagus. At
the base of the image is the Trachea. Toward the front of the face
below the hard palate is the oral cavity. The teeth are behind the lips.
The tongue is between the teeth. The mandible is the chin area.
Return to presentation
Appendix B
Figure 3 dash 3 shows a side profile of a face with the
internals of the Parotid gland above the oral cavity. Then
there are the teeth and tongue. The sublingual gland is
below the tongue and the submandibular gland is below the
sublingual gland.
Appendix C
Figure 3 dash 4 shows the Stomach. An image of a male
shows the interior stomach. Starting with the Esophagus
mid chest and moving counter clockwise, Fundus, Cardia,
body, Pancreas posterior to stomach, Rugae, Omentum,
Duodenum, Pyloric sphincter, pulorus, and lower
esophageal sphincter.
Appendix D
Image shows small and large intestine. Starting at the top left of the
image is the liver right below the esophagus. The stomach is below the
Esophagus. The spleen is below the stomach. The transverse colon is
below the liver. Duodenum is below the Transverse colon and flows to
the Jejunum which leads to ileum. The Ascending colon is below the
Duodenum and above the cecum. To the right is the Descending colon
and the Sigmoid colon. The appendix is below the cecum. At the
bottom of the image is the Tectum, Anus and Anal sphincter.
Appendix E
Bile flows through hepatic ducts in the liver that merge to
form the common hepatic duct. It joins the cystic duct from
the gallbladder and becomes the common bile duct.
Because of their branched appearance, these ducts are
known as the biliary tree. The pancreatic duct joins the
common bile duct just before it enters the duodenum.
Appendix F
Child eats an apple next to the G I System flow chart. From the top.
Upper G I System. Oral cavity and salivary glands. Right arrow to
Amylase. Pharynx. Esophagus. Stomach with right arrow to
Hydrochloric acid, pepsinogen (pepsin), gastrin, extrinsic factor. Lower
G I system and small intestine. Duodenum with arrow to the right
Cholecystokinin. To the left of Duodenum splits off Gallbladder and
Pancreas with Liver above and Bile to the left. Below Pancreas is
Amylase, lipase, protein digesting enzymes. Below Duodenum is
Jejunum with Lactase to the right. Lleum to the large intestine down to
cecum. Ascending colon. Transverse colon. Descending colon.
Sigmoid colon. Rectum. Anus.
Appendix G
Long description for Figure 3-17ABC
Image A is a sliding hernia with a loop of intestine in hernia
sac. Image B is a strangulated hernia entrapped necrotic
loop of intestine where the intestine is trapped in the hernia
sac and its tissues begin to die. Photo C is a baby born
with an omphalocele, a hernia at the umbilicus. The hernia
sac is only a layer of peritoneum with the intestine inside.
Appendix H
An endoscope is passed through the mouth, esophagus,
stomach, and into the duodenum. A catheter is passed
through the endoscope, and then contrast dye is injected to
visualize the common bile duct and pancreatic duct.
Retrograde means the contrast dye is injected in the
opposite direction of the normal flow of bile.
Appendix I
Photo of operating room to remove a gallbladder
laparoscopically. This is done as a minimally invasive
laparoscopic cholecystectomy that uses a laparoscope that
is inserted through tiny incisions in the abdominal wall.
Carbon dioxide gas is used to inflate the abdominal cavity
and separate the organs. A laparoscope is inserted through
one of several small incisions and it is used to visualize the
gallbladder on a computer screen, while other instruments
grasp and remove the gallbladder.
Appendix J
Long description for Figure 3-32AB
Image A shows a colostomy on the sigmoid colon. The red
mucosa of the cut end of the sigmoid colon was rolled back
on itself to create a stoma, which is sutured to the
abdominal wall. Photo B shows the patient wears a plastic
disposable colostomy bag that adheres to the skin and
collects feces.

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Medical Language: Immerse Yourself

Fifth Edition Susan M. Turley

• Describe the functions of the gastrointestinal system.

• Describe common gastrointestinal diseases.

• Describe common gastrointestinal medical procedures, drugs, and surgical

• Demonstrate proficiency in medical language.

The oral cavity contains the teeth, tongue,

For long description, see slide 94, Appendix A

The large, flat parotid glands are on either side

• Gastric is the adjective form for stomach.

• The stomach produces hydrochloric acid, pepsinogen, and gastrin.

• Chyme remains in the stomach for about an hour after a meal.

The stomach has four regions. The cardia is a

For long description, see slide 96, Appendix C

• Pouches called haustra line the walls of the large intestine.

The small intestine consists of the duodenum,

For long description, see slide 97, Appendix D

Bile flows through hepatic ducts in the liver

• cholangi/o- = bile duct

• choledoch/o- = common bile duct

• It begins in the mouth with amylase.

• It continues in the stomach as it secretes four substances.

• The duodenum releases cholecystokinin that stimulates release of pancreatic

• Some remaining water is absorbed in the large intestine.

Everyone enjoys eating! The gastrointestinal system

Decreased appetite because of disease or the GI side

Difficult or painful eating or swallowing.

Excessive overeating due to overactive thyroid, DM, or

Infection or inflammation of the tongue.

Presence of a stone in a salivary gland that blocks

Inflammation of the oral mucosa.

Swollen, protruding vein in the esophageal mucosa.

Acute or chronic inflammation of the stomach.

Acute infection or inflammation of the stomach and

Temporary irritation of the esophagus due to reflux of

Nausea is an unpleasant, queasy feeling in the

Chronic irritation, burning pain, and erosion of the

Absence of normal peristalsis.

Telescoping of one intestinal segment inside another.

Twisting or rotating of the small intestine around itself;

Cancerous tumor of the colon that develops when

Weakness in the colon wall forms a pouch.

Autoimmune disorder and toxic reaction to gluten in

Chronic inflammation of parts of the small and large

A condition of numerous polyps, which are fleshy

Swollen, protruding veins.

Inflammation of the rectum due to radiation treatments

A hernia in the wall of the rectum that causes the

Failure to have regular, soft bowel movements.

Abnormally frequent, loose, and watery feces; involves

Excessive amounts of gas in the stomach or

Blood in the feces; bright red blood indicates a lower

A defect and weakness in the muscle of the diaphragm

• May also be named according to location.

A. In a sliding hernia, the intestine and peritoneum

For long description, see slide 100, Appendix G

Serious infection of the peritoneum that occurs when

Accumulation of ascitic fluid in the abdominopelvic

Chronic, progressive inflammation and irreversible

Enlargement of the liver due to cirrhosis, hepatitis, or

Infection and inflammation of the liver by the hepatitis

Yellow discoloration of the skin and whites of the eyes

Inflammation of the bile ducts due to cirrhosis or

Inflammation of the gallbladder due to blockage of the