THE DIGESTIVE SYSTEM-PART 3

Transcription

1 Welcome back to InterpreterPrep.com THE DIGESTIVE SYSTEM-PART 3 This is the third part of a series of 4 presentations on the DIGESTIVE SYSTEM. We will be continuing our journey down the digestive tract where we left off at the stomach. In this presentation we'll be talking about: 1) The LIVER 2) The GALLBLADDER Once the chyme exits the stomach it will come in contact with bile from the liver and pancreatic juice in the duodenum. These secretions will help to breakdown and absorb FAT, PROTEINS and CARBOHYDRATES. But before I go on let's talk a little more about the liver and gallbladder. 1) LIVER: the liver is the largest gland in the body. We see it here in the upper right quadrant of our blue man's abdomen highlighted in red. The liver produces and secretes about a half a liter of bile per day. It's a dark yellow liquid which you probably got a taste of sometime when you vomited a lot. It tastes bitter. The bile flows out of the liver through a series of ducts- which we can see in green in this next image. The 2 HEPATIC DUCTS come together to form the COMMON HEPATIC DUCT. 2) GALL BLADDER: looks like a green pear seen there on the upper left of the image and is located under the liver. It has its own duct which joins the common hepatic duct to form the COMMON BILE DUCT which ends at a nipple-like structure called the AMPULLA OF VATER. In this image, a part of the DUODENUM was removed to show the ampulla in the lumen of the duodenum and the see through pancreas lets us observe the PANCREATIC DUCT which also ends at the ampulla. So, now we understand that it is through the ampulla that the bile and pancreatic juice pour into the duodenum which is the first segment of the small bowel. Just to be clear: LIVER MAKES BILE and the GALLBLADDER STORES BILE in between meals. BILE facilitates ABSORPTION of dietary FATS in the intestine and contains a dark pigment called BILIRUBIN which gives our feces their brownish color and makes our urine yellow. The liver helps REGULATE GLUCOSE in the body by storing it when there's too much of it and by releasing it out to the bloodstream when it is needed. Glucose is like gasoline for the cells. It's basic cell fuel!

2 OTHER LIVER FUNCTIONS: MAKE PROTEINS & CLOTTING FACTORS (needed for blood to clot) and DETOXIFICATION because the liver's enzymes convert potentially harmful substances like alcohol or medicines into less toxic ones. Remember: everything we eat is absorbed in the intestines and then goes to the liver via the Portal venous system. The liver also: STORE COPPER, VITAMINS and IRON. So let's quickly review the digestive process. So far, the food was chewed and mixed with saliva to form the bolus as discussed in part one, then the bolus was swallowed and pushed down the esophagus where it reached the stomach and was broken down further by the pepsin and hydrochloric acid found in the stomach as discussed in part 2. Here in part three the partially digested food (chyme) exits the stomach and comes in contact with the pancreatic juices and bile in the duodenum where further digestion takes place. Now let s talk about: SOME SIGNS OF DISEASE 1) JAUNDICE: when the liver's sick it can't process the bilirubin well. The bilirubin starts to accumulate and leaks out into the skin making it look YELLOW 2) ABDOMINAL PAIN 3) DARK URINE: due to too much bilirubin leaking into the urine. 4) LIGHT COLORED STOOLS: means that the bile is not reaching the stools because of blocked bile ducts. 5) ITCHINESS: the bile salts contained in the bile leak to the skin causing itching. 6) FLU-LIKE SYMPTOMS can be seen in acute hepatitis SOME LIVER DISEASES 1) CIRRHOSIS: in the image we see a normal liver to the left and a liver with cirrhosis to the right. Cirrhosis is hardening of the liver and is due to chronic liver inflammation which causes scarring of the liver. Mainly due to alcohol abuse. As more and more scars appear, the liver starts shutting down. The inflamed liver literally starts crying and its tears fill the abdomen with a fluid called ASCITES causing a puffy belly. So for those of you out there partying hard... you may want to give that a second thought. 2) PRIMARY BILIARY CIRRHOSIS: in this case our own body makes antibodies against the liver's ducts. The diseases that result when our own immune system attacks our organs are known as autoimmune diseases AUTOIMMUNE DISEASES

3 3) HEPATITIS: is inflammation of the liver. The liver swells up and starts to leak it's enzymes into the bloodstream which is detected in blood tests that show elevated liver enzymes. Hepatitis can be classified as: -HEPATITIS A: type you see in SCHOOL KIDS -HEPATITIS B: considered a sexually transmitted disease (STD) -HEPATITIS C: BLOOD BORNE DISEASE transmitted through intravenous drug use or a blood transfusion. The patient's do not turn yellow (HEP C no jaundice) Hepatitis A, B and C are all caused by a virus. The problem with Hep B and C is that they can result in liver cancer many years later. Hepatitis can also be caused by medicines and for unknown reasons, our body can attack our own liver causing what's known as AUTOIMMUNE HEPATITIS. 4) LIVER CANCER: as we can see on the left side of that image. 5) FATTY LIVER: can be caused by drinking but is reversible if you stop drinking (not the case with cirrhosis). Once you have cirrhosis, you're stuck with it. Stopping drinking will not cure it. Fatty Liver can also appear in people who don't drink and in those cases is generally not dangerous. 6) GALLSTONES: when gallstones form inside the gallbladder they give way to intermittent pain called COLICKY PAIN a type of pain which comes in waves. If the gallstone travels out of the gallbladder and gets stuck in the bile ducts CHOLECYSTITISinflammation of the gallbladder can occur- or even worse PANCREATITIS can occur if the stone gets lodged in the ampulla blocking the pancreatic duct! SOME DIAGNOSTIC STUDIES 1) ABDOMINAL ULTRASOUND: useful to detect gallstones 2) LIVER NEEDLE BIOPSY: needle is put into liver to get a tissue sample. 3) CAT SCAN AND MRI: to obtain images of the liver and bile ducts. 4) LABS : there are blood tests done to assess liver function like: -LIVER ENZYMES. -BILIRUBIN LEVELS SOME TREATMENTS: 1) INTERFERON: used to treat Chronic Hepatitis B and C. Boosts the immune system response. 2) STEROIDS like PREDNISONE and IMMUNOSUPPRESSANTS like AZATHIOPRINE: are used to treat autoimmune hepatitis. They slow the immune system down.

4 3) LIVER TRANSPLANT: done in END-STAGE liver diseases like cirrhosis. 4) SURGERY: CHOLECYSTECTOMY to remove gallbladder and surgery to remove small liver tumors. 5) PARACENTESIS: introduction of a needle into the abdomen to obtain a sample of peritoneal fluid or to drain excess fluid when the patient has developed ascites. 6) VACCINES: there are vaccines available to prevent hepatitis A and B. Doctors who specialize in diseases of the liver are called HEPATOLOGISTS which is a subspecialty of GASTROENTEROLOGY. TERMINOLOGY REVIEW. Now it's time for review so let's go over the terminology mentioned in this presentation in English and in the target language. 1) LIVER: hígado 2) GALLBLADDER: vesícula biliar 3) BILE: bilis 4) PANCREATIC JUICE: jugo pancreático 5) PROTEIN: proteína 6) CARBOHYDRATE: carbohidrato 7) DUCTS: conductos 8) COMMON BILE DUCT: conducto colédoco 9) GLUCOSE: glucosa 10) CLOTTING FACTORS: factores de la coagulación 11) ENZYME: enzima 12) COPPER: cobre 13) VITAMIN: vitamina 14) IRON: hierro 15) JAUNDICE: ictericia 16) DARK URINE: orina oscura 17) LIGHT COLORED STOOLS: heces claras, deposiciones claras 18) ITCHING: comezón 19) CIRRHOSIS: cirrosis 20) ASCITIES: ascitis 21) PRIMARY BILIARY CIRRHOSIS: cirrosis biliar primaria 22) HEPATITIS: hepatitis 23) ELEVATED LIVER ENZYMES: enzimas hepáticas elevadas 24) BLOOD BORNE DISEASE: enfermedad de transmisión sanguínea 25) AUTOIMMUNE HEPATITIS: hepatitis autoinmune 26) LIVER CANCER: cáncer de hígado 27) FATTY LIVER: hígado graso, esteatosis 28) COLICKY PAIN: cólico 29) CHOLECYSTITIS: colecistitis 30) PANCREATITIS: pancreatitis 31) ABDOMINAL ULTRASOUND: ecografía abdominal, ultrasonido de abdomen 32) NEEDLE BIOPSY: biopsia por punción 33) INTERFERON: interferón

5 34) PREDNISONE: prednisona 35) IMMUNOSUPPRESSANTS: inmunosupresores 36) LIVER TRANSPLANT: trasplante de hígado 37) CHOLECYSTECTOMY: colecistectomía 38) PARACENTESIS: paracentesis 39) END-STAGE DISEASE: enfermedad terminal 40) HEPATOLOGIST: hepatólogo In this presentation we have gone over many terms related to HEPATOLOGY while we discussed the anatomy of the liver and gallbladder. Signs and symptoms of sickness, diseases, diagnostic procedures and some treatments were also discussed. At the end of the presentation a list of 40 related terms were provided in English and the target language for you to review. I hope you've enjoyed this lesson and come away with a better understanding of HEPATOLOGY and the terms related to this field of medicine. Thank you for choosing InterpreterPrep.com