THE DIGESTIVE SYSTEM-PART 2 Ok, so far we said the TONGUE pushed the bolus back into the THROAT (aka PHARYNX) to be swallowed. When the bolus is pushed back, the SOFT PALATE goes up so that the bolus goes down your throat and not up into your nose! All this that we've talked about: putting food in your mouth, chewing and swallowing is known as INGESTION. Once the bolus hits the pharynx waves of muscle contractions called peristalsis push the bolus down a muscular tube called the ESOPHAGUS guiding it down into the stomach. The esophagus is lined by mucous membrane and is located in the back part of the thorax. Before connecting to the stomach the esophagus passes through a thin, dome shaped muscle called the DIAPHRAGM which separates the abdomen from the thorax. The point where the esophagus meets the stomach is known as the LOWER ESOPHAGEAL SPHINCTER and this area acts as a valve keeping the acid in the stomach. Ok. We are now at the STOMACH which is located in left upper quadrant of the abdomen. At this point the bolus is now in a chamber full of HYDROCHLORIC ACID. There is also PEPSIN in the stomach, an enzyme that breaks down protein. The stomach is all wrinkled on the inside these wrinkles are called rugae which help the stomach expand when the food arrives. The stomach is divided into 3 parts: 1) The FUNDUS: top part 2) The BODY: it's central part 3) The PYLORUS: where it narrows down and the duodenum begins. The point where the stomach ends is marked by a muscular ring called PYLORIC SPHINCTER which regulates the passage of the partially digested food, now no longer called bolus but called CHYME to the DUODENUM. The STOMACH'S FUNCTION is to: HOLD the FOOD, BEGIN DIGESTION breaking it down and REGULATE DELIVERY TO the DUODENUM a little at a time so that the intestine's job of absorbing it is easier. SOME SIGNS OF DISEASE (ESOPHAGUS/ STOMACH) 1) ABDOMINAL PAIN 2) HEARTBURN 3) DIFFICULTY SWALLOWING 4) BAD BREATH
5) REGURGITATION: causes a vinegar-like taste in the mouth. 6) NAUSEA/ VOMITING 7) INDIGESTION: sluggish emptying of stomach. 8) G-I BLEEDING SOME DISEASES 1) ESOPHAGEAL VARICES: dilated veins found in the esophagus. Frequently seen in alcoholics. Can bleed. 2) ESOPHAGEAL CANCER: related to drinking very hot liquids and chronic GERD 3) BARRETT'S ESOPHAGUS: changes in the lining of the esophagus, observed during endoscopy, due to chronic inflammation. Risk factor for developing esophageal cancer. 4) GERD: stands for: GastroEsophageal Reflux Disease and is caused by a disorder of the lower esophageal sphincter. When it malfunctions, the acid in the stomach spills up into the esophagus (ACID REFLUX) which causes heartburn. Sometimes there is no heartburn (SILENT REFLUX) but it can cause hoarseness, sore throat and cough. 5) HIATAL HERNIA: When you hear the term hernia it always means that something is out of place. In this case a part of the stomach is poking up through the hole in the diaphragm normally used by the esophagus to reach the stomach. Predisposes to gastric reflux. 6) GASTRITIS: inflammation of the lining of the stomach 7) STOMACH CANCER: tough to diagnose early. Cancer means, if I didn't explain it before, that cells are dividing too fast and growing wildly out of control. Stomach cancer may not give any symptoms in the beginning since there is a lot of place for the tumor to grow. Sometimes incidentally diagnosed by a chronic anemia detected in the lab workup due to blood loss caused by the stomach cancer. 8) GASTRIC ULCER (aka PEPTIC ULCER): simply said, an ulcer is a wound in the lining of the stomach. Ulcers are associated with infection of the stomach by a bacteria called H. PYLORI ALCOHOL NSAIDS (e.g. ibuprofen). If untreated, the ulcer can deepen and perforate the wall of the stomach giving way to PERITONITIS 9) PERITONITIS: is the inflammation of the peritoneum which is a membrane that covers most of the abdominal organs. It can be caused by an infection (burst appendix) or be chemical in nature (perforated ulcer with spill of hydrochloric acid into the abdomen).
10) NUTCRACKER ESOPHAGUS: chest pain and difficulty swallowing due to abnormal peristalsis (muscle contractions) of the esophagus. SOME DIAGNOSTIC PROCEDURES 1) BARIUM SWALLOW aka ESOPHAGRAM: which is a special kind of x-ray in which the patient is given a barium suspension to swallow which coats the lining of the esophagus making the esophagus visible to X-rays. 2) UPPER G-I SERIES aka BARIUM MEAL: as in the barium swallow, the patient is also given a barium suspension (by mouth) allowing the stomach and duodenum to also become visible on X-rays. 3) ESOPHAGEAL MANOMETRY: test used to measure pressures inside the esophagus. 4) UPPER ENDOSCOPY (aka EGD: esophagogastroduodenoscopy): used to see the esophagus, stomach and duodenum using a fiber optic endoscope. An endoscope is a thin tube with a light and a camera on its tip. Generally done under sedation. 5) ABDOMINAL CAT SCAN. When you get a CAT scan, your body is introduced into a machine that looks like a huge donut! This machine produces images of slices of the human body but fortunately w/o cutting anyone up! 6) ABDOMINAL MRI: obtains similar images to a CAT scan but uses a magnetic field and radio waves instead of radiation (CAT scan uses radiation) to do so. 7) LABS: H. PYLORI TEST: used to diagnose H. Pylori infection in the stomach. SOME TREATMENTS 1) STOMACH PROTECTORS: protect the stomach by reducing the acid it makes: OMEPRAZOLE, RANITIDINE. To treat gastritis and ulcers. 2) ANTACIDS: neutralize stomach acid, example: Mylanta, Tums 3) SURGERY : GASTRECTOMY: removal of the stomach totally or in part used to treat complicated ulcers, cancer VAGOTOMY: cuts the nerves that make the stomach produce acid- used to treat ulcers FUNDOPLICATION: a surgical procedure used to treat hiatal hernias (to avoid the acid reflux from occurring) where the fundus of the stomach is wrapped around the lower esophagus which acts as a belt strengthening the lower esophageal sphincter and reducing any reflux. Plicate means fold.
4) ANTIBIOTICS: for H. Pylori like AMOXICILLIN, CLARITHROMYCIN, etc. 5) ANTIEMETICS: to treat nausea: ONDANSETRON (brand name: ZOFRAN). TERMINOLOGY REVIEW. 1) PHARYNX: faringe 2) ESOPHAGUS: esófago 3) STOMACH: estómago 4) EPIGLOTTIS: epiglotis 5) PERISTALSIS: peristaltismo 6) INGESTION: ingestión 7) DIAFRAGM: diafragma 8) LOWER ESOPHAGEAL SPHINCTER: esfínter esofágico inferior 9) GASTROESOPHAGEAL REFLUX DISEASE (GERD): (ERGE) enfermedad por reflujo gastroesofágico. 10) GASTRIC REFLUX: reflujo gástrico 11) SILENT REFLUX: reflujo asintomático, reflujo silente 12) HYDROCHLORIC ACID: ácido clorhídrico 13) PYLORUS: píloro 14) PYLORIC SPHINCTER: esfínter pilórico 15) ABDOMINAL PAIN: dolor abdominal 16) HEARTBURN: acidez, agrura 17) BAD BREATH: mal aliento 18) DIFFICULTY SWALLOWING: dificultad para tragar. 19) REGURGITATION: regurgitación 20) NAUSEA: nausea 21) VOMITING: vómitos 22) INDIGESTION : indigestión 23) G-I BLEEDING: hemorragia digestiva 24) MELENA: melena 25) ACHALASIA: acalasia 26) ESOPHAGEAL VARICES: várices esofágicas 27) ESOPHAGEAL CANCER: cáncer de esófago 28) ALCOHOLIC: alcohólico 29) BARRETT'S ESOPHAGUS: esófago de Barrett 30) HIATAL HERNIA: hernia de hiato 31) GASTRITIS: gastritis 32) GASTRIC ULCER: úlcera gástrica 33) PEPTIC ULCER: úlcera péptica, úlcera gastroduodenal 34) VOMIT BLOOD: vomitar sangre 35) STOOLS: deposiciones, heces, excremento 36) FECES: heces 37) PERITONITIS: peritonitis 38) PERITONEUM: peritoneo 39) NUTCRACKER ESOPHAGUS: esófago en cascanuez 40) H. PYLORI TEST: prueba para Helicobacter Pylori 41) BARIUM SWALLOW/ ESOPHAGRAM: esofagografía
42) BARIUM MEAL/ UPPER G-I SERIES: tránsito esofagogastroduodenal 43) UPPER ENDOSCOPY: endoscopía alta 44) ANTACID: antiácido 45) OMEPRAZOLE: omeprazol. 46) RANITIDINE: ranitidina. 47) GASTRECTOMY: gastrectomía 48) VAGOTOMY: vagotomía 49) FUNDOPLICATION: fundoplicatura, cirugía antireflujo 50) AMOXICILLIN: amoxicilina 51) CLARITHROMYCIN: claritromicina 52) ANTIEMETICS: antieméticos 53) ONDANSETRON: ondansetron Thank you for choosing InterpreterPrep.com