Accessory Organs Hepatitis

In the United States and other industrialized countries, hepatitis is most often caused by viral infection. More than six types of hepatitis virus have now been identified. The most common is hepatitis A virus (HAV), which is spread by fecal-oral contamination, often by food handlers, and in crowded, unsanitary conditions. It may also be acquired by eating contaminated food, especially seafood. Hepatitis B virus (HBV) is spread by blood and other body fluids. It may be transmitted sexually, by sharing needles used for injection, and by close interpersonal contact. Infected individuals may become carriers of the disease. Most patients recover, but the disease may be serious, even fatal, and may lead to liver cancer. Hepatitis C is spread through blood and blood products or by close contact with an infected person. Hepatitis D, the delta virus, is highly pathogenic but only infects those already infected with hepatitis B. Hepatitis E, like HAV, is spread by contaminated food and water. It has caused epidemics in Asia, Africa, and Mexico. Hepatitis G is believed to be spread through contact with blood of an infected person. Vaccines are available for hepatitis A and B.

The name hepatitis simply means "inflammation of the liver," but this disease also causes necrosis (death) of liver cells. Hepatitis also may be caused by other infections and by drugs and toxins. Liver function tests performed on blood serum are important in diagnosis.

Accessory Organs The Digestive System

Jaundice, or icterus, is a symptom of hepatitis and other diseases of the liver and biliary system. It appears as yellowness of the skin, whites of the eyes, and mucous membranes caused by the presence of bile pigments, mainly bilirubin, in the blood.

Cirrhosis is a chronic liver disease characterized by hepatomegaly, edema, ascites, and jaundice. As the disease progresses there is splenomegaly, internal bleeding, and brain damage caused by changes in the composition of the blood. A complication of cirrhosis is increased pressure in the portal system that brings blood from the abdominal organs to the liver, a condition called portal hypertension. The main cause of cirrhosis is the excess consumption of alcohol.

Cholelithiasis refers to the presence of stones in the gallbladder or bile ducts, which is usually associated with cholecystitis, inflammation of the gallbladder. Most of these stones are composed of cholesterol, an ingredient of bile. Gallstones form more commonly in women than in men, especially in women on oral contraceptives and in those who have had several pregnancies. The condition is characterized by biliary colic (pain) in the right upper quadrant (RUQ), nausea, and vomiting. Drugs may be used to dissolve gallstones, but often the cure is removal of the gallbladder in a cholecystectomy. This procedure was originally performed through a major abdominal incision, but now the gallbladder is almost always removed laparoscopically through a small incision in the abdomen.

Ultrasonography and radiography are used for diagnosis of gallstones. Endoscopic retrograde cholan-giopancreatography (ERCP) (Fig. 12-10) is a technique for viewing the pancreatic and bile ducts and for performing certain techniques to relieve obstructions. Contrast medium is injected into the biliary system from the duodenum and radiographs are taken.

CIRRHOSIS

GALLSTONES

FIGURE 12-10. Endoscopic retrograde cholangiopancreatography (ERCP). A contrast medium is injected into the pancreatic and bile ducts in preparation for radiography.

FIGURE 12-10. Endoscopic retrograde cholangiopancreatography (ERCP). A contrast medium is injected into the pancreatic and bile ducts in preparation for radiography.

Percutaneous Endoscopic Gastrostomy Peg
ductal system

PANCREATITIS

Pancreatitis, or inflammation of the pancreas, may result from alcohol abuse, drug toxicity, bile obstruction, infections, and other causes. Blood tests in acute pancreatitis show increased levels of the enzymes amylase and lipase. Glucose and bilirubin levels may also be elevated. Often the disease subsides with only treatment of the symptoms.

Key Clinical Terms

DISORDERS

appendicitis a-pen-di-SI-tis

Inflammation of the appendix

ascites a-SI-tez

Accumulation of fluid in the abdominal cavity; a form of edema. May be caused by heart disease, lymphatic or venous obstruction, cirrhosis, or changes in plasma composition.

bilirubin bil-i-RU-bin

A pigment released in the breakdown of hemoglobin from red blood cells; mainly excreted by the liver in bile

cholecystitis ko-le-sis-TI-tis

Inflammation of the gallbladder

cholelithiasis ko-le-li-THI-a-sis

The condition of having stones in the gallbladder; also used to refer to stones in the common bile duct

cirrhosis sir-RO-sis

Chronic liver disease with degeneration of liver tissue

colic KOL-ik

Acute abdominal pain, such as biliary colic caused by gallstones in the bile ducts

Cr_ohn disease kron

A chronic inflammatory disease of the gastrointestinal tract usually involving the ileum

diarrhea di -a-RE-a

The frequent passage of watery bowel movements

diverticulitis di -ver-tik-u-LI-tis

Inflammation of diverticula (small pouches) in the wall of the digestive tract, especially in the colon

d_iverticulo_sis_

di -ver-tik-u-LO-sis

The presence of diverticula, especially in the colon

dysphag_ia dis-FA-je-a

Difficulty in swallowing

emesis EM-e-sis

FIS-tu-la

An abnormal passageway between two organs or from an organ to the body surface, such as between the rectum and anus (anorectal fistula)

Disorders, continued

gastroenteritis gas-tro-en-ter-I-tis

Inflammation of the stomach and intestine

hemorrhoids

HEM-o-roydz

Varicose veins in the rectum associated with pain, bleeding, and sometimes prolapse of the rectum

hepatiti_s hep-a-TI-tis

Inflammation of the liver; commonly caused by a viral infection

hepatomegaly hep-a-to -MEG-a-le

Enlargement of the liver

h_ia_tal hernia hi -A-tal

A protrusion of the stomach through the opening (hiatus) in the diaphragm through which the esophagus passes (see Fig. 6-5)

icterus

IK-ter-us

IL-e-us

Intestinal obstruction. May be caused by lack of peristalsis (adynamic, paralytic ileus) or by contraction (dynamic ileus). Intestinal matter and gas may be relieved by passage of a tube for drainage.

intussusception in-tu-su-SEP-shun

Slipping of one part of the intestine into another part below it. Occurs mainly in male infants in the ileocecal region (see Fig. 12-8). May be fatal if untreated for more than 1 day.

jaundice JAWN-dis

A yellowish color of the skin, mucous membranes, and whites of the eye caused by bile pigments in the blood (from French jaune meaning "yellow"). The main pigment is bilirubin, a byproduct of the breakdown of red blood cells.

nausea

NAW-zha

An unpleasant sensation in the upper abdomen that often precedes vomiting. Typically occurs in digestive upset, motion sickness, and sometimes early pregnancy.

occult blood

Blood present in such small amounts that it can be detected only microscopically or chemically; in the feces, a sign of intestinal bleeding (occult means "hidden")

pancre_atitis_

pan-kre-a-TI-tis

Inflammation of the pancreas

peptic ulcer

PEP-tik UL-ser

A lesion in the mucous membrane of the esophagus, stomach, or duodenum caused by the action of gastric juice

perito_niti_s per-i-to-NI-tis

Inflammation of the peritoneum, the membrane that lines the abdominal cavity and covers the abdominal organs. May result from perforation of an ulcer, rupture of the appendix, or infection of the reproductive tract, among other causes.

polyp

POL-ip

A tumor that grows on a stalk and bleeds easily

portal hypertension

An abnormal increase in pressure in the hepatic portal system. May be caused by cirrhosis, infection, thrombosis, or tumors.

Disorders, continued

pyloric stenosis

Narrowing of the opening between the stomach and the duodenum; pylorostenosis

splenomegaly

Enlargement of the spleen

sple-no-MEG-a-le

ulcerative col_itis_

Chronic ulceration of the colon of unknown cause

UL-ser-a-tiv ko-LI-tis

volvulus

Twisting of the intestine resulting in obstruction. Usually involves

VOL-vu-lus

the sigmoid colon and occurs most often in children and in the elderly. May be caused by congenital malformation, foreign body, or adhesion. Failure to treat immediately may result in death (see Fig. 12-8).

DIAGNOSIS AND TREATMENT

anastomosi_s

A passage or communication between two vessels or organs. May be

a-nas-to-MO-sis

normal or pathologic, or may be created surgically.

barium study

Use of barium sulfate as a liquid contrast medium for fluoroscopic or radiographic study of the digestive tract. Can show obstruction, tumors, ulcers, hiatal hernia, and motility disorders, among others.

cholecystectomy

Surgical removal of the gallbladder

ko-le-sis-TEK-to-me

Dukes classification

A system for staging colorectal cancer based on degree of penetration of the bowel wall and lymph node involvement; severity is graded from A to C

endoscop_y_

Use of a fiberoptic endoscope for direct visual examination. GI stud

en-DOS-ko-pe

ies include esophagogastroduodenoscopy, proctosigmoidoscopy (rectum and distal colon), and colonoscopy (all regions of the colon) (see Fig. 12-5).

ERCP

Endoscopic retrograde cholangiopancreatography; a technique for viewing the pancreatic and bile ducts and for performing certain techniques to relieve obstructions. Contrast medium is injected into the biliary system from the duodenum and radiographs are taken (see Fig. 12-9).

ostomy_

An opening into the body; generally refers to an opening created for

OS-to-me

elimination of body waste. Also refers to the operation done to create such an opening (see stoma).

sto_ma

A surgically created opening to the body surface or between two

STO-ma

organs (literally "mouth")

aortal gLORia,

Supplementary Terms

NORMAL STRUCTURE AND FUNCTION

bolus

BO-lus

A mass, such as the rounded mass of food that is swallowed

cardia

KAR-dë-a

The part of the stomach near the esophagus, named for its closeness to the heart

chyme kim

The semiliquid partially digested food that moves from the stomach into the small intestine

defecation def-e-KA-shun

The evacuation of feces from the rectum

deglutition deg-l u-TISH-un

Swallowing

duodenal bulb

The part of the duodenum near the pylorus; the first bend (flexure) of the duodenum

duodenal papilla

The raised area where the common bile duct and pancreatic duct enter the duodenum (see Fig. 12-10); papilla of Vater (FA-ter)

greater omentum o-MEN-tum

A fold of the peritoneum that extends from the stomach over the abdominal organs

hepatic flexure

The right bend of the colon, forming the junction between the ascending colon and the transverse colon (see Fig. 12-1)

ile_oc_ecal valve il-e-o-SE-kal

A valvelike structure between the ileum of the small intestine and the cecum of the large intestine

mesentery_

MES-en-ter-e

The portion of the peritoneum that folds over and supports the intestine

meso_col_on mes-o-KO-lon

The portion of the peritoneum that folds over and supports the colon

papilla of Vater

See duodenal papilla

perito_neu_m per-i-to-NE-um

The serous membrane that lines the abdominal cavity and supports the abdominal organs

ru_gae_ RU-j_

The large folds in the lining of the stomach seen when the stomach is empty

sphi_ncter of Oddi OD-ë

The ring of muscle at the opening of the common bile duct into the duodenum

splenic flexure

The left bend of the colon, forming the junction between the transverse colon and the descending colon (see Fig. 12-1)

u_vu_la

U-vu-la

A hanging fleshy mass. Usually means the mass that hangs from the soft palate (see Fig. 12-2).

achalasia

Failure of a smooth muscle to relax, especially the lower esophageal

ak-a-LA-ze-a

sphincter, so that food is retained in the esophagus

achlorhydria

Lack of hydrochloric acid in the stomach; opposite is

a-klor-HI-dre-a

hyperchlorhydria

anorexia

Loss of appetite. Anorexia nervosa is a psychologically induced re

an-o-REK-se-a

fusal or inability to eat (adjective, anorectic, anorexic).

aphagia

Refusal or inability to eat; inability to swallow or difficulty in

a-FA-je-a

swallowing

aphthous ulcer

A small ulcer in the mucous membrane of the mouth

AF-thus

bulimia

Excessive, insatiable appetite. A disorder characterized by overeating

bu-LIM-e-a

followed by induced vomiting, diarrhea, or fasting.

cachexia_

Profound ill health, malnutrition, and wasting

ka-KEK-se-a

carie_s

Tooth decay

KA-rS

ce_lia_c disease

A disease characterized by the inability to absorb foods containing

SE-le-ak

gluten

cheil_osis

Cracking at the corners of the mouth, often caused by B vitamin

ki-LO-sis

deficiency (root cheil/o means "lip")

chol_estasis

Stoppage of bile flow

ko-le-STA-sis

constipa_tion

Infrequency or difficulty in defecation and the passage of hard,

con-sti-PA-shun

dry feces

dyspepsia

Poor or painful digestion

dis-PEP-se-a

eructati_on

Belching

e-ruk-TA-shun

familial adenomatous

A heredity condition in which multiple polyps form in the colon and

polyposis (FAP)

rectum, predisposing to colorectal cancer

flatulence

Condition of having gas or air in the GI tract

FLAT-u-lens

flat_us

Gas or air in the gastrointestinal tract; gas or air expelled through

FLA-tus

the anus

gastroesophageal

Backflow of gastric contents into the esophagus. May result in inflam-

reflux disease (GERD)

mation and damage to the esophagus; heartburn.

h_ematemesis

Vomiting of blood

hl-ma-TEM-e-sis

irritable bowel

A chronic stress-related disease characterized by diarrhea, constipa

syndrome (IBS)

tion, and pain associated with rhythmic contractions of the intestine.

Mucous colitis; spastic colon.

megacolon

An extremely dilated colon. Usually congenital but may occur in

meg-a-KO-lon

acute ulcerative colitis.

melena

Black tarry feces resulting from blood in the intestines. Common in

MEL-e-na

newborns. May also be a sign of gastrointestinal bleeding.

obstipation

Extreme constipation

ob-sti-PA-shun

pernicious anemia

A form of anemia caused by failure of the stomach to secrete a sub

per-NISH-us

stance (intrinsic factor) needed for the absorption of vitamin B12

pilonidal cyst

A dermal cyst in the region of the sacrum, usually at the top of the

pi-lo-NI-dal

cleft between the buttocks. May become infected and begin to drain.

r_egurgitati_on

A backward flowing, such as the backflow of undigested food

re-gur-ji-TA-shun

DIAGNOSIS AND TREATMENT

appendectomy_

Surgical removal of the appendix

ap-en-DEK-to -me

Billroth operations

Gastrectomy with anastomosis of the stomach to the duodenum

(Billroth I) or to the jejunum (Billroth II) (Fig. 12-11)

gavage

Process of feeding through a nasogastric tube into the stomach

ga-VAHZH

lavage

Washing out of a cavity; irrigation

la-VAJ

manometry_

Measurement of pressure; pertaining to the GI tract, measurement of

man-OM-e-tre

pressure in the portal system as a sign of obstruction

Murphy sign

Inability to take a deep breath when fingers are pressed firmly

below the right arch of the ribs (below the liver). Signifies

gallbladder disease.

nasogastric (NG) tube

Tube that is passed through the nose into the stomach (Fig. 12-12).

May be used for emptying the stomach, administering medication,

giving liquids, or sampling stomach contents.

parenteral

Complete intravenous feeding for one who cannot take in food. Total

hyperalimentation

parenteral nutrition (TPN).

percutaneous endoscopic

Tube inserted into the stomach for long-term feeding (Fig. 12-13)

gastrostomy (PEG) tube

vagotom_y_

Interruption of impulses from the vagus nerve to reduce stomach se-

va-GOT-o-me

cretions in the treatment of gastric ulcer. Originally done surgically

but may also be done with drugs.

DRUGS

antacid

Agent that counteracts acidity, usually gastric acidity

ant-AS-id

antidiarrheal

Treats or prevents diarrhea by reducing intestinal motility or absorb-

an-ti-di-a-RE-al

ing irritants and soothing the intestinal lining

antiemetic

Agent that relieves or prevents nausea and vomiting

an-te-e-MET-ik

antiflatulent

Agent that prevents or relieves flatulence

an-ti-FLAT-u-lent

antispasmodic

Agent that relieves spasm, usually of smooth muscle

an-ti-spas-MOD-ik

emetic

An agent that causes vomiting

e-MET-ik

histamine H2 antagonist

Drug that decreases secretion of stomach acid by interfering with the

action of histamine at H2 receptors. Used to treat ulcers and other

gastrointestinal problems.

laxative

Promotes elimination from the large intestine. Types include stimu

LAK-sa-tiv

lants, substances that retain water (hyperosmotics), stool softeners,

and bulk-forming agents.

Billroth Billroth Antes Depois
FIGURE 12-11. Gastrojejunostomy (Billroth II operation). The dotted lines show the portion removed
Medical Terminology Images

Stomach Mushroom Internal crossbar FIGURE 12-13. Percutaneous endoscopic wall cap catheter in contact with gastrostomy (PEG) tube in place in the stomach. mushroom catheter

Stomach Mushroom Internal crossbar FIGURE 12-13. Percutaneous endoscopic wall cap catheter in contact with gastrostomy (PEG) tube in place in the stomach. mushroom catheter

ABBREVIATIONS

BE

Barium enema (for radiographic study

HDV

Hepatitis D virus

of the colon)

HEV

Hepatitis E virus

BM

Bowel movement

HCl

Hydrochloric acid

CBD

Common bile duct

IBD

Inflammatory bowel disease

ERCP

Endoscopic retrograde cholangio-

IBS

Inflammatory bowel syndrome

pancreatography

NG

Nasogastric (tube)

FAP

Familial adenomatous polyposis

N & V

Nausea and vomiting

GERD

Gastroesophageal reflux disease

N/V/D

Nausea, vomiting, and diarrhea

GI

Gastrointestinal

ponv

Postoperative nausea and vomiting

HAV

Hepatitis A virus

TPN

Total parenteral nutrition

HBV

Hepatitis B virus

UGI

Upper gastrointestinal (radiograph

HCV

Hepatitis C virus

series)

Labeling Exercise 12-1

The Digestive System

Write the name of each numbered part on the corresponding line of the answer sheet.

11 12

11 12

Cecum Pressing Blader

21 22

21 22

Anus Appendix Ascending colon Cecum

Common bile duct

Descending colon

Diaphragm

Duodenum

Esophagus

Gallbladder

Liver

Oral cavity

Pancreas

Parotid gland

Pharynx

Rectum

Sigmoid colon

Small intestine

Spleen

Stomach

Sublingual gland

Submandibular gland

Trachea

Transverse colon

Accessory Organs of Digestion

Write the name of each numbered part on the corresponding line of the answer sheet.

Accessory Organs Ducts

Common bile duct

Common hepatic duct

Cystic duct

Diaphragm

Duodenum

Gallbladder

Liver

Pancreas

Pancreatic duct

Spleen

1.

6.

2.

7.

3. 8.

4.

9.

Match the following terms and write the appropriate letter to the left of each number:

1. polysialia

2. gingiva

3. agnathia

4. hypoglossal

5. labial a. pertaining to the lip b. gum c. absence of the jaw d. excess secretion of saliva e. sublingual

6. choledochal

7. lithiasis

8. cholangiectasis

9. icterus

10. cholelithotripsy a. jaundice b. pertaining to the common bile duct c. crushing of a biliary calculus d. condition of having stones e. dilation of a bile duct

11. gastropathy

12. pylorostenosis

13. gastrocele

14. pylorospasm

15. emetic a. narrowing of the pylorus b. substance that induces vomiting c. hernia of the stomach d. any disease of the stomach e. sudden contraction of the pylorus

16. cecopexy

17. proctocele

18. cholestasis

19. proctorrhaphy

20. colocentesis

SUPPLEMENTARY TERMS

_ 21. cachexia

_ 23. deglutition

_ 25. mastication a. stoppage of bile flow b. hernia of the rectum c. surgical fixation of the cecum d. surgical puncture of the colon e. surgical repair of the rectum a. malnutrition and wasting b. chewing c. tooth decay d. swallowing e. feeding through a tube

_ 26. bolus a. inability to eat

_ 27. cardia b. partially digested food

_ 28. peritoneum c. part of the stomach near the esophagus

_ 30. chyme e. serous membrane in the abdomen

Fill in the blanks:

31. The palatine tonsils are located on either side of the _

32. Stomatosis is any disease condition of the _.

33. Dentin is the main substance of the _.

34. Glossorrhaphy is suture of the _.

35. From its name you might guess that the buccinator muscle is in the

36. An enterovirus is a virus that infects the

37. A wave of contractions in an organ wall, such as the contractions that move material through the digestive tract, is called _.

38. The blind pouch at the beginning of the colon is the _.

39. The anticoagulant heparin is found throughout the body, but it is named for its presence in the

40. The substance cholesterol is named for its chemical composition (sterol) and for its presence in

41. The organ that produces bile is the

42. The organ that stores bile is the _

True-False. Examine each of the following statements. If the statement is true, write T in the first blank. If the statement is false, write F in the first blank and correct the statement by replacing the underlined word in the second blank.

43. The epigastrium is the region of the abdomen above the stomach. _ _

44. The first portion of the small intestine is the jejunum. _ _

45. The cystic duct carries bile to and from the gallbladder. _ _

46. Cirrhosis is a disease of the esophagus. _ _

47. The appendix is attached to the ileum. _ _

48. The common hepatic duct and the cystic duct merge to form the common bile duct.

49. Enteropathy is any disease of the intestine.

50. The hepatic portal system carries blood to the spleen.

Word building. Write a word for each of the following definitions:

51. a dentist who specializes in straightening of the teeth _

52. surgical repair of the palate _

53. surgical excision of the stomach _

54. inflammation of the pancreas _

55. pertaining to the ileum and cecum _

56. hernia of the rectum _

57. surgical creation of a passage between the stomach _

and the duodenum

58. medical specialist who treats diseases of the stomach _

and intestine

59. surgical creation of an opening into the colon _

60. inflammation of the ileum _

Plurals. Write the plural form of each of the following words:

62. diverticulum _

64. calculus _

65. anastomosis _

Write the meaning of each of the following abbreviations:

Word analysis. Define each of the following words, and give the meaning of the word parts in each. Use a dictionary if necessary.

75. cholecystectomy _

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  • Eleleta
    What virus caused accessory organ infections?
    7 years ago

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