digestive system
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| what is the digestive system and also what is another name for the digestive system? | alimentary canal
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| function of the digestive system | is the path that food takes from the mouth to the anus
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| what are two parts of the digestive system? | accessory glands and the alimentary canal
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| accessory glands of the digestive system | salivary glands, liver, gallbladder, and pancreas
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| salivary glands | digestive enzymes which help break down food
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| liver | produces bile which helps break down fat
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| gallbladder | stores bile
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| pancreas | endocrine, produces insulin and helps aide in digestion
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| divisions of alimentary canal | mouth, pharynx,esophagus, stomach, small intestine, and large intestine which terminates at anus
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| abdominopelvic cavity | extends from diaphragm to bony pelvis
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| abdominal cavity contains | stomach, small intestines, large intestines, liver, pancreas, spleen, gallbladder, and kidneys
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| pelvic cavity contains | rectum, sigmoid, urinary bladder, and the reproductive organs
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| peritoneum | double layered membrane sac of the abdominal cavity in the abdomen
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| parietal peritoneum | wall of abdomen
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| visceral peritoneum | direct contact with the organ
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| peritoneal cavity | is an actual cavity in the abdomen
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| messentery | extension of visceral peritoneum which anchors the organ in place. blood supply to organ
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| retroperitoneum | urinary system which is part of reproduction. area behind peritoneum
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| whats structures are included in the retroperitoneum? | kidneys and the large intestine
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| omentum | extension of messentery
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| greater omentum | outside the stomach, connects greater part of stomach transverse colon
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| lesser omentum | inside of the stomach, connects lesser curvature of the stomach to the liver
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| mesocolon | connects transverse colon to posterior abdominal wall
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| lumen | cavity within a hollow organ, or opening of a vessel
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| sphincter | circular muscle that controls opening and closing of an orifice or passage
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| peristalsis | wavelike motion that pushes food through the digestive tract
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| segmentation | churning, happens in the stomach
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| stenosis | narrowing of a lumen (cavity within a hollow organ)
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| atresia | an absence of an opening
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| what are the 4 layers of the walls of the digestive tract from outer most? | serous or adventitia, muscular, submucosal, and mucosal
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| serous or adventitia | outside layer in contact with visceral peritoneum
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| muscular | responsible for peristalsis
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| submucosal | just below muscular
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| mucosal | inner most wall of stomach/ mucus-inside
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| six substances required to meet bodily requirements | carbs, fats, mineral salts, proteins, vitamins, and water
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| ingestion | consumption of a substance by an organism
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| mastication | chewing
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| deglutition | swallowing
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| digestion | getting ready for absorption, chemical and mechanical of food
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| absorption | the passage of food into the blood or lymp capillaries in the small intestines
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| mouth | also called oral cavity. first division of digestive system, enclosed dental arches, and receives saliva from salivary glands
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| divisions of the mouth | oral vestibule and oral cavity
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| oral vestibule | from cheek to cheek in a closed mouth
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| oral cavity | behind the teeth
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| hard palate | top of oral cavity, made up of maxilla and palpatine bone
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| soft palate | just behind hard palate, fold of epithelial tissue for septum between mouth and pharynx (oropharnyx and nasopharnyx)
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| uvula | gag reflex
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| tonsils | tissue that sits on either side of the uvula located anterior and posterior to hard palate
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| tongue | muscle covered by epithelial tissue. strongest of all muscles in the body houses taste buds. tip of tongue is the apex, base of tongue posterior. forces food into teeth
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| sublingual space | part that lies under the tongue
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| frenulum of tongue | anchors tongue to oral cavity
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| teeth | allows for chewing, makes food smaller
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| salivary glands | produce saliva which break down food
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| three pairs of salivary glands | parotid/duct stenson
submandibular/ whartons
sublingual/sublingul
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| ptyalin | saliva or digestive enzyme
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| parotid | largest of salivary glands. sits in front of the ear to mastoid tip. duct (stenson) opens into orovestible right between second upper molar
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| submandibular | located below the mandible from first lower molar to mandible, whartons is the associated duct
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| sublingual | smallest gland(s) but numerous. located on the floor of the mouth in front of the submandibular
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| sialography | radiographic image of salivary gland. only one gland can be examed at a time. infrequently performed. modality of choice MRI
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| fistulae | abnormal communication between two structures
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| diverticula | pocket where stuff goes into
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| calculi | stone
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| strictures | stenosis
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| what secretory stimulant is given to the patient for sialography procedure? | lemon
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| radiographs | still images
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| pharynx | common to both digestive and respiratory system
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| nasopharynx | behind the nose
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| orapharynx | behind the mouth
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| laryngopharynx | behind the throat
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| layers of the esophagus | muscular, submucosal, and mucosal
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| location of the esophagus | at midsagittal plane posterior to trachea. starts at c6 and passes through diaphragm at t9. joins with stomach at t10
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| function of esophagus | takes digested food to stomach from the mouth
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| cardiac antrum | belling out portion of the stomach close to the heart
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| cardiac orifice | opening at the end of the stomach
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| stomach | located in the left upper quadrant. lies more obliquely and aides in getting food to the small intestines
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| segmentation | breaks down food
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| T or F alcohol is absorbed in the stomach?` | true
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| how many peristalsis waves are in the stomach? | 3 to 4 per minute in a filled stomach
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| emptying of the stomach and transit time to the ileocecal valve takes how long? | 2 to 3 hours
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| chyme | food that has been broken down,which enters the small intestine
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| gastric enzymes of the stomach are? | pepsin, renin- curdels milk, and gastrin
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| 4 layers of the stomach | 1. serous- outside layer 2. muscular 3. submucosal 4. mucosal
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| rugae | mucosal folds of the stomach and bladder
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| what are four pairts of the stomach? | cardia, fundus, body, and pyloric portion
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| cardia consists of | cardiac orifice and cardiac sphincter
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| the fundus is located where? | superior and sits posteriorly
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| pyloric portion consists of | pyloric antrum, canal, orifice and sphincter
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| achalasia | is a cardiac sphincter that does not work
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| diverticulum | out pouching
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| zinckers pouch | large divertiuculum found at the distal portion of the esophagus
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| pyloric stenosis | seen in babies, projectile vomiting
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| lesser curvature | medial side right border 4" long hooks up with the liver from esophogastric to pyloric antrum
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| greater curvature | lateral side, 16" long left border, cardiac notch to pyloric antrum
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| cardiac notch | esophograstric junction, angle
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| small intestine | found in all four quadrants, is 22' feet long and has three portions
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| what are the three portions of the small intestine? | duodenum 8-10" jejunum 9' ileum 13'
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| function of the small intestine | absorption of nutrients
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| plica circularis | only found in the jejunum to increase surface area,with contrast the circular folds take on a feather affect
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| vili | increases absorption area, found throughout all three portions and they are like finger like projections
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| duodenum | is a 8-10" in size and has has four regions 1. superior, 2. descending, 3. horizontal and 4. ascending
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| superior region of duodenum | duodenal bulb where contents from stomach are dumped into
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| descending region of the duodenum | amupulla vater, which is controlled by the sphincter of oddi
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| horizontal region of the duodenum | third region of duodenum
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| ascending region of the duodenum | angle of treitz, which is supported by a ligament suspensory muscle where duodenum meets it
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| cholecystokinin or CCK | hormone released from duodenum which triggers the release of bile which triggers the gallbladder to contract and release bile
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| cystic duct | comes directly off of the gall bladder
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| * liver * | produces bile, right and left hypatic duct forms common hypatic duct, which in turn forms common bile duct. common bile duct hooks up behind to pancreatic duct at the apulla of vater (which is controlled by the spihncter of oddi)
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| GERD | gastroesophageal reflux disease, heart burn
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| barrett's | chronic gerd which causes inflammation of the esophagus
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| jejunum | 9' feet and is located between the duodenum and the ileum
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| ileum | size is 13'feet. is also where the ileocecal valve is located.
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| ileocecal valve | prevents backflow, distal portion of ileum called merkels diverticulum
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| small intestine pathology | crohn's disease and lymph follicle (peyer's patch)
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| lymph follicle (peyer's patch) | caused by unpasteurized milk
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| crohn's disease | auto immune disease which affects from the mouth to the anus, ulcers, and inflammation. affects prodominantly the small intestine
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| large intestine | 5 ft in size and is located in the abdomen. absorbes water and is storage for waste
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| nine parts of the large intestine | 1. cecum 2. ascending colon 3. right colic (hepatic) flexure 4. transverse colon 5. left colic (splenic) flexure 6. descen. colon 7. sigmoid colon 8. rectum 9. anal canal & anus
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| cecum | RLQ. appendix comes off of the cecum
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| ascending colon | on the right side
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| right hepatic flexure | more anterior
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| transverse colon | comes out anteriorly
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| left splenic flexure | left side much more cephalic
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| descending colon | left side
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| sigmoid colon | left side more caudal is "S" shaped
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| rectum | 5-6 inches long. follows the curve of the sacrum anterior.
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| rectal ampulla | opening into rectum
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| rectal columns | alot of blood vessels
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| hemorroids | causes out pouching of blood vessels
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| anal sphincter | internal- involuntary smooth muscle external- voluntary skeletal muscle
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| haustra | mucosal folds in the large intestine
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| taeniae coli | longitudinal bands of muscle that cause the puckering affect of the haustra
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| semi-lunar folds | folds found in haustra
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| mucosal glands |
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| appendicitis | inflammation of the appendix
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| ulcerative colitis | auto immune disease similar to chron's. consistant to large bowel, rectum is not spared
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| cholecystitis | inflammation of the gall bladder
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| colitis | inflammation of the colon
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| duodenitis | inflammation of the duodenum
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| diverticulitis | involves the formation of pouches diverticula on the outside of the colon one of these diverticula becomes inflammed or infected
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| enteritis | inflammation of the small intestine
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| peritonitis | inflammation of the peritoneum
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| volvulous | bowel twists upon itself with causes a blockage
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| intersusseption | bowel telescopes itself with can cause a blockage
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| fistula | abnormal communication between two structures
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| ileus | just a blockage, bowel looses peristalysis, obstruction bowel dies
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| toximaga colon | colon looses peristalic ability
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| pancreas | across the abdomen mixed gland. exocrine function enzymes/ pancreatic duct. endocrine function ilets of langerhans/hormones
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| ilets of langerhans | nest of cells where insulin is produced
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| horomomes of pancreas/endocrine | insulin and glucagon
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| gall bladder | RUQ depression under surface of liver and pear shaped.
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| cholecyst | gall bladder, sac
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| 3 coverings of the gall bladder | mucosal,muscle, and serous
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| 3 parts | fundus, body, and neck
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| function of gall bladder | to store and release bile
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| gall bladder position varies with what? | body habitus
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| liver | has double blood supply and is the largest cell and organ in the entire body.
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| location of liver | RUQ consists of two lobes, falciform ligament. right caudate and quadrate. left capsule of glisson
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| capsule of glisson | network of small blood vessels, connective tissue which forms capsule around the liver
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| blood supply of the liver | hepatic artery, portal vein and kupffer cells where blood detoxification takes place
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| main physiological function of the liver | the production of bile
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| biliary system | includes liver and gall bladder
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| function of biliary system | to get bile into digestive tract. from liver right and left hepatic duct followed by common hepatic duct. cystic duct comes from the gall bladder, common hepatic duct leads to common bile duct to hepatopancreatic duct/ ampulla of vater sphincter of oddi
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| procedure for abdomen pt. prep | gown pt and remove artifacts. 70-80 kvp and 115 grid, large FSS, IR for adult 14x17. SID 40-44", right ID markers. radiation protection.
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| pt. instructions | on expiration to slow down peristalysis and moves diaphragm out of the way
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| prep for contrast exams | consist of controlled diet, laxative, and enemas and is aggressive
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| gastrografin | iodine which is water soluble
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| no preliminary prep on | acutely ill pts and suspected visceral rupture which you would never give contrast
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| expo technique | 70-80 kvp you want long scale contrast/gray scale. AEC phototimer. 115 grid is always used for an abdomen
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| tissue structures used to determine effective technique | lower liver border, psoas muscles- on either side of spine, kidney shadow, lower ribs,spleen, transverse processs of lumbar, intra-abdomnial calcifi or tumor masses
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| IR size | 14x17
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| SID | 44"
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| ID markers | R or L
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| radiation protection | shield pediatrics and pts of reproductive age. close collimation and optimum technique factors
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| patient instructions | history-why you are, surgeries and pain if so where at. explanation of the procedure. respiration on exhalation to raise diaphragm and slow peristalysis
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| essential projections | AP, KUB/supine, and upright
AP, L lateral decubitus in lue of upright to differentiate between free air and stomach contents
lateral L dorsal decubitus to show aortic aneurysm
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| if pt can not stand | AP upright in stretcher to include diaphragm
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| an acute abdominal series generally consists of | AP supine-abdominal contents
AP, upright-free air
PA chest
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| AP abdomen, supine/ AKA KUB pt position | supine, without rotation, support knees to reduce strain
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| IR centered | iliac crest L4-L5 at msp-perpendicular/ mcp-parallel
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| must include | kidneys, entire bladder area and pubic symphysis
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| CR | perpendicular to IR no angling. enters pt on msp at level of iliac crests L4-L5
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| body habitus considerations | hypersthenic pts and tall pts
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| AP abdomen, supine demonstrated | area from pubic symphysis to upper abdomen included. abdomen aligned and centered vertebral column. ribs, pelvis, and hips on both sides of image. wings of ilia symmetric
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| what anatomy should be demonstrated in an AP abdomen, supine | flank stripe, psoas muscle, lower border of liver, and kidneys. inferior ribs, transverse process of lumber vertebrae and R or L marker, but not in anatomy
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| AP abdomen upright | standing with back in contact with IR/w vertical grid device. MSP and transpiloric plane centered to grid top of armppit at top of IR.
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| critique of AP abdomen, upright | diaphragm without motion. marker indicating upright position. density to upright simliar to to supine- free air
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| pt position for AP abdomen left lateral decubitus | done if pt. can not sit up or stand. recumbent left lateral on radiolucent pad. arms above diaphragm, knees flexed slightly and centered at iliac crest
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| CR for AP left lateral decub | horizontal to the floor and perpendicular to center of IR
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| AP abdomen left lateral decub demonstates | diaphragm, both sides of abdomen. demonstrate side down if fluid is suspected and side up if pneumoperitoneum is suspected. no rotation. right side marked which is the side up
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| a lateral abdomen, dorsal decub is only ordered to see what? | an aortic aneurysm
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| ectomy | to cut out/ surgical removal
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| stomy | to create an opening
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| cholecystectomy | removal of gall bladder
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| colostomy | opening made in the colon to bypass obstruction
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| enterocolostomy | opening between the small and large intestine to bypass obstruction
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| gastrectomy | removal of the stomach
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| colectomy | removal of the colon
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| ileostomy | to create an opening in small intestine
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