Digestive System

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• Chapter 8

• Digestive System

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Related Combining Forms
Structure Related Combining Forms
Mouth or/o, stomat/o
Pharynx pharyng/o
Esophagus esophag/o
Stomach gastr/o
Small intestine enter/o
Large intestine col/o, colon/o
Rectum and anus an/o, proct/o, rect/o
Liver hepat/o
Gallbladder cholecyst/o
Pancreas pancreat/o
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Structures of Digestive System

• Gastrointestinal tract
• (gastr/o stomach intestin intestine)
• Upper GI tract
• Mouth, pharynx, esophagus, stomach
• Lower GI tract
• Small and large intestines, rectum, anus
• Accessory organs
• Liver, gallbladder, pancreas

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Structures of Digestive System
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Oral Cavity

• Also known as the mouth
• Major structures
• Lips, hard and soft palates, salivary glands,
  tongue, teeth, periodontium
• Lips
• Surround the opening to oral cavity
• Play a role in eating, breathing, speaking, and
  expression of emotions

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Oral Cavity
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Palate

• Hard palate
• Anterior portion of the palate covered with
  specialized mucous membrane
• Soft palate
• Flexible posterior portion of the palate closes
  off nasal passage during swallowing preventing
  upward movement of food/liquid
• Uvula
• Plays role in swallowing, snoring, and speech

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Tongue

• Very strong, flexible, and muscular in nature
• Important in chewing, speaking, and swallowing
• Upper surface dorsum contains taste buds
• Sublingual surface under the tongue
• Lingual frenum attaches tongue to the floor of
  the mouth

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Soft Tissues of Oral Cavity

• Periodontium
• Surround, support, and attach to teeth
• (peri- surrounding odonti teeth -um noun
  ending)
• Gingiva
• Specialized mucous membrane covering bone of
  dental arches and surrounding neck of the teeth
• Also known as Gum

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Soft Tissues of Oral Cavity

• Sulcus
• Space between a tooth and surrounding gingiva
• Infection can result from buildup of food debris
  and bacteria

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Dental Arches

• Bony structures of oral cavity
• Maxillary arch
• Upper jaw does not move
• Mandibular arch
• Lower jaw movable
• Temporomandibular joint
• Formed at the back of mouth where maxillary and
  mandibular arches come together

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Teeth

• Dentition
• Natural teeth arranged in upper and lower jaws
• Incisors and canines (cuspids)
• Used for biting and tearing
• Premolars (bicuspids) and molars
• Used for chewing and grinding

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Teeth
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Primary and Permanent Dentition

• Primary dentition
• Deciduous dentition baby teeth
• 20 teeth
• Erupt in early childhood
• Permanent dentition
• 32 teeth
• 20 replace primary teeth 12 erupt at the back of
  the mouth

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Structures and Tissues of Teeth

• Crown
• Portion visible in the mouth
• Covered with enamelthe hardest substance in the
  body
• Roots
• Hold teeth securely within the dental arch
• Cervix
• Neck of the tooth where crown and root meet

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Structures and Tissues of Teeth
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Structures and Tissues of Teeth

• Dentin
• Bulk of a tooth
• Pulp cavity
• Within the crown and roots of a tooth
• Pulp
• Consists of rich supply of blood vessels and
  nerves providing nutrients and innervation to a
  tooth

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Saliva and Salivary Glands

• Saliva
• Colorless liquid that maintains moisture in the
  mouth
• Begins the digestive process by lubricating food
  during chewing and swallowing
• Contains amylase, the first step in chemical
  digestion

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Saliva and Salivary Glands
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Saliva and Salivary Glands

• Parotid glands
• Located slightly in front of each ear
• Sublingual glands
• Located on floor of the mouth under the tongue
• Submandibular glands
• Located on floor of the mouth near the mandible

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Pharynx

• Common passageway for respiration and digestion
• Important role in deglutition (swallowing)
• Epiglottis closes entrance to trachea to prevent
  food and liquid from moving from pharynx during
  swallowing

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Esophagus

• Muscular tube for the passage of ingested food
  from pharynx to stomach
• Lower esophageal sphincter
• Muscular ring between esophagus and stomach
  relaxes to allow food to enter the stomach and
  contracts to prevent stomach contents from
  regurgitating into the esophagus

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Stomach

• Consists of fundus (upper, rounded part), body
  (main portion), and antrum (lower part)
• Rugae
• Folds in mucosa lining allowing the stomach to
  increase and decrease in size
• Gastric juices
• Enzymes and hydrochloric acid that aid in food
  digestion

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Stomach
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Stomach

• Pyloric sphincter
• Ring-like muscle at base of stomach controlling
  flow of partially digested food from stomach to
  the duodenum
• Pylorus
• Narrow passage connecting stomach with the small
  intestine

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Small Intestine

• Extends from pyloric sphincter to the first part
  of the large intestine
• Three sections
• Duodenum first portion
• Jejunum middle portion
• Ileum longest portion

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Large Intestine

• Extends from end of small intestine to the anus
• Site of preparation of waste products of
  digestion for excretion
• Major parts of the large intestine
• Cecum, colon, rectum, anus

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Large Intestine
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Cecum

• Lies on the right side of the abdomen
• Ileocecal sphincter
• Controls flow from ileum into cecum
• Vermiform appendix
• Appendix
• Hangs from the lower portion of the cecum
• Made up of lymphoid tissue

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Colon

• Four parts
• Ascending colon travels upward from cecum to the
  undersurface of the liver
• Transverse colon lies horizontal across the
  abdominal cavity from right to left
• Descending colon travels down the left side of
  the abdominal cavity
• Sigmoid colon continues from descending colon
  and joins rectum

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Rectum and Anus

• Rectum
• Widest division of large intestine ends at anus
• Anus
• Lower opening of digestive tract
• Internal and external anal sphincters control the
  flow of waste

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Accessory Digestive Organs

• Play role in digestive process, but are not the
  part of the GI tract
• Liver
• Largest organ in the body
• Many functions, such as removing toxins from
  blood and turning food into fuel/nutrients
• Bilirubin causes yellowgreen color of bile
• Bile secreted by liver and aids in fat digestion

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Accessory Digestive Organs
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Biliary Tree

• Provides channels for transportation of bile from
  liver to small intestine

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Gallbladder

• Located under the liver
• Stores and concentrates bile
• Cholecystic pertaining to the gallbladder

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Pancreas

• Located behind the stomach
• Plays roles in digestive and endocrine system
• Secretes pancreatic juices aid in digestion and
  sodium bicarbonate that aid in neutralization of
  stomach acids

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Digestion

• Process by which complex food is broken down into
  nutrients to be used by the body
• Digestive enzymes
• Responsible for chemical changes in food

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Digestion

• Nutrient
• Substance necessary for normal functioning of the
  body
• Primary (macronutrients)
• Carbohydrates, fats, proteins
• Essential micronutrients
• Vitamins, minerals

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Metabolism

• Chemical reactions involved in body's use of
  nutrients
• (metabol change)
• Two parts
• Anabolism
• Builds up cells/substances by use of nutrients
• Catabolism
• Breaks down cells/substances releasing energy and
  carbon dioxide

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Absorption

• Complete digestion of nutrients and their
  transportation to cells
• Villi
• Finger-like projections covering mucosa of small
  intestine
• Lacteals
• Lymphatic structures absorbing fats and
  fat-soluble vitamins that cannot be transported
  directly by the bloodstream

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Role of Mouth, Salivary Glands, and Esophagus

• Mastication
• Chewing
• Bolus
• Mass of food ready to be swallowed
• Peristalsis
• Wave-like contractions moving food forward into
  the digestive system

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Role of Stomach

• Continued breakdown of food by gastric juices and
  digestive enzymes
• Chyme
• Semifluid mass of partly digested food that
  passes out of the stomach through pyloric
  sphincter into the small intestine

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Role of Small Intestine

• Duodenum
• Site of mixing of chyme with pancreatic juice and
  bile
• Jejunum
• Continues process of digestion using large
  amounts of digestive enzymes
• Ileum
• Site of absorption of nutrients

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Role of Large Intestine

• Receives and stores waste products of digestion
• Feces
• Solid body wastes
• Defecation
• Bowel movement
• Gut microflora
• Bacteria in large intestine fight infections

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Role of Large Intestine

• Borborygmus
• Rumbling noise caused by the movement of gas in
  the intestine
• Flatulence (flatus)
• Passage of gas out of the body through the rectum

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Medical Specialties Related to Digestive System

• Bariatrics
• Branch of medicine related to prevention and
  control of obesity
• Dentist
• Specializes in diagnosing/treating
  diseases/disorders of teeth and tissues of the
  oral cavity

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Medical Specialties Related to Digestive System

• Gastroenterologist
• Specializes in diagnosing/treating
  diseases/disorders of stomach and intestines
• (gastr/o stomach enter small intestine)
• Oral or maxillofacial surgeon
• Specializes in surgery of face and jaws to
  correct deformities, treat diseases, or repair
  injuries

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Medical Specialties Related to Digestive System

• Orthodontist
• Specializes in prevention/correction of
  malocclusion of teeth and related facial
  structures
• (orth straight or normal odont teeth)
• Periodontist
• Specializes in prevention/treatment of disorders
  of tissue surrounding the teeth
• (peri- surrounding odont teeth -ist
  specialist)

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Medical Specialties Related to Digestive System

• Proctologist
• Specializes in disorders of colon, rectum, and
  anus
• (proct anus and rectum -ologist specialist)
• Registered dietitian
• Specialist in food and nutrition counsels
  patients on improving dietary intake

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Pathology of Digestive System

• Tissues of the oral cavity
• Aphthous ulcers
• Graywhite pits with red border in soft tissues
  lining the mouth
• Cheilosis
• Crack-like sores at the corners of the mouth
• (cheil lips -osis abnormal condition or
  disease)

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Tissues of Oral Cavity

• Herpes labialis
• Blister-like sores on lips and adjacent facial
  tissue
• Caused by oral herpes simplex virus type 1
• Leukoplakia
• White precancerous lesion developing on tongue
  and inside of the cheek
• (leuk/o white -plakia plaque)

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Tissues of Oral Cavity

• Stomatitis
• Inflammation of mucosa of the mouth
• (stomat mouth or oral cavity)
• Stomatomycosis
• Disease of the mouth due to fungus
• (stomat/o mouth or oral cavity myc fungus)
• Oral thrush
• Due to Candida albicans

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Tissues of Oral Cavity

• Trismus
• Restriction of opening of the mouth
• Caused by trauma, surgery, or radiation of oral
  cancer
• Xerostomia
• Lack of adequate saliva due to diminished
  secretions by salivary glands
• (xer/o dry stom mouth or oral cavity -ia
  pertaining to)

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Cleft Lip and Cleft Palate

• Cleft lip
• Deep groove of the lip upward to the nose as a
  result of portion of the lip failing to close
  during prenatal development
• Cleft palate
• Failure of palate to close during early
  development of the fetus
• Cleft lip/palate may occur singly or together
  corrected by surgery

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Dental Diseases and Conditions

• Bruxism
• Grinding/clenching of teeth
• Dental caries
• Infectious disease caused by bacterial
  destruction of enamel and dentin of the teeth
• Dental plaque
• Formed in sheltered areas near gums/teeth
• Consists of bacteria and bacterial by-products

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Dental Diseases and Conditions

• Edentulous
• Without teeth
• Halitosis
• Unpleasant odor coming from the mouth
• (halit breath -osis abnormal condition or
  disease)
• Malocclusion
• Any deviation from normal position of upper teeth
  against lower teeth

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Dental Diseases and Conditions

• Peridontal disease
• Inflammation of tissues surrounding and
  supporting the teeth
• Dental calculus (tartar)
• Hardened dental plaque
• Gingivitis
• Earliest state of periodontal disease and affects
  only the gums
• (gingiv gums)

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Dental Diseases and Conditions

• Acute necrotizing ulcerative gingivitis
• Due to abnormal growth of bacteria in the mouth
• Can lead to inflammation, bleeding, deep
  ulceration, and death of gum tissues

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Esophagus

• Dysphagia
• Difficulty in swallowing
• Eosionophilic esophagitis
• Chronic immune system disease in which
  eosinophils build up in the esophagus, usually as
  result of allergy to certain foods
• (esophagi esophagus -itis inflammation)

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Esophagus

• Gastroesophageal reflux disease
• Upward flow of acid from the stomach into the
  esophagus
• (gastr/o stomach esophag esophagus -eal
  pertaining to)
• Barretts esophagus
• Occurs when chronic acid exposure causes damage
  of cells in the epithelial tissue of the esophagus

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Esophagus

• Stricture
• Abnormal narrowing of the esophagus due to scar
  tissue or other damage
• May result in swallowing difficulties
• Pyrosis
• Burning sensation due to acid reflux
• (pyr fever or fire -osis abnormal condition or
  disease)

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Esophagus

• Esophageal varices
• Enlarged, swollen veins at the lower end of the
  esophagus
• Hiatal hernia
• Portion of the stomach protrudes upward through
  an opening in the diaphragm
• (hiat opening -al pertaining to)

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Stomach

• Gastritis
• Inflammation of stomach lining
• Often caused by Helibactor pylori
• Gastroparesis
• (gastr/o stomach -paresis partial paralysis)
• Improper functioning of stomach muscles
  preventing normal emptying of contents
• Gastrorrhea (gastr/o stomach -rrhea flow or
  discharge)
• Excessive secretion of gastric juice/mucus

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Peptic Ulcers

• Peptic (pept digestion -ic pertaining to)
• Gastric ulcers
• Occur in the stomach
• Duodenal ulcers
• Occur in the upper part of the small intestine
• Perforating ulcer
• Erosion through entire thickness of organ wall
• Complication of peptic ulcer

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Nutritional Disorders

• Anorexia
• Loss of appetite
• Cachexia
• Physical wasting away with loss of weight and
  muscle mass due to inability of body to properly
  absorb nutrients
• Dehydration
• Fluid loss exceeds fluid intake
• (de- removal hydra water -tion the process
  of)

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Nutritional Disorders

• Malnutrition
• Lack of proper food/nutrients in body due to
  shortage of food, poor eating habits, or
  inability of body to digest, absorb, and
  distribute these nutrients
• (mal- bad or poor)
• Malabsorption
• Inability of small intestine to absorb nutrients

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Nutritional Disorders

• Obesity
• Excessive accumulation of fat in the body
• More than 2030 over the established weight
  standards for height, age, and gender
• Morbid obesity
• Weighing two times or more than ideal weight
• Body mass index (BMI) greater than 40
• BMI body weight adjusted for height

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Indigestion and Vomiting

• Aerophagia
• Excessive swallowing of air while eating or
  drinking
• (aer/o air -phagia swallowing)
• Dyspepsia
• Indigestion
• (dys- painful -pepsia digestion)

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Indigestion and Vomiting

• Emesis
• Reflex ejection of the stomach contents
• (emesis or -emesis vomiting)
• Eructation
• Belching

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Indigestion and Vomiting

• Hematemesis
• Vomiting of blood
• (hemat blood -emisis vomiting)
• Hyperemesis
• Extreme, persistent vomiting resulting in
  dehydration
• (hyper- excessive -emesis vomiting)

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Indigestion and Vomiting

• Nausea
• Urge to vomit
• Regurgitation
• Return of swallowed food into the mouth

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Intestinal Disorders

• Celiac disease
• Inherited autoimmune disorder characterized by
  severe reaction to food containing gluten
• Damages villi of small intestine leading to
  malabsorption
• Gluten intolerance
• Digestive distress due to the response to gluten
• Does not cause intestinal tissue damage

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Intestinal Disorders

• Food allergy
• Immune system reaction occurring after eating of
  certain foods
• Lactose intolerance
• Inability to digest dairy products
• Due to absence of the enzyme lactase
• Colorectal carcinoma
• Colon cancer

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Intestinal Disorders

• Polyp
• Mushroom-like growth from the surface of the
  mucous membrane
• May be benign or malignant
• Diverticulosis
• Chronic presence of abnormal number of
  diverticula
• Often asymptomatic
• (diverticul diverticulum -osis abnormal
  condition or disease)

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Intestinal Disorders

• Diverticulum
• Small pouch in the lining or wall of a tubular
  organ
• Diverticulitis
• Inflammation or infection of the diverticula
• Enteritis
• Inflammation of the small intestine
• May be viral or bacterial
• (enter small intestine -itis inflammation)

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Intestinal Disorders

• Ischemic colitis
• Deprivation of blood supply to the large
  intestine
• Ileus
• Partial or complete blockage of the small or
  large intestine
• Due to decrease in peristalsis
• May occur temporarily after abdominal surgery
  (postoperative ileus)

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Intestinal Disorders

• Irritable bowel syndrome
• Intermittent cramping and abdominal pain
  accompanied by constipation or diarrhea
• Unknown cause
• Inflammatory bowel diseases
• General term for diseases that cause inflammation
  and swelling in intestines
• Most common are ulcerative colitis and Crohns
  disease

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Intestinal Disorders

• Ulcerative colitis
• Chronic, repeated episodes of inflammation in the
  innermost lining of the rectum and large
  intestine causing ulcers and irritation
• (col colon -itis inflammation)
• Crohns disease
• Chronic, autoimmune disorder occurring anywhere
  in the digestive tract
• Permeates every layer of affected tissue

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Intestinal Disorders

• Intestinal obstruction
• Partial or complete blockage of small or large
  intestine
• Adhesions join parts of the intestine which
  otherwise should be separated
• Strangulating obstruction blocks blood flow to
  the intestine leading to gangrene or perforation

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Intestinal Disorders

• Volvulus
• Twisting of the intestine on itself
• Intussusception
• Telescoping of one part of the small intestine
  into the opening of the adjacent part
• (intussuscept to take up or to receive within
  -ion condition)

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Intestinal Disorders
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Intestinal Disorders

• Inguinal hernia
• Protrusion of loop of bowel through weak place in
  lower abdominal wall
• (inguin groin -al pertaining to)
• Strangulated hernia
• Constriction of portion of intestine inside
  hernia
• Decreased blood supply causes ischemia in this
  tissue

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Infectious Diseases of Intestines

• Clostridium difficile
• Bacterial infection typically occurs following
  the use of antibiotics that wipe out competing
  bacteria
• Common in hospitals or long-term care facilities
• Prevention infection control measures
• Dysentery
• Bacterial infection spreads through food/water
  contaminated with human feces

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Infectious Diseases of Intestines

• Escherichia coli (E.coli)
• Transmitted through improper cooking of
  contaminated food
• Salmonellosis
• Transmitted by feces through direct contact with
  animals or eating contaminated foods,
  unpasteurized milk, and cheese products

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Anorectal Disorders

• Anal fissure
• Crack-like sore in the skin of anus
• Bowel incontinence
• Inability to control the excretion of feces
• Constipation
• Difficulty in emptying the bowel due to hardened
  and dry feces

86
Anorectal Disorders

• Diarrhea
• Frequent flow of loose or watery stools
• (dia- through -rrhea flow or discharge)
• Hemorrhoids
• Cluster of veins, muscles, and tissues which slip
  near or through the anal opening

87
Anorectal Disorders

• Rectocele
• Bulging of front wall of rectum into vagina
• May be the result of childbirth or pregnancy
• (rect/o rectum -cele hernia)

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Abnormal Stools

• Hematochezia
• Flow of bright red blood in stool
• Usually indicates bleeding from lower part of GI
  tract
• Melena
• Black, tarry, foul-smelling feces
• Usually indicates bleeding in upper part of GI
  tract

89
Abnormal Stools

• Steatorrhea
• Presence of excess fat in stool
• Frothy, foul-smelling stool
• Usually caused by pancreatic disease, removal of
  gallbladder, or malabsorption disorders
• (steat/o fat -rrhea flow or discharge)

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Liver

• Ascites
• Abnormal accumulation of serous fluid in
  peritoneal cavity
• May be the result of severe liver disease
• Hepatomegaly
• Abnormal enlargement of liver
• (hepat/o liver -megaly enlargement)

91
Liver

• Jaundice
• Yellow discoloration of skin, mucous membranes,
  and eyes
• Due to increased bilirubin in the blood
• Hepatitis
• Inflammation of liver
• Usually caused by viral infection
• (hepat liver -itis inflammation)

92
Liver

• Cirrhosis
• Chronic degenerative disease of liver
• May be due to alcohol abuse or viral hepatitis B
  or C
• (cirrh yellow or orange -osis abnormal
  condition or disease)
• Nonalcoholic fatty liver disease
• Accumulation of fat in liver of the people who
  drink small amount or no alcohol

93
Liver

• Nonalcoholic steatohepatitis
• Fatty accumulations plus liver-damaging
  inflammation
• May progress to cirrhosis, irreversible liver
  scarring, or liver cancer

94
Gallbladder

• Cholangitis
• Acute inflammation of bile duct
• Usually caused by bacterial infection
• (cholang bile duct -itis inflammation)
• Cholecystitis
• Inflammation of gallbladder
• Often associated with gallstones
• (cholecyst gallbladder)

95
Gallbladder

• Gallstone
• Hard deposit in gallbladder and bile ducts due to
  concretion of bile components
• Cholelithiasis
• Presence of gallstones in gallbladder or bile
  ducts
• (chole bile or gall -lithiasis presence of
  stones)

96
Diagnostic Procedures of Digestive System

• Abdominal computed tomography
• Radiographic procedure showing cross-section of
  tissue structure within abdomen
• Abdominal ultrasound
• Noninvasive test using very-high-frequency sound
  waves to visualize internal organs

97
Diagnostic Procedures of Digestive System

• Cholangiography
• Radiographic examination of bile ducts with the
  use of contrast medium
• (cholangi/o bile duct -graphy the process of
  recording)

98
Diagnostic Procedures of Digestive System

• Enema
• Placement of solution into rectum/colon to empty
  the lower intestine
• Esophagogastroduodenoscopy
• Allows direct visualization of upper GI tract
• (esophag/o esophagus gastr/o
  stomachduoden/o duodenum -scopy visual
  examination)

99
Diagnostic Procedures of Digestive System

• Upper GI series and lower GI series
• Radiographic studies to examine digestive system
• Require contrast medium
• Stool samples
• Specimens of feces that are examined for
  content/characteristics

100
Endoscopic Procedures

• Require instrument for visual examination of
  internal structures
• Anoscopy
• Visual examination of anal canal/lower rectum
• Capsule endoscopy
• Use of tiny video camera that is swallowed by
  patient
• Camera transmits images of small intestine
  transmitted to data recorder worn by patient

101
Screening for Colorectal Carcinoma

• Colonoscopy
• Direct visual examination of inner surface of the
  entire colon from rectum to cecum
• (colon/o colon -scopy visual examination)
• Sigmoidoscopy
• Endoscopic examination of the interior of the
  rectum, sigmoid colon, and possibly a portion of
  the descending colon
• (sigmoid/o sigmoid colon)

102
Screening for Colorectal Carcinoma

• Hemoccult test
• Laboratory test for hidden blood in stool
• (hem blood -occult hidden)
• Cologuard
• Noninvasive stool test using DNA testing along
  with screening for hidden blood

103
Treatment Procedures of Digestive System

• Antioxidants
• Chemicals, such as vitamins, that may prevent or
  delay cell damage
• Present in fruits, beans, berries, nuts, and dark
  chocolate
• Probiotics
• Living microorganisms that aid digestion and
  protection of body from harmful bacteria
• (pro supporting)

104
Treatment Procedures of Digestive System

• Medications
• Antacids
• Neutralize acids in the stomach
• Proton pump inhibitors
• Decrease the amount of acid produced by the
  stomach

105
Treatment Procedures of Digestive System

• Medications
• Antiemetic
• Prevents or relieves nausea/vomiting
• (anti- against emet vomit -ic pertaining to)
• Laxatives
• Medications/foods that stimulate bowel movements

106
Treatment Procedures of Digestive System

• Medications
• Intravenous fluids
• Administered to combat dehydration
• (intra- within ven/o vein -us noun ending)
• Oral rehydration therapy
• Liquid preparation of electrolytes administered
  to counteract dehydration, especially in young
  children

107
Oral Cavity and Esophagus

• Dental prophylaxis
• Professional cleaning of teeth
• Dental implant
• Crown, bridge or denture that may or may not be
  anchored to the jaw
• Root canal
• Removal of diseased or damaged pulp

108
Oral Cavity and Esophagus

• Gingivectomy
• Surgical removal of the diseased gingival tissue
• (gingiv gingival tissue -ectomy surgical
  removal)
• Palatoplasty
• Surgical repair of cleft palate, or cleft lip
• (palat/o palate -plasty surgical repair)

109
Stomach

• Gastrectomy
• Surgical removal of all or part of the stomach
• (gastr stomach -ectomy surgical removal)
• Nasogastric intubation
• Placement of feeding tube through nose into the
  stomach to provide nutrition
• (nas/o nose gastr stomach -ic pertaining to)

110
Stomach

• Gastrostomy tube
• Surgically placed feeding tube from exterior of
  body directly into stomach to provide nutrition
• (gastr stomach -ostomy surgically creating an
  opening)

111
Stomach

• Total parenteral nutrition
• Specialized intravenous solution administered to
  patients who cannot or should not get nutrition
  through eating
• Bariatric surgery
• Treats morbid obesity
• Restricts amount of food entering the stomach for
  digestion

112
Stomach

• Gastric bypass surgery
• Stapling of a section of stomach to make a small
  pouch
• Causes food to bypass first part of small
  intestine
• Lap-band adjustable gastric banding
• Places inflatable band around the exterior of the
  stomach restricting food intake

113
Stomach

• Endoscopic sleeve gastroplasty
• Suturing of stomach to make it a small tube,
  reducing its capacity
• Endoscopic option for bariatric surgeries
  requiring general anesthesia

114
Intestines

• Colectomy
• Surgical removal of all or part of the colon
• (col colon -ectomy surgical removal)
• Colotomy
• Surgical incision into the colon
• (col colon -otomy surgical incision)

115
Intestines

• Diverticulectomy
• Surgical removal of diverticulum
• (diverticul diverticulum -ectomy surgical
  removal)
• Gastroduodenostomy
• Anastomosis between upper portion of stomach and
  duodenum
• (gastr/o stomach duoden first part of the
  small intestine -ostomy surgically creating an
  opening)

116
Intestines

• Anastomosis
• Surgical connection between two hollow structures
• Ileectomy
• Surgical removal of the ileum
• (ile ileum -ectomy surgical removal)

117
Ostomies

• Ileostomy
• Surgical creation of artificial excretory opening
  between ileum and outside of abdominal wall
• (ile small intestine)
• Colostomy
• Surgical creation of artificial excretory opening
  between the colon and the body surface
• May be temporary or permanent

118
Rectum and Anus

• Hemorrhoidectomy
• Surgical removal of hemorrhoids
• (hemorrhoid hemorrhoid)
• Proctopexy
• Surgical fixation of prolapsed rectum to an
  adjacent tissue/organ
• (proct/o rectum -pexy surgical fixation)

119
Liver

• Hepatectomy
• Surgical removal of all or part of the liver
• (hepat liver -ectomy surgical removal)
• Liver transplant
• Option for the patient whose liver is not
  functioning properly for a reason other than
  liver cancer

120
Gallbladder

• Choledocholithotomy
• Incision into common bile duct for the removal of
  gallstones
• (choledoch/o common bile duct lith stone
  -otomy surgical incision)

121
Gallbladder

• Cholecystectomy
• Surgical removal of the gallbladder
• (cholecyst gallbladder -ectomy surgical
  removal)