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Digestive System

Department Training – Medical Coding

Applicability Coding Department

Document Type Training Module

Version 1.0

Author Kaveri.Devendran

Approved by Head of Training Department

Effective 11/28/2018

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Digestive System
Medical Terminologies Version History

Version #` Version Date Reason for References Author(s) Content

change/Source affected

1.0 11/28/2018 Launched Not Applicable Kaveri.Devendran All contents

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Digestive System
Objectives POA
 List and describe the functional anatomy of the organs and accessory organs of the digestive system
 Discuss the processes and control of ingestion, propulsion, mechanical digestion, chemical digestion,
absorption, and defecation
 Discuss the roles of the liver, pancreas, and gallbladder in digestion

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Digestive System
Introduction POA
 Group of organs working together to convert food into energy and basic nutrients to feed the entire body
 Food passes through a long tube inside the body known as the alimentary canal or the gastrointestinal track
(GI tract)

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Digestive System
Gastrointestinal Tract POA
The tract itself is divided into upper and lower tracts:
Upper Gastrointestinal Tract
 Mouth
 Pharynx
 Esophagus
 Stomach
 Duodenum
Lower Gastrointestinal Tract
 Small Intestine
 Large Intestine

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Digestive System
Accessory Organs POA
Accessory organs that help your body to digest food are:
Upper Gastrointestinal Tract
 Teeth
 Tongue
 Salivary glands
Lower Gastrointestinal Tract
 Liver
 Gallbladder
 Pancreas

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Digestive System
Upper GI – Mouth POA
 Mouth is the first portion of the alimentary canal that receives food and produces saliva
 Consists of two regions, the vestibule and the oral cavity
 The vestibule is the area between the teeth, lips and cheeks
 The oral cavity is bounded front by teeth and at the back by its roof
 Hard palate at the front, and a soft palate at the back
 The uvula projects downwards from the middle of the soft palate

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Digestive System
Upper GI – Mouth [AccessoryPOA
organs]
Tongue
 Helps grind food into a bolus
 Sensory organ for taste

Salivary glands
 Submandibular Glands
 Sublingual Glands
 Parotid Glands
 Produces and Secretes saliva
 Begins the chemical breakdown of food

Teeth
 There are 32 permanent teeth in the entire Oral cavity
 The function of the molars is to chew, crush and grind food

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Digestive System
Upper GI – Pharynx POA
 The pharynx or throat is a muscular tube, about 5 inches long, lined with a mucous membrane
 It serves as a passage way both for air traveling from the nose (nasal cavity) to the windpipe (trachea) and
for food traveling from the oral cavity to the esophagus
 When swallowing (deglutition)occurs, a cartilaginous flap of tissue, the epiglottis, covers the trachea so that
food cannot enter and become lodged there

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Digestive System
Upper GI – Esophagus POA
 The esophagus is a 9- to 10-inch muscular tube extending from the pharynx to the stomach
 It carries swallowed masses of chewed food along its length
 Its length average 25 cm
 Esophageal Glands – Produce mucus to lubricate bolus
 Esophageal Sphincter – Prevents backflow into oral cavity
 Cardiac Sphincter – prevents backflow onto esophagus

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Digestive System
Upper GI – Stomach POA
 Temporary storage area for food and allows it to mix with gastric juice to produce chyme
The stomach has three main parts:
 Fundus(upper portion)
 Body(middle section)
 Antrum(lower portion)
 Digestive glands that produce the enzyme pepsin(to begin digestion of proteins) and hydrochloric acid
 The pylorus, the lowest section of the stomach which attaches to the duodenum through the pyloric canal

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Digestive System
Lower Gastrointestinal Tract –POA
Small Intestine
 The small intestine extends for 20 feet from the pyloric sphincter to the first part of the large intestine
 Receives chyme from stomach
 By the time food leaves the small intestine, around 90% of all nutrients have been extracted from the food
that entered it
 The inner surface of the small intestine is velvety in appearance. This is due to many finger-like projections of
the mucous membrane called villi
 The villi increase the surface area of the small intestine which helps it absorb digested food

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Digestive System
Lower Gastrointestinal Tract –POA
Small Intestine
Parts of Small Intestine
Duodenum
First, widest and the shortest part of small intestine. considered as the mixing bowl
that receives chyme from stomach and digestive secretions from pancreas and liver
Jejunum
Middle part of small intestine. most of the chemical digestion and nutrient
absorption takes place here
Ileum
 The final segment of small intestine
 Ends at the ileocecal valve, a sphincter that controls flow of material from the
ileum into the large intestine

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Digestive System
Lower Gastrointestinal Tract POA
Large Intestine
 The large intestine is a long, thick tube about 2.5 inches in diameter and about 5 feet long
 It is located just inferior to the stomach and wraps around the superior and lateral border of the small
intestine

Functions
 Reabsorption of remaining water and electrolytes
 Production and absorption of Vitamins B and K
 Defecation is the expulsion or passage of feces from the body through the anus

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Digestive System
Large Intestine(Colon) POA
Appendix
Is a slender, hollow appendage about 9 cm (3.6 in.) long

Cecum
Is an expanded pouch receives material arriving from the ileum stores materials and begins compaction

Ascending Colon
 Begins at superior border of cecum
 Ascends along right lateral and posterior wall of peritoneal cavity to inferior surface of the liver and bends at
right colic flexure (hepatic flexure)

Transverse Colon
Crosses abdomen from right to left; turns at left colic flexure (splenic flexure)

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Digestive System
Large Intestine(Colon) POA
The Descending Colon
Proceeds inferiorly along left side to the iliac fossa (inner surface of left ilium).

The Sigmoid Colon

 Starts at sigmoid flexure and lies posterior to urinary bladder
 Empties into rectum

The Rectum
Forms last 15 cm (6 in.) of digestive tract is an expandable organ for temporary storage of feces

Anus
Also called anal orifice is exit of the anal canal.

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Digestive System
Lower Gastrointestinal Tract –POA
Accessory Organs
 The liver, gallbladder, and Pancreas
 Play crucial roles in the proper digestion and absorption of nutrients

Liver
The liver, located in the right upper quadrant (RUQ) of the abdomen, manufactures
a thick, orange-black, sometimes greenish, fluid called bile which emulsifies fats.

Gallbladder
 A pear-shaped sac under the liver, which stores and concentrates the bile for
later use
 After meals, in response to the presence of food in the stomach and duodenum,
the gallbladder contracts, forcing the bile out the cystic duct into the common
bile duct

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Digestive System
Lower Gastrointestinal Tract –POA
Accessory Organs
Pancreas
 Secretes pancreatic juices(enzymes) that are released into the pancreatic duct, which joins with the common
bile duct just as it enters the duodenum
 The duodenum thus receives a mixture of bile and pancreatic juices
 The pancreas is both an exocrine and an endocrine organ
 As an exocrine gland, it produces enzymes to digest starch, such as amylase, to digest fat, such as lipase, and to
digest proteins, such as protease
 These pass into the duodenum through the pancreatic duct
 As an endocrine gland (secreting into the bloodstream), the pancreas secretes insulin
 This hormone, needed to help release sugar from the blood, acts as a carrier to bring glucose into cells of the
body to be used for energy

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Digestive System
Digestive Process POA
There are six food processing activities:
1. Ingestion- brining food into the mouth (eating)
2. Propulsion- moving food through the GI tract, peristalsis (contractions of smooth muscle in GI tract) helps to
move the food along.
3. Mechanical Digestion- physical change of the food particles from large to small, this helps to increase the
surface area to make chemical digestion more effective. Actions include chewing, churning of food in stomach,
and mixing food with digestive juices.
4. Chemical Digestion- chemical change of the food particles, bonds are broken to change a large molecule
into a smaller one so absorption can happen more effectively. This involves the use of enzymes, hydrochloric
acid, and other digestive juices.
5. Absorption- transport of digested food molecules from the GI into the blood and lymphatic vessels
6. Defecation- elimination of feces (indigestible substance/digestive waste)

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Digestive System
Suffix POA

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Digestive System
Combining Form POA
Combining form Meaning Terminology

bucc/o mouth, cheek Buccal

chol/e gallbladder cholelithiasis

cholangi/o bile ducts Cholangitis

cholecyst/o gallbladder Cholecystectomy
enter/o intestine Gastroenteritis
gastr/o stomach gastrojejunostomy
lith/o stone cholecystolithiasis
proct/o rectum Proctosigmoidoscopy
pylor/o Pylorus pyloric stenosis
sialaden/o salivary gland Sialadenectomy
steat/o fat Steatorrhea
rect/o rectum rectal carcinoma

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Digestive System
Pathological Conditions POA
Signs and Symptoms
 Anorexia – Lack of appetite
 Ascites – Abnormal accumulation of fluid in the abdomen
 Diarrhea – Frequent passage of loose, watery stools
 Dysphagia – Difficulty in swallowing
 Hematochezia – Passage of fresh, bright red blood from the rectum
 Jaundice (icterus) – Yellow-orange coloration of the skin and whites of the eyes caused by high levels of
bilirubin in the blood (hyperbilirubinemia)
 Melena – Black, tarry stools; feces containing digested blood

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Digestive System
Pathological Conditions POA
Oral cavity and Teeth
 Aphthous stomatitis – Inflammation of the mouth with small, painful ulcers
 Dental caries – Tooth decay (is a breakdown of teeth due to activities of bacteria)
 Herpetic stomatitis – Inflammation of the mouth caused by infection with the herpesvirus
 Oral leukoplakia – White plaques or patches on the mucosa of the mouth
 Periodontal disease – Inflammation and degeneration of gums, teeth, and surrounding bone

Dental caries Herpetic stomatitis

Aphthous stomatitis

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Digestive System
Pathological Conditions POA
Upper Gastrointestinal Tract
 Achalasia – Failure of the lower esophagus sphincter (LES) muscle to relax
 Esophageal cancer – Malignant tumor of the esophagus.
 Esophageal varices – Swollen, varicose veins at the lower end of the esophagus
 Gastric cancer – Malignant tumor of the stomach
 Gastroesophageal reflux disease (GERD) – Solids and fluids return to the mouth from the stomach
 Peptic ulcer – Open sore in the lining of the stomach or duodenum

Esophageal Varices
Hiatal Hernia

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Digestive System
Pathological Conditions POA
Upper Gastrointestinal Tract
 Hernia A hernia happens when part of an internal organ or
tissue bulges through a weak area of muscle. Most hernias
are in the abdomen. There are several types of hernias,
including
 Inguinal Hernia , in the groin. This is the most common
type
 Umbilical Hernia, around the belly button
 Incisional Hernia, through a scar
 Hiatal Hernia, a small opening in the diaphragm that allows
the upper part of the stomach to move up into the chest
 Congenital diaphragmatic Hernia, a birth defect that
needs surgery
 Epigastric hernia, usually between the belly button and
the chest

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Digestive System
Pathological Conditions POA
Lower Gastrointestinal Tract
 Anal fistula – Abnormal tube-like passageway near the
anus
 Colonic polyps – Polyps (benign growths) protrude from
the mucous membrane of the colon
 Colorectal cancer – Adenocarcinoma of the colon or
rectum, or both
 Crohn disease (“Crohn’s”) – Chronic inflammation of the
intestinal tract
 Diverticulosis – Abnormal outpouchings (diverticula) in the
intestinal wall of the colon
 Dysentery – Painful, inflamed intestines commonly caused
by bacterial infection
 Hemorrhoids – Swollen, twisted, varicose veins in the
rectal region

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Digestive System
Pathological Conditions POA
Lower Gastrointestinal Tract
 Ileus – Loss of peristalsis with resulting obstruction of the
intestines
 Inflammatory bowel disease (IBD) – Inflammation of
the colon and small intestine.
 Intussusception – Telescoping of the intestines
 Irritable bowel syndrome (IBS) – Group of GI symptoms
(abdominal pain, bloating, diarrhea, constipation), but
without abnormalities in the intestines
 Ulcerative colitis – Chronic inflammation of the colon with
presence of ulcers
 Volvulus – Twisting of the intestine on itself

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Digestive System
Pathological Conditions POA
Liver, Gallbladder and Pancreas
 Cholelithiasis – Gallstones in the gallbladder
 Cirrhosis – Chronic degenerative disease of the liver
 Pancreatic cancer – Malignant tumor of the pancreas
 Pancreatitis – Inflammation of the pancreas
 Viral hepatitis – Inflammation of the liver caused by a virus
 Appendicitis – Is an inflammation of the appendix

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Digestive System
Abbreviations POA
ALT, AST Alanine transaminase
BE Barium enema
BM Bowel movement
EGD Esophagogastroduodenoscopy
ERCP Endoscopic retrograde Cholangiopancreatography
EUS Endoscopic ultrasonography
G tube Gastrostomy tube
GERD Gastroesophageal reflux disease
GI Gastrointestinal
HBV Hepatitis B virus
IBD Inflammatory bowel disease
LFTs Liver function tests
NG tube Nasogastric tube
PEG tube Percutaneous endoscopic gastrostomy tube—feeding tube
PTHC Percutaneous trans hepatic cholangiography
PUD Peptic ulcer disease

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Digestive System

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