ANATOMY OF

THE
DIGESTIVE
SYSTEM
AND IT’S
FUNCTION
Major Function of the digestive system

 Digestion - Physical and chemically breaking

of large complex food to a less complex
substances capable of crossing in mucous
membrane.
 Absorption – The process of transporting
simple form of nutrient to blood.
 Elimination – the process of excreting the
insoluble, unabsorbable and undigested food
material.
 ASSESSMENT OF THE GASTRO -
INTESTINAL TRACT

Health History
.Pain – character, duration, pattern, frequency and
time of pain location, meals, rest,
defecation may directly affect the pain,.
.Indigestion- due to the nervous control of the
stomach, fatty foods, coarse vegetables
highly seasoned food ,bowel movement
may or may not relieve the pain.
. Intestinal gas- belching – expulsion of gas
from the stomach through the mouth.

. Flatulence-expulsion of gas from the rectum.

. Change in bowel habit and stool characteristic

. Diarrhea-content moves rapidly through the

intestine and colon. it is also associated
with pain and cramping.
DIAGNOSTIC
PROCEDURE
Radiography

The use of X-rays to view unseen or hard-to-

image objects. The main diagnostic
purposes of X-rays are to see inside one’s
body, most commonly the bones which
can be viewed at an optimum resolution
Magnetic Resonance Imaging

 primarilya medical imaging technique most

commonly used in radiology to visualize the
internal structure and function of the body. MRI
provides much greater contrast between the
different soft tissues of the body than
computed tomography (CT) does, making it
especially useful in neurological (brain),
musculoskeletal, cardiovascular, and
oncological (cancer) imaging.
Contrast studies: • Barium & double-
contrast barium
 Using air with barium will show filling
defects, strictures, erosions & ulcers &
even motility disorders if under
fluoroscopy.
 Colonoscopy

 Colonoscopy enables your doctor to

examine the lining of your colon (large
intestine) for abnormalities by inserting a
flexible tube as thick as your finger into
your anus and slowly advancing it into the
rectum and colon.
Flexible sigmoidoscopy
 is a diagnostic test used to detect
abnormalities, such as polyps, ulcers or
cancerous changes, in the rectum and
sigmoid colon of the large intestine.  This
test may be performed to find the cause of
diarrhea, constipation or abdominal pain.
A few days prior to the test, the patient is
asked to eat a clear liquid diet, including
things such as ginger ale, plain tea and
coffee, gelatin, ginger ale and water.
ULTRASOUND

technique that uses sound

waves to study and treat hard-to-
reach body areas. In scanning with
ultrasound, high-frequency sound
waves are transmitted to the area
of interest and the returning
echoes recorded .
 MANAGEMENT of

PATIENT with
INGESTIVE and
UPPER
GIT PROBLEM
Dental Plaque and Carries
Gluey gelatin like substances that adheres to
the teeth. Teeth damage depends on the
following factor:

a) Presence of dental plaque

b) Strength of acid and ability of saliva to
neutralize
Dental plaque
c) length of time acid are in contact
with the teeth
d) susceptibility of the teeth to decay
Management:

a. effective mouth wash

b. reduce intake of sugar
c. applying fluoride in teeth
Periapical Abscess (tooth abscess) -
collection of pus in the apical dental
periosteum
Management
May drill an opening into the pulp chamber
to relieve tension and pain. After the
inflammation subside teeth is extracted .
Periapical abscess
Malocclusion – misalignment of the teeth
and lower dental arc when the jaws are
closed.

Management:
Realigns the teeth by orthodontist by
using wires or plastic band
Jaw Repositioning and Reconstructions

Causes:
. Fracture of mandible due to blow
. After trauma from accident or
cancer
Jaw Reconstruction
Management:
a. rigid plate fixation (placement of
metal plates and screw into the bone)
b. place patient head slightly elevated
c. NGT connected to low pressure
suction to remove discharges
 d. wire cutter should be at the bedside-

if the patient vomit wire should be cut to

prevent aspiration
e. rewiring will be repeated if wire will be

cut
f. antiemetics are administered
 Periodontal disease - spectrum of disease
ranging from disorder of the gums, gingivitis,
to periodontal disease, its worst form.

Clinical manifestation
a. bleeding associated with trauma
b. alteration in color
c. rarely painful
Management

Prevention, plaque removal, thoroughly

cleansing
DISORDERS OF THE
SALIVARY GLANDS
 Parotitis – inflammation of parotid gland

Contributing factor
• people with decreased salivary flow
due to generalize dehydration or medication

Clinical manifestation
• fever, gland swells and become
tender
Parotitis
Nursing Intervention

a. prevention is important

b. maintain adequate nutrition and fluid

intake along with oral hygiene

c. decrease intake of medicine that

decreases secretion of saliva eg.
diuretics and tranquilizers
Sialadenitis – inflammation of salivary
gland.
Causes
Dehydration, radiation therapy, stress,
malnutrition

Management
Antibiotics administration
Sialadinitis
 Salivary Calculus- sialolithiasis
Salivary calculi in the submandibular
gland it form from calcium phosphate and,
they vary in Diameter
Manifestation
No symptoms unless with infection
Calculus that obstructs the gland
cause local and often colicky pain
Stomatitis - caused by mechanical or
chemical trauma

Primary caused by herpes simplex

and Vincent angina
Secondary caused when the client
resistance lowered and an
opportunistic infection occurs
Types:

1. Aphthous stomatitis (canker sore)

Recurrent, small ulcerated lesion of
the soft tissue of the mouth

Management
Topical or systemic steroid
2. Herpes Simplex
Cause by viral infection
Clinical manifestation
Vesicular lesion which last for one wk..
Tongue appears coated
Client complain of foul smell breath
odor

3. Vincent Angina
Acute viral infection of the gingival
DISORDERS OF THE
ESOPHAGUS
Achalasia - failure of the esophageal
sphincter to relax in response to swallowing

Clinical manifestation
¤ Difficulty in swallowing liquid and solid
¤ As condition worsen, food is
regurgitated
¤Complain of chest pain and heart burn
(pyrosis)
Diagnosis:
X-ray studies, barium swallow,
endoscopy, mamometer

Management
Eat slowly and drink fluid with meals
Calcium channel blocker (use to
decrease esophageal pressure)
Pneumatic dilation (Esophageal balloon
dilation)
Esophagomyortomy – thoracotomy is
performed to provide access and an

incision is made through the

muscularis of the lower esophagus
Diffuse Spasm - motor disorder of the
esophagus characterized by difficulty or pain
on swallowing and chest pain similar to that
of coronary artery spasm.

Diagnostic procedure
X-ray
Management

Small frequent feeding and soft diet

Pneumatic dilation
Gastro Esophageal Reflux – back flow of
gastric and duodenal content into the
esophagus due to incompetent lower
esophageal sphincter, pyloric stenosis
and or motility disorder.

Clinical manifestation
Pyrosis, dyspepsia, regurgitation and
hypersalivation
Diagnostic procedure
12-36 hours esophageal ph monitoring

Management
¤Teach patient to avoid factor that
decreases lower esophageal sphincter.
¤ Low fat high fiber diet
¤ Avoid caffeine and tobacco
¤ Avoid overweight
¤ If reflux persists give antacid and
histamine receptor blockers
Hiatal Hernia - esophagus enter the
abdomen through the opening in the
diaphragm

2 types;
a. axial or sliding – occurs when the upper

stomach and the gastro esophageal

junction are displaced upward.
Clinical manifestation
Heartburn, regurgitation, dysphagia

Diagnostic Procedure
X-ray, upper GI series
Management

¤ Small frequent feeding

¤ Not to recline for 1 hour after feeding
to prevent reflux
¤ Bed should be incline for 4-8 inches
after eating
b. Paraesophageal hernia - all parts of

the stomach are being push through

the diaphragm next to

gastroesophageal sphinter.

Clinical manifestation
Sense of fullness after eating
Diagnostic procedure
X-ray , Upper GI series

Management
Surgery
Diverticulum – out pouching of mucosa and

sub mucosa that protrude through a

weak portion of the muscle

3 types
pharyngoesophageal diverticulum
- occurs in the mid line of the neck
Clinical manifestation
Difficulty in swallowing and fullness in
the neck

Diagnostic procedure
Barium swallow

Management
Surgical removal of diverticulum
B. Mid esophageal
Diverticulum occurs in the middle
of esophagus not very common

C. Epiphrenic
Occurs just below the esophagus
above the diaphragm
D. Intramural
numerous small diverticula associated

with stricture of the upper esophagus

Management
Surgery
Rings and webs
Esophageal rings are thin concentric
membranous consisting of mucosal
in esophageal junction while esophageal
web consists of mucosa tissue forming
concentric shelves along the entire
esophagus
Clinical manifestation
Dysphagia

Diagnostic procedure
Barrium swallow

Management
Require dilation