XI. DISEASES
OF THE
DIGESTIVE
SYSTEM
A. Mouth and Associated Parts
– inflammation of the mouth
1. Stomatitis
– causes may be pathogenic organisms, mechanical trauma, irritants ie. alcohol, tobacco, hot foods
2. Glossitis
– inflammation of the tongue
– often associated with stomatitis
3. Gingivitis
– inflammation of the gingiva or gums
– may also be associated with generalized stomatitis
– usually caused by the long term effects of plaque buildup on the surface of the teeth
– can occur with deficiency diseases such as scurvy or metallic poisoning
4. Cheilitis
– inflammation of the lips
Common organisms that cause inflammation of the oral cavity include:
– Candida albicans
– the fungus that causes thrush
– Herpes simplex I
– the virus that causes cold sores or fever blisters
– Treponema pallidum
– the bacterium that causes syphilis
B. Pharynx
– inflammation of the throat
– Pharyngitis
– may be a primary infection such as strep throat or diphtheria
– or may be a complication of other infections such as rhinitis, sinusitis or influenza
C. Esophagus
– Esophagitis
– inflammation of the esophagus
– often caused by regurgitation of stomach acid through the cardiac sphincter
C. Esophagus
– Esophagitis
– inflammation of the esophagus
– often caused by regurgitation of stomach acid through the cardiac sphincter
– stenosis or stricture of the esophagus is also a common condition
D. Stomach
1. Gastritis
– inflammation of the stomach
– may result from pernicious anemia, bacterial or viral infection, excessive indulgence in alcoholic beverages, dietary indiscretions or too much aspirin
2. Peptic Ulcer
– ulcers that occur in the mucous membranes of the stomach or duodenum
– caused by hyperacidity of the gastric juices
2. Peptic Ulcer
– ulcers that occur in the mucous membranes of the stomach or duodenum
– caused by hyperacidity of the gastric juices
– this hyperacidity is caused by the presence of the bacterium Helicobacter pylori
– A complication of peptic ulcers is
– perforation
– this refers to an ulcer that eats through the stomach wall and allows the contents to reach the abdominal cavity causing a severe infection known as
– peritonitis
Endoscopy showing perforated ulcer
– another complication of peptic ulcers that occur in the area of the pyloric valve is
– this refers to stenosis of the pyloric valve between the stomach and small intestine
– pyloric stenosis
– caused by the formation of scar tissue from chronic ulcers
E. Small Intestine
– inflammation of the intestines
1. Enteritis
– caused by a number of organisms, some of which are normal flora
– these organisms are often obtained from
– contaminated food or water
– symptoms may include:
– abdominal pain, cramping, diarrhea, fever and dehydration
2. Crohn’s Disease
– an idiopathic inflammatory bowel disease that may lead to blockage of the intestine by swelling and scar tissue formation
3. Hernia
– a condition in which a segment of intestine protrudes through the abdominal wall
– the major concern with hernias is that the intestine may become obstructed, blocking the passage of its contents
– or the blood supply could be pinched off resulting in necrosis
Types of Hernias
a. Inguinal Hernia
– a hernia in which a segment of small intestine protrudes through the inguinal ring
– this loop may protrude down into the scrotum of the male or the labia majora of the female
Types of Hernias
b. Femoral Hernia
– a hernia in which a segment of small intestine protrudes through the femoral ring
– this loop may protrude into the soft tissues adjacent to the femoral vessels in the area of the groin
– most commonly seen in women
c. Umbilical Hernia
– a hernia at the navel in which a segment of small intestine of an infant protrudes through an imperfect closure of the umbilicus following birth
Types of Hernias
d. Diaphragmatic Hernia
– a hernia in which a segment of an organ protrudes through one of the orifices of the diaphragm
Types of Hernias
d. Diaphragmatic Hernia
– a hernia in which a segment of an organ protrudes through one of the orifices of the diaphragm
Hiatal hernia
Types of Hernias
– a hernia in which a portion of the stomach protrudes through the diaphragm
– a special type of this is the
Repair of an inguinal hernia:
F. Colon and Rectum
– inflammation of the mucous membrane of the colon
– the most frequently seen gastro-intestinal disease
1. Colitis
– the most common causes seem to be stress and certain foods and beverages
2. Ulcerative Colitis
– another idiopathic inflammatory bowel disease that causes ulcers in the lining of the lower colon and rectum
– causes diarrhea, the ulcers bleed and produce pus
– 25 to 40% of patients must eventually have their colons removed because of massive bleeding, severe illness, rupture of the colon or risk of cancer
3. Diverticulosis
– the condition of having a sac or pouch-like structure in the wall of the large intestine
– these are called
diverticula
– Diverticulitis
– inflammation of the diverticula
– occurs when the diverticula become impacted with fecal material and bacteria
– symptoms include chronic constipation, mucus in the stool and severe abdominal pain
4. Obstructions:
– a decrease in peristalsis in a section of the large intestine caused by a lack of nerve or blood supply
a. Paralysis
b. Volvulus
– a twisting of a loop of intestine
c. Intussusception
– a slipping or telescoping of one segment of intestine into another
d. Adhesions
– scar tissue formed on loops of the bowel adhere the loops together preventing the normal process of peristalsis
5. Proctitis
– inflammation of the rectum and anus
6. Hemorrhoids
– varicose veins of the rectum or anus
Piles
– determined by how close they are to the anorectal line
– internal and external
-Two kinds
– also known as
If you are squeamish, you might want to look away for the next 2 pictures
7. Appendicitis
– inflammation of the appendix
– if untreated, an inflamed appendix may burst and cause peritonitis
8. Polyps
– very common benign tumor-like growths
G. Liver
– inflammation of the liver
Infiltration and Degeneration
2. Hepatitis
a. Two types:
– review your Pathology I notes on fatty infiltration, fatty degeneration, and fatty change
– caused by exposure to certain poisons. ie. drugs
1) Toxic Hepatitis
2) Viral
caused by several viral agents
– three known as:
– spread directly from person to person by the fecal oral route
a) Hepatitis A
– also known as infectious hepatitis
– usually due to poor sanitation methods
– not as serious as other forms
b) Hepatitis B
– also known as serum hepatitis
– transmitted through contaminated body fluids
– may result in chronic hepatitis and permanent liver damage
– represents an occupational hazard to people who work with blood and blood products
– more serious than hepatitis A
c) Hepatitis C
– even more serious because there is not yet a vaccine available
– also known as
Non-A Non-B hepatitis
– also transmitted through contaminated body fluids
b. Jaundice
– a symptom of liver disruptions
– a yellowish staining of the integuments, deeper tissues and the excretions with bile pigments
– causes a yellowness of the skin, whites of the eyes, mucous membranes, and body fluids due to the deposition of the bile pigment bilirubin
3. Cirrhosis
– degenerative changes in liver parenchyma cells with the formation of dense connective tissue, fatty infiltration, and scarring
– results in the loss of functioning liver cells and an increased resistance to the flow of blood through the liver
– seen in the end stage of chronic liver disease
– can be caused by chronic alcoholism and damage by other toxins or drugs, or previous infections
Toxic hepatitis cirrhosis
Cirrhosis from chronic alcoholism
– Postmortem Conditions:
a. b.
c.d.
Jaundice
Ascites
Edema
Hemorrhage
– hemorrhaging is from a ruptured esophageal varix
– occurs because of the blockage of the portal vein
– this blockage could also lead to ammonia toxicity in the body
H. Gallbladder and Bile Ducts
H. Gallbladder and Bile Ducts
– inflammation of the gallbladder
– may be acute or chronic
– acute form is usually a result of the irritation caused by gallstones
1. Cholecystitis
H. Gallbladder and Bile Ducts
– inflammation of the gallbladder
– may be acute or chronic
– acute form is usually a result of the irritation caused by gallstones
– chronic form is important in the production of gallstones
1. Cholecystitis
2. Cholelithiasis
– the formation or presence of calculi or bilestones in the gallbladder or common duct
– most commonly composed of cholesterol, but mixed stones are common as well
– gallstones may block the passageway for bile and cause a backup leading to cholecystitis
3. Cholangitis
– inflammation of the bile ducts
– caused by the obstruction of a duct by gallstones infected with bacteria
I. Pancreas
I. Pancreas
– inflammation of the pancreas
– usually a consequence of alcoholism (chronic) or gallstone blockages(acute)
– Pancreatitis
– acute form is characterized by necrosis, suppuration, gangrene, and hemorrhage
– chronic form leads to the formation of scar tissue associated with malfunction
J. Peritoneum
– inflammation of the membrane that lines the wall of the abdomen and covers the abdominal organs
– Peritonitis
– usually due to a bacterial infection caused by perforation of an ulcer or intestine
K. Postmortem Conditions of Digestive System Disorders
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Ascites
Dehydration
Rapid decomposition
Febrile lesions
Emaciation
Rapid coagulation of blood
Jaundice
Edema
Hemorrhage
Purge
Abdominal
Distention
XII. DISEASES OF THE RESPIRATORY SYSTEM
A. Upper Respiratory Tract
1. Acute Inflammation
– inflammation of the nasal mucosa
a. Rhinitis
– part of having a cold
– inflammation of the sinuses
b. Sinusitis
– due to a variety of allergic, viral and bacterial causes
c. Pharyngitis
– inflammation of the pharynx
d. Laryngitis
– inflammation of the larynx
– commonly called the throat
– commonly called the voice box
e. Coryza
– commonly known as the common cold
– nasal congestion
– runny nose
– runny eyes
– mild sore throat
– headache
– an acute viral infection of the upper respiratory tract
– characterized by:
– a common upper respiratory viral infection
– characterized by:
–
–
–
–
–
–
2. Influenza
– a common upper respiratory viral infection
– usually called the flu
fever
chills
sore throat
headache
cough
muscle pain
– characterized by:
–
–
–
–
–
–
– possible vomiting
3. Hay fever
– a form of allergy as a result of hypersensitivity to various grass and tree pollens
– a common upper respiratory problem characterized by watery and itchy eyes, a runny nose, and sneezing and coughing
4. Nasal Polyps
– the most common tumor-like growth to the nose
– inflammatory growths with a stem or a pedicle
B. Trachea and Bronchi
– inflammation of the trachea
– also known as the windpipe
1. Tracheitis
2. Bronchitis
– inflammation of the bronchi
– characterized by fever, chest pain, difficulty breathing and chronic cough
– caused by the person trying to clear excess mucous from the linings of the respiratory passageway
3. Bronchiolitis
– inflammation of the smaller bronchi and bronchioles
– an allergic response characterized by a hypersecretion of mucous and spasms of the bronchial muscles
4. Bronchial Asthma
C. Lungs
– inflammation of the lungs due to infection with bacteria, viruses or other pathogenic organisms
1. Pneumonia
– causes the buildup of inflammatory exudates in the alveoli
– if the lungs are inflamed due to other agents that are not infectious, the term pneumonitis is used
a. Three Varieties
– inflammation localized in one or two lobes of the lung
1) Lobar Pneumonia
– Streptococcus pneumoniae causes the majority of the cases
– the affected lobe(s) is usually full of a thick, fibrinous exudate making the exchange of respiratory gases difficult
– responds well to antibiotic treatment and therefore is usually an acute disease
2) Bronchial pneumonia or Bronchopneumonia
– more scattered throughout the bronchi and lungs as spotty patches than lobar pneumonia
– inflammation of the bronchi and terminal bronchioles that can spread into the lungs
– it is most commonly a secondary disease
– seen as a complication of:
– whooping cough
– measles
– influenza
– chronic bronchitis
– cancer
– AIDS
– it is also a common nosocomial infection
3) Viral Pneumonia
– caused by a variety of viruses
b. Associated Conditions w/ pneumonia
– inflammation of the membranes surrounding the lungs
– also known as pleurisy
1) Pleuritis
– often accompanies lobar pneumonia
– fluid in the pleural cavity
2) Pleural effusion
– also known as hydrothorax
– accompanies circulatory disorders
3) Empyema
– pus in the pleural cavity
– also known as pyothorax
4) Hemothorax
– may accompany wounds, infections, or tumors
– blood in the pleural cavity
– accompanies many infectious diseases
5) Pneumothorax
– air in the pleural cavity
– results of a penetrating wound from outside the body or from the rupture of an alveoli in diseases like tuberculosis and emphysema
6) Anoxia
– deficient blood oxygen supply to the tissues of the body
c. Postmortem Conditions of pneumonia
1)
2)
3)
4)
Rapid coagulation of blood
Cyanosis
Dehydration
Edema
– the bluish color of mucous membranes resulting from lack of oxygen
2. Tuberculosis
a. Cause –
b. Lesion –
Mycobacterium tuberculosis
Tubercle or Ghon's lesion
Tubercle or Ghon's lesion
– has a granulomatous characteristic with gross visible necrosis forming a cheesy, crumbly, caseous mass
– known as caseation necrosis
Tubercle or Ghon's lesion
– tubercle contents may become liquified and resemble pus but without all the cardinal signs of inflammation
– this is the formation of a Cold Abscess
Tubercle or Ghon's lesion
– tubercles may also erode the wall of a bronchus leaving an empty cavity
– this is the process of Cavitation
c. sputum is grayish yellow or white
– involving the lungs
– the most common form
d. Forms of Tuberculosis
1) Pulmonary
135
– generalized tuberculosis with minute tubercles in the affected part
2) Miliary
– brain
– kidneys
– intestines
– bones
– skin
– most often affected organs are: