HOSA Pathophysiology Digestive System

Missing Teeth

-Permanent teeth missing.

-S&S- Malocclusion (improper positioning of teeth), jaw pain, bolting (inadequate chewing of food).

~Congenital, periodontal disease

Impacted Third Molars (Wisdom Teeth)

-Third molar is malpositioned, preventing tooth eruption.

~Become impacted when they don't have enough room for eruption due to bone structure; adjacent teeth block eruption

Dental Caries (Tooth Decay)

-Erosion of tooth surface causing infection.

-S&S-Mild toothache, hypersensitivity to sweets and temp. extremes

~Acid plaque eroding tooth enamel causing formation of cavity

Discolored Teeth

-Teeth are discolored

-S&S- colors from slight yellow to brown and gray; brown spots, patches

~Age, Smoking, Dead tooth (gray color), red wine, coffee, tea, food, certain drugs, pertussis (whooping cough)

Gingivitis

-Inflammation and swelling of gums

-S&S- gums become red,soft, and shiny; bleed easily; leads to periodontitis if not treated

~Plaque (sticky deposit of mucus, bacteria and food particles that builds up as a result of inadequate brushing and flossing)

Periodontitis

-Destructive gum and bone disease around one or more of the teeth

-S&S- end result of gingivitis; pockets form between teeth and gums in ging. that expose the root; plaque develops; halitosis

~Plaque biofilm and unchecked gingivitis; poor personal oral hygiene; smoking.

Oral Tumors

-Neoplasms, benign(noncancerous) or malignant(cancerous), localized or invasive.

-S&S- begin as single, small pale lumps. Benign do not metastasize.

~Unknown cause

Malocclusion

-Specific angles of malposition and contact of the maxillary and mandibular teeth, faulty bite

-S&S- protrusion/recession of the jaw; teeth turned/twisted out of position because of crowding

~Characteristics inherited from parents; early loss of primary teeth or oral habits (thumb/finger sucking)

Temporomandibular Joint (TMJ) Syndrome

-Symptom complex related to inflammation, disease, or dysfunction of temporomandibular joint

-S&S- clicking sounds during chewing; severe pain/aching beind ears and jaw joints, headache, dizziness

~Bruxism (grinding of teeth); malocclusion; habitual gum chewing

Tooth Abscesses

-Pus-filled sac in the tissue surrounding the base of the root

-S&S- persistent aches/throbs; glands in neck and face become swollen/tender; fever

~Forms when a tooth is decayed/dying or when the tooth structure loss exposes the dental nerve to mouth bacteria

Mouth Ulcers (Canker Sores)

-Lesion on the mucous membrane, exposing underlying sensitive tissue

-S&S- aphthous: occur during stress/illness; traumatic: from injury (hot food burn, rough denture)

~No viral cause known. Acute ulcerations- viral and bacterial infections, mechanical trauma, stress, or illness

Herpes Simplex (Cold Sores)

-Contagious recurrent viral infection affecting skin and mucous membranes

-S&S- on lips and inside the mouth; tingling and numbness around the mouth precede the appearance (prodrome- initial stage of disease before onset of actual symptoms)

~Herpes simplex virus type 1 (HSV-1); recurrent because virus can lie dormant

Thrush

-Candidiasis of the oral mucosa (mouth, tongue, palate, and gums)

-S&S- burning sensation in the mouth; painful when rubbed; light bleeding might occur; sore slightly raised pale yellow patches in the mouth and sometimes the throat

~The fungus Candida albicans; can multiply out of control; prolonged treatment of antibiotics; cancer chemotherapy; diabetes

Necrotizing Periodontal Disease

-Infection affecting the gums and the anchoring structure of the teeth

-S&S- primary symptom: painful, red, swollen gums with ulcers that bleed; gray gums in areas of decomposing tissue; metallic taste

~anaerobic opportunistic bacteria; results from poor oral hygiene and bacterial infection secondary to gingivitis; stress; poor nutrition; smoking

Oral Leukoplakia

-Leukoplakia or white plaque is a thickening and hardening of a part of the mucous membrane in the mouth

-S&S- can vary in size; mucous membrane become rough, hard, and whitish gray, sensitive to hot or highly seasoned foods

~Chronic irritation e.g friction caused by habitual cheek biting, rough teeth that rubs an area raw; reaction to heat from tobacco smoke

Oral Cancer

-Squamous cell carcinoma and adenocarcinoma of the oral cavity (lips, cheek mucosa, anterior tongue, mouth floor, hard palate, upper and lower gingiva

-S&S- white, patchy lesion or an oral ulcer that fails to heal, pain occurs late in disease process which delays seeking medical treatment, dysphagia (difficulty swallowing), odynophagia (painful swallowing), weight loss

~Smoking, alcohol, betel nut chewing (SE Asia)

Gastroesophageal Reflux Disease (GERD)

-Regurgitation of stomach and duodenal contents into the esophagus

-S&S- belching with burning sensation in chest and mouth; dysphagia; eroded tooth enamel

~Overeating, pregnancy, or weight; relaxation of the lower esophageal sphincter; increase in intraabdominal pressure

-Treatment: proton pump inhibitor

Esophageal Varices

-Dilated submucosal veins that develop in patients w/ underlying portal hypertension

-S&S- superficial veins lining the esophagus become dilated and twitsted at the distal end; with rupture hematemesis(vomiting of blood); melena (dark, tarry stools stained with digested blood); hypovolemic shock (blood in the circulatory system is decreased)

~increased pressure within the veins causes varices; pressure occurs when the venous return to the liver is impeded

Esophagitis

-Inflammation and tissue injury of the esophagus

-S&S: burning chest pain (heartburn); hematemesis

~reflux (backward flow) of the acid contents of the stomach resulting from a defect of the lower esophageal sphincter; GI manifestation of HIV infection

Esophageal Cancer

-Malignancy of the esophagus (squamous cell carcinoma and adenocarcinoma)

-dysphagia, weight loss, burning sensation

~SCC- cigarette smoking, alcohol consumption

-Adenocarcinoma- smoking, obesity

Gastric and Duodenal Peptic Ulcers

-Ulcers of stomach-gastric; Ulcers of duodenum- duodenal

-S&S- Gastric: nausea; vomiting; abdominal pain. Duodenal: nausea; vomiting; heartburn

~H. Pylori infection; use NSAIDs; ingestion of gastric irritants

Gastritis

-Inflammation of the stomach lining

-S&S- Hematemesis; indigestion; epigastric pain

~Irritants such as aspirin; poisons; alcohol; tobacco

Gastric Cancer

-Cancer of the stomach

-S&S- hematemesis; dysphagia; melena; nausea

~H. Pylori- smoking; genetic predisposition; dietary factors (e.g diet high in salt)

Acute Appendicitis

-Inflammation of the appendix

-S&S- nausea, vomiting, and fever

~As bacteria multiply, they invade the wall of the appendix, ad eventually the circulation of the appendix is compromised

Hiatal Hernia

-Protrusion of part of the stomach through the diaphragm at the point where the esophagus joins the stomach

-S&S- Heartburn; chest pain; dysphagia; indigestion

~Congenital defect in the diaphragm; weakness in diaphragm

Abdominal Hernia

-Condition in which an organ protrudes through an abnormal opening of the abdominal wall

-S&S- sharp pain in groin (inguinal hernia); gangrene (trapped or strangulated hernia)

~Congenital malformation in abdominal cavity; pregnancy; trauma

Crohn's Disease (Regional Enteritis)

-Chronic inflammatory disorder of the gastrointestinal tract (any portion from mouth to anus can be affected)

-S&S- chronic diarrhea; weight loss; malaise; nausea; anorexia; fever

~Immunologic factors play a role

Ulcerative Colitis

-Serious inflammation of the colon

-S&S- chronic diarrhea; abdominal cramping; urgency to defecate; mucoid stools; tenesmus

~Unknown cause

Gastroenteritis

-Inflammation of the stomach and intestines

-S&S- increased intestinal motility; body may lose fluids too rapidly causing dehydration

~Contaminated food or water; ingestion of the poison in certain food or chemicals

Intestinal Obstruction

-Mechanical or functional blockage of the intestines

-S&S- Severe pain; nausea; vomiting; electrolyte imbalance

~Occurs when the contents of the intestine cannot move forward because of partial/complete blockage of the bowel; mechanical: neoplasm; foreign bodies; volvulus (twisting of the bowel on itself); intussusception (the bowel telescopes into itself); strangulated hernia

Diverticulosis

-Progressive condition characterized by defects in the muscular wall of the large bowel

-S&S- usually causes no symptoms; blood in stool; diarrhea; difficulty in defecation

~Lack of roughage; outpouches (diverticula) of the mucosa penetrate weak points in the muscular layer of the large intestine

Diverticulitis

-Infection of one or more of the diverticula

-S&S- Abdominal pain or tenderness

~When one or more of the diverticula become inflamed due to to trapped fecal matter; lack of dietary bulk, inadequate fluid intake, and constipation

Colorectal Cancer

-Cancer of the colon and rectum

-S&S- Abdominal pain, change in bowel habits; bloody stools; weight loss; cachexia (wasting disorder linked with malnutrition); lymphadenopathy (disease of the lymph nodes)

~Risk increases with age; adenomatous polyps

Pseudomembranous Enterocolitis

-Bowel mucosa has a membranous appearance

-S&S-mild to severe greenish, foul smelling watery diarrhea; nausea; vomiting

~use of broad spectrum antibiotics; antibiotic therapy reduces the body's natural intestinal flora and allows a bacterial infection with C. difficile to develop

Short-Bowel Syndrome

-Small bowel fails to absorb nutrients because of inadequate absorptive surface

-S&S- malnutrition; diarrhea; abnormal stools; brittle nails and hair

~Length of intact or functioning small bowel is altered significantly by disease or surgery; Chron's diesease; intestinal farction; volvulus; tumor resection

Irritable Bowel Syndrome

-Functional bowel disorder of motility: chronic abdominal pain or discomfort; bloating; erratic dysfunction of bowel habits

-S&S- change of bowel habits with predominant diarrhea or constipation; bloating; abdominal distention

~Unknown cause

Peritonitis

-Inflammation of the peritoneum

-S&S- abdominal pain; nausea; vomiting; weakness; profuse sweating

~inflammatory process of peritonitis has the potential to cause abscesses and adhesions to form in the abdominal cavity; primary infection caused by blood borne organisms

Hemorrhoids

-Varicose dilations of a vein in the anal canal or the anorectal area

-Often painless; rectal pain; itching; protrusion; or bleeding after defecation

~Veins in rectal and anal area become varicose, swollen, and tender as a result of blockage

Cirrhosis of the Liver

-Slow deterioration of the liver due to replacement of normal liver cells with hard fibrous scar tissue

-S&S- loss of appetite and weight; nausea and vomiting; indigestion

~Chronic alcoholism; malnutrition; hepatitis

Viral Hepatitis

-Inflammation of the liver

-S&S- jaundice;anorexia; malaise; fever nausea; dark urine

Hepatitis A

-Infectious hepatitis; highly contagious

~transmitted by fecal-oral route from contaminated food, water, and stools

Hepatitis B

-Serum hepatitis

-S&S- can mimic flu

~Sexual contact or blood exchange from the sharing of contaminated needles

Hepatitis C

-Transmitted mainly through blood transfusions (by blood and body fluids)

~Working in health care environment is a risk factor

Cancer of the Liver (Hepatocarcinoma)

-Liver cancer

-S&S- upper abdominal pain; weight loss; jaundice

~Hepatitis B

Cholelithiasis

-Abnormal presence of gallstones that form in bile

-S&S- Nausea and vomiting

~Insoluble cholesterol and bile salts

Cholecystitis

-Inflammation of the gallbladder

-S&S- nausea; vomiting; fever; jaundice; dark urine

~Obstruction of the biliary duct caused by gallstones; trauma or insult including infection

Acute and Chronic Pacreatitis

-Inflammation of the pancreas

-S&S- severe abdominal pain; nausea; vomiting; patient is diaphoretic (profuse perspiration) and tachyycardiac (rapid heartbeat); mild jaundice

~Protein- and lipid-digesting enzymes become activated within the pancreas and begin to digest the pancreas itself (autodigestion)

Pancreatic Cancer

-Cancer of the pancreas

-S&S- abdominal pain; weight loss; jaundice; nausea; vomiting; acholic (without bile) stools

~Cigarette smoking; obesity

Malnutrition

-Disorder of nutrition caused by primary deprivation of protein-energy

-Loss of energy; diarrhea; drastic weight change; loss of hair; poor nails

~Kwashiorkor: deficiency of protein in the presence of adequate energy; Marasmus: extreme malnutrition and emaciation

Malabsorption Syndrome

-Group of disorders in which intestinal absorption of dietary nutrients is impaired

-S&S- abdominal discomfort; bloating with gas; chronic diarrhea

~Defective mucosla stools in the small intestine

Celiac Disease (Gluten Enteropathy)

-Disease of SI characterized by malabsorption, gluten intolerance, ad damage to the lining of the intestine

-S&S- weight loss; anorexia; diarrhea; flatulence (gas)

Food Poisoning

-Illness that results from eating food that contains bacterial toxins and viral, chemical, or toxic substances

-S&S- malaise; fever; nausea; vomiting

~Food contaminated with bacteria or toxins

Anorexia Nervosa

-Eating disorder hunger is denied by self- imposed starvation

-S&S- sadness; insomnia; thinning hair; cold intolerance; bloating

~Unknown

Bulimia

-Binge eating followed by self induced vomiting or purging

-S&S- compulsive exercise; vomiting; broken blood vessels in the eye

~Uncertain

Motion Sickness

-Loss of equilibrium experience during motion

-S&S- nausea, vomiting, air hunger, excessive salivation, sweating

~Disturbance in the sense of balance; fluid in the semicircular canals of the ears becomes dislocated because of the motion