Problem 1 Group 10 Gastrointestinal

8/17/2019 Problem 1 Group 10 Gastrointestinal

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Problem 1

Group 10

Gastrointestinal Track System26th August 2015


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Group 10

Tutor: dr !ulia"ati

#eader: $arissa %cta&iani '(051)00*0+

Secretary: Sammy ,aspati '(051)0115+

-riter: .ebrina&ega -andy '(051)00**+

/embers:

• Seri Agustin '(051201)2+

• Putri Ayu '(051)001*+

• .eli Setia"an '(051)00*)+

• ion %rlando '(051)00*(+

• Suni $hristina '(051)0111+

• ica $laudia '(051)01((+

• !esslyn ,us3ardy '(051)015*+

• Almira abila '(051)01*)+

• 4essica esbet '(051)0211+


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n3amiliar Terms

1 ysphagia: di7culty s"allo"ing

2 $aries dentis: holes in the teeth


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e8ne the Problems

1 9s there any relationship bet"een caries dentis and dysphagia

2 ;o" smoking and drinking alcohol a -hat can cause s"elling under the ?a"

@ 9s there any relationship bet"een halitosis dry mouth crackedlips "ith dysphagia and s"elling

* -hat causes "hite patches in the mouth mucosa and tongueulcers

10-hy at birth patients get surgery


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Brainstorm Possible;ypothesis

1 $aries dentis in3ection s"elling dysphagia

2 /edicine hormone alcohol C lo"er esophageal sphincter tonus GD, dysphagia

) 4es surgery scar tissue dysphagia

( E

5 $aries dentis pain3ul s"allo"ing dysphagia

6 Damination:

1 Dndoscopy

2 ideo Fuoroscopy

) Panoramic Eray

( /outh s"ab

> $auses:

1 Trauma

2 Tumor

) 9n3ection abscess

( S"ollen lymphatic node

@ ysphagia di7culty drinking dehydration dry mouth cracked lips

* $auses:

1 #ess drinking

2 $andidiasis 'caused by consuming antibiotic+

) $hemical burn 'caused by aspirin+

10$ongenital disorder: pallatum esophageal atresia


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$ongenital disorder

Abscess

$ariesdentis

Aspirin Smoking drinking alcohol

-hitepatches

$hemical

burn

$andidiasi

s

%ral

thrush

C lo"eresophagealsphincter

tonus

GD,

ysphagia

• Dndoscopy• /outh s"ab

• HEray•ideoFuorosco

py• Teeth

eamination Treatment

,e&ie"


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#earning %b?ecti&es

1 $apable to eplain about anatomy o3 upperdigestion system

2 $apable to eplain about physiology o3

upper digestion system) $apable to eplain about histology o3 upper

digestion system

( $apable to eplain about biochemistry o3

upper digestion system

5 $apable to eplain about diseases o3 upperdigestion system


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LO1. ANATOMY OF UPPERDIGESTION SYSTEM


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Anatomy o3 pper G9 Tract

• pper Gastrointestinal Tract:

Dsophagus E Gaster E uodenum EProimal !e?unum E TreitI ligament

• #o"er Gastrointestinal Tract:

TreitI ligament E istal !e?unum J9leum J$olon E Anus


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AAT%/4


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%ral $a&ity 'mouth+

• Dntrance to the G9 tract• 9nitial site o3 digestion:

– mechanical digestion '&ia mastication+ – chemical digestion '&ia enIymes in sali&a+

• Bounded anteriorly by the teeth and lips• Bounded posteriorly by the oropharn!.• Superior boundary is 3ormed by the hard

and so"t palates.• .loor or in3erior sur3ace o3 the oral ca&ity

– the ton#$e – the mylohyoid muscle co&ered "ith mucosa


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%ral $a&ity 'mouth+

• T"o regions o3 the oral ca&ity

– estibule is the space bet"een the cheeks orlips and the gums

– %ral ca&ity proper• The lateral "alls are 3ormed by the cheeks

– $ontain buccinator muscles• #ips 'labia+

– %rbicularis oris muscle

– KeratiniIed strati8ed sLuamous DT• Gingi&ae or gums

– ense regular $T

– onkeratiniIed DT• #abial 3renulum


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Teeth• $ollecti&ely kno"n as the dentition

• ,esponsible 3or mastication

– 8rst part o3 the mechanical digestion

• A tooth has:

– eposed cro"n

– constricted neck

– one or more roots

• ,oots o3 the teeth 8t into dental al&eoli

– are sockets "ithin the al&eolar processes

– on both the maillae and the mandible

• $ollecti&ely the roots the dental al&eoli and theperiodontal ligament that binds the roots to theal&eolar processes 3orm a gomphosis ?oint


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LO%. P&YSIOLOGY OFUPPER DIGESTIONSYSTEM


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Physiology

• There are 3our basic digesti&eprocesses: – Motility

– Secretion

– Digestion

– Absorption


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/otility

• /otility re3ers to the muscularcontractions that mi and mo&e3or"ard the contents o3 the digesti&e

tract

• 9t also maintains a constant lo" le&elo3 contraction kno"n ad tone

• T"o basics type o3 motility : – Propulsi&e mo&ement

– /iing mo&ement


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Secretion

• Dach digesti&e secretion consist o3 "aterelectrolytes and speci8c organic constituentsimportant in digesti&e process

•Secretion o3 all digesti&e ?uices reLuires energyboth 3or acti&e transport o3 some o3 the ra"material into the cell and 3or synthesis o3secretory products by the endoplasmicreticulum

• ormally the digesti&e secretions arereabsorbed in one 3orm or another back intothe blood a3ter their participation in digestion


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igestion

• The term digestion re3ers to the biochemicalbreakdo"n o3 the structurally comple3oodstu


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igestion

• igestion is accomplished byenIymatic hydrolysis

• igesti&e enIymes are speci8c in thebonds they can hydrolyIe

http:NN"""chembookcoukN8g25E(?pg


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Absorption

• igestion completed in the smallintestine and most absorption occurs

• Through the process o3 absorptionthe small absorbable units thatresults 3rom digestion are trans


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$hapter 16 Theigesti&e SystemHuman Physiology by#auralee Sher"oodO200> BrooksN$oleE

(ontrol o" Sali)ar Se'retion

Thinking of

food

Seeing food

Smelling food


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S"allo"ing

• S"allo"ing can be di&ided into:

1. a voluntary stage "hich initiates thes"allo"ing process

2. a pharyngeal stage "hich isin&oluntary and constitutes passage o33ood through the pharyn into theesophagus

3. an esophageal stage anotherin&oluntary phase that transports 3ood3rom the pharyn to the stomach


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/atsuo K Palmer B! Anatomy and

physiology o3 3eeding ands"allo"ing Phys /ed ,ehabil $lin

E


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Sher"ood # 9ntroduction to human

physiology @th ed nited States:BrooksN$oleE$engage #earning


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LO*. &ISTOLOGY OFUPPER DIGESTIONSYSTEM


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di.iore Atlas o3 ;istology 2(>

9GDST9D S4STD/

• T"o groups o3 organs compose thedigesti&e system:

– Gastrointenstinal 'G9+ tract or alimentary

canal J mouth most o3 pharynesophagus stomach small intestineand large intestine

– Accessory digesti&e organs J teeth

tongue sali&ary glands li&ergallbladder and pancreas

• ;istologic organiIation:


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;istologic organiIation:

– /ucosa:

• Dpithelium lamina propria muscularis mucosa

– Submucosa:

• connecti&e tissue &essels and /eissners pleusessome times mucous glands

– /uscularis eterna: 2E) layers o3 smooth muscle 'plusskeletal muscle in esophagus+ myenteric 'Auerbach+pleus in bet"een muscle layers

– Serosa and ad&entitia: %utermost layer o3 looseconnecti&e tissue and blood &essels $all serosa i3co&ered my mesothelium ad&entitia other"ise

mucosa submuco muscula serosa


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%,A# $A9T4

• 9nner sur3ace o3 the lips cheeks so3tpalate sur3ace o3 tongue and Foor o3 themouth

– onkeratiniIed strati8ed sLuamous epithelium – #amina propria

– Submucosa

• Gingi&a and hard palate

– KeratiniIed strati8ed sLuamous epithelium – #amina propria

• Tongue: specialiIed mucosa "ith papillae


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T;D #9P


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T;D T%GD

!unLuiera # $ '201)+ Basic ;istology tet Atlas 1)rd

edn/cGra" ;ill e" 4ork


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T%GD PAP9##AD• There are 3our types:

3ungi3orm

8lli3orm


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3oliate

circum&allate


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TASTD B


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TDDT;


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DS%P;AGS

• /ucosa: nonEkeratiniIing strati8edsLuamous

• Submucosa: contains mucous glands

– 9ncreased mucous glands at lo"er esophagus'GD ?unction+ to protect esophagus 3romgastric ?uices

• /uscularis eterna: inner circular and

outer longitudinal – $ontains skeletal muscle 8bers


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DsophagusSLuamousmucosa

/uscularis Dterna

Submucosa

Ad&entitia N

Serosa

/ucosa

/uscularismucosa

s


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L o

w e r e s o p

h a g u s

U p p e r e s o p h a g u


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LO+. ,IO(&EMISTRY OFUPPER DIGESTIONSYSTEM


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The mouth

• igestion o3 starchbegins in the mouth

• Sali&ary gland releases

aEamylase

con&ertsstarch to smallerpolysaccharides 'aEdetrins+

• Sali&ary aEamylase isinacti&ated by theacidity o3 stomach';$#+

/arks= Basic /edical Biochemistry A $linical Approach 2nd Ddition


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Pancreas

• Pancreatic aEamylase andbicarbonate are secreted by theeocrine pancreas into thelumen o3 the small intestine

• Bicarbonate neutraliIe thegastric secretions

• Pancreatic aEamylase continuesthe digestion o3 aEdetrins con&erting them to

disaccharides 'maltose+trischarrides 'maltotriose+ andoligosaccharides 'limit detrins+



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9ntestine

• igestion o3 thedisaccharides lactose dansucrose maltosemaltotriose dan limit

detrins occurs throughthe membrane sur3ace o3the brush border'micro&illi+ o3 intestinal

epithelial cells

con&erted tomonosaccharides byglycosidases



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LO-. A,NORMALITIES OFUPPER DIGESTIONSYSTEM


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$le3t lip and palate

• $le3t lip and cle3t palate are birthde3ects that occur "hen a baby=s lipor mouth do not 3orm properly during

pregnancy Together these birthde3ects commonly are calledQoro3acial cle3tsR These birth de3ects

happen early during pregnancy Ababy can ha&e a cle3t lip a cle3tpalate or both a cle3t lip and cle3tpalatehttp:NN"""cdcgo&NncbdddNbirthde3ectsNcle3tliphtml


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http:NN"""cdcgo&Nncbdd

dNbirthde3ectsNcle3tliphtml


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$le3t lip

• The lip 3orms bet"een the 3ourth and se&enth"eeks o3 pregnancy A cle3t lip happens i3 thetissue that makes up the lip does not ?oincompletely be3ore birth This results in anopening in the upper lip The opening in thelip can be a small slit or it can be a large

opening that goes through the lip into thenose A cle3t lip can be on one or both sideso3 the lip or in the middle o3 the lip "hichoccurs &ery rarely $hildren "ith a cle3t lipalso can ha&e a cle3t palate


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$le3t palate

• The roo3 o3 the mouth 'palate+ is3ormed bet"een the sith and ninth"eeks o3 pregnancy A cle3t palate

happens i3 the tissue that makes upthe roo3 o3 the mouth does not ?ointogether completely during

pregnancy .or some babies boththe 3ront and back parts o3 the palateare open .or other babies only parto3 the palate is openhttp:NN"""cdcgo&NncbdddNbirthde3ectsNcle3tliphtml


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• The causes o3 oro3acial cle3ts among mostin3ants are unkno"n

• Some children ha&e a cle3t lip or cle3t palatebecause o3 changes in their genes

• $le3t lip and cle3t palate are thought to becaused by a combination o3 genes and other3actors such as things the mother comes incontact "ith in her en&ironment or "hat

the mother eats or drinks or certainmedications she uses during pregnancy

http:NN"""cdcgo&NncbdddNbirthde3ectsNcle3tliphtml


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,isk .actor

• Smoking-omen "ho smoke during pregnancy aremore likely to ha&e a baby "ith an oro3acial cle3t than

"omen "ho do not smoke

• iabetes-omen "ith diabetes diagnosed be3orepregnancy ha&e an increased risk o3 ha&ing a child "ith acle3t lip "ith or "ithout cle3t palate compared to "omen

"ho did not ha&e diabetes

• se o3 certain medicines-omen "ho used certainmedicines to treat epilepsy such as topiramate or

&alproic acid during the 8rst trimester 'the 8rst )months+ o3 pregnancy ha&e an increased risk o3 ha&ing a

baby "ith cle3t lip "ith or "ithout cle3t palate comparedto "omen "ho didn=t take these medicines



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Treatment

• Surgery to repair a cle3t lip usually occurs in the 8rst 3e"months o3 li3e and is recommended "ithin the 8rst 12months o3 li3e

• Surgery to repair a cle3t palate is recommended "ithin

the 8rst 1@ months o3 li3e or earlier i3 possible• /any children "ill need additional surgical proceduresas they get older 'Surgical repair can impro&e the lookand appearance o3 a child=s 3ace and might also impro&ebreathing hearing and speech and language

de&elopment+• $hildren born "ith oro3acial cle3ts might need other

types o3 treatments and ser&ices such as special dentalor orthodontic care or speech therapy



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/icrognathia

– $ri du chatsyndrome

– ;allermanEStrei<syndrome

– /ar3an syndrome – Pierre ,obin

syndrome

– Progeria

– ,ussellESil&er

– Seckel syndrome

– SmithE#emliE%pitIsyndrome

– TreacherE$ollinssyndrome

– Trisomy 1) – Trisomy 1@

– H% syndrome 'Turnersyndrome+

• /icrognathia is a term 3or a lo"er ?a" thatis smaller than normal

• Dtiology :


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/icrognathia

• Pathology : – A small mandible occurs secondary to

abnormalities o3 the 8rst branchial arch "hichin turn are caused by de8cient or insu7cientmigration o3 neural crest cells

– %ccur around the (th "eek o3 gestation

• $linical mani3estasions :

– The tongue is usually o3 normal siIe but theFoor o3 the mouth is 3oreshortened

– The air passages can become obstructedparticularly on inspiration


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Treatments

• The in3ant should be maintained in aprone or partially prone position sothat the tongue 3alls 3or"ard to

relie&e respiratory obstruction• Tracheostomy

• /andibular distraction


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Glossitis

• A problem in"hich the tongueis s"ollen and

changes coloro3ten making thesur3ace o3 the

tongue appearsmooth


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Glossitis

• Glossitis is o3ten a symptom o3 otherconditions such as: – Allergic reactions to oralcare products 3oods or

medicine

– ry mouth due to S?ogren syndrome

– 9n3ection 3rom bacteria yeast or &iruses 'includingoral herpes+

– 9n?ury 'such as 3rom burns rough teeth or badE8tting dentures0

– Skin conditions that a


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Glossitis

• Symptoms: – Problems che"ing s"allo"ing or

speaking

– Smooth sur3ace o3 the tongue – Sore tender or s"ollen tongue

– Pale or bright red color to the tongue

– Tongue s"elling – Blocked air"ay 'rare+

Glossitis


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Glossitis• Daminations:

– An eam to look 3or:• .ingerElike bumps on the sur3ace o3 the tongue 'called

papillae+ that may be missing

• S"ollen tongue 'or patches o3 s"elling+

– Blood tests to rule out other medical problems• Treatment:

– Good oral care Brush your teeth thoroughly atleast t"ice a day and Foss at least once a day

– Antibiotics or other medicines to treat in3ection – iet changes and supplements to treat nutrition

problems

– A&oiding irritants 'such as hot or spicy 3oods

alcohol and tobacco+ to ease discom3ort


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Glossitis•

Prognosis: – Glossitis goes a"ay "ith i3 the cause o3problem is remo&ed or treated

• Pre&ention: – Good oral care 'thorough tooth brushing

and Fossing and regular dentalcheckups+


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#eukoplakia

• #eukoplakia is a "hite or graypatch that de&elops on the tonguethe inside o3 the cheek or on theFoor o3 the mouth 9t isthe mouthUs reaction to chronicirritation o3 the mucousmembranes o3 the mouth

• #eukoplakia usually isnUtdangerous but it can sometimes

be serious Although mostleukoplakia patches arenoncancerous 'benign+ somesho" early signs o3 cancer

http:NN"""mayoclinicorgNdiseasesEconditionsNleukoplakiaNbasicsNde8nitionNconE2002)

@02http:NN""""ebmdcomNoralEhealthNguideNdentalEhealthEleukoplakia

http://www.mayoclinic.org/diseases-conditions/leukoplakia/basics/definition/con-20023802http://www.mayoclinic.org/diseases-conditions/leukoplakia/basics/definition/con-20023802http://www.mayoclinic.org/diseases-conditions/leukoplakia/basics/definition/con-20023802http://www.mayoclinic.org/diseases-conditions/leukoplakia/basics/definition/con-20023802


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Dtiology '#eukoplakia+

• 9rritation 3rom rough teeth 8llings orcro"ns or illE8tting dentures that rubagainst your cheek or gum

• $hronic smoking pipe smoking orother tobacco use

• Sun eposure to the lips

• ;9 or A9S hairy leukoplakia DB

http:NN""""ebmdcomNoralEhealthNguideNdentalEhealthEleukoplakia


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Sign and symptoms '#eukoplakia+

#eukoplakia may appear:

• -hite or grayish in patches that canUt be "iped

a"ay

• 9rregular or FatEtetured

• The patch may ha&e de&eloped slo"ly o&er "eeksto months and be thick slightly raised and maye&entually take on a hardened and rough teture

• Along "ith raised red lesions 'erythroplakia+ "hich

are more likely to sho" precancerous changes• sually is painless but may be sensiti&e to touch

heat spicy 3oods or other irritation

http:NN"""mayoclinicorgNdiseasesEconditionsNleukoplakiaNbasicsNde8nitionNconE2002)

@02http:NN""""ebmdcomNoralEhealthNguideNdentalEhealthEleukoplakia

Test and diagnosis

http://www.mayoclinic.org/diseases-conditions/leukoplakia/basics/definition/con-20023802http://www.mayoclinic.org/diseases-conditions/leukoplakia/basics/definition/con-20023802http://www.mayoclinic.org/diseases-conditions/leukoplakia/basics/definition/con-20023802http://www.mayoclinic.org/diseases-conditions/leukoplakia/basics/definition/con-20023802


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Test and diagnosis'#eukoplakia+

To test 3or early signs o3 cancer:

• Reo)e a tiss$e saple /0iops "oranalsis. This in&ol&es remo&ing cells 3romthe sur3ace o3 the lesion "ith a smallspinning brush 'oral brush biopsy+ orsurgically remo&ing the entire leukoplakiapatch 'ecisional biopsy+ i3 the patch is small

• Send the tiss$e "or la0 analsis. A highlyspecialiIed imaging system allo"s apathologist to detect abnormal cells

http:NN"""mayoclinicorgNdiseasesEconditionsNleukoplakiaNbasicsNtestsEdiagnosisNconE2002)@02


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Treatment '#eukoplakia+

Treatment 3or leukoplakia i3 needed in&ol&es remo&ing thesource o3 irritation .or eample i3 leukoplakia is caused by

a rough tooth or an irregular sur3ace on a denture or a8lling the tooth "ill be smoothed and dental appliances

repaired

.or most people stopping tobacco or alcohol use clears

the condition -hen this isnUt e


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Treatment ';airy#eukoplakia+

• anti&iral medicine acyclo&ir

• antiretro&iral medicine Iido&udine

• apply directly to the lesions in mouth'topical medication+ such aspodophyllum

http:NN"""mayoclinicorgNdiseasesEconditionsNleukoplakiaNbasicsNtreatmentNconE2002)@02

didi i


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$andidiasis

• Dtiologic agents:Candida albicans 'themost common cause+

• All Candida speciespathogenic 3or humansare also encountered as

commensals o3 humansparticularly in themouth stool and &agina

$li i l i3 t ti


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• $linical mani3estations – /ucocutaneous candidiasis

• %ral thrush "hite plaLues on the oral andpharyngeal mucosa particularly in the mouth and

on the tounge

• $utaneous candidiasis

• Dsophageal candidiasis

– %3ten asymptomatic but can cause substernal pain or asense o3 obstruction on s"allo"ing

– $an cause bleeding and impaired alimentation

– /ost lesions are in the distal third o3 the esophagus andappear on endoscopy as areas o3 redness and edema3ocal "hite patches or ulcers

– eeply in&asi&e candidiasis

9n the obstructed urinary tract Candida cancause cystitis pyelitis or renal papillarynecrosis


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• Daminations

– -et smear

pseudohyphae• Scrapings 3or the smear may be obtained3rom skin nails and oral and &aginalmucosa

– $ulture 3or con8rmation

• rine sputum eisting abdominal drainsendotracheal aspirates or the &agina

– ;istologic section o3 biopsies

– $ulture o3 cerebrospinal Fuid blood ?oint Fuid $TEguided needle aspiratesor surgical specimens

• Treatment


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• Treatment


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• Prophylais – .luconaIole C the incidence o3 deeply

in&asi&e candidiasis in recipients o3allogeneic bone marro" transplants'(00 mg gi&en daily+

$ i ti


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$aries entis

• Dtiology : – .reLuent ingestion o3

sugar either in thebottle or in solid 3oods

– $oloniIation "ithcariogenic bacteria

• $linical mani3estasions

:arkened or ca&itatedlesions on the toothsur3aces

$ i ti


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$aries entis

• Pathophysiology :

Bacterial 3ermentation o3 dietarycarbohydrates 'Streptococcus mutans+ produce organic acids reduce the p; o3dental plaLue ad?acent to the toothdemineraliIation occurs opaLue "hite

spot lesion on the enamel

progressi&eloss o3 tooth mineral ca&itation o3 thetooth occurs

$ li ti


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$omplication

• ental caries destroymost o3 the tooth andin&ade the dentalpulp pulpitis

pulp necrosis dental abcess

• isrupt normalde&elopment o3 the

successor permanenttooth

• Sepsis and in3ectiono3 the 3acial space

$ i ti


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$aries entis

Treatent

• Sil&er amalgam

• Plastic composite

• Stainless steel cro"ns• Pulpotomy

• Pulpectomy

• %ral antibiotics '3e&ercellulitis and 3acials"elling+ penicillin

• %ral analgesics ibupro3en

Pre)ention

• %ral hygiene

• iet

• ental sealant

Gi i iti


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Gingi&itis

• Gingi&itis is a 3orm o3 periodontal disease Periodontaldisease is inFammation and in3ection that destroys thetissues that support the teeth This can include the gumsthe periodontal ligaments and the tooth sockets 'al&eolarbone+

• Gingi&itis is due to the longEterm e


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,isk .actor

• $ertain in3ections and bodyE"ide 'systemic+diseases

• Poor dental hygiene

• Pregnancy 'hormonal changes increase the

sensiti&ity o3 the gums+• ncontrolled diabetes

• /isaligned teeth rough edges o3 8llings and illE8tting or unclean mouth appliances 'such as

braces dentures bridges and cro"ns+• se o3 certain medications including phenytoin

bismuth and some birth control pills

S t


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Symptoms

• Bleeding gums 'blood on toothbrushe&en "ith gentle brushing o3 theteeth+

• Bright red or redEpurple appearanceto gums

• Gums that are tender "hen touched

but other"ise painless• /outh sores

• S"ollen gums

• Shin a earance to ums

Treatment


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Treatment

• The goal is to reduce inFammation

• The dentist or dental hygienist "illclean your teeth The may use

di


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#ud"ig=s Angina

• An in3ection o3the Foor o3 themouth under the

tongue• $auses: in3ection

o3 the roots o3

the teeth 'suchas toothabscess+ or a

mouth in?ury

#ud"ig=s Angina


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#ud"ig s Angina• Symptoms:

– Breathing di7culty – $on3usion or other mental changes

– .e&er

– eck pain

– eck s"elling

– ,edness o3 the neck

– -eakness 3atigue ecess tiredness

– i7culty s"allo"ing

– rooling

– Darache

– Speech that is unusual and sounds like theperson has a Whot potatoW in the mouth

#ud"ig=s Angina


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#ud"ig=s Angina

• Daminations: – Physical eamination 'to look 3or

redness and s"elling o3 the upper neck

and under the chin+ – $T scan o3 the neck

– A sample o3 the Fuid 3rom the tissuemay be sent to the lab to test 3or

bacteria

#ud"ig=s Angina


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#ud"ig s Angina

• Treatment: – 93 the s"elling blocks the air"ay

breathing tube through mouth or nose

and into the lungs tracheostomy'creates an opening through the neckinto the "indpipe+

– 9n3ection antibiotics

– Tooth in3ections dental treatment

– Surgery to drain Fuids that are causingthe s"elling

#ud"ig=s Angina


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g g• Prognosis

– $an be li3e threatening – $an be cured "ith getting treatment to keep

the air"ays open and taking antibioticmedicine

• Possible complications – Air"ay blockage

– GeneraliIed in3ection 'sepsis+

–Septic shock

• Pre&ention

– isit the dentist 3or regular checkups

– Treat symptoms o3 mouth or tooth in3ection

right a"ay

Parotitis


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Parotitis

• Parotid gland is located in eachcheek o&er the ?a" in 3ront o3the ears 9nFammation o3 one ormore o3 these glands is calledparotitis or parotiditis

• Dtiology : – iral in3ections such as mumps

o3ten a


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Sptos• Abnormal tastes 3oul tastes

• ecreased ability to open the mouth

• ry mouth

• .e&er• /outh or 3acial pain especially "hen eating

• ,edness o&er the side o3 the 3ace or the upper neck

• S"elling o3 the 3ace

E!as 5 A $T scan /,9 scanor ultrasound


98/111

Treatent• Antibiotics i3 you ha&e a 3e&er or pus drainage

or i3 the in3ection is caused by bacteria

• Surgery or aspiration to drain an abscess i3you ha&e one

O$tloo2 /Pro#nosis

• /ost sali&ary gland in3ections go a"ay on

their o"n or are cured "ith treatment Somein3ections "ill return $omplications are notcommon

Achalasia


99/111

Achalasia

• Dtiology :loss o3 ganglion cells "ithin theesophageal myenteric pleus that

caused by autoimmune processattributable to a latent in3ection "ith

human herpes simple &irus 1combined "ith genetic susceptibility

• Sign : progressi&e dilatation andsigmoid de3ormity o3 the esophagus

"ith hypertrophy o3 the #DS

• Symptoms : dysphagia regurgitationchest pain "eight loss and solid and

liLuid 3ood dysphagia


100/111

Achalasia


101/111

Achalasia

• Pathophysiology : – Dcitatory 'cholinergic+ ganglionic neurons

are &ariably a


102/111

Achalasia

• Daminations : endoscopy $T scanning orendoscopic ultrasonography barium s"allo" Eray andNor esophageal manometry

• : barium s"allo" Eray dilated esophagus

"ith poor emptying an airEFuid le&el andtapering at the #DS gi&ing it a beakElikeappearance

• $omplications : bronchitis pneumonia or lung

abscess 3rom chronic regurgitation and aspiration• : DS $hagasU disease and pseudoachalasia


103/111

Achalasia


104/111

Achalasia

• Pharmaco : – Botulinum toin in?ected into the #DS

– Sildena8l or alternati&e

phosphodiesterase inhibitors• onpharmaco :

– Pneumatic dilatation

– ;eller myotomy

Dsophageal Atresia


105/111

Dsophageal Atresia

• .ailure o3 3usion bet"een the proimal and distalesophagus associated "ith a tracheoesophageal8stula

• Symptoms : 3rothing and bubbling at the mouth

and nose a3ter birth as "ell as episodes o3coughing cyanosis and respiratory distress

• $omplication : – .eeding eacerbates these symptoms causes

regurgitation and can precipitate aspiration – ;Etype 8stula : chronic respiratory problems including

re3ractory bronchospasm and recurrent pneumonias


106/111

Dsophageal Atresia


107/111

Dsophageal Atresia

• : – The inability to pass a nasogastric or

orogastric tube in the ne"born

– Plain radiography : a coiled 3eeding tubein the esophageal pouch andNor an airEdistended stomach DA M TD.

– Airless scaphoid abdomen DA


108/111

Treatment


109/111

Treatment

• Dsophageal suctioning minimiIes aspiration• Prone positioning minimiIes mo&ement o3 gastric

secretions into a distal 8stula

• Surgical ligation o3 the TD. and primary endEtoEend

anastomosis o3 the esophagus• 9n the premature or complicated in3ant a primary

closure may be delayed by temporiIing "ith 8stulaligation and gastrostomy tube placement

• 93 the gap bet"een the atretic ends o3 the esophagus

is X)E( cm primary repair cannot be done optionsinclude using gastric ?e?unal or colonic segments

interposed as a neoEesophagus

Prognosis


110/111

Prognosis

• $omplications o3 surgery during the 8rst5 yr o3 li3e

• Anastomotic leak

• ,e8stuliIation• Anastomotic stricture

• Gastroesophageal reFu disease 'GD,+

,esulting 3rom intrinsic abnormalities o3esophageal 3unction o3ten combined "Ndelayed gastric emptying

a3tar Pustaka


111/111

a3tar Pustaka

• /oore E $linically %riented Anatomy >th Dd• Sher"ood # 9ntroduction to ;uman Physiology @th Dd SA: BrooksN$ole 201)

• !unLueira #$ $arneiro ! Basic ;istology Tet and Atlas 1)th ed /cGra"E;ill 201)

• /arks= Basic /edical Biochemistry A $linical Approach 2nd Ddition

• Kliegman ,/ Stanton B. St Geme !- Schor . Behrman ,D elson Tetbook o3 Pediatrics1*th Dd Philadelphia: Dlse&ier Saunders 2011

• .auci AS Braun"ald D Kasper # ;auser S# #ongo # !ameson !# et al editors ;arrison=sPrinciples o3 9nternal /edicine 1@th Dd nited States o3 America: The /cGra"E;ill $ompanies

2012

• Gingi&itis Y9nternetZ A&ailable 3rom:https:NN"""nlmnihgo&NmedlineplusNencyNarticleN001056htm

• Glossitis Y9nternetZ A&ailable 3rom:https:NN"""nlmnihgo&NmedlineplusNencyNarticleN00105)htm

• #ud"ig=s Angina Y9nternetZ A&ailable 3rom:https:NN"""nlmnihgo&NmedlineplusNencyNarticleN0010(>htm

• Parotitis Y9nternetZ A&ailable 3rom: http:NNemedicinemedscapecomNarticleN@@2(61Eo&er&ie"• http:NN"""aa3porgNa3pN1***N0215Np*10html

• https:NN"""nlmnihgo&NmedlineplusNencyNarticleN00))06htm

• http:NN"""mayoclinicorgNdiseasesEconditionsNleukoplakiaNbasicsNde8nitionNconE2002)@02

• http:NN""" "ebmd comNoral healthNguideNdental health leukoplakia
https://www.nlm.nih.gov/medlineplus/ency/article/001056.htmhttps://www.nlm.nih.gov/medlineplus/ency/article/001053.htmhttps://www.nlm.nih.gov/medlineplus/ency/article/001047.htmhttp://emedicine.medscape.com/article/882461-overviewhttp://www.aafp.org/afp/1999/0215/p910.htmlhttps://www.nlm.nih.gov/medlineplus/ency/article/003306.htmhttp://www.mayoclinic.org/diseases-conditions/leukoplakia/basics/definition/con-20023802http://www.mayoclinic.org/diseases-conditions/leukoplakia/basics/definition/con-20023802https://www.nlm.nih.gov/medlineplus/ency/article/003306.htmhttp://www.aafp.org/afp/1999/0215/p910.htmlhttp://emedicine.medscape.com/article/882461-overviewhttps://www.nlm.nih.gov/medlineplus/ency/article/001047.htmhttps://www.nlm.nih.gov/medlineplus/ency/article/001053.htmhttps://www.nlm.nih.gov/medlineplus/ency/article/001056.htm

Documents

Problem 1 Group 10 Gastrointestinal