Introduction
The gastrointestinal system comprises a hollowed-out muscular pipe that begins at the oral cavity throughout the pharynx, the esophagus, the stomach, the guts through the rectum, and finally, anus. The primary function of the digestive tract is breaking down food substances into nutrients, and these nutrients are taken up the bloodstream for the provision of energy. The oral cavity or mouth is accountable for the ingestion of food. The tongue rolls the food bolus, which encounters the teeth for chewing. The salivary glands interact with the mouth as they produce saliva to formulate and moisturize the mouth. The esophagus is a pipe that extending from the pharynx to the gastrointestinal through a vent in the diaphragm. It is a means of transport between sections in the tract. The stomach has four major parts and two boundaries known as the lesser and greater curvatures. Most of the gastric glands are situated here where a large percent of the food mixing happens. The small intestine consists of the jejunum, ileum, and duodenum. The duodenum syndicates digestive discharges from the liver and pancreas with the stomach contents. Most of the breakdown and absorption of food takes place in the jejunum. The ileum clears into the caecum. The large intestine comprises of the caecum, the rectum, appendix, transverse, ascending, sigmoid and descending colon. The liver secretes bile and absorbs nutrients. All nutrients are absorbed in the intestines go through the liver where they are processed. The bile goes into the guts at the duodenum, where bile salts break-down lipids. The pancreas lies behind the stomach. It produces hormones in the Islets of Langerhans. The pancreas produces fluid containing enzymes that help in the digestion of food.
Health History Questions/Subjective Data
Common problems associated with the system include abnormal bowel habits, heartburn, pain, nausea, and vomiting. If a patient experience any of these, you need to ask the location, onset, quality, duration, severity, and frequency of every symptom (Wilkins & Lippincott 2010). Past medical history questions include:
- "Do you have an ulcer?"
- "Do you have an inflammatory bowl?"
- "Do you have irritable bowel syndrome?"
- "Do you have liver, pancreas, or gallbladder disease?"
- "Do you have gastroesophageal reflux disease?"
- "Do you have past abdominal trauma or surgeries?"
- "Are you taking any medication or are allergic to foods or medications?"
Objective Data / Normal Physical Examination Findings
The gastrointestinal disease usually manifests as a change in appetite, dysphagia, nausea and vomiting, weight loss or gain, food intolerance, abdominal pain, and abnormal bowel habits (Jarvis, 2011). Appetite and feeding could be influenced by a lot of factors that may stipulate gastrointestinal disease. People having dysphagia have trouble or pain while swallowing. A patient should be asked if they experience any difficulty when swallowing and when it started. Irritation or infection could lead to the esophagus narrowing.
Additionally, esophagus cancer may lead to swallowing issues. Treatment for this cancer can sometimes lead to dysphagia. Intolerance to foods is dependent on gastrointestinal imbalance like smaller amounts of an enzyme, which can obstruct the right processing and utilization of food in the body. The intolerance could be linked to inflammatory bowel disease, and the symptoms include gas, burping, stomach discomfort, bloating, diarrhea, and flatulence. Nausea and vomiting could suggest food poisoning. Blood in vomitus could be a sign of duodenal or gastric ulcers or esophageal varices. Coffee ground emesis shows old, partly digested food that is like grounds of coffee (Jarvis, 2011). The consistency, color, and frequency of bowel activities need to be evaluated in the case of abnormal bowel movements. Tarry black stools could reveal a bleed in the upper gastrointestinal, iron supplements ingestion, or ingestion of medications to relieve gastrointestinal distress (Shaw, 2012). Stools containing bright red blood may reveal gastrointestinal bleeding or hemorrhoids. Currant jelly stools usually show substantial bleeding that requires a quick assessment of the hemodynamic status of the patient (Shaw, 2012).
Explain Special Physical Assessment Examination Techniques or Procedures Specific to Assessing This Body System
There are four main techniques for conducting physical exams: inspection, auscultation, percussion, and palpation, which are used from the one with minimal disturbance to the most disturbing (Jarvis, 2011). The first one is a more non-invasive inspection. And this is followed by auscultation. The stomach must be auscultated before palpation or percussion to prohibit the generation of incorrect bowel sounds. The patient should be relaxed to allow the correct assessment of the stomach. They need to be in a comfortable position with their arms at the sides and knees held, and the bladder emptied. The surrounding needs to have good light and warm temperature. The inspection involves visualizing the whole stomach. It is crucial to note that the exact location of the physical assessment findings when examining the stomach. And the abdomen could be classified into nine or four quadrants.
During the examination, the patient lies with the face upwards for investigation of masses, movements or pulsations, bulges, hernias, spider nevi, ascites, enlarged veins. The patient should slightly lift their head. In case any incisions or swelling around the umbilicus is noticed, a hernia could be existing (Jarvis, 2011). A doctor examines the stomach from various angles to look for protrusion of the abdominal wall, which might occur with enlargement of an organ or abnormal growth.
Auscultation begins in the lower right quadrant. The doctor looks for tenderness as well as any enlarged organs or irregular masses. Discomfort triggered by slight pressure on the abdomen and increases on the release of pressure could indicate inflammation and sometimes infection of the lining of the abdominal cavity.
Incase bowel sounds are absent, listen for around 5 minutes to ensure the finding is accurate (Jarvis, 2011). Bowel noises reflect the deep motions of the guts. Usually, gurgling sounds and high-pitched clicking are heard about every five to fifteen seconds. It's advisable to listen for one full minute to determine if they are hypoactive, ordinary, or hyperactive. The rectum and the anus are assessed with a gloved finger. Usually, a small stool sample is tested for occult blood. A psychologic examination is sometimes necessary for the evaluation of digestive problems since digestive issues could be because of depression, anxiety, or other treatable psychologic disorders that can affect the activity of digestive tract contractions and sensitivity of people to these sensations.
Adaptation of Physical Assessment
Special populations include pregnant women, infants, and geriatric adults. When conducting a medical history for a pediatric, the parents are always the principal source of information, and its crucial t to build a connection with them. Approach an infant in a slow, gentle, and calm manner. Let the guardian hold an infant when doing a treatment or an assessment, if possible. If the child must lie down, let the parent be close to the infant (Lewis, 1999). Utilize warm hands and instruments and let the child handle instruments like a stethoscope or an otoscope if it's safe with children, attempt to make the treatment or assessment of a game to minimize fear. Utilize your imagination and get the infant involved; for instance, use dolls, puppets, or storybooks. Give reassurance during the procedure/assessment.
A family member may accompany the geriatric. There is evidence revealing that this enhances the patient's satisfaction with the examination and assessment and improves the quality and amount of details kept by the patient (Wolff, Rotter, 2008).
Geriatrics usually process information slower than younger people. They usually complex and multiple medical issues. Hence, more details must be collected and given during an assessment and examination, so schedule more time must be done, if possible. The use of questionnaires before a visit can smoothen the process, and, in some cases, it may be a requirement to plan more than one appointment to address the patient's issues (Houchin's, Robinson and White 2011). When assessing an old adult or when giving information, consider that they may have difficulty processing new information fast or hearing; hence, the style and pace of verbal communication need to be modified.
Gastrointestinal diseases are common during pregnancy, and this could be due in part to elevated levels of progesterone, for instance, vomiting, diarrhea reflux ailment. Some the pregnant women have a gastrointestinal disease that is unique or specific to pregnancy, while others present with chronic GI which requires special consideration during their pregnancy. Medical practitioners need to understand the prevalence as well as various presentations of gastrointestinal disorder to effectively optimize care for pregnant women.
Most tests conducted on pregnant women and any ailment present its self in a urinalysis test. However, for the gastrointestinal, it is important to make sure that the assessment and the outcome are carefully done to avoid the wrong diagnosis (Houchin's, Robinson and White 2011). Before the physical examination of the patient, it is important to ask about the patient's history with gastrointestinal diseases; this gives more insight as to which condition to look out for.
During the assessment, the doctor could utilize one of these techniques, the inspection, percussion, auscultation as well as palpation. The physical examination needs to be conducted on an empty bladder. Have the woman lay down on her back with head supported by a pillow. Then the medical examiner can make use of a warm hand to gently press her abdomen to assess the tenderness of her lower abdomen. It is also very critical to be careful with the delivery of the outcome since they are very sensitive.
Gastrointestinal Disorders
The gastrointestinal disorders include conditions such as bowel syndrome, constipation, dysentery, gastroesophageal reflux disorder, appendicitis, gallstone, esophageal cancer, cholera, jaundice, Crohn ailment, celiac disorder and many more.
For instance, the Crohn disorder is chronic inflammation of the digestive tract which mainly occurs in the terminal position of the ileum, the region of the small intestines which is furthest from the stomach (Houchin's, Robinson and White 2011). This disease was first discovered in the year 1904 by a surgeon called Antoni lesniowski.
Cholera is a severe infection of the small intestines, which is triggered by a bacterium vibrio cholera and it is characterized by severe diarrhea with increased reduction of the body fluid and salt.
The gastroesophageal reflux disorder is a very common digestive disease that is characterized by the recurrent passage of gastric content from the stomach back into the esophagus. The most noticeable symptoms associated with this kind of ailment include heartburn, an irritating burning feeling in the higher abdomen as well as chest.
Conclusion
The gastrointestinal system consists of organs that liquids and food and pass through in the process of digestion. The organs include the oral cavity, pharynx, esophagus, stomach, small intestine, colon, rectum, and anus. Every part of the gastrointestinal system helps in the movement of liquid and food through the digestive tract, breaks down food and liquid into small digestible parts, and absorbs the final nutrients into the bloodstream. The large intestine takes up water while the waste products of digestion are...
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