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GASTROINffiSTINAL SYSTEM 503

Figure 8� 1 . Schematic representation of the ga.strointestinal system. (Original

artwork by Peter Wu.)

Clinical Evaluation

Evaluation of the GI system involves combining information gathered

through physical examination and diagnostic studies.

Physical Examillatioll

Physical examination of the abdomen consists of inspection, allsculta�

tion, percussion, and palpation. Physicians and nurses usually perform this examination on a daily basis in the acute care setting; however, physical therapists can also petform this examination to

help delineate between systemic and musculoskeletal pain.

504 ACUTF CARE IiANDBOOK FOR I'HYMCAI 11IERAI'ISTS

Table 8-2. Structure and Function of the Primary Organs of Digestion

Structure

Function

Oral cavity

Entrance to the gastrointestln31 system, mechamcal and chemical digestion begins here

Pharynx

Involved in swallowing and mechanical

movemcnr of food to esophagus

Esophagus

Connects mouth to the srom3ch, transports and

disperses food

Stomach (cardia,

Mechanical (unctIons: storage, mixing, and

fundus, body, pylorus)

grinding of food and regulation of outflow to

small intestine

EXOCrine f,mctiorls: secretion of hydrochloric

acid, intrinsic factOr, pepsinogen, and mucus

necessary for digestion

Endocrine fu'''tiotls: secretion of hormones that

trigger the release of digestive enzymes from

the pancreas, liver, and gallbladder IOto the

duodenum

Small inrestine

Duodenum: neutralizes acid in food transported

(duodenum, jejunum)

from the stOmach and mixes pancreatic :lnd

ileum)

biliary secretions with food

Jejullum: absorbs nutrients, W:lter, and

electrolytes

Ileum: absorbs bile acids and intrinsic factors to

be recycled In the body-necessary to prevent

Vitamin BIZ deficiency

Large inrestine (cecumj

Absorbs water and electrolytes

appendix; ascending,

Stores and eliminates mdigestible matenal as

transverse, descend·

feces

lng, and sigmoid

coJonj rectumj 3nus)

Sources: Data from JC Scanlon, T Sanders (eds). Essentials of AnafOl11Y and Physiulogy

(2nd ed). Philadelphia: FA Davis. 1993;362; :ll1d AC Guyron, JE Hall (eds). Textbook

of Medicall)hysiology (9th ed). Philadelphia: Saunders, 1996;803-844.