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GASTROINTESTINAl SYSTEM 505

Table 8-3. Structure and Function of the Accessory Organs of Digestion

Srructure

Function

Teeth

Break down food {Q combine with saliva.

Tongue

Provides taste sensations by cranial nerve VII (taste).

Keeps the food between the teeth {Q maintain efficient

chewing action for food {Q mix with saliva.

S.lhvary glands

Produce saliva, which is necessary to dissolve food for

tasting and moistens food for swallowing.

Llvcr

Regulates serum levels of fats. proteins, and carbohydrates.

Bile I� produced in the liver and is necessary for the

�lbsorption of lipids and lipid-soluble substances.

The liver also assists with drug metabolism and red blood

cell and vltamm K production.

G..lllhiadder

Stores and releases bile IIltO the duodenum via the hepatic

duct when food enters the stomach.

Pancreas

Exocrme portion secretes bicarbonate and digestive

cl11.ymes into duodenum.

Endocrine portion secretes insulin, glucagons, and

numerous other hormones IO{Q the bloodstream, all of

which are essential in regulating blood glucose levels.

Spleen·

Filters out foreign substances and degenerates blood

cells from the bloodstream.

Also stores lymphocytes.

·Thc '>pleen .\ not part 01 rhe ga�trolllre!lrmal system bur l!i localed ncar or her gasrrolllre�rinal component!. 111 Ihe .lbdonunal caviry.

Source�: Data from JC Scanlon, T Sanders. Essentials of Anatomy and Physiology (2nd

ed). PhLl.1delphta: rA DaVIS, 1993; and AC Guyron, JE Ilall. Texrbook of Medical Phys

Iology (9th cd). Philadelphia: S"unders, 1996;803-844.

History

Before performing the physical examination, the presence or absence

of Items related to GI pathology is ascertained through patient interview, questionnaire completion, or chart review. For a list of these items, see Table 8-4. Appendix I-A also describes the general medical

record review.

Inspection

Figure 8-2 demonstrates the abdominal regions associated with

organ location. DUring inspection, the physical therapist should

notc asymmetries in size and shape in each quadrant, umbilicus

506 AClJfE CARE HANDBOOK FOR PHYSICAL TI-lERAI'ISTS

Table 8-4. Items Associated with Gastrointestinal Pathology

Stool and Urine

Signs and Symptoms

Characteristics

Associated Disorders

Nausea and vomiting

Change In stool color

History of hernia

Hemoptysis

Change in urine color

History of hepatitis

Constipation

Hematochezia (bright

Drug and alcohol

Diarrhea

red blood in srool)

abuse

Jaundice

Melena (black, tarry

Fatty food inrolerance

Heartburn

stools)

Abdominal pain

Sources: Data from MB Koopmeiners. Screening for Gastrointestinal System Disease.

In WG Boisonnauh (cd), Exammation In PhYSical Therapy Practice. New York: