Fundamental anatomy and physiology of the gastrointestinal and urinary systems

Fundamental anatomy and physiology of the gastrointestinal and urinary systems

The structures which comprise the gastrointestinal system include the mouth, oesophagus, stomach, duodenum, colon and the rectum, plus the accessory organs. The oesophagus carries food from the mouth to the stomach. The stomach is a hollow, muscular organ which breaks down food using gastric acid into a substance called chyme. The chyme is released progressively through the pyloric sphincter and into the duodenum, and subsequently the colon. It is moved through the intestines by rhythmic contractions of the intestinal muscles, called peristalsis. In the intestines, key nutrients, electrolytes and water are absorbed from the chyme, leaving nothing but waste products. These are eventually excreted from the body via the rectum, as stool. Assessing The Genitalia And Rectum Essay

There are a number of accessory organs which support the function of the digestive system. The liver, the largest organ in the body, is located directly beneath diaphragm, on the right hand side; it performs a number of key roles including:

Metabolising protein, carbohydrate and fat.
Storing glucose, a substance the body uses for energy.
Storing other vitamins and minerals, including iron, copper and B-complex vitamins.
Detoxification of substances.
Producing and secreting bile, which has a role in digestion.
The transfer of bilirubin, another substance with a role in digestion, from the blood.
Producing clotting factors and fibrinogen, which help the blood to clot. Assessing The Genitalia And Rectum Essay
Synthesis of many plasma proteins.
The gallbladder is another accessory organ of the gastrointestinal system; it stores bile produced by the liver. Another organ, the pancreas, secretes a number of substances to support the metabolism of carbohydrates, proteins and fats. The last accessory organ in the abdomen, the spleen, has immune function and also supports the production and maintenance of the body’s blood.

The abdomen also contains the urinary system. The urinary system functions to remove water-soluble wastes from the blood, and eventually from the body. The key organs in the urinary system are the kidneys, which filter the blood to remove waste products. Once liquid waste, now in the form of urine, has been filtered by the kidneys, it travels down two muscular tubes called the ureters and into the bladder. When the bladder volume reaches between 300 millilitres and 450 millilitres, the person experiences the urge to void and urine exits the body via another tube called the urethra. Assessing The Genitalia And Rectum Essay

Gastrointestinal and urinary systems – focused health history

When assessing a patient’s gastrointestinal and urinary systems, the nurse must commence by collecting a health history. This involves collecting data about:

Present health status
Chronic illnesses
Current medications
Alcohol consumption
Tobacco smoking (past and current)
Bladder and bowel habits
Past medical history
Injuries to, or illnesses of, the gastrointestinal or urinary system organs Assessing The Genitalia And Rectum Essay
Family history of diseases affecting the gastrointestinal / urinary systems
In some cases, a person will present with a specific problem related to their gastrointestinal / urinary system/s.

Abdominal pain is a particularly significant symptom indicating dysfunction in the gastrointestinal / urinary systems. The location, quality, quantity, chronology, associated manifestations and aggravating / alleviating factors a patient experiences can provide important information about the cause of this pain – and allow the patient’s health care team to make a differential diagnosis. Review the information in the following table:

Cause of Pain

Factors Enabling Differential Diagnosis

Gastro-oesophageal reflux disease (GORD)

Pain is often described as “gnawing”, “burning” pain is located in the mid-epigastric region, may radiate to the jaw; pain may be associated with weight loss; pain is aggravated by a recumbent position; pain is alleviated by a high-sitting position, antacids, etc. Assessing The Genitalia And Rectum Essay

Gastritis

Pain is often described as a “constant burning” pain is located in the epigastric region; pain may be associated with nausea / vomiting, diarrhoea, fever; pain is aggravated by alcohol, food, salicylates; pain is alleviated by antacids; on assessment, a nurse will often find hyperactive bowel sounds.

Peptic ulcer

Pain is often described as “gnawing”, “burning” pain is located in the epigastric, back and upper abdominal regions; pain may be associated with nausea, vomiting, weight loss; pain is aggravated by stress, alcohol, food or