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Grand Rapids Ostomy Association
Helping People with Ostomies and Alternate Surgeries in Southwest Michigan
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Palliative ; serving or tending to palliate; specif., a) alleviating b) excusing; extenuating
Pancreas
; a large, elongated gland situated behind the stomach and secreting a
digestive juice (pancreatic juice) into the small intestine:
groups of differentiated cells (islets of Langerhans) in the gland produce the
hormone insulin:
Paralytic ileus ; Adynamic obstruction, which results from an absence of peristalsis such as in paralytic ileus , is a temporary condition that resolves once the initiating cause is corrected.
Parietal cells in the stomach produce HCL acid, which converts pepsinogen (secreted by the chief cells) into pepsin. Pepsin is a proteolytic enzyme. The parietal cells secrete intrinsic factor, which is essential for absorption of vitamin B12.
Perineal . Pertaining to the perineum (see below).
Perineum . Area between legs, includes anal areas, scrotal area (men) and vaginal area (women). In an ostomy operation where the rectum is removed it refers to the anal area. Peristalsis. The progressive movement of the intestine by which the contents are pushed toward the outlet.
Perirectal Abscess usually begins with throbbing, constant pain around the rectal area. A tender mass may be found, either near or within the rectum. If the abscess is large, the person also may have fever. The abscess must be removed surgically.
Perineum; The external perineum is a diamond-shaped area that is bounded by the external genitalia to the front, the buttocks to the back, and the medial aspect of each thigh.
Peristalsis progressive waves of motion which occur without voluntary control to push waste material through the intestine.
Peristomal skin ; Optimally the peristomal skin appears healthy and intact, with no differences between the peristomal skin and the adjacent skin surface. Peristomal skin damage is evidenced by erythema, maceration, denudation, rash, ulceration, or blister formation. In persons with dark skin, the damaged skin may appear lighter or darker than the surrounding skin, as opposed to erythematous.
Peritoneum ; the transparent serous membrane lining the abdominal cavity and reflected inward at various places to cover the visceral organs
Pernicious anemia; a form of anemia characterized by a gradual reduction in the number of the red blood cells, gastrointestinal and nervous disturbances, etc., due to a deficiency of vitamin B12
Peutz-Jeghers syndrome , (PJS) is characterized by hamartomatous polyps in the stomach, small intestine, and colon. The predominant concentration is in the jejunum and ileum. PJS also is typffied by mucocutaneous pigmentation (melanin spots) that are particularly noticeable around the mouth. Abdominal pain as a result of small-bowel intussusception, obstruction by a large polyp, or bleeding are the primary symptoms. Treatment of PJS is largely conservative; associated GI carcinomas are rare.
Pharyngoesophageal sphincter prevents reflux of food and fluid from the esophagus into the mouth
Phenacetin ; a white, crystalline powder, used to reduce fever and to relieve headaches and muscular pains; acetophenetidin
Polyp small projection inside of bowel, often mushroom shaped; may be flat. It is usually benign, but can be malignant. COLONIC POLYPS Two types of polyps that may develop in the colon are called pedunculated if they have a stalk and sessile (f they have no stalk Djfferences in tissue seen under the microscope further divide them into adenomatous and villous. Some colonic polys apparently lead to the development of cancer. Large polyps are more dangerous than small ones, and villous polyps are more dangerous than adenomatous ones.
Polyps Benign
make up the majority of tumors of the colon. These are localized overgrowths of
tissue, often in or near the sigmoid colon. Some polyps have a fibrous stalk
connecting the tumor with the colon. These are referred to as pedunculated
polyps. Polyps usually cause no symptoms. The treatment of most polyps, whether
they cause symptoms or not, is removal, because polyps occasionally may
degenerate into cancer.
Most colonic polyps can be removed without an operation. The polyp is located
by sigmoidoscope or colonoscope. A wire snare advanced through the scope is
looped around the base (around the stalk if the polyp is pedunculated).
Electrical current applied through the wire can cut through the tissue and
simultaneously seal off any bleeding vessels. The severed polyp then is
retrieved and examined for malignancy. There are a number of rare familial
polyposis syndromes, where the polyps are widespread and the risk of cancer
approaches 100 percent. The usual treatment for these patients is removal of
the colon
Polyps Colonic
Two types of polyps that may develop in the colon are called pedunculated if
they have a stalk and sessile if they have no stalk. Differences in tissue seen
under the microscope further divide them into adenomatous and villous.
Some colonic polys apparently lead to the development of cancer. Large polyps
are more dangerous than small ones, and vilous polyps are more dangerous than
adenomatous ones.
Priapism ; a pathological condition characterized by persistent erection of the penis, esp. without sexual excitement
Proctoscopy . Visual examination of anus and rectum by means of a hollow instrument. Sometimes shortened to "procto." See Sigmoidoscopy and Endoscopy.
Proctoscopic examination ; the direct examination of the interior of the rectum
Prolapse a "falling out" in which the stoma becomes longer. To "fall out." In referring to ostomy, some of the stoma end of the intestine turns "wrongside out" and protrudes from the body.
Prosthesis an artificial substitute for a missing body part, such as an arm or leg, eye, or tooth, used for functional or cosmetic reasons or both.
Proximal . Opposite of distal; for example, in gastro-intestinal tract, mouth is most proximal, anus is most distal.
Prune-belly syndrome is a rare condition that occurs in 1/35,000 to 1/50,000 live births.39 It occurs almost exclusively in boys; however, rarely a girl can be affected. Infants with prune-belly syndrome are born with a congenital absence, deficiency, or hypoplasia of abdominal wall musculature so that the belly actually looks like a prune. The abdominal wall is quite thin, and many creases and wrinkles are present . Patients have large hypotonic bladders; dilated, tortuous ureters; and bilateral undescended testicles. The cause of the syndrome is unknown. .
Pruritus ani is not a disease but a symptom, and a common one. It is an intense itching sensation at the rectum. It is not caused by hemorrhoids. Most cases are of unknown cause. Relief usually is obtained by good (but not overly aggressive) anal hygiene. Pruritus ani is not a serious malady, but it certainly is a humbling one.
Pseudoverrucous lesions ; In the ostomy patient an oversized aperture in a urinary pouch may cause predisposition to pseudoverrucous lesions.
Pyelonephritis ; infection of one or both kidneys, usually involving both the pelvis and the functional tissue
Rectal mucosectomy ; surgical procedure typically performed during the first stage of an ileoanal reservoir
Rectum lowest portion of the large intestine. The rectum is the terminal part of the large intestine, and extends from the sigmoid fiexure to the anal orifice. The superior limit cannot be determined precisely, since there is no point of demarcation between the sigmoid flexure and the first part of the rectum; but the brim of the true pelvis, opposite the left sacro-iliac joint, is arbitrarily given as its point of commencement, From this point it passes downward, backward, and to the right to the level of the third sacral vertebra, where it lies in the middle line. This is the first pact of the retum. The second part curves forward and is continued downward as far as the apex of the prostate gland, about an inch in front of the tip of the coccyx. From this point the bowel is directed backward, and, passing downward, terminates at the anal orifice. This is the third portion of the rectum, or, the anal canal. The length of the rectum is about eight inches. The first part is four inches, the second three and the third one and one half.See Large Intestine
Regional Enteritis . Inflammation of ileum. Also called ileitis, regional ileitis and Crohn's disease.
Renal artery ; blood supply to the kidney is via the Renal artery.
Renal parenchyma ; the essential or functional tissue of an organ, as distinguished from its connective tissue, blood vessels, etc.
Resection surgical removal or excision.
Retraction the act of drawing back. In reference to ostomy, the stoma draws back into the body.
Revision construction of a new stoma when the original one does not function well.
Sacculations The taeniae coli are three muscle bands that create sacculations in the colon wall known as haustrations.
Schistosomiasis infections; a chronic, usually tropical, disease, caused by schistosomes and characterized in humans by disorders of the liver, urinary bladder, lungs, or central nervous system
Sigmoid The sigmoid flexure is the narrowest part of the colon: it is situated in the left iliac fossa, commencing from the termination of the descending colon, and ending in the rectum at the brim of the true pelvis opposite the left sacro-iliac symphysis. It curves in the first place forward, dowmward, and inward for about two inches, and then forms a loop, which varies in length and position, and which terminates in the rectum. See Large Intestine
Sigmoidoscopy . Visual examination with a 1 0 inch or longer, lighted tube (sigmoidoscope) of anus, rectum and lower part of sigmold colon. See Proctoscopy of Endoscopy. A newly developed device can visualize the entire colon and is called a colonoscope.
Skin Barrier any one of several substances used to cover skin around the stoma. Can be pliable sheets, pastes, etc.
The Small Intestine is a convoluted tube, extending from the phlorus to the ileo-caecal valve where it terminates in the large intestine. It is about twenty feet in length and gradually diminishes in size from its commencment to its termination. It is contained in the central and lower part of the abdominal cavity, and is surrounded above and at the sides by the large intestine; a portion of it extends below the brim of the pelvis and lies in front of the rectum. The small intestine is divisible into three portions the duodenum, the jejunun, and ilium.
Soave and Swenson procedures ;are corrective surgical techniques for Hirschsprung's disease.
Solvent fluid used to remove cement and adhesive residue from skin or appliance.
Somatostatin ; a hormone produced mainly in the hypothalamus and pancreas, or prepared synthetically, that inhibits the release of glucagon and insulin from the pancreas: used in treating diabetes
Sphincter . A ringlike muscle surrounding and able to open and close. The sphincter in the anus makes possible bowel control. The bladder sphincter controls urine.
Stenosis narrowing or tightness of the stoma which may cause obstruction. Narrowing or stricture of a duct or canal; narrowing or excessive tightness of stoma. See Obstruction.
Stoma (opening) / the end of the ureter, ileum, or colon which may be seen coming through the skin. It often protrudes like a nipple and is .75 to 1.75 inch, (19 to 44 mm) in diameter. It is usually bright red in color. There are no nerve endings in the stoma; therefore it is not a source of pain or discomfort.
Stomach The stomach resembles an inverted wineskin, rounded at its upper end and tapering toward a neck (the pylorus). Joined with the esophagus through the hiatus opening in the diaphragm, the stomach lies in the upper portion of the abdominal opening Food from the esophagus enters at the cardia and is stored in the fundus and upper body. Strong muscles in the walls of the body and antrum squeeze and knead the food as it moves toward the pyloru& The contents are then discharged at intervals into the duodenum.
Stricture an abnormal narrowing of a body passage.
Superior mesenteric artery ; Blood flow for most of the small intestine is provided by the Superior mesenteric artery.
Suprapubic tube ;management approach for patients with a spinal cord injury includes Credé and Valsalva maneuvers, intermittent catheterization, urethral catheter, suprapubic tube , urinary conduit or continent stoma
Synapse ; the minute space between a nerve cell and another nerve cell, a muscle cell, etc., through which nerve impulses are transmitted from one to the other
Taeniae ;a ribbonlike part or structure, as of muscle or nerve tissue
Taeniae coli ; are three muscle bands that create sacculations in the colon wall known as haustrations.
Telescoped bowel Intussusception is a "telescoping" of a loop of bowel, somewhat like pushing the finger of a rubber glove into itself. The infolded segment may obstruct passage of the contents of the intestine and endanger the local blood supply. Symptoms usually include sharp, sudden abdominal pain, nausea, and vomiting. Immediate treatment is necessary.
Thrombyctopenia ; Example of use. neutropenia and the potential for infection with the mucosa as a portal of entry; thus careful cleansing and manipulation are required to prevent damage. Thrombyctopenia can result, and excessive bleeding is a potential.
Toxic megacolon is an uncommon complication of ulcerative colitis. Patients with this disorder are very sick with fever, abdominal distension, and even mental changes. The abdomen is distended and X ray of the abdomen shows an enlarged colon. There is danger that the colon may perforate. If medication does not bring prompt improvement, surgery is undertaken. A patient with severe and unresponsive symptoms but without megacolon is treated first with medications. If there is no improvement after several months, surgery usually is recommended. Finally, surgery may be undertaken in some patients who have had their disease more than 10 years because the risk of colon cancer is increased, especially among those whose disease began in childhood and whose entire colon is involved.
Transverse Colon; the longest part of the large intestine, passes transversely from right to left across the abdomen, into the left region, where it curves downward beneath the lower end of the spleen, forming the splenic flexure. In its course is describes an arch directed backward toward the vertebral column and a little upward; hence the name transverse arch of the colon. This is the most movable part of the colon.bg See Large Intestine
Trauma . A physical injury caused by a mechanical force, as a blow, a twist, a knife or a bullet. Psychic trauma is an injury to subconscious mind by emotional shock.
Turnbull loop end stoma; Distal portion of the bowel segment is brought to abdominal surface as a loop. Anterior wall of bowel segment is opened and matured to form functional and nonfunctional limbs of loop stomas.
Turcot syndrome is characterized by adematous polyps in the colon and the coexistence of a malignant tumor of the central nervous system (such as a glioblastoma or medulloblastoma). The colonic polyps most often are tubular and premalignant. Turcot syndrome, which is genetically transmitted, has been detected in persons between the ages of 10 and 25 years.
Ulcer an inflamed lesion of the skin.
Ulcerative Colitis one form of inflammatory bowel disease in which ulcers form in the intestinal lining of the colon and rectum. Severe, often bloody, diarrhea is the primary symptom of the disease, which occurs most often in young adults. Ileostomy cures this disease in severe cases.
Unilateral Ureterostomy. Similar to bilateral except only one ureter is brought through the abdomen with the other joined internally to the externalized one.
Ureteral stones ; Stones that lodge in the ureter can precipitate ureteral obstruction and create the risk of infection proximal to the stone. Points of ureteral narrowing where stones commonly lodge are (1) at the ureteropelvic junction, (2) at the point where the ureter crosses over the iliac vessels, and (3) in the ureterovesical zone. The most prudent treatment for infections proximal to an obstruction is immediate drainage. Once the obstruction and infection have been relieved, treatment of the ureteral stone can proceed with ureteroscopy, laser Iithotripsv, extracorporeal shock wave lithotripsy, or, rarely, open surgery.
Ureter . The fibromuscular tube which conveys the urine from a kidney to the bladder. It empties into the base of the bladder and is from 16 to 18 inches long.
Urinary Ostomy A urinary ostomy (urinary diversion) may be one of several types of operations performed because of the loss of the bladder or of bladder function. In such operations artificial openings are provided for urine drainage. Often the bladder is removed. Causes. Urinary ostomies are necessitated by birth defects, malignancy, injury, and nerve damage or malfunction.
Valves of Houston ;The valves of Houston are three folds located in the rectum, two on the left and one on the right; they serve as landmarks and must be carefully negotiated during proctoscopic examination.
Vesicostomy In a vesicostomy an opening is made directly in the front of the bladder. This opening is sutured to an opening in the abdominal wall. Urine is eliminated through the opening. An appliance must be worn.Vesicostomy is most commonly used to provide temporary bladder drainage in infants and young children; it is an ideal diversion in this group of patients because the infant's bladder is located more abdominally than is the adult bladder and the infant's care can be easily managed with diapers. Vesicostomy in the adult is a more complex procedure and has been largely replaced by other forms of medical and surgical .
Wound . An injury to the body caused by physical means, with disruption of the normal continuity of body structures. Relative to operations it refers to the area where an incision or excision was made, such as "perineal wound" where the rectum is removed.