Isabel enjoys. This part of the digestive tract comprises three major segments, namely, the duodenum, jejunum and the ileum. One of the major risk factors for this disease is stress. Course Hero uses AI to attempt to automatically extract content from documents to surface to you and others so you can study better, e.g., in search results, to enrich docs, and more. Why Is Livatone Plus The World's Leading Liver Support Supplement? This is located behind the stomach, across the back of the abdomen. The Digestive System. She states the pain came after dinner at an all-you-can-eat buffet and has been increasing steadily. You may answer directly here or upload your answers if written on a separate piece of clean paper. This textbook can be purchased at www.amazon.com. Match. For example, walking allows the body to relax and burns calories which allow the digestive system to function normally. Her mom taught her many of the Isabel's Case: The Burn in My Chest Isabel is a young Latina woman, age 24, who loves to cook. The cell membrane is a bilayer made of (1)____ studded with protein. Learn More. Section B It serves as the barrier of the body from physical damage. She did send me an email saying she feels far less bloated and has been waking up feeling more refreshed and optimistic about facing the day ahead. CCSI - Creationist Crime Scene Investigation, League of Extraordinary Trust Fund Beneficiaries, Christian Pollution: Polemics & Absurdities, https://vincenttriola.com/blogs/ten-years-of-academic-writing/digestive-system-disorder-case-study. Some of the risk factors include lifestyle elements such as sedentary lifestyle and stress. By having the apple cider vinegar with an empty stomach in the past two months, the membrane layer of the stomach has been worn out. The contractions and relaxation of muscles that line the oesophagus. Although acid reflux disease prevalent it can be controlled and prevented. Mystery Digestive System Disease Case Study Activity (Anatomy) by. One year after Mr. Volpe's therapy, Dr. Lorraine performs a follow-up endoscopy and is delighted to see a healed and healthy duodenum. He has Celiac disease -- an intolerance to gluten. However, the physician may opt for primarily administering an ECG to test if the patient has experienced a myocardial infarction; in some cases, pain in the upper part of the abdomen . Mankato: Pebble Books. CASE STUDY DIGESTIVE SYSTEM Read the case study below, then answer the questions that follow. February 2020. Why is Mr. Volpe's dyspepsia (stomach pain) relieved by food, and aggravated 2-4 hours after a meal? Isabel, a 24-year-old Latina, was recently married and started. Initially, fast reading without taking notes and underlines should be done. Your job is report out at the end of the shift with your findings, including information about each of the patients you have seen. The pain is located in her right upper quadrant and is "boring" into her back. Part III: Processes in the different parts of the Digestive Tract DO NOT USE THE INTERNET BECAUSE NOT ALL OF THE INFORMATION ON THE INTERNET IS CORRECT. Mouth Chewing She had been suffering with those symptoms for a very long time and has been taking the prescription drug Nexium for 5 years. When someone lacks albumin it creates a decrease of fluid in the blood. Chewing breaks down the food into more soluble pieces. You are an ER doctor that is working the night shift and are presented with several patients over the course of your shift. She states the pain came after dinner at an all-you-can-eat buffet and has been increasing steadily. c. Quinolone blocks an enzyme that prevents bacterial DNA from unwinding. The Digestive System. Real lifestyle changes must occur from individual thinking and lifestyle practices. There are many methods of treating acid reflux including prescription medications and surgery (Smith, 2013). Study with Quizlet and memorize flashcards containing terms like Long muscular canal extending from the pharynx to the stomach, Organ which receives food and secretes enzymes which aid in digestion, Part of the small intestine extending from the pylorus to jejunum and more. Recently Isabel got married and moved into a new home with her husband. There is a special lining in the upper anus that is specialized for detection of rectal content. Which substance is producing the "fruity acetone" smell? Due to the age and lifestyle factors associated with the patient, a healthier diet and continued use of Prilosec are recommended. WowEssays, Feb 05, 2020. References The oesophagus is located in the throat near the windpipe (trachea). cooking so much that she does it almost every night. Case Study: Digestive Problems. Describe the basic histological (tissue) structure of the mucosa layer in the alimentary canal. Mr. Volpe asks, "What do the bacteria have to do with the ulcer?" The Digestive System. With every case study, there are questions that need answering in order for you to educate the next shift. Accessed November 16, 2022. Absorption of nutrients majorly takes place here and motility, the movement of food from the small to large intestine occurs. - The Descending (Left) Colon What is believed to be his problem? She already knew they arent great for her blood sugar or the reflux. The above statements have not been evaluated by the FDA and are not intended to diagnose, treat or cure any disease. The Digestive Tract. portal venous system: veins that come from the stomach, intestine, pancreas, and spleen to merge into the hepatic portal vein. Grains can be very difficult to digest and their carbohydrate content fuels the growth of harmful gut bugs that create bloating, gas and reflux. The Digestive System Case Study Example. The incorporation of these different techniques can decrease digestive disorders by relieving the stress response and allowing the body to return to its natural function. How does the duodenum accomplish this, and in what way does this protect the duodenum? Again, referring to normal physiological functioning of the liver, why do these two things happen when alcohol damages hepatocytes? Ends in the small intestine. What are the two great controlling systems of the body? This is a chamber that links the colon to the anus. Her, mom taught her many of the traditional spicy Hispanic dishes, her family ate while growing up. Please try again later. doing lots of home cooking. sample is kindly provided by a student like you, use it only as a guidance. (30 pts.) Through the process of digestion. For the best experience on our site, be sure to turn on Javascript in your browser. For instance, one can reduce stress and acid reflux by recognizing the cause of the stress and changing ones response to it (Donatelle, 2011). Digestive System Case Study. 2020. There were several risk factors present in the patients history including: high stress job, poor diet, lack of exercise, and overweight. Cirrhosis leads to liver scarring as well as increased hydrostatic pressure in the hepatic portal vein. Digestive enzymes are produced and secreted by the gastrointestinal system to degrade fats, proteins, and carbohydrates, to accomplish the digestion and, afterwards, the absorption of nutrients. There was no family history of the disease present. Harold, a fifty-eight year old grocery store manager, had recently been waking up in the middle of the night with abdominal pain. Domestic Orders $75+. Base on the case study, the dietary of the patient has caused the weakening of the digestive system. How might your hypothesis be diagnosed and treated? Harold, a fifty-eight-year-old grocery store manager, had recently been waking up in the middle of the night with abdominal pain. the food just hasnt seemed to agree with her. C. It is body's outer covering D . Acid reflux is also present in individuals with high stress levels. Exercise can lower stress by relaxing the body, allowing an outlet for releasing tension or frustration, and lowering blood pressure (Donatelle, 2011). View digestive system case study.docx from BIO 111 at Oakland University. She says she feels "gassy" and bloated. Why is this new diet prescribed? Urinary and Digestive System Case Study Essay example Case Study 20: The Digestive and Urinary Systems 1) Marissa, a newborn with a cleft lip and palate, is the third child of Juan and Maria. b. Streptomycin binds bacterial ribosomes, disabling them. Westport: Greenwood Press. It has five distinct sections. She states the pain came after dinner at an all-you-can-eat buffet and has been increasing steadily. Where in the body are ketone bodies produced? 3. [Accessed November 16, 2022]. Digestive System Case Study. JavaScript seems to be disabled in your browser. What energy source does the body use to produce these substances? Clotting proteins are produced in the liver, if hepatocyte are damaged clotting will be inhibited. Digestive System Case Study DC comes to the emergency room complaining of acute abdominal pain. Where is the epigastric region and what organs associated with digestion are located in that area? Dr. Lorraine also explains to Mr. Volpe that H. pylori impairs the normal buffering effect in his duodenum. Digestive System Case Study MODULE 14: ANATOMY & PHYSIOLOGY CASE STUDY #7 Isabel's Case: The Burn in My Chest Isabel is a young Latina woman, age 24, who loves to cook. During her physical exam of the heart, the NP notices that he has a new mitral regurgitation murmur that is described as a, A pregnant women who has gestational diabetes mellitus (GDM) in the second trimester has which type of diabetes? Briefly describe how these three organelles contribute to this major function of the liver. The news stories suggest that the source of infection was unpasteurized apple cider, but the group wants to know if hamburgers are safe. This is the third stage of the digestive process. Fri, Jan 22, 2021. People With Skin Allergies Are Less Likely To Develop Cancer, Exercise Is Not Likely To Prevent Obesity Or Type 2 Diabetes. What causes the release of Ach from axon terminal. For the best experience on our site, be sure to turn on Javascript in your browser. The appendix is located in the right lower section of the abdomen. Explain why his body is producing ketones in the presence of such large amounts of glucose. She loves making bread and cakes. 287869995, Well-researched, fact-checked, and accurate, Eloquently written and immaculately formatted. Well email you the instructions on how to reset it, Get ready to grab 15% OFF the first order & 35% OFF the second one, Leave your email and be the first to know about the start. Explain why the underproduction of albumin by a cirrhotic liver also may contribute to excessive filtration, which contributes to ascites. Mucosa with simple columnar epithelium covered by mucus. This coping strategy works well for social stress and environmental stress (Donatelle, 2011). Intestinal glands also present going into the lamina propria. Dery, B. She was scared of developing type 2 diabetes because several family members suffer with the disease. Your job is report out at the end of the shift with your findings, including information about each of the patients you have seen. study the digestion system relating to organs and anatomy of the Upper and lower GI tract. Retrieved November 16, 2022, from https://www.wowessays.com/free-samples/the-digestive-system-case-study-example/. The patient was prescribed Prilosec to reduce stomach acid. It involves the use of the teeth. Acid reflux was determined to be the problem through length of time with symptoms. The epigastric region is in the upper abdomen and the organs near or in the epigastric region are the stomach, pancreas, liver, gallbladder, esophagus, and duodenum. Some antibiotic drugs fight infection by interfering with DNA replication, transcription, or translation in bacteria. In this sample case a 41 year old male was diagnosed with Acid reflux disease. Histamine- Pathway for hydrogen generation. The membranes (2)_____ molecules prevent water-soluble molecules from entering, whereas the (3)_____ molecules serve as channels for specific molecules. 5.0. The membrane's protein molecules may also serve as anchors for (4)______ that form part of the cytoskeleton. Digestive System AnaAnatomy and Physiology of the Digestive System Objectives Identify the anatomical structures of the digestive system and their functions Explain the physiology of digestion through the system Assignment Overview This exercise helps students understand the anatomical structures of the digestive system Deliverables Annotated diagram of the digestive system Step 1 Draw a . . What to Do If You Don't Have a Gallbladder? Digestive System Case Study DC comes to the emergency room complaining of acute abdominal pain. She tried to stick to gluten free versions of baking, but even they gave her reflux and gas. The digestive tract starts at the mouth. When the doctor knocks and walks in, she finds the 66-year-old man looking exhausted and uncomfortable.Sal gets to the reason for his visit immediately: He's been suffering from "stomach . Regardless of the payment method you choose for checking out, all transactions are safe and encryption-protected. The excess drinking lead to chronic inflammation of the liver which lead it to not be able to secrete bilirubin which lead to jaundice. On the basis of these responses, do you have an idea what Mr. Gutteman's diarrhea stems from? H. pylori weakens the duodenal mucosa making it more susceptible to gastric juice. She states the pain came after dinner at an all-you-can-eat buffet and has been increasing steadily. Ketones produce acid conditions when in high amounts. DC comes to the emergency room complaining of acute abdominal pain. Food, Urinary System, Digestive System, Digestive, System, Stomach, New York, Tract. The small intestine is one the largest organs in the body, it is 22 feet long and is mainly muscular. She could make bread from things like almond meal and coconut flour. Bolt, R. J. Digestive System Case Studies. She says she feels "gassy" and bloated. Because there is no single cause of acid reflux disease, lifestyle changes can prevent or control acid reflux disease. It is said that case should be read two times. The liver is reddish brown in colour and is located on the right hand side of the stomach. Case Study with Worksheet Peptic Ulcer Disease: A Case on the Digestive System It's Friday morning and Sal Volpe is sitting in Dr. Lorraine's exam room, dozing after another night of disrupted sleep. Initial reading is to get a rough idea of what information is provided for the analyses. Which of the following is the function of the integumentary system? By curbing stress once can reduce or eliminate acid reflux. There were several risk factors present in the patients history including: high stress job, poor diet, lack of exercise, and overweight. She would see plicae circulares and villi with a healthy epithelium on the mucosa. Note: this The case study highlights the importance of prevention of acid reflux disease. - The Ascending (Right) Colon That means it prevents histamine release. Besides the nurse's "bender" comment, and Mrs. Fender's social history, Carole suspects alcohol abuse based on many of her physical exam findings. However, it has been found to store and protect good bacteria that enhance the process of digestion. The risk factors for acquiring this disorder include: obesity, overeating, eating nutritionally poor foods, eating specific combinations of foods, and abnormalities in the digestive system. National Institute of Diabetes and Digestive and Kidney Diseases. Created by. Smooth ER: microsomal enzyme: convert chemicals into something soluble. Retrieved from The Visual Dictionary: http://www.infovisual.info/03/057_en.html Digestive System Disorder Case Study Retrieved from https://vincenttriola.com/blogs/ten-years-of-academic-writing/digestive-system-disorder-case-study. Free Shipping On U.S. Course Hero is not sponsored or endorsed by any college or university. 2nd_course_question_analysIII_82641248.docx, Case Study in Heartburn Assignment Nutrition 100 Menu 3.docx, LWW_BATES_OSCE14_ChildAndAdolescentObesity_FINAL (1).pdf, COMPREHENSIVE ASSESSMENT__TINA JONES__SH.docx, Chamberlain College of Nursing ADVANCED P NR509, Indiana Wesleyan University, Marion NURSING 297, River Parishes Community College NURSING 2124, pts Question 6 A debit is not the normal balance for which of the following, The systematic and deliberate advancement made by an individual on his career in, Is sublimation an efficient method of purification Is the value of the melting, GROUP-2-Sample-Survey-Questionnaire-Format.docx, C money output D potential output Answer D Diff 1 Topic The Long Run Aggregate, The Company is principally engaged in the business of manufacturing and selling, 10 B 11 A B 12 B 13 B 14 The zooxanthellate invertebrates lose their, and services We could explain the process and some brief information about, Which of the following is NOT true above dopamine a Dopamine signals when, link and broadcast link 41Which one is not a service provided by the link layer, In GPO1 add Script1ps1 as a startup script Attach a WMI filter to GPO1 Answer B, The teacher instructed the students to develop a paragraph describing a scenic, Cameroon Congo Cte dIvoire and Senegal where efforts taken to reduce their, Which of the following is the amount percentage of solar power that is, and edge of the tub on the way down She screams in pain awakening John An, video record the session for your assessor to watch later Your assessor can, 541 teorema Agar A matritsaning barcha 1 j j i j m m n xos qiymatlari Re 0 1 j j, More significantly quantum powered AI may be used by adversaries for more, DLs birthing parent tells you they were raped Sexual maltreatment or rape occurs, Biology Chewing breaks down the food into more soluble pieces. The stomach is located on the upper abdomen, on the left side. in starvation). Section A The pain is located in her right upper quadrant and is "boring" into her back. provide detailed description of the path of chyme, and later feces, . Study with Quizlet and memorize flashcards terms like You are at dinner with four of your friends. C -- Only one of the twin daughters is ill, yet both children most likely ate the same food items (the fruit and baby jar food item). Digestive Case Studies. Recently Isabel got married, and moved into a new home with her husband. It can be adapted and modified for smaller groups or even individual students. This part receives food from the mouth. What do the median nerve and ulnar nerve innervate? Well remind you about the start of Black Friday. Chelsea House Publishers. a. elevation b. dorsiflexion c. eversion d. plantar flexion. By submitting your email address you agree to joining our mailing list. When one has acid reflux disease, acid flows back into the esophagus from the stomach (Smith, 2013). often because of the small sample size of the studies reviewed, except in the case of primary biliary cirrhosis where a benefit on survival was . Movement of organ walls can propel food and liguid down. Many people experience heartburn occasionally but acid reflux diseases is marked by symptoms occurring two to three times per week (Smith, 2013). Password recovery email has been sent to email@email.com, Don't waste time. Therefore, there is a decrease in acid production when using Pepcid. Explain how the pH of Mr. Boulard's blood and urine is related to the ketone bodies measured in each of these fluids. This was happening several nights a week. We will write a custom Case Study on Digestive System Diagnostic's Case specifically for you. The final part of the digestive tract or system is the Anus. Refer again to the forces that determine net filtration pressure in the capillaries, and to the production and function of albumins. The patient came to the clinic complaining of burning esophagus and sour stomach. The goal is for students to understand how digestion works and how an autoimmune disease (celiac) interferes with the process. Where is the epigastric region and what organs associated with digestion are located in that area? (2011). (1983). The pain is located in her right upper quadrant and is "boring" into her back. 3. Case Study, Topic: This backflow of acid is known as heartburn due to the burning sensation in the chest. She says she feels "gassy" and bloated. The medication Pepcid that Mr. Volpe took for partial relief of his dyspepsia is called an H2 (histamine) receptor antagonist, or H2 blocker. This also increases the surface area for which the digestive enzymes can work on the food in the latter stages . With every case study, there are questions that need answering in order for you to educate the next shift. Available from: https://www.wowessays.com/free-samples/the-digestive-system-case-study-example/, "The Digestive System Case Study Example." Digestive System. This is the process of breaking down food into smaller pieces to enhance absorption and increase surface area for action by digestive enzymes. This is the store for the bile that is used in the digestion process in the stomach. There are a host of alternative treatments such as meditation and relaxation techniques which can also reduce stress (Donatelle, 2011). The liver is known for its ability to remove certain toxins from the blood. She is aware of the fact that it reduces nutrient absorption and increases the risk of osteoporosis. The Digestive System. high blood pressure with the portal venous system. The stomach receives food from the oesophagus through a muscular valve known as the lower oesophageal sphincter. The pain is located in her right upper quadrant and is "boring" into her back. She had, People who experience reflux, gas and bloating are almost always deficient in bile. . Type I Type 2 Neither QUESTION 2 Sara is a 38 y/o multipara who is in her 6th-7th, Jeremy is suffering from chronic alcohol abuse. Accessed 16 November 2022. New York: Children Press. As Dr. Lorraine is listening to Mr. Volpe's complaints she automatically visualizes the organs in the epigastric region that are the potential source of his problems. She says she feels "gassy" and bloated. Additionally, she has. Digestive System Case Study. New York: Twenty-First Century Books. It is a small pouch that looks like a finger. Increasing the pressure causes portal hypertension Things get backed up, portal hypertension happens at the backup of the liver, which backs up blood to capillaries so more fluid can leave the abdominal capillaries into the abdomen. Ruth only worked two days a week and said there was no major stress in her life, so she blamed the Nexium. Ketone bodies are produced in the liver from the breakdown of fat. A change in diet and lifestyle is also necessary to manage symptoms. Free Essay Examples - WowEssays.com. She states the pain came after dinner at an all-you-can-eat buffet and has been increasing steadily. A. The patient came to the clinic complaining of burning esophagus and sour stomach. New York: HarperCollins. But lately. Accessed November 16, 2022. https://www.wowessays.com/free-samples/the-digestive-system-case-study-example/, WowEssays. Digestive System Case Studies You are an ER doctor that is working the night shift and are presented with several patients over the course of your shift. Smith, M. W. (2013, June 28). I designed this digestive system case study for my anatomy class and remote learners. Smith, M. E., & Morton, D. G. (2001). Ruth loves to cook. The production of large amounts of ketone bodies is often seen when glucose is not readily available as an energy source (e.g. Bicarbonate secreted by the pancreas, liver and duodenal glands neutralizes the acid from the stomach -- preventing stomach acid and enzymes from digesting the wall of the duodenum. Food is further broken down by aid of enzymes from pancreas and liver. One of the most common digestive disorders is acid reflux disease. Digestive System Case Study. When one takes the first bite, food begins the digestion process through chewing. Digestion begins in the mouth. B. If its faulty or wrongly described, well replace it. Indicate whether each of the following effects is on replication, transcription, or translation: a. Rifampin binds to bacterial RNA polymerase. A -- The sick twin had stuffed clover leaves into her mouth, making the clover leaves a suspected source of infection, as opposed to a contaminated food item or preparation area. Proceed if you agree to this policy or learn more about it. Exercise and other lifestyle changes were also recommended. Patient was also told that continued acid reflux may create a situation where surgery is necessary in order to repair the esophagus. The Digestive System. The enzyme pepsin can digest the duodenal wall. She says she feels "gassy" and bloated. At her annual gynecological exam, she asks her womens health physician if she can refer her to a, physician specializing in stomach or heart problems., Apparently, Isabel has been feeling a pain in her chest or upper, abdomen nearly every evening, especially right before bed or, right when she lies down. (1994). What does she mean by the "buffering effect?" It receives food from the oesophagus. Mrs. Fender's prolonged clotting times and excessive bruising are related. Edinburgh: Churchill Livingstone. Flashcards. Simon, S. (2005). (2020, February, 05) The Digestive System Case Study Example. 2nd: mix of food liquid and digestive juice produced by the stomach. Stille, D. R. (1997). It also has exchange blood vessel capillaries called sinusoids. Digestive System Case Study. Small Intestine Breakdown of food, absorption and motility BIOS256 week 2 case study for digestive system. ", "The Digestive System Case Study Example,". Albumin is a blood protein that is made by the liver and it helps keep the osmotic pressure in the blood. She states the pain came after dinner at an all-you-can-eat buffet and has been increasing steadily. This is the second stage of the digestion process. A local outbreak of Escherichia coli O157:H7 has been in the news. Choosing a selection results in a full page refresh. The pain is located in her right upper quadrant and is "boring" into her back. Things you must know if you dont have a gallbladder. New York: Chelsea Houise Publishers. What are the effects of adrenal sex hormones in females? One of the ways in which people cope with stress is by exercising. It is made up of two anal sphincters and pelvic floor muscles. It is well protected by the rib cage and weighs 3 pounds. The patient has a wife and one child and appears to have support from family. Avraham, R. (1989). Boston, MA: Benjamin Cummings. - The Cecum DC comes to the emergency room complaining of acute abdominal pain. Test. Stomach Storage and Breakdown of Food (1) $3.00. I would remember the locations of the organs by reviewing the picture above and memorizing the location of the organs by having the image clearly in my mind. Dont forget to check inbox. Because acid secretion continues for hours after eating, pain comes again after the stomach is empty. Changes in lifestyle will require diet and exercise which benefits from family support. When one takes the first bite, food begins the digestion process through chewing. Frost, H. (2004). to suspect that maybe her diet is involved. The pain is located in her right upper quadrant and is "boring" into her back. Identify the unique features of the mucosa in the stomach and in the duodenum, and explain how this uniqueness determines the function of the stomach and the duodenum. Hole's Essentials of Human Anatomy and Physiology, David Shier, Jackie Butler, John Hole, Ricki Lewis, Human Anatomy and Physiology, Global Edition, Which motion moves the bottom of the foot away from the midline of the body? It does work well for Ruth, but since she started taking it, symptoms of abdominal bloating and gas became worse. Donatelle, R. J. Digestive System Case Study. Her husband tells her it must be, heartburn, but truthfully Isabel did not understand what, heartburn really meant until she googled it. This part of the digestive tract is 6 feet long and connects the small intestine to the rectum. This preview shows page 1 - 2 out of 4 pages. digestive system case study.docx - Isabels Case: The Burn in My Chest Isabel is a young Latina woman, age 24, who loves to cook. Acid reflux disease occurs when the esophagus is no longer strong enough to handle stomach acid. Get help with 11% offusing code - GETWOWED, No, thanks! The incorporation of these different techniques can decrease digestive disorders by relieving the stress response and allowing the body to return to its natural function. . What is the source and normal function of acid in the stomach and what regulates its production? The pain is located in her right upper quadrant and is "boring" into her back. Match. https://www.wowessays.com/free-samples/the-digestive-system-case-study-example/. A smooth wall without ulcers present. Explain how Mrs. Fender's cirrhosis is related to her jaundice. We only work with verified PCI DSS-compliant platforms that ensure customers' confidentiality and absolute security of their data. In Mr. Boulard's case, large amounts of glucose are in the blood. Once the stressor is recognized, which may take some practice, the person can change the way they perceive the problem.
Mongodb Schema Examples, Farmers World Monitor, Cannabox February 2022 Spoilers, Truck Wash Near Montgomery Alabama, Ashcraft's Pediatric Surgery, Lynnwood Recreation Center Login, What Base Can Be Used For Acrylic Pouring, Bellevue Community Center, Pasquale's Pizza Wall Nj Menu,
Mongodb Schema Examples, Farmers World Monitor, Cannabox February 2022 Spoilers, Truck Wash Near Montgomery Alabama, Ashcraft's Pediatric Surgery, Lynnwood Recreation Center Login, What Base Can Be Used For Acrylic Pouring, Bellevue Community Center, Pasquale's Pizza Wall Nj Menu,