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Peritoneum
Peritoneum
visceral layer covers organs parietal layer lines the walls of body cavity
Peritoneal Cavity
potential space containing a bit of serous fluid
Salivary Glands
Parotid below your ear and over the masseter Submandibular is under lower edge of mandible Sublingual is deep to the tongue in floor of mouth All have ducts that empty into the oral cavity
Wet food for easier swallowing Dissolves food for tasting Protects mouth from infection with its rinsing action: 1 to 1 qt/day Bicarbonate ions buffer acidic foods Bulimia---vomiting hurts the enamel on your teeth Salivary Amylase (enzyme): Starts chemical digestion of starch Lysozyme (enzyme): helps destroy bacteria
Mumps
Myxovirus that attacks the parotid gland Symptoms inflammation and enlargement of the parotid fever, malaise & sour throat (especially swallowing sour foods) swelling on one or both sides Sterility rarely possible in males with testicular involvement (only one side involved) Vaccine available since 1967
Enamel hardest substance in body calcium phosphate or carbonate Dentin calcified connective tissue Cementum bone-like periodontal ligament penetrates it
Dentition
Primary/baby teeth
20 teeth that start erupting @ 6months 1 new pair of teeth per month
Permanent teeth
32 teeth erupt b/t 6 & 12 years of age
Chemical Digestion
Amylase
Lingual Lipase
begins starch digestion at: pH of 6.5 or 7.0 found in mouth when bolus & enzyme hit pH 2.5 gastric juices hydrolysis ceases
secreted by glands in tongue begins breakdown of triglycerides into fatty acids and glycerol
Pharynx
Funnel-shaped tube extending from internal nares to the esophagus (posteriorly) and larynx (anteriorly) Skeletal muscle lined by mucous membrane Deglutition/swallowing is facilitated by saliva and mucus 1. starts when bolus is pushed into the oropharynx 2. sensory nerves send signals to deglutition center in brainstem 3. soft palate is lifted to close nasopharynx 4. larynx is lifted as epiglottis is bent to cover glottis
Esophagus
Collapsed muscular tube In front of vertebrae Posterior to trachea Posterior to the heart Pierces the diaphragm at hiatus
hiatal hernia or diaphragmatic hernia
Voluntary Phase: tongue pushes food to back of oral cavity Involuntary Phase: pharyngeal stage breathing stops & airways are closed soft palate & uvula are lifted to close off nasopharynx vocal cords close epiglottis is bent over airway as larynx is lifted
Swallowing
Upper sphincter relaxes when larynx is lifted Peristalsis pushes food down
circular fibers behind bolus longitudinal fibers in front of bolus shorten the distance of travel
Travel time:
4-8 seconds for solids 1 sec for liquids
Anatomy of Stomach
Parts of stomach
Cardia Fundus Body Pylorus: starts to narrow as approaches Pyloric Sphincter
Empties as small squirts of chyme leave the stomach through the pyloric valve
Pyloric Stenosis
narrowing of sphincter indicated by projectile vomiting must be corrected surgically
Muscularis
Three layers of smooth muscle: Outer Longitudinal Circular Inner Oblique Permits greater churning & mixing of food with gastric juice
HCl kills microbes in food Mucous cells protect stomach walls from being digested w/13 mm thick layer of mucous
Cephalic Phase =
Cerebral Cortex:
sight, smell, taste & thought stimulate PNS
Vagus Nerve:
increases stomach muscle and glandular activity
Gastric Phase =
Nervous control keeps stomach active
stretch receptors & chemoreceptors provide info vigorous peristalsis and glandular secretions continue chyme is released into duodenum
Stomach Working
distention & presence of caffeine or protein cause G cells secretion of gastrin into bloodstream gastrin hormone increases stomach glandular secretion gastrin hormone increases stomach churning and sphincter relaxation
Cholecystokinin (CCK)
Digestive Hormones
Gastrin Gastric inhibitory peptide--GIP Secretin
stomach & pancreas pancreas, liver & stomach stomach, gastric & ileocecal sphincters
Cholecystokinin--CCK
pancreas, gallbladder, sphincter of Oddi, & stomach
When chyme enters the duodenum, proteins & carbohydrates are only partly digested, & fat digestion needs to be carried out Enzymes aid in digestive breakdown & absorption of chyme
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Bile Salts (Liver & Gallbladder) Fat Fat Droplets
Bile is a thick digestive fluid secreted by the liver and stored in gallbladder. Facilitates digestion by emulsifying fats into fatty acids, which can be absorbed by the digestive tract
Digestive Enzymes
Pancreatic & Salivary Amylase (Pancreas & Mouth Starch + H2O Maltose
1. 2. 3.
A deep breath is taken, the glottis is closed, and the larynx is raised to open the upper esophageal sphincter. Soft Palate is elevated to close of external nares Diaphragm contracts down to create a negative pressure in the thorax, which facilitates opening of the esophagus and esophageal sphincter Simultaneously with the downward movement of the diaphragm, the abdominal muscles contract elevating inner gastric pressure. With the pylorus closed and the esophagus open the exit route is clear
pancreatic amylase, pancreatic lipase, proteases Ribonuclease to digest nucleic acids deoxyribonuclease
Pancreatitis
Pancreatitis: inflammation of the pancreas occurring with the mumps Acute Pancreatitis: associated with heavy alcohol intake or biliary tract obstruction
result is patient secretes trypsin in pancreas & starts to digest themselves
GIP
CCK
Gallbladder
fundus, body & neck The gallbladder stores about 50 ml of bile
Liver FunctionsCarbohydrate Metabolism Turn proteins glucose Turn triglycerides glucose Turn excess glucose glycogen & store in the liver Turn glycogen back glucose as needed
helps move cholesterol back to liver for removal from bloodstream (GOOD)
LDL
(low-density lipoprotein)
Deamination = removes NH2 (amine group) from amino acids so can use what is left as energy source Converts resulting toxic ammonia (NH3) into urea for excretion by the kidney Synthesizes plasma proteins utilized in clotting mechanism and immune system Convert one amino acid into another
Bile Production
1 quart of bile/day is secreted by the liver Components
yellow-green in color & pH 7.6 to 8.6
water & cholesterol Bile Salts = Na & K salts of bile acids Bile Pigments (bilirubin) from hemoglobin molecule Globin = a reuseable protein Heme = broken down into iron and bilirubin
Bile capillaries Hepatic ducts connect to form common hepatic duct Cystic duct from gallbladder & common hepatic duct join to form common bile duct Common bile duct & pancreatic duct empty into duodenum
Plica Circularis
Villi
permanent inch tall folds that contain part of submucosal layer not found in lower ileum cannot stretch out like stomach 1 Millimeter tall Contains vascular capillaries and lacteals (lymphatic capillaries)
Small Intestine
Microvilli
Absorption and digestion Digestive enzymes found at cell surface on microvilli Digestion occurs at cell surfaces
Segmentation:
local mixing of chyme with intestinal juices sloshing back & forth
Digestion of Carbohydrates
Mouth: salivary amylase Esophagus & stomach: nothing happens Duodenum: pancreatic amylase Brush Border Enzymes (maltase, sucrase & lactose) act on disaccharides
produces monosaccharides-fructose, glucose & galactose lactose intolerance (no enzyme; bacteria ferment sugar)--gas & diarrhea
Nucleotides produced are further digested by brush border enzymes Absorbed by active transport
Digestion of Proteins
Stomach
HCl denatures or unfolds proteins pepsin turns proteins into peptides
Digestion of Lipids
Mouth: lingual lipase
Small intestine
emulsification by bile Pancreatic Lipase: splits into fatty acids & monoglyceride No enzymes in brush border
Pancreas
digestive enzymes: split peptide bonds b/t different amino acids brush border enzymes: split off amino acid at amino end of molecule or split dipeptide
Absorption of Monosaccharides
Absorption into epithelial cell glucose & galactose: sodium symporter(active transport) Fructose: facilitated diffusion Movement out of epithelial cell into bloodstream by facilitated diffusion
Absorption of Lipids
Small fatty acids enter cells & then blood by simple diffusion Larger lipids exist only within micelles (bile salts coating) Lipids enter cells by simple diffusion leaving bile salts behind in gut Bile salts reabsorbed into blood & reformed into bile in the liver
Sources of electrolytes GI secretions & ingested foods and liquids Enter epithelial cells by diffusion & secondary active transport sodium & potassium move = Na+/K+ pumps (active transport) chloride, iodide and nitrate = passively follow iron, magnesium & phosphate ions = active transport Intestinal Ca+ absorption requires vitamin D & parathyroid hormone
Absorption of Electrolytes
Fat-Soluble Vitamins
Absorption of Vitamins
Water-Soluble Vitamins
Vitamin B complex, Ca absorbed by diffusion
B12 combines with intrinsic factor before it is transported into the cells
receptor mediated endocytosis
Absorption of Water
9 liters of fluid dumped into GI tract each day Small intestine reabsorbs 8 liters Large intestine reabsorbs 90% of that last liter Absorption is by osmosis through cell walls into vascular capillaries inside villi
5 feet long by 2 inches in diameter Ascending & descending colon are retroperitoneal Cecum & appendix Rectum = last 8 inches of GI tract anterior to the sacrum & coccyx Anal canal = last 1 inch of GI tract
internal sphincter----smooth muscle & involuntary external sphincter----skeletal muscle & voluntary control
Appendicitis
Inflammation of the appendix due to blockage of the lumen by chyme, foreign body, carcinoma, stenosis, or kinking Symptoms
high fever, elevated WBC count, neutrophil count above 75% referred pain, anorexia, nausea and vomiting pain localizes in right lower quadrant
Haustral Churning: relaxed pouches filled from below by muscular contractions (elevator) Gastroileal Reflex when stomach is full, gastrin hormone relaxes ileocecal sphincter so small intestine will empty and make room Gastrocolic Reflex when stomach fills, a strong peristaltic wave moves contents of transverse colon into rectum
Some electrolytes: After 3 to 10 hours, 90% of H2O has been removed from chyme Feces are semisolid by time reaches transverse colon Feces = dead epithelial cells, undigested food such as cellulose, bacteria (live & dead)
Na+ and Cl-
Defecation
Gastrocolic reflex moves feces into rectum Stretch receptors signal sacral spinal cord Parasympathetic nerves contract muscles of rectum & relax internal anal sphincter External sphincter is voluntarily controlled
Diarrhea
Defecation Problems
Constipation
chyme passes too quickly through intestine H20 not reabsorbed decreased intestinal motility too much water is reabsorbed Remedy = fiber, exercise and water
Insoluble Fiber
Dietary Fiber
Soluble Fiber
Woody parts of plants (wheat bran, veggie skins) speeds up transit time & reduces colon cancer gel-like consistency beans, oats, citrus white parts, apples lowers blood cholesterol by preventing reabsorption of bile salts so liver has to use cholesterol to make more
Changes that occur: decreased secretory mechanisms & motility loss of strength & tone of muscular tissue changes in neurosensory feedback diminished response to pain & internal stimuli Symptoms: sores, loss of taste, peridontal disease, difficulty swallowing, hernia, gastritis, ulcers, malabsorption, jaundice, cirrhosis, pancreatitis, hemorrhoids and constipation Colon or rectum is common
Nutrient:
Carbohydrates Most are derived from plants Exceptions: lactose from milk and small amounts of glycogens from meats Lipids Saturated fats from animal products Unsaturated fats from nuts, seeds, and vegetable oils Cholesterol from egg yolk, meats, and milk products Proteins Complete proteins contain all essential amino acids Most are from animal products Legumes and beans also have proteins, but are incomplete Vitamins Most vitamins are used as cofactors and act with enzymes Found in all major food groups Minerals Play many roles in the body Most mineral-rich foods are vegetables, legumes, milk, & some meats
Categories of Nutrients
Metabolism
Anabolism Larger molecules are built from smaller ones Energy Required
The amount of energy expended while at rest, (meaning that the digestive system is inactive, which requires about twelve hours of fasting in humans). Release of
Males
18-30
30-60 >60
Females
0-3
3-10
10-18 18-30 30-60
>60
BMI Categories
Underweight: Less than 18.5
Normal Weight: 18.5 - 24.9 Overweight: 25 - 29.9
Obese: 30 or higher