DIGESTIVE SYSTEM
DIGESTIVE SYSTEM. FUNCTION??. MAKE FOOD SMALL ENOUGH TO BE ABSORBED MONOMERS. DIGESTIVE SYSTEM. kidshealth.org. DIGESTIVE SYSTEM. www.nlm.nih.gov. DIGESTIVE SYSTEM. arbl.cvmbs.colostate.edu. MICROANATOMY OF THE DIGESTIVE TUBE. arbl.cvmbs.colostate.edu. MUCOSA.
DIGESTIVE SYSTEM
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FUNCTION?? • MAKE FOOD SMALL ENOUGH TO BE ABSORBED • MONOMERS
DIGESTIVE SYSTEM kidshealth.org
DIGESTIVE SYSTEM www.nlm.nih.gov
DIGESTIVE SYSTEM arbl.cvmbs.colostate.edu
MICROANATOMY OF THEDIGESTIVE TUBE arbl.cvmbs.colostate.edu
MUCOSA • SURFACE EPITHELIUM; CONNECTIVE TISSUE; SMOOTH MUSCLE; SOME HAVE FOLDINGS TO ?; TUBULAR GLANDS: • MUCUS; DIGESTIVE ENZYMES • LUMEN • PROTECTS LAYERS & BODY; SECRETION AND ABSORPTION
SUBMUCOSA • LOOSE CONNECTIVE TISSUE; GLANDS; BLOOD VESSELS; LYMPH VESSELS; NERVES; • TO NOURISH AND TRANSPORT MATERIAL AWAY
MUSCULAR LAYER • INNER COAT: CIRCULAR SMOOTH MUSCLE FIBERS: DIAMETER DECREASES • OUTER COAT: LONGITUDINAL FIBERS: TUBE SHORTENS • FOR MOVEMENTS
SEROSA/SEROUS LAYER • OUTER COVERING: VISCERAL PERITONEUM; CONNECTIVE TISSUE WITH EPITHELIUM ON TOP (OUTSIDE); • PROTECT TISSUES BELOW; SECRETE SEROUS FLUID: MOISTENS AND LUBRICATES SO ORGANS SLIDE FREELY
MUCOSAL EPITHELIUM arbl.cvmbs.colostate.edu
MOVEMENTS • MIXING: • MOVEMENT OF STOMACH, OR SEGMENTS (SEGMENTATION); MIXES FOOD AND DIGESTIVE ENZYMES • PROPELLING: • PERISTALSIS: RING OF CONTRACTION & CAUSES RECEPTIVE RELAXATION
SEGMENTATION arbl.cvmbs.colostate.edu
PERISTALSIS arbl.cvmbs.colostate.edu
PERISTALSIS www.nlm.nih.gov
INNERVATION • USUALLY WHICH ONE ? • PARASYMPATHETIC • BY PLEXUSES ? • INCREASE ACTIVITY; VAGUS NERVE & SACRAL POTION OF S.C. • SYMPATHETIC • DECREASE • FIGHT OR FLIGHT
MOUTH • CHEEK & LIPS: SKELETAL MUSCLES • TONGUE: • LINGUAL FRENULUM: TO FLOOR • PAPILLAE • FRICTION, TASTE BUDS • HYOID BONE • LINGUAL TONSILS: OF ?
PALATE • ANTERIOR: HARD • POSTERIOR: SOFT • UVULA • SWALLOWING: CLOSE NASAL PASSAGES • PALATINE TONSILS • PHARYNGEAL TONSILS: ADENOIDS
TEETH • HARDEST STRUCTURES OF BODY • NOT BONE ? • PRIMARY: 10; 6 Mo TO 4y • SECONDARY: 32; 6 y TO 22y • FUNCTION: ? WHY? • INCISORS: BITE • CANINES: GRAB AND TEAR • PREMOLARS, MOLARS: GRINDING
TEETH en.wikipedia.org
CROWN • ENAMEL: CALCIUM; HARDEST SUBSTANCE; NOT REPLACED, WEARS DOWN • ROOT • DENTIN: HARDER THAN BONE • CENTRAL CAVITY: PULP • BLOOD VESSELS, NERVES, CONNECTIVE TISSUE • ROOT CANALS: CEMENTUM AROUND ROOT • PERIDONTAL LIGAMENT: COLLAGEN; CEMENTUM TO JAW
SALIVARY GLANDS • PRODUCE ? FOR? • MOISTENS, BINDS, STARTS CHEMICAL DIGESTINO OF FOOD; SOLVENT: DISSOLVES FOOD = TASTE; BICARBONATE IONS: BUFFER: BALANCE pH FOR ENZYME ACTION; 3 PAIR AND MANY MINOR GLANDS • 3 PAIR AND MANY MINOR GLANDS • SEROUS GLANDS • SALIVARY AMYLASE • STARCH AND GLYCOGEN • MUCOUS GLANDS • BINDS; LUBRICATES
SALIVARY CONTROL • PARASYMPATHETIC • LARGE AMOUNT OT WATERY SALIVA • REFLEX: PAVLOV’S DOGS • SYMPATHETIC • SMALL AMOUNT OF VISCOUS SALIVA • UNPLEASANT LOOK, TASTE, SMELL • LESS SALIVA= HARD TO SWALLOW
SALIVARY GLANDS www.entassociates.com
MAJOR SALIVARY GLANDS • PAROTID • LARGEST; CLEAR WATERY; LOTS OF AMYLASE • SUBMANDIBULAR • EQUALLY SEROUS AND MUCOUS • SUBLINGUAL • SMALLEST OF 3 • MOSTLY MUCOUS
PHARYNX • CONNECT NASAL AND ORAL CAVITY TO LARYNX AND ESOPHAGUS • NASOPHARYNX • BEHIND SOFT PALATE • AIR PASSAGEWAY • EUSTACHIAN CANAL OPENING • OROPHARYNX • END OF OUTH TO EPIGLOTTIS • LARYNGOPHARYNX • EPIGLOTTIS TO LARYNX
PHARYNX 1) Nasopharynx 2) Nasal Septum 3) Hard Palate 4) Tongue 5) Oropharynx 6) Laryngopharynx anatomy.med.umich.edu
CIRCULAR MUSCLES= CONSTRICTOR MUSCLES • SUPERIOR; MIDDLE; INFERIOR • SOME OF INFERIOR CONSTRICTOR MUSCLES ARE USUALLY CONTRACTED TO KEEP AIR OUT OF ESOPHAGUS • SKELETAL MUSCLES BUT MOSTLY A REFLEX
SWALLOWING STEPS • 1: VOLUNTARY; CHEWING AND TURNING FOOD INTO BOLUS; TONGUE FORCES TO PHARYNX • 2: SWALLOWING REFLEX STIMULATED • SOFT PALATE RAISES ? • EPIGLOTTIS BLOCKS TRACHEA ? • TONGUE PRESSES ON SOFT PALATE ? • LONGITUDINAL MUSCLES CONTSTRICT ? • INFERIOR CONSTRICTOR MUSCLE RELAXES ? • SUPERIOR CONSTRICTOR MUSCLE CONTRACTS • 3: PERISTALSIS: FOOD THROUGH ESOPHAGUS TO STOMACH
EPIGLOTTIS • http://www.youtube.com/watch?v=aPMw7acrVro&feature=player_detailpage SWALLOWING: http://www.youtube.com/watch?v=wqMCzuIiPaM
ESOPHAGUS • 25 CM; COLLAPSIBLE ?; • HOW DOES FOOD GET TO ABDOMEN ? • HIATUS • MUCOUS GLANDS ? • LOWER ESOPHAGEAL SPHINCTER ? • USUALLY CLOSED ? • PERISTALSIS OPENS SPHINCTER ?
STOMACH • 25-30 CM; CAVITY ~ 1L; RUGAE ? • JUST BELOW DIAPHRAGM • TYPE OF DIGESTION ? • BOTH; • MIXES FOOD WITH GASTRIC JUICE; STARTS PROTEIN DIGESTION; SOME ABSORPTION; FOOD TO INTESTINES • REGULAR 2 SMOOTH MUSCLE LAYERS: PLUS OBLIQUE MUSCLES (ESPECIALLY FUNDUS AND BODY); • STRONGER; MORE MIXING
http://gerd.emedtv.com/gerd-video/what-happens-when-you-have-gerd-video.htmlhttp://gerd.emedtv.com/gerd-video/what-happens-when-you-have-gerd-video.html
PARTS • CARDIA: NEAR ESOPHAGEAL OPENING • FUNDUS: BALLOON AREA AT START: STORAGE • BODY: DILATED AREA; MIDDLE; • PYLORIC ANTRUM: FUNNEL SHAPED; AT END TO ? • PYLORIC CANAL: BEFORE SMALL INTESTINE • PYLORIC SPHNCTER: THICK CIRCULAR MUSCLE; VALVE: CONTROLS EMPTYING
GASTRIC SECRETIONS • GASTRIC PITS: GASTRIC GLANDS: TUBULAR: OR 3 SECTRETORY CELL TYPES • MUCOUS: NEAR OPEININGS OF PITS; • CHIEF CELLS: DEEPER; DIGESTIVE ENZYMES • PARIETAL CELLS: DEEPER; HCl • ALL= GASTRIC JUICE • CHIEF CELLS RELEASE PEPSINOGEN: INACTIVE FORM OF PEPSIN WHY INACTIVE? • PEPSINOGEN AND HCl= PEPSIN • GASTRIC LIPASE: MOSTLY ON BUTTERFAT BECAUSE OF LOW pH
MUCUS PROTECTS FROM PEPSIN • PARIETAL CELLS ALSO SECRETE INTRINSIC FACTOR: HELPS ABSORB VITAMIN B12
CONTROL OF GASTRIC SECRETIONS • PRODUCED CONTIUOUSLY BUT IN VARYING AMOUNTS • CELLS OF GASTRIC GLANDS SECRETE SOMATOSTATIN: INHIBITS ACID SECRETION • PARASYMPATHETIC: ACh SUPRESSES SOMATOSTATIN AND MORE GASTRIC JUICE PRODUCED • GASTRIN ALSO INCREASES SECRETION • CAUSE HISTAMINE TO BE RELEASED= INCREASES GASTRIC SECRETION
http://highered.mcgraw-hill.com/olcweb/cgi/pluginpop.cgi?it=swf::535::535::/sites/dl/free/0072437316/120105/anim0037.swf::Three%20Phases%20of%20Gastric%20Secretionhttp://highered.mcgraw-hill.com/olcweb/cgi/pluginpop.cgi?it=swf::535::535::/sites/dl/free/0072437316/120105/anim0037.swf::Three%20Phases%20of%20Gastric%20Secretion • http://highered.mcgraw-hill.com/olcweb/cgi/pluginpop.cgi?it=swf::535::535::/sites/dl/free/0072437316/120105/anim0037.swf::Three%20Phases%20of%20Gastric%20Secretion
THREE STAGES • CEPHALIC PHASE: • BEFORE FOOD ENTERS STOMACH: SMALL, TASTE, LOOK, THOUGHT OF FOOD BY PARASYMPATHETIC STIMULATION • GREATER HUNGER = GREATER SECRETION • 30-50% OF SECRETION • GASTRIC PHASE: • 40-50%; WHEN FOOD ENTERS STOMACH • DISTENSION OF STOMACH = RELEASE OF GASTRIN = PRODUCTION OF MORE GASTRIC SECRETION • pH AT 3.0 = GASTRIN INHIBITED; 1.5 = GASTRIC SECRETION STOPS • H FOR HCl COMES FROM BLOOD REPLACED BY BICARBONATE ION
INTESTINAL PHASE: • 5%; WHEN FOOD ENTERS SMALL INTESTINES RELEASES INTESTINAL GASTRIN FROM INTESTINES • MORE FOOD ENTERS SMALL INTESTINES AND SYMPATHETIC IMPULSES = INHIBITS SECRETION • PROTEIN AND FAT RELEASES CHOLECYSTOKININ WHICH SLOWS MIXING OF STOMACH • FATS CAUSE RELEASE OF INTESTINAL SOMATOSTATIN WHICH DECREASES GASTRIC SECRETION
GASTRIC ABSORPTION • A LITTLE BIT • WATER, SOME SALTS, SOME LIPID-SOLUBLE DRUGS, ALCOHOL
MIXING/EMPTYING • STOMACHACHE FROM TOO MUCH FOOD • MIXING: BOLUSCHYME • PERISTALSIS SLOWLY MOVES CHYME INTO SMALL INTESTINES • PASSING THROUGH DEPENDS ON TYPE OF FOOD: FATS UP TO 6 HOURS • AS FOOD ENTERS SMALL INTESTINES THE PRESSURE BUILDS UP AND ENTEROGASTRIC REFLEX INHIBITS STOMACH PERISTALSIS AND SLOWS INTESTINAL FILLING • CHOLECYSTOKININ RELEASED TO DECREASE PERISTALSIS
Peristalsis • http://www.nature.com/gimo/contents/pt1/fig_tab/gimo13_V1.html • http://emedicine.medscape.com/article/1948973-overview http://www.youtube.com/watch?v=Ln09qihUi3g&feature=player_embedded
VOMITTING: REVERSE PERISTALSIS BY VOMITTING CENTER OF MEDULLA CONTRACTS ON STOMACH TO EXPELL STOMACH
PANCREAS • DUCT TO DUODENUM • CELLS: • PANCREATIC ACINAR CELLS
PANCREATIC JUICE • PANCREATIC ACINAR CELLS: • PANCREATIC AMYLASE: ? • PANCREATIC LIPASE: ? • TRYPSIN, CHYMOTRYPSIN, CARBOXYPEPTIDASE: SPECIFIC PEPTIDE BONDS • STORED AND RELEASED IN INACTIVE FORMS ? • TRYPSINOGEN ACTIVATED BY ENTEROKINASE THEN TRYPSIN ACTIVATES THE OTHER 2 NUCLEASES: ? BICARBONATE: ALKALINE; NEUTRALIZES HCl
CONTROL OF SECRETION • NERVOUS AND ENDOCRINE SYSTEMS • DURING CEPHALIC AND GASTRIC PHASES PARASYMPATHETIC STIMULATES PANCREAS • SECRETIN STIMULATES RELEASE WHEN CHYME ENTERS DUODENUM: MOST;LY BICARBONATE IONS • PROTEIN & FAT STIMULATES RELEASE OF CHOLECYSTOKININ STIMULATES SECRETION
LIVER • FIBROUS CAPSULE; TWO MAJOR LOBES; TWO MINOR LOBES • HEPATIC LOBULES: FUNCTIONAL UNIT • HEPATIC CELLS; HEPATIC SINUSOIDS; • KUPFFER CELLS: REMOVE BACTERIA • COMMON HEPATIC DUCT
CARBOHYDRATE METABOLISM, GLYCOGEN; GLUCONEOGENESIS; OXIDIZING FATTY ACIDS; SYNTHESIS OF MOLECULES; DEAMINATION OF AMINO ACIDS, FORMATION OF UREA AND OTHER AMINO ACIDS; STORAGE: GLYCOGEN, IRON, VITAMINS A, D, B12; DESTROY DAMAGED RBCs; REMOVES TOXIC MATERIAL; PHAGOCYTIZE PATHOGENS; BLOOD RESERVOIR; SECRETES BILE