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The Gastrointestinal
System:
Fuel for the Trip
• Takes in (ingests) raw
material
• Breaks it down (digests)
both physically and
chemically to usable
elements
• Absorbs those elements
• Eliminates what isn't
usable

Gastrointestinal System
Gastrointestinal System
• Digestive tract, often
called alimentary
tract or canal, is
muscular tube that
contains organs of
digestion
• Tube begins with
mouth and ends at
anus

Alimentary Canal
In Between:

Alimentary Canal
Digestive System Functions
Digestive System Functions
Figure 15-1
The digestive system.
• Mouth (oral cavity)
is mucous-lined
opening; also called
buccal cavity
• Lips (labia) act as
door to cavity
• Hard and soft
palates create roof

Oral Cavity
• Tongue acts as
floor
• Tongue's base
and uvula act as
boundary between
oral cavity and
pharynx

Oral Cavity-Tongue is Border
• Uvula aids in
swallowing,
directing food
toward pharynx and
blocking food from
entering nose
• Tonsils help in
fighting infection as
part of lymphatic
system
• Teeth for grinding
food

Oral Cavity-Uvula, Teeth & Tonsils
Salivary Glands Begin Breakdown of Food
• Sides of cavity created by
cheeks
• Mouth receives, tastes,
mechanically breaks
down, and begins process
of chemical breakdown
of food, adding saliva

Oral Cavity
Figure 15-2
The mouth and oral
cavity.
• Tongue is muscle that
provides taste stimuli to
brain, determines
temperature,
manipulates food, aids
in swallowing
• As tongue moves food
around in oral cavity,
saliva added to
moisten and soften it,
while teeth crush food

Tongue
• Tongue pushes food
into ball-like mass,
called bolus, so it may
be swallowed, passed
to pharynx

Tongue
• Lingual frenulum,
membrane under
tongue, keeps you
from swallowing your
tongue and aids in
speaking

Tongue-The
Frenulum
Salivary Glands-3 Pairs
Large Parotid Salivary Gland
• Controlled by
autonomic nervous
system
• Found slightly inferior
and anterior to each
ear; these swell
when you get mumps

Salivary Glands-3 Pairs
Sublingual and Submandibular Salivary Gland
• Sublingual salivary
glands: located
under tongue
• Submandibular
salivary glands: on
both sides along
inner surfaces of
mandible, or lower
jaw

Salivary Glands-3 Pairs
*Sight of food can stimulate secretion of saliva*
• Salivary glands
produce 1–1.5 liters of
saliva daily
• Saliva is 99.4%
water; contains
antibodies, buffers,
ions, waste products,
and enzymes

Salivary Glands
Salivary Amylase breaks down Carbohydrates
• Enzymes are
biological catalysts to
speed up chemical
reactions
• Salivary amylase:
speeds chemical
activity of breaking
down
carbohydrates

Salivary Glands-Enzymes
Ptyalin converts starches to simple sugars
• Enzymes are
biological catalysts to
speed up chemical
reactions
• Ptyalin: specific
salivary amylase
that converts
starches to simple
sugars

Salivary Glands-Enzymes
• After eating,
saliva cleans
oral surfaces,
reducing amount
of bacteria that
grows in mouth

Less bacteria in the mouth

Saliva Cleans Teeth
Figure 15-3
The salivary glands.
• Nasopharynx: primarily
part of respiratory
system,
• Oropharynx and
laryngopharynx: act as
passageway for food,
water, and air
• Epiglottis: covers
trachea to prevent food
from entering lungs,
forcing food into opening
for esophagus

Pharynx-3 Parts
• Approximately ten
inches long;
connected to stomach
• Extends from pharynx,
through thoracic cavity,
and diaphragm,
connecting to
stomach in peritoneal
cavity

Esophagus
• Rhythmic
contractions,
called peristalsis,
pushes food down
esophagus

Esophagus-Peristalsis
• Pharyngo esophageal
sphincter, relaxes to
open esophagus so food
can enter
• Walls lined with
stratified squamous
epithelium that secrete
mucus to make walls
slippery

Esophagus
Condition called GERD caused by
incompetent sphincter
• At entrance to stomach
is lower esophageal
sphincter, or cardiac
sphincter, opening door
to stomach and closing
to prevent acidic
gastric juices from
splashing into
esophagus causing
heartburn

Esophagus
Located under the diaphragm,
mid to left upper quadrant

Stomach

• Approximately ten
inches long with
diameter
dependent on how
much just eaten
• Can hold up to four
liters when filled
• Rugae, or folds,
help stomach
expand and
contract
Stomach-4 Functions
• Liquids pass through
fairly quickly
• Carbohydrates move
through quickly
• Proteins take more
time to pass through
• Fats take longest,
usually between 4 to 6
hours

Stomach

Movement of material
through stomach
• FOUR REGIONS
• Near heart is cardiac
region, surrounding
lower esophageal
sphincter
• Fundus, lateral and
slightly superior to
cardiac region,
temporarily holds food
as it enters stomach

Stomach
• FOUR REGIONS
• Body is mid portion of
stomach
• Funnel-shaped, terminal
end of stomach called
pylorus; most of work
of stomach performed
here; where food passes
through pyloric sphincter
into small intestine

Stomach
Food “churned up” by muscles of the stomach
• Muscular action works
like cement mixer,
achieved by three
layers of muscles:
longitudinal layer,
circular layer, and
oblique layer

Stomach
• Churns food as it
mixes with gastric
juices excreted by
gastric glands in
gastric pits of
columnar epithelial
lining of stomach

Stomach
• Works food toward
pyloric sphincter
through peristaltic
activity of
muscles
• Both chemical and
physical digestion
occurs here

Stomach
Stomach-Gastric Juices
• Pepsin, chief digestive
enzyme
• Pepsin breaks down
protein; HCl breaks
down connective tissue

Stomach-Gastric Juices
• HCl has pH of 1.5 to 2;
effective at killing
pathogens
• Mucous cells generate
thick layer of mucus
shielding stomach from
effects of HCl

Stomach-Gastric Juices
• Stomach also secretes
intrinsic factor, allowing
vitamin B12 to be
absorbed

Stomach-Vitamin 12 Absorbed
Table 15-1 Gastric
Glands and Their
Functions
• Activity controlled by
parasympathetic
nervous system,
particularly vagus
nerve
• Vagus nerve
stimulation
increases motility
and secretory
rates of gastric
glands

Stomach
Three Phases

Gastric Juice Production
Cephalic phase
Sensory stimulation (sight or
smell of food) stimulates
parasympathetic nervous
system via medulla
oblongata, stimulating
release of gastrin which
travels through bloodstream
and reaches stomach,
stimulating gastric gland
activity

Gastric Juice Production
Gastric phase
•Two-thirds of gastric juices
secreted as food enters
stomach and distends,
signaling stomach to secrete
more gastric fluid

Gastric Juice Production
Intestinal phase
•Food enters duodenum,
distending and sensing
acidity, causing intestinal
hormones to be released,
slowing gastric gland
secretions; lasts until bolus
leaves duodenum

Gastric Juice Production
Figure 15-9
Mechanisms of peptic
ulcers and GERD
• Located in central
and lower
abdomen
• Functions as major
organ of digestion;
where most of food
digested

Small Intestine
• Small in diameter,
not length; longest
section of alimentary
canal; length up to
20 feet and
diameter ranging
from 4 cm where it
connects to stomach
and 2.5 cm where it
meets large intestine

Small Intestine
Walls secrete digestive
enzymes, important for
final stages of chemical
digestion, and two
hormones that stimulate
pancreas and
gallbladder to act, and
control stomach activity

Figure 15-10
The small intestine.
Villi in small intestine increase
surface area for absorption
• 80% of absorption of
usable nutrients
occurs when chyme
comes in contact with
mucosal walls; amino
acids, fatty acids,
simple sugars, vitamins,
and water are all
absorbed here into
bloodstream and cells

Small Intestine-Villi
• Remaining 20%
absorbed in
stomach
• Any residue not
utilized in small
intestine sent to
large intestine for
removal from body

Small Intestine
Duodenum:, located
near head of pancreas;
Jejunum: middle section,
2.5 m long
Ileum: terminal end, 6–
12 feet long; attaches to
large intestine at ileocecal
valve

Small Intestine-3 Sections
• Pancreas and
gallbladder add
secretions: bile from
gallbladder
• Pancreatic juice
from pancreas
• Bile emulsifies fat,
making fat disperse in
water

Small Intestine-Pancreas &
Gallbladder
• Mechanical and
• Chemical irritation
of acidic chyme, plus
• Distention of
intestinal walls,
creates localized
reflex action that
causes release of
enzymes and two
hormones

Small Intestine
• Secretin from
duodenum stimulates
secretion of enzymes
and sodium
bicarbonate from
pancreas, which
neutralizes acidic
chyme
• Cholecystokinin (CCK)
secreted by duodenum
stimulates gallbladder
activity

Small Intestine-2 Hormones
Table 15-2 Hormones
in the Digestive Process
• Muscular action occurs in
two ways
• Segmentation causes mixing
of chyme and digestive
juices like cement mixer
• Peristalsis moves food
toward large intestine

Small Intestine

Chyme
Acinar cells secrete digestive
enzymes in the small intestine

• Digestive enzymes
needed to
complete
chemical
digestion are
produced by
exocrine cells

Small Intestine
Nutrients travel to Liver
before going to the body
• Capillaries absorb and
transport sugars
(result of carbohydrate
digestion) and amino
acids (result of protein
digestion) to liver for
further processing
before being sent
throughout body

Small Intestine
• Glycerol and fatty acids
(obtained from fat digestion)
are now a white, milky
substance called chyle
• Chyle goes directly into
lymphatic system for
distribution into bloodstream

Small Intestine
Take a Break
• Beginning at
junction of small
intestine, ileocecal
orifice, and
extending to anus is
large intestine,
bordering small
intestine

Large Intestine
Large Intestine
Approximately five feet
long and 2.5 inches in
diameter; divided into
three main regions:
cecum,
colon, and
rectum
Pouch-shaped structure,
cecum, receives
undigested food and
water from ileum

Figure 15-12
The large intestine.
• Some of water used in
digestion and
electrolytes
reabsorbed in cecum
and ascending
colon; water absorbed
is small amount, but
crucial to maintaining
proper fluid balance

Large Intestine
• Attached to
cecum
• Three inches
long, slender,
hollow, deadend tube lined
with
lymphatic
tissue

Appendix
• Reservoir for
useful bacteria
to replace
bacteria lost
in intestines
as result of
diseases

Appendix
• If becomes
blocked or
inflamed, causes
appendicitis and
must be treated
with either
antibiotics or
surgical removal

Appendix
• Four sections of
colon:
•
•
•
•
•

Ascending,
Transverse,
Descending, and
Sigmoid
Ascending colon travels
up right side to level of
liver

Large Intestine
• Transverse colon
travels across
abdomen just below
liver and stomach
• Descending colon
bends downward near
spleen and travels to
left side becoming
sigmoid colon

Large Intestine
• Sigmoid colon
extends to rectum
• Rectum opens to anal
canal that leads to
anus
• Anus relaxes and
opens to allow
passage of solid waste
(feces)

Large Intestine
• Peristalsis continues
in large intestine, but
at slower rate
• As slower
intermittent waves
move fecal matter
toward rectum,
water is removed,
turning it from
watery soup to
semisolid mass

Large Intestine
• As rectum fills
with feces,
defecation reflex
occurs, which
causes rectal
muscles to
contract and
anal sphincters
to relax

Rectum
• If fecal matter moves
through too rapidly,
not enough water is
removed and
diarrhea occurs
• Conversely, if fecal
matter remains too
long in large
intestine, too much
water is removed and
constipation occurs

Diarrhea/Constipation
• Bacteria in bowel play
two important roles:
• Help break down
indigestible materials
• Produce B complex
vitamins and most of
vitamin K needed for
proper blood clotting

Large Intestine
• Besides salivary glands found in mouth, other
accessory organs needed for digestion:
• Liver
• Gallbladder
• Pancreas

Accessory Organs
• Weighs 1.5 kg, located
below diaphragm;
largest glandular organ
in body, and largest
organ in abdomino
pelvic cavity
• Organ performs many
functions vital to life

Liver
• Divided into large
right lobe and
smaller left lobe;
right side has
anterior lobe and
two smaller,
inferior lobes

Liver
• Receives about 1.5
quarts of blood every
minute from portal
vein (carrying blood
full of end products of
digestion) and
hepatic artery
(providing oxygen-rich
blood)

Liver-Portal Vein
Figure 15-15
The liver.
Liver-Functions
Liver-Functions
Liver-Functions
• Secretion of
hormone secretin
stimulates bile
production, critical
liver digestive
function

Liver and Bile Production
• Salts found in bile
act like detergent,
breaking fat up
into tiny
droplets; process
called
emulsification,
making work of
digestive enzymes
easier

Liver and Bile Production
• Bile helps absorb
fat from small
intestine and
transports bilirubin
and excess
cholesterol to
intestine for
elimination

Liver and Bile Production
• Bile leaves liver via
hepatic duct,
travels through
cystic duct to
gallbladder, and is
stored there until
needed by small
intestine

Gallbladder Stores Bile
• Sac-shaped
organ, 3 to 4
inches long,
located under
liver's right lobe

Gallbladder
• While storing bile
absorbs much of its
water content,
making it 6 to 10
times more
concentrated; if too
much water
reabsorbed, bile salts
may solidify into
gallstones

Gallbladder and Gallstones
• Fatty foods in
duodenum cause
release of CCK
• Release causes
smooth muscle walls
of gallbladder to
contract, squeezing
bile into cystic duct,
through common bile
duct, and into the
duodenum

Gallbladder and Bile
Secretes insulin from cells in Islets of Langerhans
• Plays role in
digestion, as well as
being endocrine
gland
• 6 to 9 inches long,
located posterior to
stomach, and
extends laterally
from duodenum to
spleen

Pancreas
• Exocrine portion
secretes buffers
and digestive
enzymes through
pancreatic duct to
duodenum

Pancreas
• Buffers needed to
neutralize acidity
of chyme, to pH
ranging from 7.5 to
8.8, saving
intestinal walls
from damage

Pancreas
Pancreas-Digestive Enzymes
• Generally include one
or more of the
following:
•
•
•
•

Vomiting
Diarrhea
Constipation
Abdominal pain

Common Symptoms of Digestive
System Disorders
• Vomiting
• Protective
mechanism, ridding
digestive tract of
irritant or overload
of food that
stimulates sensory
fibers, sending signal
to vomiting center in
brain

Common Symptoms of
Digestive System Disorders
• Vomiting
• Motor impulses sent
to diaphragm and
abdominal muscles
to contract,
squeezing
sphincter at
esophageal
opening, and
contents are
regurgitated

Common Symptoms of
Digestive System Disorders
• Diarrhea
• Fluid contents in small
intestine rushed through
large intestine without
reabsorbing enough
water
• Proper absorption of
electrolytes and
nutrients prevented;
can cause serious
problems

Common Symptoms of
Digestive System Disorders
• Diarrhea
• Frequent loose and
watery bowel
movements
• Caused by infection,
poor diet, toxins,
food allergies or
irritants, and stress

Common Symptoms of
Digestive System Disorders
• Constipation
• Opposite of
diarrhea; feces
pass too slowly
through colon
and too much
water is
reabsorbed;
stool becomes
hard, dry,
difficult to pass

Common Symptoms of Digestive
System Disorders
• Constipation
• May be over
stimulation of
musculature of
intestine
creating more
narrow passage
for material

Common Symptoms of
Digestive System Disorders
• Constipation
• May be musculature has
become flaccid or slow
as often found in
bedridden geriatric
patients

Typical “FOS” Xray

Common Symptoms of Digestive
System Disorders
• Constipation
• Dietary changes with
more liquid, more
roughage,
reestablishment of
regular bowel habits,
avoidance of
stress/tension,
moderate exercise can
contribute to improving
condition

Common Symptoms of Digestive
System Disorders
• Constipation
• Chronic use of
laxatives and
enemas should be
avoided; may
aggravate existing
conditions or create
new ones

Common Symptoms of Digestive
System Disorders
• Pain

Large amount of gas can cause
temporary pain until released

• Can be sharp, dull,
localized, diffuse,
radiating,
occasional, or
constant
• Severity of pain does
not always indicate
severity of disease

Common Symptoms of Digestive
System Disorders
• Pain
• Stomach cancer may initially present with relatively mild
form of indigestion
• Any pain from GI tract should be investigated

Common Symptoms of Digestive
System Disorders
Review SOAP Note on
Gastrointestinal
Disease

Watch video in
class (not
available online)

Case Study

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The Digestive System: Breaking Down Food for Energy

  • 2. • Takes in (ingests) raw material • Breaks it down (digests) both physically and chemically to usable elements • Absorbs those elements • Eliminates what isn't usable Gastrointestinal System
  • 4. • Digestive tract, often called alimentary tract or canal, is muscular tube that contains organs of digestion • Tube begins with mouth and ends at anus Alimentary Canal
  • 9. • Mouth (oral cavity) is mucous-lined opening; also called buccal cavity • Lips (labia) act as door to cavity • Hard and soft palates create roof Oral Cavity
  • 10. • Tongue acts as floor • Tongue's base and uvula act as boundary between oral cavity and pharynx Oral Cavity-Tongue is Border
  • 11. • Uvula aids in swallowing, directing food toward pharynx and blocking food from entering nose • Tonsils help in fighting infection as part of lymphatic system • Teeth for grinding food Oral Cavity-Uvula, Teeth & Tonsils
  • 12. Salivary Glands Begin Breakdown of Food • Sides of cavity created by cheeks • Mouth receives, tastes, mechanically breaks down, and begins process of chemical breakdown of food, adding saliva Oral Cavity
  • 13. Figure 15-2 The mouth and oral cavity.
  • 14. • Tongue is muscle that provides taste stimuli to brain, determines temperature, manipulates food, aids in swallowing • As tongue moves food around in oral cavity, saliva added to moisten and soften it, while teeth crush food Tongue
  • 15. • Tongue pushes food into ball-like mass, called bolus, so it may be swallowed, passed to pharynx Tongue
  • 16. • Lingual frenulum, membrane under tongue, keeps you from swallowing your tongue and aids in speaking Tongue-The Frenulum
  • 18. Large Parotid Salivary Gland • Controlled by autonomic nervous system • Found slightly inferior and anterior to each ear; these swell when you get mumps Salivary Glands-3 Pairs
  • 19. Sublingual and Submandibular Salivary Gland • Sublingual salivary glands: located under tongue • Submandibular salivary glands: on both sides along inner surfaces of mandible, or lower jaw Salivary Glands-3 Pairs
  • 20. *Sight of food can stimulate secretion of saliva* • Salivary glands produce 1–1.5 liters of saliva daily • Saliva is 99.4% water; contains antibodies, buffers, ions, waste products, and enzymes Salivary Glands
  • 21. Salivary Amylase breaks down Carbohydrates • Enzymes are biological catalysts to speed up chemical reactions • Salivary amylase: speeds chemical activity of breaking down carbohydrates Salivary Glands-Enzymes
  • 22. Ptyalin converts starches to simple sugars • Enzymes are biological catalysts to speed up chemical reactions • Ptyalin: specific salivary amylase that converts starches to simple sugars Salivary Glands-Enzymes
  • 23. • After eating, saliva cleans oral surfaces, reducing amount of bacteria that grows in mouth Less bacteria in the mouth Saliva Cleans Teeth
  • 25. • Nasopharynx: primarily part of respiratory system, • Oropharynx and laryngopharynx: act as passageway for food, water, and air • Epiglottis: covers trachea to prevent food from entering lungs, forcing food into opening for esophagus Pharynx-3 Parts
  • 26. • Approximately ten inches long; connected to stomach • Extends from pharynx, through thoracic cavity, and diaphragm, connecting to stomach in peritoneal cavity Esophagus
  • 27. • Rhythmic contractions, called peristalsis, pushes food down esophagus Esophagus-Peristalsis
  • 28. • Pharyngo esophageal sphincter, relaxes to open esophagus so food can enter • Walls lined with stratified squamous epithelium that secrete mucus to make walls slippery Esophagus
  • 29. Condition called GERD caused by incompetent sphincter • At entrance to stomach is lower esophageal sphincter, or cardiac sphincter, opening door to stomach and closing to prevent acidic gastric juices from splashing into esophagus causing heartburn Esophagus
  • 30. Located under the diaphragm, mid to left upper quadrant Stomach • Approximately ten inches long with diameter dependent on how much just eaten • Can hold up to four liters when filled • Rugae, or folds, help stomach expand and contract
  • 32. • Liquids pass through fairly quickly • Carbohydrates move through quickly • Proteins take more time to pass through • Fats take longest, usually between 4 to 6 hours Stomach Movement of material through stomach
  • 33. • FOUR REGIONS • Near heart is cardiac region, surrounding lower esophageal sphincter • Fundus, lateral and slightly superior to cardiac region, temporarily holds food as it enters stomach Stomach
  • 34. • FOUR REGIONS • Body is mid portion of stomach • Funnel-shaped, terminal end of stomach called pylorus; most of work of stomach performed here; where food passes through pyloric sphincter into small intestine Stomach
  • 35. Food “churned up” by muscles of the stomach • Muscular action works like cement mixer, achieved by three layers of muscles: longitudinal layer, circular layer, and oblique layer Stomach
  • 36. • Churns food as it mixes with gastric juices excreted by gastric glands in gastric pits of columnar epithelial lining of stomach Stomach
  • 37. • Works food toward pyloric sphincter through peristaltic activity of muscles • Both chemical and physical digestion occurs here Stomach
  • 39. • Pepsin, chief digestive enzyme • Pepsin breaks down protein; HCl breaks down connective tissue Stomach-Gastric Juices
  • 40. • HCl has pH of 1.5 to 2; effective at killing pathogens • Mucous cells generate thick layer of mucus shielding stomach from effects of HCl Stomach-Gastric Juices
  • 41. • Stomach also secretes intrinsic factor, allowing vitamin B12 to be absorbed Stomach-Vitamin 12 Absorbed
  • 42. Table 15-1 Gastric Glands and Their Functions
  • 43. • Activity controlled by parasympathetic nervous system, particularly vagus nerve • Vagus nerve stimulation increases motility and secretory rates of gastric glands Stomach
  • 45. Cephalic phase Sensory stimulation (sight or smell of food) stimulates parasympathetic nervous system via medulla oblongata, stimulating release of gastrin which travels through bloodstream and reaches stomach, stimulating gastric gland activity Gastric Juice Production
  • 46. Gastric phase •Two-thirds of gastric juices secreted as food enters stomach and distends, signaling stomach to secrete more gastric fluid Gastric Juice Production
  • 47. Intestinal phase •Food enters duodenum, distending and sensing acidity, causing intestinal hormones to be released, slowing gastric gland secretions; lasts until bolus leaves duodenum Gastric Juice Production
  • 48. Figure 15-9 Mechanisms of peptic ulcers and GERD
  • 49. • Located in central and lower abdomen • Functions as major organ of digestion; where most of food digested Small Intestine
  • 50. • Small in diameter, not length; longest section of alimentary canal; length up to 20 feet and diameter ranging from 4 cm where it connects to stomach and 2.5 cm where it meets large intestine Small Intestine
  • 51. Walls secrete digestive enzymes, important for final stages of chemical digestion, and two hormones that stimulate pancreas and gallbladder to act, and control stomach activity Figure 15-10 The small intestine.
  • 52. Villi in small intestine increase surface area for absorption • 80% of absorption of usable nutrients occurs when chyme comes in contact with mucosal walls; amino acids, fatty acids, simple sugars, vitamins, and water are all absorbed here into bloodstream and cells Small Intestine-Villi
  • 53. • Remaining 20% absorbed in stomach • Any residue not utilized in small intestine sent to large intestine for removal from body Small Intestine
  • 54. Duodenum:, located near head of pancreas; Jejunum: middle section, 2.5 m long Ileum: terminal end, 6– 12 feet long; attaches to large intestine at ileocecal valve Small Intestine-3 Sections
  • 55. • Pancreas and gallbladder add secretions: bile from gallbladder • Pancreatic juice from pancreas • Bile emulsifies fat, making fat disperse in water Small Intestine-Pancreas & Gallbladder
  • 56. • Mechanical and • Chemical irritation of acidic chyme, plus • Distention of intestinal walls, creates localized reflex action that causes release of enzymes and two hormones Small Intestine
  • 57. • Secretin from duodenum stimulates secretion of enzymes and sodium bicarbonate from pancreas, which neutralizes acidic chyme • Cholecystokinin (CCK) secreted by duodenum stimulates gallbladder activity Small Intestine-2 Hormones
  • 58. Table 15-2 Hormones in the Digestive Process
  • 59. • Muscular action occurs in two ways • Segmentation causes mixing of chyme and digestive juices like cement mixer • Peristalsis moves food toward large intestine Small Intestine Chyme
  • 60. Acinar cells secrete digestive enzymes in the small intestine • Digestive enzymes needed to complete chemical digestion are produced by exocrine cells Small Intestine
  • 61. Nutrients travel to Liver before going to the body • Capillaries absorb and transport sugars (result of carbohydrate digestion) and amino acids (result of protein digestion) to liver for further processing before being sent throughout body Small Intestine
  • 62. • Glycerol and fatty acids (obtained from fat digestion) are now a white, milky substance called chyle • Chyle goes directly into lymphatic system for distribution into bloodstream Small Intestine
  • 64. • Beginning at junction of small intestine, ileocecal orifice, and extending to anus is large intestine, bordering small intestine Large Intestine
  • 66. Approximately five feet long and 2.5 inches in diameter; divided into three main regions: cecum, colon, and rectum Pouch-shaped structure, cecum, receives undigested food and water from ileum Figure 15-12 The large intestine.
  • 67. • Some of water used in digestion and electrolytes reabsorbed in cecum and ascending colon; water absorbed is small amount, but crucial to maintaining proper fluid balance Large Intestine
  • 68. • Attached to cecum • Three inches long, slender, hollow, deadend tube lined with lymphatic tissue Appendix
  • 69. • Reservoir for useful bacteria to replace bacteria lost in intestines as result of diseases Appendix
  • 70. • If becomes blocked or inflamed, causes appendicitis and must be treated with either antibiotics or surgical removal Appendix
  • 71. • Four sections of colon: • • • • • Ascending, Transverse, Descending, and Sigmoid Ascending colon travels up right side to level of liver Large Intestine
  • 72. • Transverse colon travels across abdomen just below liver and stomach • Descending colon bends downward near spleen and travels to left side becoming sigmoid colon Large Intestine
  • 73. • Sigmoid colon extends to rectum • Rectum opens to anal canal that leads to anus • Anus relaxes and opens to allow passage of solid waste (feces) Large Intestine
  • 74. • Peristalsis continues in large intestine, but at slower rate • As slower intermittent waves move fecal matter toward rectum, water is removed, turning it from watery soup to semisolid mass Large Intestine
  • 75. • As rectum fills with feces, defecation reflex occurs, which causes rectal muscles to contract and anal sphincters to relax Rectum
  • 76. • If fecal matter moves through too rapidly, not enough water is removed and diarrhea occurs • Conversely, if fecal matter remains too long in large intestine, too much water is removed and constipation occurs Diarrhea/Constipation
  • 77. • Bacteria in bowel play two important roles: • Help break down indigestible materials • Produce B complex vitamins and most of vitamin K needed for proper blood clotting Large Intestine
  • 78. • Besides salivary glands found in mouth, other accessory organs needed for digestion: • Liver • Gallbladder • Pancreas Accessory Organs
  • 79. • Weighs 1.5 kg, located below diaphragm; largest glandular organ in body, and largest organ in abdomino pelvic cavity • Organ performs many functions vital to life Liver
  • 80. • Divided into large right lobe and smaller left lobe; right side has anterior lobe and two smaller, inferior lobes Liver
  • 81. • Receives about 1.5 quarts of blood every minute from portal vein (carrying blood full of end products of digestion) and hepatic artery (providing oxygen-rich blood) Liver-Portal Vein
  • 86. • Secretion of hormone secretin stimulates bile production, critical liver digestive function Liver and Bile Production
  • 87. • Salts found in bile act like detergent, breaking fat up into tiny droplets; process called emulsification, making work of digestive enzymes easier Liver and Bile Production
  • 88. • Bile helps absorb fat from small intestine and transports bilirubin and excess cholesterol to intestine for elimination Liver and Bile Production
  • 89. • Bile leaves liver via hepatic duct, travels through cystic duct to gallbladder, and is stored there until needed by small intestine Gallbladder Stores Bile
  • 90. • Sac-shaped organ, 3 to 4 inches long, located under liver's right lobe Gallbladder
  • 91. • While storing bile absorbs much of its water content, making it 6 to 10 times more concentrated; if too much water reabsorbed, bile salts may solidify into gallstones Gallbladder and Gallstones
  • 92. • Fatty foods in duodenum cause release of CCK • Release causes smooth muscle walls of gallbladder to contract, squeezing bile into cystic duct, through common bile duct, and into the duodenum Gallbladder and Bile
  • 93. Secretes insulin from cells in Islets of Langerhans • Plays role in digestion, as well as being endocrine gland • 6 to 9 inches long, located posterior to stomach, and extends laterally from duodenum to spleen Pancreas
  • 94. • Exocrine portion secretes buffers and digestive enzymes through pancreatic duct to duodenum Pancreas
  • 95. • Buffers needed to neutralize acidity of chyme, to pH ranging from 7.5 to 8.8, saving intestinal walls from damage Pancreas
  • 97.
  • 98. • Generally include one or more of the following: • • • • Vomiting Diarrhea Constipation Abdominal pain Common Symptoms of Digestive System Disorders
  • 99. • Vomiting • Protective mechanism, ridding digestive tract of irritant or overload of food that stimulates sensory fibers, sending signal to vomiting center in brain Common Symptoms of Digestive System Disorders
  • 100. • Vomiting • Motor impulses sent to diaphragm and abdominal muscles to contract, squeezing sphincter at esophageal opening, and contents are regurgitated Common Symptoms of Digestive System Disorders
  • 101. • Diarrhea • Fluid contents in small intestine rushed through large intestine without reabsorbing enough water • Proper absorption of electrolytes and nutrients prevented; can cause serious problems Common Symptoms of Digestive System Disorders
  • 102. • Diarrhea • Frequent loose and watery bowel movements • Caused by infection, poor diet, toxins, food allergies or irritants, and stress Common Symptoms of Digestive System Disorders
  • 103. • Constipation • Opposite of diarrhea; feces pass too slowly through colon and too much water is reabsorbed; stool becomes hard, dry, difficult to pass Common Symptoms of Digestive System Disorders
  • 104. • Constipation • May be over stimulation of musculature of intestine creating more narrow passage for material Common Symptoms of Digestive System Disorders
  • 105. • Constipation • May be musculature has become flaccid or slow as often found in bedridden geriatric patients Typical “FOS” Xray Common Symptoms of Digestive System Disorders
  • 106. • Constipation • Dietary changes with more liquid, more roughage, reestablishment of regular bowel habits, avoidance of stress/tension, moderate exercise can contribute to improving condition Common Symptoms of Digestive System Disorders
  • 107. • Constipation • Chronic use of laxatives and enemas should be avoided; may aggravate existing conditions or create new ones Common Symptoms of Digestive System Disorders
  • 108. • Pain Large amount of gas can cause temporary pain until released • Can be sharp, dull, localized, diffuse, radiating, occasional, or constant • Severity of pain does not always indicate severity of disease Common Symptoms of Digestive System Disorders
  • 109. • Pain • Stomach cancer may initially present with relatively mild form of indigestion • Any pain from GI tract should be investigated Common Symptoms of Digestive System Disorders
  • 110. Review SOAP Note on Gastrointestinal Disease Watch video in class (not available online) Case Study