basics of digestive system in children and infants

1. By
Kavan vyas
203

3. Oral cavity is relatively small, and the tongue is
large.
 In the center of the upper lip protruding platen
size 3-4 mm. Transverse orogeny on the lips.
 Chewing muscles are well developed muscles
and lips.
 Lumps of Bichat (thick fat pads).
 In the first 3 months of saliva is formed by a
little, it is used to seal the mouth.

4.  Mucous membrane is a thin, tender, has many
vessels.
 Prior to the year of entry into the larynx is
situated high above the lower rear edge of the
Palatine curtains.
 Salivary gland function with the first days of
life, but the lack of saliva secretion and
increased to 2-3 months, and 6 months from the
4 - physiological salivation, saliva pH neutral at
first, then alkaline.
 Saliva contains amylase, lysozyme, Ig A,…

5.  The activity of amylase rises to 1-4 years.
 Bactericidal action of saliva low.
 In infants lowered Ig A saliva.
 The Act of sucking consists of 3 's phases: a
phase of aspiration phase squeezing the nipple,
a phase of swallowing.
 The Act of sucking is provided unconditional
reflexes-sucking and swallowing, these reflexes
are well expressed immediately after birth.

6.  Funnel shape of the esophagus before 3 years.
 Entrance into the esophagus is located between
the 3rd and 4th cervical vertebrae, in the 12
years between the VI-VII.
 Relatively large sizes: newborn-10 cm, 5 years-
15 cm, 15 years old-20 cm., adult-25 cm.
 Mucous has many vessels.
 Weak muscle fibers and connective tissue.

7.  Form the stomach depends on the amount
and consistency of adopted food.
 The volume of the stomach in the newborn 7
ml., volume increases with age: 10 days-80 ml,
year-250 ml, 3 year-500 ml., 12 years 1500 ml.
 At an early age the stomach is horizontal, the
year the child begins to walk and the stomach
gradually adopts the vertical position.

8.  The muscular layer of the stomach at an early
age are underdeveloped, particularly
underdeveloped cardiac sphincter (hiatus).
 Muscles of the pylorus to the contrary
expressed strongly that promotes
pilorospazme.
 The mucosa of a relatively thick, the number
of glands in the newborn is low (2 million)
and increases with age (adult-25 million.).

9.  Newborn cardiac sphincter, violation of
technology of feeding, the imperfection of the
neuroendocrine regulation often lead to
aerophagia and regurgitation.
 The main cells that produce pepsin,
developmentally disabled.
 In adequate quantity, reduced function of the
parietal gland that produce hydrochloric acid.
 Few Goblet cells mucin producing.

10.  after birth of gastric juice produced little
acidity is low, the protein pepsin cleavage is
absent.
 Breaks down protein in the stomach himozin
(rennet enzyme), its activity increases with
age.
 Fats are broken down by the action of lipase,
which also occurs in human milk.
 In children who are breastfed, the evacuation
of the food faster.

11.  Small intestine in a newborn relative to body
length longer than the adult.
 Slimy slim, has a many vessels, has a lot of lint.
Epithelial cells quickly updated.
 Intestinal glands larger.
 Long mesentery, which contributes to
intussusception and volvulus.

12.  At the time of the birth of large intestine
immature.
 Formation of the cecum, the year ends at an
early age she more limber.
 The rising part of the colon until 4 years more
downward.
 Transverse part of the colon takes the
horizontal position for 2 years.
 Sigmoid colon in the newborn is long and
mobile, to 5 years is located in the abdominal
cavity, and then in the pelvis.

13.  Rectum in preschool children is located over
the entrance of the small pelvis,
schoolchildren in the pelvis.
 In the rectum underdeveloped muscular layer
of the mucosa and submucosa fixing weak
shells at an early age, that creates the
preconditions to its loss.
 After the birth of a child from the rectum
during 1-3 days with meconium is allocated,
from 3-day transitional feces, with 5 days-
normal.

14.  Up to 3 years more unsteady, not sufficiently
differentiated.
 Tubules, capsule pancreas less dense and
more malleable (never her strong
compression).
 Diameter of the main pancreatic duct
throughout the same.
 These features contribute to more frequent
defeat pancreas and easier flow of
pancreatitis in children.

15.  Secretes pancreatic juice containing organic
(albumins, globulins, enzymes) and
nonorganic (Na, K, P, Ca, Cl, Zn, Mg,
bicarbonate) substances.
 Produced enzymes 3-groups: Cleave proteins:
trypsin, chymotrypsin, pancreatic amylase,
splitting carbohydrates: amylase, maltase;
splitting fats: lipase.
 Secretes hormones: insulin, glucagon,
somatostatin, lipokain, etc. hormone-like
substances.

16. Relatively large (4.4% of newborn and adult 2.8%
of body weight).
The left fraction of the liver in the newborn of
large sizes, it is reduced to the age of 1.5 years.
The lower edge of the liver in children up to 2-3
years to 2-3 cm, and up to 5-7 years in the 1-2 cm.
advocates of the hypochondrium and more
mobile.
Vaguely expressed liver lobulation (it is formed
by the end of the 1-th year of life).

17.  In infants the liver parenchyma,
differentiation is incomplete differs
inadequate connective tissue, abundant
vascularization.
 The functionality of the liver are low,
especially the inadequate newborn system
enzyme (indirect bilirubin metabolism
deficient, the consequence is a physiologic
jaundice).
 Bile production in children occurs less
intensively than in adults.

18.  The newborn’s GALL BLADDER is located
deep inside the liver and has a fusiform
shape, its length is about 3 cm. A typical pear-
shaped acquires to 6-7 months and reaches
the edge of the liver to 2 years.
 Bile acids, bile salts is poor and cholesterol,
but rich in water, mucin, pigments, and in the
neonatal period - urea.
 The predominance of taurocholic acid on
glycocholic acid enhances the bactericidal
action of bile and pancreatic juice branch.

19.  Burp air.
 Heartburn (antral gastritis, gastroduodenitis,
peptic ulcer, duodenal ulcer).
 Nausea.
 Vomiting (In peptic ulcer disease vomiting
combined with pain syndrome and usually
brings relief to a patient).
 Violations of the stool (usually a tendency to
constipation).

20.  A blood test for liver function tests: total
bilirubin, direct, indirect; ALT, AST; thymol
and sublimate samples, alkaline phosphatase
 Ultrasound examination
 Сholecystography
 Scintigraphy of the liver
 Duodenal intubation and fractional duodenal
intubation
 Scatological study stool