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Digestion - mechanical ( larger to smaller particles) and chemical ( complex to simple chemicals) breakdown of foods into forms that cells can absorb. Four functions: 1. Ingestion - selective intake of nutrients 2. Digestion - breakdown of molecules; mechanical and chemical 3. Absorption - uptake of nutrients by digestive tract, blood and lymph 4. Defecation - elimination of undigested residue.
Digestion - mechanical ( larger to smaller particles) and chemical ( complex to simple chemicals) breakdown of foods into forms that cells can absorb. Four functions: 1. Ingestion - selective intake of nutrients 2. Digestion - breakdown of molecules; mechanical and chemical 3. Absorption - uptake of nutrients by digestive tract, blood and lymph 4. Defecation - elimination of undigested residue.
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Digestion - mechanical ( larger to smaller particles) and chemical ( complex to simple chemicals) breakdown of foods into forms that cells can absorb. Four functions: 1. Ingestion - selective intake of nutrients 2. Digestion - breakdown of molecules; mechanical and chemical 3. Absorption - uptake of nutrients by digestive tract, blood and lymph 4. Defecation - elimination of undigested residue.
Авторское право:
Attribution Non-Commercial (BY-NC)
Доступные форматы
Скачайте в формате PPT или читайте онлайн в Scribd
particles) and chemical ( complex to simple chemicals) breakdown of foods into forms that cells can absorb Digestive System • DIGESTIVE TRACT – tube ~ 9 m long • Gastrointestinal tract or Alimentary canal • DIGESTIVE ORGANS - Oral cavity, pharynx, esophagus, stomach, small intestine, large intestine, anal canal • ACCESSORY ORGANS - teeth, tongue, salivary glands, liver, gallbladder, pancreas Digestive functions & processes • FOUR FUNCTIONS • 1. Ingestion – selective intake of nutrients • 2. Digestion – breakdown of molecules; mechanical & chemical • 3. Absorption – uptake of nutrients by digestive tract, blood & lymph • 4. Defecation – elimination of undigested residue Digestive Processes • 1. Motility – muscle contractions – Break up food – mastication, churning of stomach – Propel thru canal - peristalsis – Mix with digestive enzymes - segmentation • 2. Secretion – enzymes, hormones to carry out or regulate digestion • 3. Membrane transport – absorbing nutrients to blood and lymph Stages of Digestion • MECHANICAL DIGESTION • Physical breakdown • Teeth – cutting and grinding - mastication –(chewing) • Churning – stomach & small intestine • Action of digestive enzymes – food to small particles • CHEMICAL DIGESTION • Macromolecules to monomers • Polysaccharides to monosaccharides • Proteins to amino acids • Fats to glycerol and fatty acids • Nucleic acids to nucleotides • Done by digestive enzymes produced by: • Salivary glands, stomach, pancreas, small intestine • Absorbed – no digestion – vitamins, free amino acids, minerals, cholesterol, water Mouth • Oral or Buccal cavity • Receives food • Begins mechanical digestion • Ingestion, taste, mastication ( chewing), chemical digestion( starch) , deglutition ( swallowing), speech , respiration • Enclosed by cheeks, lips, palate, tongue • Lined – non-keratinized stratified squamous epithelium Cheeks & Lips • Form lateral walls of mouth – skin, adipose, muscles • Retain food; mastication; Speech articulation • Sucking and blowing actions • SUPERIOR AND INFERIOR LABIAL FRENULUM attaches lip to gum • VESTIBULE – space between cheeks and lips, external to teeth • Lips – surround mouth opening; skeletal muscle & sensory receptors – temperature & food texture Tongue • Muscular, bulky, thick • Manipulates food, moves food to pharynx • Lingual papillae – bumps & projections, taste buds, provides friction • Lingual tonsils (lymphatic tissue) at root which attaches to hyoid bone • Lingual frenulum – membranous fold attaches body to floor of mouth Palate Fig 17.7 • Separates oral cavity and nasal cavity • Anterior – bony palate; Posterior – soft palate; uvula(cone shaped projection) • Palatine tonsils on each side of oral cavity – swollen can block swallowing & breathing – Protect body against infections During swallowing soft palate rises to block nasal cavity Pharyngeal tonsils ( adenoids) – posterior wall – pharynx; above soft palate Teeth Fig 17.9; Table 17.2 • Called dentition; Adults – 32 teeth • On each side of jaw – – Incisors – 2 – chisel-like cutting – Canines – 1 – puncture & shred – Premolar – 2 & molar – 3 – crushing & grinding • Children – 20 deciduous teeth – Erupt 6 to 30 months • Between 6 yrs and 25 yrs lost and replaced = permanent teeth • Wisdom teeth – 17 and 25 yrs • Fig 17.10 • Alveolus – socket for tooth • Alveolus lined with peridontal ligament – anchors tooth • Gingiva – gum covers alveolar bone • Crown – tooth above gumline • Neck – from gum to alveolar bone • Root – in alveolus • Dentin – hard, yellowish tissue; most of tooth • Enamel – covers crown and neck • Cementum – covers root • Dentin & cementum – living; Enamel , not • Internally – tooth – • Pulp cavity – crown • Root canal – root • Contain pulp – loose connective tissue, blood & lymphatic vessels, nerves
• Plaque bacteria + sugars acids dental
caries • Plaque calcifies = tartar gingivitis peridontal disease = 80 to 90 % adult tooth loss • Includes Inflammation of gum & dental pulp Saliva • Moistens mouth & food • Digest some starch and fat • Cleanses teeth • Inhibits bacterial growth • Stimulates taste buds • Moistens food • Binds food particles to aid swallowing Saliva • Mostly water 97 to 99.5% pH = 6.8 to 7.0 • Solutes: • Salivary amylase – begins starch digestion, starch to disaccharides • Lingual lipase – digest fats in stomach; needs low pH • Mucus – binds & lubricates food mass; dissolves food chemicals • Major Salivary Glands Fig 17.11 • EXTRINSIC SALIVARY GLANDS 1 – 1.5 liters of saliva /day • Exocrine glands • 1.PAROTID GLANDS – anterior & inferior to ear – clear, watery saliva & amylase – Stenson’s duct – enters opposite 2nd upper molar • MUMPS – viral inflammation & swelling • 2. SUBMANDIBULAR GLANDS - body of mandible • Secretes serous fluid – serous cells • Wharton’s Ducts – open inferior to tongue near frenulum • 3. SUBLINGUAL GLANDS – floor of mouth – Multiple ducts posterior to submandibular duct ( Rivinus ducts) – Mucous secretions – mucous cells – thick & stringy Pharynx • Connects nasal and oral cavities with larynx & esophagus • Divisions _ nasopharynx, oropharynx, laryngopharynx Fig 17.7 • Superior, middle, inferior PHARYNGEAL CONSTRICTORS – circular – force food down during swallowing Fig 17.13 Divisions • Nasopharynx - air – Most superior to soft palate • Oropharynx - Food & air – Posterior to mouth – Soft palate to esophagus • Laryngopharynx - food – Esophagus to cricoid cartilage – Passageway to esophagus; Wall of alimentary canal • Four tissue layers Table 17.1 • 1. Mucosa or mucous membrane – nonkeratinized stratified squamous epithelium; underlying connective tissue, smooth muscle • Protection, secretion, absorption • Folds & projections > absorptive surface area • Glands secrete mucus & enzymes • 2. Submucosa – loose connective tissue, vessels, nerve plexuses, esophageal glands • Vessels nourish tissue & carry away absorbed materials
• 3. Muscularis externa – inner layer –
circular; outer layer – longitudinal; provides movement of tube • 4. Adventitia ( above diaphragm ) or Serosa ( below diaphragm) • Connective tissue – adventitia • Simple squamous mesothelium and areolar tissue – serosa • Visceral peritoneum – epithelium - outside, connective tissue – inside • Protects; secretes serous fluid – moistens and lubricates Innervation of tube • ENTERIC NERVOUS SYSTEM – regulates motility, secretion, and blood flow • Location – esophagus,stomach, intestines • Two plexuses – submucosal & myenteric – control motility and secretion Swallowing • Deglutition • Coordinated by SWALLOWING CENTER in medulla oblongata & pons • Three stages Fig. 17.14 • 1. buccal stage; voluntary; tongue collects food; pressed against palate = bolus; mastication; push back to oropharynx • 2. Pharyngeal – esophageal phase – bolus stimulates tactile receptors; • Swallowing reflex • A. Soft palate rises, blocks nasopharynx • B. Root of tongue blocks oral cavity • C. Larynx pulls up , epiglottis covers opening, vestibular folds adduct and close airway • Pharyngeal constrictors push bolus downward; bolus into esophagus & triggers PERISTALSIS • 3. Peristalsis • wavelike muscular contraction, pushes food down esophagus, no matter position of body; occurs from pharynx to anus • Liquid – 1-2 sec Bolus – 4 – 8 sec • Esophagus
• Straight muscular tube 25 to 30 cm;
passageway for food • Begins at cricoid cartilage • Thru mediastinum • Thru diaphragm – esophageal hiatus • Meets stomach – cardiac orifice • Cardiac orifice – muscular lower esophageal sphincter to close off area Stomach • Bolus reaches stomach – LOWER ESOPHAGEAL SPHINCTER relaxes and bolus enters. • Muscular sac in LUQ , inferior to diaphragm • Mechanically breaks up food • Chemical breakdown of proteins & fats • Produces CHYME – soupy or pasty mixture of semidigested food Parts of stomach • J – shaped • Regions of stomach: • A.Cardiac region – immediately inside cardiac orifice • B.Fundus – dome shaped portion • C.Body – greatest part inferior to cardiac orifice, main part of stomach • D.Pyloric region – inferior end pouch; antrum – funnel like area narrows to pylorus which is surrounded by pyloric sphincter – regulates chyme into s.i. Stomach Wall • Mucosa – simple columnar glandular epithelium • Mucosa & submucosa - flat and smooth when stomach filled; longitudinal wrinkles when empty = RUGAE • Muscularis externa – Three layers – – Outer – longitudinal – Middle – circular – Inner - oblique • MUCOSA – gastric pits – depressions of columnar epithelium • Cell types include – • Mucous cells – mucus - c & p glands; gastric glands called mucous neck cells • Regenerative cells – produce new cells , base of pit & neck of gland • Parietal cells – upper half of gland, HCl & Intrinsic Factor; most gastric glands, few pyloric glands • Chief cells – rennin & lipase – infancy; pepsinogen throughout life; lower half gastric glands, none in cardiac or pyloric glands • Enteroendocrine cells – lower end of gland, chemical messengers to regulate digestion Gastric Secretions • 2-3- liters gastric juice/day • Hydrochloric Acid – parietal cells • Gastric juice pH = .8 • To keep stomach from being “burned’ by acid • Parietal cells take carbon dioxide from blood & combine with water ( carbonic anhydrase) carbonic acid • Carbonic acid bicarbonate ion + Hydrogen ion • Hydrogen ion pumped into lumen of stomach & exchanged for K by H-K ATP ase • Bicarbonate ion returns to blood and exchanged for a Cl ion which enters lumen • H ion + Cl ion HCl • HCl accumulates in stomach & bicarbonate ions accumulate in blood • pH > in blood leaving stomach when digestion is occurring – called ALKALINE TIDE Stomach acid functions • Activates pepsin & lingual lipase (enzymes) • Breaks up connective tissue & plant cell walls • Converts Fe ions to usable form for hemoglobin synthesis • Destroys ingested bacteria & other pathogens Intrinsic Factor • From parietal cells • Essential in absorption of vitamin B12 by small intestine • No vitamin B 12 – no hemoglobin – pernicious anemia • Pernicious anemia risk > age d/t atrophy of gastric mucosa Pepsin • Zymogens – inactive proteins ( enzymes), general term • Chief cells – pepsinogen • HCl – parietal cells – converts pepsinogen to pepsin • Pepsin digests proteins to shorter peptide chains – digest complete in duodenum Chemical messengers • Gastric and pyloric glands – enteroendocrine cells – hormones (20) • Some secretions –stimulate gastric mucosa within short distance • Some act neurotransmitters – produced by neurons • Ex. Gastrin, serotonin, histamine, somatostatin Table 25.2 Gastric Motility • Swallowing signals stomach to relax – signals from swallowing center of M.O. • Arrival of food stretches stomach - activates receptive – relaxation response – stomach briefly resists stretching , then relaxes to accommodate more food • Peristaltic contractions - churn food, mix with gastric juice, which promotes physical breakup & chemical digestion • ~3 ml of chyme enters duodenum at a time • Duodenum neutralizes stomach acid & digests nutrients • Meal is emptied from stomach ~ 4 hours • Less time – more liquid • More time – more fat Protection of Stomach • 1. Mucous coat – thick, highly alkaline • 2. Epithelial cell replacement – replaced rapidly – 3 to 6 days • 3. Tight junctions – keep gastric juices from seeping between epithelial cells Gastric functions • Gastric juices are produced continuously; rates vary; neural and hormonal control • Parietal cells secrete somatostatin - inhibits gastric secretions • ACh from parasympathetic impulses suppress SS and stimulate gastric secretions – HCL & pepsinogen • Stomach cells – pyloric region – release gastrin ( peptide hormone) - > gastric gland activity • Parasympathetic impulses & gastrin cause release of histamine ( gastric mucosal cells) which stimulate additional gastric secretions Fig 17.21 • Gastrin – hormone produced in pyloric glands; bloodstream; cause release of HCl by parietal cells and pepsinogen by chief cells Regulation of Gastric function • Three stages • 1. CEPHALIC PHASE • M.O. signals stomach by vagus nerve > gastric secretions & motility • Sight, small, taste thought of food = stimulus • Gastric secretions stimulated before food is swallowed • 2. GASTRIC PHASE • Swallowed food & semi-digested proteins activate gastric activity • 2/3 of gastric secretions occur now • Stretching of stomach & raising pH of contents stimulates gastric activity • Gastric secretions is stimulated by – acetylcholine, histamine, gastrin • As protein is digested , more gastrin secreted ( positive feedback system ) , protein digestion accelerated • Below pH = 2 stomach acid inhibits parietal cells– negative feedback loop • And gastric phase ends as the need for pepsin and HCl < • 3. INTESTINAL PHASE • Duodenum receives chyme • reflex - stimulate stomach and enhances gastric secretions • Acid & semidigested fats – duodenum – ENTEROGASTRIC REFLEX –inhibit stomach • Chyme causes enteroendocrine cells of duodenum to release secretin, gastric inhibitory peptide, & cholecystokinin to suppress gastric secretions & motility • Duodenum can now process chyme already received Gastric absorption • Gastric enzymes ( pepsin) breaksdown proteins • Limited absorption – only water, salts, some lipid soluble drugs, alcohol • Most absorption – small intestines Mixing and emptying actions • Food enters stomach; Smooth muscles stretch • Too much food – Stomachache C.A. 17.2 • Mixing movements of stomach wall produces semi-fluid paste = chyme • 5-15 ml moves into S. I. when pyloric sphincter relaxes • Lower esophageal sphincter prevents reflux of stomach contents into esophagus Fig 17.22 • Rate of stomach emptying – fluidity & type of food • Liquids • Carbohydrates • Proteins • Fats • Chyme fills duodenum; > intestinal pressure; intestinal wall stretches • Enterogastric Reflex Fig 17.23 • Begins – intestine; ends – stomach • < parasympathetic impulses; peristalsis inhibited; < intestine filling • Chyme – fatty – CCK released – inhibit peristalsis • Chyme enters duodenum – pancreas, liver, gall bladder add secretions • VOMITING Excess stretch of stomach • Psychological stimuli • Chemical irritants – Alcohol – Bacterial toxins • Emetic center – in m.o. causes lower esophageal sphincter to relax , diaphragm & abdominal muscles contract and stomach contents are expelled • Severe vomiting = contents of s.i. expelled Liver, Gallbladder, Pancreas • LIVER • Reddish, brown gland, inferior to diaphragm, largest gland • Secretes bile • GROSS ANATOMY –four lobes – right , left, caudate, quadrate • Left and right lobe separated by falciform ligament • Round ligament – reminant of umbilical vein Microscopic anatomy • Hepatic lobules – tiny cylinders make up interior of liver; functional units of liver • Lobule – central vein; surrounded by radiating sheets of cuboidal cells – hepatocytes • Between plates of hepatocytes – blood filled channels – hepatic sinusoids • Blood filtering between hepatocytes comes from intestines • Sinusoids – Kupffer cells – hepatic macrophages; removes bacteria & debris from blood • Hepatic triad – 3 or more lobules meet ; contains 2 blood vessels and 1 bile duct • After filtering thru sinusoids blood collects in central vein • Flows into L & R hepatic veins and enters inferior vena cava • Bile canaliculi - narrow channels between sheets of hepatocytes ; liver secretes bile here • Bile passes into bile ductules of triads & into R & L hepatic ducts • Hepatic ducts merge Common hepatic duct • Common hepatic duct + Cystic duct from gallbladder join Bile duct • Bile duct joins Pancreatic duct at Hepatopancreatic ampulla and enters duodenum • Hepatopancreatic sphincter regulates passage of bile and pancreatic juices into duodenum Gallbladder & Bile • Sac on underside of liver • Stores and concentrates bile • Bile – yellow – green fluid • Contains minerals, cholesterol, neutral fats, phospholipids, bile pigments, bile acids (salts) • Bile salts aid in digestion of fats • Excessively concentrated = gallstones • 80% bile salts recycled • 20% bile – excreted in feces Pancreas • Spongy gland – retroperitoneal • Posterior to stomach • Endocrine & exocrine function • Exocrine cells – acinar cells produce 1200 to 1500 ml pancreatic juice /day • Pancreatic duct delivers juices to duodenum • At hepatopancreatic ampulla Pancreatic juices • Water • Enzymes – pancreatic amylase, pancreatic lipase, nucleases • Zymogens – trypsinogen, chymotrypsinogen, procarboxypeptidase( intestinal lumen - trypsinogen activated to trypsin by enterokinase ; trypsin converts chymotrypsinogen chymotrypsin and procarboxypeptidase carboxypeptidase = protein digestion) • Sodium bicarbonate – buffers HCl from stomach Secretion Regulation • Bile & pancreatic juices secreted – parasympathetic and inhibited by sympathetic; stimulated by gastrin, CCK, secretin • Acid & fat enter duodenum – CCK secreted – gallbladder contracts – bile; pancreatic enzymes secreted; h-p sphincter relaxes • Chyme – duodenum – secretes secretin – hepatic bile ducts& pancreatic ducts secrete bicarbonate to neutralize acid in duodenum Small Intestine • Nearly all chemical digestion & nutrient absorption occurs here • Longest part of digestive tract • Circular folds of mucosa , villi, and microvilli – enhance surface area for absorption of nutrients Gross anatomy • Three regions: Fig 17.33 • Duodenum - first 25 cm • Jejunum – next 2.5 m • Ileum – last 3.6 m ; ends at ileocecal junction – joins cecum of large intestine Microscopic anatomy • Largest folds – circular folds – mucosa & submucosa – plicae circularis • From duodenum to middle ileum – mixing & nutrient absorption • Mucosa – projections – villi – largest in duodenum & get smaller – covered by absorptive cells and goblet cells • Core of villus – arteriole, capillary, venule, lacteal • Absorptive cells of villus – microvilli – making a brush border of small intestine - > absorptive area & contains enzymes – enterokinase and enzymes that need chyme to touch brush border ( contact digestion) • Duodenal glands – secrete bicarbonate rich mucus Intestinal motility • 1. Mixes chyme with intestinal juices, bile, pancreatic juice • 2. Churn chyme, aide contact digestion and absorption • 3. Moves residue into large intestine • SEGMENTATION – kneads and churns contents; mixes food & digestive secretions; enhances contact digestion • When most nutrients absorbed, segmentation declines and peristalsis begins • Food in stomach triggers release of gastrin and GASTROILEAL REFLEX - both enhance segmentation in ileum and relaxation of ileocecal valve • CARBOHYDRATES – begin in mouth; completed in S.I.; enters blood by active transport or facilitated diffusion • Glucose – main sugar; galactose; fructose • PROTEINS – begin in stomach; completed in S. I. ;facilitated diffusion – capillaries • Enzymes of pancreas most important in digestion • LIPIDS – lipases; lingual & pancreatic • EMULSIFICATION – Bile salts & lecithin • Break up large fat globules to droplets and pancreatic lipases act on droplets • Triglycerides are coated with bile salts and form droplets called MICELLES which pass into absorptive cells • FFA’s & monoglycerides reform triglycerides - golgi complex coats triglycerides = CHYLOMICRONS – enter lacteal of villus • NUCLEIC ACIDS – decompose to phosphate ions, nitrogenous bases and sugars ( DNA or RNA); Enter capillary • VITAMINS – Fat soluble vitamins – D, E, A, K enter as all lipids do; need fat containing food present to aid in absorption • Water soluble – B complex & vitamin C – simple diffusion; B12 – must be bound to intrinsic factor & taken up by receptor mediated endocytosis in distal ileum • MINERALS – electrolytes; active transport & simple diffusion WATER – 9 L. - 8 L. reabsorbed by s.I. And .8 L by L.I.; .2 L voided Water is absorbed by osmosis
Diarrhea – L.I. Absorbs too little water d/t
intestinal irritation or high solute concentration
Constipation - fecal movement moves too
slowly; too much water reabsorbed d/t lack of fiber or exercise; emotional upset; long – term laxative abuse Large intestine • 1.5 m long • Cecum – blind pouch in LRQ • Vermiform appendix – blind tube at lower end of cecum • Ascending colon – ileocecal valve , along right side of abdominal cavity • Right colic ( hepatic ) flexure – right angle turn near right lobe of liver • Transverse colon – across upper abdominal cavity, • Left colic (splenic) flexure – right angle turn downward near spleen • Descending colon – down left side of abdominal cavity • Sigmoid colon – S-shaped portion • Rectum – in pelvic cavity; stores feces • Anal canal – mucosa forms anal columns, • Distension of veins in this area = HEMORRHOIDS • Anal canal terminates at ANUS • Anus – two sphincters – internal anal sphincter ( smooth muscle) & external anal sphincter ( skeletal muscle) Microscopic Anatomy • Mucosa of large intestine = simple columnar epithelium except anal canal = nonkeratinized stratified squamous epithelium • No circular folds • No villi Bacterial flora & Intestinal Gas • Bacterial flora • Ferment cellulose • Synthesize vitamin B & K
• Flatus – 500 ml / day = gas
• N, CO2, H, methane, H2S, two amines – indole & skatole Absorption & Motility • Reabsorbs water and electrolytes • Mass movements – 1-3 times per day; after a meal in transverse and sigmoid colon, moving residue to rectum Defecation • Stretching of rectum stimulates defecation reflexes • Intrinsic defecation reflex – stretch signals • Transmit impulses to spinal cord • Spinal reflex causes contraction of rectum and relaxation of internal anal sphincter • Relaxation of external anal sphincter is under voluntary control & can be suppressed • With relaxation of the external anal sphincter, fecal material can pass to the outside
Alkalizing Nutritional Therapy in The Prevention and Treatment of Any Cancerous Condition by Robert Young Galina Migalko (Young, Robert Migalko, Galina)