Digestion Lecture 2 Flashcards

(87 cards)

1
Q

Stomach Function

The Stomach

A
  • It connects the esophagus to the duodenum
  • Serves as mixing chamber and holding reservoir (Mechanical digestion)
  • In the stomach, digestion of starch continues (briefly), digestion of proteins begins, and digestion of
    triglycerides increases and certain substances are absorbed (Chemical digestion)
  • Produces intrinsic factor
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2
Q

Stomach Structure

A
  • a muscular, expandable, J-shaped organ with three layers in the muscular layer
  • Highly variable shape depending on contents
  • Empty: muscular tube with constricted lumen
  • Full: can expand to contain 1–1.5 liters of material (chyme)
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3
Q

Chyme

The Stomach

A
  • Viscous, highly acidic, soupy mixture formed from the combination of food, saliva, and gastric gland secretions
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4
Q

Stomach
* Lesser curvature forms and attaches

The Stomach

A
  • forms the medial surface
  • Attached to the mesentery of the lesser omentum
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5
Q

Stomach
* Greater curvature forms and attaches

The Stomach

A
  • forms the lateral and inferior surfaces
  • Attached to the mesentery of the
    greater omentum
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6
Q

The Stomach

4 stomach regions

A
  1. Fundus
  2. Cardia
  3. Body
  4. Pylorus
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7
Q

Fundus

The Stomach

A
  • Superior to the junction between the stomach and esophagus
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8
Q

Cardia

The Stomach

A
  • Superior, medial portion within 3 cm of gastroesophageal junction
  • Secretes mucus to protect esophagus from stomach acid/enzymes
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9
Q

Pylorus

The Stomach

A
  • Sharp curve of “J” of the stomach
  • Frequently changes shape with mixing movements
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10
Q

The pylorus is made up of the

The Stomach

A
  • Pyloric antrum
  • Pyloric canal
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11
Q

Pyloric antrum

The Stomach

A
  • Portion connected to stomach body
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12
Q

Pyloric canal

The Stomach

A
  • Empties into the duodenum (proximal segment of small intestine)
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13
Q

pyloric sphincter

The Stomach

A

Controls chyme leaving the stomach

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14
Q

Rugae

The Stomach

A
  • Wrinkles
  • Prominent, temporary mucosal folds
  • Allow gastric expansion by flattening
    out with stomach expansion
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15
Q

Histology
* Mucosa
* simple columnar epithelium

The Stomach

A
  • Composed of simple columnar epithelium
  • Produces layer of alkaline mucus
  • Protects epithelial cells against acid and enzymes in gastric lumen
  • Epithelial cells extend down into lamina propria to form columns of secretory cells called gastric glands which open up into gastric pits
  • Secretions flow from gastric glands 🡪 gastric pits 🡪 lumen
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16
Q

Histology
* Mucosa
* Gastric pits

The Stomach

A
  • Shallow depressions opening onto the gastric surface
  • Active stem cells at the base of each pit replace superficial cells shed into the chyme
  • Each pit communicates with several gastric glands
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17
Q

Histology
* Mucosa
* Gastric glands

The Stomach

A
  1. Glands in the fundus and body
  • Secrete most of the acid and enzymes enabling gastric digestion
  • Dominated by parietal cells and chief cells
  • Secrete ~1.5 L of gastric juice each day
  1. Glands in the pylorus
  • Secrete mucus and hormones that
    coordinate and control digestive activity
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18
Q
  • Cells of gastric glands
  • Four main cell types:

The Stomach

A
  1. Parietal Cells (exocrine)
  2. Chief Cells (exocrine)
  3. Mucous neck cells (exocrine)
  4. G cells (endocrine)
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19
Q

Parietal cells secrete

The Stomach

A
  1. Intrinsic factor
  • Glycoprotein that aids in vitamin B12 absorption
  1. Hydrochloric acid (HCl)
  • Activates pepsinogen
  • Keeps stomach at pH 1.5–2
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20
Q

G cells (enteroendocrine cells)

The Stomach

A
  • Secretes gastrin which regulates digestion
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21
Q

Chief cells secrete

The Stomach

A
  1. Pepsinogen
  • Activated by HCl to become pepsin
  • Active proteolytic (protein-digesting) enzyme
  1. Gastric lipase
  • Fat digesting enzyme
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22
Q

Mucous neck cells

The Stomach

A
  • Secrete mucus to protect epithelial layer of the stomach from high acid contents
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23
Q

Submucosa

The Stomach

A
  • composed of areolar connective tissue
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24
Q

Muscular 3 layer’s

The Stomach

A
  • 3 layers of smooth muscle: an outer longitudinal, middle circular, and an inner oblique layer
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25
Serosa ## Footnote The Stomach
* part of visceral peritoneum * From lesser curvature, it forms the lesser omentum * From the greater curvature, it forms greater omentum
26
Layers of the muscularis externa ## Footnote The Stomach
1. Oblique layer * Strengthens the stomach wall * Assists in mixing and churning to form chyme 2. Circular layer 3. Longitudinal layer
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Mixing waves ## Footnote Mechanical digestion in the stomach
* gentle, rippling peristaltic movements * creates chyme by breaking down food, mixing it with secretions of the gastric glands
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gastric emptying ## Footnote Digestion in the Stomach
* Once the food reaches the pyloric sphincter, each mixing wave forces about 3mL of chyme into the duodenum
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Salivary amylase ## Footnote Chemical digestion in the stomach
* It continues acting in the stomach until the churning mixes it with the acidic gastric juices
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Lingual lipase ## Footnote Chemical digestion in stomach
* Becomes more active in the stomach * acts to digest triglycerides into fatty acids and diglycerides
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Hydrochloric acid (HCl) ## Footnote Chemical digestion in the stomach
* * secreted by parietal cells * kills many microbes, denatures proteins, and stimulates the release of hormones that promote flow of bile and pancreatic juice
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Pepsin ## Footnote Chemical digestion in the stomach
* secreted by chief cells * Secreted as pepsinogen (inactive form) * WHY? * It is activated once it comes in contact with HCl * Acts to break down certain peptide bonds between amino acids which leaves smaller peptide fragments
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Gastric lipase ## Footnote Chemical digestion in the stomach
* Secreted by chief cells * splits triglycerides into fatty acids and monoglycerides
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There is only a small amount of nutrient absorption that takes place in the stomach ## Footnote Absorption in the Stomach
* Some water * Ions * short chain fatty acids * certain drugs (aspirin) * alcohol
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The small intestine ## Footnote The Small Intestine
* Plays key role in nutrient digestion and absorption * 90 percent of nutrient absorption occurs in small intestine * Most of remaining 10 percent occurs in large intestine * Average overall length = 6 m (19.7 ft) * Diameter ranges from 4 cm (1.6 in.) near stomach to 2.5 cm (1 in.) near large intestine
36
Small intestine 3 segments
1. Duodenum 2. Jejunum 3. Ileum
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Duodenum ## Footnote Segments of the small intestine
* 25 cm (10 in.) in length * Segment closest to the stomach * Acts as a “mixing bowl” * Receives chyme from stomach and digestive secretions from liver, gallbladder, and pancreas * Mostly retroperitoneal * **Duodenal glands** produce mucous secretions * Has few circular folds and small villi * Main function is to neutralize acidic chyme
38
Jejunum ## Footnote Segments of the small intestine
* Between the duodenum and ileum * ~2.5 m (8.2 ft) in length * In the peritoneal cavity * Has numerous circular folds and abundant, long villi * Majority of chemical digestion and nutrient absorption occurs in jejunum
39
Ileum ## Footnote Segments of the small intestine
* Final segment of small intestine * ~3.5 m (11.5 ft) in length * Ends at the **ileocecal valve** * Sphincter controlling flow from the ileum into the cecum of the large intestine * Has few circular folds (none in the distal portion) * Villi are relatively stumpy * Submucosa contains aggregated lymphoid nodules
40
S cells: ## Footnote small intestine mucosa
* secretes secretin
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CCK cells ## Footnote Small intestine mucosa
* Secretes CCK
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K Cells ## Footnote Small intestine mucosa
* secretes glucose-dependent insulinotropic peptide (GIP)
43
Peyer’s patches ## Footnote small intestine mucosa
* Groups of lymphatic nodules in the ileum
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Duodenal (Brunner’s) glands ## Footnote Small intestine submucosa
* secrete alkaline mucus that helps neutralize gastric acid in the chyme
45
Small intestine Muscularis
* Has an outer longitudinal layer and an inner circular layer
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Small intestine serosa
* Completely surrounds the small intestine except for majority of duodenum * Retroperitoneal, has adventitia
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Circular folds ## Footnote Special Structures of the Intestinal Tract
* Series of transverse folds along the intestinal lining * Permanent feature * compare to rugae * Roughly 800 folds in the small intestine * Mostly in the jejunum * Increase AS for absorption
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Villi ## Footnote Special Structures of the Intestinal Tract
* Small mucosal projections that increase surface area for absorption * Covered by epithelial cells * Surfaces covered with microvilli * Contains arteriole, venule, blood capillary, and lacteal
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Internal structure of a villus ## Footnote Special Structures of the Intestinal Tract
* Extensive capillary network in the lamina propria * Carries absorbed nutrients to the hepatic portal circulation
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lacteal ## Footnote Internal structure of a villus
* Transports materials that cannot enter blood capillaries * Example: * Absorbed fatty acids assembled into protein–lipid packages (chylomicrons) too large to diffuse into bloodstream * Transported by lymphatic system to venous circulation
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muscularis mucosae ## Footnote Internal structure of a villus
* Smooth muscle Moves villi back and forth, exposing surfaces to intestinal contents * Squeezes lacteal, assisting in lymph movement
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Microvilli ## Footnote Special Structures of the Intestinal Tract
* Projections of apical membrane of absorptive cells * Creates a brush border with brush border enzymes
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* Brush border ## Footnote Microvilli
* Carpet of microvilli on the surface of the epithelial cells * Increases surface area for absorption * Contains enzymes that digest materials * Epithelial cells can then absorb breakdown products
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The Pancreas
* The pancreas has endocrine and exocrine functions * The exocrine functions of the pancreas contribute to digestion
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Pancreatic duct (duct of Wirsung) ## Footnote Pancreas
* Delivers exocrine secretions to the duodenum * Joins the common bile duct from the liver and gallbladder and enters duodenum as a common duct at the hepatopancreatic ampulla (ampulla of Vater) * The ampulla opens at the major duodenal papilla
56
Accessory pancreatic duct (Santorini duct)
* Branches from the pancreatic duct and empties separately into the duodenum * Occurs in 3–10 percent of the population
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pancreatic acini
* Makes up 99% of Pancreatic tissue * Contain pancreatic acinar cells * Secrete pancreatic enzymes and buffers * EXOCRINE
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pancreatic islets
* makes up 1% of Pancreatic tissue * Secrete hormones (glucagon, insulin, somatostatin, and pancreatic polypeptide) * ENDOCRINE
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Pancreatic juice ## Footnote the pancreas
* About 1200 - 1500 mL of pancreatic juice are produced each day * Combination of mostly water and ions (secreted by epithelial cells lining the duct) and exocrine secretions (enzymes and buffers)
60
Pancreatic amylase ## Footnote Pancreatic juice enzymes
* digests starch * Carbohydrase (breaks down certain starches) * Almost identical to salivary amylase
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Proteolytic enzymes ## Footnote Pancreatic juice enzymes
* digests protein * Break proteins apart into mixture of dipeptides, tripeptides, and amino acids * Secreted as inactive proenzymes * Activated in the duodenum * Active forms include trypsin, chymotrypsin, carboxypeptidase, elastase
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Pancreatic lipase ## Footnote Pancreatic juice enzymes
* main fat-digesting enzyme
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Nucleases (Ribonuclease and deoxyribonuclease): ## Footnote Pancreatic juice enzymes
* digest RNA and DNA
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Trypsinogen ## Footnote Pancreatic juice enzymes
* digests protein * released from the pancreas and will reach the small intestine and will encounter enterokinase (a brush-border enzyme) which activates trypsin, which then acts on the other inactive enzymes to activate them
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Liver
* Largest visceral organ * It is inferior to the diaphragm and occupies most of the right hypochondriac and part of the epigastric region of the abdominopelvic cavity * The gallbladder is a pear shaped sac that is located in a depression of the posterior surface of the liver and hangs from the anterior margin * Wrapped in tough fibrous capsule * Covered by layer of visceral peritoneum
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Liver Functions
1. Carbohydrate metabolism 2. Lipid metabolism 3. Protein metabolism 4. Processing of drugs and hormones 5. Excretion of bilirubin 6. Synthesis of bile salts 7. Storage of glycogen 8. Phagocytosis 9. Activation of vitamin D
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4 lobes of the liver
1. Left lobe 2. Right lobe 3. Caudate lobe 4. Quadrate
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Liver L & R lobes separated by
falciform ligament
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Caudate lobe ## Footnote 4 lobes of the liver
* On the posterior surface of the liver
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Quadrate lobe ## Footnote 4 lobes of the liver
* Located between the left lobe and the gallbladder
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Gallbladder ## Footnote Liver Associated structures
* Temporarily stores bile produced by the liver
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Bile duct ## Footnote Liver Associated structures
* Carries bile from the liver and gallbladder to the duodenum
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Hepatocytes ## Footnote Cells of the liver
* Make up 80% of the liver * major functional cells of liver * Wide variety of metabolic, secretory, and endocrine functions
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Stellate macrophages (Kupffer cells) ## Footnote Cells of the liver
* Immune function
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Bile canaliculi ## Footnote The Liver
* ducts between hepatocytes that collect bile * exits livers as common hepatic duct
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Hepatic sinusoids ## Footnote The Liver
* highly permeable blood capillaries receiving oxygenated blood from hepatic artery and deoxygenated nutrient-rich blood from hepatic portal vein * Hepatic sinusoids will converge and deliver blood to a central vein which then drains into the inferior vena cava
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Portal triad ## Footnote The Liver
* a bile duct * a branch of the hepatic artery * a branch of the hepatic portal vein * Branches from the arteries and veins of each portal area deliver blood to liver (hepatic) sinusoids of adjacent liver lobules
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Portal triad 3 structures ## Footnote The Liver
1. A branch of the hepatic portal vein 2. A branch of the hepatic artery proper 3. A bile duct
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Hepatic lobules ## Footnote The Liver
* Liver contains ~100,000 liver lobules * Hexagonal shape in cross section * Surrounded by six portal triads (one at each corner of the lobule) * Each roughly 1 mm in diameter
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Portal Lobule ## Footnote The Liver
* Triangle cornered by three central veins
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Hepatic acinus
* the smallest functional * contains a small portal tract at the center and central veins at the periphery * divided into zones 1, 2, and 3
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Explain Functional anatomy of a liver lobule
1. Blood enters liver sinusoids from hepatic artery and vein 2. Hepatocytes beside sinusoids regulate solute and nutrient absorption and secretion 3. Stellate macrophages engulf pathogens, debris, damaged cells 4. Sinusoids drain into central vein 5. Hepatocytes secrete bile into bile caniculi 6. Bile caniculi merge to form bile ductules - carry to nearest bile ducts ## Footnote The liver lobule filters and processes blood. Blood from the digestive system and arteries flows through the lobule, where liver cells absorb nutrients, remove toxins, and make bile to help digest fats. Cleaned blood leaves through veins, and bile goes to the digestive tract. The purpose is to keep the body’s blood clean and support digestion.
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Bile
* Hepatocytes secrete 800-1000mL of bile daily * Mostly water, bile salts, cholesterol, lecithin, bile pigments and several ions * Partially excretory product/partially digestive secretion * Bile salts play role in emulsification (the breakdown of large lipid globules into a suspension of small lipid globules)
84
The Gallbladder
* Hollow, pear-shaped organ * Located in the depression on the posterior surface of the liver’s right lobe * Between meals, stores and concentrates bile secreted from the liver * Contraction of smooth muscle fibers eject contents of gall bladder into cystic duct
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Explain Path of bile
1. Left and right hepatic ducts collect bile from liver 2. L and R hepatic ducts unite forming common hepatic duct 3. Bile will then go to the common bile duct (to the duodemum) or the cystic duct (to gallbladder for storage) 4. common bile duct and pancreatic duct meet at hepatopancreateic ampulla 5. Enter the duodenum
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Gallbladder location and regions
* Located in the depression on the posterior surface of the liver’s right lobe * three regions: the fundus, the body, and the neck
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Functional relationships in bile storage/ejection ## Footnote Gallbladder
* Liver produces about 1 L of bile per day * Unless hepatopancreatic sphincter is open, bile flows into the gallbladder for storage * Release of CCK by the duodenum triggers: * Dilation of the hepatopancreatic sphincter * Contraction of the gallbladder * Bile is ejected into the duodenum * Bile salts break apart lipid droplets through emulsification