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A&P2 > Test 4: Digestive & Reproductive System FINAL > Flashcards

Test 4: Digestive & Reproductive System FINAL Flashcards

1
Q

Digestive System Functions

A

Digestive system—organ system that processes food, extracts nutrients, and eliminates residue

Five stages of digestion

  1. Ingestion: selective intake of food
  2. Digestion: mechanical and chemical breakdown of food into a form usable by the body
  3. Absorption: uptake of nutrient molecules into the epithelial cells of the digestive tract and then into the blood and lymph
  4. Compaction: absorbing water and consolidating the indigestible residue into feces
  5. Defecation: elimination of feces
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2
Q

Digestive Types

A
  1. Mechanical digestion—the physical breakdown of food into smaller particles

2.Chemical Digestion: a series of hydrolysis reactions that breaks dietary macromolecules into their monomers (residues)

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3
Q

Mechanical Digestion

A

the physical breakdown of food into smaller particles

  • Cutting and grinding action of the teeth
  • Churning action of stomach and small intestines
  • Exposes more food surface to digestive enzymes
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4
Q

Chemical Digestion

A

a series of hydrolysis reactions that breaks dietary macromolecules into their monomers (residues)

•Carried out by digestive enzymes produced by salivary glands, stomach, pancreas, and small intestine

Polysaccharides into monosaccharides

Proteins into amino acids

Fats into monoglycerides and fatty acids

Nucleic acids into nucleotides

Some nutrients are present in a usable form in ingested food and can be directly absorbed

•Vitamins, amino acids, minerals, cholesterol, and water

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5
Q

Digestive System: Subdivisions

A
  1. digestive tract
  2. accessory organs
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6
Q

Digestive Tract

A

Aka the alimentary canal

  • 30 ft long muscular tube extending from mouth to anus
  • Mouth, pharynx, esophagus, stomach, small intestine, and large intestine
  • Gastrointestinal (GI) tract is the stomach and intestines
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7
Q

Accessory Organs

A

•Teeth, tongue, salivary glands, liver, gallbladder, and pancreas

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8
Q

Digestive Tract Structure & Layers

A

Most of digestive tract follows a basic structural plan with the digestive tract wall consisting of layers:

  • Mucosa: epithelium, lamina propria, muscularis mucosae
  • Submucosa
  • Muscularis externa: inner circular layer, outer longitudinal layer
  • Serosa: areolar tissue, mesothelium
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9
Q

Mucosa (Mucous Membrane) & Layers

A

lines the lumen and consists of:

1.Inner epithelium

  • Simple columnar in most of digestive tract
  • Stratified squamous from mouth through esophagus, and in lower anal canal
  1. Lamina propria: loose connective tissue layer
  2. Muscularis mucosa: thin layer of smooth muscle
  • Tenses mucosa creating grooves and ridges that enhance surface area and contact with food
  • Improves efficiency of digestion and nutrient absorption

4.Mucosa-associated lymphatic tissue (MALT): the mucosa exhibits an abundance of lymphocytes and lymphatic nodules

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10
Q

Submucosa: Structure

A

thicker layer of loose connective tissue

  • Contains blood vessels, lymphatic vessels, a nerve plexus, and in some places mucus-secreting glands that dump lubricating mucus into the lumen
  • MALT extends into the submucosa in some parts of the GI tract
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11
Q

Muscularis Externa: Structure & Layers

A

consists of usually two layers of muscle near the outer surface

1.Inner circular layer

•In some places, this layer thickens to form valves (sphincters) that regulate the passage of material through the tract

2.Outer longitudinal layer

•Responsible for the motility that propels food and residue through the tract

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12
Q

Enteric Nervous System: Structure & Function

A

nervous network in esophagus, stomach, and intestines that regulates digestive tract motility, secretion, and blood flow

  • Thought to have over 100 million neurons
  • Can function independently of central nervous system
  • But CNS usually exerts influence on its action
  • Often considered part of autonomic nervous system
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13
Q

Serosa: Structure

A

composed of a thin layer of areolar tissue topped by simple squamous mesothelium

  • Begins in the lower 3 to 4 cm of the esophagus
  • Ends just before the rectum
  • Adventitia: fibrous connective tissue layer that binds and blends the pharynx, most of the esophagus, and the rectum into adjacent connective tissue of other organs
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14
Q

Enteric Nervous System: Two Networks of Neurons

A

1.Submucosal plexus: in submucosa

  • Controls glandular secretions of mucosa
  • Controls movements of muscularis mucosae

2.Myenteric plexus: parasympathetic ganglia and nerve fibers between the two layers of the muscularis externa

Controls peristalsis and other contractions of muscularis externa

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15
Q

Mesenteries: Structure & Function

A

connective tissue sheets that suspend stomach and intestines from abdominal wall

Functions

  1. Looseness allows stomach and intestines to undergo strenuous contractions with freedom of movement in the abdominal cavity
  2. Hold abdominal viscera in proper relationship to each other
  3. Prevent intestines from becoming twisted and tangled by changes in body position and by its own contractions
  4. Provide passage of blood vessels and nerves that supply digestive tract
  5. Contain many lymph nodes and lymphatic vessels
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16
Q

Parietal Peritoneum: Structure

A

a serous membrane that lines the wall of the abdominal cavity

  • Turns inward along posterior midline
  • Forms posterior mesentery: a translucent two-layered membrane extending to the digestive tract
  • The two layers of the mesentery separate and pass around opposite sides of the organ forming the serosa
  • Come together on the far side of the organ and continue as another sheet of tissue, called the anterior mesentery
  • May hang freely in the abdominal cavity

May attach to the anterior abdominal wall or other organs

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17
Q

Lesser Omentum

A

a ventral mesentery that extends from the lesser curvature of the stomach to the liver

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18
Q

Greater Omentum

A

hangs from the greater curvature of the stomach (its left inferior margin)

  • Covers small intestine like an apron
  • The inferior margin turns back on itself and passes upward
  • Forming a deep pouch between its deep and superficial layers
  • Inner superior margin forms serous membranes around the spleen and transverse colon—mesocolon
  • Part of the body’s first line of defense against toxins and infections
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19
Q

Intraperitoneal

A

when an organ is enclosed by mesentery on both sides

  • Considered within the peritoneal cavity
  • Stomach, liver, and parts of small and large intestine
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20
Q

Retroperitoneal

A

when an organ lies against the posterior body wall and is covered by peritoneum on its anterior side only

  • Considered to be outside the peritoneal cavity
  • Duodenum, pancreas, and parts of the large intestine
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21
Q

Regulation of the digestive tract

A

Motility and secretion of the digestive tract are controlled by:

  1. neural
  2. hormonal
  3. paracrine mechanisms
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22
Q

Digestive Tract Regulation: Neural Control

A
  • Short (myenteric) reflexes: stretch or chemical stimulation acts through myenteric plexus
  • Stimulates peristaltic contractions of swallowing
  • Long (vagovagal) reflexes: parasympathetic stimulation of digestive motility and secretion
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23
Q

Digestive Tract Regulation: Hormones

A
  • Chemical messengers secreted into bloodstream that stimulate distant parts of the digestive tract
  • Gastrin and secretin
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24
Q

Digestive Tract Regulation: Paracrine Secretions

A

•Chemical messengers that diffuse through the tissue fluids to stimulate nearby target cells

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25
Q

The Mouth: Structure & Functions

A

The mouth is known as the oral, or buccal cavity

Functions:

  • Ingestion (food intake)
  • Taste and other sensory responses to food
  • Chewing and chemical digestion
  • Swallowing, speech, and respiration

Mouth enclosed by cheeks, lips, palate, and tongue

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26
Q

The Mouth: Oral Fissure

A

anterior opening between lips

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27
Q

The Mouth: Fauces

A

posterior opening to the throat

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28
Q

Mouth Tissue Type

A

Stratified squamous epithelium lines mouth

  • Keratinized in areas subject to food abrasion: gums and hard palate
  • Nonkeratinized in other areas: floor of mouth, soft palate, and insides of cheeks and lips
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29
Q

The Cheeks & Lips: Structure & Functions

A

Structure:

  • Fleshiness due to subcutaneous fat, buccinator muscle of the cheek, and orbicularis oris of the lips
  • Labial frenulum: median fold that attaches each lip to the gum between the anterior incisors
  • Vestibule: space between cheeks or lips and the teeth

Function:

  • Retain food and push it between the teeth
  • Essential for speech
  • Essential for sucking and blowing actions, including suckling by infants
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30
Q

The Tongue: Structure & Function

A

Lingual glands: serous and mucous glands amid the extrinsic muscles

•Secrete a portion of the saliva

Lingual tonsils: contained in the root

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31
Q

The Palate: Structure & Function

A

•separates oral cavity from nasal cavity; makes it possible to breath while chewing food

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32
Q

•Hard (bony) palate

A

•Hard (bony) palate—anterior portion that is supported by the palatine processes of the maxillae and the palatine bones

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33
Q

Soft Palate

A

•posterior to hard palate with more spongy texture

Structure/ Function:

  • Composed of skeletal muscle and glandular tissue
  • No bone
  • Uvula: conical medial projection visible at the rear of the mouth
  • Helps retain food in the mouth until one is ready to swallow
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34
Q

•Palatine rugae:

A

transverse ridges that help the tongue hold and manipulate food

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35
Q

Pairs Muscular Arches on each side of oral cavity

A
  • Palatoglossal arch: anterior arch
  • Palatopharyngeal arch: posterior arch
  • Palatine tonsils are located on the wall between the arches
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36
Q

The Teeth: Structure & Function

A

Structure:

32 adult teeth

16 in mandible (lower jaw)

16 in maxilla (upper jaw)

From midline to the rear of each jaw

2 incisors—chisel-like cutting teeth used to bite off a piece of food

1 canine—pointed and act to puncture and shred food

2 premolars—broad surface for crushing, shredding, and grinding

3 molars—even broader surface for crushing, shredding, and grinding

Function:

Masticate (chew) food into smaller pieces

  • Makes food easier to swallow
  • Exposes more surface area for action of digestive enzymes, speeding chemical digestion
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37
Q

The Teeth: Alveolus

A

tooth socket in bone

•Gomphosis joint formed between tooth and bone

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38
Q

The Teeth: Periodontal Ligament

A

—modified periosteum whose collagen fibers penetrate into the bone on one side and into the tooth on the other

  • Anchors tooth firmly in alveolus
  • Allows slight movement under pressure of chewing
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39
Q

Gingiva (gum)

A

covers the alveolar bone

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40
Q

Regions of a tooth

A
  1. Crown: portion above the gum
  2. Root: the portion below the gum, embedded in alveolar bone
  3. Neck: the point where crown, root, and gum meet
  4. Gingival sulcus: space between the tooth and the gum

•Hygiene in the sulcus is important to dental health

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41
Q

The Teeth: Dentin

A

hard yellowish tissue that makes up most of the tooth

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42
Q

The Teeth: Enamel

A

covers crown and neck

•A noncellular secretion that cannot regenerate

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43
Q

The Teeth: Cement

A

—covers root

Cementum and dentin are living tissue and can regenerate

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44
Q

The Teeth: Root Canal

A

—space in a root leading to pulp cavity in the crown

  • Nerves and blood vessels
  • Apical foramen: pore at the basal end of each root canal
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45
Q

The Teeth: Occlusion

A

meeting of the teeth with the mouth closed

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46
Q

The Teeth Development

A

20 deciduous teeth (milk teeth or baby teeth)

Teeth develop beneath gums and erupt in a predictable order

  • Erupt from 6 to 30 months
  • Beginning with incisors
  • Between 6 and 25 years of age, are replaced by 32 permanent teeth

Third molars (wisdom teeth) erupt from age 17 to 25 years

•May be impacted: crowded against neighboring teeth and bone so they cannot erupt

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47
Q

Teeth & Gum Disease

A

The human mouth is home to more than 700 species of microorganisms, especially bacteria

1.Plaque—sticky residue on the teeth made up of bacteria and sugars

  • Calculus: calcified plaque
  • Bacteria metabolize sugars and release acids that dissolve the minerals of enamel and dentin to form dental caries (cavities)
  1. Root canal therapy is necessary if cavity reaches pulp
  2. Calculus in the gingival sulcus wedges the tooth and gum apart
  • Allows bacterial invasion of the sulcus
  • Gingivitis: inflammation of the gums
  • Periodontal disease: destruction of the supporting bone around the teeth which may result in tooth loss
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48
Q

Saliva & the Salivary Glands: Function

A

Saliva

  1. Moistens mouth
  2. Begins starch and fat digestion
  3. Cleanses teeth
  4. Inhibits bacterial growth
  5. Dissolves molecules so they can stimulate the taste buds
  6. Moistens food and binds it together into bolus to aid in swallowing
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49
Q

Saliva Structure

A

Saliva is a hypotonic solution of 97.0% to 99.5% water and the following solutes:

  1. Salivary amylase: enzyme that begins starch digestion in the mouth
  2. Lingual lipase: enzyme that is activated by stomach acid and digests fat after food is swallowed
  3. Mucus: binds and lubricates a mass of food and aids in swallowing
  4. Lysozyme: enzyme that kills bacteria
  5. Immunoglobulin A (IgA): an antibody that inhibits bacterial growth
  6. Electrolytes: Na^+, K^+, Cl^-, phosphate, and bicarbonate

•pH: 6.8 to 7.0

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50
Q

Saliva: Mucus

A

•binds and lubricates a mass of food and aids in swallowing

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51
Q

Saliva: Salivary Amylase

A

•enzyme that begins starch digestion in the mouth

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52
Q

Saliva: Lingual Lipase

A

enzyme that is activated by stomach acid and digests fat after food is swallowed

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53
Q

Saliva: Lysozyme

A

enzyme that kills bacteria

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54
Q

Saliva: Immunoglobulin A

A

•an antibody that inhibits bacterial growth

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55
Q

Saliva Electrolytes

A

Na^+, K^+, Cl^-, phosphate, and bicarbonate

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56
Q

Saliva pH

A

6.8 to 7.0

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57
Q

Salivary Glands Structure

A

Compound tubuloacinar glands

•Branched ducts ending in acini

Mucous cells secrete mucus

Serous cells secrete thin fluid rich in enzymes and electrolytes

Mixed acinus has both mucous and serous cells

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58
Q

The Pharynx: Structure/ Function

A

muscular funnel connecting oral cavity to esophagus and nasal cavity to larynx

  • Digestive and respiratory tracts intersect
  • Has deep layer of longitudinal skeletal muscle
  • Has superficial layer of circular skeletal muscles that form pharyngeal constrictors (superior, middle, and inferior) that force food downward during swallowing
  • When not swallowing, the inferior constrictor (upper esophageal sphincter) remains contracted to exclude air from the esophagus
  • Disappears at the time of death when the muscles relax, so it is a physiological sphincter, not an anatomical structure
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59
Q

The Esophogus: Structure & Function

A

Esophagus—straight muscular tube 25–30 cm long

  • Begins at level between C6 and the cricoid cartilage
  • Extends from pharynx to cardial orifice of stomach passing through esophageal hiatus in diaphragm
  • Lower esophageal sphincter: food pauses here because of constriction
  • Prevents stomach contents from regurgitating into the esophagus
  • Protects esophageal mucosa from erosive stomach acid
  • Heartburn—burning sensation produced by acid reflux into the esophagus
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60
Q

The Esophogus: Tissue

A

Nonkeratinized stratified squamous epithelium

Esophageal glands in submucosa secrete mucus

Deeply folded into longitudinal ridges when empty

Skeletal muscle in upper one-third, mix of muscle types in middle one-third, and only smooth muscle in bottom one-third

Meets stomach at level of T7

Covered with adventitia

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61
Q

The Stomach: Structure & Function

A

Stomach—a muscular sac in upper left abdominal cavity immediately inferior to the diaphragm

  • Primarily functions as a food storage organ
  • volume of about 50 mL when empty
  • 1.0 to 1.5 L after a typical meal
  • Up to 4 L when extremely full—can extend nearly as far as the pelvis
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62
Q

The Stomach: General Mechanics

A

Mechanically breaks up food, liquefies it, and begins chemical digestion of protein and fat

•Chyme: soupy or pasty mixture of semidigested food in the stomach

Most digestion occurs after the chyme passes on to the small intestine

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63
Q

Chyme

A

•soupy or pasty mixture of semidigested food in the stomach

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64
Q

Stomach Anatomy: 4 Regions

A

J-shaped; relatively vertical in tall people, horizontal in short people

•Divided into four regions:

  1. Cardial part (cardia)—small area within about 3 cm of the cardial orifice
  2. Fundus—dome-shaped portion superior to esophageal attachment
  3. Body—makes up the greatest part of stomach
  4. Pyloric part—narrower pouch at the inferior end
  • Subdivided into the funnel-like antrum
  • Narrower pyloric canal that terminates at pylorus
  • Pylorus—narrow passage to duodenum
  • Pyloric sphincter—regulates the passage of chyme into the duodenum
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65
Q

Stomach Anatomy: Microscopic

A

Stomach has a simple columnar epithelium covered by mucous

  • Apical regions of its surface cells are filled with mucin
  • Mucin swells with water and becomes mucus after it is secreted

Mucosa and submucosa are flat when stomach is full but form longitudinal wrinkles called gastric rugae when empty

Muscularis externa has three layers (instead of the two seen elsewhere)

•Outer longitudinal, middle circular, and inner oblique layers

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66
Q

Stomach: Gastric Pits

A

Gastric pits—depressions in gastric mucosa

  • Lined with simple columnar epithelium
  • Two or three tubular glands open into the bottom of each gastric pit
  • Cardiac glands in cardial part
  • Pyloric glands in pyloric parts

Gastric glands in the rest of the stomach

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67
Q

Stomach: Mucus Cells

A

secrete mucus

  • Predominate in cardiac and pyloric glands
  • In gastric glands, called mucous neck cells since they are concentrated at the neck of the gland
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68
Q

Stomach: Regenerative (Stem Cells)

A

found in base of pit and in neck of gland

•Divide rapidly and produce continual supply of new cells to replace cells that die

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69
Q

Stomach: Parietal Cells

A

found mostly in the upper half of the gland

•Secrete hydrochloric acid (HCl), intrinsic factor, and a hunger hormone called ghrelin

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70
Q

Hydrochloric Acid

A

HCl activates pepsin and lingual lipase

Breaks up connective tissues and plant cell walls

•Helps liquefy food to form chyme

Converts ingested ferric ions (Fe^(3+) ) to ferrous ions (Fe^(2+) )

•Fe^(2+) absorbed and used for hemoglobin synthesis

Contributes to nonspecific disease resistance by destroying most ingested pathogens

Most ulcers are caused by acid-resistant bacteria Helicobacter pylori, which can be treated with antibiotics and Pepto-Bismol

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71
Q

Somtach: Chief Cells

A

most numerous

  • Secrete gastric lipase and pepsinogen
  • Dominate lower half of gastric glands
  • Absent from pyloric and cardiac glands
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72
Q

Enteroendocrine Cells

A

concentrated in lower end of gland

•Secrete hormones and paracrine messengers that regulate digestion

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73
Q

Pepsin

A

Zymogens—digestive enzymes secreted as inactive proteins

•Converted to active enzymes by removing some of their amino acids

Pepsinogen—zymogen secreted by chief cells

  • Hydrochloric acid removes some of its amino acids and forms pepsin that digests proteins
  • Autocatalytic effect—as some pepsin is formed, it converts more pepsinogen into more pepsin

Pepsin digests dietary proteins into shorter peptides

Protein digestion is completed in the small intestine

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74
Q

Gastric Lipase

A

produced by chief cells

Gastric lipase and lingual lipase play a minor role in digesting dietary fats

  • Digests 10% to 15% of dietary fats in the stomach
  • Rest digested in the small intestine
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75
Q

Intrinsic Factor

A

a glycoprotein secreted by parietal cells

Essential to absorption of vitamin B_12 by the small intestine

•Binds vitamin B_12 and then intestinal cells absorb this complex by receptor-mediated endocytosis

Vitamin B_12 is needed to synthesize hemoglobin

•Deficiency causes anemia

Secretion of intrinsic factor is the only indispensable function of the stomach

•Digestion can continue if stomach is removed (gastrectomy), but B_12 supplements will be needed

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76
Q

Chemical Messengers

A

Gastric and pyloric glands have a variety of cells that produce a variety of chemical messengers

  • Most are hormones that enter blood and stimulate distant cells
  • Some are paracrine secretions that stimulate neighboring cells
  • Several are peptides produced in both the digestive tract and the central nervous system: gut–brain peptides
  • Substance P, vasoactive intestinal peptide (VIP), secretin, gastric inhibitory peptide (GIP), cholecystokinin, and neuropeptide Y (NPY)
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77
Q

Gastric Motility: Process

A

Swallowing center of medulla oblongata signals stomach to relax

Vagus nerve relays message from medulla and activates a receptive-relaxation response in stomach

•Resists stretching briefly, but relaxes to hold more food

Soon stomach shows a rhythm of peristaltic contractions controlled by enteric pacemaker cells in longitudinal layer of muscularis externa

  • A ring of constriction every 20 seconds
  • Becomes stronger contraction at pyloric part

Thick muscularis of antrum acts as a strong pump that breaks up semidigested food and prepares it for intestine

Antral contractions come in waves that churn and break up the chyme into small particles

Only about 3 mL of chyme is squirted into the duodenum at a time; this small amount allows duodenum to:

  • Neutralize the stomach acid
  • Digest nutrients little by little

If duodenum is overfilled, it inhibits gastric motility

Typical meal emptied from stomach in 4 hours

•Less time if the meal is more liquid

As long as 6 hours for a high-fat meal

  • After 30 minutes or so these contractions become quite strong
  • They churn the food, mix it with gastric juice, and promote its physical breakup and chemical digestion
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78
Q

Gastric Motility

A
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79
Q

Vomiting

A

forceful ejection of stomach and intestinal contents (chyme) from the mouth

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80
Q

Vomiting & Emetic Center

A

Emetic center in the medulla oblongata integrates multiple muscle actions

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81
Q

Vomiting induced by

A
  • Overstretching of the stomach or duodenum
  • Chemical irritants such as alcohol and bacterial toxins
  • Visceral trauma
  • Intense pain or psychological and sensory stimuli
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82
Q

Chronic Vomiting

A
  • Results in dangerous fluid, electrolyte, and acid–base imbalances
  • Bulimia: eating disorder; hydrochloric acid in vomit causes tooth enamel to erode
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83
Q

Digestion & Absorbtion

A

Stomach does not absorb any significant amount of nutrients

•Does absorb aspirin and some lipid-soluble drugs

Alcohol is absorbed mainly by small intestine

•Intoxicating effects depend partly on how rapidly the stomach is emptied

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84
Q

Regulation of Gastric Function: Steps

A
  1. Cephalic Phase: Vagus nerve stimulates gastric selection even before food is swallowed
  2. Gastric Phase: Food stretches the stomach and activate myentric and vagovagal reflexes. These reflexes stimulate gastric secretion. Histamine and gastrin also stimualate acid and enzyme secretion.
  3. Intestinal Phase: Intestinal gastrin briefly stimulates the stomach but then secretin, CCK, and the enterogastric reflex inhibit gastric secretion and motility where the duodenum processes the chume already in it. Symphathetic nerve fibers supress gastric activity, while vagal (parasymphatetic) stimulation of the stomach is now inhibited.
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85
Q

Regulation of Gastric Function: Cephalic Phase

A
  • Stomach responds to sight, smell, taste, or thought of food
  • Sensory and mental inputs converge on hypothalamus
  • Hypothalamus relays signals to medulla oblongata
  • Vagus nerve fibers from medulla stimulate the enteric nervous system of stomach, stimulating gastric secretion
  • 40% of stomach’s acid secretion occurs in cephalic phase
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86
Q

Regulation of Gastric Function: Gastric Phase

A
  • Period in which swallowed food and semidigested protein activate gastric activity
  • Two-thirds of gastric secretion and one-half of acid secretion occur in this phase
  • Ingested food stimulates gastric activity in two ways
  • By stretching the stomach
  • Activates short reflex mediated through myenteric plexus; activates long reflex mediated through the vagus nerves and the brainstem

By increasing the pH of its contents

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87
Q

Gastric secretion is stimulated by three chemicals

A
  1. Acetylcholine (ACh)—secreted by parasympathetic nerve fibers of both reflexes
  2. Histamine—a paracrine secretion from enteroendocrine cells in the gastric glands
  3. Gastrin—a hormone produced by the enteroendocrine G cells in pyloric glands
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88
Q

Regulation of Gastric Function: Intestinal Phase

A
  • Duodenum responds to arriving chyme and moderates gastric activity through hormones and nervous reflexes
  • Duodenum initially enhances gastric secretion but soon inhibits it
  • Stretching of duodenum accentuates vagovagal reflex that stimulates stomach
  • Peptides and amino acids in chyme stimulate G cells of duodenum to secrete more gastrin, further stimulating stomach
  • Soon acids and fats trigger enterogastric reflex—duodenum sends inhibitory signals to stomach by way of enteric nervous system
  • Duodenum also signals medulla to inhibit vagal nuclei (reducing vagal stimulation of stomach) and stimulate sympathetic neurons (sending inhibitory signals to the stomach)
  • Chyme also stimulates duodenal enteroendocrine cells to release secretin and cholecystokinin
  • They stimulate the pancreas and gallbladder
  • Also suppress gastric secretion
  • Gastrin secretion declines and pyloric sphincter contracts tightly to limit chyme entering duodenum
  • Gives duodenum time to work on chyme
  • Enteroendocrine cells also secrete glucose-dependent insulinotropic peptide (GIP) originally called gastrin-inhibiting peptide
  • Stimulates insulin secretion in preparation for processing nutrients about to be absorbed by small intestine
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89
Q

The liver, gallbladder, and pancreas

A

Small intestine receives chyme from stomach and secretions from liver and pancreas

  • These secretions enter digestive tract near the junction of stomach and small intestine
  • These secretions are important to the digestive process of the small intestine
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90
Q

The Liver: Anatomy

A

Liver—reddish brown gland located immediately inferior to the diaphragm

The body’s largest gland

•Weighs about 1.4 kg (3 lbs)

Variety of functions

Secretes bile which contributes to digestion

Four lobes—right, left, quadrate, and caudate

  • Falciform ligament separates left and right lobes
  • Sheet of mesentery that suspends the liver from the diaphragm
  • Round ligament (ligamentum teres)—fibrous remnant of umbilical vein
  • Carries blood from umbilical cord to liver of the fetus

Hilum—irregular opening between quadrate and caudate lobes

  • Point of entry for hepatic portal vein and proper hepatic artery
  • Point of exit for the bile passages
  • All travel in lesser omentum

Gallbladder—adheres to a depression on the inferior surface of the liver, between right and quadrate lobes

Bare area on superior surface where it attaches to diaphragm

91
Q

The Liver: Microscopic Anatomy

A

Hepatic lobules—tiny cylinders that fill the interior of the liver

  • About 2 mm long and 1 mm in diameter
  • Central vein: passes down the core
  • Hepatocytes: cuboidal cells surrounding central vein in radiating sheets or plates

Each plate of hepatocytes is an epithelium one or two cells thick

Hepatic sinusoids: blood-filled channels that fill spaces between the plates

  • Lined by a fenestrated endothelium that separates hepatocytes from blood cells
  • Allows plasma into the space between the hepatocytes and endothelium
  • Hepatocytes have brush border of microvilli that project into this space
  • Blood filtered through the sinusoids comes directly from the stomach and intestines, enters through hepatic portal vein and leaves to drain into vena cava

Stellate macrophages: phagocytic cells in the sinusoids that remove bacteria and debris from the blood

92
Q

The Liver: Microscopic Anatomy- Hepatocytes

A

Hepatocytes

  • After a meal, hepatocytes absorb from the blood: glucose, amino acids, iron, vitamins, and other nutrients for metabolism or storage
  • Between meals, hepatocytes break down stored glycogen and release glucose into the blood
  • Remove and degrade: hormones, toxins, bile pigments, and drugs

Secrete into the blood: albumin, lipoproteins, clotting factors, angiotensinogen, and other products

93
Q

The Liver: Microscopic Anatomy- Bile Canaliculi

A

Bile canaliculi—narrow channels into which the liver secretes bile

Bile passes into bile ductules of the triads

Ultimately into the right and left hepatic ducts

94
Q

The Liver: Microscopic Anatomy- Common Hepatic Duct

A

formed from convergence of right and left hepatic ducts on inferior side of the liver.

95
Q

The Liver: Microscopic Anatomy- Cystic & Bile Duct

A

Cystic duct coming from gallbladder joins common hepatic duct

Bile duct: formed from union of cystic and common hepatic ducts

•Descends through lesser omentum toward the duodenum

96
Q

Gallbladder

A

a pear-shaped sac on underside of liver

•Serves to store and concentrate bile by absorbing water and electrolytes

97
Q

Bile

A

Bile—yellow-green fluid containing minerals, cholesterol, neutral fats, phospholipids, bile pigments, and bile acids

Bilirubin: principal pigment derived from the decomposition of hemoglobin

Bacteria in large intestine metabolize bilirubin to urobilinogen

Stercobilin responsible for the brown color of feces

Urobilin responsible for yellow color of urine

Bile acids (bile salts): steroids synthesized from cholesterol

Bile acids and lecithin, a phospholipid, aid in fat digestion and absorption

Gallstones may form if bile becomes excessively concentrated with wastes

98
Q

Gallstones

A

hard masses in either the gallbladder or bile ducts

•Composed of cholesterol, calcium carbonate, and bilirubin

99
Q

Cholelithiasis

A

presence of gallstones

•Most common in obese women over 40—excess cholesterol

100
Q

Painful obstruction of ducts

A

•Result in jaundice (yellowing of skin), poor fat digestion, and impaired absorption of fat-soluble vitamins

101
Q

Lithotripsy

A

use of ultrasonic vibration to pulverize stones without surgery

102
Q

The Pancreas

A

spongy retroperitoneal gland posterior to greater curvature of stomach

  • Measures 12 to 15 cm long, and 2.5 cm thick
  • Has a head encircled by duodenum, a body (midportion), and a tail on the left
103
Q

Pancreas Glands

A
  • Endocrine portion—pancreatic islets that secrete insulin and glucagon; concentrated in the tail of the gland
  • Exocrine portion—99% of pancreas that secretes 1,200 to 1,500 mL of pancreatic juice per day
  • Secretory acini release their secretion into small ducts that converge on the main pancreatic duct
104
Q

Pancreatic Ducts

A

1.Pancreatic duct runs lengthwise through middle of the gland

  • Joins the bile duct at the hepatopancreatic ampulla
  • Hepatopancreatic sphincter controls release of both bile and pancreatic juice into the duodenum

2.Accessory pancreatic duct: smaller duct that branches from the main pancreatic duct

  • Opens independently into the duodenum
  • Bypasses the sphincter and allows pancreatic juice (alkaline mixture of water, enzymes, zymogens, sodium bicarbonate, and other electrolytes ) to be released into duodenum even when bile is not
105
Q

Pancreatic zymogens: 3 Types

A

1.Trypsinogen

  • Secreted into intestinal lumen
  • Converted to trypsin by enteropeptidase that is secreted by mucosa of small intestine

Trypsin is autocatalytic—converts trypsinogen into still more trypsin

  1. Chymotrypsinogen: converted to trypsinogen by trypsin
  2. Procarboxypeptidase: converted to carboxypeptidase by trypsin
106
Q

Pancreatic Enzymes

A
  1. Panncreatic Amylase:digests starch
  2. Pancreatic Lipase:digests fat
  3. Ribonuclease and deoxyribonuclease: digest RNA and DNA, respectively
107
Q

Regulation of Secretion in Pancreas: Stimuli Types

A

Three stimuli are chiefly responsible for the release of pancreatic juice and bile: acetylcholine, cholecystokinin, and secretin

108
Q

Regulation of secretion: Acetylcholine

A
  • from vagus and enteric nerves
  • Stimulates acini to secrete enzymes during cephalic phase of gastric control even before food is swallowed
  • Enzymes remain in acini and ducts until chyme enters the duodenum
109
Q

Regulation of secretion: Cholecystokinin

A

(CCK): secreted by mucosa of duodenum in response to arrival of fats in small intestine

  • Stimulates pancreatic acini to secrete enzymes
  • Strongly stimulates gallbladder
  • Induces contractions of gallbladder and relaxation of hepatopancreatic sphincter to discharge bile into duodenum

Secretin: released from duodenum in response to acidic chyme arriving from the stomach

•Stimulates ducts of both liver and pancreas to secrete more sodium bicarbonate

Raises pH to the level required for activity of the pancreatic and intestinal digestive enzymes

110
Q

Regulation of secretion: Secretin

A

Secretin: released from duodenum in response to acidic chyme arriving from the stomach

•Stimulates ducts of both liver and pancreas to secrete more sodium bicarbonate

Raises pH to the level required for activity of the pancreatic and intestinal digestive enzymes

111
Q

The Small Intestine: general structure & function

A

Function:

Nearly all chemical digestion and nutrient absorption occurs in the small intestine

Structure:

The longest part of the digestive tract

  • About 5 m long in a living person
  • Up to 8 m long in a cadaver—no muscle tone

“Small” intestine refers to the diameter—not length

•Diameter is about 2.5 cm (1 in.)

112
Q

Small Intestine: Gross Anatomy/ Structure & Location

A

coiled tube filling most of the abdominal cavity inferior to stomach and liver

113
Q

Small Intestine: Gross Anatomy/ Three Divisions

A
  1. Duodenum: first 25 cm (10 in.)
  2. Jejunum:first 40% of small intestine beyond duodenum
  3. Ileum: forms last 60% of the postduodenal small intestine
114
Q

Small Intestine: Gross Anatomy/ Duodenum

A

Structure:

  • Begins at pyloric valve
  • Major and minor duodenal papillae distal to pyloric valve
  • Receives major and minor pancreatic ducts, respectively
  • Arches around head of the pancreas

Ends at a sharp bend called the duodenojejunal flexure

•Most is retroperitoneal

Function:

  • Receives stomach contents, pancreatic juice, and bile
  • Stomach acid is neutralized here
  • Fats are physically broken up (emulsified) by bile acids
  • Pepsin is inactivated by increased pH
  • Pancreatic enzymes perform chemical digestion
115
Q

Small Intestine: Gross Anatomy/ Jejunum

A

Structure:

first 40% of small intestine beyond duodenum

  • Roughly 1.0 to 1.7 m in a living person
  • Has large, tall, closely spaced circular folds
  • Its wall is relatively thick and muscular
  • Especially rich blood supply which gives it a red color

Function

•Most digestion and nutrient absorption occurs here

116
Q

Small Intestine: Gross Anatomy/ Ileum

A

Structure: forms last 60% of the postduodenal small intestine

  • About 1.6 to 2.7 m, thinner, less muscular, less vascular, and paler pink color
  • Aggregated lymphoid nodules—prominent lymphatic nodules in clusters on the side opposite the mesenteric attachment; visible to naked eye; become larger near large intestine
  • Ileocecal junction—end of the small intestine; where the ileum joins the cecum of the large intestine
  • Ileal papilla—formed by the thickened muscularis of the ileum; protrudes into the cecum; regulates passage of food residue into the large intestine
  • Both jejunum and ileum are intraperitoneal and covered with serosa
117
Q

Small Intestine: Circulation

A

The small intestine receives nearly all of its blood supply from the superior mesenteric artery

Fans out through the mesentery to give rise to 12 to 15 jejunal and ileal arteries

Superior mesenteric vein

•This joins the splenic vein and then flows into the hepatic portal system, headed for the liver with its load of nutrients

118
Q

Small Intestine: Microscopic Anatomy Structure/ Function

A

Small intestine tissues designed for nutrient digestion and absorption

  1. Lumen lined with simple columnar epithelium
  2. Muscularis externa is noted for a thick inner circular layer and a thinner outer longitudinal layer
  3. Large internal surface area—great length and three types of internal folds or projections
  • Circular folds (plicae circulares)—increase surface area by a factor of 2 to 3
  • Villi—increase surface area by a factor of 10
  • Microvilli—increase the surface area by a factor of 20
119
Q

Small Intestine: Microscopic Anatomy: Circular Folds

A

Circular folds (plicae circulares)—largest folds of intestinal wall

  • Up to 10 mm high
  • Involve only mucosa and submucosa
  • Occur from duodenum to middle of ileum
  • Relatively small and sparse in ileum; not found in distal half, as most nutrient absorption is completed by this point
  • Cause chyme flow in spiral path causing more contact with mucosa
  • Promote more thorough mixing and nutrient absorption
120
Q

Small Intestine: Microscopic Anatomy- Villi

A

Villi—finger-like projections 0.5 to 1 mm tall

  • Make mucosa look fuzzy
  • Villus covered with two types of epithelial cells
  • Absorptive cells (enterocytes)
  • Goblet cells—secrete mucus
  • Epithelia joined by tight junctions that prevent digestive enzymes from seeping between them
  • Core of villus filled with areolar tissue of lamina propria
  • Contains arteriole, capillaries, venule, and lymphatic capillary called a lacteal
121
Q

Small Intestine: Microscopic Anatomy- Microvilli

A

Microvilli: form a fuzzy brush border on apical surface of each absorptive cell

  • Brush border enzymes—contained in plasma membrane of microvilli
  • Carry out some of the final stages of enzymatic digestion
  • Not released into the lumen
  • Contact digestion: chyme must contact the brush border for digestion to occur
  • Intestinal churning of chyme ensures contact with the mucosa
122
Q

Small Intestine: Microscopic Anatomy- Intestinal Crypts

A

Intestinal crypts—numerous pores that open into tubular glands on the floor of the small intestine between bases of the villi

  • Similar to gastric glands
  • In upper half, have enterocytes and goblet cells like the villi
  • In lower half, dominated by dividing stem cells
  • Life span of 3 to 6 days; new epithelial cells migrate up the crypt to the tip of the villus where they are sloughed off and digested
  • A few Paneth cells are clustered at the base of each crypt
  • Secrete lysozyme, phospholipase, and defensins—defensive proteins that resist bacterial invasion of the mucosa
123
Q

Small Intestine: Microscopic Anatomy- Duodneal Glands

A

in submucosa of duodenum

  • Secrete an abundance of bicarbonate-rich mucus
  • Neutralize stomach acid and shield the mucosa from its erosive effects
124
Q

Small Intestine: Microscopic Anatomy- Lymphocytes

A

Large population of lymphocytes throughout lamina propria and submucosa of small intestine

•Intercept pathogens before they can invade bloodstream

Aggregated into lymphatic nodules in ileum

125
Q

Intestinal Motility: Small Intestine Contraction Functions: 3 Reasons

A

1.To mix chyme with intestinal juice, bile, and pancreatic juice

  • To neutralize acid
  • Digest nutrients more effectively
  1. To churn chyme and bring it in contact with the mucosa for contact digestion and nutrient absorption
  2. To move residue toward large intestine
126
Q

Intestinal Motility: Segmentation

A

movement in which stationary ring-like constrictions appear in several places along the intestine

  • They relax and new constrictions form elsewhere
  • Most common kind of intestinal contraction
  • Enteric pacemaker cells in muscularis externa set rhythm of segmentation
  • Contractions about 12 times per minute in the duodenum
  • 8 to 9 times per minute in the ileum
  • When most nutrients have been absorbed and little remains but undigested residue, segmentation declines and peristalsis begins

Ileal papilla usually closed

  • Food in stomach triggers gastroileal reflex that enhances segmentation in the ileum and relaxes the valve
  • As cecum fills with residue, pressure pinches the valve shut

Prevents reflux of cecal contents into the ileum

127
Q
A
128
Q

Carbohydrate Digestion: Starch

A

Starch—most digestible dietary carbohydrate

  • Cellulose is indigestible
  • Starch is first digested to oligosaccharides (up to eight glucose residues long)
  • Oligosaccharides then digested to the disaccharide maltose
  • Maltose finally digested to glucose which is absorbed by the small intestine
129
Q

Carbohydrate Digestion: Process (Mouth)

A

Process begins in the mouth

  • Salivary amylase hydrolyzes starch into oligosaccharides
  • Amylase works best at pH of 6.8 to 7.0 of oral cavity
  • Amylase quickly denatured on contact with stomach acid and digested by pepsin
  • About 50% of dietary starch is digested before it reaches small intestine
  • Pancreatic amylase resumes starch digestion in intestine
130
Q

Carbohydrate Digestion: Process (small Intestine)

A

When reaching small intestine, pancreatic amylase quickly converts starch to oligosaccharides and maltose

Brush border enzymes continue carbohydrate digestion:

  • Dextrinase and glucoamylase hydrolyze oligosaccharides
  • Maltase hydrolyzes maltose (a disaccharide)
  • Sucrase and lactase hydrolyze the disaccharides sucrose and lactose
  • In most people, lactase production stops in childhood
  • Monosaccharides produced by disaccharide hydrolysis (such as glucose) are immediately absorbed
131
Q

Carbohydrate Digestion: Process (Monosaccharides/ Glucose)

A

Plasma membrane of absorptive cells has transport proteins that absorb monosaccharides as soon as brush border enzymes release them

80% of absorbed sugar is glucose

  • Taken up by sodium–glucose transport (SGLT) proteins
  • Glucose is transported out the base of absorptive cell into ECF by facilitated diffusion
  • Sugar entering ECF increases its osmolarity
  • Draws water osmotically from lumen of intestine, through leaky tight junctions between epithelial cells
  • Water carries more glucose and other nutrients with it by solvent drag
132
Q

Carbohydrate Digestion: Process (Galactose, Fructose, etc)

A

SGLT also absorbs galactose

Fructose is absorbed by facilitated diffusion (by a different carrier protein) and converted to glucose

Glucose, galactose, and any remaining fructose are transported out of the base of the cell by facilitated diffusion

Absorbed by blood capillaries in the villus

Hepatic portal system delivers them to the liver

133
Q

Lactose Intolerance

A

In people without lactase, lactose passes undigested into large intestine

  • Increases osmolarity of intestinal contents
  • Causes water retention in the colon and diarrhea
  • Gas production by bacterial fermentation of the lactose

Occurs in many people

•15% of American Whites, 90% of American Blacks, 70% of Mediterraneans; and nearly all of Asian descent

Can consume yogurt and cheese since bacteria have broken down the lactose

134
Q

Protein Digestion- Sources

A

Amino acids absorbed by the small intestine come from three sources

  • Dietary proteins
  • Digestive enzymes digested by each other
  • Sloughed epithelial cells digested by enzymes

Endogenous amino acids from last two sources total about 30 g/day

Exogenous amino acids from our diet total about 44 to 60 g/day

135
Q

Protein Digestion: Proteases

A

Proteases (peptidases)—enzymes that digest proteins

  • Begin their work in stomach in optimum pH of 1.5 to 3.5
  • Pepsin hydrolyzes any peptide bond between tyrosine and phenylalanine
  • Pepsin digests 10% to 15% of dietary protein into shorter peptides and some free amino acids
136
Q

Protein Digestion: Small Intestine- Pepsin

A

Protein digestion continues in small intestine

  • Pepsin inactivated when it passes into the duodenum and mixes with alkaline pancreatic juice (pH 8)
  • Pancreatic enzymes trypsin and chymotrypsin take over the process

Hydrolyze polypeptides into even shorter oligopeptides

137
Q

Protein Digestion: Carboxypeptidase, Aminopeptidase, & Dipeptidase

A

1.Carboxypeptidase—removes amino acids from –COOH end of the chain

Carboxypeptidase is a pancreatic secretion

  1. Aminopeptidase (Brush border enzyme)—removes amino acids from –NH2 end
  2. Dipeptidase (brush border enzyme)—splits dipeptides in the middle and release two free amino acids
138
Q

Protein Absorbstion

A

Brush border enzymes finish task, producing free amino acids that are absorbed into intestinal epithelial cells

  • Sodium-dependent amino acid cotransporters move amino acids into epithelial cells
  • Facilitated diffusion moves amino acids out into bloodstream

Infants absorb proteins by pinocytosis (maternal IgA) and release them into the blood by exocytosis

139
Q

Lipids Absorption

A

Hydrophobicity of lipids makes their digestion and absorption complicated

Lipases—fat-digesting enzymes

  • Lingual lipase secreted by intrinsic salivary glands of the tongue
  • Active in mouth, but more active in stomach along with gastric lipase
  • 10% to 15% of lipids digested before reaching duodenum
  • Before digestion in duodenum, vigorous pumping in stomach’s antrum emulsifies the fat (breaks up globs)

Emulsification droplets are passed to small intestine

140
Q

Lipid Digestion: Emulification Droplets Breakdown

A

Emulsification droplets are broken down further by bile, lecithin, and agitation produced by intestinal segmentation

•Exposes more fat surface to enzymatic action

There is enough pancreatic lipase in the small intestine after a meal to digest the average daily fat intake in as little as 1 to 2 minutes

Lipase acts on triglycerides

•Removes first and third fatty acids from glycerol backbone, but leaves the middle one

The product of lipase action are two free fatty acids (FFAs) and a monoglyceride

141
Q

Lipid Digestion: Micelles

A

Absorption of free fatty acids, monoglycerides, and other lipids depends on minute droplets in the bile called micelles

  • Made in the liver
  • Consist of 20 to 40 bile acid molecules aggregated with their hydrophilic side groups facing outward and their hydrophobic steroid rings facing inward

Bile phospholipids and cholesterol diffuse into the center of the micelle to form its core

142
Q

Lipid Digestion: Micelles Function

A

Micelles pass down the bile duct into the duodenum

•There they absorb fat-soluble vitamins, cholesterol, and the FFAs and monoglycerides produced by fat digestion

They transport lipids to the surface of the intestinal absorptive cells

Lipids leave the micelles and diffuse through the plasma membrane into the cells

Micelles are reused, picking up another cargo of lipid,
transporting them to the absorptive cells

143
Q

Lipid Digestion: free fatty acids and monoglycerides

A

Within the intestinal cell, free fatty acids and monoglycerides are transported to the smooth ER

Resynthesized into triglycerides

Golgi complex coats these with phospholipids and protein to form chylomicrons

  • Packaged into secretory vesicles that migrate to basal surface of cell
  • Release their contents into core of villus
  • Taken up by lacteal into lymph
  • White, fatty intestinal lymph (chyle) flows into larger and larger lymphatic vessels until it enters the bloodstream
144
Q

Nucleic Acid Digestion

A

Nucleic acid

  • Nucleases (deoxyribonuclease and ribonuclease) of pancreatic juice hydrolyze DNA and RNA to nucleotides
  • Nucleosidases and phosphatases of brush border split them into phosphate ions, ribose or deoxyribose sugar, and nitrogenous bases

Membrane carriers allow absorption

145
Q

Vitmain Digestion

A
  • Absorbed unchanged
  • Fat-soluble vitamins: A, D, E, and K absorbed with other lipids
  • If ingested without fat-containing food, they are not absorbed at all but are passed in the feces and wasted
  • Water-soluble vitamins, B complex and C, absorbed by simple diffusion and B_12 if bound to intrinsic factor from the stomach
146
Q

Mineral Digestion (Electrolytes)

A

Minerals (electrolytes)

  • Absorbed all along small intestine
  • Na+ cotransported with sugars and amino acids
  • Cl− exchanged for bicarbonate reversing chloride–bicarbonate exchange that occurs in the stomach
  • K+ absorbed by simple diffusion
147
Q

Mineral Digestion (Iron & Calcium)

A

Iron and calcium absorbed as needed

  • Iron absorption is inhibited by liver hormone hepcidin to prevent overload
  • Absorptive cells bind ferrous ions (Fe2+) and internalize them by active transport
  • Unable to absorb ferric ions (Fe3+) but stomach acid reduces ferric ions to absorbable ferrous ions
  • Transferrin (extracellular protein) transports iron in blood to bone marrow, muscle, and liver
148
Q

Mineral Digestion: Calcium Absorbtion Mechanisms

A

1.Transcellular absorption in the duodenum

  • Enters through calcium channels in apical cell membrane
  • Binds to calbindin protein so concentration gradient will continue to favor calcium influx
  • Actively transported out of base of cell into bloodstream by calcium–ATPase and Na+–Ca2+ antiport

2.Diffusion between epithelial cells in jejunum and ileum

  • Most absorbed calcium is from meat and dairy
  • Dietary fat retards calcium absorption
149
Q

Mineral Digestion: Calcium PTH

A

Parathyroid hormone—secreted in response to a drop in blood calcium levels

  • Stimulates kidney to synthesize vitamin D from precursors made by epidermis and liver
  • Vitamin D affects absorptive cells of the duodenum in three ways
  • Increases number of calcium channels in apical membrane
  • Increases the amount of calbindin in cytoplasm
  • Increases the number of calcium–ATPase pumps at basal membrane
  • Parathyroid hormone increases the level of calcium in the blood
150
Q

Water Digestion

A

Digestive system is one of several systems involved in fluid balance

Digestive tract receives about 9 L of water/day

  • 0.7 L in food, 1.6 L in drink, 6.7 L in gastrointestinal secretions
  • 8 L is absorbed by small intestine and 0.8 L by large intestine

0.2 L voided in daily fecal output

151
Q

Water Digestion: Mechanisms

A

Water is absorbed by osmosis following the absorption of salts and organic nutrients

Diarrhea—occurs when large intestine absorbs too little water

  • Feces pass through too quickly if intestine is irritated
  • Feces contain high concentrations of a solute (such as lactose)

Constipation—occurs when fecal movement is slow, too much water gets reabsorbed, and feces become hardened

152
Q

Large Intestine: Gross Anatomy

A

Large intestine

  • Measures 1.5 m (5 ft.) long and 6.5 cm (2.5 in.) in diameter in cadaver
  • Begins as cecum inferior to ileal papilla
  • Appendix attached to lower end of cecum
  • Densely populated with lymphocytes—a significant source of immune cells
  • Ascending colon, right colic (hepatic) flexure, transverse colon, left colic (splenic) flexure, and descending colon frame the small intestine
  • Sigmoid colon is S-shaped portion leading down into pelvic cavity
153
Q

Large Intestine: Gross Anatomy- Rectume

A

Rectum: portion ending at anal canal

•Has three curves and three infoldings, called the transverse rectal folds (rectal valves)

154
Q

Large Intestine: Gross Anatomy- Anal Canal

A

Anal canal: final 3 cm of the large intestine

  • Passes through levator ani muscle and pelvic floor, terminates at the anus
  • Anal columns and sinuses—exude mucus and lubricant into anal canal during defecation
  • Large hemorrhoidal veins for superficial plexus in anal columns and around orifice
  • Hemorrhoids—permanently distended veins that protrude into anal canal or bulge outside the anus
  • Obesity and pregnancy
155
Q

Large Intestine: Muscularis Externa Features

A
  • Taenia coli—longitudinal fibers concentrated in three thickened, ribbon-like strips
  • Haustra—pouches in the colon caused by the muscle tone of the taeniae coli
  • Internal anal sphincter—smooth muscle of muscularis externa
  • External anal sphincter—skeletal muscle of pelvic diaphragm
156
Q

Omental appendices

A

club-like, fatty pouches of peritoneum adhering to the colon; unknown function

157
Q

Large Intestine Blood Supply

A

Supplied by mesenteric arteries.

The superior and inferior mesenteric veins drain the same parts of the large intestine as the correspondingly named arteries and drain into the hepatic portal system

158
Q

Large Intestine: Microscopic Anatomy- Mucosa

A

simple columnar epithelium

•Anal canal has nonkeratinized stratified squamous epithelium in its lower half for abrasion resistance

159
Q

Large Intestine: Microscopic Anatomy- Circular Folds/ Villi

A

None

160
Q

Large Intestine: Microscopic Anatomy- Intestinal Crypts

A

Intestinal crypts—glands sunken deep into lamina propria with a high density of mucus-secreting goblet cells

161
Q

Large Intestine: Microscopic Anatomy- Lamina Propia & Submucosal Layer

A

Lamina propria and submucosal have a lot of lymphatic tissue

•Provides protection from large population of bacteria in large intestine

162
Q

Intestineal Microbes

A

Gut microbiome—about 800 species of bacteria that populate the large intestine

  • Bacteria digest cellulose, pectin, and other carbohydrates for which our cells lack enzymes
  • Help in synthesis of vitamins B and K
163
Q

Flatus

A

Flatus—intestinal gas

  • Average person produces 500 mL of flatus per day
  • Most gas in large intestine is reabsorbed instead
  • Much of flatus is swallowed air, but bacteria add to it
  • Hydrogen sulfide, indole, and skatole produce odor
  • Hydrogen gas may explode during electrical cauterization used in surgery
164
Q

Large Intestine: Absorbtion & Motility

A

Large intestine takes about 36 to 48 hours to reduce residue of a meal to feces

  • Most time in transverse colon
  • Does not chemically change the residue
  • Reabsorbs water and electrolytes

Feces consist of about 75% water and 25% solids

•Solids: 30% bacteria, 30% undigested fiber, 10% to 20% fat, small amount of mucus, proteins, salts, digestive secretions, and sloughed epithelial cells

165
Q

Large Intestine: Absorbtion & Motility/ Contraction & Movement

A

Haustral contractions occur every 30 minutes

  • Distension of a haustrum stimulates it to contract
  • Churns and mixes residue promoting water and salt absorption

Mass movements—stronger contractions that occur one to three times a day

  • Triggered by gastrocolic and duodenocolic reflexes
  • Filling of the stomach and duodenum stimulates motility of the colon
  • Move residue several centimeters
166
Q

Neural Control of Defecation

A
  1. Feces stretch the rectum and stimulate stretch receptors, which transit signal to the spinal cord.
  2. A spinal reflex stimulates a contraction of the rectum
  3. The spinal reflex also relaxes the internal anal sphincter
  4. Impulses from the brain prevent untimely defecation by keeping the extermal anal sphinchter contracted

***Defecation only occurs only if this sphincter also relaxes

167
Q

What is the default of the reproductive development in the fetus? If no hormones are produced, can the XY embryo develop the female organ? Why or Why not?

A

•Sex of child determined by type of sperm that fertilizes
mother’s egg AND stimulation of specific hormones during development

–X-carrying sperm fertilizes the egg: female

–Y-carrying sperm fertilizes the egg: male

  • Initially, a fetus is sexually undifferentiated
  • Gonads begin to develop at 5 or 6 weeks as gonadal ridges
  • Two sets of ducts adjacent to each gonadal ridge

–In males, mesonephric ducts develop into reproductive tract; paramesonephric ducts degenerate

–In females, paramesonephric ducts develop into reproductive tract; mesonephric ducts degenerate

•The two sexes indistinguishable for first 8 to 10 weeks of development

1.Female reproductive tract develops from the paramesonephric ducts

–Not due to the positive action of any hormone but because of the absence of testosterone and müllerian-inhibiting factor (MIF)

-Estrogen levels are always high in pregnancy but if estrogen was the

–If estrogen was the hormone that directed female development, all fetuses would be feminized from mothers hormone

•Female development of a fetus occurs whenever there is an absence of androgen hormones

–Not because estrogen is present

2.SRY Gene (sex determining region on Y chromosome) found only in males codes for a portein TDF (testes determining factor)-TDF that initiates development of testes

–Testes begin to secrete testosterone at 8 to 9 weeks

•Stimulates mesonephric ducts to develop into male tracts

–At same time, the testes secrete müllerian-inhibiting factor causing degeneration of the paramesonephric ducts

168
Q

At what stage can you differentiate the sex of the fetus?

A

8-10 weeks into development when reproductive tract forms

169
Q

What hormones regulate the development and maturation of the male and females structures (gonads) and subsequently the sperm and oocyte? What roles do these homrones perform during different development stages? Fetus, infancy, childhood, adulthood?

A
  • *Male:**
    1. TDF (from SRY Gene)
  • fetal development: initiatives development of testes
    2. Mullerian Inihibiting Factor
  • fetal development: causes degeneration of the paramesonephric ducts
    3. Testosterone:
  • fetal development (at 8-9 weeks): stimulates mesenphreic duct to develop into male tract; levels are as about as high as they are in mid-puberty and then they become dormant until puberty; from puberty to adulthood, reproductive function is regulated by hormonal links btw. hypothalamus, pituitary gland, and gonads
  • puberty: secondary sexual characterisitcs; secretion peaks at 20 and then declines with age
    4. GnRH: released as hypothalamus is matured later in life> GnRH stimulates anterior pituitary to release:
    a. FSH (helps stimulate spermatogenesis)
    b. LH (stimulates production of testosterone)

Female:

  • female fetal development occus when there is a lack or absence of androgen hormones (not because estrogen is present)
    1. GnRH: stimulates anterior pituitary to secrete FSH (stimulats ovarian follicles to stimulate estrogen, progerstone, inhibin, and some androgen) and LH
    2. Estrogen: feminizing hormones with widespread effects on body-Estradiol, Estriol, Estrone.
  • Functions; vaginal metalplasia, growth of ovaries & sexual seconary sex organs, stimulates growth hormone secretion, stimulates fat deposition, thickens skin,etc.
    3. Progestrone: primarly acts on the utererus preparing it for possible pregnancy in the second half of the menstrual cycle; breast development;
    4. Prolactin- breast development in puberty
    5. Androgen: secondary sexual characteristics ie. pubic, axillary hair, sebaceous glands, axillary glands
    6. Leptin:stimulates gonadotropin secretion important in menstruation
170
Q
A
171
Q

GnRH

A

Rising levels of GnRH stimulates anterior pituitary to secrete FSH and LH in both male and females

172
Q

FSH in Females

A

stimulates ovarian follicles and they begin to secrete estrogen, progesterone, inhibin, and a small amount of androgen

173
Q

Estrogen

A

•feminizing hormones with widespread effects on the body

Estradiol (most abundant), estriol, and estrone

•Estradiol stimulates many changes in puberty

–Stimulates vaginal metaplasia

–Stimulates growth of ovaries and secondary sex organs

–Stimulates growth hormone secretion

•Increase in height and widening of pelvis

–Stimulates fat deposition (breast, hips, etc…)

–Thickens skin

•But girls’ skin is still thinner, softer, and warmer than boys

-

174
Q

Progesterone

A

–Primarily acts on the uterus preparing it for possible pregnancy in the second half of the menstrual cycle

175
Q

Estrogen/ Progestrone AND FSH/ LH

A
  • Estrogens and progesterone suppress FSH and LH secretion through negative feedback
  • Inhibin selectively suppresses FSH secretion
  • Hormone secretion is distinctly cyclic and the hormones are secreted in sequence
176
Q

Oogenesis

A

egg production

177
Q

Oogenesis Process

A

–Produces haploid gametes by means of meiosis

–Distinctly cyclic event that normally releases one egg each month

–Accompanied by cyclic changes in hormone secretion

–Cyclic changes in histological structure of the ovaries and uterus

  • Uterine changes result in monthly menstrual flow
  • Embryonic development of ovary

–Female germ cells arise from yolk sac

–Colonize gonadal ridges the first 5 to 6 weeks of development

–Differentiate into oogonia and multiply until the fifth month

•6 to 7 million in number

–Transform into primary oocytes: early meiosis I

–Most degenerate (atresia) by the time the girl is born

–Egg, or ovum: any stage from the primary oocyte to the time of fertilization

–By puberty, 200,000 oocytes remain

Lifetime supply—probably will ovulate only 480 times

•Egg development resumes in adolescence

–FSH stimulates monthly cohorts of about 24 oocytes to complete meiosis I

–Each oocyte divides into two haploid daughter cells of unequal size and different destinies

  • Important to produce an egg with as much cytoplasm as possible
  • If fertilized, it must divide repeatedly and produce numerous daughter cells

–Secondary oocyte: large daughter cell that is the product of meiosis I

–First polar body: smaller one that ultimately disintegrates

A means of discarding the extra set of haploid chromosomes

–Secondary oocyte proceeds as far as metaphase II

  • Arrests until after ovulation
  • If not fertilized, it dies and never finishes meiosis
  • If fertilized, it completes meiosis II and casts off a second polar body

–Chromosomes of the large remaining egg unite with those of the sperm

178
Q

Descent of Gonads (Development)

A
179
Q

Spermatogenesis

A

process of sperm production in seminiferous tubules

180
Q

Spermatogenesis Process

A

•Involves three principal events:

  1. Division and remodeling of large germ cells into small, mobile sperm cells with flagella
  2. Reduction of chromosome number by one-half
  3. Shuffling of genes so each chromosome contains new gene combinations that did not exist in parent

•Ensures genetic variation in the offspring

181
Q

Why is meiosis important in the production of the gametes, when is it completed in the female and when is it completed in the males?

A

Meiosis is important to produce haploid cells so that the sperm and egg can fuse and combin genetic material to form a full set.

Females: starts at fetal development and resumes at adolescence

–FSH stimulates monthly cohorts of about 24 oocytes to complete meiosis I

–Each oocyte divides into two haploid daughter cells of unequal size and different destinies

  • Important to produce an egg with as much cytoplasm as possible
  • If fertilized, it must divide repeatedly and produce numerous daughter cells

–Secondary oocyte: large daughter cell that is the product of meiosis I

–First polar body: smaller one that ultimately disintegrates

A means of discarding the extra set of haploid chromosomes

–Secondary oocyte proceeds as far as metaphase II

  • Arrests until after ovulation
  • If not fertilized, it dies and never finishes meiosis
  • If fertilized, it completes meiosis II and casts off a second polar body

Males:

  • Primary spermatocyte undergoes meiosis I which gives rise to two equal-size, haploid, genetically unique secondary spermatocytes
  • Each secondary spermatocyte undergoes meiosis II dividing into two spermatids—a total of four for each spermatogonium
  • Spermiogenesis—four spermatids undergo transformations in which they differentiate into a spermatozoa
182
Q

Testes

A

combined endocrine and exocrine glands that produce sex hormones and sperm

183
Q

Testes: Tunica Albuginea

A

white fibrous capsule on testes

184
Q

Testes: Seminiferous tubules

A

•ducts where sperm are produced

–One to three in each lobule

–Each tubule lined with a thick germinal epithelium of germ cells (becoming sperm) and nurse cells

–Nurse cells in between germ cells

  • Protect the germ cells, and promote their development
  • Germ cells depend on them for nutrients, waste removal, growth factors, and other needs
185
Q

Testes: Vas Deferens

A
186
Q

Testes: Epidiymis

A
187
Q

Testes: Rete Tesis

A

•a network on the posterior side of the testis that collects sperm from seminiferous tubules

–Sperm flow with fluid secreted by nurse cells

–Sperm do not swim while in the male reproductive tract

188
Q

Testes: Testicular Artery

A

•A testicular artery supplies each testis

–Low BP of testicular artery results in poor O_2 supply to the testes

–Sperm develop large mitochondria to cope with poor oxygen supply and to help them survive hypoxic environment of female reproductive tract

189
Q

Ovaries

A

•female gonads that produce egg cells (ova) and sex hormones

190
Q

Ovaries: Outer Cortex

A

where germ cells develop

191
Q

Ovaries: Inner medulla

A

occupied by major arteries and veins

192
Q

Ovaries: Ligaments

A

–Attached to uterus by ovarian ligament

–Attached to pelvic wall by suspensory ligament

•Contains ovarian artery, vein, and nerves

–Anchored to broad ligament by mesovarium

193
Q

Ovaries: Arteries

A

•Ovary receives blood from two arteries

–Ovarian branch of the uterine artery

–Ovarian artery

Equivalent to testicular artery in male

194
Q

What is the blood-testis-barrier?

A

•formed by tight junctions between nurse cells

–Separates sperm from immune system

–Prevents antibodies and other large molecules in the blood from getting to germ cells

–Germ cells are immunologically different from body cells and would be attacked by the immune system

195
Q

Climacteric

A

•midlife change in hormone secretion

–Accompanied by menopause: cessation of menstruation

196
Q

Menopause

A

cessation of menstruation

–Usually occurs between ages of 45 and 55

–Age of menopause has increased in last century

–Menopouse considered complete when there has been no menstruation for a year

197
Q

Menopause Symptoms

A

Symptoms:

–Follicles less responsive to gonadotropins – secrete less estrogen and progesterone

–Uterus, vagina, and breast atrophy

–Intercourse may become uncomfortable

–Vaginal infections more common

–Skin becomes thinner

–Cholesterol levels rise, increasing risk of cardiovascular disease

–Bone mass declines, increasing risk of osteoporosis

–Blood vessels constrict and dilate in response to shifting hormone balances

•Dilations may produce hot flashes: spreading sense of heat from abdomen to thorax, neck, and face

198
Q

Andropause

A

•male climacteric

–A period of declining reproductive function that may be first seen in early 50s

–Although sperm counts decline, men can still father children throughout old age

199
Q

Andropause Symptoms

A
200
Q

Breast

A

•mound of tissue overlying pectoralis major

–Enlarges at puberty and remains so for life

–Most of the time it contains very little mammary gland

201
Q

Mammary Gland

A

•Mammary gland—develops within the breast during pregnancy

–Remains active in the lactating breast

–Atrophies when a woman ceases to nurse

202
Q

Breast: Body

A

–conical to pendulous, with nipple at its apex

203
Q

Breast: Axillary Tail

A

–extension toward armpit

•Lymphatics in axillary tail are important as a route for breast cancer metastasis

204
Q

Breast: Nipple

A

•surrounded by circular colored zone, called the areola

–Capillaries and nerves close to skin surface: more sensitive

–Sensory nerve fibers of areola trigger a milk ejection reflex when an infant nurses

205
Q

Breast: Areolar glands:

A

–intermediate between sweat glands and mammary glands

•Secretions protect the nipple from chapping and cracking during nursing

–Smooth muscle fibers in dermis of areola that contract in response to cold, touch, and sexual arousal, wrinkling the skin and erecting the nipple

206
Q

Breast: Suspensory ligaments

A

attach breast to dermis of overlying skin and fascia of the pectoralis major

207
Q

Nonlactating breast consists mostly of what?

A

•The nonlactating breast consists mostly of adipose and collagenous tissue

–Breast size determined by amount of adipose tissue

208
Q

Breast: Ducts

A

•branch through fibrous stroma and converge on the nipple

–Mammary gland develops during pregnancy

–15 to 20 lobes around the nipple

–Lactiferous duct drains each lobe

•Dilates to form lactiferous sinus which opens into nipple

–Ducts ends in acini (sacs)

Acini are surrounded by myoepithelial cells

209
Q

Breast Cancer: Risk Factors, Causes, Symptoms, Testing

A

•Breast cancer occurs in 1 out of 8 or 9 American women

–A leading cause of female mortality

•Tumors begin with cells from mammary ducts

–May metastasize by mammary and axillary lymphatics

  • Signs may include lump, skin puckering, changes in skin texture, and drainage from nipple
  • Contibuting causes

–BRCA1 and BRCA2: two breast cancer genes

•But most breast cancer is nonhereditary

–Some breast cancers are stimulated by estrogen

•Risk factors

–Aging, exposure to ionizing radiation, carcinogenic chemicals, excessive alcohol and fat intake, and smoking

–Over 70% of cases lack identifiable risk factors

  • Tumor discovery usually during breast self-examination (BSE)—monthly for all women
  • Mammograms (breast X-rays)

–Late 30s: baseline mammogram

–Ages 40 to 49: every 2 years

–Over age 50: yearly

210
Q

Breast Cancer: Treatments

A
  1. Lumpectomy: removal of tumor only
  2. Simple mastectomy: removal of breast tissue only or breast tissue and some axillary lymph nodes
  3. Radical mastectomy: removal of breast, underlying muscle, fascia, and lymph nodes

•Rarely done as it generally does not improve outcome

  1. Surgery is followed by radiation or chemotherapy
  2. Breast reconstruction from skin, fat, and muscle from other parts of the body
211
Q

Prostate Cancer: Causes, Symptoms, Tests

A

–Second most common cancer in men after lung cancer

–Tumors tend to be near the periphery of the gland where they do not obstruct urine flow

•Go unnoticed until they cause pain

–Metastasize to nearby lymph nodes and then to lungs and other organs

–Digital rectal exam (DRE): palpated through rectal wall to check for tumors

–Diagnosed from elevated levels of serine protease (PSA) and acid phosphatase in the blood

212
Q

Benign prostatic hyperplasia

A

•noncancerous enlargement of the prostate

–Compresses urethra and obstructs flow of urine

–Promotes bladder and kidney infections

213
Q

Sexually Transmitted Diseases: Incubation Period

A

•Many STDs have an incubation period in which the pathogen multiplies with no symptoms and a communicable period in which the disease can be transmitted to others

–Symptomless carriers do exist

214
Q

Bacterial STDs

A
  1. Chlamydia
  2. Gonorrhea
  3. Syphilis
215
Q

Chlamydia

A

Bacterial STD

may cause urethral discharge and testicular pain

216
Q

Gonorrhea

A

Bacterial STD

–pain and pus discharge; may result in sterility from pelvic inflammatory disease

217
Q

Syphilis

A

Bacterial STD

–hard lesions (chancres) at site of infection

  • Disappearance of chancres ends first stage
  • Second stage is widespread pink rash
  • Neurosyphilis is third stage with cardiovascular damage and brain lesions
218
Q

Viral STDs

A
  1. Genital herpes:
  2. Genital warts:
  3. Hepatitis B and C:
219
Q

Genital Herpes

A

Viral STD

–most common STD in United States

•Blisters and pain

220
Q

Genital warts:

A

Viral STDs

–warts on perineal region, cervix, anus

  • Caused by human papillomavirus (HPV)
  • Vaccine available
221
Q

Hepatitis B and C

A

Viral STD

inflammatory liver disease

222
Q

Menarche & Menstrual Cycles

A

first menstrual period

–Requires at least 17% body fat in teenager

  • Improved nutrition has lowered age of onset to age 12
  • Leptin stimulates gonadotropin secretion
  • If body fat and leptin levels drop too low, gonadotropin secretion declines and menstrual cycle might cease

–Menstruation ceases when body fat drops below 22% in adult woman

  • First few menstrual cycles are anovulatory (no egg ovulated)
  • Girls begin ovulating regularly about a year after they begin menstruating
223
Q

What hormones are associated with the development of the secondary male and female structures during puberty?

A

Males: Testosterone

Females:

estrogen= widespread effects

  • vaginal metaplasa
  • growth of ovaries and secondary sex organs
  • growth hormone secretion (height and widening of pelvis)
  • fat deposition (breasts, hips, etc)
  • thickens skins

progestone= breast development; utereus preparation for pregnancy

prolactic= breast development

androgens= pubarche (pubic and axillary hair, sebacaceous glands,& axillary glands)

A&P2 (13 decks)

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