Unit 18 - Digestive System #2

Question 1

The ______ finishes the chemical digestion process and is responsible for absorbing most of the nutrients and fluids.

Answer 1

Small Intestine

Question 2

Ingested nutrients spend at least ______ in the small intestine as chemical digestion and absorption are completed.

Answer 2

12 hours

Question 3

The small intestine extends from the pylorus of the stomach to the cecum of the large intestine, and thus occupies a significant portion of the abdominal cavity.

Answer 3

True

Question 4

The “small intestine” (small bowel) is a coiled, thin-walled tube about 20 feet in length in a freshly dead person (it is much shorter in a living individual due to muscle tone).

Answer 4

True

Question 5

The small intestine receives its blood supply primarily from branches of the ______

Answer 5

superior mesenteric artery

Question 6

Venous drainage of the small intestine leads to the _____

Answer 6

hepatic portal vein

Question 7

The small intestine consists of three specific segments.

Answer 7

Duodenum, Jejunum, Ileum

Question 8

The duodenum, 10 inches long, is arched into a C-shape around the head of the pancreas and becomes continuous with the jejunum at the _____

Answer 8

“duodenojejunal flexure”

Question 9

Most of the duodenum is ____

Answer 9

retroperitoneal.

Question 10

Within the duodenum is the _____ through which bile from the liver and pancreatic juice from the pancreas enter the duodenum.

Answer 10

“major duodenal papilla”,

Question 11

The jejunum is the primary region within the small intestine for chemical digestion and nutrient absorption.

Answer 11

True

Question 12

It extends about 7.5 feet and makes up approximately two-fifths of the small intestine’s total length.

Answer 12

Jejunum

Question 13

It is intraperitoneal and suspended in the abdomen by the mesentery proper.

Answer 13

Jejunum and Ileum

Question 14

It is about 10.8 feet in length and forms approximately three-fifths of the small intestine.

Answer 14

Ileum

Question 15

Ileum’s distal end terminates at the _____, a sphincter that controls the entry of materials into the large intestine.

Answer 15

“ileocecal valve”

Question 16

The walls of the ileum have numerous aggregates of lymph nodes _____

Answer 16

(Peyer patches)

Question 17

Internally, the mucosal and submucosal tunics of the small intestine are thrown into _____

Answer 17

“circular folds”

Question 18

Circular folds, which can be seen with the naked eye, help increase the surface area through which nutrients can be absorbed.

b. In addition, the circular folds act like speed bumps to slow down the movement of chyme and ensure that it remains within the small intestine for maximal nutrient absorption.

Answer 18

True

Question 19

Circular folds are more numerous in the duodenum and jejunum, and least numerous in the ileum.

Answer 19

True

Question 20

When circular folds are viewed at the microscopic level, smaller, fingerlike projections of mucosa only, called _____, can be seen along their surface.

Answer 20

“villi”

These villi help increase further the surface area for absorption and secretion.

Question 21

Increasing the absorptive surface area even further are ______ along the free surface of the surface epithelial cells.

Answer 21

“microvilli”

Question 22

Each villus contains an arteriole and a venule, forming a rich capillary network, and a single lacteal.

Answer 22

True

Question 23

The capillaries absorb most nutrients.

The lacteal absorbs lipids and lipid-soluble vitamins, which are too large to be absorbed by the capillaries.

Answer 23

True

Question 24

Between some of the intestinal villi are invaginations of mucosa called ______ that produce mucus, digestive enzymes, and hormones that aid digestion.

Answer 24

“intestinal glands”

Question 25

The proximal duodenum contains ______ which produce a viscous, alkaline mucus that protects the duodenum from the acidic chyme.

Answer 25

“submucosal glands”

Question 26

a problem that often follows abdominal surgery.

Answer 26

Adhesions

Question 27

forms a three-sided perimeter in the abdominal cavity around the centrally located small intestine.

Answer 27

Large Intestine

Question 28

From its origin at the ileocecal junction to its termination at the anus, the large intestine has an approximate length of ____

Answer 28

5 feet.

Question 29

It is called the “large” intestine because its diameter is greater than that of the small intestine.

Answer 29

True

Question 30

On average, about _____ of digested material passes from the small intestine to the large intestine daily.

Answer 30

1 liter

Question 31

The large intestine absorbs most of the water and electrolytes (salts) from the remaining digested material.

a. In so doing, the watery material that first enters the large intestine soon solidifies and becomes “feces”.

The large intestine also absorbs a very small percentage of the nutrients and fluids still remaining in the digested material.

Answer 31

True

Question 32

The first region of the large intestine is a blind sac, called the ______, located in the right lower abdominal quadrant

Answer 32

“cecum”

Question 33

This pouch extends inferiorly from the “ileocecal valve”, which represents the attachment of the distal end of the small intestine to the proximal end of the large
intestine.

Answer 33

Cecum

Question 34

Projecting inferiorly from the posteromedial region of the cecum is the _____, a thin, hollow, fingerlike sac lined by lymphocyte-filled lymphatic nodules.

Answer 34

“vermiform appendix”

Question 35

Inflammation of the appendix is called

Answer 35

appendicitis

Question 36

Most cases of appendicitis occur because _____ obstructs the appendix. As the tissue in its wall becomes inflamed, the appendix swells, the blood supply is compromised, and bacteria may proliferate in the wall.

Answer 36

fecal matter

Question 37

the appendix may burst and release its contents into the peritoneum, causing a massive and potentially deadly infection called _____

Answer 37

peritonitis

Question 38

If the appendicitis fails to resolve, the inflamed appendix may be surgically removed in a procedure called an _____

Answer 38

appendectomy

Question 39

Both the cecum and the appendix are ____ organs.

Answer 39

intraperitoneal

Question 40

originates at the ileocecal valve and extends superiorly

from the superior edge of the cecum along the right lateral border of the abdominal cavity.

Answer 40

“ascending colon”

Question 41

The ascending colon is retroperitoneal, since its posterior wall directly adheres to the posterior abdominal wall, and only its anterior surface is covered with peritoneum.

Answer 41

True

Question 42

As it approaches the inferior surface of the liver, the ascending colon makes a 90-
degree turn toward the left side of the abdominal cavity.
- This bend in the colon is called the _____

Answer 42

“right colonic flexure”

Question 43

The ______ originates at the right colonic flexure and curves slightly anteriorly as it projects horizontally across the anterior region of the abdominal cavity.

Answer 43

“transverse colon”

It is intraperitoneal.

Question 44

As the transverse colon approaches the spleen in the left upper quadrant of the abdomen, it makes a 90-degree turn inferiorly.
- The resulting bend in the colon is called the ______

Answer 44

“left colonic flexure” (“splenic flexure”).

Question 45

The “descending colon” is ______ and found along the left side of the abdominal cavity.

It originates at the left colonic flexure and descends vertically until it terminates at the sigmoid colon.

Answer 45

retroperitoneal

Question 46

The ______ originates at the “sigmoid flexure”, where the descending colon curves inferomedially into the pelvic cavity.

Answer 46

“sigmoid colon”

Question 47

The sigmoid colon is intraperitoneal.

It terminates at the rectum.

Answer 47

True

Question 48

A condition called _______ which may occur in the sigmoid colon because of the increased pressure (from constipation and/or gas) that exists in this region, can lead to small sacs or pouches developing in the intestinal wall.

Answer 48

“diverticulosis”

Question 49

These diverticuli may become inflamed (“diverticulitis”)

Answer 49

True

Question 50

The _____ is a retroperitoneal structure that connects to the sigmoid colon.

Answer 50

“rectum”

Question 51

Three thick transverse folds of the rectum, called ______, ensure that fecal material is retained during the passing of gas

Answer 51

“rectal valves”

Question 52

The _____ is a muscular tube that readily expands to store accumulated fecal material prior to defecation.

Answer 52

rectum

Question 53

The terminal few centimeters of the large intestine are called the ______

Answer 53

“anal canal”.

Question 54

The internal lining of the anal canal contains relatively thin longitudinal ridges, called ______, between which are small depressions termed _______.

Answer 54

“anal columns”, “anal sinuses”

Question 55

As fecal material passes through the anal canal during defecation, pressure exerted on the anal sinuses causes their cells to release ______

Answer 55

mucin.

Question 56

At the base of the anal canal are the ______, which close off the opening to the anal canal and relax (open) during defecation.

Answer 56

“internal anal sphincter” and the “external anal sphincter”

Question 57

Unlike the small intestine, the large intestine lacks intestinal ______; however, it contains numerous intestinal glands that secrete mucus.

Answer 57

villi

Question 58

The _____ act like elastic on a waistband to help bunch up the large intestine into many sacs, collectively called ______

Answer 58

teniae coli, “haustra”

Question 59

Hanging off the external surface of the haustra are lobules of fat called _______

Answer 59

“epiploic appendages”.

Question 60

second most common type of cancer in the United States

Answer 60

Colorectal cancer

Question 61

_____ refers to a malignant growth anywhere along the intestine (colon and rectum)

Answer 61

colorectal cancer

Question 62

Most colorectal cancers arise from _____, which are outgrowths from the colon mucosa.

Answer 62

polyps

Question 63

_______, which checks for the presence of blood in the stools

Answer 63

fecal occult blood test

Question 64

an endoscope is inserted into the rectum and sigmoid colon to check for polyps or cancer

Answer 64

sigmoidoscopy

Question 65

The endoscope is inserted into the large intestine at least up to the right colic flexure of the colon, and sometimes as far proximally as the ileocecal valve

Answer 65

colonoscopy

Question 66

an autoimmune disorder that affects up to 1% of the population in the United States. Gluten—a protein common in wheat, rye, and barley (but not rice or corn)—stimulates an immune response in affected individuals that damages the villi of the small intestine, which interferes with absorption.

Answer 66

Celiac disease

Question 67

The term inflammatory bowel disease (IBD) applies to two autoimmune disorders,

Answer 67

Crohn disease and ulcerative colitis. In both of these disorders, selective regions of the intestine become inflamed

Question 68

characterized by intermittent and relapsing episodes of intense abdominal cramping and diarrhea. Although any region of the GI tract may be involved, the distal ileum is the most frequently and severely affected site.

Answer 68

Crohn disease

Question 69

ulcerative colitis involves only the large intestine

Answer 69

True

Question 70

ulcerative colitis is associated with a profoundly increased risk of colon cancer.

Answer 70

True

Question 71

characterized by abnormal function of the colon with symptoms of crampy abdominal pain, bloating, constipation, and/or diarrhea. It occurs in about one in every five people in the United States, and is more common in women than men.

Answer 71

irritable bowel syndrome (IBS)

Question 72

lies in the right upper quadrant of the abdomen, immediately inferior to the diaphragm and it is the largest internal organ of the body.

Answer 72

Liver

Question 73

The liver is covered by a connective tissue capsule.

Answer 73

True

Question 74

The liver is separated into two major lobes by the _______ a peritoneal fold that secures the liver to the anterior abdominal wall.

Answer 74

falciform ligament

Question 75

The liver’s connective tissue capsule branches through the liver and forms septa that partition the liver into thousands of small, polyhedral _______, which are the structural and functional units of the liver.

Answer 75

“hepatic lobules”

Question 76

Within hepatic lobules are liver cells called _____

Answer 76

“hepatocytes”.

Question 77

At the periphery of each lobule are several “portal triads”, composed of:

Answer 77

(a) Branches of the hepatic portal vein
(b) Branches of the hepatic artery
(c) Branches of the hepatic duct

Question 78

At the center of each lobule is a ______ that drains the blood flow to the lobule.
(a) Central veins collect venous blood and merge throughout the liver to form numerous “hepatic veins” that eventually empty into the inferior vena cava.

Answer 78

“central vein”

Question 79

The _____ carries blood from the capillaries of the GI tract, spleen,
and pancreas and provides about 75% of the blood volume to the liver.
- This blood is rich in nutrients and other absorbed substances but is relatively poor in oxygen.

Answer 79

“hepatic portal vein”

Question 80

The ______, a branch of the celiac trunk, carries well-oxygenated blood and supplies the remaining blood to the liver.

Answer 80

“hepatic artery proper”

Question 81

The numerous spokes of the wheel (hepatic lobule) are the _____, which are bordered by cords of hepatocytes.

Answer 81

“hepatic sinusoids”

Question 82

_______ are thin-walled and leaky capillaries where venous and arterial blood are mixed and then flow slowly toward the central vein.

Answer 82

Hepatic sinusoids

Question 83

The sinusoids are lined with stellate cells called _______ which phagocytize debris in blood as well as help break down and recycle components of aged erythrocytes and damaged or worn-out formed elements.

Answer 83

“reticuloendothelial cells”

Question 84

Nutrients are absorbed from the sinusoids and enter the hepatocytes.

In the spaces between the spokes are cords of hepatocytes.

Answer 84

True

Question 85

Sandwiched between each cord of hepatocytes is a small ______ which conduct bile from the hepatocytes to the hepatic duct in the portal triad.

Answer 85

“bile canaliculus”

Question 86

Hepatocytes produce _____, a yellowish or greenish fluid that breaks down fats into small droplets to assist in their chemical digestion.

Answer 86

“bile”

Bile contains bile salts, bilirubin (breakdown product of blood), and cholesterol

Question 87

(b) Hepatocytes detoxify drugs, metabolites, and poisons.
(c) Hepatocytes also store excess nutrients (typically as glycogen) and vitamins and
release them when they are needed.
(d) Hepatocytes synthesize blood plasma proteins.
- Albumin
- Globulins
- Clotting proteins

Answer 87

True

Question 88

results when hepatocytes have been destroyed and are replaced by fibrous scar tissue. This scar tissue often surrounds isolated nodules of regenerating hepatocytes.

Answer 88

Cirrhosis of the Liver

Question 89

The scar tissue also compresses both (1) the blood vessels, resulting in _____ (high blood pressure in the hepatic portal venous system

Answer 89

hepatic portal hypertension

Question 90

a long-term inflammation of the liver that leads to necrosis of liver tissue

Answer 90

Chronic hepatitis

Question 91

Most frequently, viral infections from either hepatitis B or hepatitis C produce chronic hepatitis

Answer 91

True

Question 92

Advanced liver cirrhosis may have a variety of complications:

Answer 92

■Jaundice (yellowing of the skin and sclerae of the eyes) occurs when the liver’s ability to eliminate bilirubin is impaired.

■Edema (e-dē′mă), the accumulation of fluid in body tissues, is evident due to reduced formation and release of albumin.

■Ascites (ā-sī′tēz; fluid accumulation in the abdomen) develops because of decreased albumin production.

■Intense itching occurs when bile products are deposited in the skin.

■Toxins in the blood and brain accumulate because the liver cannot effectively process them.

■Hepatic portal hypertension (high blood pressure in the hepatic portal venous system) can lead to dilated veins of the inferior esophagus (esophageal varices).

Question 93

End-stage liver cirrhosis can be treated only with a _____

Answer 93

liver transplant

Question 94

Attached to the inferior surface of the liver, a saclike organ called the ______ concentrates bile produced by the liver and stores this concentrate until it is needed for digestion.

Answer 94

“gallbladder”

Question 95

The ______ connects the gallbladder to the common bile duct.

Answer 95

“cystic duct”

Question 96

High concentration of certain materials in the bile may lead to the eventual formation of ____

Answer 96

gallstones

Question 97

The term _____ refers to the presence of gallstones in either the gallbladder or the biliary apparatus

Answer 97

cholelithiasis

Question 98

Treatment consists of surgical removal of the gallbladder, called _____

Answer 98

cholecystectomy

Question 99

Blood is brought to the gallbladder by a branch of the ______ and venous drainage eventually empties into the hepatic portal vein.

Answer 99

hepatic artery

Question 100

The pancreas is referred to as a mixed gland because it exhibits both _____ functions.

Answer 100

endocrine and exocrine

Question 101

The endocrine functions are performed by pancreatic islets ______ which produce insulin and glucagon.

Answer 101

(islets of Langerhans)

Question 102

Exocrine activity of pancreas results in the secretion of digestive enzymes, collectively called _____ into the duodenum

Answer 102

“pancreatic juice”

Question 103

The pancreas is a _______ organ that extends horizontally from the edge of the duodenum toward the left side of the abdominal cavity, touching the spleen.

Answer 103

retroperitoneal

Question 104

The Pancreas:

1) It exhibits a wide “head” adjacent to the curvature of the duodenum
2) A central, elongated “body” projecting toward the left abdominal wall
3) A “tail” that tapers as it approaches the spleen

Answer 104

Yes

Question 105

Pancreatic juice, in addition to digestive enzymes, contains _____ to help neutralize the acidic chime arriving in the duodenum from the stomach.

Answer 105

sodium bicarbonate

Question 106

The majority of the pancreatic juice travels through the ________ towards the duodenum.

Answer 106

“main pancreatic duct”

Question 107

The pancreas is supplied with arterial blood by a branch of the splenic artery and superior mesenteric artery while venous blood eventually drains into the hepatic portal vein.

Answer 107

Yes

Question 108

The _____ is a network of thin ducts that carry bile from the liver and gallbladder to the duodenum.

Answer 108

“biliary apparatus”

Question 109

The left and right lobes of the liver drain bile into the ______, respectively.

Answer 109

“left and right hepatic ducts”

Question 110

The left and right hepatic ducts merge to form a single _____.

Answer 110

“common hepatic duct”

Question 111

The ______ attaches to the common hepatic duct and carries bile to and from the gallbladder.

Answer 111

“cystic duct”

Question 112

The union of the cystic duct and the common hepatic duct from the ______ that extends inferiorly to the duodenum.

Answer 112

“common bile duct”

Question 113

The ______ is a posteriorly placed swelling on the duodenal wall where the common bile duct and main pancreatic duct merge and pierce the duodenal wall.

Answer 113

“hepatopancreatic ampulla”

Question 114

Bile and pancreatic juice mix in the hepatopancreatic ampulla prior to emptying in
the duodenum via the ______

Answer 114

“major duodenal papilla”.

Question 115

The exit of the hepatopancreatic ampulla into the duodenum is regulated by the
______ which controls the release of fluid from the hepatopancreatic ampulla and prevents the entrance of duodenal contents.

Answer 115

“sphincter of Oddi”