The Digestive System and Body Metabolism  Anus

Mouth (Oral Cavity) Anatomy

 Digestion  Lips (labia) – protect
o Breakdown of ingested food the anterior
 Absorption opening
o Passage of nutrients into the blood
 Metabolism  Cheeks – form the
o Production of cellular energy (ATP) lateral walls

 Hard palate –
forms
Organs of the Digestive System
the anterior roof
 Two main groups
 Soft palate – forms
 Alimentary canal – continuous coiled the posterior roof
hollow tube
 Uvula – fleshy
 Accessory digestive organs projection of the
soft palate

 Vestibule – space
between lips
externally and
teeth and gums
internally

 Oral cavity – area

contained by the
teeth

 Tongue – attached
at hyoid and styloid
processes of the
skull, and by the
lingual frenulum

 Tonsils

 Palatine tonsils

 Lingual tonsil
Organs of the Alimentary Canal

 Mouth
Processes of the Mouth
 Pharynx
 Mastication
 Esophagus (chewing) of food
 Stomach  Mixing masticated food with saliva
 Small intestine  Initiation of swallowing by the tongue
 Large intestine  Allowing for the sense of taste
Pharynx Anatomy  Submucosa

 Nasopharynx –  Just beneath the mucosa

not part of the
 Soft connective tissue with blood
digestive system
vessels, nerve endings, and lymphatics
 Oropharynx –
 Muscularis externa – smooth muscle
posterior to oral
cavity  Inner circular layer
 Laryngopharynx –  Outer longitudinal layer
below the
oropharynx and  Serosa
connected to  Outermost layer – visceral peritoneum
the esophagus
 Layer of serous fluid-producing cells
Pharynx Function

 Serves as a passageway for air and food

 Food is propelled to the esophagus by two

muscle layers

 Longitudinal inner layer

 Circular outer layer

 Food movement is by alternating contractions

of the muscle layers (peristalsis)

Esophagus

 Runs from pharynx to stomach through the Stomach Anatomy

diaphragm
 Located on the left side of the abdominal cavity
 Conducts food by peristalsis
 Food enters at the cardioesophageal sphincter
(slow rhythmic squeezing)
 Regions of the stomach
 Passageway for food only (respiratory system
branches off after the pharynx) o Cardiac region – near the heart
Layers of Alimentary Canal Organs o Fundus
 Mucosa o Body
 Innermost layer o Phylorus – funnel-shaped terminal end
 Moist membrane  Food empties into the small intestine at the
 Surface epithelium pyloric sphincter

 Small amount of connective  Rugae – internal folds of the mucosa

tissue  External regions
(lamina propria)
o Lesser curvature
 Small smooth muscle layer
 o Greater curvature  Parietal cells – produce hydrochloric
acid
 Layers of peritoneum attached to the stomach
 Endocrine cells – produce gastrin
 Lesser omentum – attaches the liver to
the lesser curvature Structure of the Stomach Mucosa

 Greater omentum – attaches the  Gastric pits formed by folded mucosa

greater curvature to the posterior body
 Glands and specialized cells are in the gastric
wall
gland region
 Contains fat to insulate, cushion, and
protect abdominal organs

Small Intestine

 The body’s major digestive organ

 Site of nutrient absorption into the blood

 Muscular tube extending form the pyloric

sphincter to the ileocecal valve
Stomach Functions  Suspended from the posterior abdominal wall
by the mesentery
 Acts as a storage tank for food
Subdivisions of the Small Intestine
 Site of food breakdown
“Dogs Just Itch!
 Chemical breakdown of protein begins
 Duodenum
 Delivers chyme (processed food) to the small
intestine  Attached to the stomach
Specialized Mucosa of the Stomach  Curves around the head of the pancreas
 Simple columnar epithelium  Jejunum
 Mucous neck cells – produce a sticky  Attaches anteriorly to the duodenum
alkaline mucus
 Ileum
 Gastric glands – secrete gastric juice
 Extends from jejunum to large intestine
 Chief cells – produce protein-digesting
enzymes (pepsinogens) Chemical Digestion in the Small Intestine

 Source of enzymes that are mixed with chyme

  Intestinal cells

 Pancreas

 Bile enters from the gall bladder Structures Involved in Absorption of Nutrients

 Absorptive cells

 Blood capillaries

 Lacteals
(specialized
lymphatic
capillaries)

Villi of the Small Intestine

 Fingerlike structures formed by the mucosa

 Give the small intestine more surface area Folds of the Small Intestine

 Called circular folds or plicae circulares

 Deep folds of the mucosa and submucosa

 Do not disappear when filled with food

 The submucosa has Peyer’s patches (collections

of lymphatic tissue)

Digestion in the Small Intestine

 Enzymes from the brush border

 Break double sugars into simple sugars

 Complete some protein digestion

 Pancreatic enzymes play the major digestive

function

 Help complete digestion of starch

(pancreatic amylase)

Microvilli of the Small Intestine  Carry out about half of all protein
digestion (trypsin, etc.)
 Small projections
of the plasma  Pancreatic enzymes play the major digestive
membrane function (continued)

 Found on  Responsible for fat digestion (lipase)

absorptive cells
 Digest nucleic acids (nucleases)

 Alkaline content neutralizes acidic

chyme
  Accumulation of lymphatic tissue that
sometimes becomes inflamed
(appendicitis)
Absorption in the Small Intestine
 Hangs from the cecum
 Water is absorbed along the length of the small
 Colon
intestine
o Ascending
 End products of digestion
o Transverse
 Most substances are absorbed by active
transport through cell membranes o Descending
 Lipids are absorbed by diffusion o S-shaped sigmoidal
 Substances are transported to the liver by the  Rectum
hepatic portal vein or lymph
 Anus – external body opening

Food Breakdown and Absorption in the Large Intestine

Propulsion in the Small Intestine
 No digestive enzymes are produced
 Peristalsis is the major means of moving food
 Resident bacteria digest remaining nutrients
 Segmental movements
 Produce some vitamin K and B
 Mix chyme with digestive juices
 Release gases
 Aid in propelling food
 Water and vitamins K and B are absorbed
Large Intestine
 Remaining materials are eliminated via feces
 Larger in diameter, but shorter than the small
intestine Propulsion in the Large Intestine

 Frames the internal abdomen  Sluggish peristalsis

 Mass movements

 Slow, powerful movements

 Occur three to four times per day

 Presence of feces in the rectum causes a

defecation reflex

 Internal anal sphincter is relaxed

 Defecation occurs with relaxation of the

voluntary (external) anal sphincter

Structures of the Large Intestine Accessory Digestive Organs

 Cecum – saclike first part of the large intestine  Salivary glands

 Appendix  Teeth

 Pancreas
  Liver

 Gall bladder

Salivary Glands

 Saliva-producing glands

 Parotid glands – located anterior to ears

 Submandibular glands

 Sublingual glands
Regions of a Tooth
Saliva
 Crown – exposed part
 Mixture of mucus and serous fluids
 Outer enamel
 Helps to form a food bolus
 Dentin
 Contains salivary amylase to begin starch
digestion  Pulp cavity

 Dissolves chemicals so they can be tasted  Neck

Teeth  Region in contact

with the gum
 The role is to masticate (chew) food
 Connects crown
 Humans have two sets of teeth to root
 Deciduous (baby or milk) teeth Pancreas
 20 teeth are fully formed by age two  Produces a wide spectrum of digestive enzymes
 Permanent teeth that break down all categories of food

 Replace deciduous teeth beginning  Enzymes are secreted into the duodenum
between the ages of 6 to 12  Alkaline fluid introduced with enzymes
 A full set is 32 teeth, but some people neutralizes acidic chyme
do not have wisdom teeth  Endocrine products of pancreas
Classification of Teeth  Insulin
 Incisors  Glucagons
 Canines Liver
 Premolars  Largest gland in the body
 Molars  Located on the right side of the body under the
diaphragm

 Consists of four lobes suspended from the

diaphragm and abdominal wall by the falciform
ligament

 Connected to the gall bladder via the common

hepatic duct
 Bile  Mechanical digestion

 Produced by cells in the liver  Mixing of food in the mouth by the

tongue
 Composition
 Churning of food in the stomach
 Bile salts
 Segmentation in the small intestine
 Bile pigment (mostly bilirubin from the
breakdown of hemoglobin)

 Cholesterol Processes of the Digestive System

 Phospholipids  Chemical Digestion

 Electrolytes  Enzymes break down food molecules

into their building blocks
Role of the Liver in Metabolism
 Each major food group uses different
 Several roles in digestion
enzymes
 Detoxifies drugs and alcohol
 Carbohydrates are broken to
 Degrades hormones simple sugars

 Produce cholesterol, blood proteins (albumin  Proteins are broken to amino

and clotting proteins) acids

 Plays a central role in metabolism  Fats are broken to fatty acids

and alcohols
Gall Bladder
 Absorption
 Sac found in hollow fossa of liver
 End products of digestion are absorbed
 Stores bile from the liver by way of the cystic in the blood or lymph
duct
 Food must enter mucosal cells and then
 Bile is introduced into the duodenum in the into blood or lymph capillaries
presence of fatty food
 Defecation
 Gallstones can cause blockages
 Elimination of indigestible substances as
Processes of the Digestive System feces
 Ingestion – getting food into the mouth

 Propulsion – moving foods from

one region of the digestive
system to another

Processes of the Digestive System

 Peristalsis – alternating waves of

contraction

 Segmentation – moving
materials back and forth to
aid in mixing

Processes of the Digestive System

Control of Digestive Activity - Upper abdominal discomfort associated with eating
(commonly called indigestion), is the most common
 Mostly controlled by reflexes via the
symptom of patients with GI dysfunction.
parasympathetic division

 Chemical and mechanical receptors are located

in organ walls that trigger reflexes Intestinal Gas

 Stimuli include: • The accumulation of gas in the GI tract may

result in belch_x0002_ing (expulsion of gas
 Stretch of the organ from the stomach through the mouth) or
 pH of the contents flatulence (expulsion of gas from the rectum).

 Presence of breakdown products • Nausea is a vague, uncomfortable sensation of

sickness or “queasiness” that may or may not
 Reflexes include: be followed by vomiting.
 Activation or inhibition of glandular CAUSES
secretions
(1) Visceral afferent stimulation (ie, dysmotility,
 Smooth muscle activity peritoneal irritation, infections, hepatobiliary or
pancreatic disorders, mechanical obstruction);
Body Energy Balance
(2) CNS disorders (ie, vestibular disorders, increased
 Energy intake = total energy output (heat +
intracranial pressure, infections, psychogenic disorder);
work + energy storage)
(3) Irritation of the chemoreceptor trigger zone from
 Energy intake is liberated during food
radiation therapy, systemic disorders, and antitumor
oxidation
chemotherapy medications.
 Energy output

 Heat is usually about 60%

Change in Bowel Habits and Stool Characteristics
 Storage energy is in the form of
fat or glycogen

Assessment of Gastrointestinal system

Common Symptoms

• Pain

PHYSICAL EXAMINATION

• Dyspepsia
 - Researchers have refined methods for genetics risk
assessment, preclinical diagnosis, and prenatal
diagnosis to identify people who are at risk for certain
GI disorders (eg, gastric cancer, lactose deficiency,
inflammatory bowel disease, colon cancer)

• Imaging Studies

- Xray and contrast studies

- computed tomography (CT)

- three-dimensional CT

DIAGNOSTIC EVALUATION - magnetic resonance imaging (MRI)

Serum Laboratory Studies - positron emission tomography (PET)

• CBC - scintigraphy (radionuclide imaging)

• Complete metabolic panel - virtual colonoscopy

• prothrombin time/partial thromboplastin time Xray

• triglycerides

• liver function tests

• amylase, and lipase.

Stool Tests

• Basic examination of the stool includes

inspecting the specimen for consistency, color,
and occult (not visible) blood.

• Breath Tests
CT
The hydrogen breath test was developed to evaluate
carbohydrate absorption, in addition to aiding in the
diagnosis of bacterial overgrowth in the intestine and
short bowel syndrome.

Urea breath tests detect the presence of Helicobacter

pylori, the bacteria that can live in the mucosal lining of
the stomach and cause peptic ulcer disease.

• Abdominal Ultrasonography

Ultrasonography is a noninvasive diagnostic technique

in which high-frequency sound waves are passed into
internal body structures and the ultrasonic echoes are
recorded on an oscilloscope as they strike tissues of
different densities.

• DNA Testing
3D-CT

Endoscopy

Scintigraphy

Colonoscopy & Sigmoidoscopy

PET

Disorders of the Oral Cavity

Dental Plaque and Caries

• Tooth decay is an erosive process that begins
with the action of bacteria on fermentable
Management
carbohydrates in the mouth, which produces acids that
dissolve tooth enamel. • Needle aspiration or drill
• Extent of damage to the teeth may be related • Antibiotics
to the following:
• Opioid analgesics
- Presence of dental plaque
DISORDERS OF THE JAW
- The length of time acids are in contact with
the teeth. Temporomandibular disorder

- The strength of acids and the ability of the • Myofascial pain: a discomfort in the muscles
saliva to neutralize them. controlling jaw function and in neck and shoulder
muscles
- The susceptibility of the teeth to decay.
• Internal derangement of the joint: a dislocated jaw, a
Prevention displaced disk, or an injured condyle
• Effective mouth care • Degenerative joint disease: rheumatoid arthritis or
osteoarthritis in the jaw joint
• reducing the intake of starches and sugars
(refined carbohydrates) Clinical manifestations
• applying fluoride to the teeth or drinking • Jaw pain (dull ache to throbbing, debilitating
fluoridated water pain that can radiate to the ears, teeth, neck muscles,
and facial sinuses.
• refraining from smoking
• restricted jaw motion and locking of the jaw.
• controlling diabetes
• clicking, popping, and grating sounds when the
• using pit and fissure sealants.
mouth is opened, and chewing and swallowing may be
Periapical Abscess difficult.

• AKA abscessed tooth, involves a collection of • Headaches, earaches, dizziness, and hearing
pus in the apical dental periosteum (fibrous membrane problems
supporting the tooth structure) and the tissue
Management
surrounding the apex of the tooth.
• nonsteroidal anti-inflammatory drugs (NSAIDs)
• Acute periapical abscess is usually secondary to
a suppurative pulpitis (a pus-producing inflammation of • opioids
the dental pulp) that arises from an infection extending
from dental caries. • muscle relaxants

• Chronic dentoalveolar abscess is a slowly • mild antidepressants

progressive infectious process. DISORDERS OF SALIVARY GLANDS
Clinical manifestations • Parotitis
• Pain (dull, gnawing, continuous) • Sialadenitis
• Swollen gum • Disoders of the Esophagus
• Swelling and cellulitis of the facial structures

• Systemic reaction: fever, and malaise.