THE DIGESTIVE SYSTEM

Makalah ini Disusun Untuk Memenuhi Tugas Mata Kuliah

“Bahasa Inggris”

Dosen Pengampu : Wiwit Agus S, S.Kep, Ns., M.Kep

Disusun Oleh :

Annisatul Ulfiati Rifa’I (201201006)

Auliya Alfatika Widodo (201701007)

Eka Juliastuti (201701014)

Galih Ekky Sapta Pertiwi (201701021)

Herlin Yuliastuti (201701022)

Mutiarani Ragil Ayu Pramesti (201701027)

Siti Latifah (201701031)

PROGRAM STUDI DIPLOMA III KEPERAWATAN

AKADEMI KEPERAWATAN
PEMERINTAH KABUPATEN PONOROGO
TAHUN 2018/2019
 The Digestive System

A. Digestive Processes

The food we eat is utilized at the cellular level in chemical

reactions involving : synthesis of proteins, carbohydrates, hormones, and
enzymes, cellular division, growth, and repair, and production of heat.To
become usable by the cells, most food must first be mechanically and
chemically reduced to forms that can be absorbed through the intestinal
wall and transported to the cells by the blood. The processes involved with
digestion include :

1. Ingestion : Taking food into the mouth (mechanical process)

2. Mastication : Chewing food (mechanical process)

Salivary action (chemical process)

3. Deglutition : Swallowing (mechanical process)

4. Peristaltis : Wavelike contractions that move food through the

GI tract (mechanical process)

5. Absorption : Passage of food molecules from the GI tract into

the circulatory or lymphatic system (mechanical and chemical process)

6. Defecation : Elimination of undigestible wastes (mechanical

process)

The digestive system can be divided into a tubular gastrointestinal

tract (GI tract) and accessory digestive organs.The GI tract extends from
the oral cavity, pharynx, esophagus, stomach, small intestine, and large
intestine,.The rectum and anal canal are located at the terminalend of the
large intestine.The accessory digestive organs include the teeth, tongue,
salivary glands liver, gallbladder, and pancreas.

B. Structure and Functions of the GI Tract

1. Oral cavity. The oral cavity ingests food, grinds and mixes it with
saliva, initiates digestion of carbohydrates, forms bolus, swallow
bolus.

 Teeth, four types of teeth :

- Insicors (4 upper, 4 lower) for cutting and shearing food

- Canines (2 upper, 2 lower) for holding and tearing

 - Premolars (4 upper, 4 lower) and Molars (6 upper, 6 lower)
both for crushing and grinding food.

 Tongue, Moves food around mouth during mastication, assists in

swallowing, formation of speech sounds, location of taste buds.

 Salivary glands, Three salivary glands :

- Parotid gland : located over the masseter muscle.

- Submandibular gland : inferior to the base of the tongue.

- Sublingual gland : under the tongue, produces saliva

and begin chemical digestion of carbohydrates.

 Palate, Roof of the oral cavity consisting of the bony hard palate
anteriorly and the soft palate posteriorly. The uvula is suspended
from the soft palate. The soft palate closes the nasopharynx during
swallowing.

2. Pharynx : A funnel-shaped passageway that connects the oral and

nasal cavity to the esophagus and trachea. Function is swallowing.

3. Esophagus : .A muscular tube located in the thorax behind the trachea

that connects the pharynx to the stomach. Transports bolus to the
stomach via peristaltis.

4. Stomach : The stomach receives the bolus from esophagus, churns

bolus with gastric juice to form chyme, initiates digestion of proteins,
carries out limited absorption, and moves chye into duodenum.
Specializations of the tunics of the stomach include: an additional
smooth muscle layer, the oblique layer, longitudinal folds of the
mucosa called rugae and gastric glands, which secrete gastric juice.

Table Composition of Gastric Juice

Component Source Function

Hydrocloric acid Pariatal cells Converts pepsinogen

(HCl) to pepsin, kills
pathogens

Pepsinogen Chief cells Inactive form pepsin

Pepsin From pepsinogen in Protein splitting

the presence of HCl enzyme

Mucus Goblet cells Protects the mucosa

Intrinsic factor Parietal cells Aids absorption of
vitamin B12

Serotonin & Argentaffin cells Autocrine regulators

histamine

Gastrin G cells Stimulates secretion

of HCl

5. Small Intestine:

The region between stomach and the large intestine, approximately 10

feet long. It receives chyme from the stomach, bile and pancreatic
secretions from the liver and pancreas respectively, chemically and
mechanically break down chyme, absorbs nutrients, and transports
wastes to the large intestine. Divisions of the small intestine :

 Duodenum: From pyloric sphincter of stomach to duodenojejunal

flexure (approx. 10 in.). Common bile duct and pancreatic duct
empty into duodenum.

 Jejenum: Middle section of the small intestine. Characterized by

deep folds of the mucosa and submucosa, plicae circulars.

 Ileum: Joins the cecum of the large intestine at the ileocecal valve.

Modifications of the small intestine facilitate absorption. The plicae

circulares and the villi, fingerlike projections of the mucosa, increase
absorptive area. Each villus contains a capillary network and a lymph
vessel, a lacteal. Absorption is accomplished as food molecules enter
these vessels through microvilli, microprojections on the surface of the
villi. At the bases of the villi are intestinal glands that secrete digestive
enzymes. Intestinal enzymes and their actions :

 Peptidase: Converts proteins into amino acids.

 Sucrase (maltase and laktase): Converts disaccharides into

monosaccharides.

 Lipase: Convert fats into fatty acids and glycerol.

 Nuclease: Converts nucleic acids into nucleotides.

 Enterokinase: Activates trypsin secreted from the pancreas.

 6. Large Intestine: Extends from the ileocecal valve to the anus, approx.
5 feet long. It receives wastes from the small intestine, absorbs water
and electrolytes, forms, stores, and expels feces through defecation.
Divisions of the large intestine :

 Cecum: First portion, resembles a dilated pouch.

 Ascending colon: Extends superiorly on the right from the cecum

to the liver, at the hepatic flexure.

 Tranverse colon: Tranversely crosses the upper peritoneal cavity.

 Descending colon: Extends inferiorly on the left from the splenic

flexure to the pelvis.

 Sigmoid colon: S-shaped bend in the pelvic region.

 Rectum: Terminal portion of the large intestine.

7. The appendix, consisting of lymphatic tissue, is attached to the

cecum.The tunics, mucosa, and submucosa have sacculations called
haustra, the muscularis cinsists of longitunal bands called taeniae coli,
and attached to the adventitia are fat-filled pouches called epiploic
appendages.

C. Accessory Organs

1. Liver.

Lobes of the liver are:

 Lobes of the liver.

 Right and left lobe, separated by the falcirorm ligament.

 Caudate lobe is near the inferior vena cava.

 Quadrate lobe is between the left lobe and the gall bladder.

The liver receives oxygenated blood from the hepatic artery, a branch
of the celiac artery. It also receives food-laden blood from the hepatic
portal vein, which carries venous blood from the GI tract. In the liver
sinusoids, blood from both source mix. Oxygen, Nutrients, and certain
toxic substances are extracted by hepatic cells.

Function of the liver are :

 Synthesis, storage, and release of vitamins and glycogen.

  Synthesis of blood proteins.

 Phagocytosis of worn red and white blood cells and bacteria.

 Removal of toxic compounds.

 Production of bile, which emulsifies fats in the duodenum.

2. Gall bladder. Pouchlike organ attached to the inferior surface of the

liver. Stores and concentrates bile. Bile, produced in the liver, drains
through the hepatic ducts and bile duct to the duodenum. When the
small intestine is empty, bile is forced up the cystic duct to the gall
bladder for storage.

3. Pancreas. Lies horizontally along the posterior abdominal wall,

adjacent to the greater curvature of the stomach. Among other
functions, the pancreas is the chief factory for digestive enzymes that
are secreted into the duodenum, the first segment of the small intestine.
These enzymes break down protein, fats, and carbohydrates.
What Is Digestion?

Digestion is the complex process of turning the food you eat into nutrients , which
the body uses for energy, growth and cell repair needed to survive. The digestion
process also involves creating waste to be eliminated.

The digestive tract (or gastrointestinal tract) is a long twisting tube that starts at
the mouth and ends at the anus . It is made up of a series of muscles that
coordinate the movement of food and other cells that produce enzymes and
hormones to aid in the breakdown of food. Along the way are three other organs
that are needed for digestion: the liver , gallbladder, and the

pancreas .

Food's Journey Through the Digestive System

Stop 1: The Mouth

The mouth is the beginning of the digestive system , and, in fact, digestion starts
here before you even take the first bite of a meal. The smell of food triggers the
salivary glands in your mouth to secrete saliva , causing your mouth to water.
When you actually taste the food, saliva increases.

Once you start chewing and breaking the food down into pieces small enough to
be digested, other mechanisms come into play. More saliva is produced. It
contains substances including enzymes that begin the process of breaking down
food into a form your body can absorb and use. Chew your food more -- it also
helps with your digestion.

Stop 2: The Pharynx and Esophagus

Also called the throat, the pharynx is the portion of the digestive tract that receives
the food from your mouth. Branching off the pharynx is the esophagus, which
carries food to the stomach , and the trachea or windpipe, which carries air to the
lungs .

The act of swallowing takes place in the pharynx partly as a reflex and partly
under voluntary control. The tongue and soft palate -- the soft part of the roof of
the mouth -- push food into the pharynx, which closes off the trachea. The food
then enters the esophagus.

The esophagus is a muscular tube extending from the pharynx and behind the
trachea to the
stomach . Food is pushed through the esophagus and into the stomach by means
of a series of contractions called peristalsis.

Just before the opening to the stomach is an important ring-shaped muscle called
the lower esophageal sphincter (LES). This sphincter opens to let food pass into
the stomach and closes to keep it there. If your LES doesn't work properly, you
may suffer from a condition called GERD , or reflux, which causes heartburn and
regurgitation (the feeling of food coming back up).

Stop 3: The Stomach and Small Intestine

The stomach is a sac-like organ with strong muscular walls. In addition to holding
food, it serves as the mixer and grinder of food. The stomach secretes acid and
powerful enzymes that continue the process of breaking the food down and
changing it to a consistency of liquid or paste. From there, food moves to the
small intestine. Between meals, the non-liquefiable remnants are released from the
stomach and ushered through the rest of the intestines to be eliminated.

Made up of three segments -- the duodenum, jejunum, and ileum -- the small
intestine also breaks down food using enzymes released by the

pancreas and bile from the liver . The small intestine is the 'work horse' of
digestion, as this is where most nutrients are absorbed. Peristalsis is also at work
in this organ, moving food through and mixing it up with the digestive secretions
from the pancreas and liver , including bile. The duodenum is largely responsible
for the continuing breakdown process, with the jejunum and ileum being mainly
responsible for absorption of nutrients into the bloodstream.

A more technical name for this part of the process is "motility," because it
involves moving or emptying food particles from one part to the next. This
process is highly dependent on the activity of a large network of nerves,
hormones, and muscles. Problems with any of these components can cause a
variety of conditions.

While food is in the small intestine, nutrients are absorbed through the walls and
into the bloodstream. What's leftover (the waste) moves into the large intestine
(large bowel or colon ).

Everything above the large intestine is called the

upper GI tract. Everything below is the lower GI tract

Stop 4: The Colon, Rectum, and Anus

The colon (large intestine) is a five- to seven -foot -long muscular tube that
connects the small intestine to the rectum. It is made up of the cecum, the
ascending (right) colon, the transverse (across) colon, the descending (left) colon
and the sigmoid colon, which connects to the rectum. The appendix is a small tube
attached to the ascending colon. The large intestine is a highly specialized organ
that is responsible for processing waste so that defecation (excretion of waste) is
easy and convenient.

Stool, or waste left over from the digestive process, passes through the colon by
means of peristalsis, first in a liquid state and ultimately in solid form. As stool
passes through the colon, any remaining water is absorbed. Stool is stored in the
sigmoid (S-shaped) colon until a "mass movement" empties it into the rectum,
usually once or twice a day.

It normally takes about 36 hours for stool to get through the colon. The stool itself
is mostly food debris and bacteria. These bacteria perform several useful
functions, such as synthesizing various vitamins , processing waste products and
food particles, and protecting against harmful bacteria. When the descending
colon becomes full of stool, it empties its contents into the rectum to begin the
process of elimination.

The rectum is an eight-inch chamber that connects the colon to the anus. The
rectum:

Receives stool from the colon

Lets the person know there is stool to be evacuated

Holds the stool until evacuation happens

When anything (gas or stool) comes into the rectum, sensors send a message to
the brain. The brain then decides if the rectal contents can be released or not. If
they can, the sphincters relax and the rectum contracts, expelling its contents. If
the contents cannot be expelled, the sphincters contract and the rectum
accommodates so that the sensation temporarily goes away.

The anus is the last part of the digestive tract. It consists of the muscles that line
the pelvis (pelvic floor muscles) and two other muscles called anal sphincters
(internal and external).

The pelvic floor muscle creates an angle between the rectum and the anus that
stops stool from coming out when it is not supposed to. The anal sphincters
provide fine control of stool. The internal sphincter is always tight, except when
stool enters the rectum. It keeps us continent (not releasing stool) when we are
asleep or otherwise unaware of the presence of stool. When we get an urge to
defecate (go to the bathroom), we rely on our external sphincter to keep the stool
in until we can get to the toilet.
Accessory Digestive Organs

Pancreas

Liver

The liver has multiple functions, but two of its main functions within the digestive
system are to make and secrete an important substance called bile and to process
the blood coming from the small intestine containing the nutrients just absorbed.
The liver purifies this blood of many impurities before traveling to the rest of the
body.

Gallbladder

The gallbladder is a storage sac for excess bile. Bile made in the liver travels to
the small intestine via the bile ducts. If the intestine doesn't need it, the bile travels
into the gallbladder, where it awaits the signal from the

intestines that food is present. Bile serves two main purposes. First, it helps absorb
fats in the diet, and secondly, it carries waste from the liver that cannot go through
the kidneys .