Republic of the Philippines UNIVERSITY OF NORTHERNPHILIPPINES Tamag, Vigan City COLLEGE OF NURSING ANATOMY AND PHYSIOLOGY

Lecturer: Maureen Angelica Q. Gonzalo, RN VI. THE DIGESTIVESYSTEM 1. Activities in the Digestive System 2. Trunks or Layers of the Digestive System 3. Organs and Functions of the Digestive System 4. Movements and secretions in the Digestive System 5. Metabolism THE ENDOCRINE SYSTEM 1. Hormones 2. The Endocrine Glands and their Hormones 3. Other Hormones THE URINARY SYSTEM AND FLUID BALANCE 1. Structure and Function 2. Kidney 3. Ureters 4. Urinary Bladder 5. Urethra FLUIDS AND ELECTROLYTES 1. Body Fluid Compartments 2. Composition of Fluid in the Body Fluid Compartment 3. Exchange between Body Fluid Compartments 4. Regulation of Extracellular Fluid Compartments 5. Regulation of Acid-Base Mechanism 6. Alteration in the Buffering Mechanism THE INTEGUMENTARY SYSTEM 1. Structure of the Skin 2. Accessory Skin Structures

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DIGESTIVE SYSTEM
The digestive system processes food into molecules that can be absorbed and utilized by the cells of the body. - Mostly controlled by reflexes via the parasympathetic division of the nervous system - Sensors (mechanoreceptors and chemoreceptors) involved are located in the wall of the alimentary canal organs and respond to a number of stimuli. When receptors are activated they start reflexes that activate or inhibit 1. The glands that secrete digestive juices into the lumen or hormones into the blood 2. The smooth muscles of the muscularis that mix and propel the food along the tract TWO MAIN GROUPS: 1. Alimentary Canal performs the whole menu of digestive functions. (ingests, digests, absorb, defecates) 2. Accessory Organs assist the process of digestive breakdown in various ways. (teeth, tongue and several large digestive glands) I. ACTIVITIES IN THE DIGESTIVE SYSTEM

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Ingestion - The first activity of the digestive system is to take in food through the mouth. It has to take place before anything else can happen. Propulsion the mechanism by which food are propelled from one organ to the next. Peristalsis (swallowing) is involuntary and involves alternating waves of contraction and relaxation Food breakdown: mechanical digestion mixing of food in the mouth by the tongue, churning of food in the stomach, and the segmentation in the small intestines. - It prepares food for further degradation (breakdown of compound) by enzyme by physically fragmenting the foods into smaller particles. Churning breaking up Segmentation single segments of the intestines alternately contract and relax to help propel foodstuffs through the small intestines. It normally moves food back and forth across the internal wall of the organ, serving to mix it with the digestive juices. (mechanical digestion) Food Breakdown: chemical digestion the sequence of steps in which large food molecules (carbohydrates, proteins, fat) are broken down to their building blocks of enzyme. Hydrolysis water molecules is added to each bond to be broken. Water is necessary as a dissolving medium and softening agent for food digestion.
The complex molecules of carbohydrates, proteins, and fats are transformed by chemical digestion into smaller molecules that can be absorbed and utilized by the cells. Chemical digestion, through a process called hydrolysis, uses water and digestive enzymes to break down the complex molecules. Digestive enzymes speed up the hydrolysis process, which is otherwise very slow.

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Carbohydrates monosaccharides or simple sugar (building block) Glucose most important aka as sugar, blood glucose and the universal cellular fuel Fructose most abundant sugar in fruits Galactoctose found in milk - Disaccharides double sugars, formed when two simple sugars are joined by a synthesis reaction known as dehydration synthesis - Broken down (digested) to their monosaccharidesunits to beabsorb from the digestive tract into the blood this is accomplished by hydrolysis Sucrose (glucose and fructose) cane sugar Lactose (glucose and galactose) found in milk Maltose (glucose and glucose) malt sugar - Polysaccharides literally know as many sugar. Because they are large insoluble molecules, they are ideal storage products. - they lack sweetness - some are trapped in the ATP and not immediately needed in the synthesis of ATP, thus dietary carbs are converted to glycogen and fat and are stored (gain weight) Starch polysaccharides formed by plants (potatoes and carrots Glycogen found in animal tissue(muscle and liver) Proteins amino acid Lipids fatty acid and glycerol

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Absorption The simple molecules that result from chemical digestion pass through cell membranes of the lining in the small intestine into the blood or lymph capillaries. - Small intestines is the major absorptive site Defecation is the elimination of ingested residues from the GI tract via the anus in a form of feces The food molecules that cannot be digested or absorbed need to be eliminated from the body. II. Layers of the Digestive System With few exceptions, the wall of the digestive tube from the mouth to the anus is composed of four basic layers or tunics.

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1. Tunica serosa is the outermost covering of the digestive tube (esophagus to the large intestines) - it consists of a visceral peritoneum which is a single thin layer of flat serous fluid-producing cell and a
parietal peritoneum which lines the abdominopelvic cavity - In regions outside of the abdominal cavity where the digestive tube is essentially affixed to adjacent structures via its outer layer of connective tissue (esophagus and rectum), this tunic is referred to as tunica adventitia instead of tunica serosa.

2. Tunica muscularis endows the digestive tube with an ability to be motile. - In most of the digestive tube, this tunic consists of two thick layers of smooth muscle. Muscle fibers in the
inner layer are aligned circularly, whereas those in the outer layer have a longitudinal orientation. - This combination of circular and longitudinal smooth muscle gives the tube an ability to perform complex movements that squeeze and propel ingesta in the lumen. Between the inner circular and outer longitudinal layers of smooth muscle is another critical component of the digestive tract's nervous system - the myenteric plexus. Plexus a network of nerves, blood vessels, or other vessels in the body, a complex network or interwoven structure,

3. Tunica submucosa lies immediately beneath the mucosa, and is a layer of loose to dense connective tissue containing
blood, nerve endings, lymph nodules and lymphatic vessels. - The submucosa also contains the submucous plexus, a critical component of the digestive tract's nervous system which provides nervous control to the mucosa.

4. Tunica mucosa is the innermost layer of the digestive tube and lines the cavity or lumen of the organ.
- It consists primarily of a surface epithelium, plus a small amount of connective tissue (lamina propia) and a scanty smooth muscle layer. - Among the four tunics, the mucosa is most variable in structure and function, endowing the tube with an ability to perform diverse and specialized digestive tasks along its length. III. Organs and Functions of the Digestive System

ALIMENTARY CANAL aka Gastrointestinal (GI) tract - A continuous, coiled, hollow, muscular tube that winds through the ventral body cavity and is open at both ends. - Its organs are the mouth, esophagus, stomach, small intestines and large intestines - In a cadaver the it is approximately 9cm (about 30 feet) long - In a living person, it is considerable shorter because of its relatively muscle tone. - Open to external environment at both ends (mouth, anus) that is why food materials with in the tube is technically outside the body and because it has contact only the cells lining the tract.

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Mouth -

aka oral cavity where initially enter it is lined with mucous membrane

COMPONENTS OF THE ORAL CAVITY a. LIPS anterior opening protector labia b. CHEEKS - forms the lateral wall of the mouth c. HARD PALATE forms the anterior roof of the mouth d. SOFT PALATE forms the posterior roof of the mouth e. UVULA a fleshy finger-like projection of the soft palate which extends downward from its posterior edge f. VESTIBULE the space between the lips and cheeks externally and the teeth and gums internally g. ORAL CAVITY PROPER the area contained by teeth h. TONGUE occupies the floor of the mouth. Bone attachment of the tongue i. Hyoid bone - a U-shaped bone positioned at the base of the tongue and above the thyroid cartilage that supports the tongue and its muscles

ii. Styloid process of the skull - describes a bony protuberance process that is long and thin
Taste buds are specific receptors for the sense of taste and are widely scattered in the oral cavity. Papillae small peg-like projections covering the surface of the tongue. - Has 3 forms : filiform papillae, fungiform papillae, circumvallate papillae. - Circumvallate and fungiform papillae where the taste buds are found Five Basic Taste Sensations/ Major types of taste bubs Sweet receptors respond to substances such as sugars, saccharine and some amino acid o Satisfy the bodys need for carbohydrates and minerals Sour receptors responds to hydrogen ions or the acidity of the solution o Naturally acidic foods (such as oranges, lemons and tomatoes) are rich source of vitamin C Bitter receptors alkaloids o Protective factor since natural poisons and spoiled foods arebitterness Salty receptors metal ions in solution Umami a taste discovered by the Japanese Elicited by amino acid glutamate which is responsible for beef taste o Guides the intake of protein i. LINGUAL FRENULUM a fold of mucous membrane that secures the tongue to the floor of the mouth and limits its posterior movements j. PALATINE TONSILS paired masses of lymphatic tissue located at the posterior end of the oral cavity k. LINGUAL TONSILS covers the base of the tongue

2. Pharynx a muscular passageway about 13cm (5 inches) long that vaguely resembles a short length of red garden hose.
Commonly called as the throat Serves as a common passage way for food and air Its walls contain two skeletal muscle layers. Inner layer runs longitudinally Outer layer runs around in a circular fashion. Alternating contractions of these two muscle layers propel food through the pharynx into the esophagus below. This mechanism is called peristalsis. 3 SUBDIVISION OF PHARYNX a. Nasopharynx part of the respiratory passageway. (air enters) superior portion b. Oropharynx posterior to the oral cavity c. Laryngopharynx continuous with the esophagus below 3. Esophagus also called as gullet - runs from the pharynx through the diaphragm to the stomach - about 25cm (10inches) long - a passageway that conducts food (by peristalsis) to the stomach -

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Stomach C-shaped organ on the left side of the abdominal cavity, nearly hidden by the liver and the diaphragm. Approximately 25 cm long (10inches) long Full stomach can hold 4 liters (1 gallon) of food. Empty stomach collapses on itself Greater Curvature convex lateral surface of the stomach Lesser Curvature concave medial surface DIFFERENT REGIONS OF THE STOMACH a. Cardiac region named for its position near the heart It surrounds the cardioesophageal sphinter where entrance of food to the stomach takes place b. Fundus the expanded part of the stomach lateral to the cardiac region. c. Body the mid portion of the stomach d. Pyloric antrum narrow portion inferior to the body of the stomach e. Pyluros the terminal part of the stomach. - Funnel shaped Columnar epithelium produces large amount of mucus that lines the stomach Gastric glands connected with the gastric pit located at the surface of the stomach Secretes solution called gastric juice Intrinsic factor a substance secreted by some stomach cells that is needed for the absorption of vitaminB12 (pernicious anemia) CELLS OF THE STOMACH 1. Chief cells produce protein digesting enzyme called pepsinogen 2. Parietal cells produce hydrochloric acid which makes that stomach content acidic and activates enzyme

3. Mucous neck cells produce a sticky alkaline solution that protects the stomach wall itself from being damaged by the acid and digested by the enzymes Chyme stomach-processed food at resembles a heavy cream that is ready to enter the small intestines.

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Small Intestines the bodys major digestive organ - A muscular tube extending from the pyloric sphincter to the ileocecal valve - It is the longest section of the alimentary canal - Average length of 2.5-7m (8-18ft) in a living person - Nearly all food absorption occurs

Pyloric Sphincter control food movement ant prevent the SI from being overwhelmed Rugae large folds of the stomach that appears when empty SUBDIVISIONS OF THE SMALL INTESTINES a. Duodenum twelve finger widths long 5% of the total length of the SI - Where pancreatic duct and bile duct empties their enzymes that completes that chemical breakdown of food b. Jejunum empty nearly 40% of the total length of the SI c. Ileum twisted almost 60% of the total length of the SI WALL STRUCTURE OF THE SI a. Circular folds aka Plicae circulars Deep folds of mucosa and submucosa layer b. Villi- finger like projections of the mucosa that gives a velvet like appearance and feel c. Microvilli are tiny projections of the plasma membranes that gives a fuzzy appearance, also called as the brush border Peyers patches local collection of lymphatic tissue found toward the end of the SI -Prevents bacteria of undigested food from entering the bloodstream

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Large Intestines larger in diameter than the SI but shorter in length - About 1.5m (5ft) long - Extends from the ileocecal valve to the anus - Major function is to dry out indigested food residue by absorbing water - And to eliminate residue from the body as feces - It frames the SI - No villi but contains tremendous goblet cells

Goblet cells - produce alkaline mucus that acts as a lubricant to ease the passage of feces to the end of the Digestive system SUBDIVISIONS OF THE LI a. Cecum first part of the large intestines - saclike b. Appendix wormlike (vermiform) appearance - Potential trouble shoot spot since it is usually twisted and ideal location for bacterial growth and multiple c. Colon Distinct Regions a. Ascending colon travels up the right side of the abdominal cavity and makes turn at the right colic (hepatic) flexure b. Transverse colon part of colon that travel across the abdominal cavity turns at the left colic (splenic) flexure c. Descending colon- down the left side of the abdominal cavity Sigmoid colon end of the descending colon d. Rectum where residues ready to be excreted stay e. Anal Cana l- opens to the exterior External Involuntary Sphincter acts like apurse string to open and close the anus ACCESSORY DIGESTIVE ORGANS 1. Salivary Glands - Empties their secretion into the mouth THREE PAIRS OF SALIVARY GLANDS Parotid Glands lie anterior to the ear Submandibular Glands and Submandibular Glands empty their secretion into the floor of the mouth - Produces saliva Saliva a mixture of mucus and serous fluids that helps moisten and bind food together to form a bolus that makes chewing and swallowing easier

-Dissolves food chemicals so they can bee tasted Salivary amylase clear serous postion of the saliva containing enzyme (bicarbonate-rich juice) that begins to process strch digestion in the mouth Lysozyme and IgA component of saliva that inhibits bacteria

2. Teeth tear and grind food, breaking it down into smaller fragments
Decidous teeth also called baby teeth or milk teeth - Begins to eruptaound six months - Full set of teeth (20) by the age of 2 years old - Loosens out between the age 6-12 Permanent Teeth erupts at the end of adolescence except for the third molars - 32 permanent teeth Third Molars also called the wisdom tooth erupts between the ages 17-25 CLASSIFICATION OF TEETH ACCORDING TO SHAPE AND FUNCTION a. Incisors chisel shaped used for cutting b. Canines fang-like teeth used for tearing and piercing c. Premolars (bicuspids) and molars broad crowns with rounded cusps that are best suited for grinding MAJOR REGIONS OF THE TOOTH a. Crown covered with enamel, and is the exposed part of the tooth above the gums or gingiva Enamel the hardest substance in the body - Fairly brittle because it is heavily mineralized with calcium salts b. Neck where the crown and root of the tooth connects c. Root embedded in the jawbone Cementum the outer covering of the root Periodontal membrane (ligament) holds the tooth in place in th bony jaw Dentin bone-like material underlies the enamel and forms the bulk of the tooth Pulp Cavity composed of tissues, blood vessels and nerve fibers called the pulp Pulp supplies the nutrients to the tooth tissues and provide tooth sensation Root Canal provides a route for blood vessels, nerves and other pulp structure

3. Pancreas soft pink triangular gland that extends across the abdomen from the spleen to the duodenum - Retroperitoneal location of the pancreas (posterior to the parietal peritoneum
It produces enzyme and hormones called insulin and glucagon Pancreatic enzyme secreted by the pancreas into the duodenum which neutralizes the acidic chime coming from the stomach

4. Liver the largest gland in the body Located under the diaphragm more to the right side of the body Its digestive function is to produce bile
Bile a yellow-to-green, watery solution containing bile salts, bile pigments, cholesterol, phospholipids and a variety of electrolytes. Leaves the liver through the common hepatic duct Bile salts and phospholipids are the only components that aid in the digestive process by emulsify fats by physically breaking larger fat globules into smaller one

5. Gall Bladder a small thin-walled green sac that snuggles in a shallow fossa in the inferior surface of the liver
Cystic Duct where unused bile enter to be stored in the gall bladder -Later, fatty foods enter the duodenum, a hormonal stimulus prompts the

MOVEMENTS AND SECRETION OF THE DIGESTIVE SYSTEM

MOUTH no food absorption occurs Where saliva continuously secreted Reflexes such as salivation is initiated by the parasympathetic fibers in the cranial nerve V and IX Some drugs such as nitroglycerine area absorbed in the oral mucosa PHARYNX AND ESOPHAGUS has no digestive function but to provide passage way or carry the food to the next process site, the stomach Deglutition complicated process that involves the coordinated activity of the several structures (tongue, soft palate, pharynx and esophagus) - Has two major phases 1. Buccal phase occurs in the mouth 2. Pharyngeal-esophageal phase the transport of food to the pharynx and esophagus

- Vagus nerve parasympathetic division of the autonomic nervous system controls this phase and promotes the
mobility of the digestive organs from this point on STOMACH where gastric juices are secreted - 2-3L gastric juice are produce everyday - It takes 4 hours for stomach to empty completely for well balanced meal - It takes 6 hours for high fat meal Gastrin a hormone secreted by the stomach as a result to the presence of food and a falling of pH in the stomach - Produces protein-digesting enzymes (pepsinogen), mucus and hydrochloric acid Hydrochloric acid makes the stomach content acidic - Dangerous because it has the ability to digest the stomach itself Pylorus hold about 30mL of chyme Pyloric sphincter barely opens, each contraction squirts 3 mL or less into the small intestines. The rest of the food is propelled back into the stomach for more mixing Enterogastric reflex a nervous reflex that puts the brakes on gastric activity and slows the emptying of the stomach by inhibiting the vagus nerves and tightening the pyloric sphincter allowing time for intestinal processing to catch up. SMALL INTESTINES the food takes 3-6 hours travel - By the time the food reaches the end of the small intestines, digestion is complete and nearly all food absorption has occurred Brush border enzyme found along the microvilli of the SI - It breaks down double sugars into simple sugars and complete protein digestion Intestinal Juices enzyme-poor and protective mucus is probably the most important intestinal gland secretion Secretin and Cholecystokinin hormones that is releases as a result to vagus nerve stimulation in the SI - Influence the release of pancreatic juice and bile Pacreatic Juice ducted from the pancreas - The only source of lipases responsible in fatmetabolism - Has a rich supply of bicarbonate making the SI basic (pH 8) - Functions: 1. Help in the digestion of starch 2. Carry out half of protein digestion 3. Totally responsible for fat digestion 4. Digest nuclei acids LARGE INTESTINES where food residue stays for 12-24 hours - No digestive enzyme is produce Resident bacteria lives within the lumen metabolizes some of the remaining nutrients, releasing gases that contribute to the odor of feces - About 500mL of gas is produces each day Feces solid product delivered to the rectum, containing undigested food residues, mucus, millions of bacteria with just enough water Mass movements are long, slow moving but powerful contractile waves that move over large areas of the colon - 3-4 times daily and forces the content towards the rectum METABOLISM

- Broad term referring to all chemical reactions that are necessary to maintain life.
Catabolism substance are broken into simpler substance Anabolism larger molecules are built from smaller ones