1. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Memmler’s The Human Body in Health and Disease 11 th edition Chapter 19 The Digestive System

2. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Function and Design of the Digestive System Chief functions –Digestion –Absorption –Elimination Organs –Digestive tract –Accessory organs

3. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins The Wall of the Digestive Tract Mucous membrane (mucosa) –Digestive juice-secreting cells –Mucus-secreting cells (goblet cells) Submucosa –Connective tissue –Contains blood vessels and nerves that help regulate digestion Smooth muscle –Inner layer –Outer layer –Peristalsis Serous membrane –Epithelium –Loose connective tissue

4. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Wall of the digestive tract. The mucous membrane of the small intestine shown here has numerous projections called villi. Zooming In: What type of tissue is between the submucosa and the serous membrane in the digestive tract wall?

5. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins The Peritoneum Membrane that lines the abdominopelvic cavity Parietal peritoneum Visceral peritoneum Mesentery Mesocolon Greater omentum Lesser omentum

6. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins The Peritoneum (cont’d) Peritoneal cavity: space between two layers of the membrane Greater peritoneal cavity: main portion, located in abdominal cavity, extends into pelvic cavity Lesser peritoneal cavity: extends to the liver and the back attachment of the diaphragm

7. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins The abdominopelvic cavity. Subdivisions of the peritoneum fold over, supporting and separating individual organs. Zooming In: What part of the peritoneum is around the small intestine?

8. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Organs of the Digestive Tract Alimentary tract or gastrointestinal (GI) tract Mouth Pharynx Esophagus Stomach Small intestine Large intestine

9. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins The digestive system. Zooming In: What accessory organs of digestion secrete into the mouth?

10. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins The Mouth Also called oral cavity, processes food by Ingestion Mastication Mixing with saliva Deglutition

11. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins The Teeth Deciduous teeth (baby teeth) –20 teeth Adult permanent teeth –32 teeth –Incisors –Cuspids (canines or eyeteeth) –Molars Structure –Dentin –Blood vessels –Nerves –Gingiva –Crown –Enamel –Roots –Cementum

12. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins The Pharynx Also called the throat Oropharynx Palatine tonsils Nasopharynx Laryngeal pharynx Soft palate Uvula Epiglottis

13. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins The Esophagus Muscular tube –No digestion occurs here –Joins with stomach Esophageal hiatus

14. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins The Stomach – Structure Additional angled muscle layer Greater and lesser curvature Fundus Lower esophageal sphincter (LES) (cardiac sphincter) Pylorus Pyloric sphincter Rugae

15. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins The Stomach – Functions Store food and liquid Secrete gastric juice (hydrochloric acid and pepsin) Secrete mucus Chyme: highly acidic mixture of gastric juice and food that leaves the stomach for the small intestine

16. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Longitudinal section of the stomach. The stomach’s interior is visible, along with a portion of the esophagus and the duodenum. Zooming In: What additional muscle layer is in the wall of the stomach that is not found in the rest of the digestive tract?

17. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins The Small Intestine – Structure Duodenum Jejunum Ileum

18. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins The Small Intestine – Function Secrete mucus Secrete enzymes Absorb digested food –Villi –Microvilli –Blood vessels –Specialized lymphatic capillaries (lacteals)

19. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins The small and large intestines. Zooming In: What part of the small intestine joins the cecum?

20. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins The Large Intestine — Structure Cecum Ileocecal valve Vermiform appendix Colon –Ascending –Transverse –Descending –Sigmoid Rectum Anal canal Anus

21. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins The Large Intestine – Function Secrete mucus Reabsorb some water Form feces (stool) Defecation

22. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins The Accessory Organs Release secretions through ducts into digestive tract Salivary glands to mouth All other organs to duodenum

23. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Accessory organs of digestion. Zooming In: Into what part of the intestine do these accessory organs secrete?

24. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins The Salivary Glands Functions of saliva –Moistens food –Facilitates mastication and deglutition –Helps keep teeth and mouth clean Production of saliva –Parotid glands –Submandibular (submaxillary) glands –Sublingual glands

25. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins The Liver – Structure Right, left lobes Portal vein Hepatic artery

26. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins The Liver – Function Manufacture bile Store glycogen, convert to glucose Modify fats Store vitamins, iron Form blood plasma proteins Destroy old red blood cells Synthesize urea Detoxify harmful substances

27. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins The Gallbladder Bile Flows from liver through cystic duct Is stored in gallbladder Flows through cystic duct and common bile duct to duodenum when needed

28. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins The Pancreas Releases enzymes that digest fats, proteins, carbohydrates, and nucleic acids Produces alkaline (basic) fluid to neutralize acidic chyme in small intestine Produces insulin and glucagon to regulate sugar metabolism

29. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Enzymes and the Digestive Process Enzymes Speed up rate of chemical reactions Are not changed or used up in reactions Are proteins Are highly specific in their actions

30. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins The Role of Water Process of digestion technically hydrolysis (split by water) Water is used to Produce digestive juices Dilute food Aid chemical process of digestion Added to nutrient molecules as they are split by enzymes

31. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Digestion, Step-by-Step Mouth –Chews food, mixes with saliva –Some starches changed to sugars Stomach –Secretes hydrochloric acid, enzymes –Secretes mucus –Forms chyme –Begins digestion of proteins (with pepsin) Small intestine –Mixes chyme with bile –Receives pancreatic juice enzymes –Produces enzymes –Emulsifies fats

32. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins AbsorptionAbsorption Villi in mucosa of small intestine –Arteriole and venule bridged with capillaries Capillaries absorb –Simple sugars –Small proteins –Amino acids –Simple fatty acids –Water Portal system transports nutrients to liver

33. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Absorption of Fats Lacteals absorb fat Fat/lymph mixture (chyle) drains from small intestine Chyle merges with lymphatic circulation, enters blood in veins near heart Liver further processes absorbed fats

34. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Absorption of Vitamins and Minerals When vitamins and minerals are Dissolved in water –Absorbed directly into blood Incorporated in fats –Absorbed with fats Produced by bacterial action –Absorbed in large intestine

35. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Control of Digestion Nervous –Parasympathetic stimulation increases activity –Sympathetic stimulation decreases activity Hormonal –Digestive organs produce hormones Gastrin Gastric-inhibitory peptide (GIP) Secretin Cholecystokinin

36. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Hunger and Appetite Hunger –Hypothalamic centers regulate –Blood nutrient levels stimulate –Satisfied by adequate meal Appetite –No relationship to need for food –May not be satisfied by adequate meal –Leptin; hormone produced in adipose tissue; involved in weight regulation

37. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Eating Disorders Anorexia –Chronic loss of appetite –Possible emotional, social factors Anorexia nervosa –Psychological disorder –Bulimia (binge-purge syndrome)

38. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Disorders of the Digestive System Sources of digestive problems Mechanical Nervous Chemical Hormonal

39. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Peritonitis Infection of the peritoneum following infection of an organ covered by peritoneum Localized Generalized

40. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Diseases of the Mouth and Teeth Dental caries Gingivitis Periodontitis Vincent disease Leukoplakia

41. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Disorders of the Esophagus and Stomach Acid reflux Varicose veins of the esophagus Hiatal hernia Heartburn Chronic reflux or gastroesophageal reflux disease (GERD) Nausea Vomiting (emesis) Gastritis Flatulence Stomach cancer Peptic ulcer Pyloric stenosis

42. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Intestinal Disorders Appendicitis Inflammatory bowel disease (IBD) –Crohn disease –Ulcerative colitis Irritable bowel syndrome (IBS) Gastroenteritis Diverticulitis Diarrhea Constipation Intestinal obstruction –Intussusception –Volvulus –Ileus –Hemorrhoids Colon and rectum cancer

43. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Infection of the Salivary Glands Mumps Contagious viral infection of parotid salivary glands Possible complications –Inflammation of testicles –Sterility in males Prevented by childhood vaccine (MMR)

44. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Cirrhosis and Other Liver Diseases Cirrhosis –Active liver cells replaced by scar tissue –Alcoholic (portal) type is most common Jaundice Hepatitis –Liver inflammation –Viral causes –Known viruses that cause h. are named A through E (e.g., hepatitis A) Cancer

45. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Gallstones Cholelithiasis Most common gallbladder disease May remain in gallbladder or lodge in bile ducts

46. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Pancreatitis Pancreatic enzymes back up into pancreas Can be fatal (acute pancreatitis)

47. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Aging and the Digestive System Loss of appetite Difficulty swallowing Decreased digestive organ activity Digestive disorders Tumors and cancer

48. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins End of Presentation