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BATCH | NUTRITION AND THE DIGESTIVE SYSTEM |

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NURSING

OUTLINE
Fundamentals of Anatomy and Physiology

B. Accessory Structures
Mark
Chang

 Includes:
 Teeth
I. Introduction  Tongue
II. General Organization  Salivary Glands
III. Histology  Liver
IV. The Mouth or Oral Cavity  Gallbladder
V. The Salivary Glands  Pancreas
VI. Teeth
VII. The Pharynx III. HISTOLOGY
VIII. The Esophagus
 The walls of the alimentary canal from the esophagus
IX. The Stomach
to the anal canal have the same arrangement of tissue
X. The Pancreas
layers.
XI. The Liver
A. The Gall Bladder  Coats / Tunics – Tissue layers in the walls of the
XII. The Small Intestine alimentary canal – Esophagus to the Anal Canal.
XIII. The Large Intestine  The 4 Coats / Tunis of the Canal:
XIV. The Formation of the Feces 1. Tunica Mucosa
 Innermost lining of the canal
I. INTRODUCTION  Consist of a mucous membrane attached to a
thin layer of visceral muscle.
 The function of the Digestive System is to break  3 Layers make up the Mucous Membrane:
down food via Hydrolysis;  Epithelial Tissue (Endothelium)
 Into simpler Substance – Nutrients  Direct Contact with the content of
 Digestion – a Process of transforming food into the canal
nutrients.  Function:
 Digestion allows the converted food into high – a) Protection
energy ATP molecule. b) Secretion of enzymes and
 The major organs and accessory structure that mucus
perform this function are collective called as c) Absorption of nutrients
Digestive System.  Lamina Propria
 The 5 Basic Digestive Activities:  Underlying loose connective tissue
1. Ingestion  Supports epithelium
 Taking the food into the body  Binds it to the muscularis mucosa
2. Peristalsis  Provides with its lymph and blood
 Physical movement supply.
 Pushing of food along the digestive  Muscularis Mucosa
tract  Special Layer
3. Digestion  Made of muscle fibers
 Breakdown of food by both  Produce folds to tremendously
mechanical and chemical increase the digestive and absorptive
mechanisms area of the small intestine
4. Absorption 2. Tunica Submucosa
 Passage of digested food from the  Consists of loose connective tissue
digestive tract into the cardio and  Binds Tunica Mucosa to the next layer –
vascular and lymphatic systems for Tunica Muscularis
distribution to the body’s cells. 3. Tunica Muscularis
5. Defecation  Mouth, Pharynx, and the first part of the
 Elimination from the body of those esophagus consist of skeletal muscle
substance that are ingestible and  The Skeletal Muscle allows the voluntary act
cannot be absorbed of swallowing.
II. GENERAL ORGANIZATION  The rest of the tract consists of Smooth
Muscle
 Two main organ groups of Digestion:  Smooth Muscle can be classified into 2:
A. Gastrointestinal Tract (Alimentary Canal)  An inner circular layer
 Long continuous tube that runs through the  An outer longitudinal Layer of fibers
venal cavity of the body—Mouth to Anus  Involuntary contractions of these smooth
 Length is approximately 30 feet (9 meters). muscle fibers break down food
 Organs include: physically
 Mouth (Oral Cavity)  It mixes with the digestive secretions that
 Oropharynx break down food chemically, and propel
 Esophagus the food through the canal
 Stomach  Plexus of Auerbach - The major nerves
 Small and Large Intestine supply to the Alimentary Canal
 Churning – Muscular contraction in the tube
breaking down food physically
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4. Adventitia / Tunica Serosa
Fundamentals of Anatomy and Physiology Mark
Chang

 3 Types of Papillae found on the Tongue:

 Outermost layer 1. Filiform Papillae
 Consists of Serous Membrane made up of  Found at the front of the tongue
connective and epithelial tissue  These are rough and important in
 Also known as Visceral Peritoneum licking
 It covers organs and has large folds that 2. Fungiform Papillae
weave in and between organs  Found at the back of the tongue
 Binding the organs to each other and to the  Contain taste buds
walls of the cavity. 3. Circumvallate Papillae
 It also contains:  Also found at the back of the tongue
 Blood Vessels  Contain taste buds
 Lymph Vessels  5 Taste Buds:
 Nerves 1. Sweet
 Mesentery – Extension of the Visceral 2. Sour
Peritoneum 3. Salt
IV. THE MOUTH OR ORAL CAVITY 4. Umami
 Idetified by Japanese Researcher
 Also known as Buccal Cavity  Detects MSG
 Anatomy of the Mouth:  Distinct Flavor popular in Asian
Foods
Sides Cheeks 5. Bitter
Anterior Hard Palate
(Bony) V. THE SALIVARY GLANDS
Roof
Posterior Soft Palate
(Muscular)
 The major portion of the saliva is secreted by the large
Floor Tongue salivary glands
 Lips – Freshly Folds, surround the opening or orifice
 Buccal Glands – These are mucous membrane lining
of the mouth
of the mouth that contains many small glands
 The Oral Cavity
 The large salivary glands are found outside the oral
 Outer Side – Covered by skin
cavity
 Inside – Covered by Mucous Membrane
 3 Pairs of Salivary Glands:
 The lips and cheeks help in chewing the food to be
1. Parotid Gland
kept between the upper and lower teeth.
2. Submandibular Gland / Submaxillary Gland
 They also assist in speech 3. Sublingual Gland
 Uvula – Hanging in the posterior soft palate; cone –  Saliva
shaped muscular structure.  99.5% water – medium for dissolving foods
Function: In the swallowing process and prevents  0.5% - consist of following solutes:
food from backing up into the nasal area  Chloride activate the salivary enzymes
 Tongue Amylase
 Consists of skeletal muscle covered with mucous  Amylase initiates the breakdown of
membrane complex carbohydrates like starch and
 Lingual Frenulum – a septum that divides the glycogen into simple sugar
tongue symmetrically into 2  Bicarbonates and Phosphates, which are
 Attached to and supported by the Hyoid Bone buffer chemicals, keep the saliva at slightly
 2 Types of Skeletal Muscle in the Tongue: acidic pH of 6.35 – 6.85
a) Extrinsic Muscle  Urea and Uric Acid, are waste product
 Originates outside the tongue and insert  Mucin forms mucus to lubricate food
into it  The enzyme lysozyme, destroys bacteria,
 Moving the tongue from side to side and thus protecting mucous membrane from
in and out to manipulate food. infection and the teeth from possible decay
b) Intrinsic Muscle
 Originate and insert within the tongue VI. TEETH
 Altering the size and shape of the tongue
 Also known as Dentes
for speech and swallowing
 Located in the sockets of Alveolar Process of the
 Papillae
 covering the upper surface and sides of the mandible and maxillae bones.
tongue  Mastication – Chewing
 Projections of the Lamina Propria is covered  There are 20 temporary or deciduous teeth that form
with epithelium. in infant
 It produce the rough surface of the tongue  32 Permanent teeth by the age of 13
 The anterior two – thirds contains the taste
buds and are most numerous are the tip of the
tongue and on the posterior surface of the
tongue
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 Incisors
UERM
NURSING
Fundamentals of Anatomy and Physiology Mark
Chang

 The food bolus stimulates oropharyngeal

 Eight front teeth receptors that send impulse to the brain
 Used to cut food  Causes the soft palate and uvula to move upward
 Canine and close off the nasopharynx.
 Used to tear food  The larynx is pulled forward and upward under
 They have one cusp the tongue where it meets the epiglottis ad seals
 Also called as Cuspids off the glottis
 Molar Teeth  Glottis – common opening into the trachea
 Used to grind food  The food bolus passes through the
 2 Kinds of Molar Teeth: laryngopharynx and enters the esophagus in
1. Premolars about 1 second.
 We have eight premolars  The respiratory passageways reopen and
 Have 2 cusps or projection breathing resumes.
 Also called as Bicuspids
2. Molars VIII. THE ESOPHAGUS
 We have 12 molars  The esophagus is a collapsible, muscular tube that is
 Have 3 cusps situated behind the trachea or the windpipe
 Also called as Tricuspid  10 inches long and begins at the end of the
 But many have four cusps and the laryngopharynx
maxillary first molar actually has  Passes through the Mediastinum
five cusps  Mediastinum – Space between the lungs
 Gingivae – covers the Alveolar Process; also referred  Pierces through the diaphragm
as the Gums  Esophageal Hiatus – an opening and ends at the
 The sockets are lined by the Periodontal Ligament superior portion of the stomach
that anchors the teeth in position and acts as a shocks  Functions:
absorber to soften the forces created by chewing.  Secretes Mucus
 Tooth can be divided into 3 Principal Portion:  Transport food to the stomach
1. Crown  It does not absorb food
 Portion above the level of the gums  Food is pushed through the esophagus by peristalsis
 Covered with enamel  Movement of solid, or semisolid foods from the
 Enamel – Hardest substance in the body that mouth to the stomach takes 4 to 8 seconds
protects tooth from wear and acids
 Liquid pass about 1 second.
2. Cervix / Neck
 Lower Esophageal / Gastroesophageal Sphincter –
 Constricted junction between the crown and
connects esophagus with the stomach and controls the
the root
passage of food into the stomach
3. Root
 Consist of 1, 2, 3 projections embedded in the IX. THE STOMACH
socket
 Larger teeth will have one or more roots  Enlargement of the GI Tract
 Dentin  Lies in the upper part of the abdominal cavity; under
 It is where teeth are made of the diaphragm muscle.
 Bonelike substance  Shape of letter J
 It Encloses the Pulp Cavity  When it is empty, it is about the size of a large
 Root Canals - Narrow Extension of the pulp cavity sausage; however, it can stretch.
project into the root  4 Parts of the Stomach:
 Apical Foramen 1. Cardia
 An opening at the base of each root canal  Surrounds the gastroesophageal sphincter
 It is where blood vessels and nerves enter 2. Fundus
the tooth and become part of the pulp  Rounded portion above and to the left of
 Cementum – covering of the dentin which attaches the cardia
the root to the periodontal ligament 3. Body
 Large central portion of the stomach
VII. THE PHARYNX 4. Pylorus / Antrum
 Narrow inferior region that connects with
 Part of both Digestive and Respiratory System
the duodenum via the pyloric sphincter
 Deglutination – Swallowing
 Rugae – these are large fold of mucosa; when there
 Its function is to begin the process of swallowing are no foods (it disappears when the stomach is fill)
 Swallowing – move from mouth to the stomach
 3 Kinds of Gastric Glands:
 Food Bolus – product of the combination of the 1. Zymogenic/ Chief Cells
tongue, teeth and the saliva; it is a soft mass  Secretes principal gastric enzymes
 Oropharynx – it is where food is being forces to  Pepsinogen – Principal gastric enzymes
after the mouth cavity (Voluntary stage of 2. Parietal Cells
swallowing)  Secretes HCL
 Involuntary Stage of Swallowing  Activates Pepsinogen (then it became
 The respiratory passage way close and breathing Pepsin [ an enzyme ] )
is temporarily interrupted.  Pepsin – breaks down proteins
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3. Mucous Cells
Fundamentals of Anatomy and Physiology
 Secretes mucus that protects the stomach
from being digested
 Gastric Juice – secretions of the gastric glands
 The muscularis coat of the stomach has uniquely 3
layers of smooth muscle:
1. Inner Oblique
2. Middle Circular
3. Outer Longitudinal
 The three layers allow the stomach to contract in
a variety of ways.
 Break up food into small pieces
 Churn it
 Mix it with gastric juice
 Growling – An activity that occurs when the
stomach is empty
 Main Chemical Activity: Begin the digestion of
protein by the pepsin.
 The protein components of the stomach cells
themselves are protected from being digested by the
mucus secreted by the mucous cells.
 The stomach then empties all its contents into the
duodenum of the small intestine approximately 2 to
6 hours after ingestion.
 Food containing large amounts of fats take the
longest to pass into the duodenum.
 The stomach participates in the absorption of some
water and salts.
 Chemical Digestion – This process depends on
secretion from the intestinal glands and on secretion
of the two large accessory glands of the system:
 Pancreas
 Liver and its Gallbladder
X. THE PANCREAS
 Soft and oblong gland
 6 inches and 1 inch thick
 Found beneath the great curvature of the stomach
and is connected by a duct to the duodenum.
 Pancreas is divided into 3:
1. Head
 The part closest to the duodenum
2. Body
 Main Part
3. Tail
 The pancreas is made up of clusters of glandular
epithelial cells:
 Islets of Langerhans / Pancreatic Islets
 Form the endocrine portion of the gland
 Part of the Endocrine System
 Alpha Cells
 Secretes the hormone glucagon
 Beta Cells
 Secrets the hormone insulin
 Acini
 Masses of Cells
 Exocrine Glands of the organ
 Pancreatic Juice - mixture of digestive
enzymes:
 Lipases
 Carbohydrates
 Proteases
 Leaves the pancreas through a large main
tube – Pancreatic Duct / Duct of Wirsung
 The duct cells secrete sodium bicarbonate.

Mark
Chang
Ampulla of Vater (Hepatopancreatic Ampulla)
- Common bile duct of the liver and enters the
duodenum in a common duct.
 Functions:
 Acini secretes enzymes that continue the
digestion
 Secrete the hormone glucagon and insulin that
regulate and control blood sugar levels.
XI. THE LIVER
 One of the largest organs of the digestive systems
 Weighs 4 pounds
 Divided into 2 principal lobes:
 Right Lobe
 Left Lobe
 Separated by the Falciform Ligament
 The lobes of the liver are made up of numerous
functional units called Lobules
 6 Major Functions of the Liver:
1. Manufactures anticoagulant (Heparin) and
most of the other plasma proteins, such as
Prothrombin and Thrombin (involved in
blood clotting mechanism )
2. Kupffer cells eat certain bacteria and old, worn
– out WBCs and RBCs
3. Contains various enzymes that either break
down poisons or transform them into less
harmful substance.
4. Excess glucose can be stored as glycogen or
converted into fat.
5. Stores glycogen, copper, and iron, as well as
vitamins A,D,E, and K.
6. Produces bile salts that break down fats.
 Bile salts are sent to the duodenum of the
small intestine for emulsification and
absorption of fats.
 Emulsification – breakup
A. THE GALLBLADDER
 Pear – Shaped sac about 3 to 4 inches
 Located in a depression of the surface of the liver
 Its lining has rugae to allow it to expand and fill with
stored bile.
 Function: Store and concentrate the bile produced by
the liver lobules
 The bile enters the duodenum through the common
bile duct.
 XII. THE SMALL INTESTINE
 Major portion of absorption and digestion occurs in
the small intestine
 21 feet in length; 1 inch in diameter
 Divided into 3 parts:
1. Duodenum
 Originates at the Pyloric Sphincter
 Shortest part
 10 inches long
2. Jejunum
 8 feet long
3. Ileum
 12 feet and joins the large intestine at the
Ileocecal Valve (Sphincter)
 Intestinal Glands / Crypts of Lieberkuhn – pits that
lined with glandular epithelium; they secrete
intestinal digestive enzymes that supplement the bulk
of the digestive enzymes by the liver and pancreas.
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 Brunner’s Gland
UERM
NURSING
Fundamentals of Anatomy and Physiology


Mark
Chang

The Rectum is the last GI Tract (7 to 8 inches)

 Now called Duodenal Glands  It is situated anterior to the sacrum and coccyx
 Component of the submucosa of the duodenum  Anal Canal – Terminal 1 inch of rectum
 Secrete an alkaline mucus  Anal Columns – Series of Longitudinal folds;
 Additional mucus is secreted by the goblet cells – it contains a network of arteries and veins
protects the walls of the small bowel from being  Bacteria in the colon manufacture 3 important
digested by enzymes vitamins:
 Chyme 1. Vitamin K – clotting
 Digested 2. Biotin – Glucose metabolism
 Viscous 3. Vitamin B5 – Hormones and neurotransmitters
 Semifluid of the intestine  Mucus is also produced by glands in the intestine
 80% of all absorption of nutrients occurs in the small  Intestinal Water absorption is greatest in the cecum
intestine. and ascending colon.
 Plicae – Larger surface for absorption of nutrients  XIV. THE FORMATION OF THE FECES
by the structure of the walls of the tract, which are  Feces – semisolid mass of materials as a result of the
known into series of folds. absorption of water
 Villi – Mucosal coat in transformed into projection  Components of Feces:
 Structure of each villus contains capillary  Water
network where blood picks up nutrient.  Inorganic Salts
 Microvilli – Individual epithelial cells that cover the  Epithelial Cells from the mucosa of the tract that
surface of a villus were scraped away as the chime move through
 XIII. THE LARGE INTESTINE the tract
 Functions:  Escherichia Coli – Bacteria of the Feces
 Absorption of Water  The products of bacterial decomposition, such as gas
 Manufacturing and Absorption of Certain and odor, and undigested parts of food not attacked
Vitamins by bacteria are also found in the feces
 Formation and expulsion of Feces  The more fiber in the diet the more indigestible
 5 feet in length; 2.5 inches in diameter materials in the feces and the softer the stool.
 Also referred as Bowel  When mass peristalsis pushes the fecal material into
 Attached to the posterior wall of the abdomen by the rectum causes Distention of the Rectal Walls
extension of its visceral peritoneum (Mesocolon)  It triggers pressure – sensitive receptors in the walls
 Divided into 4 Regions: of the rectum.
1. Cecum  Sending an impulse to the nervous system – which
 The pouchlike; first part initiate the reflex of defecation.
 2 to 3 inches  Defecation is the final activity of the digestive
 Hangs below the Ileocecal Valve system.
 One end is close
2. Colon
 Largest part
3. Rectum
4. Anal Canal
 Ileocecal Valve – opening from the ileum; fold of
mucous membrane
 Vermiform Appendix – Twisted tube that is
attached to the cecum; 3 inches in length
 Haustrae – Tube of consecutive pouches
 Colon is Divided into 3 parts:
1. Ascending Colon
 Rises on the right side of the abdomen
 Reaches under surface of the liver
 Turns to the left at the Right Colic
(Hepatic) Flexure
2. Transverse Colon
 Curves beneath the lower end of the spleen
to the left side as the Left Colic (Splenic)
Flexure)
3. Descending Colon
 Sigmoid Colon – Last part of the colon
 It is where colon joins the rectum
 3 Mechanical Movements occur in the Large
Intestine:
 Haustral Churning
 Peristalsis
 Mass Peristalsis – Strong Peristaltic Wave
 Food in the stomach initiate mass peristalsis