LESSON 10THE DIGESTIVE SYSTEM

INTRODUCTION

The digestive system begins in the mouth where food enters the body, and ends with the anus where feces leaves the body. The main functions of the organs of the digestive system are to take complex food materials that are taken into the mouth and break them down mechanically and chemically. Foods traveling through the digestive tract are helped in their breakdown by digestive enzymes. Complex proteins are broken down to simpler amino acids; complex sugars are broken down to simple sugars such as glucose; and large fat molecules (triglycerides) are broken down to fatty acids and glycerol.

After food is digested into their smallest components, its absorbed into the blood and lymph vessels by passing through the lining of the small intestine. Nutrients such as sugars, fats, and amino acids, can then travel to all the cells of the body. Structures within the cell, like the mitochondria, metabolize nutrients in the presence of oxygen to release energy (ATP) stored within the food. Cells may use amino acids to build large protein molecules needed for growth and repair. Although the walls of the small intestine absorb fatty acids and glycerol, many of these nutrients enter lymphatic vessels rather than blood vessels. Fats eventually enter the bloodstream via the lymph vessels in the upper chest region.

Another function of the digestive system is the removal of the solid waste materials that cannot be absorbed into the bloodstream. The large intestine first removes the water, then compacts the solids, and finally removes them from the body through the anal meatus. The expelled wastes are known as feces.

ANATOMY

Mouth

The digestive system begins with the mouth or oral cavity. The sides of the mouth are soft epithelial tissue. The roof of the mouth towards the anterior is a hard palate; towards the posterior is the soft palate. Irregular ridges called rugae cover the hard palate. Extending down from the soft palate is the uvula, which aids in speech. The floor of the mouth is mostly composed of the tongue which aids in the movement of food and contains the taste senses which are small papillae which arise from the tongue’s surface. The tongue aids in producing sounds. Located to the back of the mouth are the tonsils which are masses of lymphatic tissue found on both sides of the oral pharynx. Tonsils act as filters to protect the body from the invasion of microorganisms and produce lymphocytes, known as white blood cells, that are able to fight disease.

The gums are made of fleshy tissue and surround the teeth. The human mouth contains 32 teeth. They are:

central incisorsecond premolar

lateral incisorfirst molar

cuspid or caninesecond molar

first premolarthird molar, or wisdom tooth

Three pairs of salivary glands surround the oral cavity. These exocrine glands produce a fluid called saliva that contains important digestive enzymes. Saliva is released from the parotid gland, submandibular gland, and sublingual gland on each side of the mouth. Narrow ducts carry the saliva into the oral cavity. Small stones sometimes form in these narrow ducts that can cause severe mouth pain.

Pharynx

The pharynx or throat is a muscular tube about 5 inches long, lined with a mucous membrane. It serves as a common passageway for air traveling from the nose (nasal cavity) to the windpipe (trachea) and food traveling from the oral cavity to the esophagus. When swallowing occurs a flap of tissue, the epiglottis, covers the trachea so that food cannot enter and become lodged there.

Stomach

Food passes from the esophagus into the stomach. The stomach is composed of an upper portion called the fundus, a middle section known as the body, and a lower portion, the pylorus. Rings of muscles called sphincter control the openings into and from the stomach. The cardiac sphincter relaxes and contracts to move food from the esophagus into the stomach, whereas the pyloric sphincter allows food to leave the stomach when it has been sufficiently digested. Folds in the mucous membrane (mucosa) which lines the stomach are called rugae. The rugae contain digestive glands that produce enzymes and hydrochloric acid.

The role of the stomach is to prepare the food chemically and mechanically so that it can be received in the small intestine for further digestion and absorption into the bloodstream. Food does not enter the bloodstream through the walls of the stomach. The stomach controls the passing of foods into the first part of the small intestine so that it proceeds only when it is chemically ready and in small amounts. Food leaves the stomach in 1-4 hours depending upon the amount and type of food eaten.

Small Intestine

The small intestine extends for 20 feet from the pyloric sphincter to the first part of the large intestine. It has three parts: duodenum, jejunum, and ileum. The duodenum is the first section. It receives food from the stomach and bile from the liver through the gallbladder. It also receives pancreatic juice from the pancreas. Enzymes and bile help

to digest food before it passes the small intestine. The jejunum is about 8 feet long. It connects with the third part, the ileum which is about 11 feet long. The ileum attaches to the first part of the large intestine.

Millions of tiny, microscopic projections called villi line the walls of the small intestine. The tiny capillaries (microscopic blood vessels) in the villi absorb the digested nutrients into the bloodstream and lymph vessels.

Large Intestine

The large intestine extends from the end of the ileum to the anus. It is divided into four parts: cecum, colon, sigmoid colon, and rectum. The cecum is a pouch on the right side that attaches to the ileum by the ileocecal sphincter. The appendix hangs from the cecum; its function is like other lymph structures to aid in the control of bacteria moving into the small intestines. The excessive bacteria may cause the appendix to become inflamed.

The colon is about 5 feet long and has three divisions. The ascending colon extends from the cecum to the under surface of the liver where it turns to the left to become the transverse colon. The transverse colon passes horizontally to the left toward the spleen and turns downward into the descending colon. The sigmoid colon, shaped like an S, lies at the distal end of the descending colon and leads into the rectum. The rectum terminates in the lower opening of the gastrointestinal tract, the anus.

The large intestine receives the fluid waste products of digestion and stores these wastes until they can be excreted from the body. Because the large intestine absorbs most of the water within the waste material, the body can expel solid feces. Diarrhea can result from lack of absorption of the water through the walls of the large intestine. Constipation happens when the feces stops moving, which is mostly related to diet.

Liver, Gallbladder, and Pancreas

Three important additional organs of the digestive system - the liver, gallbladder, and pancreas - play crucial roles in the proper digestion and absorption of nutrients. The liver is located in the right upper quadrant and produces a thick, yellowish-brown fluid called bile. Bile contains cholesterol, bile acids, and several bile pigments. One of these pigments, bilirubin, is produced from the breakdown of hemoglobin in the liver. The liver combines bilirubin with bile and then excretes both into the duodenum. They are expelled from the body with the feces.

The liver continuously produces bile. Bile moves from the liver through the hepatic duct, to the cystic duct, and then is stored in the gallbladder. Upon eating fatty food the body releases bile into the common bile duct which joins with the pancreatic duct just before the entrance to the duodenum. The duodenum thus receives a mixture of bile and pancreatic juices. Bile has a detergent-like effect on fats in the duodenum. It breaks apart large fat globules so that enzymes from the pancreas can digest the fats. This is called emulsification. Without bile, most of the fat taken into the body would remain undigested.

Besides producing bile, the liver has several other vital and important functions including keeping the glucose in the blood at a normal level. The liver removes excess glucose from the bloodstream and stores it as glycogen. When the blood sugar level becomes dangerously low the liver can convert stored glycogen back into glucose via a process called glycogenolysis. In addition, the liver can convert proteins and fats into glucose when the body needs sugar by a process called gluconeogenesis.

The liver’s other functions include production of some blood proteins, particularly those necessary for blood clotting, destruction of old erythrocytes and release of bilirubin, and removal of poisons or detoxification of the blood.

The hepatic portal system brings blood to the liver directly from the intestines. Digested foods pass into the portal vein directly after being absorbed into the bloodstream from the small intestine, thus giving the liver its first chance at using the nutrients.

The pancreas has both an exocrine and an endocrine organ function. As an exocrine gland, it produces pancreatic juices filled with enzymes (amylase and lipase) to digest food. These pass into the duodenum through the pancreatic duct. As an endocrine gland (secrets into the bloodstream), the pancreas secretes insulin and glucogon.

LESSON 10 GRAPHICS


TERMS FOR LESSON 10: THE DIGESTIVE SYSTEM

Anatonomical Terms to Know

mouth

palate

pharynx

esophagus

stomach

antrum

pyloric sphincter

small intestine

duodenum

jejunum

ileum

large intestine

cecum

colon

rectum

anus

Accessory Organs to Know

salivary gland

liver

gallbladder

pancreas

peritoneum

appendix

abdomen

Word Roots to Know: Digestive System

an/o

antr/o

cec/o

col/o

duoden/o

enter/o

esophag/o

gastr/o

ile/o

jejun/o

proct/o

rect/o

sigmoid/o

stomat/o

or/o

appendic/o

cheil/o

chol/o

diverticul/o

gingiv/o

gloss/o

lingu/o

hepat/o

herni/o

lapar/o

abdomin/o

palat/o

pancreat/o

peritone/o

pylor/o

sial/o

uvul/o

Diagnostic Terms to Know: Digestive System

appendicitis

cholecystitis

cholelithiasis

diverticulitis

diverticulosis

gastritis

gastroenteritis

gastroenterocolitis

gingivitis

hepatitis

hepatoma

palatitis

pancreatitis

proctoptosis

rectocele

sialolith

uvulitis

adhesion

anorexia nervosa

cirrhosis

Crohn’s disease

duodenal ulcer

gastric ulcer

intussusception

peptic ulcer

ulcerative colitis

volvulus

Surgical Terms to Know: Digestive System

anoplasty

antrectomy

appendectomy

cheilorrhaphy

cholecystectomy

colectomy

colostomy

diverticulectomy

esophagogastroplasty

gastrectomy

gastrojejunostomy

gastrostomy

gingivectomy

glossorrhaphy

herniorrhaphy

ileostomy

laparotomy

palatoplasty

pyloroplasty

uvulectomy

abdominoperineal resection

anastomosis

vagotomy

Diagnostic Procedural Terms to Know: Digestive System

cholecystogram

endoscope

endoscopy

esophagoscope

esophagoscopy

gastroscope

gastroscopy

sigmoidoscope

sigmoidoscopy

lower GI series

upper GI series

Additonal Terms to Know: Digestive System

abdominal

anal

apepsia

aphagia

abdominocentesis

bradypepsia

dyspepsia

dysphagia

gastromalacia

gastrodynia

glossopathy

ileocecal

nasogastric

oral

pancreatic

peritoneal

proctologist

proctology

stomatogastric

sublingual

ascites

feces

gavage

gastric lavage

nausea

PRACTICE EXERCISES FOR LESSON 10

THE DIGESTIVE SYSTEM

MATCHING

----lower bulge of the stomachasalivary gland

----hangs from roof of mouthbpancreas

----produces salivacperitoneum

----produces bileduvula

----roof of mouthegallbladder

----opening between stomach &fpalate

---- duodenumgabdomen

----behind stomachhliver

----small pouchiappendix

----abdominal liningjpyloric sphincter

----between pelvis and thoraxkcecum

----stores bilelantrum

DEFINE:

procto/o

gastr/o

an/o

cec/o

ile/o

stomat/o

duoden/o

col/o

or/o

enter/o

rect/o

antr/o

esophag/o

jejun/o

sigmoid/o

DEFINE:

herni/o

abdomin/o

sial/o

chol/o

diverticul/o

gingiv/o

appendic/o

gloss/o

hepat/o

cheil/o

peritone/o

palat/o

pancreat/o

lapar/o

lingu/o

pylor/o

uvul/o

DEFINE:

cholelithiasis

diverticulosis

sialolith

pancreatitis

proctoptosis

gastritis

rectocele

hepatitis

cholecystitis

anorexia nervosa

Crohn’s disease

ASSIGNMENT FOR LESSON 10

Medical Terminology, HS 280

The Digestive System

MATCHING

----1digestion mostly takes placeastomach

----2holding tank for foodbliver

----3lower bulge of stomachcsalivary gland

----4hangs from roof of mouthdplate

----5produces salivaeappendix

----6produces bilefgallbladder

----7roof of mouthgpyloric sphincter

----8small pouch with no functionhteeth

----9stores bileismall intestine

----10chops foodjovula

MATCHING

----11an/oacecum

----12antro/obintestines

----13cec/ocileum

----14enter/odanus

----15ile/oemouth

----16jejun/ofantrum

----17proct/oganus

----18sigmoid/ohjejunum

----19or/oisigmoid colon

----20duoden/ojduodenum

MATCHING - May Be Used More Than Once

----21ceo/oastomach

----22col/obintestine

----23duoden/ocileum

----24enter/odmouth

----25gastr/oejejunum

----26ile/ofrectal area

----27jejun/ogjejunum

----28stomat/ohcecum

----29proct/oiduodenum

----30or/o

Assignment for Lesson 10, Digestive, pg. 2

MATCHING - May Be Used More Than Once

----31appendic/oatongue

----32cheil/oblip

----33chole/ocgall, bile

----34cholangi/odgum

----35diverticuli/oehernia

----36gingiv/ofliver

----37glossgbile duct

----38hepat/ohappendix

----39herni/o

----40lingu/o

DEFINE: THE DIGESTIVE SYSTEM

appendectomy

cholelithiasis

diverticulitis

gastroenterocolitis

gingivitis

pancreatitis

proctoptosis

rectocele

Crohn’s disease

duodenal ulcer

peptic ulcer

cholecystogram

lower GI series

upper GI series

aphagia

dysplagia

glossopathy

proctologist

Assignment for Lesson 10, Digestive, pg. 3

DEFINE:

sublingual

ascites

gastric lavage

peritoneum

appendix

salivary glands

rectum

diverticulosis

gastritis

hepatitis

hepatoma

sialolith

uvulitis

cirrhosis

intussusception

ulcerative colitis

appendicectomy

cheilorrhaphy

cholecystectomy

colectomy

nausea