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An elderly male with stomach cancer recently had a feeding tube inserted…

- - - - Mouth
        
        Salivary glands
        
        Sublingual gland
        
        Parotid gland
        
        Submandibular gland
        
        Teeth
        
        primary dentition
        
        Permanent teeth
        
        Tongue
        
        forms Bolus
        
        Palate
        
        hard palate
        
        soft palate
        
        uvula
      - Pharynx/esophagus
        
        Gastroesophageal (cardiac) sphincter
        
        food: oropharynx -> Laryngopharynx
      - Liver/gallbladder
        
        accessory organs
        
        Gallbladder
        
        store & concentrate bile
        
        Cystic duct
        
        Liver
        
        Round ligament
        
        Hepatic artery & Vein
        
        Porta-hepatis
        
        Falciform Ligament
        
        Common hepatic duct
      - pancreas
        
        secrete pancreatic juice
    - - small intestine
        
        Major organ of digestion & absorption
        
        Subdivisions
        
        Jejunum
        
        Ileum
        
        Duodenum
        
        Point where joins large int.: Ileocecal Valve
      - large intestine
        
        Subdivisions
        
        Appendix
        
        Colon
        
        Cecum
        
        Rectum
        
        Anal canal
        
        Unique features
        
        Teniae coll
        
        Haustra
      - stomach
        
        sections
        
        Body: mid-portion
        
        Pyloric region & Valve
        
        Fundus
        
        Greater curvature
        
        convex lateral surface
        
        Cardial Region
        
        Lesser curvature
        
        concave lateral surface
        
        mesenteries
        
        Greater Omentum
        
        Lesser omentum
      - Colon
        
        regions
        
        Descending colon
        
        Sigmoid colon
        
        S shape, travels through Pelvis
        
        Transverse
        
        Ascending
  - - - A
      - K
      - E
      - B12
      - D
    - - starch
    - - calcium
      - iron
    - - helps push food through digestive system
  - - - pancreatic juice
        
        digestive enzymes
        
        Amylase
        
        Proteases
        
        Lipases
        
        Nucleases
    - - Liver
        
        Bile salts
        
        fat and emulsification and absorption
        
        Bilirubin
        
        gives brown color of feces
      - Gallbladder
        
        store & concentrate bile
    - - Mass movement
        
        slow, powerful peristaltic waves
      - Defecation Reflux
        
        mass movement forcing feces towards rectum
        
        2.spinal reflex is initiated -> stimulate contraction of rectum
        
        feces move into rectum stimulation stretch receptors
        
        3.voluntary motor neuron inhibited -> external anal sphincter relaxes
      - propulsion of feces to anus and defecation
      - absorbs vitamins (B & K) by Bacterial Flora
    - - physical digestion
        
        Mechanical digestion by chewing
        
        initiates Propulsion
        
        Ingests
        
        Starts digestion of polysaccharides
      - salivary glands
        
        breaks down starch with Amylase
        
        serous cells & mucous cells
        
        dissolves food chemicals
      - teeth
        
        mastication
    - - Pass food from mouth -> stomach
      - 2 phases
        
        Buccal Phase
        
        voluntary contraction of tongue
        
        pharyngeal-esophageal phase
        
        involuntary swallowing center in brain stem
      - Major function
        
        Propulsion that starts with Deglutition
    - - digestive process
        
        protein digestion begins
        
        pepsin carries out enzymatic digestion of proteins
        
        lipid-soluble drugs absorbed into blood
        
        mechanical breakdown of food
        
        churning
        
        intrinsic factor
        
        protein that helps intestines absorb vitamin B12.
        
        exhibits propulsion to deliver chyme to small int.
      - regulation of Gastric Secretion
        
        3 phases gastric secretion breakdown
        
        Gastric phase
        
        intestinal phase
        
        Enterogastric reflex
        
        Enterogastrones
        
        Cephalic (reflux) phase
        
        ACh, Gastrin, & Histamine stimulate parietal cells to secrete HCI ( hydrochloric acid)
      - gastric gland cells
        
        chief cells
        
        secrete pepsinogen
        
        Enteroendocrine cells
        
        secrete chemical messengers
        
        Parietal cells
        
        secrete
        
        HCI
        
        activates pepsin
        
        kills bacteria
        
        denatures protein
        
        intrinsic factor
    - - microscopic
        
        Villi
        
        lacteal for absorption
        
        Microvilli
        
        brush border enzymes
        
        final digestion of proteins
        
        Circular folds
        
        force chyme through lumen
        
        more time for nutrient absorption
      - major digestion & absorption organ
      - digestion process
        
        between meal
        
        Propulsion
        
        after meal
        
        segmentation (mechanical breakdown)
      - Nutrients absorbed
        
        Electrolytes
        
        water (95%) absorbed
        
        Vitamins
        
        A, D, E, K absorbed by diffusion
        
        C, B absorbed by active & passive transport
        
        B12 -> intrinsic factor
  - - - breaks down protein into polypeptides
      - produced in stomach by Chief cells
      - proteins broken into
        
        amino acid monomers
        
        small polypeptides
        
        large polypeptides
    - - produced in pancreas and stomach
      - breaks down proteins & peptides
    - - breaks down carbs/starch
      - produced by salivary gland/saliva
      - digestion of carbohydrates
        
        brush border enzyme
        
        Pancreatic amylase
        
        only monosaccharides are absorbed
    - - breaks down lipids
      - produced in pancreas
      - digestion of lipids
        
        diffusion
        
        Micelle formation
        
        pancreatic lipases breakdown fat into 3 fatty acids
        
        emulsification
    - - breaks down/splits nucleic acids
      - produced in pancreas
      - digestion
        
        pancreatic nucleases
        
        brush border enzymes
        
        breakdown nucleotides
        
        Pentose sugar
        
        phosphate ions
        
        nitrogenous bases