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Elderly stomach cancer male patient gets insertion of feeding tube (NJ)…

- - - - Oral Cavity: physical and mechanical digestion
        
        Pharynx: receives food from mouth
        
        Esophagus: conduct embolus and liquids to stomach for digestion
        
        Stomach: chemical digestion by secretion of enzymes and acid
        
        Small Intestine: absorption of nutrients and minerals from food
        
        Large Intestine: recovery of water and electrolytes, formation and storage of feces and fermentation of some of the indigestible food by bact.
        
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        Duodenum: receives partially digested food (known as chyme) from the stomach and plays a vital role in the chemical digestion of chyme
        
        Jejunum: absorption of important nutrients such as sugars, fatty acids, and amino acids
        
        Ileum: absorb vitamin B12, bile salts, and whatever products of digestion were not absorbed by the jejunum
        
        Lacteals: absorb dietary fats
        
        Peritoneum: support the organs in the abdominal cavity and also allows nerves, blood vessels, and lymph vessels to pass through to the organs
        
        Mesentery: attaches the intestines to the posterior abdominal wall
        
        Plicae Circulares: increase the amount of surface area available for the absorption of nutrients
        
        Rugae: allow for stretching/distension of the stomach
        
        Cardiac Sphincter: prevent acid content of stomach from moving into the esophagus
        
        Pyloric Sphincter: valve that controls flow of partially digested food into the small intestine
        
        Greater Omentum: fat deposition and infection/wound isolation (immune)
        
        Lesser Omentum: separate the greater sac from the omental bursa
        
        Fundus: stores both undigested food and gases that are released during the process of chemical digestion
        
        Oropharynx: passageway for air and food
        
        Laryngopharynx: protect pharynx against food abrasion
        
        Salivary Glands: breaks down carbs w/ enzymes and lubricates passage of food for swallowing
        
        Teeth: tearing, shredding, and mastication of food
        
        Tongue: helps push food around and form bolus which is pushed towards back of throat
        
        Uvula: prevent food from going into nasal cavity
  - - - Nutrient Digestion
        
        Carbohydrates: breakdown of starch into indiv. glucose molecules; breakdown of disaccharides into monosaccharides
        
        Small Intestine: pancreatic amylase released by pancreatic juice into small intestine; digests starch into shorter strands of glucose, maltose, and indiv. glucose molecules
        
        Dextrinase & glucoamylase break bonds btwn glucose subunits and maltase breaks bonds btwn 2 glucose molecules that compose maltose
        
        Other disaccharides require a special enzyme such as lactase or sucrase
        
        Monosaccharides are then absorbed into small intestine across epithelial lining into blood; becomes either oxidized through cellular resp., blood glucose, or stored in adipose tissues
        
        Oral Cavity: salivary amylase breaks chem. bonds btwn glucose molecules to partially digest starch
        
        Salivary amylase inactivated by low pH of stomach when bolus swallowed
        
        Proteins: digestion of protein release individual amino acids to be absorbed into the blood & transported to cells for synthesis of new proteins
        
        Stomach: pepsin is formed from pepsinogen and hydrochloric acid is released from parietal cells; causes low pH of stomach that activates pepsinogen to pepsin to denature proteins
        
        Small Intestine: high pH inhibits pepsin after the entry of chyme; pancreas releases trypsinogen, chymotrypsinogen, and procarboxypeptidase into small intestine in inactive form
        
        Trypsinogen is activated by enteropeptidase which transforms trypsinogen into trypsin and chymotrypsinogen to chymotrypsin and procarboxypeptidase to carboxypeptidase
        
        Trypsin & chymotrypsin break bonds btwn spec. amino acids to prod. peptides; trypsin cleaves protein @ + charged arginine and lysine; chymotrypsin cleaves hydrophobic amino acids
        
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        Carboxypeptidase breaks the bond btwn amino acid and carboxyl end of protein; creates dipeptides & free amino acids as breakdown products
        
        Free amino acids are absorbed across small intestine into epithelial lining to enter blood
        
        Used as building blocks for new proteins, excess absorbed and converted to either glucose or deaminated in the liver; used as fuel for cellular resp.
        
        Lipids: enzymes are required to break the bonds btwn glycerol and fatty acids; chemical digestion of cholesterol is not required for its absorption
        
        Stomach: Lingual lipase in the oral cavity saliva which is activated once it reaches the stomach; triglycerides undergo limited digestion by lingual & gastric lipase
        
        Acidic lipases digest 30% of triglycerides to diglyceride and fatty acids; lipase enzymes requires participation of bile salts.
        
        Small Intestine: Triglyceride digestion facilitated by pancreatic lipase; enzyme prod. by pancreas and released into duodenum
        
        Pancreatic lipase digests triglycerides into monoglycerides & 2 free-fatty acids
        
        Lipids do not dissolve in luminal fluids of digestive system & form large lipid masses
        
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        Lipid Absorption: micelles transport lipids to simple columnar epi of small intestine; bile salts remain in small intestine to be recycled
        
        Triglycerides, cholesterol, & other lipid molecules are wrapped in proteins to form chylomicron
        
        Golgi apparatus packages chylomicrons into secretory vesicles; vesicles merge w/ plasma mem. of epi. cells to release chylomicrons by exocytosis
        
        Overlapping of endothelial cells of lacteals act as one-way valves to permit entry of chylomicrons
        
        Chylomicrons enter the blood and deliver lipids to liver & other tissues (connective & muscular)
        
        Nucleic Acid: not an essential nutrient, but are digested by specific enzymes of digestive systems like ess. nutrients
        
        Small Intestine: Nucleases synth. & released by pancreas; breaks the phosphodiester bond btwn indiv. nucleotides of DNA & RNA
        
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        Water Absorption
        
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- - - - Not being able to utilize these enzymes, he will not be able to process food properly or absorb the proper water or nutrients from the food which would lead to malnutrition, therefore the insertion of the tube for feeding
- - - - Not be able to break down into polypeptide and peptide fragments; no absorption of proteins
        
        Malnutrition due to not being able to synthesize proteins back into blood for building blocks of new cells to form additional proteins
        
        Due to this, possible protein denaturation and inability to construct new proteins
    - - Lingual lipase cannot digest triglycerides to diglyceride to fatty acid
        
        Improper absorption of triglycerides
        
        Cannot deliver lipids liver, adipose, skeletal, and cardiac muscle tissue need
        
        Cannot synthesize cholesterol properly & use for plasma membrane synthesis; loss of protection of fatty layer for organs; no fat for heat or excess nutrient storage
    - - Not able to secrete phosphatase & nucleosidase from small intestine walls
        
        Unable to break bond btwn phosphate and nucleotide & sugar and itrogenous base
        
        Nucleic acid building blocks are then not absorbed across epithelium of small intestine into blood
        
        Inhibits replication and transcription if proper nucleic acids are not present for building new DNA and mRNA strands
        
        Unable to produce proteins or enzymes further
  - - - Cannot absorb glucose back into the bloodstream
        
        Excess fatigue due to not being able to utilize glucose in cellular resp.
        
        Bypassing glycolysis, using lipids for energy
        
        Causes increased CO2 release into the blood & causes pH increase = acidosis
    - - Cannot break down polypep. into smaller fragments for reabsorption
        
        Malnutrition & not being able to synth. proteins due to no fragments for building blocks of proteins
    - - Same as mentioned above in stomach