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Elderly male with stomach cancer (Background Information (Anatomy of…
Elderly male with stomach cancer
Upstream Causes
Organs being bypassed: esophagus, stomach, and duodenum
These organisms are not participating in the digestive process
Chemicals and enzymes not being used
Mechanical breakdown of food
Propulsion of food which mixes food with gastric juices
Intrinsic factor for absorption of Vitamin B12
Duodenal mucosa cells secreting secretin & CCK
Gallbladder was removed which stores and concentrates bile by absorbing water
Part of the small intestine (duodenum) was removed; small intestine is most responsible for digestion and absorption so a lot of nutrients may not be absorbed
Background Information
Anatomy of digestive system
Accessory organs: teeth, tongue. and gall bladder
Mouth
Pharynx
Esophagus
Stomach
Gastric gland cells
Parietal cells secrete Hydrochloric Acid & Intrinsic Factor
Hydrochloric acid: denatures proteins, activates pepsin, breaks down plant cell walls, and kills many bacteria
Intrinsic Factor: required for absorption of Vitamin B12 in small intestine
Chief cells:secrete Pepsinogen
Pepsinogen is an inactive enzyme that is activated to pepsin
Enteroendocrine cells: secrete chemical messangers
Some are paracrines while others are hormones
Small & large intestines
Small intestine contains these types of cells in the villi and crypts
Goblet cells: mucus-secreting cells
Enteroendocrine cells: source of enterogastrones; CCK and secretin
Paneth cells: secrete antimicrobial agents
(Duodenum) Duodenal glands in small intestine
Secrete alkaline mucus to neutralize acidic chyme
inhibits gastric secretions
Anus
Colon
Intestinal mucous layers
Inner layer secrets surface goblet cells
Outer layer is a habitat for bacteria
Liver & Pancreas
Nutrients the body needs
Carbohydrates
Proteins
Lipids
Nucleic Acids
Vitamins, electrolytes, and water
Physiology of digestive system organs
Mouth
Chemical digestion: stars the digestion of polysaccharides
Mechanical breakdown: Chewing
Esophagus
Physical digestion: conduit to pass food from mouth to stomach; major function is propulsion
Stomach
Physical digestion: stomach mucosa forms folds called rugae, which allows the stomach to expand; storage area for food; carries mechanical breakdown of food to churning action
Chemical digestion: Converts bolus of food to paste like chyme; protein digestion begins here
Absorption of nutrients: contains intrinsic factor which is needed for intestinal absorption of Vitamin B12;
Liver
Chemical digestion: contains bile which has bile salts that helps absorb fat
Pancreas
Composed of pancreatic juices that neutralize chyme coming from the stomach
Small instestine
major organ for digestion & absorption
circular folds, villi, and microvilli increase surface area for absorption
modification of mucosa and submucosa aid with digestion
Segmentation: mixes chyme with pancreatic and brush border enzymes and bile
Large intestine
Contains more goblet cells to create more mucosa for feces
Contain bacterial flora which help ferment some indigestible carbohydrates and mucin; also helps synthesize some Vitamin B & K
Absorption of vitimans, water, and electrolytes
Major function is propulsion of feces to anus and defecation
Enzymes responsible for digesting nutrients
Carbohydrate digestion
Salivary amylase: found in mouth
Pancreatic amylase: found in small intestine
Brush border enzymes: found in small intestine
Protein digestion
Pepsin: found in stomach
Pancreatic enzymes: found in small intestine
Brush border enzymes: found in small intestine
Fat digestion
Lingual lipase: found in mouth
Gastric lipase: found in the stomach
Emulsification by the detergent action of the bile salts deducted in from the liver
Pancreatic lipases: found in small intestine
Downstream Effects
What is not able to occur in digestive system
Food is not being mechanically broken down by the stomach
Cannot be given foods that are not broken down easily
Intrinsic factor is not being secreted by the stomach so Vitamin B12 is not being absorbed which essential to life
Needs to make sure he is getting B12 from other sources such as an injection
Stomach cannot act as a storage area
Needs to be given foods that do not require a lengthy amount of time for digestion
Since the duodenum is being bypassed, some nutrients may not get absorbed or may take longer to absorb
Needs food items in high nutrition to make sure he is getting an essential amount of nutrients
What will be need to be provided in the feeding tube?
liquefied foods high in nutrients
Foods that have protein and fat able to digest
Needs Vitamins A,D, E, K as well as Vitamin C&B
Needs electrolytes
Protein & fat harder to absorb