DIGESTIVE SYSTEM

PART 2
The Accessory Organs
 Learning Outcomes
By the end of this lecture, learner should be
able to:
Describe how digestive secretions are regulated.
Describe the mechanisms of swallowing, digestion,
absorption, and defecating.
List the major sources of carbohydrates, lipids, and
proteins in diet.
Describe how cells utilize carbohydrates, lipids, and
amino acids.
List the fat-soluble and water-soluble vitamins, and
summarize the general functions of each vitamin.
List the major minerals and trace elements, and
summarize the general functions of each.
Introduction
Pancreas

4
 Pancreas
Pancreatic juice

Contains the following:

Bicarbonate:
Pancreatic amylase:
Pancreatic lipase:
Nucleases:
Trypsin, chemotrypsin, and
carboxypeptidase:
6
 Clinical Link Cystic
Fibrosis

http://en.wikipedia.org/wiki/File:ClubbingCF.JPG
Cystic Fibrosis Cystic Fibrosis - A Day in the Life
The Liver
Studyblue.com
11
Liver Functions
Gall Bladder

13
Putting it all together
Small Intestine
16
 Small Intestine
Structure of
intestinal wall
The inner wall of the small
intestine is lined with
finger-like villi, which
increase the absorption
surface area and aid in
mixing actions.
Each villus contains a core
of connective tissue
housing blood capillaries
and a lacteal.
 Small Intestine
Regulation of small intestinal
secretions:
Mechanical and chemical stimulation from
chyme causes goblet cells to secrete mucus.
Distention of the intestinal wall stimulates
parasympathetic reflexes that stimulate
secretions from the small intestine.
 Small Intestine
Movements small intestinal secretions:
The small intestine carries out two movements:

The ileocecal sphincter at the junction of the

small and large intestines usually remains closed
unless a gastroileal reflex is elicited after a meal.
 Small Intestine
Absorption in the small intestines:

The small intestine is the major site of

absorption within the alimentary canal.

Water
Monosaccharide
Amino acids
 Small Intestine
Absorption in the small intestines:

Fatty acids are absorbed and

transported differently than the other
nutrients.
How?
What role do chylomicrons have?
What is their purpose?
24
 Large Intestine

Large intestine starts at the lower right side of

the abdomen where the ileum joins the cecum
and it opens to the outside of the body as the
anus.
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www.blessedherbs.com
 Large Intestine
Function of large intestine:
No digestion and minimal absorption.
The large intestine secrete mucous which
-
-
-

Form feces from the remaining of chyme.

What does the large intestine absorb?

What else is contained within the large
intestine?
 Large Intestine
Movement of large intestine:
The movements of the large intestine are
similar to those of the small intestine but
much slower. Peristaltic waves happen only 2-
3 times/day in a vigorous way that pushes
intestinal contents toward the rectum.
The passage of the intestinal contents into the
rectum distends the rectum wall trigger the
_______________which increases the intra-
abdominal pressure to squeeze the rectum.
The internal anal sphincter relaxes but the
external one remains under voluntary control.
 Large Intestine
Feces:
Feces are composed of:
-
-
-
-
-
Both the color of feces and its odor is due to
the action of bacteria on bile pigments
excreted in the feces.
 Clinical Link
Constipation
Diarrhea
 Constipation
- Definition: infrequent and/or unsatisfactory
defecation twice weekly or less (may vary) or
passage of hard stool or incomplete defecation.
- The definition of constipation may vary from
one person to the other because of we differ in
our bowel habits.
- To understand constipation, we need to
understand the defecation process.
Constipation

Suppression of defecation urge

may cause constipation.
 Constipation
Causes of constipations are:
- Disordered movement through the colon.
- Dehydration (due to fever, vomiting, diarrhea)
- Diseases (ex. colon cancer, diabetes, depression,
IBS)
- Drugs: Anticholinergic drugs, morphine-like pain
meds, CCB, Al hydroxide.
- Lack of exercise
- Insufficient intake of liquids/ insoluble fibers.
 Diarrhea
- Definition: unusual frequent excretion of watery
stools

- Diarrhea can quickly lead to ____________ and

- _______________imbalance.
 Diarrhea
Causes of diarrhea
 Clinical Link
Inflammatory Bowel Diseases:
Progressive, chronic, autoimmune disease
It has 4 forms, the most common are
Crohns Disease (CD)
inflammation of any part (from anus to
mouth)and all layers of intestinal tract.
May also have some extra-intestinal
manifestations such as affecting the joints, eyes
and joints
Ulcerative Colitis: Inflammation of the mucosal
surface of the colon only
Ulcerative Proctitis: Inflammation of the mucosal
surface of the rectum only
Clinical Link
 Clinical Link
Inflammatory Bowel Diseases:
Causes / contributing factors:
 Clinical Link
Inflammatory Bowel Diseases:
Common symptoms include: Abdominal
pain, diarrhea, cramping, rectal bleeding,
anemia, weight loss, loss of appetite,
 Nutrition and Nutrients
Nutrition is:

Essential nutrients:

An adequate diet provides

Malnutrition is
 Carbohydrates
Carbohydrates are organic compounds
used for sources of energy.
Digestion converts complex carbohydrates
into monosaccharides which can be
absorbed by the body.
Fructose and galactose are converted to
glucose by liver enzymes. glucose is the
main cellular fuel.
1 g of glucose yields 4 Kcal
What can the body use in the absence of
glucose?
 Carbohydrates
Extra glucose is stored as ___________ in liver
and muscle cells and as_______ in adipose
tissue.
Ribose and deoxyribose) are used in _________
CHO also required for lactose (milk sugar)
synthesis
Requirements: at least 125 175 g/day to
avoid metabolic disorders and muscle
wasting.

What about cellulose?

 Lipids
The most common dietary lipids are
Triglycerides. Other forms are
phospholipids, fats, and cholesterol.

Fatty acids can be converted to AcetylcoA

by beta oxidation.

Lipid Utilization
 Lipids
Can essential fatty acids by synthesized by the
liver?

Essential fatty acids are:

The liver controls circulating lipids and

cholesterol.
Excessive lipids are stored in adipose tissue.
1 g of lipid produces 9 Kcal
Daily requirements is 3% of total energy
 Proteins
Proteins are polymers of amino acids with a
wide variety of functions in cells and in
the body (enzymes, hormones, antibodies,
clotting factors).

AA are potential sources of energy ( 1 g =

4 Kcal)

Requirements: 0.8 g/kg per day (30 g more

in pregnant and 20 in lactating female)
 Obesity
It is a chronic disease characterized by
individuals total body weight has greater
quantities of fat than what is considered
normal.
Body mass index (BMI) is the most commonly
used clinical measurement to assess and treat
obesity.

BMS = Body weight (Kg)/ Height2 (meter2)

 Obesity
- According to BMI, people can be classified to:

BMI Obesity Class

< 18.5 kg/m2 Underweight
18.5 24.9 Normal
25.0 29.9 Overweight
30.0 34.9 Obese Class I
35.0 39.9 Obese Class II
40 Obese Class III
 Obesity
- Obesity is developing from the interactive
influences of numerous factors:
- Organic (ex. renal diseases and heart failure)
- Genetics (1 and 2 obese parent chance by 50 and
80% respectively)
- Physiological (chemical mediators).
- Metabolic.
- Medications (Antidepressants, steroids, estrogen).
- Social cultural behaviors.
- Environment.
 Obesity
Some Health Risks of Obesity
- Higher incidence of cardiovascular disease.
- Higher incidence of non-insulin dependent
diabetes.
- Osteoarthritis.
- Sleep apnea.
- Skin (stretch marks and fungal infection)
- Anxiety, stress, poor self-esteem
 Vitamins
Vitamins are organic compounds required
in small amounts for normal metabolic
processes, and are not produced by cells
in adequate amounts.
Vitamins are fat-soluble (vitamins A, D, E,
and K) or water-soluble (B vitamins and
vitamin C).
Fat soluble vitamins
Water soluble vitamins
Minerals
Trace elements