1. DIGESTIVE SYSTEM

2. FUNCTION?? MAKE FOOD SMALL ENOUGH TO BE ABSORBED MAKE FOOD SMALL ENOUGH TO BE ABSORBED MONOMERS MONOMERS

3. DIGESTIVE SYSTEM kidshealth.org

4. DIGESTIVE SYSTEM www.nlm.nih.gov

5. DIGESTIVE SYSTEM arbl.cvmbs.colostate.edu

6. MICROANATOMY OF THE DIGESTIVE TUBE arbl.cvmbs.colostate.edu

7. MUCOSA SURFACE EPITHELIUM; CONNECTIVE TISSUE; SMOOTH MUSCLE; SOME HAVE FOLDINGS TO ?; TUBULAR GLANDS: SURFACE EPITHELIUM; CONNECTIVE TISSUE; SMOOTH MUSCLE; SOME HAVE FOLDINGS TO ?; TUBULAR GLANDS: –MUCUS; DIGESTIVE ENZYMES LUMEN LUMEN PROTECTS LAYERS & BODY; SECRETION AND ABSORPTION PROTECTS LAYERS & BODY; SECRETION AND ABSORPTION

8. SUBMUCOSA LOOSE CONNECTIVE TISSUE; GLANDS; BLOOD VESSELS; LYMPH VESSELS; NERVES; LOOSE CONNECTIVE TISSUE; GLANDS; BLOOD VESSELS; LYMPH VESSELS; NERVES; TO NOURISH AND TRANSPORT MATERIAL AWAY TO NOURISH AND TRANSPORT MATERIAL AWAY

9. MUSCULAR LAYER INNER COAT: CIRCULAR SMOOTH MUSCLE FIBERS: DIAMETER DECREASES INNER COAT: CIRCULAR SMOOTH MUSCLE FIBERS: DIAMETER DECREASES OUTER COAT: LONGITUDINAL FIBERS: TUBE SHORTENS OUTER COAT: LONGITUDINAL FIBERS: TUBE SHORTENS FOR MOVEMENTS FOR MOVEMENTS

10. SEROSA/SEROUS LAYER OUTER COVERING: VISCERAL PERITONEUM; CONNECTIVE TISSUE WITH EPITHELIUM ON TOP (OUTSIDE); OUTER COVERING: VISCERAL PERITONEUM; CONNECTIVE TISSUE WITH EPITHELIUM ON TOP (OUTSIDE); PROTECT TISSUES BELOW; SECRETE SEROUS FLUID: MOISTENS AND LUBRICATES SO ORGANS SLIDE FREELY PROTECT TISSUES BELOW; SECRETE SEROUS FLUID: MOISTENS AND LUBRICATES SO ORGANS SLIDE FREELY

11. MUCOSAL EPITHELIUM arbl.cvmbs.colostate.edu

12. MOVEMENTS MIXING: MIXING: –MOVEMENT OF STOMACH, OR SEGMENTS (SEGMENTATION); MIXES FOOD AND DIGESTIVE ENZYMES PROPELLING: PROPELLING: –PERISTALSIS: RING OF CONTRACTION & CAUSES RECEPTIVE RELAXATION

13. SEGMENTATION arbl.cvmbs.colostate.edu

14. PERISTALSIS

15. PERISTALSIS www.nlm.nih.gov

16. INNERVATION USUALLY WHICH ONE ? USUALLY WHICH ONE ? PARASYMPATHETIC PARASYMPATHETIC –BY PLEXUSES ? –INCREASE ACTIVITY; VAGUS NERVE & SACRAL POTION OF S.C. SYMPATHETIC SYMPATHETIC –DECREASE –FIGHT OR FLIGHT

17. MOUTH CHEEK & LIPS: SKELETAL MUSCLES CHEEK & LIPS: SKELETAL MUSCLES TONGUE: TONGUE: –LINGUAL FRENULUM: TO FLOOR –PAPILLAE  FRICTION, TASTE BUDS –HYOID BONE –LINGUAL TONSILS: OF WHICH SYSTEM?

18. PALATE PALATE –ANTERIOR: HARD –POSTERIOR: SOFT –UVULA  SWALLOWING: CLOSE NASAL PASSAGES –PALATINE TONSILS –PHARYNGEAL TONSILS: ADENOIDS

19. TEETH HARDEST STRUCTURES OF BODY HARDEST STRUCTURES OF BODY NOT BONE ? NOT BONE ? PRIMARY: 10; 6 Mo TO 4y PRIMARY: 10; 6 Mo TO 4y SECONDARY: 32; 6 y TO 22y SECONDARY: 32; 6 y TO 22y FUNCTION: ? WHY? FUNCTION: ? WHY? –INCISORS: BITE –CANINES: GRAB AND TEAR –PREMOLARS, MOLARS: GRINDING

20. TEETH en.wikipedia.org

21. CROWN CROWN –ENAMEL: CALCIUM; HARDEST SUBSTANCE; NOT REPLACED, WEARS DOWN ROOT ROOT DENTIN: HARDER THAN BONE DENTIN: HARDER THAN BONE CENTRAL CAVITY: PULP CENTRAL CAVITY: PULP –BLOOD VESSELS, NERVES, CONNECTIVE TISSUE ROOT CANALS: CEMENTUM AROUND ROOT ROOT CANALS: CEMENTUM AROUND ROOT PERIDONTAL LIGAMENT: COLLAGEN; CEMENTUM TO JAW PERIDONTAL LIGAMENT: COLLAGEN; CEMENTUM TO JAW

22. SALIVARY GLANDS PRODUCE ? FOR? PRODUCE ? FOR? –MOISTENS, BINDS, STARTS CHEMICAL DIGESTION OF FOOD; SOLVENT: DISSOLVES FOOD = TASTE; BICARBONATE IONS: BUFFER: BALANCE pH FOR ENZYME ACTION; 3 PAIR AND MANY MINOR GLANDS 3 PAIR AND MANY MINOR GLANDS 3 PAIR AND MANY MINOR GLANDS –SEROUS GLANDS  SALIVARY AMYLASE –STARCH AND GLYCOGEN –MUCOUS GLANDS  BINDS; LUBRICATES

23. SALIVARY CONTROL PARASYMPATHETIC PARASYMPATHETIC –LARGE AMOUNT OT WATERY SALIVA –REFLEX: PAVLOV’S DOGS SYMPATHETIC SYMPATHETIC –SMALL AMOUNT OF VISCOUS SALIVA –UNPLEASANT LOOK, TASTE, SMELL –LESS SALIVA= HARD TO SWALLOW WHY?

24. SALIVARY GLANDS www.entassociates.com

25. MAJOR SALIVARY GLANDS PAROTID PAROTID –LARGEST; CLEAR WATERY; LOTS OF AMYLASE SUBMANDIBULAR SUBMANDIBULAR –EQUALLY SEROUS AND MUCOUS SUBLINGUAL SUBLINGUAL –SMALLEST OF 3 –MOSTLY MUCOUS

26. PHARYNX CONNECT NASAL AND ORAL CAVITY TO LARYNX AND ESOPHAGUS CONNECT NASAL AND ORAL CAVITY TO LARYNX AND ESOPHAGUS NASOPHARYNX NASOPHARYNX –BEHIND SOFT PALATE –AIR PASSAGEWAY –EUSTACHIAN CANAL OPENING OROPHARYNX OROPHARYNX –END OF MOUTH TO EPIGLOTTIS LARYNGOPHARYNX LARYNGOPHARYNX –EPIGLOTTIS TO LARYNX

27. PHARYNX 1) Nasopharynx 2) Nasal Septum 3) Hard Palate 4) Tongue 5) Oropharynx 6) Laryngopharynx anatomy.med.umich.edu

28. CIRCULAR MUSCLES= CONSTRICTOR MUSCLES CIRCULAR MUSCLES= CONSTRICTOR MUSCLES –SUPERIOR; MIDDLE; INFERIOR SOME OF INFERIOR CONSTRICTOR MUSCLES ARE USUALLY CONTRACTED TO KEEP AIR OUT OF ESOPHAGUS SOME OF INFERIOR CONSTRICTOR MUSCLES ARE USUALLY CONTRACTED TO KEEP AIR OUT OF ESOPHAGUS SKELETAL MUSCLES BUT MOSTLY A REFLEX SKELETAL MUSCLES BUT MOSTLY A REFLEX

29. SWALLOWING STEPS 1: VOLUNTARY; CHEWING AND TURNING FOOD INTO BOLUS; TONGUE FORCES TO PHARYNX 1: VOLUNTARY; CHEWING AND TURNING FOOD INTO BOLUS; TONGUE FORCES TO PHARYNX 2: SWALLOWING REFLEX STIMULATED 2: SWALLOWING REFLEX STIMULATED –SOFT PALATE RAISES ? –EPIGLOTTIS BLOCKS TRACHEA ? –TONGUE PRESSES ON SOFT PALATE ? –LONGITUDINAL MUSCLES CONTSTRICT ? –INFERIOR CONSTRICTOR MUSCLE RELAXES ? –SUPERIOR CONSTRICTOR MUSCLE CONTRACTS 3: PERISTALSIS: FOOD THROUGH ESOPHAGUS TO STOMACH 3: PERISTALSIS: FOOD THROUGH ESOPHAGUS TO STOMACH

30. ESOPHAGUS 25 CM; COLLAPSIBLE ?; WHICH STATE (COLLAPSED/UNCOLLAPSED) USUALLY? WHY? 25 CM; COLLAPSIBLE ?; WHICH STATE (COLLAPSED/UNCOLLAPSED) USUALLY? WHY? HOW DOES FOOD GET TO ABDOMEN ? HOW DOES FOOD GET TO ABDOMEN ? –HIATUS –MUCOUS GLANDS ? –LOWER ESOPHAGEAL SPHINCTER ? –USUALLY CLOSED ? –PERISTALSIS OPENS SPHINCTER ?

31. STOMACH 25-30 CM; CAVITY ~ 1L; RUGAE ? 25-30 CM; CAVITY ~ 1L; RUGAE ? JUST BELOW DIAPHRAGM JUST BELOW DIAPHRAGM TYPE OF DIGESTION ? TYPE OF DIGESTION ? –BOTH; MIXES FOOD WITH GASTRIC JUICE; STARTS PROTEIN DIGESTION; SOME ABSORPTION; FOOD TO INTESTINES MIXES FOOD WITH GASTRIC JUICE; STARTS PROTEIN DIGESTION; SOME ABSORPTION; FOOD TO INTESTINES REGULAR 2 SMOOTH MUSCLE LAYERS: PLUS OBLIQUE MUSCLES (ESPECIALLY FUNDUS AND BODY); REGULAR 2 SMOOTH MUSCLE LAYERS: PLUS OBLIQUE MUSCLES (ESPECIALLY FUNDUS AND BODY); –STRONGER; MORE MIXING

32. PARTS CARDIA: NEAR ESOPHAGEAL OPENING CARDIA: NEAR ESOPHAGEAL OPENING FUNDUS: BALLOON AREA AT START: STORAGE FUNDUS: BALLOON AREA AT START: STORAGE BODY: DILATED AREA; MIDDLE; BODY: DILATED AREA; MIDDLE; PYLORIC ANTRUM: FUNNEL SHAPED; AT END TO ? PYLORIC ANTRUM: FUNNEL SHAPED; AT END TO ? PYLORIC CANAL: BEFORE SMALL INTESTINE PYLORIC CANAL: BEFORE SMALL INTESTINE PYLORIC SPHNCTER: THICK CIRCULAR MUSCLE; VALVE: CONTROLS EMPTYING PYLORIC SPHNCTER: THICK CIRCULAR MUSCLE; VALVE: CONTROLS EMPTYING

33. GASTRIC SECRETIONS GASTRIC PITS: GASTRIC GLANDS: TUBULAR: OR 3 SECTRETORY CELL TYPES GASTRIC PITS: GASTRIC GLANDS: TUBULAR: OR 3 SECTRETORY CELL TYPES –MUCOUS: NEAR OPEININGS OF PITS; –CHIEF CELLS: DEEPER; DIGESTIVE ENZYMES –PARIETAL CELLS: DEEPER; HCl –ALL= GASTRIC JUICE CHIEF CELLS RELEASE PEPSINOGEN: INACTIVE FORM OF PEPSIN WHY INACTIVE? CHIEF CELLS RELEASE PEPSINOGEN: INACTIVE FORM OF PEPSIN WHY INACTIVE? –PEPSINOGEN AND HCl= PEPSIN GASTRIC LIPASE: MOSTLY ON BUTTERFAT BECAUSE OF LOW pH GASTRIC LIPASE: MOSTLY ON BUTTERFAT BECAUSE OF LOW pH

34. MUCUS PROTECTS FROM PEPSIN MUCUS PROTECTS FROM PEPSIN PARIETAL CELLS ALSO SECRETE INTRINSIC FACTOR: HELPS ABSORB VITAMIN B12 PARIETAL CELLS ALSO SECRETE INTRINSIC FACTOR: HELPS ABSORB VITAMIN B12

35. CONTROL OF GASTRIC SECRETIONS PRODUCED CONTIUOUSLY BUT IN VARYING AMOUNTS CELLS OF GASTRIC GLANDS SECRETE SOMATOSTATIN: INHIBITS ACID SECRETION PARASYMPATHETIC: ACh SUPRESSES SOMATOSTATIN AND MORE GASTRIC JUICE PRODUCED GASTRIN ALSO INCREASES SECRETION CAUSE HISTAMINE TO BE RELEASED= INCREASES GASTRIC SECRETION

36. THREE STAGES CEPHALIC PHASE: CEPHALIC PHASE: –BEFORE FOOD ENTERS STOMACH: SMALL, TASTE, LOOK, THOUGHT OF FOOD BY PARASYMPATHETIC STIMULATION –GREATER HUNGER = GREATER SECRETION –30-50% OF SECRETION GASTRIC PHASE: GASTRIC PHASE: –40-50%; WHEN FOOD ENTERS STOMACH –DISTENSION OF STOMACH = RELEASE OF GASTRIN = PRODUCTION OF MORE GASTRIC SECRETION –pH AT 3.0 = GASTRIN INHIBITED; 1.5 = GASTRIC SECRETION STOPS –H+ FOR HCl COMES FROM BLOOD REPLACED BY BICARBONATE ION

37. INTESTINAL PHASE: INTESTINAL PHASE: –5%; WHEN FOOD ENTERS SMALL INTESTINES RELEASES INTESTINAL GASTRIN FROM INTESTINES –MORE FOOD ENTERS SMALL INTESTINES AND SYMPATHETIC IMPULSES = INHIBITS SECRETION –PROTEIN AND FAT RELEASES CHOLECYSTOKININ WHICH SLOWS MIXING OF STOMACH –FATS CAUSE RELEASE OF INTESTINAL SOMATOSTATIN WHICH DECREASES GASTRIC SECRETION

38. GASTRIC ABSORPTION A LITTLE BIT A LITTLE BIT –WATER, SOME SALTS, SOME LIPID-SOLUBLE DRUGS, ALCOHOL

39. MIXING/EMPTYING STOMACHACHE FROM TOO MUCH FOOD STOMACHACHE FROM TOO MUCH FOOD MIXING: BOLUS  CHYME MIXING: BOLUS  CHYME PERISTALSIS SLOWLY MOVES CHYME INTO SMALL INTESTINES PERISTALSIS SLOWLY MOVES CHYME INTO SMALL INTESTINES PASSING THROUGH DEPENDS ON TYPE OF FOOD: FATS UP TO 6 HOURS PASSING THROUGH DEPENDS ON TYPE OF FOOD: FATS UP TO 6 HOURS AS FOOD ENTERS SMALL INTESTINES THE PRESSURE BUILDS UP AND ENTEROGASTRIC REFLEX INHIBITS STOMACH PERISTALSIS AND SLOWS INTESTINAL FILLING AS FOOD ENTERS SMALL INTESTINES THE PRESSURE BUILDS UP AND ENTEROGASTRIC REFLEX INHIBITS STOMACH PERISTALSIS AND SLOWS INTESTINAL FILLING CHOLECYSTOKININ RELEASED TO DECREASE PERISTALSIS CHOLECYSTOKININ RELEASED TO DECREASE PERISTALSIS

40. VOMITTING: REVERSE PERISTALSIS BY VOMITTING CENTER OF MEDULLA CONTRACTS ON STOMACH TO EXPELL STOMACH VOMITTING: REVERSE PERISTALSIS BY VOMITTING CENTER OF MEDULLA CONTRACTS ON STOMACH TO EXPELL STOMACH

41. PANCREAS DUCT TO DUODENUM DUCT TO DUODENUM CELLS: CELLS: –PANCREATIC ACINAR CELLS

42. PANCREATIC JUICE PANCREATIC ACINAR CELLS: PANCREATIC ACINAR CELLS: –PANCREATIC AMYLASE: ? –PANCREATIC LIPASE: ? –TRYPSIN, CHYMOTRYPSIN, CARBOXYPEPTIDASE: SPECIFIC PEPTIDE BONDS  STORED AND RELEASED IN INACTIVE FORMS ?  TRYPSINOGEN ACTIVATED BY ENTEROKINASE THEN TRYPSIN ACTIVATES THE OTHER 2 NUCLEASES: ? BICARBONATE: ALKALINE; NEUTRALIZES HCl ALKALINE; NEUTRALIZES HCl

43. CONTROL OF SECRETION NERVOUS AND ENDOCRINE SYSTEMS NERVOUS AND ENDOCRINE SYSTEMS DURING CEPHALIC AND GASTRIC PHASES PARASYMPATHETIC STIMULATES PANCREAS DURING CEPHALIC AND GASTRIC PHASES PARASYMPATHETIC STIMULATES PANCREAS SECRETIN STIMULATES RELEASE WHEN CHYME ENTERS DUODENUM: MOST;LY BICARBONATE IONS SECRETIN STIMULATES RELEASE WHEN CHYME ENTERS DUODENUM: MOST;LY BICARBONATE IONS PROTEIN & FAT STIMULATES RELEASE OF CHOLECYSTOKININ STIMULATES SECRETION PROTEIN & FAT STIMULATES RELEASE OF CHOLECYSTOKININ STIMULATES SECRETION

44. LIVER FIBROUS CAPSULE; TWO MAJOR LOBES; TWO MINOR LOBES FIBROUS CAPSULE; TWO MAJOR LOBES; TWO MINOR LOBES HEPATIC LOBULES: FUNCTIONAL UNIT HEPATIC LOBULES: FUNCTIONAL UNIT –HEPATIC CELLS; HEPATIC SINUSOIDS; –KUPFFER CELLS: REMOVE BACTERIA –COMMON HEPATIC DUCT

45. FUNCTIONS: FUNCTIONS: CARBOHYDRATE METABOLISM, GLYCOGEN; GLUCONEOGENESIS; OXIDIZING FATTY ACIDS; SYNTHESIS OF MOLECULES; DEAMINATION OF AMINO ACIDS, FORMATION OF UREA AND OTHER AMINO ACIDS; STORAGE: GLYCOGEN, IRON, VITAMINS A, D, B12; DESTROY DAMAGED RBCs; REMOVES TOXIC MATERIAL; PHAGOCYTIZE PATHOGENS; BLOOD RESERVOIR; SECRETES BILE CARBOHYDRATE METABOLISM, GLYCOGEN; GLUCONEOGENESIS; OXIDIZING FATTY ACIDS; SYNTHESIS OF MOLECULES; DEAMINATION OF AMINO ACIDS, FORMATION OF UREA AND OTHER AMINO ACIDS; STORAGE: GLYCOGEN, IRON, VITAMINS A, D, B12; DESTROY DAMAGED RBCs; REMOVES TOXIC MATERIAL; PHAGOCYTIZE PATHOGENS; BLOOD RESERVOIR; SECRETES BILE

46. BILE COMPOSITION: WATER, BILE SALTS, BILE PIGMENTS, CHOLESTEROL, ELECTROLYTES COMPOSITION: WATER, BILE SALTS, BILE PIGMENTS, CHOLESTEROL, ELECTROLYTES

47. GALL BLADDER DEPRESSION IN LIVER DEPRESSION IN LIVER STORES, CONCENTRATES AND RELEASES BILE STORES, CONCENTRATES AND RELEASES BILE RELEASED WHEN STIMULATED BY CHOLECYSTOKININ RELEASED WHEN STIMULATED BY CHOLECYSTOKININ RELEASED THROUGH BILE DUCT TO HEPATOPANCREATIC SPHINCTER RELEASED THROUGH BILE DUCT TO HEPATOPANCREATIC SPHINCTER CHOLESTEROL COULD FORM GALL STONES CHOLESTEROL COULD FORM GALL STONES

48. BILE SALT FUNCTION EMULSIFICATION EMULSIFICATION –AIDS LIPASE AIDS ABSORBTION AIDS ABSORBTION –FATTY ACIDS, GLYCEROL, & FAT SOLUBLE VITAMINS: A, D, E, K MOST OF BILE SALTS ARE REABSORBED IN SMALL INTESTINES

49. SMALL INTESTINE 9-10 FT LONG 9-10 FT LONG RECEIVES DIGESTIVE ENZYMES FROM LIVER AND PANCREAS; FINISHES CHEMICAL DIGESTION; ABSORBTION; MOVES MATERIAL TO LARGE INTESTINES RECEIVES DIGESTIVE ENZYMES FROM LIVER AND PANCREAS; FINISHES CHEMICAL DIGESTION; ABSORBTION; MOVES MATERIAL TO LARGE INTESTINES

50. PARTS DUODENUM: DUODENUM: –SHORTEST (25cm); MOST FIXED; JEJUNUM: JEJUNUM: –PROXIMAL 2/5THS; MOBILE ILEUM: ILEUM: –REST; MOBILE; USUALLY NO DISTINCT BREAK BUT JEJUNUM HAS LARGER DIAMETER; THICKER WALL, MORE ACTIVE, MORE VASCULAR, MORE LYMPH MATERIAL HELD BY MESENTERY

51. STRUCTURE INTESTINAL VILLI ? INTESTINAL VILLI ? –ESPECIALLY DUODENUM AND PROXIMAL JEJUNUM –SIMPLE COLUMNAR EPITHELIUM; LACTEAL; MICROVILLI ? –INTESTINAL GLANDS/CRYPTS OF LIEBERKUHN –PLICAE CIRCULARES ?

52. SECRETIONS GOBLET CELL: ? GOBLET CELL: ? BRUNNER’S GLANDS BRUNNER’S GLANDS –SUBMUCOSA OF PROXIMAL DUODENUM –THICK, ALKALINE MUCUS INTESTINAL GLANDS INTESTINAL GLANDS –BASE OF VILLIE –A LOT OF WATERY FLUID; NO ENZYMES ? –ENZYMES IN MEMBRANE OF MICROVILLI CELLS  PEPTIDASES  SUCRASE, MALTASE, LACTASE  INTESTINAL LIPASE

53. REGULATION OF SECRETION MUCUS SECRETION INCREASES IN RESPONSE TO MECHANICAL STIMULUS AND IRRITANTS (GASTRIC JUICE) MUCUS SECRETION INCREASES IN RESPONSE TO MECHANICAL STIMULUS AND IRRITANTS (GASTRIC JUICE) CHYME STIMULATES GOBLET AND INTESTINAL CELLS TO SECRETE CHYME STIMULATES GOBLET AND INTESTINAL CELLS TO SECRETE DISTENSION: PARASYMPATHETIC STIMULATION TO INCREASE SECRETION DISTENSION: PARASYMPATHETIC STIMULATION TO INCREASE SECRETION

54. ABSORPTION MOST ABSORBABLE MATERIAL IS ABSORBED MOST ABSORBABLE MATERIAL IS ABSORBED MONOSACCHARIDES MONOSACCHARIDES –FACILLITATED DIFFUSION PROTEINS PROTEINS –ACTIVE TRANSPORT LIPIDS LIPIDS –FATTY ACIDS:  DIFFUSE  RESYNTHESIZED BY ER  CLUSTERS ENCASED IN PROTEIN: CHYLOMICRONS TO LACTEALS  CONTRACTIONS MOVE CHYLOMICRONS THROUGH LYMPH  TO BLOOD TO MUSCLE AND ADIPOSE TISSUE

55. VLDL: VERY-LOW-DENSITY- LIPOPROTEINS CARRY TRIGLYCERIDES TO ADIPOSE TISSUE VLDL: VERY-LOW-DENSITY- LIPOPROTEINS CARRY TRIGLYCERIDES TO ADIPOSE TISSUE VLDL  LDL (LOW-DENSITY- LIPOPROTEINS) HIGH CHOLESTEROL  REMOVED BY CELLS VLDL  LDL (LOW-DENSITY- LIPOPROTEINS) HIGH CHOLESTEROL  REMOVED BY CELLS HDL (HIGH-DENSITY-LIPOPROTEINS) REMOVE CHOLESTEROL FROM CELLS TO LIVER ENTER BY RECEPTORMEDIATED ENDOCYTOSIS HDL (HIGH-DENSITY-LIPOPROTEINS) REMOVE CHOLESTEROL FROM CELLS TO LIVER ENTER BY RECEPTORMEDIATED ENDOCYTOSIS CHOLESTEROL BECOMES BILE OR BILE SALTS MOST IS REABSORBED CHOLESTEROL BECOMES BILE OR BILE SALTS MOST IS REABSORBED

56. ALSO REABSORBS ALSO REABSORBS –WATER –ELECTROLYTES

57. PROTEINS arbl.cvmbs.colostate.edu

58. LIFE SPAN CHANGES OVERALL: SLOW, LITTLE OVERALL: SLOW, LITTLE TOOTH CARE VITAL TOOTH CARE VITAL –LOSS OF ENAMEL; WEAR; CEMENTUM AND DENTUM THICKEN, PULP LESSENS; NEURON LOSS; GUMS RECEDE; LOOSE TEETH; XEROSTOMIA: DRY MOUTH XEROSTOMIA: DRY MOUTH –MOST OFTEN DUE TO MEDICATIONS PERISTALSIS SLOWS= HEARTBURN; STOMACH LINING THINS; GASTRIC SECRETIONS DIMININSH = TAKES LONGER FOR DIGESTION PERISTALSIS SLOWS= HEARTBURN; STOMACH LINING THINS; GASTRIC SECRETIONS DIMININSH = TAKES LONGER FOR DIGESTION

59. SMALL INTESTINE ABSORBS LESS: A,D,K, AND ZINC SMALL INTESTINE ABSORBS LESS: A,D,K, AND ZINC –A: SKIN AND VISION PROBLEMS –D: WEAK BONES –K: LESS CLOTTING –ZINC: LOWERED HEALING AND IMMUNITY, ALTERED TASTE LACTOSE INTOLERANCE LACTOSE INTOLERANCE LESS INTRINSIC FACTOR: ANEMIA LESS INTRINSIC FACTOR: ANEMIA LOSS OF MUSCLE AND ELASTICITY: LESS PERISTALSIS OF LARGE INTESTINE: CONSTIPATION LOSS OF MUSCLE AND ELASTICITY: LESS PERISTALSIS OF LARGE INTESTINE: CONSTIPATION

60. PANCREAS AND LIVER DON’T CHANGE MUCH PANCREAS AND LIVER DON’T CHANGE MUCH LIVER MAY NOT DETOXIFY AS WELL LIVER MAY NOT DETOXIFY AS WELL GALLBLADDER LESS SENSITIVE BUT COMPENSATES GALLBLADDER LESS SENSITIVE BUT COMPENSATES