The Digestive System: For Discussion: True or False?

The Digestive System: For Discussion: True or False?
1. Of all the organs, the stomach is most central to the structure and function of the digestive system. False 2. The liver is the 2nd-largest organ in the body. True The liver is the 2nd-most complicated organ in the body. True 4. The liver is the 3rd-most immediately vital organ in the body. False, but it’s probably 4th-most immediately vital. 5. The pancreas is the only organ of the human body that can regenerate. False 6. The large intestine is larger than the small intestine. False, except that is larger in diameter. It is much shorter. 7. The digestive system contains the hardest substance in the human body. True 8. The human appendix, like the human coccyx, is a vestigial organ. True

The Digestive System ACCESSORY GLANDS ALIMENTARY CANAL Mouth
Mechanical breakdown of food; begins chemical digestion of carbohydrates Salivary glands Secrete saliva, which contains enzymes that initiate breakdown of carbohydrates Pharynx Connects mouth with esphagus Esophagus Peristalsis pushes food to stomach Stomach Secretes acid (HCl) and enzymes. Mixes food with secretions to begin enzymatic digestion of proteins Liver Produces bile, which emulsifies fat Gallbladder Stores bile and introduces into small intestine Small Intestine Mixes food with bile and pancreatic juice. Final breakdown of food molecules; main site of nutrient absorption Pancreas Produces and secretes pancreatic juice, containing digestive enzymes and bicarbonate ions, into small intestine Large Intestine Absorbs water and electrolytes to from feces Rectum Regulates elimination of feces Anus External sphincter

The Digestive System I. Alimentary Canal -__________ ________ _____ through which _____ passes from ______ to _____ continuous muscular tube food mouth anus A. Mouth -________ _____, _____ ______is ______, __________and __________ by _______ during ___________, provides for ___________ _________ along with ________ and ____ ________ receives food food bolus mixed positioned swallowed tongue mastication mechanical digestion tongue jaw muscles 1. Cheeks -contain ________ for ________ (_________ and __________) and ____________ of food in the _____ _______ (__________) muscles chewing masseter temporalis positioning oral cavity buccinator 2. Lips -made from ________ _______ (__________ ____) skeletal muscle orbicularis oris -_____- ________, many ________ _________, important in ________ ___________ and _______ of _____ thin skinned sensory receptors sensing temperature texture food -_________ ________ mark __________ between _____ of _____ and ________ __________ of __________ ______ external borders boundaries skin face mucous membranes alimentary canal

2. Lips Rx – Cold Sores -_______ by _______ _________ __ ______ caused Herpes Simplex I virus -_______ _____ and ________ ___________ during _____ ______, when it is ___________ infects skin mucous membranes lytic phase contagious -_______ ______ cell during its _______, making _________ __________, _________ by _______ infects nerve latency infection permanent triggered stress -_______ with _________, which _______ the ____________ ______ ________ and ________ treated Acyclovir mimics nitrogenous bases adenine guanine 3. Tongue -most _________ ________ ________ in the _____, per _______ _____ powerful skeletal muscles body square inch -____ and ________ _____ between _____ during ________, ________ _____ toward the ________ during ____________ mix position food teeth chewing pushes food pharynx swallowing -________ with ________ ___________ and ______ ________, _____ of which ________ _______ and _____ of which ______ ______ _____ covered mucous membranes rough papillae some provide friction some house taste buds

A. Mouth Lingual tonsils Epiglottis Lip Hard palate Palatine
Soft palate Uvula Palatine tonsils Papillae Tongue Lingual frenulum Vestibule Lip

A. Mouth 4. Palate a. Hard palate -______ the _____ of the _____ ______ forms roof oral cavity -________ by the _______ of the ________ _________ of the ________ in the ______ and the ________ ______ in the ______ formed fusion palatine processes maxillae front palatine bones back b. Soft palate -_________ _____ which _______ from the _________ _____ _______ to _____ _____ and into the _____-______ _____ muscular arch extends posterior hard palate taper back cone shaped uvula -________ _____ ____ _______ and ______ up to ________ _____ from _________ the ______ _______ muscles draw soft palate uvula prevent food entering nasal cavity c. Tonsils -______ ______ __________ with ______ ___________ of ___________ _________ lymph nodes associated mucous membranes respiratory passages -_____ _______ ____ against ________ by ________ ___________ and ___________ help protect body infection harboring macrophages lymphocytes

-_______, _________, and ___________ (_________) lingual palatine
A. Mouth 4. Palate c. Tonsils -_______, _________, and ___________ (_________) lingual palatine pharyngeal adenoids Rx – Tonsilitis -_____ _______; ____________ of the _______ caused by _________ or ______ _________ sore throat inflammation tonsils bacterial viral infection -can _______ to cause _________ of the __________ = _____ ______ spread Pharyngeal tonsils (adenoids) infection middle ear otitis media Palatine tonsils -_______with __________, or ____________ treated antibiotics Lingual tonsils tonsilectomy 5. Teeth -________ __________ in the _____; ____ __________ ____ of ________ _______ hardest structures body not considered part skeletal system

-____ _____ _____during ____________ two sets form development
A. Mouth 5. Teeth -____ _____ _____during ____________ two sets form development -________ (__________) ______ _____ and ______ through the _____, or _______, between the ______ of __ ________ and __ ______ primary deciduous teeth form erupt gums gingiva ages 6 months 4 years -___ _______ _____ in _____ ____ _______ of __ _______ ________, __ ______ ________, __ _______ (_______), __ _____ _______ and __ _______ ________, for ___ ______ 10 primary teeth each jaw consist 2 central incisors 2 lateral incisors 2 cuspids canines 2 first molars 2 Partially dissected child’s skull revealing deciduous teeth in place and permanent teeth developing in the maxillae and the mandible second molars 20 total -__________ _____ _____ ________ at ____ __ and ______ between ____ ___-___ with ______ _______ (_______ _____); _________ _______ ______ _______ when ______ _______ become ___________ _______, ____ to ______ and are __________ ________ (or ______) permanent teeth begin erupting age 6 finish ages 17 25 third molars wisdom teeth impacted wisdom teeth result third molars abnormally wedged fail erupt surgically removed pulled

-_____ ______ ________ of __ ______ _______;
A. Mouth 5. Teeth -_____ ______ ________ of __ ______ _______; the ______, which ________ above the _____ _____, and the _____, which is _________ to the ________ __________ in the _________ and the _________ each tooth consists 2 major portions crown projects gum line root anchored Enamel alveolar processes mandible maxillae Dentin Crown Pulp cavity Gingiva Root Alveolar process Root canal Cementum Periodontal ligament

A. Mouth 5. Teeth a. enamel -______ of ________ ______, ________ __________ in the _______ _____, ______ the ______ of the ______ made calcium salts hardest substance human body covers crown tooth -_______ _____ with ____ and _________ _______ or _______ and is ____ ________ wears away age abrasive action injury not replaced b. dentin -_____-_____ ________ _______ ___ _____ of the ______, _____ under _______ and __________ the _____ _______ bone like material making up most tooth lies enamel surrounds pulp cavity Rx – Dental Caries -________; ______ in the ________and _______ of a ______ _______ by _________ cavities holes enamel dentin tooth caused bacteria -_________ ___________ _______ left on ______ to ________ _____, which _______ _______ and ______ bacteria metabolize sugars teeth produce acids destroy enamel dentin -__________ by ________ _________ and ________, _______ ________, and ________, which is ____________into _______ and ______ it _________ prevented regular brushing flossing dental sealants fluoride incorporated enamel makes stronger

Rx – Dental Caries: the chemistry of cavity protection
1Ca5(PO4)3OH (s) 1Ca5(PO4)31+(aq) + 1OH- (aq) Hydroxyapatite Ksp = 6.8 x 1Ca5(PO4)3OH (s) + 1F- (aq) 1Ca5(PO4)3F(s) + 1OH- (aq) Fluoroapatite H+ 1Ca5(PO4)3F (s) 1Ca5(PO4)31+(aq) + 1F- (aq) Fluoroapatite Ksp = 1.0 x

A. Mouth 5. Teeth c. pulp cavity -________ the ______ _______ and ______ which ______ the ______ in _______ _____ _______, and the __________ ______ _____ contains blood vessels nerves supply tooth tubular root canals connective tissue pulp Rx – Gingivitis -__________ __ of the _______ due to the _____________ of _______, a _______ _____ of _________ which ________ _______ that ________ _____ _______ inflammation gingiva accumulation plaque sticky film bacteria produce toxins damage gum tissue -_____ become ____ and ________ and ______ _______ gums red swollen bleed easily -can be _________ by _________ and _________ reversed brushing flossing Rx – Periodontitis -_____ ________; _______ builds up and _________ into _________ (______), ______ ______, _________ ________ into _____ of _________ __________ and ___________ _________; ______ become ______ and may need to be __________; _________ _______ of ______ ______ gum disease plaque hardens calculus tartar gums recede infection spreads bone alveolar processes periodontal ligament teeth loose extracted leading cause tooth loss

-______ ___________ __________ by ________
A. Mouth 5. Teeth -______ ___________ __________ by ________ _____ into ________ _______ to ________ ________ _____ to _______ up __________ __________ __________ _________ begin mechanical digestion breaking food smaller pieces increase surface area speed upcoming enzymatic chemical reactions Central incisor a. incisors -_______-_______ ________ ______ for _______ off ______ _______ of _____ chisel shaped cutting teeth Lateral incisor biting large pieces food Central incisor Lateral incisor Lateral incisor Central incisor Central incisor Lateral incisor

-_____-_______ ______ for _________ and _______ _____ cone shaped
A. Mouth 5. Teeth b. cuspids (canines) -_____-_______ ______ for _________ and _______ _____ cone shaped teeth Central incisor grasping tearing food Lateral incisor Cuspid Cuspid Central incisor Lateral incisor Cuspid Central incisor Lateral incisor Cuspid Lateral incisor Central incisor

-______ with _________ _________ for _________ ______ teeth flattened
A. Mouth 5. Teeth c. bicuspids and molars -______ with _________ _________ for _________ ______ teeth flattened Central incisor surfaces grinding First premolar (bicuspid) food Lateral incisor Second premolar (bicuspid) Cuspid Second premolar (bicuspid) Cuspid Central incisor Lateral incisor First molar Second molar Third molar Third molar Second premolar (bicuspid) Second molar First molar Cuspid First premolar (bicuspid) First molar First premolar (bicuspid) Central incisor Lateral incisor Cuspid Lateral incisor Central incisor

A. Mouth 6. Salivary glands -________ _______ to ________ _____ _________, ______ them _________, and ______ the _________ _________ of _____________ secrete saliva moisten food particles bind together begin chemical digestion carbohydrates -______ _____as a _______ to _______ __________ in _____ so that they can be _______ saliva acts solvent dissolve substances food tasted -_______ __________ (______) _____, which ______ the ___ of ______ to _____ it _______ and _________ the ___ of _____ _____ to _______ _____ contains bicarbonate HCO3- ions buffer pH saliva keep neutral neutralize pH acidic foods protect teeth -_______ ______ ________ ________ __________ __________ the _______ _________ ________ which _______ _____ and ________ into ___________ serous cells produce watery secretions containing enzyme salivary amylase splits starch glycogen dissacharides -_______ ____ _______ ______ to ____ and ________ ____ for ___________ mucous cells produce mucus bind lubricate food swallowing

-_____ _____ of _____ _______ ______ three pairs major salivary glands
A. Mouth 6. Salivary glands -_____ _____ of _____ _______ ______ three pairs major salivary glands a. Parotid glands -_______ of the _______ ______ largest salivary glands -_______ a _______ _______ _____ in ________ through the _________ _____ just _________ the ______ _______ ______ secrete watery saliva rich amylase Stensen’s duct opposite upper Parotid gland second molar Rx – Infectious Parotitis -______; caused by ____ _________ of the ______ _______ _______ mumps viral infection Parotid (Stensen’s) duct parotid salivary Tongue glands Mandible -can ______ to _____ ______ ______ like the ________ or the ________ spread other ducted glands pancreas testicles -__________ against with the _____ vaccinated MMR

a. Submandibular glands -_______ a _______ that is
A. Mouth 6. Salivary glands a. Submandibular glands -_______ a _______ that is about _____ _______ and _____ ________ through the __________ _____ under the _______ near the _______ _________ secrete saliva half serous half mucous Wharton’s duct Parotid gland tongue lingual frenulum Parotid (Stensen’s) duct Tongue Mandible Submandibular (Wharton’s) duct Submandibular gland

-________ a _______ that is _______ ______ through _____
A. Mouth 6. Salivary glands a. Sublingual glands -________ a _______ that is _______ ______ through _____ ______, _________ ______ called _________ ______ secrete saliva mostly mucus many small separate ducts Rivinus’s ducts Parotid gland Parotid (Stensen’s) duct Tongue Mandible Sublingual gland Submandibular (Wharton’s) duct Submandibular gland

-lies _________ to the _____ _______ superiorly soft palate
B. Pharynx -throat 1. Nasopharynx -lies _________ to the _____ _______ superiorly soft palate -____________ for ____ lying between ______ _______ and ___________ passageway air nasal cavity oropharynx -_________ (___________) _____ opens through _____ of ___________ auditory Eustachian tube wall nasopharynx Opening of Auditory (Eustachian) tube Nasopharyx

-lies __________ to the _____ _______
B. Pharynx 2. Oropharynx -lies __________ to the _____ _______ and __________ to the ___________ inferiorly soft palate superiorly epiglottis -___________ for ____ lying between the _____ _______ and the _______; ___________ for _____ lying between ______ _______ and _______________ passageway air oral cavity larynx passageway food oral cavity laryngopharynx Opening of Auditory (Eustachian) tube Nasopharyx Oropharyx

-lies __________ to the ___________ from the ______ _______of the
B. Pharynx 3. Laryngopharynx -lies __________ to the ___________ from the ______ _______of the __________ to the ______ _______ of the ________ __________ inferiorly oropharynx upper border epiglottis lower border cricoid cartilage -___________ for _____ lying between the ___________ and the __________ passageway food oropharynx esophagus Opening of Auditory (Eustachian) tube Nasopharyx Oropharyx Laryngopharyx

Figure 17.14a B. Pharynx -swallowing mechanism
1. The _______ _______ _____ into the _________. tongue forces food pharynx

Figure 17.14b B. Pharynx -swallowing mechanism
2. The _____ _______, ______, and _______ are _______, the _______ is ________ against the _______, the __________ _______, and the _________ ___________ _________ ______ so that the ___________ _______. soft palate hyoid larynx raised tongue pressed palate epiglottis closes inferior constrictor muscles relax esophagus opens

Figure 17.14c B. Pharynx -swallowing mechanism
_________ ___________ _________ _________ and ______ _____ into the __________. Superior constrictor muscles contract force food esophagus

B. Pharynx -swallowing mechanism ___________ _______ ______ _____ through the __________ and into the ________. Peristaltic waves move food esophagus stomach

-________ _______ _____ _______ as a
C. Esophagus -________ _______ _____ _______ as a ____________ for _____ lying between the _______________ and the _________ smooth muscle tube acting passageway food laryngopharynx stomach -_______ through the ____________ between the ______ and through an ________ in the ___________ called the ___________ _______ passes mediastinum lungs opening diaphragm esophageal hiatus - ___________(________) _________ _________ ___________ to ________ _____________ of _________ _____ into the __________ esophageal cardiac sphincter normally constricted prevent regurgitation stomach acid esophagus Esophagus Esophageal hiatus Diaphragm Stomach

C. Esophagus Rx – Heartburn -_____________of the ___________ ________ caused by ____ ______ from the ________ into the __________ inflammation esophageal mucosa acid reflux stomach esophagus -_______ by ___________, ______ ______ _____, _____ ______ ______ after _______, or _______ too _______ caused overeating eating spicy foods lying down right eating eating quickly -________ __________ __________ _____ __________ caffeine stimulates increased acid production -________ ________ and ________ ______ the ________ ______ and ______ the ___________ _________, __________ the _________ of _____ _______ cigarette smoking alcohol irritate stomach lining relax esophageal sphincter increasing liklihood acid reflux -_______with _________, which _______ _____ treated antacids buffer acid ______ __ ______  ______ __ ______  _____ __ _____ 2 HCl + CaCO3 CaCl2 + H2CO3 H2O + CO2 ______ __ _______  ______ __ ______  _____ __ ____ 2 HCl + NaHCO3 NaCl + H2CO3 H2O + CO2 Rx – Hiatal hernia -___________ of ______ of the ________ through the ___________ _______ into the _______ protrusion part stomach esophageal hiatus thorax -_______ __________, _________ in ___________, ____________ ______, ______ _____, and _____________ to ____________ _______ causes heartburn difficulty swallowing esophageal ulcer blood loss predisposition esophageal cancer

-_________, __________ ______ with a _________
D. Stomach -_________, __________ ______ with a _________ of about __ ______ or _____ J-shaped pouchlike organ capacity 1 liter more -_____ ______ _______ with _____ _____ _______ _____, which ______ out ___ as _______ is ________ inner lining marked thick folds called rugae stretch flat stomach distended -_____ ______ the ________ when _________ ______ of the __________ cause the ___________ _________ to ______ food enters stomach peristaltic waves esophagus esophageal sphincter relax Esophageal sphincter -________ into ____ _______: ________ _______, _______ _______, _____, and _______ ______ divided four regions Fundic region cardiac region fundic region body Esophagus pyloric region Cardiac region Body region Pyloric sphincter Duodenum Rugae Pyloric region Stomach

-______ _______ contains _______ _______, which
D. Stomach -______ _______ contains _______ _______, which ________ and _______ _______ _____, a _______ of ____________ ____, ______, and the _______ ______ inner lining gastric glands produce secrete gastric juice mixture hydrochloric acid mucus enzyme pepsin -______ is ________ by ___________ ____ and ______ the ________ of ______ ___ _____ of ______ _______ pepsin activated hydrochloric acid begins digestion nearly all types dietary protein -_____ ________ of ________ ______ in ______ _____ _____ and _______ the ______ of the ________ to _______ ______ from _________ the ________ _____ large amounts alkaline mucus gastric juice coat protect lining stomach prevent pepsin digesting stomach itself -_________ ______ of ___________ ____ _____ with _______ _____ to _______ ______, which is ______ ___ to _____ ________ after about __ ____ on _______ peristaltic waves contractions mix foods gastric juice produce chyme moved on small intestine 1 hour average -________ ______ and ______-________ _________, _________ ________ absorbs water water soluble substances While both carbohydrates and proteins have begun to chemically digest and move through the stomach quickly, fatty foods may take from 3-6 hours to move out of the stomach, so after eating fatty foods it may take longer to “feel” hungry including alcohol

-_______, or ____________ of the ______of the
D. Stomach Rx – Peptic ulcers -_______, or ____________ of the ______of the _______ _______ to the ____________of _____ ______ (_______) gastritis inflammation lining stomach leading development open sores ulcers -______ by ______________ of ____________ _____ brought on by _____ _____ and _______, ________ with ______- _________ ______ caused overproduction hydrochloric acid poor diet stress treated acid lowering drugs -many caused by ________of ________ ____________ ______, ________ with ____________ and _____ -_________ ______ infection bacteria Helicobacter pylori treated antibiotics acid lowering drugs Child showing the distended stomach and fatty liver characteristic of kwashiorkor, caused from protein deficiency accompanied by caloric sufficiency. The stomach is swollen from edema. E. Pancreas -has both _________ (________) ______ ________ and _________ (_______) ______ __________ endocrine ductless gland functions exocrine ducted gland functions

-_________ __ _________ from _______ of ___________, or
E. Pancreas 1. Endocrine functions -_________ __ _________ from _______ of ___________, or ___________ ______ ,which are ________ of ______ __________ around ______ ________ lying between the _____ of the ________ secretes 3 hormones Islets Langerhans pancreatic islets groups cells clustered blood vessels ducts pancreas Pancreas

E. Pancreas 1. Endocrine functions a. alpha cells -_______ ________, which _________ the ______ to ______ _____ _________ into ________ (_____________), to ________ ________________ like ______ ____ into ________ (______________), and to _____ ______ ____ into ____ _____ and _______ secrete glucagon stimulates liver break down glycogen glucose glycogenolysis convert noncarbohydrates amino acids glucose glyconeogenesis break down fats fatty acids glycerol b. beta cells -_______ _______, which __________ the ____ to _____ ________ from _______ and _______ ________ __________ from ____- _____________, _________ __________ _________ of ________ into _______ ____ and ______ and ________ _______ _____, _________ _________ of ______ ____ into _____ to ________ _______ ________, and __________ ________ _____ to _________ and ______ ____ secrete insulin stimulates liver form glycogen glucose inhibits glucose formation non carbohydrates promotes facilitated diffusion glucose adipose cells cardiac skeletal muscle cells promotes transport amino acids cells increase protein synthesis stimulates adipose cells synthesize store fat

E. Pancreas 1. Endocrine functions b. beta cells Rx – Diabetes Type I -_______-_________ _______ _______, also has been _____ “_______ _____” ________, _____ is usually before ___ ___ insulin dependent diabetes mellitus called juvenile onset diabetes onset age 20 -______ up _____ of all ________ ______ makes 15% diabetes cases -an ___________ ________ in which a ______ ________ the _____ ______ of the ______ of ___________, __________ _____ and ________ ________ ___________ autoimmune disease virus attacks beta cells Islets Langerhans destroying them halting insulin production -without _______, _______ is not _____ ___ by _______ and _______ _____, ________ _________ is ________, and _______ ___________ in the _____ (_____________) until ________ by _______, _______ ____ _____________ ________ for ______, and ______ _______ ________ into ______, causing _________ _________ of __________ and ___________ and _______ insulin glucose taken up adipose muscle cells glycogen formation inhibited glucose accumulates blood hyperglycemia excreted kidneys forming new concentration gradient water water follows glucose urine increased frequency urination dehydration thirst

E. Pancreas 1. Endocrine functions b. beta cells Rx – Diabetes Type I -without ________, ________ _________ __________ and ________ ______ _____ as ______ use _______ for ______ insulin protein synthesis decreases tissues waste away cells protein energy -without ________, ____ is not ___________ or _______ and _____ ______ ______ ___ in the _____, along with _______ from ____ ___________, which are _________ from the ________ and the ______ as ________ ______ (_______ ______-_________ _______), causing _________ insulin fat synthesized stored fatty acids build up blood ketones fat metabolism excreted kidneys lungs sodium salts causes fruity smelling breath acidosis -_____ _________, ________ in _____ and ______ from ____________ and _________ left untreated results coma death dehydration acidosis -_______ with _____ _________ of _______ ________ _____________ by __________-___________ _________ (__ _____), or _________ from the _________ of ______ or _______, __________ for a _________ own _____ ______ to be ______ in ________ and ________ into _____ ______ treated daily injections human insulin manufactured genetically engineered bacteria E. coli harvested slaughter cattle swine potential patient’s stem cells grown culture infused body later

E. Pancreas 1. Endocrine functions b. beta cells Rx – Diabetes Type II -___________-__________ _________ _________ noninsulin dependent diabetes mellitus -________ begins __________, in _______ over ____ ___ usually gradually people age 40 -______ _____________ _____ ________ __________ and become _____ _____ to ________ to ________ ________ _______, or ________ ________ too ______ ________ cells progressively lose insulin receptors less able respond normal insulin levels pancreas produces little insulin -________ _________, ____________ by a _________ of ___________ and _______________ genetic tendency compounded lifestyle overeating underexercising -_________ in the _____, _______ ________-________ _______ _____ in _________, after ________ endemic U.S. second fastest growing health risk America obesity -________ by ________ _____ and _________, _____________ of _____ to ______ ______ that ________ ________ ___________ (_______ and _________) treated weight loss exercise modification diet avoid foods stimulate insulin production sugars starches

E. Pancreas 1. Endocrine functions b. beta cells Rx – Hypoglycemia -____ _______ ________ _______ due to ______________ of ________ low blood glucose levels overproduction insulin -causes _________ of __________, __________, and _______ episodes weakness shakiness anxiety -______ by ______ _________ ______ ____ in _____________ and _____ in ________ treated small frequent meals low carbohydrates high protein c. delta cells -________ ____________, which _____ _________ ________ ___________ by __________ _________ of _________ and ________ secrete somatostatin helps regulate glucose metabolism inhibiting secretion glucogon insulin 2. Exocrine functions -_________ __________ ______ through ___________ _____ into __________ of ______ _________ secretes pancreatic juice pancreatic duct duodenum small intestine

-_________ _____ contains __________ ________ to _____
E. Pancreas 2. Exocrine functions -_________ _____ contains __________ ________ to _____ _________ of ______ and _________ into ____________, __________ ______ to _____ down ___________, _____ _____ and ______________, _______, ____________, and ________________ to ______ ______ ________ into ______ ______, and ________ to ______ ______ _______ ______ into ___________ pancreatic juice pancreatic amylase split molecules starch glycogen disaccharides pancreatic lipase break triglycerides Pyloric sphincter fatty acids monoglycerides Pancreatic Islets trypsin chymotrypsin Pancreas carboxypeptidase break down proteins amino acids nuclease break down nucleic acids nucleotides Pancreatic duct -__________ ______ contains _____ _______________ of ___________ ______ to __________ _______ _______ _________ from ________ and ________ ______ from ________ the _________ ______ pancreatic juice high concentrations bicarbonate Duodenum ions neutralize acidic chyme arriving stomach prevent pepsin digesting duodenal wall

E. Pancreas Rx – Cystic fibrosis -an ___________ __________ ________, _____ _________ in ___________ autosomal recessive disease most common Caucasians -_________ _____ _____ for ______ ________ ________ for the ________ ____ in _______ _____, ________ the ________ ____ to be ________ in ________ _____, which _______ a _____________ ________ that ______ ______ into the _____ recessive gene codes faulty carrier protein chloride ion certain cells causing chloride ion retained certain cells creates concentration gradient draws water cells -_______ ___________ of the _____ and _________ _____ ___ and become ______, ________ up the _______, ____________ _________, and causing _____________ mucus secretions lungs pancreas dry out sticky plugging organs encouraging infection malnutrition -_______ with _________ ________ _____________ treated digestive enzyme supplements

E. Pancreas Rx – Cystic fibrosis ♂ C c ♀ If Cybill, who does not have cystic fibrosis but her father does, and Cyrus, who is heterozygous for the cystic fibrosis gene, have 7 children, how many, according to the odds, should have cystic fibrosis? CC Cc C 1 4 c Cc cc x 7 = 2

-________ _________ ______ largest internal organ
F. Liver -________ _________ ______ largest internal organ -_______ ________ _______ ____________ of ______ ________ by __________ to _________ and _______ helps maintain normal concentration blood glucose responding glucagon insulin -________ _____ ____ into _____ _____ and _______, then _______ them to ______ ______, or ________ ____ ____ of _____ ____ to _______, ___________ ____________, ___________ (____ _________ __________), and __________ breaks down fats fatty acids glycerol oxidizes release energy converts one type fatty acid another synthesizes phospholipids lipoproteins fat transport complexes cholesterol Liver – anterior view Liver – inferior view Inferior vena cava Quadrate lobe Gallbladder Hepatic duct Right lobe Left lobe Right lobe Cystic duct Hepatic artery Left lobe Hepatic Portal vein Common bile duct Gallbladder Inferior vena cava Caudate lobe

-________ ________ of ______ _____________ and
F. Liver -________ ________ of ______ _____________ and ________ into ____ for _______ in ________ _______ converts portions excess carbohydrates proteins fat storage adipose tissue -__________ _______ ______ so that they can be _____ for _______ deaminates amino acids used energy H H O I I II H—N—C—C—O I H H H O H I II I H—N—C—N—H Deamination 2 To Urine Urea Glycine H I H—N—H Ammonia -_________ _________ _________ by ________ in the __________ to ______, which is _________ as _______ in the ______ converts ammonia produced bacteria intestine urea excreted waste urine 42

F. Liver -_________ one _____ of _______ _____ to ________ converts type amino acid another -__________ _______ ________ like _______ _______ synthesizes plasma proteins clotting factors -______ ________, ____, and ________ __, __, and ____ stores glycogen iron Vitamins A D B12 -_____ ____________ ___________ ____ or _________ ____ and ______ ______ ______ liver macrophages phagocytize old damaged red white blood cells -_________ _________ and _____________ to _________ _________ detoxifies alcohols formaldehyde Hydrogen peroxide -________ _____, a ________ of ______, _____ ______, ____ _________, ___________, and ___________ produces bile mixture water bile salts bile pigments cholesterol electrolytes -____ _________ include ___________ _________ of ___________ _________ and __________ bile pigments breakdown products hemoglobin bilirubin biliverdin

F. Liver The extraordinary ability of the liver to regenerate following injury or resection has long fascinated physicians, scientists and lay people. The earliest allusion to the liver’s regenerative capacity is described in Hesiod's Theogony ( B.C.). Prometheus, a Titan, angered Zeus by stealing fire and giving it to the primitive humans. As his punishment, Prometheus was chained to a rock in the Caucasus Mountains where Zeus tormented him by sending an eagle each day to devour his liver. Nightly,his damaged liver regenerated leaving him fit for the next days’ torture. Scientific documentation of the ability of the human liver to regenerate was not made until 1890, however. Normally, only % of hepatocytes undergo mitosis at any given time. This low cell turnover in healthy liver tissue, however, can be altered by toxic liver injury or surgical resection, which results in sudden, massive hepatocyte proliferation, producing recovery of functional liver mass within two weeks after the loss of up to two-thirds of the liver. Current thinking suggests that a special gene or special growth factors or cytokines trigger regeneration of the liver.

-__________ ____ of the _____, ________ (_________),
F. Liver Rx – Jaundice -__________ ____ of the _____, ________ (_________), and ________ ___________ ____ to ___________ of _____ _________ yellowish hue skin sclerae eyeballs mucous membranes due deposition bile pigments 1. Obstructive jaundice -_____ ______ are ________ with __________ or ________ bile ducts blocked gallstones tumors 2. Hepatocellular jaundice -the _____ ___________ is __________ by the ____________ due to a ________ _________ or the ________ _________ from _________ liver architecture disrupted inflammation Hepatitis infection scarring resulting cirrhosis 3. Hemolytic jaundice -____ ______ ______ are __________ too ________ because of a ______- _________ _______ ___________ or a ______ _________ like ________ red blood cells destroyed rapidly cross matched blood transfusion blood infection malaria

F. Liver Rx – Hepatitis -_____________ of the ______ due ______ ______ to __________ by the _________ ________, but also ___________ or ______________ inflammation liver most often infection Hepatitis viruses alcoholism autoimmunity 1. Hepatitis A -_____ _______ ______ most severe form -______ __________ include _____ _________, _____ ______, ________, _____ of ________, ________, _________, and _____ _______ early symptoms mild headache low fever fatigue lack appetite nausea vomiting stiff joints -_____ a ______ __________ _________ to _____, _____ in ______ ______ _________ of _________, _____ _______ ______, _____ ______, ________ _______ ______ ______, _________ after week symptoms progress rash pain upper right quadrant abdomen dark foamy urine pale feces swollen axillary lymph nodes jaundice 2. Hepatitis B -_________ ____________ ________, ____ _______ ______________ _______ __________ that can _______ _______ sexually transmitted disease 300 million asymptomatic carriers worldwide infect others -_______ _________ that can ____ up to __ _______ chronic symptoms last 6 months -____ ________ ______ _______ 5% develop liver cancer

F. Liver Rx – Hepatitis -inflammation of the liver due to infection by the hepatitis viruses 3. Hepatitis C -___________ _______ by ___________ _____ ____ transmitted mainly intravenous drug use -_______ with _________, which _______ ________ in the ________ _____ treated ribavirin mimics guanine genetic code 4. Hepatitis D -_______ in _______ ________ ________ with __________ __ occurs people already infected Hepatitis B -______ ____ of the _______ it ________ kills 20% people infects 5. Hepatitis E -_____ ________ in ___________ ________ due to _____ _____________ of _________ ______ more common developing nations fecal contamination drinking water -______ _________ _______ more ________ affects pregnant women severely 6. Hepatitis F -can _____ through ______ _____________ to other _________ pass fecal contamination primates 7. Hepatitis G -causes ________ ________, which, if left ________, causes _______ or ______ _______ and _____ fulminant hepatitis untreated kidney liver failure coma

Liver cancer tumors metastasized from testicular cancer
Rx – Liver Cancer -______ of the _____ most often got there from _________ (____________) from ___________ ____, like the ______ cancer liver spreading metastasizing somewhere else lungs -______ ____ of all _______ ______ ________ are _____________ ___________, because ______ of the _______ ______ are ___________ about 75% actual liver cancers hepatocellular carcinomas most liver’s cells hepatocytes -about ______ as ________ in _____ than ________, and _____ _____ ________ in the ___________ __________ of _______ and _____ _____, where it often is the _____ ________ _____ of _______ twice common men women much more common developing countries Africa East Asia most common type cancer -_______ about ______ ______ each ____ in the ____ causes 17,000 deaths year U.S. Liver cancer tumors metastasized from testicular cancer

-__________ of the _____ ___________ by the _________
Rx – Cirrhosis -__________ of the _____ ___________ by the _________ of _____ _______ in the ______ in its ________ to _____ ____ and ________ ______ of _______ _________ by _________ or _______ disruption liver architecture deposition scar tissue liver attempt wall off isolate areas tissue damaged infections toxins -______ to __________ of ______ _______, __________ with ______ _____ and _________ ______ ___________ leads hardening liver tissue interferes blood flow impedes liver functioning -_______ _______ _______ _________ in the _____, over _____ of which are ________ to __________ causes 25,000 deaths annually U.S. half related alcoholism Autopsy photographs of liver affected by cirrhosis compare to healthy liver 49

-_________ ____ which _______ _____ _________ by the ______ muscular
G. Gallbladder -_________ ____ which _______ _____ _________ by the ______ muscular sac stores bile produced liver -_________ to _______ _____ through the _______ _____, then through the _________ _____ _____ into the ___________ contracts inject bile cystic duct common bile duct duodenum -_____ ______ ______ ____ _________ into _________ by _____________, ______ like a ______ does, _______ the _____ with ______ and __________ the ________ _____ for _______ to act upon bile salts break fat globules droplets emulsification much soap mixing fats water increasing surface area lipase -_____ ______ ____ in the ___________ of ______ ______, ___________, and the ____- ________ _________ __, __, __, and __ bile salts aid absorption fatty acids cholesterol fat soluble Vitamins A D E K -_____ ______ are _________ along with the _____ _____ into the ___________ by the ______ ________, where they are ________ to the _____ and _______ _________ back into the ____ ____ bile salts absorbed fatty acids bloodstream small Gallbladder intestine returned liver largely resecreted bile ducts

-____________ and _____________ of __________
G. Gallbladder Rx – Gallstones -_____________ cholelithiasis -____________ and _____________ of __________ from _____ ____ to _____________ of ___________, _______________ of ______ from _____, or _____________ of the ___________ (____________) precipitation crystallization cholesterol bile due overproduction cholesterol overabsorption water bile inflammation gallbladder cholecystitis -__________ ______ _____ _____, causing __________ _________ and ______ ______ __________ _____ gallstones block bile duct obstructive jaundice upper right abdominal pain -______ ________ with _______________, or ________ __________ of the ____________ often treated cholecystectomy surgical excision gallbladder Thickened gallbladder wall and gallstones assoicated with chronic cholecystitis

-________ ______ __________ from the
H. Small Intestine -________ ______ __________ from the ________ __________ to the ______ ________, can be up to ___ _____ in _______, _________ __________ of ______ and ________, ____ as _____ of __________ of ________ of ____ ________ of ________, _______ _________ of ________ into ___________, and _________ ______ on to ______ _________ tubular organ extending pyloric sphincter large intestine 20 feet length receives secretions liver pancreas acts site completion digestion all classes nutrients absorbs products digestion bloodstream transports waste large intestine Duodenum Stomach Jejunum Small Intestine Ileum 52

H. Small Intestine -________ of ______ ________: the __________, the _________, and the ______ consists three sections duodenem jejunum ileum 1. Duodenum -________ (______), _______ in ________, (_____), and ______ _________ ________ shortest 25 cm largest diameter 5 cm least movable segment 2. Jejunum -_____ between the __________ and ______, _______ up the _____ _____ of _______, _______ in _________, ________-________, ______ _________, and ______ _______ than the _______ lies duodenum ileum makes next 40% length larger diameter thicker walled more vascular more active ileum 3. Ileum -______ _______ ________, with ______ ________ ________ (________ ________) and a _______ _________ ___________ most distal segment more lymph nodules Peyer’s patches higher bacterial population

-_______-________ _____ of ___________
H. Small Intestine 4. Mesentery -_______-________ _____ of ___________ which _______ _______, ______ ________, and __________ ________ which _______ _________, and from which the _________ and the ______ are __________ double layered fold peritoneum houses nerves blood vessels lymphatic vessels supply intestine jejunum ileum suspended Duodenum Stomach Jejunum Mesentery Small Intestine Ileum

-______ on the _______ with __________
H. Small Intestine -______ on the _______ with __________ _____, which are __________ __________ in the __________ and the __________ _________, and _________ the ________ ______ for ___________ lined inside intestinal villi especially numerous duodenum proximal Intestinal Villus jejunum increase surface area absorption -______ __________ and ________ (_________ ___________) ______ away _________ blood capillaries lacteals lymphatic capillaries carry nutrients -_________ _______ (_______ of ___________) ________ a _______ ______ which is _________ by the ______, along with _________ _________ intestinal glands Crypts Lieberkühn secrete watery fluid absorbed villi digestive products

-_________ _________ __________ in the
H. Small Intestine -_________ _________ __________ in the _____ ___________ of the __________ ________ ______ ______ _____ _________ just before ___________; ___________ break down _________ into ______ ______, ________, ________, and ________ break down the _____________ ________, ________, and ________ into the ________________ ________, _________, and __________ digestive enzymes embedded cell membranes intestinal mucosa break down food molecules Intestinal Villus absorption peptidases peptides amino acids sucrase maltase lactase disaccharides sucrose maltose lactose monosaccharides glucose fructose galactose

Rx – Lactose Intolerance -______ _______ do not ________ _______
H. Small Intestine Rx – Lactose Intolerance -______ _______ do not ________ _______ _______ to _______ ______ ________ many adults produce enough lactase digest dairy products -__________ _______ _________ ________ _________ of the _________ ________ and _______ ______ into the ________, ________ in ________ undigested lactose increases osmotic pressure intestinal contents draws water intestines resulting diarrhea -_________ ________ _______ ________, __________ ______ and ____ which ______ in _________ _________ and ________ intestinal bacteria digest lactose producing acids gas result intestinal cramping bloating

Rx – Lactose Intolerance -______ _______ with _______ ______ before
H. Small Intestine Rx – Lactose Intolerance -______ _______ with _______ ______ before _______ ______, _______ ______ ____-_____ ________ adults treated lactase pills eating dairy infants drink soy based formula -_______ _________ ________ that ________ ___________ in _______ is _______, and the _______ to ______ ______ as _______ is a _________ which _________ only in _______ ________ _______ that _________ as ___________ ___________ ______ ________ into the _______ _____ in the _____ _______ ______ genetic evidence suggests lactose intolerance adults normal ability digest dairy adults mutation occurred recent genetic history persisted agriculture introduced dairy products human diet past 10,000 years Archaeological evidence suggests goats were first domesticated in the Euphrates river valley in Turkey about 11,000 years ago 58

-__________ _______ _______ ______ ____
H. Small Intestine -__________ _______ _______ ______ ____ into ______ ______ and _________ intestinal lipase breaks down fats fatty acids glycerol 5. Digestion in the Small Intestine a. ___________ disaccharides -from _____________ __________ carbohydrate digestion Hydrolysis b. _______ peptides -from ______ ________ protein digestion Hydrolysis

5. Digestion in the Small Intestine
H. Small Intestine 5. Digestion in the Small Intestine b. _______ peptides -______ ______ into ______ ______ break down amino acids Dipeptide Hydrolysis + Amino acid Amino acid

H. Small Intestine 5. Digestion in the Small Intestine b. peptides Cysteine Phenylalanine Amino acid

H. Small Intestine 5. Digestion in the Small Intestine c. _____ fats -______ ______ into ______ ______ and _________ break down fatty acids glycerol Hydrolysis

H. Small Intestine 5. Digestion in the Small Intestine c. fats Triglyceride (fat) Fatty acids

H. Small Intestine -_______, ___________ like ________, __________, ________, _______, ___________, ________, ___________, and ________ _____ are ________ through _________ _____, and ______ ________ finally electrolytes sodium potassium chloride nitrate bicarbonate calcium magnesium sulfate ions absorbed intestinal villi water follows Rx – Diarrhea -an _________ ________ and ___________ of ______ and an __________ __________ of ______ ___________ due to _________ of the _______ of the _________ increased volume wateriness feces increased frequency bowel movements irritation lining intestine 1. Secretory diarrhea -________ or ______ _______ __________ with _______ _________ of ___________ _____ into ______ , _________ in _____ of __________, _________ ___________ __________in the _______ of the ________, and _______ ________ bacterial viral toxins interfere active transport electrolyte ions cells resulting loss electrolytes creating hypertonic conditions lumen intestine water follows -_________ of __________ ____ or _______ symptom intestinal flu cholera

H. Small Intestine Rx – Diarrhea 2. Invasive diarrhea -_________ or ______ _______ ________ __________ ________ and ______ ________ _______ _________, __________ in ______ and ___________ _____ and ______ _____ bacterial viral toxins destroy intestinal mucosa blood vessels lining intestine resulting water electrolyte loss blood loss -_________ of ________ _____ or __________ symptom typhoid fever salmonella Rx – Diarrhea -_________ of ________ ___________ for ______ ______ than any other _________ symptom disease responsible more deaths symptom -_____ to ______ from ____________ and ___________ ______ ________ to _______ of the ______ leads death hypotension circulatory shock leading anoxia brain -_______ with ____________, __________ ___________, and ___________ in the _____ of _________ __________ treated rehydration electrolyte replacement antibiotics case bacterial infection

-_______ _____ of ___________ ___________ which _______ like an
H. Small Intestine 6. Greater omentum -_______ _____ of ___________ ___________ which _______ like an _______ over the __________ double fold peritoneal membrane drapes apron intestines -____ _________ to __________ _________ __________ against _______ ________ fat clinging omentum cushions intestines blunt trauma -in the _____ of ___________ of the ___________ ______ _____, the __________ ________ to the _____ of ____________ to ________ _______ of _________ into the __________ _______ (__________) case infections alimentary canal wall omentum adheres site Liver inflammation prevent Stomach spread infection Gallbladder peritoneal cavity appendicitis Transverse colon Greater omentum

-_______ in ________ than _____ ________, about __ _____ _____ larger
I. Large Intestine -_______ in ________ than _____ ________, about __ _____ _____ larger diameter small intestine 5 feet long - ________ ______ left over from _________, along with any __________ ___________, ______ and _______ ______, acts as the ______ _____ for ________ __________ absorbs water digestion dissolved electrolytes forms stores feces main site enteric digestion -_______ _______ from ______ _________ through the _________ _________, which _________ ________ ___________, but _______ in _________ to __________ __________ of the ______ after a ______ chyme enters small intestine ileocecal sphincter normally remains constricted opens response increased peristalsis ileum meal Ileum Ileocecal sphincter Cecum Vermiform appendix

-______ at the __________ of the ______ ________ pouch beginning large
I. Large Intestine 1. Cecum -______ at the __________ of the ______ ________ pouch beginning large intestine 2. Vermiform appendix -________ _______, the ______ ____ of _______ _________ in other ________ like _______ and _____ vestigial cecum main site enteric digestion animals horses pigs -_________ no _______ _______, but ________ __________ ______ which ______ it a ______ for _________, like the _______ performs useful function contains lymphatic tissue make target infection tonsils Ileum Ileocecal sphincter Cecum Vermiform appendix

-_____________ of the _________ usually _______ by
I. Large Intestine 2. Vermiform appendix Rx – Appendicitis -_____________ of the _________ usually _______ by a _________ __________ inflammation appendix caused bacterial infection -________ with __________ or _____________, _____ of _________ _________ and ________ ________ __________ of the ___________ called __________ treated antibiotics appendectomy risk appendix bursting creating massive infection peritoneum peritonitis 3. Colon -________ into _________, __________, ___________, and ________ _______ divided ascending Ileum Cecum Ileocecal sphincter Vermiform appendix Transverse colon transverse descending sigmoid colons Descending colon Ascending colon Sigmoid colon Rectum

I. Large Intestine 4. Rectum -as _____ become __________ with ______, _______ __________ ______ in ___________ ______ and ________ ________ _____ ________ to ______ walls distended feces triggers defecation reflex descending colon triggers internal anal sphincter relax Rx – Hemorrhoids -____________ _______ by __________ _________ on _________ of the ______ _____ inflammation caused prolonged pressure branches rectal vein -________ due to _________, _______, ___________, _________, and ______ ________ pressure pregnancy obesity constipation diarrhea liver disease -_______, ______ _____, and sometimes ________, ______ may ______ out of _____ when _________ itching sharp pain bleeding veins bulge anus distended -may ________ ________ to ________ require surgery correct

I. Large Intestine 5. Anus -_______ ________ ________ of __________ ______ inferior external opening alimentary canal -__________ by the ________ _____ _________, which is ______ of _______ _______ and _____ ___________ ________, and the ________ ____ _________, which is ______ of ________ _______ and ______ _________ _______ constricted internal anal sphincter made smooth muscle under involuntary control external anal sphincter made skeletal muscle under voluntary control I. Large Intestine -________ an ________ _______ to _____ ______ ________, ________ the _________ ______ against _________, and __________ ______ _________ by ________ secretes alkaline mucus bind feces together protect intestinal wall abrasion neutralize acids produced bacteria -________ about _____ of the ______ _________ in _______ absorbs 90% water entering chyme

-_________ of _____ becoming ______ ___________,
I. Large Intestine Rx – Constipation -_________ of _____ becoming ______ ___________, _______ __________ ________ condition feces overly dehydrated making defecation difficult -_____ _________ in the _____, whose ___________ ____________ become _______ with ____ and whose _______ __________ _________ with ____ more common aged peristaltic contractions weaker age mucus secretions decrease age I. Large Intestine -______to __________ ______, which ______ ______ __________ (______) as an _______ _______ and __________ _________ ___, ____, _________, and __________ home intestinal flora break down cellulose fiber energy source synthesize Vitamins K B12 thiamine riboflavin -________ ________ include ____________ ____,and ___________ ________,and _____ _______ _________ __________ bacterial species Escherichia coli Clostridium difficile yeast species Candida albicans 72

-______________ of ______ in ______ _________
Rx – Yeast infection -______________ of ______ in ______ _________ __________ of ______ ________ ____________ _________ ________ of ______, __________ as ______ are ______ __________ ____________ from _____ to _______ overpopulation yeast colon increase likelihood yeast causing opportunistic infection outside colon especially yeast easily transferred mechanically anus vagina -_________ in ________ and _________ _____ in ________ common women children still diapers -due to ____ _____ in ______ and _____ in ______, which ___________ ________ ______ while __________ _______ of ______ ___________, or _________ of __________, which ________ ________ _________ __________, ___________ ________ ___________for __________ diet poor fiber rich sugar suppresses bacterial flora triggering growth yeast population overuse antibiotics suppress helpful bacterial population eliminating yeast’s competition resources Yeast infection in diaper area of infant female associated with diaper rash

Rx – Inflammatory Bowel Disease -_________ ______ and ______ _______
I. Large Intestine Rx – Inflammatory Bowel Disease -_________ ______ and ______ _______ ulcerative colitis Crohn disease -____________ and __________ of the ______ of the _________ inflammation ulceration lining intestine -_______, _______ ________, ______ _____, __________ __________, and _____________ to ______ _______ cramps bloody diarrhea weight loss electrolyte imbalance predisposition colon cancer -______ _________, _________ to be ____ to _______ _____________, ________ _________, or _____________ cause unknown suspected due genetic predisposition bacterial infection autoimmunity

Cancer polyp in the colon of a 46 year-old woman
I. Large Intestine Rx – Colorectal Cancer -_______-_____ ________ _______in the _____ and _______-_____ ________ ______ of ______ ______; ________ _______ _______ each _____ in the _____ fourth most common cancer U.S. second most common cause cancer death causing 56,000 deaths year U.S. -__________ include _______ in __________ or ____________ of ______ ___________, ______ in ______, __________ _____, _______ _____, ________, _________ symptoms change frequency consistency bowel movements blood feces abdominal pain weight loss fatigue vomiting -________ by ________ _________, possible __________ treated surgical excision colostomy Cancer polyp in the colon of a 46 year-old woman 75

The Digestive System: For Discussion: True or False?

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The Digestive System: For Discussion: True or False?

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