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Anatomy and Physiology
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ANP1107Notes1Digestive System11Cell types111DuodenumBrunners glandsduodenal glands found in the submucosa of the duodenum only Produce an alkaline bicarbonaterich mucus that helps neutralize the acidic chyme moving in from the stomach When protective barrier is inadequate the intestinal wall erodes and duodenal ulcers result112Small intestineAbsorptive cells brush border enzymesGoblet cellsEnteroendocrine cellsPaneth cellsStem cellsIntraepithelial lymphocytes IELs113LiverHepatocytesKupffer cellshepatic macrophages12Tissue types121MouthMucosaoThick stratified squamous epithelium Epithelium of gums hard palate and dorsum of tongue slightly keratinized for extra protection against abrasion during eating oDefensins antimicrobial peptides produced by the oral mucosa in response to injury Act as local antibiotic and function as cytokines to call defensive cells to the mouthoRed margin reddened area of lips a transitional zone where keratinized skin meets oral mucosa Poorly keratinized and translucent allowing red color of blood in underlying capillaries to show through Lacks sweat or sebaceous glandsoHard palate rigid surface against which the tongue forces food during chewing Mucosa on either side of midline ridge raphe is slightly corrugated to help create frictionoLingual frenulum a fold of mucosa that secures the tongue to the floor of the mouth and limits posterior movements of the tongueoFiliform papillae a type of tongue papillae keratinized projections of underlying tongue mucosa that are keratinized and give the tongue a roughness that aids in licking semisolid foods and provide friction for manipulating foods in the mouth Smallest and most numerous in type align in parallel rows on tongue dorsumoFungiform papillae mushroomshaped tongue papillae scattered widely over tongue surface that house taste buds Vascular core gives papillae reddish hue oCircumvallatevallate papillae tongue papillae that house taste buds Located in a Vshaped row at back of tongue Resemble fungiform papillae but have additional surrounding furrowoFoliate papillae house taste buds that mainly function in infancy and early childhoodoRoot of tongue mucosa lacks papillae but is still bumpy because of lingual tonsil just deep to mucosaoIntrinsic salivary glandsbuccal glands small salivary glands scattered throughout oral cavity mucosa MusculatureoSkeletal muscle and voluntary Smooth muscle the dominant muscle type once food passes into bottom portion of esophagus oOrbicularis oris fleshy lips help keep food between the teeth when we chewoBuccinators form most of the cheeks help keep food between the teeth when we chewoSoft palate mobile fold formed mostly of skeletal muscle that rises reflexively during deglutition The uvula projects downwards from the free edge of the soft palateoIntrinsic muscles of the tongue confined in the tongue and not attached to bone Fibers run in several different planes Muscle fibers allow tongue to change shape but not position oExtrinsic muscles of the tongue extend to tongue from points of origin on bones of skull or soft palate Alter tongues position protrudes retract move from side to side Identical muscle groups on either side of tongues median septum of connective tissue122Small intestineMucosaoSimple columnar epithelium absorptive cellsoBrush border enzymes on microvilliSubmucosaoTypical areolar connective tissueoLymphoid tissue Proliferating lymphocytes Tcells leave intestine enter the blood and then home in on lamina propriaoSubmucosal plexus portion of the enteric nervous system that resides within the submucosa Forms later in gestation Enteric neurons are organized in ganglia interconnected by unmyelinated fiber tracts Contains sensory and motor neurons Regulates glands and smooth muscle in the mucosaMuscularis circular and longitudinal oMyenteric plexus portion of the enteric nervous system that occupies a position between the longitudinal and circular muscle layers Develops first Enteric neurons are organized in ganglia interconnected by unmyelinated fiber tracts Provides the major nerve supply to the gastrointestinal tract Controls GI tract motility via pacemaker cells and local reflex arcs between enteric neuronssegmentation and peristalsis Serosa intraperitoneal except for most of duodenum retroperitoneal123Large intestineMucosa thicker in large intestine Abundant crypts are deeper tremendous numbers of goblet cells in the crypts mucus production eases the passage of feces and protects the intestinal wall from irritating acids and gases released by resident bacteria in the colonoColon simple columnar epitheliumoAnal canal stratified squamous epitheliumMuscularisoTeniae coli three bands of thickened longitudinal smooth muscle running along the large intestine Absent in rectum and anal canaloHaustra pocketlike sac pouches formed by tonic contractions of taenia coli When stretched they contract and squeeze their content into the next haustra Absent in rectum and anal canaloInternal anal sphincter one of the two sphincters of the anal canal which both contract to close the anal canal except during defecation Smooth muscle involuntaryExternal anal sphincter one of the two sphincters of the anal canal which both contract to close the anal canal except during defecation Skeletal muscle voluntaryoRectum muscularis muscle layers are complete and well developed in order to generate strong contractions to perform expulsion of fecesSerosaoEpiploic appendages fatfilled pouches of visceral peritoneumoMesocolons mesentery sheets that anchor the transverse and sigmoid colon parts to the posterior abdominal wall The rest of the colon is retroperitoneal 124Lymphoid tissues and cellsMucosaassociated lymphatic tissue MALT small lymphoid tissues that protect passages that are open to the exterior from the neverending onslaughts of foreign matter entering them oAssociated with Peyers patches of the small intestine appendix tonsils as well as lymphoid follicles in the walls of the bronchiDendritic cells epithelial cells of the gut mucosa respond to specific bacterial components by releasing chemicals that recruit dendritic and other immune cells into the mucosa The dendritic cells pry open tight junctions between the epithelial cells and send extensions into the lumen to sample the microbial antigens They then migrate to the nearby lymphoid follicles MALT within the gut mucosa where they present the antigens to T cells As a result an IgA antibodymediated response restricted to the gut lumen is triggered that prevents the bacteria from straying into tissues deep to the mucosa where they might elicit a much more widespread systemic response13Glands131Salivary glandsIntrinsicbuccal salivary glands small salivary glands scattered throughout oral mucosa Approximately equal numbers of serous and mucous cells Secrete saliva continuously in amounts just sufficient to keep the mouth moistExtrinsic salivary glands paired compound tubuloalveolar glands Develop from oral mucosa remain connected to it by ducts Activated when food enters the mouth and secrete large amounts of salivaoParotid gland a serous salivary gland that produces watery secretion containing enzymes ions and a tiny bit of mucinoSubmandibular gland salivary gland with approximately equal numbers of serous and mucous secretory cells oSublingual gland salivary gland that contains mostly mucous cells to produce stringy viscous solution132Small intestinePeyers patches aggregated lymphoid follicles Increase in abundance towards distal end of small intestine defensive properties against multitude of bacteria found there SubmucosaDuodenal Brunners glands produce an alkaline bicarbonaterich mucus that helps neutralize the acidic chyme moving in from the stomach Impairment results in erosion of intestinal wall and duodenal ulcers Submucosa duodenum only 14Hormones141DuodenumSecretin secretion of bile pancreatic bicarbonate Inhibition of gastric juice secretionoReleased by intestinal cells enteroendocrine cells of duodenal mucosa exposed to fatty acidic chyme HCloStimulates liver cells to secrete bileoStimulates secretion of pancreatic juice Mainly targets pancreatic duct cells resulting in a watery bicarbonaterich pancreatic juiceoDecreases secretion of gastric juiceoTarget organs stomach pancreas liverCholecystokinin CCK release of bile pancreatic enzymes Relaxation of hepatopancreatic sphincter opens hepatopancreatic ampulla Inhibits gastric emptyingoReleased by intestinal cells enteroendocrine cells of duodenal mucosa in response to proteins and fats in chymeoMajor stimulus for gallbladder contractionoAn intestinal hormone released to the blood when acidic fatty chyme enters the duodenumoStimulates secretion of pancreatic juice Stimulates the acini to release enzymerich pancreatic juice and potentiates the effect of secretinoRelaxes the hepatopancreatic sphincter so that bile and pancreatic juice can enter the duodenumoOpens hepatopancreatic ampulla sphincter of OddioCloses pyloric sphincter temporarilyoInhibits gastric emptyingoTarget organs liver pancreas gallbladder hepatopancreatic sphincterampulla stomachMotilin142LiverVascular endothelial growth factor VEGF a hormone 143AssortedParathyroid hormone calcium absorption15Enzymes151Oral cavitySalivary amylaseoSplits starch into oligosaccharides smaller fragments of two to eight linked glucose molecules oWorks best in slightly acid to neutral environment maintained by the mouth by the buggering effects of bicarbonate and phosphate ions in saliva oInactivated by stomach acid and broken apart by the stomachs proteindigesting enzymes oGenerally the larger the meal the longer salivary amylase continues to work because foodstuffs in the relatively immobile fundus are poorly mixed with gastric juicesLingual lipase152StomachPepsin actually a group of proteindigesting enzymesoPepsinogen secreted by chief cells activated in presence of HCl functions optimally in pH range of 1525 found in the stomachoPreferentially cleaves bonds involving amino acids tyrosine and phenylalanine Proteins are broken into polypeptides and small numbers of free amino acidsoInactivated by high pH in the duodenum proteolytic activity limited to stomach
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