Pancreas and Bile Function
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Questions and Answers

What is the primary composition of pancreatic juice secreted by the pancreas?

  • Acidic solution with enzymes for protein digestion
  • Watery, alkaline solution with enzymes for various nutrients (correct)
  • Watery, alkaline solution with a pH of 2
  • Viscous solution containing only lipids
  • Which type of cells in the pancreas are responsible for insulin production?

  • Epithelial cells
  • Acini cells
  • Pancreatic islet cells (correct)
  • Zymogen cells
  • Which hormone stimulates the secretion of pancreatic juice?

  • Gastrin
  • Serotonin
  • Cholecystokinin (CCK) (correct)
  • Insulin
  • What structure controls the entry of bile and pancreatic juice into the duodenum?

    <p>Hepatopancreatic sphincter (C)</p> Signup and view all the answers

    What is the primary function of the acini in the pancreas?

    <p>To produce zymogen granules containing digestive enzymes (A)</p> Signup and view all the answers

    How does the secretion of bile change in response to the presence of bile salts?

    <p>Secretion is increased due to enterohepatic circulation (A)</p> Signup and view all the answers

    What enzyme is secreted by the pancreas to digest carbohydrates?

    <p>Amylase (C)</p> Signup and view all the answers

    What effect does secretin have on bile secretion?

    <p>Stimulates bile secretion in response to acidic chyme (D)</p> Signup and view all the answers

    What method is used for the absorption of Vitamin B12 in the small intestine?

    <p>Endocytosis (B)</p> Signup and view all the answers

    Which vitamin is primarily absorbed in the large intestine through bacterial metabolism?

    <p>Vitamin K (B)</p> Signup and view all the answers

    How much water is typically absorbed in the small intestine?

    <p>95% (D)</p> Signup and view all the answers

    What hormone regulates the absorption of calcium in the digestive system?

    <p>Parathyroid hormone (PTH) (A)</p> Signup and view all the answers

    At what stage does the alimentary canal become a continuous tube from mouth to anus?

    <p>Week 5 (B)</p> Signup and view all the answers

    What is a common digestive issue associated with aging?

    <p>Fecal incontinence (C)</p> Signup and view all the answers

    Which mineral absorption is typically related to the body's need rather than a standard amount?

    <p>Iron (B)</p> Signup and view all the answers

    What contributes to the stimulation of the GI tract in infants before solid foods are introduced?

    <p>Amniotic fluid (B)</p> Signup and view all the answers

    What is the primary function of digestion in the human body?

    <p>To break down food into its chemical building blocks (C)</p> Signup and view all the answers

    Which type of transport is primarily used for most nutrients in the absorption process?

    <p>Active transport (A)</p> Signup and view all the answers

    What initiates the digestion of carbohydrates?

    <p>Salivary amylase (B)</p> Signup and view all the answers

    What is the role of bile salts in lipid digestion?

    <p>To emulsify large fat globules into smaller ones (C)</p> Signup and view all the answers

    How are amino acids primarily absorbed in the small intestine?

    <p>By active transport processes (C)</p> Signup and view all the answers

    What happens to lipids after being absorbed by epithelial cells?

    <p>They are converted back into triglycerides (C)</p> Signup and view all the answers

    What clinical condition results from a deficiency of the lactase enzyme?

    <p>Lactose intolerance (A)</p> Signup and view all the answers

    What are tight junctions in the intestinal epithelium important for?

    <p>Preventing leakage of substances between epithelial cells (A)</p> Signup and view all the answers

    What type of enzymes primarily contributes to the breakdown of proteins in the stomach?

    <p>Pepsin and proteases (A)</p> Signup and view all the answers

    What is a common cause of malabsorption in the intestine?

    <p>Bacterial infection or antibiotic use (D)</p> Signup and view all the answers

    What are the three bands of longitudinal smooth muscle in the large intestine called?

    <p>Teniae coli (C)</p> Signup and view all the answers

    Which part of the large intestine is primarily responsible for absorbing vitamins made by bacterial flora?

    <p>Colon (B)</p> Signup and view all the answers

    What structural feature of the appendix makes it particularly vulnerable to blockages?

    <p>Twisted shape (A)</p> Signup and view all the answers

    What is the primary function of the rectal valves in the rectum?

    <p>To prevent feces from being expelled with gas (D)</p> Signup and view all the answers

    Which of the following describes the peritoneal relationships of the cecum and appendix?

    <p>Retroperitoneal (B)</p> Signup and view all the answers

    What is a potential consequence of appendicitis if left untreated?

    <p>Peritonitis (C)</p> Signup and view all the answers

    Which type of epithelium is found in the anal canal to withstand abrasion?

    <p>Stratified squamous epithelium (C)</p> Signup and view all the answers

    What stimulates the mass movement of fecal matter in the large intestine?

    <p>Gastrocolic reflex (C)</p> Signup and view all the answers

    Which of the following is a characteristic of fecal matter's propulsion towards the anus?

    <p>Mass movements triggered by eating (A)</p> Signup and view all the answers

    What condition is indicated by the presence of watery stools due to insufficient absorption in the large intestine?

    <p>Diarrhea (D)</p> Signup and view all the answers

    Which component of bacterial flora in the large intestine plays a role in synthesizing certain vitamins?

    <p>Beneficial bacteria (C)</p> Signup and view all the answers

    What is a common factor that can lead to constipation in individuals?

    <p>Prolonged inactivity (B)</p> Signup and view all the answers

    What is the main reason for the formation of hemorrhoids in the anal canal?

    <p>Inflammation of superficial venous plexuses (C)</p> Signup and view all the answers

    What is the main function of the small intestine?

    <p>Digestion and absorption of nutrients (C)</p> Signup and view all the answers

    Which of the following is NOT a subdivision of the small intestine?

    <p>Cecum (C)</p> Signup and view all the answers

    How is the surface area of the small intestine increased to facilitate nutrient absorption?

    <p>Through the presence of villi and microvilli (C)</p> Signup and view all the answers

    Which cells in the small intestine are responsible for secreting mucus?

    <p>Goblet cells (A)</p> Signup and view all the answers

    What type of enzymes are bound to the plasma membrane of microvilli in the small intestine?

    <p>Brush border enzymes (B)</p> Signup and view all the answers

    What is the composition of intestinal juice primarily made up of?

    <p>Water and mucus (A)</p> Signup and view all the answers

    What specific feature of the small intestine helps in mixing chyme and digestive secretions?

    <p>Segmentation (B)</p> Signup and view all the answers

    How does the ileocecal valve function in regulating the flow of chyme into the large intestine?

    <p>Opens due to segmentation pressure (B)</p> Signup and view all the answers

    Which part of the small intestine has the most features of interest, including a retroperitoneal position?

    <p>Duodenum (B)</p> Signup and view all the answers

    What is the primary reason chemotherapy can cause gastrointestinal symptoms?

    <p>It targets rapidly dividing cells, including GI cells (D)</p> Signup and view all the answers

    What are Peyer's patches and where are they located?

    <p>Aggregated lymphoid nodules in the ileum (B)</p> Signup and view all the answers

    Which glands in the duodenum produce alkaline mucus?

    <p>Duodenal glands (C)</p> Signup and view all the answers

    What is the role of enteroendocrine cells in the small intestine?

    <p>Release enterogastrones like CCK and secretin (D)</p> Signup and view all the answers

    What modifications of the small intestine wall reflect its function in digestion?

    <p>Presence of intestinal crypts and specialized cells (D)</p> Signup and view all the answers

    Flashcards

    Pancreas Location

    Mostly behind the stomach, with its head wrapped around the duodenum and tail near the spleen.

    Pancreatic Juice Composition

    A watery, alkaline solution containing electrolytes (mostly bicarbonate) and digestive enzymes like proteases, amylase, lipases, and nucleases. The enzymes are initially inactive.

    Pancreatic Exocrine Function

    The pancreas releases pancreatic juice into the small intestine via a duct system, aiding digestion.

    Pancreatic Endocrine Function

    The pancreas secretes hormones like insulin and glucagon into the bloodstream, managing blood sugar levels.

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    Hepatopancreatic Ampulla

    A bulb-like structure where the bile duct and pancreatic duct meet.

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    CCK and Secretin

    Hormones that stimulate bile and pancreatic juice release in response to chyme.

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    Major Duodenal Papilla

    A volcano-shaped opening where the ampulla releases its contents into the duodenum.

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    Hepatopancreatic Sphincter

    A ring of muscle that controls the flow of bile and pancreatic juice into the duodenum.

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    Small intestine function

    The small intestine is the primary organ for digestion and absorption of nutrients.

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    Small intestine length

    The small intestine is about 7-13 feet long, extending from the pyloric sphincter to the ileocecal valve.

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    Duodenum

    The first part of the small intestine, which is mostly behind the abdominal wall and about 10 inches long.

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    Jejunum

    The middle part of the small intestine, approximately 8 feet long, and attached posteriorly by the mesentery.

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    Ileum

    The last part of the small intestine, about 12 feet long, attached posteriorly by the mesentery, and connects to the large intestine at the ileocecal valve.

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    Surface area of small intestine

    The small intestine has a significantly increased surface area (~200 m²) for efficient nutrient absorption.

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    Circular folds

    Permanent folds in the small intestine that slow chyme movement, increasing absorption time.

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    Villi

    Finger-like projections in the small intestine mucosa, containing capillaries and a lacteal for nutrient absorption.

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    Microvilli

    Tiny projections on the surface of the villi, increasing surface area for absorption and containing brush-border enzymes.

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    Intestinal crypts

    Tubular glands in the small intestine between villi, producing intestinal juice and containing different cell types.

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    Enterocytes

    Cells in the villi that absorb nutrients and electrolytes, and in the crypts, produce intestinal juice, containing brush border enzymes on their membranes.

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    Goblet cells

    Cells in the intestinal crypts that secrete mucus for lubrication and carrier fluid for nutrient absorption.

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    Peyer's patches

    Clusters of lymphoid tissue in the ileum's submucosa that protect against microorganisms

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    Intestinal juice

    A watery mixture of mucus secreted by the duodenal glands and goblet cells, aids in nutrient absorption from chyme.

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    Ileocecal valve

    The valve controlling the passage of chyme from the ileum into the large intestine, preventing regurgitation

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    Digestion

    The breakdown of food into smaller molecules that can be absorbed by the body.

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    Absorption

    The process of taking in nutrients from the digested food into the bloodstream.

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    What type of molecules can be absorbed?

    Only monomers, the simplest building blocks of food molecules, can be absorbed.

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    Hydrolysis

    The process of breaking down chemical bonds using water.

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    Tight Junctions

    Specialized connections between cells in the intestinal lining that prevent substances from passing between cells.

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    Apical Membrane

    The surface of an intestinal cell facing the lumen (inside of the gut) where nutrients enter.

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    Basolateral Membrane

    The surface of an intestinal cell facing the bloodstream where nutrients exit.

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    Lipid Absorption

    Lipids can be absorbed passively, while other substances need carrier proteins.

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    Active Transport

    The movement of molecules across a membrane using energy, typically from ATP.

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    Lactose Intolerance

    A condition where someone lacks enough lactase enzyme to digest lactose, causing digestive issues.

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    Teniae coli

    Three bands of longitudinal smooth muscle in the muscularis layer of the large intestine, causing characteristic bulges called haustra.

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    Haustra

    Pocket-like sacs in the large intestine, due to the tone of the teniae coli, that give it a segmented appearance.

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    What is the cecum?

    The first part of the large intestine, connected to the ileum of the small intestine.

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    Appendix

    A small, finger-like projection off the cecum containing lymphoid tissue, part of the MALT of the immune system.

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    Colon

    The major part of the large intestine, divided into ascending, transverse, descending, and sigmoid regions.

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    Ascending colon

    The region of the colon that travels upwards on the right side of the abdomen, retroperitoneal.

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    Transverse colon

    The region of the colon that travels across the abdomen, intraperitoneal.

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    Descending colon

    The region of the colon that travels downwards on the left side of the abdomen, retroperitoneal.

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    Sigmoid colon

    The S-shaped portion of the colon that travels through the pelvis, intraperitoneal.

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    Rectum

    The last part of the large intestine, located above the anal canal, responsible for storing feces before defecation.

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    Anal canal

    The final segment of the large intestine, opening to the exterior at the anus, containing both internal and external sphincters.

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    Appendicitis

    An acute inflammation of the appendix, usually caused by a blockage trapping bacteria.

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    What are the main symptoms of appendicitis?

    Pain starting near the navel, moving to the lower right abdomen, loss of appetite, nausea, vomiting, and potentially fever.

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    What is the typical treatment for appendicitis?

    Surgical removal of the appendix (appendectomy), sometimes with antibiotics.

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    What is the main function of the large intestine?

    Absorption of water and electrolytes, vitamin production by bacteria, and propulsion of feces towards the anus.

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    Fat-soluble vitamin absorption

    Vitamins A, D, E, and K are transported within micelles and absorbed by diffusion in the small intestine.

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    Water-soluble vitamin absorption

    Vitamins C and B are absorbed in the small intestine using either passive or active transport mechanisms.

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    Vitamin B12 absorption

    Vitamin B12 binds to intrinsic factor in the small intestine and is absorbed through endocytosis.

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    Electrolyte absorption

    Most electrolytes are actively transported along the small intestine.

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    Iron absorption

    Iron absorption is regulated based on bodily need. Ionic iron is stored in mucosal cells with ferritin.

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    Calcium absorption

    Calcium absorption is regulated by vitamin D and PTH. PTH activates vitamin D, promoting calcium absorption.

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    Water absorption in small intestine

    Most water (95%) is absorbed in the small intestine through osmosis, coupled with solute uptake.

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    Water absorption in large intestine

    The remaining water (most of the 5% not absorbed in the small intestine) is absorbed in the large intestine.

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    Study Notes

    Pancreas

    • Located retroperitoneally, deep to the stomach's greater curvature, with its head encircled by the duodenum and tail near the spleen.
    • Exocrine function: secretes pancreatic juice via ducts. Acini are clusters of secretory cells producing zymogen granules containing proenzymes (inactive digestive enzymes).
    • Endocrine function: secretes insulin and glucagon via pancreatic islet cells.
    • Pancreatic juice composition: watery, alkaline solution (pH 8) to neutralize acidic chyme. Contains electrolytes (primarily bicarbonate) and digestive enzymes (proteases [for proteins], amylase [for carbohydrates], lipases [for lipids], nucleases [for nucleic acids]). Proteases are secreted in inactive form to prevent self-digestion.

    Bile & Pancreatic Secretion

    • Bile and pancreatic ducts unite in the hepatopancreatic ampulla in the duodenum.
    • The ampulla opens into the duodenum via a major duodenal papilla.
    • Hepatopancreatic sphincter controls the entry of bile and pancreatic juice into the duodenum.
    • Regulation: Neural and hormonal controls stimulate bile and pancreatic juice secretion. Hormonal controls include cholecystokinin (CCK) and secretin. Bile secretion increases with: enterohepatic circulation returning large amounts of bile salts; duodenal mucosa secreting secretin in response to acidic chyme; and duodenal mucosa secreting CCK in response to fatty chyme. The hepatopancreatic sphincter is closed unless active digestion occurs. Bile is stored in the gallbladder and released to the small intestine only with contraction.

    Relationship: Liver, Gallbladder, & Pancreas

    • The liver's right and left hepatic ducts combine into a common hepatic duct.
    • The common hepatic duct joins the bile duct and the Pancreatic duct in the hepatopancreatic ampulla, which is in the duodenum.
    • A major duodenal papilla is the opening to the duodenum.

    Small Intestine

    • Major organ of digestion and absorption, extending 7-13 ft from the pyloric sphincter to the ileocecal valve.
    • Subdivisions:
      • Duodenum (~10 inches): mostly retroperitoneal, curves around pancreas.
      • Jejunum (~8 feet): attached posteriorly by mesentery.
      • Ileum (~12 feet): attached posteriorly by mesentery, joins large intestine at ileocecal valve.
    • Structural modifications for absorption: greatly increased surface area (approximately 200 m2) via circular folds, villi, and microvilli. Circular folds are permanent folds that slow chyme. Villi are fingerlike projections with a capillary bed and lacteal. Microvilli form the brush border containing brush border enzymes for final digestion.

    Microscopic Anatomy Small Intestine

    • Intestinal crypts: tubular glands between villi.
    • Cell types:
      • Enterocytes: absorb nutrients and electrolytes; contain brush border enzymes.
      • Goblet cells: secrete mucus.
      • Enteroendocrine cells: source of enterogastrones.
      • Paneth cells: secrete antimicrobial agents.
    • MALT (mucosa-associated lymphoid tissue) protects against microorganisms. Peyer's patches in ileum extend into submucosa.
    • Submucosa contains areolar tissue and duodenal glands in the duodenum, secreting alkaline mucus to neutralize acidic chyme.

    Clinical View - Cancer Treatments

    • Cancer treatments targeting rapidly dividing cells (e.g., radiation and chemotherapy) can cause nausea, vomiting, and diarrhea as a side effect due to targeting the GI tract epithelium.

    Intestinal Juice

    • 1-2 L secreted daily in response to distension or irritation of the mucosa. Hypertonic or acidic chyme is the major stimulus. Slightly alkaline and isotonic with blood plasma. Consists largely of water and mucus, secreted by duodenal glands and goblet cells.

    Digestive Processes in Small Intestine

    • Chyme contains partly digested carbohydrates, proteins, and undigested fats. Takes 3-6 hours to absorb nutrients and water.
    • Enzymes from liver and pancreas aid in digestion, and brush border enzymes complete the process.
    • Chyme is hypertonic, so slow delivery prevents water loss. Chyme's pH is adjusted, and it's mixed with bile and pancreatic juice. Enterogastric reflex and hormones control chyme entry.
    • Motility: Segmentation (mechanical breakdown) is common after a meal, mixing chyme with enzymes and bile. Between meals, peristaltic waves (propulsion) move remnants every 90-120 minutes towards the large intestine. Ileum and ileocecal valve control passage into the large intestine.

    Large Intestine

    • Unique features include taenia coli (3 bands of longitudinal smooth muscle) and haustra (pocketlike sacs).
    • Subdivisions: cecum, appendix (lymphoid tissue), colon (ascending, transverse, descending, sigmoid), rectum, and anal canal. The anal canal has an internal and external anal sphincter. Superficial venous plexuses can form hemorrhoids if inflamed. Rectal valves prevent feces from being passed with gas.

    Appendix

    • Contains masses of lymphoid tissue (part of MALT).
    • A bacterial storehouse.
    • Twisted shape can be susceptible to blockages.

    Clinical View - Appendicitis

    • Acute inflammation of the appendix often caused by blockage and trapped bacteria.
    • Most common in adolescence.
    • Venous drainage impairment can lead to ischemia and necrosis.
    • Ruptured appendix can cause peritonitis.
    • Symptoms include pain, loss of appetite, nausea, and vomiting.
    • Treatment is usually surgical removal (appendectomy) or antibiotics in some cases.

    Large Intestine Microscopic Anatomy

    • Thicker mucosa of simple columnar epithelium, except in the anal canal (where stratified squamous epithelium is present to withstand abrasion).
    • Lacks circular folds, villi, and digestive secretions. Contains abundant deep crypts with mucus-producing goblet cells.

    Bacterial Flora

    • Contains 1000+ types of bacteria, vastly outnumbering our own cells.
    • Colonizes the colon from the small intestine or anus.
    • Metabolic functions: ferment indigestible carbohydrates and mucin, producing short-chain fatty acids and gases (flatus); synthesize B complex vitamins and some vitamin K.
    • Beneficial bacteria suppress pathogenic bacteria. Mounting evidence suggests gut bacteria influence body weight, mood, and susceptibility to various diseases (e.g., diabetes, atherosclerosis, fatty liver disease). Irritable bowel disease (IBD) might be due to the immune system attacking harmless bacteria. Interventions manipulating gut bacteria may become more routine.

    Digestive Processes in Large Intestine

    • Chyme resides 12-24 hours. No digestion occurs, except by enteric bacteria.
    • Absorbs vitamins made by bacterial flora, water, and electrolytes (largely NaCl).
    • Major functions are propulsion of feces to anus and defecation.
    • Motility: Mass movements (slow, powerful peristalsis) 3-4 times daily. Initiated by the gastrocolic reflex and fiber intake. Descending and sigmoid colon act as storage.
    • Defecation reflex initiates with mass movement: parasympathetic signals initiate actions. Relaxation of internal sphincter and voluntary relaxation of external sphincter follow. Valsalva's maneuver aids. Infants have involuntary defecation.

    Clinical View – Stool Imbalances

    • Diarrhea: watery stools due to insufficient water absorption in the large intestine (occurs due to colon irritation or physical forces). Prolonged diarrhea can lead to dehydration and electrolyte imbalances.
    • Constipation: hardened stools due to extended colon residence and excessive water absorption (caused by insufficient fiber/fluid, improper habits, lack of exercise, or anesthesia).

    Mechanisms of Digestion & Absorption

    • Digestion breaks ingested foods into absorbable building blocks.
    • Enzymes carry out hydrolysis to break chemical bonds. Absorption moves substances into the body. Tight junctions force molecules through epithelial cells (not between). Lipid molecules can passively absorb; other substances need transport proteins. Nutrients are mainly absorbed via active transport.

    Digestion of Carbohydrates

    • Only monosaccharides are absorbed.
    • Starch and disaccharides are broken down to oligosaccharides and disaccharides (begins with salivary amylase). Further broken down (lactose, maltose, sucrose) to monosaccharides (glucose, fructose, galactose).
    • In the intestine: pancreatic amylase breaks down starch or glycogen; brush border enzymes further break resulting molecules into monosaccharides.

    Digestion of Proteins

    • Proteins are broken down into large polypeptides, then smaller peptides into amino acids (some dipeptides and tripeptides).
    • Digestion begins in the stomach with pepsinogen converting to pepsin (active at pH 1.5–2.5, inactive at higher pH in the duodenum).
    • Pancreatic proteases and brush border enzymes further break down proteins and peptides to amino acids.

    Digestion of Lipids

    • Emulsification: bile salts break large fat globules into smaller ones.
    • Digestion: pancreatic lipases break triglycerides into fatty acids and monoglycerides.
    • Micelle formation: digested lipid products coat with bile salts, making them absorbable. Micelles are essential to access lipid surfaces and absorb them.
    • Diffusion: Lipid products move from micelles to the epithelial membrane via diffusion. Lipids are converted back to triglycerides and enter lymphatic lacteals. Short-chain fatty acids directly enter the blood.

    Digestion of Nucleic Acids

    • Pancreatic nucleases hydrolyze DNA and RNA to nucleotides.
    • Brush border enzymes further break nucleotides into free nitrogenous bases, pentose sugars, and phosphate ions.

    Clinical View - Absorption Inbalances

    • Lactose intolerance: deficient lactase enzyme causes undigested lactose, an osmotic gradient, diarrhea, gas, bloating, and cramps. Treatment involves lactase supplements.
    • Malabsorption: impaired nutrient absorption due to damage to the intestinal mucosa (infection, antibiotics, celiac disease). Celiac disease is an immune reaction to gluten harming intestinal villi. Treatment involves a gluten-free diet.

    Absorption of Vitamins, Electrolytes, & Water

    • Fat-soluble vitamins (A, D, E, K) are absorbed by diffusion with micelles. Water-soluble vitamins (C, B) are absorbed via passive or active transport. Vitamin B12 requires intrinsic factor for absorption by endocytosis.
    • Electrolyte absorption: most ions are actively transported along the small intestine (with exceptions of iron and calcium absorption related to need). Iron stores in mucosal cells (ferritin). Calcium absorption regulated by vitamin D and PTH -- PTH stimulates vitamin D activation for calcium absorption.
    • Water absorption: 9 L water enters small intestine. 95% absorbed in the small intestine and rest in large intestine by osmosis coupled with solute uptake.

    Developmental Aspects of Digestive System

    • Alimentary canal forms by week 5.
    • Fetal nutrition is via placenta, but amniotic fluid stimulates GI tract maturation.
    • Infants progress to solid foods and an adult diet by 2 years.
    • GI activity declines in aging with reduced digestive juice, decreased absorption, slowed peristalsis, less frequent bowel movements. Taste/smell becomes less acute, and periodontal diseases develop. Fecal incontinence and GI cancers are more common. Most GI cancers are treatable early. Screenings (e.g., for colorectal cancer) and prevention through regular examinations are important.

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    Description

    This quiz covers the anatomy and functions of the pancreas, including its exocrine and endocrine roles, as well as the composition of pancreatic juice. Additionally, it explores the relationship between bile and pancreatic secretion and their entry into the duodenum.

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