Pancreas and Bile Secretion
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Questions and Answers

What mechanism is involved in the absorption of Vitamin B12?

  • Facilitated diffusion
  • Active transport
  • Passive transport
  • Endocytosis (correct)
  • Which vitamins are primarily absorbed in the large intestine?

  • Fat-soluble vitamins
  • Vitamin K and B vitamins (correct)
  • Vitamin A and D
  • Water-soluble vitamins
  • How is calcium absorption regulated in the body?

  • By passive diffusion
  • By iron levels
  • By vitamin D and parathyroid hormone (correct)
  • By the availability of fat-soluble vitamins
  • What happens to water absorption in the small intestine?

    <p>Coupled with electrolyte absorption (D)</p> Signup and view all the answers

    What role does the pancreas play in digestion?

    <p>Produces pancreatic juice containing digestive enzymes (D)</p> Signup and view all the answers

    What decline in the digestive system is common with aging?

    <p>Decreased production of digestive juices (C)</p> Signup and view all the answers

    Which of the following components is found in pancreatic juice?

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

    What is the primary source of fetal nutrition before birth?

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

    Which of the following is a common issue faced by the elderly related to the digestive system?

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

    What is the primary function of secretin in the digestive process?

    <p>Regulates pancreatic juice secretion (B)</p> Signup and view all the answers

    Where does the major duodenal papilla release bile and pancreatic juice?

    <p>Into the duodenum (A)</p> Signup and view all the answers

    What substance stores ionic iron in mucosal cells?

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

    In what state is trypsin secreted to prevent self-digestion?

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

    Which statement about the regulation of bile secretion is correct?

    <p>Increased when large amounts of bile salts return via enterohepatic circulation (B)</p> Signup and view all the answers

    Which enzyme is responsible for the digestion of carbohydrates?

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

    What controls the entry of bile and pancreatic juice into the duodenum?

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

    What is the primary function of enzymes during digestion?

    <p>To hydrolyze chemical bonds in macromolecules (A)</p> Signup and view all the answers

    What role does bile salt play in lipid digestion?

    <p>It emulsifies large fat globules into smaller ones (B)</p> Signup and view all the answers

    When does protein digestion begin in the digestive system?

    <p>In the stomach with pepsin formation (C)</p> Signup and view all the answers

    Which of the following describes the absorption of nutrients in the intestine?

    <p>Most nutrients are absorbed through active transport processes (C)</p> Signup and view all the answers

    What type of molecules can be absorbed passively through the cell membrane?

    <p>Lipid molecules (A)</p> Signup and view all the answers

    What results from the deficiency of the lactase enzyme in lactose intolerant individuals?

    <p>Undigested lactose causing diarrhea (B)</p> Signup and view all the answers

    Which step follows the formation of micelles in the digestion of lipids?

    <p>Diffusion of lipid products across the epithelial membrane (D)</p> Signup and view all the answers

    Which of the following is NOT a product of carbohydrate digestion?

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

    What condition can lead to malabsorption of nutrients in the intestines?

    <p>Immune reaction to gluten (C)</p> Signup and view all the answers

    During nucleic acid digestion, which enzyme breaks down DNA and RNA into nucleotide monomers?

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

    What is the primary function of the small intestine?

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

    Which subdivision of the small intestine is about 10 inches long and primarily retroperitoneal?

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

    What structure increases the surface area of the small intestine for nutrient absorption?

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

    Which cells in the small intestine primarily absorb nutrients and electrolytes?

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

    What is the function of the intestinal crypts in the small intestine?

    <p>Produce intestinal juice (A)</p> Signup and view all the answers

    Which process is primarily responsible for mixing chyme with digestive enzymes after a meal?

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

    What type of enzymes are responsible for the final digestion of proteins, carbohydrates, and nucleic acids in the small intestine?

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

    What stimulates the production of intestinal juice in the small intestine?

    <p>Distension or irritation of the mucosa (C)</p> Signup and view all the answers

    Which part of the small intestine joins the large intestine at the ileocecal valve?

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

    What is a significant side effect of chemotherapy related to the small intestine?

    <p>Damage to rapidly dividing cells in the GI tract (B)</p> Signup and view all the answers

    What prevents the regurgitation of chyme into the ileum?

    <p>Ileocecal valve (A)</p> Signup and view all the answers

    Which clinical feature is associated with the structure of the small intestine?

    <p>Presence of Peyer's patches (C)</p> Signup and view all the answers

    The primary function of bile in the digestive process is to:

    <p>Emulsify fats (A)</p> Signup and view all the answers

    How does the small intestine regulate chyme entry?

    <p>Via enterogastric reflex and enterogastrones (A)</p> Signup and view all the answers

    What unique feature of the large intestine is caused by the tone of the teniae coli?

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

    Which section of the large intestine is primarily responsible for water and electrolyte absorption?

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

    The appendix is primarily involved in what type of immune function?

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

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

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

    Which of the following is NOT a function of bacterial flora in the large intestine?

    <p>Digestive enzyme production (A)</p> Signup and view all the answers

    What can happen as a result of an inflamed appendix?

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

    What is the primary mechanism that initiates the defecation reflex?

    <p>Mass movements in the large intestine (D)</p> Signup and view all the answers

    Which condition arises when the large intestine absorbs too much water?

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

    What primarily triggers strong contractions in the colon?

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

    Which of the following is true regarding the structure of the large intestine?

    <p>It has thicker mucosa than the small intestine. (A)</p> Signup and view all the answers

    Diarrhea may occur due to which of the following factors?

    <p>Irritation of the colon (A)</p> Signup and view all the answers

    What part of the large intestine is primarily responsible for storage?

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

    What is the role of the internal anal sphincter during the defecation reflex?

    <p>Relaxation to allow expulsion (D)</p> Signup and view all the answers

    Vascular structures in the anal canal that can lead to hemorrhoids when inflamed are called what?

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

    Which phase of the cardiac cycle involves the closure of the AV valves?

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

    What happens during the T wave on an electrocardiogram (ECG)?

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

    Which factor decreases stroke volume (SV)?

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

    Which symptom is specifically associated with left-sided heart failure?

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

    What is the primary treatment method for fibrillation?

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

    What is the primary function of the right side of the heart?

    <p>To pump oxygen-poor blood to the lungs (C)</p> Signup and view all the answers

    Which layer of the heart is responsible for its contraction?

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

    What prevents the atrioventricular valves from everting during ventricular contraction?

    <p>Chordae tendineae (A)</p> Signup and view all the answers

    Which chamber of the heart receives deoxygenated blood from the entire body?

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

    Where does the blood flow first after leaving the right ventricle?

    <p>Pulmonary trunk (A)</p> Signup and view all the answers

    Which feature characterizes the left ventricle compared to the right ventricle?

    <p>Thicker walls for systemic circulation (B)</p> Signup and view all the answers

    What role do intercalated discs play in cardiac muscle?

    <p>Ensure coordinated contraction (A)</p> Signup and view all the answers

    Which component of the intrinsic conduction system delays the impulse before it reaches the ventricles?

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

    Flashcards

    Pancreas location

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

    Pancreatic exocrine function

    Pancreas releases pancreatic juice to aid digestion, via the pancreatic duct.

    Pancreatic acini

    Clusters of cells within the pancreas that produce digestive enzymes.

    Pancreatic endocrine function

    Secretion of hormones like insulin and glucagon.

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    Pancreatic juice composition

    Watery, alkaline solution containing bicarbonate, electrolytes, and digestive enzymes.

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    Hepatopancreatic ampulla

    Bulb-shaped structure where bile and pancreatic ducts join before entering the duodenum.

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    Hormonal control of bile & pancreatic secretion

    Cholecystokinin (CCK) and secretin regulate bile and pancreatic juice release based on chyme composition.

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    Hepatopancreatic sphincter

    A circular muscle that controls the entry of bile and pancreatic juice into the duodenum; closes unless digestive activity is required.

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    Small intestine function

    Major organ of digestion and absorption of nutrients.

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    Small intestine length

    7-13 feet long, from pyloric sphincter to ileocecal valve.

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    Duodenum

    First part of the small intestine, about 10 inches long, and surrounds part of the pancreas.

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    Jejunum

    Middle section of the small intestine, about 8 feet long, attached to the posterior abdominal wall.

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    Ileum

    Last part of the small intestine, about 12 feet long, connects to the large intestine via ileocecal valve.

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    Increased surface area

    Small intestine's adaptation for efficient nutrient absorption.

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    Circular folds

    Permanent folds in the small intestine that slow chyme movement.

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    Villi

    Finger-like projections in the small intestine mucosa, increasing surface area.

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    Microvilli

    Tiny projections on the surface of villi, further increase surface area.

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    Intestinal crypts

    Tubular glands between villi, producing intestinal juice.

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    Enterocytes

    Cells in villi that absorb nutrients and electrolytes.

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    Goblet cells

    Mucus-secreting cells of the small intestine.

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    Paneth cells

    Cells in crypts that secrete antimicrobial agents.

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    Peyer's patches

    Lymphoid tissue in the ileum, part of the immune system.

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    Ileocecal valve

    Valve that controls the flow of chyme from small to large intestine.

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    Digestion

    The breakdown of ingested food into small molecules for absorption.

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    Absorption

    The process of moving nutrients from the gut into the body.

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    Carbohydrate Digestion

    Breaking down complex carbohydrates into simple sugars (monosaccharides) for absorption.

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    Protein Digestion

    Breaking down proteins into amino acids for absorption.

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    Lipid Digestion

    Breaking down fats into fatty acids and glycerol for absorption.

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    Monosaccharides

    Single sugar units; the end product of carbohydrate digestion.

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    Amino Acids

    The building blocks of proteins, the end product of protein digestion.

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    Enzymes

    Biological catalysts that speed up chemical reactions, crucial for digestion.

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    Lactose Intolerance

    Inability to digest lactose due to insufficient lactase enzyme.

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    Malabsorption

    Impaired absorption of nutrients from the intestines.

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    Fat-soluble vitamins absorption

    Vitamins A, D, E, and K are absorbed in the small intestine with the help of micelles and diffusion.

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    Water-soluble vitamins absorption

    Vitamins C and B are absorbed in the small intestine via passive or active transport.

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    Vitamin B12 absorption

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

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    Iron absorption

    Iron absorption is regulated by the body's need and is stored in mucosal cells as ferritin.

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    Calcium absorption

    Calcium absorption is regulated by vitamin D and PTH.

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    Water absorption

    Most water absorption happens in the small intestine, and the rest in the large intestine.

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    Aging and GI activity

    With age, digestive system activity declines, including reduced juice production, less efficient absorption, and slower peristalsis.

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    Preventing GI cancer

    Regular dental and medical checkups, as well as screening for polyps, can help prevent GI cancers.

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    Teniae coli

    Three bands of longitudinal smooth muscle in the large intestine's muscularis.

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    Haustra

    Pocket-like sacs in the large intestine caused by the tone of the teniae coli.

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    Appendix

    Part of the MALT immune system, a lymphoid tissue structure in the cecum.

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    Ascending colon

    Part of the large intestine, traveling up the right side of the abdomen.

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    Descending colon

    Part of the large intestine, traveling down the left side of the abdomen.

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    Sigmoid colon

    S-shaped portion of the large intestine in the pelvis.

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    Rectal valves

    Three valves that prevent gas from passing with feces.

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    Appendicitis

    Inflammation of the appendix, commonly due to blockage.

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    Internal anal sphincter

    Smooth muscle sphincter at the end of the anal canal.

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    External anal sphincter

    Skeletal muscle sphincter at the end of the anal canal.

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    Hemorrhoids

    Inflamed superficial venous plexuses in the anal canal.

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    Bacterial flora

    The diverse bacteria in the colon, outnumbering our own cells.

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    Mass movements

    Powerful peristaltic waves in the colon, moving stool.

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    Gastrocolic reflex

    Reflex that increases colon contractions, triggered by food in the stomach.

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    Pulmonary Circuit

    The right side of the heart pumps oxygen-poor blood to the lungs to release carbon dioxide (CO₂) and pick up oxygen (O₂).

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    Systemic Circuit

    The left side of the heart pumps oxygen-rich blood to the body tissues, delivering oxygen for cellular functions.

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    Pericardium

    A double-walled sac surrounding the heart, protecting it and preventing overfilling. It also lubricates the heart for smooth beating.

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    Myocardium

    The middle layer of the heart wall, composed of contractile cardiac muscle, responsible for pumping blood.

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    Atria

    The two upper chambers of the heart, receiving blood from the body and lungs.

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    Ventricles

    The two lower chambers of the heart, responsible for pumping blood to the lungs and body.

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    Cardiac Muscle Structure

    Cardiac muscle cells are striated, branched, have a single nucleus, and are interconnected by specialized structures called intercalated discs.

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    Intrinsic Conduction System

    A specialized network of pacemaker cells within the heart that initiate and coordinate heartbeats without external nervous input.

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    Fibrillation

    Rapid, irregular heartbeats

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    Heart Block

    Disruption of electrical conduction between atria and ventricles, often due to AV node damage

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    ECG Waves

    Represent distinct electrical activities of the heart

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    Cardiac Output (CO)

    The volume of blood pumped by the heart per minute

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    Heart Failure

    Inability of the heart to pump blood effectively

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    Study Notes

    Pancreas

    • Located mostly retroperitoneally, deep to stomach's greater curvature; head encircled by duodenum, tail near spleen
    • Exocrine function: secretes pancreatic juice via ducts
      • Acini: clusters of secretory cells producing zymogen granules (inactive digestive enzymes)
    • Endocrine function: secretes insulin and glucagon via pancreatic islet cells
    • Pancreatic juice composition: watery, alkaline (pH 8) to neutralize stomach acid
      • Electrolytes (primarily HCO₃⁻) and enzymes
        • Proteases (e.g., trypsin): inactive form to prevent self-digestion
        • Amylase (carbohydrates)
        • Lipases (lipids)
        • Nucleases (nucleic acids)

    Bile and Pancreatic Secretion

    • Bile duct and pancreatic duct unite in duodenum wall forming hepatopancreatic ampulla
    • Ampulla opens into duodenum via major duodenal papilla
    • Hepatopancreatic sphincter controls bile and pancreatic juice entry
    • Regulation: neural and hormonal controls
      • Hormones: cholecystokinin (CCK) and secretin
      • Bile secretion increased by:
        • Enterohepatic circulation returning bile salts
        • Responses to acidic (secretin) and fatty (CCK) chyme by duodenal mucosa cells
      • Hepatopancreatic sphincter closed except during digestion; bile stored in gallbladder

    Liver, Gallbladder, and Pancreas Relationship

    • Liver's hepatic ducts merge to form common hepatic duct, which joins bile duct
    • Gallbladder connects to bile duct via cystic duct
    • Pancreas' main pancreatic duct joins bile duct at ampulla
    • All structures empty into duodenum at major duodenal papilla

    Small Intestine

    • Major organ of digestion and absorption (7-13 ft)
    • Subdivisions:
      • Duodenum (~10 in): retroperitoneal, curves around pancreas
      • Jejunum (~8 ft): attached posteriorly by mesentery
      • Ileum (~12 ft): attached posteriorly by mesentery, joins large intestine at ileocecal valve
    • Structural modifications for absorption:
      • Circular folds: permanent folds increasing surface area (600x)
      • Villi: finger-like projections with capillary beds and lacteals (lymphatic capillaries)
      • Microvilli: cytoplasmic extensions forming brush border with brush border enzymes for final digestion

    Small Intestine Histology

    • Mucosa and submucosa modifications reflect digestive function
    • Intestinal crypts: tubular glands between villi
      • Enterocytes: absorb nutrients and electrolytes with brush border enzymes
      • Goblet cells: secrete mucus
      • Enteroendocrine cells: secrete enterogastrones (e.g., CCK, secretin)
      • Paneth cells: secrete antimicrobial agents
    • MALT: protects against microorganisms; Peyer's patches in ileum
    • Duodenal glands (submucosa): secrete alkaline mucus to neutralize chyme

    Intestinal Juice

    • 1-2 L secreted daily in response to distension/irritation
    • Composed of water, mucus (duodenal glands and goblet cells)
    • Slightly alkaline and isotonic with blood plasma

    Digestive Processes in Small Intestine

    • Chyme (partially digested) takes 3-6 hours in small intestine for nutrient/water absorption
    • Enzymes: imported from liver and pancreas; brush-border enzymes finalize digestion
    • Chyme entry regulation: slow entry to prevent osmotic water loss; adjust pH and mix with digestive fluids; controlled by enterogastric reflexes and hormones
    • Motility: segmentation (mixes) and peristaltic waves (propulsion)
      • Segmentation most common after meal
      • Peristaltic waves occur every 90-120 minutes; move remnants/bacteria
      • Ileocecal valve controls chyme entry into large intestine

    Large Intestine

    • Unique features: teniae coli (muscle bands), haustra (pockets)
    • Subdivisions: cecum, appendix (lymphoid tissue), colon (ascending, transverse, descending, sigmoid), rectum, anal canal (internal and external sphincters)
    • Relationship to peritoneum: some retroperitoneal segments (cecum, parts of colon, and rectum), intraperitoneal segments attached by mesocolons

    Appendicitis

    • Acute inflammation; usually from blockage (feces) trapping bacteria
    • Most common in adolescence
    • Symptoms: pain (umbilical area to lower right quadrant), loss of appetite, nausea, vomiting
    • Treatment: appendectomy

    Large Intestine Histology

    • Thicker mucosa (simple columnar epithelium except anal canal; stratified squamous)
    • Lacks circular folds, villi, and digestive secretions
    • Abundant mucus-producing goblet cells

    Bacterial Flora

    • 1000+ different types; outnumber human cells 10 to 1
    • Enter from small intestine/anus and colonize
    • Metabolic functions: fermentation yielding short-chain fatty acids (used for fuel), vitamin synthesis (B complex, K)
    • Beneficial bacteria suppress pathogens
    • Evidence suggests gut bacteria impact body weight, mood, and disease susceptibility

    Digestive Processes in Large Intestine

    • Residue remains 12-24 hours
    • Absorbs vitamins from bacterial flora, water and electrolytes (NaCl)
    • Functions: propel feces to anus; defecation
    • Motility: mass movements (3-4 times/day) driven by gastrocolic reflex and fiber
      • Descending and sigmoid colon act as storage reservoir
      • Defecation reflex:
        • Parasympathetic signals, relaxation of internal anal sphincter
        • Conscious control: relaxation of external sphincter
        • Valsalva's maneuver assists

    Stool Imbalances

    • Diarrhea: rapid transit, insufficient water absorption (e.g., infection, jarring) leading to dehydration and electrolyte imbalance
    • Constipation: extended colon transit time, causing hard stool (e.g., insufficient fiber/fluid, immobility)

    Mechanisms of Digestion and Absorption

    • Digestion: breakdown of food to absorbable molecules. Enzymes (intrinsic/accessory) hydrolyze macromolecules
    • Absorption: movement of molecules from lumen to body. Tight junctions ensure passage through cells; lipids passively; other substances by transport
    • Most digestion and absorption in small intestine

    Digestion of Carbohydrates

    • Only monosaccharides are absorbed
    • Starch and disaccharides broken down to monosaccharides (glucose, fructose, galactose)
      • Salivary amylase initiates starch digestion
      • Pancreatic amylase further digests starch
      • Brush border enzymes (duodenum) finalize digestion

    Digestion of Proteins

    • Dietary, enzymatic, and mucosal proteins broken down to amino acids (dipeptides/tripeptides) via pepsin (stomach)
      • Pancreatic proteases cleave to small peptides
      • Brush border enzymes further digest to amino acids

    Digestion of Lipids

    • Emulsification (bile salts) breaks large fat globules
    • Pancreatic lipase digests triglycerides to fatty acids and monoglycerides
    • Micelle formation: bile salts coat digestion products for absorption along enterocytes
    • Diffusion: lipids leave micelles, re-form triglycerides, enter lymphatic lacteals

    Digestion of Nucleic Acids

    • Pancreatic nucleases hydrolyze DNA/RNA to nucleotides
    • Brush border enzymes break nucleotides into components

    Absorption Imbalances

    • Lactose intolerance: deficient lactase, lactose remains undigested, osmotic diarrhea and gas
    • Malabsorption: impaired nutrient absorption (bacterial infection, antibiotics, celiac disease). Gluten-sensitive enteropathy (celiac disease) due to immune response to gluten

    Absorption of Vitamins, Electrolytes, and Water

    • Fat-soluble vitamins absorbed via micelles (diffusion)
    • Water-soluble vitamins absorbed via active/passive transport
    • Vitamin B12 absorbed via intrinsic factor and endocytosis
    • Electrolyte absorption (active transport), related to need (e.g. iron, calcium)
    • Calcium absorption influenced by vitamin D and PTH
    • Water (9 L) absorption mostly in small intestine

    Developmental Aspects

    • Alimentary canal forms by week 5
    • Fetal nutrition via placenta, but GI stimulated by amniotic fluid
    • Infants progress to solid foods
    • Aging: decline in GI activity, absorption, motility; taste/smell less acute; risk of periodontal disease, fecal incontinence and GI cancers

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    Explore the anatomy and functions of the pancreas, including its exocrine and endocrine roles. Understand the composition of pancreatic juice and the regulation of bile and pancreatic secretion in the digestive system.

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