Kavitha Msn Cne 25.7.14 Final

7/27/2019 Kavitha Msn Cne 25.7.14 Final

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13th -Continuing Nursing Education

DEPARTMENT OF MEDICAL SURICAL NURSIN

Th!"!#$Dig!sti%! dis!&u'i(iriu"-Nurs!s conc!rn$

Anato") and Ph)sio'og) o* U++!r Dig!sti%! s)st!"

Mrs,,a%itha,.M,Sc /N0

L!ctur!r

Facu't) o* Nursing

Sri Ra"achandra Uni%!rsit)

Dat!#2,4,15


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Introduction

A'i"!ntar) cana'.alsocalled dig!sti%! tract,

"outh.

+har)n6.

o!so+hagus

sto"achs"a'' int!stin!.

'arg! int!stin!. and

anus


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Activities of the Digestive System


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Overview of the Digestive System

Dig!sti%! s)st!" organs*a'' into t7o "ain grou+s#

Th! a'i"!ntar) cana' or th!gastroint!stina' /I0 tract.

Acc!ssor) dig!sti%! organs th! t!!th. tongu!. ga''('add!r. sa'i%ar) g'ands. 'i%!r. and +ancr!as,


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Secretions of the GI system


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Normal GIT-pH


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Layers of the alimentary canal

1,Mucosa is theinn!r"ost. "oist. !+ith!'ia'

"!"(ran! that 'in!s th! !ntir! dig!sti%! tract, It

secretes mucus, digestive enzymes, and hormones;

absorbs digestive end products into the blood; and

protects against infectious disease.


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,Su("ucosa connective tissue layer containing ('ood and ')"+hatic %!ss!'s. ')"+hoid *o''ic'!s. and n!r%!

*i(!rs,Contains the submucosal nerve plexus of Meissner, regulates glands and muscle of the muscularis mucosae.

3,Muscu'aris !6t!rnaSmooth muscleperistalsis and segmentation.controls motility of the G.I. tract.

5,S!rosa, the protective outer layer of

the intraperitoneal organs,


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N!r%! su++') to th! a'i"!ntr) cana'PARAS8MPAT9ETIC SUPPL8

VAGS N!"V!--ALI#!NTA"$ %ANAL

SA%"AL N!"V!-DISTAL &A"T '( TH! GI

T"A%T

EFFECTS OF

IN%"!AS!D #S%LA" A%TIVIT$

IN%"!AS!D &!"ISTALSIS

IN%"!AS!D A%TIVIT$ '( #$!NT!"I%

&L!)S

IN%"!AS!D GLANDLA" S!%"!TI'N

S8MPAT9ETIC SUPPL8

N#!"'S N!"V! THAT !#!"G!

("'# TH! S&INAL %'"D IN TH!

TH'"A%I% AND L#*A"

"!GI'NS

!!C"S #!

DECREASE #S%LA" A%TIVIT$

D!%"!AS! &!"ISTALSIS

L!SS STI#LATI'N '(#$!NT!"I% &L!)S

IN%"!AS!D GLANDLA"

S!%"!TI'N


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Anatomy of the Digestive System$ Mouth

Th! 'i+s and ch!!:score of s%eletal muscle covered externally by s%in

helps to %eep food bet&een the teeth &hen &e che&

plays a small role in speech.

Th! +a'at!the hard palate anteriorly

the soft palate posteriorly.


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Mouth$ Th! "outh -stratified s'uamous epithelial

mucosa(lined cavity

#ral Cavity )ounded by

$ 'i+s ant!rior').

$ Oro+har)n6 +ost!rior')

$ Lat!ra'')muscles

of the ch!!:s$ Su+!rior') bony

hard palate and

muscular soft palate


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Lips + %hee,s and Tongue

Li+s #Important in mastication

and speech

Ch!!:s#!acial muscles act to

move lips

U%u'a#pro*ects from posterior

of soft palate +alatine tonsils

lateral &alls of fauces

Tongu!#-oluntary muscular

structure that occupies the

floor of the mouth.


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Tongue-*lood and nerve supply

;'ood su++')xternal carotid

artery

NER


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Functions o* th! tongu!

che&ing 0mastication 4

s&allo&ing

0deglutition4

speech

taste


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Th! t!!th t!ar and grind *ood. (r!a:ing it

into s"a''!r +i!c!s,

T!!th T7o s!ts

Pri"ar), deciduous,

mil% 5ost during

childhood

P!r"an!nt or

s!condar)#6dult 0784

"ypes 9Incisors,

canines, premolars

and molars


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Functions o* th! t!!th

"eeth Involved in masticationand speech

"eeth have different shapesdepending on their functions.

Incisors and canine teeth arethe cutting teeth (used for

biting off pieces of food,

+remolar and molarteeth,&ith broad,flat surfaces,are used for grinding or

che&ing

Sa'i ar g'ands


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Sa'i%ar) g'ands-structur!

produce saliva,

cleanses the

mouth,

dissolves foodchemicals for taste,

moistens food, and

brea%do&n ofstarches.


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Sa'i%ar) g'ands

$ ;'ood su++')

xternal carotid arteries

-enous drainage is into the external*ugular veins

$ Intrinsic( buccal$ E6trinsic ( parotid, submandibular,

sublingual


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Co"+osition o* sa'i%a

$ :(:. litres ofsalivadaily

$ &ater(33.,cl>4$ salivary enzymes$ mucus$ lysozomes0bacterolyti

c 4$ Immunoglobulins 6$ )lood clotting factors


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S!cr!tion o* sa'i%a

$ 6utonomic nerve control

$ +S stimulation(profuse

secretion of &aterysaliva

$ Sympathetic stimulation(

secretion of smallamount of saliva

$ !rom submandibular

glands


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Sa'i%ar) 'ands1,&arotid.largest Serous /ust

anterior to the ear &arotidduct enters the oral cavity

ad0acent to the 1 nd upper

molar

1Su2mandi2ular. mi3ed+ 2utmore serous than mucous

Duct enters oral cavity on

either side of lingual frenulum

4Su2lingual.smallest #i3ed+2ut primarily mucous !ach

has 56- 51 ducts that enter the

floor of the oral cavity Lingual

glands


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Functions o* th! sa'i%ar)

g'and+roduce saliva+revents bacterial infection5ubrication

Contains salivary amylase that brea%sdo&n starch into disaccharides,maltoseand isomaltose 0gives starch s&eet tastein mouth4.

?elps to form bolus for s&allo&ing+arasympathetic input causes salivary

production


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Phar)n6&haryn3 oro+har)n6 and

'ar)ngo+har)n6

Passag! 7a) *or *ood.

*'uids. and air,

;'ood su++')

Facia' art!ri!s

*acia' %!in and th! int!rna'

=ugu'ar %!ins,

N!r%! su++')

PS> S)"+ath!tic-

Phar)ng!a' n!r%!

PS-'osso+harng!a' >

%agus n!r%!


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Structur! o* th! O!so+hagus$ := inches long

$ pharynx to the stomach.

$ @oins the pharynx at the

sixth cervical vertebra and

$ Aiaphragm at the tenth

thoracic vertebra.$ +arallel to the

larynxtrachea ,

$ 6rch of the aorta cross

the front of theoesophagus and

$ #esophagus enters the

stomach.


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Functions o* th! o!so+hagus

$ )olus of food can travel

do&n to the stomach.

$ Baves of contractionscalled +!rista'sis,

$ Small amount of

secretion in theoesophagus, but its

basically all about moving

stuff to the stomach.


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Art!ria' and

afferent fibres via the vagi and sympathetictrun%s.

$ 6t the lo&er end (oesophageal nerve plexus.L)"+h$ pper third the deep cervical nodes

$ Middle third( the superior and posteriormediastinal nodes, and

$ 5o&er third ( celiac nodes.


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S7allo7ing 8Deglutition9. Three phases


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Sto"ach Anato") O+!nings

$ astro!so+hag!a'0cardiac4 to esophagus

$ P)'oric to duodenum

$ Parts9Cardiac 9!undus9)ody 9+yloric antrumand canal

$ r!at!r and '!ss!r

cur%atur!s# attachmentsites for omenta

$ S+hinct!rs9Cardiac0lo&er esophageal4 9

+yloric


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?a''s o* th! Sto"ach$ La)!rs9Serosa or

visceral peritoneum

$ Muscu'aris three layers

#uter longitudinal,Middle circular ,2Inner

obli'ue

$ Su("ucosa9Mucosa

Dugae folds in stomach&hen empty. Mucosa

and submucosa.


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Functions o* th! sto"ach

$T!"+orar) storag!$ Ch!"ica' dig!stion

$ M!chanica' (r!a:do7nand +roduction o* ch)"!$ A(sor+tion o* 7at!r, a'coho' and so"! *at-so'u('!

drugs$ Non-s+!ci*ic d!*!ns!against microbes$ Pr!+aration o* ion for digestion further along the tract$ +roduction of intrinsic factor needed for a(sor+tion o*

%ita"in ;1 in th! t!r"ina' i'!u"$ Degulation of the +assag! o* gastric cont!nts intoth! duod!nu"


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astric =uic!

$ 6bout 8 litres of gastric

*uicedaily

$ It consists of

&ater 2mineral salts (secreted

by gastric glands mucus secreted by mucous

cells

?C5 and intrinsic factor

(secreted by parietal cells

inactive enzymesprecursorspepsinogens

secreted by chief cells in the

gland


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Functions o* th! gastric =uic!

$ Bater further li'uefies the food s&allo&ed

$ ?C5(acidifies the food ,%ills ingested

microbes 2digestion of pepsin

$ +epsinogens are activated to pepsin by ?C5

$ Intrinsic factor (absorption of -it ):8 from

the ileum

$ Mucus prevents mechanical in*ury to the

stomach &all.


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S"a'' Int!stin!

$ Site of greatest amount ofdigestion and absorptionof nutrients and &ater

Parts o* th! s"a''

int!stin! Auodenum( first 8 cm

beyond thepyloric sphincter.

@e*unum( 8. m

Ileum( 7. m.

+eyers patches or lymphnodules


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structur! o* th! s"a'' int!stin!

$ Duod!nu". =!=unu". and i'!u",

$ 6pproximately Em in length,

$ Fro" th! +)'oric s+hinct!r o*th! sto"ach to th! i'!o-ca!ca'%a'%!separating the ileum fromthe caecum.

$ Duod!nu" is the proximal C(shaped section that curves aroundthe head of the pancreas.


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C#/"I/...

$ Duod!nu"serves a mixing function as itcombines digestive secretions from thepancreas and liver&ith the contents expelledfrom the stomach.

$ @!=unu" &here the ma*ority of digestion and

absorption occurs.

$ Th! i'!u". is the longest segment and emptiesinto the caecum at the ileocaecal *unction.


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Function o* th! s"a'' int!stin!

$ P!rista'sis is increased by

parasympathetic stimulation

$ S!cr!tion o* int!stina'

=uic!,increased byparasympathetic stimulation

$ Dig!stion o* C9O.+roti!n >*at

$ Prot!ction aganist in*!ction ()

"icro(!s

$ S!cr!tion o* th! hor"on!scho'!c)sto:inin/CC0 and

s!cr!tin

$ A(sor+tion o* nutriti!nts


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Ch!"ica' dig!stion - s"a''

int!stin!Bhen acid ch)"!passes into the smallintestine it is mixed &ith+ancr!atic =uic! .(i'!and int!stina' =uic!.and

is in contact &ith theenterocytes of the villi. C?# are bro%en do&n to

monoaccharides +roteins are bro%endo&n

to amino acids !ats are bro%en do&n to

fatty acids and glycerol


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F ti * th ti = i


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Functions o* th! +ancr!atic =uic!

1,Dig!stion o* +roti!ns

Tr)+sinog!n and ch)"otr)+sinog!n (polypeptides to tripeptides,dipeptides andamino acids

8. Dig!stion o* C9O

Pancr!atic a")'as!-polysaccharides to

disaccharides

7.Dig!stion o* *ats

5ipase converts fats to fatty acids


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;i'!

$ ;i'!. is secreted by the 'i%!r

$ It passes from the hepatic

duct to the gall bladder

$ )ile has a +9 o* around B

$ 2-1"'are secreted

daily.

$ It consists of

7at!r."in!ra'

sa'ts."ucus.(i'! sa'ts.(i'!

+ig"!nts/(i'iru(in0.cho'!st

!ro'


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Functions o* ;i'! Sa'ts

$ E"u'si*) *ats in the small intestine

$ Fat-so'u('! %ita"ins-r!adi') a(sor(!d

$Uro(i'inog!n, &hich is 7at!r-so'u('! .isr!a(sor(!d and th!n !6cr!t!d in th!

urin!.but most is con%!rt!d to

st!rco(i'in and !6cr!t!d in th! *a!c!s,

$ St!rco(i'in co'ours and d!odoris!s

th! *a!c!s.


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"elease from the gall 2ladder

$ Duod!nu" secretes thehormones secretin and CCduring the intestinal phase

$ Stimulate the contraction o*th! ga''('add!r andr!'a6ation o* th!h!+ato+ancr!atic s+hinct!r

$ Th! (i'! and th! +ancr!atic=uic! to +ass through th!duod!na' +a+i''a into th!duod!nu"


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INT!STINAL S!%"!TI'NS

$ Intestinal secretions are

9o."ucus and "in!ra'

sa'ts,

$ Its contained !n)"!s

-!nt!roc)t!sof the &alls ofthe villi.

$ Aigestion of C9O.+roti!n

and *at

$ Chemical digestion of food atthe surface of the enterocytes

are

+!+tidas!s.'i+as!.sucras!.

"a'tas! and 'actas!


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Ch!"ica' dig!stion associat!d

7ith !nt!roc)t!s$ Ent!ro:inas!( +o')+!+tid!s

to a"inoacids

$ Li+as!-*ats to *att) acidsand g')c!ro' in th! int!stin!

$ Sucras!."a'tas! and'actas!- digestion of C9O ()con%!rting disaccharid!ssuch as Sucras!."a'tas!

and 'actas! to"onosaccharid!s


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A2sorption of nutrients$ Through th! !nt!roc)t!s

.inc'udingdi**usion.os"osis.di**usion andacti%! trans+ort

$


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Kavitha Msn Cne 25.7.14 Final