Super Size Me

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Super Size Me

• My Love Affair With Oreos

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Esophagus

• Lining is more serous than mucous
• Transport bolus to stomach
• Cardiac sphincter at its end

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Oral digestion

• Mastication
• Bolus
• Amylase
• Salivary glands
• Tongue
• eDeglutition (to swallow)

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Goblet cells make mucous (so we dont digest
ourselves!)
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Stretching your stomach causes GASTRIN (hormone)
release for Hydrochloric Acid to get released
from parietal cells
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Chief Cells produce all types of enzymes for
proteins and carbodydrates (proteases/amylases)
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• Gastrin an endocrine hormone in stomach lining
  which when stomach stretches it tells other
  stomach lining glands to produce hydrochloric
  acid, parietal cells. (G cells)
• Goblet cells produce mucous to protect stomach
  lining
• Chief cells produce protein, fat and CH enzymes

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• Intrinsic factor is also in the lining of the
  stomach
• What does intrinsic factor do?

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• It absorbs extrinsic factor AKA vitamin B12 which
  does what?

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• Vitamin B12)necessary to the maturation of RBCs
• Who cant produce intrinsic factor and what
  disease do they commonly develop?

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• Pernicious anemia a type of anemia common among
  the elderly. Taking more vitamin B12 wont help
  them if they can no longer produce intrinsic
  factor so..they need B12 shots weekly to keep
  their energy levels up.

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Stomach digestion

• Chyme
• Hydrochloric acid
• Pepsin
• Gastrin
• Pyloric sphincter
• Alcohol
• Poisons

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Duodenum

• U shaped
• Bile duct and pancreatic duct empty here
• Bile from liver for fat emulsification
• Pancreatic juice (Exocrine pancreas)
• for food digestion.

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Duodenum (first part of intestines
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Digestion

• We require carbon based foods to provide fuel for
  our energy production
• Fats, carbohydrates and proteins are all energy
  sources
• We convert food to energy (ATP) and excrete
  water, wastes both liquid and solids.

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• What is the process of breaking down foods
  readying them for absorption into the blood
  called?
• What is the cellular process of further utilizing
  food products to produce energy?

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• Digestion
• Metabolism

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The Alimentary Canal

• Long muscular canal from the mouth to the anus.
  Includes the mouth, tongue, pharynx, esophagus,
  stomach, duodenum, ileum, jejunum, large
  intestine, rectum, anus
• Mucous lined, produces enzymes, absorbs nutrients
  and vitamins and water and minerals
• Expels waste products of digestion and metabolism

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• How is the digestive system innervated
  (stimulated neurologically) CNS or the ANS?
• Which nervous system specifically stimulates it
  and which inhibits it?

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• Autonomic NS the parasympathetic stimulates the
  digestive system while the sympathetic system
  inhibits it.
• What would you get if you are under stress and
  try to eat at the same time?

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• Gas, indigestion, ulcers

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• What enzymes are produced in the stomach lining?
• What can the stomach absorb?

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GERDS
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Name three causes of GERDS
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• ?
•   alcohol use?  overweight?  pregnancy? 
  smokingAlso, certain foods can be associated with
  reflux events, including?  citrus fruits? 
  chocolate?  drinks with caffeine?  fatty and
  fried foods?  garlic and onions?  mint
  flavorings?  spicy foods?  tomato-based
  foods, like spaghetti sauce, chili, and pizza

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Hiatal hernia
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Hiatal hernia in endoscope
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Longitudinal and annular sm. Mm.
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Small Intestine

• Jejunum(proximal 2/3s of sm. int. and Ileum
  (distal 1/3 of sm. Int.)
• 24 feet long
• Only small in diameter
• For food absorbtion (CH, fats, proteins)
• Villi with crypts of Lieberkuhn between
• Lacteals
• Peristalsis

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Duodenum

• Has a hormone in the lining of its wall called
  cholecystekinin which stimulates the bile duct to
  squirt bile into the duodenum.
• What is bile for?

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• Its an emulsifying agent (like soap) which mixes
  fats in your food in the duodenum with water
  soluble enzymes to digest them called lipases.
• The pancreas also releases an endocrine hormone
  into the duodenum named?

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• Insulin insulin allows sugars/starches
  (carbohydrates) to move across the walls of your
  blood vessels to get out of your blood and into
  your cells for metabolizing
• No insulin means diabetes mellitus

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What are the valleys in between the villi called?
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• Crypts of Lieberkuhn

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Large Intestine (colon)

• Primarily for water absorbtion
• Produces feces from residues of digestion
• Appendix
• Ascending, transverse, descending, sigmoid
  leading to rectum and anus

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• Caecum,
• Ileocaecal junction
• Ascending colon, transverse colon, descending
• Sigmoid colon, rectum

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Herpes

• Herpes Simplex (cold sores or fever blisters) but
  also causes genital herpes. Both are contagious,
  episodic, painful, lifelong, rapidly growing in
  our population and worldwide, 45 million in U.S.
  alone
• Tx.Valtrex, Zovirax, Acyclovir antivirals keep
  it dormant, no cure
• Herpes Zoster (shingles re-awakened chickenpox
  in the elderly)

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Cold Sore/fever blister
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Genital Warts
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Herpes

• Usually self limiting to the victim and with
  medications and good health, sometimes never
  recur BUT
• Are contagious even when no lesions visable and
  also after lesions remit they are spread by
  shedding skin tissue! High stress and poor health
  make them pop out again!

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Adenoma (polyp) easily removed during colonoscopy
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Early colonoscopy after age 50 every five yrs

• Colon cancer is slow, takes tens years to convert
  a benign adenoma (polyp) to a terminal malignant
  carcinoma
• One of the few cancers that is preventable and
  yet is the third most fatal after lung,
  breast/prostate CA for most in U.S. dont get
  colonoscopy

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Cholecystitis (inflamed gall bladder with stones)
FFFF
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Liver

• Vital organ which produces our proteins,
  antibodies, hormones, stores sugar in the form of
  glycogen, is our main detoxifying organ, makes
  clotting factors for blood (prothrombin/fibrinogen
  ), cleans up dead blood cells, makes bile for the
  emulsification of fats, and produces 80 of our
  cholesterol!! Thats why high blood cholesterol
  runs in families. Out diet only controls 20 of
  our bloods cholesterol.

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Hepatitis

• Infection/inflammation of the liver. Various
  causes Toxins like ethanol consumption leading
  to cirrhosis (fatty and scarred liver) and
  various viral infections.
• Symptoms malaise, jaundice from excess bilirubin
  from failure of liver to cleanup old
  hemoglobin),loss of appetite.

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Viral Hepatitis

• Type A fecal-oral route of transmission,
  contaminated foods, mainly third world countries
  and day care centers, poor hygiene,
  shellfish,acute and self limiting, bed rest
• Type BBlood borne only drug addicts sharing
  needles, doctors/nurses at risk and STP
  transmitted by exchanging fluids by sex Vaccine
  for all health care workers effective,
• Chronic Hep B leads to cirrhosis/liver CA

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Type C Hepatitis the silent liver killer!

• No symptoms for decades
• Blood borne
• Contagious by fluid exchange, needs, SEX
• Most common blood borne disease in the U.S. but
  most victims dont know they have it until
  cirrhosis has almost destroyed all of their
  liver transplant needed No vaccine available

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Hepatitis C
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Hepatitis
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Ulcerative Colitis (Crohns Disease)

• Genetic
• Autoimmune
• Episodic irritable bowel syndrome (IBS)
• Treated with anti-inflammatories and surgery
• Colostomy

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Inguinal Hernia
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diverticulitis
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