Kavitha Msn Cne 25.7.14 Final
Transcript of 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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