System Digestivus

Dr.Yani Istadi, M.Med.Ed FK Unissula Bagian Anatomi

Human Digestive System

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G H I J

Figure 3810 The Digestive System

Section 38-2 Mouth Pharynx Salivary glands

Esophagus

Liver Gallbladder (behind liver)

Stomach Pancreas (behind stomach) Large intestine Small intestine

Rectum

Human Digestive System

 The Digestive System: also called the Gastrointestinal

canal, Tract or the Alimentary canal begins with the mouth (the intake of food) and ends with the expulsion of waste from the anus.

The three Main functions of the Digestive System are: 1. Digestion: Chemical and Mechanical break down of Digestion: food products. 2. Absorption: into the blood stream Absorption: 3. Elimination: of solid waste from the body Elimination:

DIGESTION:
Food that is taken into the mouth is broken down mechanically by the teeth and chemically by the saliva, and then it travels through the remainder of the gastrointestinal tract. Digestive enzymes aid in the breakdown of complex nutrients (such as fats, proteins, and sugars). Protease and Peptidase Proteins amino acids Peptidase: Carbohydrase: Sugars glucose Lipase: Lipase Fats fatty acids

The Oral Cavity

The Oral Cavity contains the tongue that moves food around during mastication (chewing) and deglutition (swallowing). The tongue has small raised areas called papillae, that contain taste buds that are sensitive to the chemical nature (or taste sensation) of food. The Gums (or gingiva) are made up of fleshy tissue that surrounds the sockets of the teeth to provide support. The adult has 32 permanent teeth and a child between the ages of 6 months to 12 years has deciduous teeth (or baby teeth) that total 20 when all have erupted.

Oral Cavity
Major parts of the oral cavity

Uvula prevents food from going up into the pharynx when we swallow

The Oral Cavity cont..

The Tooth consists of a crown that shows above the crown, gumline, and a root that lies below the gumline and within the boney tooth socket. The enamel is the white covering and outermost protective layer of the crown; AND is also the hardest substance in the body. The dentin is a yellow softer boney tissue that lies below the enamel and throughout the root of the tooth. The cementum layer covers, supports, and protects the dentin in the root of the tooth; and there is also a periodontal membrane that surrounds the cementum, and holds the tooth in the tooth socket. In the middle of the tooth, beneath the dentin, is the pulp It is a soft delicate tissue that fills the tooth canal pulp. and contains blood vessels, nerve endings, connective tissue, and lymphatic vessels (also called the root canal).

Oral Cavity (contd.)

Upper permanent teeth within the dental arch

Oral Cavity (contd.)

Anatomy of a tooth

Cavities/Dental Caries

Oral Cavity (contd.)

Salivary glands
Three sets of salivary glands produce saliva which moistens food entering the mouth making it easy to swallow Saliva production is stimulated by smell, hunger and taste of food Contains salivary amylase

The Pharynx
The pharynx (throat) is a muscular tube about 5 inches in length, and lined with a mucous membrane.

The Pharynx
It serves as a common passageway for air to the trachea (windpipe), and food to the esophagus. When chewed food, mixed with saliva (called a bolus; a semisolid mass of food) is swallowed (deglutition), a flap of tissue called the epiglottis covers the trachea so that food cannot enter or become lodged there.

The Pharynx
Deglutition: Deglutition: also called swallowing

The Esophagus
The esophagus is a 9 to 10 inch muscular tube extending from the pharynx to the stomach. Made up of circular and longitudinal muscles which expand and contract to move food to the stomach Peristalsis occurs here, which is rhythmical waves of contractions of the wall muscles to propel food toward the stomach. Food travels in the esophagus for approx. 5 to 8 seconds, to which it then passes through a ring of muscles called the cardiac sphincter (or lower esophageal sphincter).

Swallowing Reflex and Esophageal Peristalsis

Stomach
J-shaped musculer sac in the middle of the digestive tract and on the left side of the upper abdomen Has two sphincters:
1. Cardiac sphincter allows food into the stomach and keeps acid from enter the esophagus 2. Pyloric sphincter regulates and releases the amount of food entering the small intestine

Stomach
The stomach is composed of three parts the fundus (upper), body (middle), and antrum (lower) and can store up to 2 liters of food or liquid. The stomach secretes acids and enzymes that digest food. Ridges/folds of muscle tissue called rugae line the stomach. Two types of digestion:
Mechanical digestion Chemical digestion

Stomach - Mechanical Digestion

Physical breaking up of food into smaller pieces by the teeth. The tongue manipulates the food into a mass called the bolus and The squishing action in the esophagus further break up the food mass the stomach walls begin to contract to mix and churn food with gastric juices This mixture is called chyme (a semi-liquid form) GROSS! This is the stuff that comes up when you get sick Food stays in the stomach approx 2 to 6 hours or longer after eating ; depending on how much and what was eaten. (longer if you eat before going to bed)

Stomach Chemical Digestion

Gastric glands found in the wall of the stomach (the rugae). It release gastric juices Gastric juices contains the enzymes pepsin (breaks proteins into polypeptides) and hydrochloric acid (maintains a pH of 2.0 in the stomach and dissolves food and kills microorganisms). Production is stimulated by:
Thought, sight or smell of food Food entering the stomach Stretching of stomach wall

With a pH of about 2, these juices are able to efficiently break down food

Stomach: Food Storage and Digestion

Stomach lining is protected from acid or gastric juices by

Mucous

The Small Intestines

The Small Intestine (also known as the small bowel the bowel) longest portion of the digestive tract. It extends 20 ft from the pyloric sphincter to the first part of the large intestines( the cecum). Much of the small intestine is coiled and suspended in a thin layer of fat - which gives the intestine a lot of flexibility and mobility; called the mesentary mesentary. The intestines subdivided into three parts: 1. Duodenum First 25 cm after the stomach 2. Jejunum The next 2 metres 3. Ileum the last 5 metres This is the site of most digestion, along with nutrient absorption

The Small Intestines

The Duodenum is the first section of the S. intestine. It receives the thick liquid mixture of partly-digested food and chyme). stomach acid (called chyme The duodenum also receives bile from the gallbladder (that is produced in the liver), liver and other digestive enzymes from the pancreas These enter the pancreas. duodenum through small ducts or tubes. The bulk of the digestion of proteins, fats and carbohydrates takes place in the duodenum before the material travels to the second and last sections: the Jejunum and Ileum.

The Small Intestines cont..

The jejunum is the coiled midsection of the small intestine and the ileum is the final portion of the small intestine. The inner linings of the jejunum and ileum contain very small finger-like bumps or projections called 'villi. The villi absorb the nutrients from the thick liquid digested food and transfer them to the bloodstream, lymph vessels, and the liver. Any food that has not been digested in the small intestine (along with some water and vitamins) then reaches the large intestine.

Small Intestine: Site of Digestion and Absorption

Large Intestine
The Large Intestine (or large bowel) extends from the ileum to the anus. It is approx. 1.5 meters (or 4 feet 9 inches) and consists of 3 primary parts: the Cecum, Colon and the Rectum Rectum. The Cecum is the first part of the large intestine. It is shaped like a small pouch and accepts and stores processed material from the small intestine and moves it towards the colon. In the cecum, the mixture of digesting food normally contains: The undigested food (such as fiber) a small amount of water non absorbed vitamins and minerals or salts

Large Intestine
The Appendix is a small projection that hangs from the cecum and has no known function, but if blocked or clogged can become infected or inflamed (a condition known as Appendicitis). Within the colon, the remaining undigested mixture, mixes with mucus and bacteria that live in the large intestine - and starts to form feces (or stool) stool). As feces travels through the colon, the lining of the colon absorbs most of the water and small amounts of vitamins and minerals. The bacterium in the colon chemically breaks down some of the fiber to produce nutrients for their survival and to nourish the cells lining the colon. Thus, fiber in your diet is important to maintain the long-term health of the colon.

Large Intestine cont

The Rectum is an 8-inch chamber that connects the colon to the anus and is the final part of the large intestine. When feces enters the rectum, sensors send a message to the brain to decide if the sphincter muscles can relax and the rectum can contract, disposing of its contents into the anus. If the contents cannot be released, the sphincter contracts and the rectum accommodates so that the sensation temporarily goes away.

Large Intestine cont

The Anus is a 2-inch long canal that detect the rectal contents, as to whether the contents are liquid, gas, or solid. The anus has two sphincters, one voluntary and one involuntary. The pressure of the feces on the involuntary sphincter causes the urge to defecate and the voluntary sphincter controls whether a person defecates or not.

Food Pathway through the GI Tract

Food enters through the oral cavity and exits through the anus

Gangguan sistem pencernaan

Aphthous Stomatitis
Aphthous Stomatitis is an illness that causes small ulcers to appear in the mouth, usually inside the lips, on the cheeks, or on the tongue. This is also known as "canker sores." The exact cause of this disease is not known, but there are many factors that are thought to be involved with the development of canker sores, including: weakened immune system allergies to food such as coffee, chocolate, cheese, nuts and citrus fruits stress viruses and bacteria trauma to the mouth poor nutrition certain medications

Ulcers
An ulcer is erosion in the lining of the esophagus, stomach, or duodenum. While acid is still considered significant in ulcer formation, the leading cause of ulcer disease is currently believed to be infection of the stomach by a bacteria called "Helicobacter pyloricus" (H. pylori). Another major cause of ulcers is the chronic use of anti-inflammatory medications.

Constipation
When you are not physically active, consuming dietary fibers, and/or become dehydrated, you are likely to suffer from constipation. It is common for a constipated person to experience uncomfortable bowel movements and also feelings of and/or bouts of bloating. This condition usually happens when waste substance remains too long in the colon, causing more and more water being absorbed from the waste which also means the feces/stool passes along the large intestine too slowly. The end result is the dry, lumpy and hard feces, that causes difficulty and pain during defecation

Diarrhea
Diarrhea most commonly happens when the intestines and part of the body gets infected. When this condition happens, the colon is unable to absorb water quickly enough from liquid waste. The waste is then pushed out of the anus quickly and simultaneously, causing spasms within the muscles of the colon, and/or within the abdominal area. Therefore, the feces passes along the large intestine too quickly and the water is not able to be absorbed from the waste. Diarrhea causes mushy, loose, watery feces/stool.

Colonic Polyposis
A polyp is an extra piece of tissue that grows inside your body. Colonic polyps grow in the large intestine, or colon. Most polyps are not dangerous. However, some polyps may turn into cancer or already be cancer. To be safe, doctors remove polyps and test them. Polyps can be removed when a doctor examines the inside of the large intestine during a colonoscopy.

Ulcerative Colitis
Ulcerative colitis is a disease that causes ulcers in the lining of the rectum and colon. It is one of a group of diseases called inflammatory bowel disease. Ulcers form where inflammation has killed the cells that usually line the colon. Ulcerative colitis can happen at any age, but it usually starts between the ages of 15 and 30. It tends to run in families. The most common symptoms are pain in the abdomen and bloody diarrhea. Other symptoms may include anemia, severe tiredness, weight loss, loss of appetite, and bleeding from the rectum.

Diverticulosis
Diverticulosis is a term for small outpouches, or sacs, that develop along an intestinal wall, usually the colon. Once diverticulosis occurs, it cannot be reversed, if one of the pouches becomes impacted with waste material, it can lead to infection and inflammation. weakening of the walls of the colon due to aging and obesity are causative factors. Diverticulosis occurs mostly in people over the age of 60, and more than half of the patients who develop it are markedly overweight. Overuse of laxatives also weakens the colon.

Colorectal Cancer
The wall of the colon and rectum is made up of layers of tissues. Colorectal cancer starts in the inner layer and can grow through some or all of the other layers. The stage (extent of spread) of a cancer depends to a great degree on how deep the cancer goes into these layers. Cancer that starts in these different areas may cause different symptoms. But colon cancer and rectal cancer have many things in common. In most cases, colorectal cancers develop slowly over many years. It is now know that most of these cancers start as a polyp -- a growth of tissue that starts in the lining and grows into the center of the colon or rectum. This tissue may or may not be cancer. A type of polyp known as an adenoma can become cancer. Removing a polyp early may keep it from becoming cancer. Over 95% of colon and rectal cancers are Adenocarcinomas.

Anal Fistula
An anal fistula is a small channel that develops between the end of the bowel, known as the anal canal, and the skin near the anus (opening where waste leaves the body). On the surface of the skin around the anus, one or more of the fistula ends may be seen as holes. An anal fistula is painful and can cause bleeding and discharge when passing stools.

Hemorrhoids
Hemorrhoids, also called piles, are swollen and inflamed veins in your anus and lower rectum. Hemorrhoids may result from straining during bowel movements, sitting on the toilet to long, or from the increased pressure on these veins during pregnancy. Hemorrhoids may be located inside the rectum (internal hemorrhoids), or they may develop under the skin around the anus (external hemorrhoids).

Anorexia: Anorexia nervosa is a type of eating disorder. People who have anorexia have an intense fear of . gaining weight. They severely limit the amount of food they eat and can become dangerously thin. weight. Anorexia affects both the body and the mind. It may start as dieting, but it gets out of control. These dieting, people think about food, dieting, and weight the majority of their day. They have a distorted body image. When they look in the mirror, they see a fat person.

Literature
Human Anatomy, First Edition McKinley & O'Loughlin Atlas sobota Ethel Sloane, Anatomi dan Fisiologi, Penerbit EGC Fisiologi, Kyung Won Chung, Gross Anatomi, Penerbit Binarupa Anatomi, Aksara Keith L.Moore dan Arthur F.Dalley. 2010. Clinically F.Dalley. oriented Anatomy. 6 Ed. Anatomy. Seeley,R.R., Stephens,T.D., Tate,P.2003. Anatomy & Physiology. McGraw Hill

Eat up!