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Nursing Anaphy Lec Session #20 - Sas (New Format)
Nursing Anaphy Lec Session #20 - Sas (New Format)
B. MAIN LESSON
You must read & study the concepts and refer to figures/tables in Chapter 16 of the book.
Digestive System – consists of the digestive tract / gastrointestinal (GI) tract (oral cavity, pharynx,
esophagus, stomach, small & large intestines, & anus), plus the specific associated organs (salivary glands,
liver, & pancreas).
▪ Teeth – located in mandible & maxilla that can be divided into four quadrants, with each contains:
1 central & 1 lateral incisors, 1 canine, 1st & 2nd premolars, and, 1st, 2nd, & 3rd molars (See figure
16.5 & 16.6)
o Permanent Teeth / Secondary Teeth – adult teeth, normally 32 in number
o Primary Teeth/ Deciduous Teeth / Milk or Baby Teeth – lost & replaced during
childhood, 20 in number
o Wisdom Teeth – the 3rd molar that appears in early 20’s.
Regions of tooth: crown (visible portion), neck, & root (largest & anchored in jawbone)
o Pulp Cavity – center of tooth that contains pulp & is surrounded by dentin (cellular,
calcified tissue)
o Enamel – extremely hard, acellular substance that protects tooth against abrasion & acids
o Alveoli – where the teeth are held in place along alveolar processes which are covered by
gingiva / gums & secured by periodontal ligaments through embedding into cementum
▪ Palate – roof of oral cavity that prevents foods from passing into nasal cavity during chewing &
swallowing; consists of hard palate (anterior) & soft palate (posterior)
o Uvula – posterior extension of soft palate
o Tonsils (Discussed already in Chapter 14. A fast recall can be done.)
▪ Salivary Glands – produce saliva & consist of three major pairs: (See figure 16.7)
o Parotid Glands – largest; located anterior to each ear where parotid ducts enter oral cavity
adjacent to the 2nd upper molars
o Submandibular Glands – felt as soft lump where submandibular ducts open into the oral
cavity on each side of the frenulum
o Sublingual Glands – smallest & primarily mucous secretions where each gland has 10-
12 small ducts opening onto the floor of oral cavity
Saliva – mixture of serous & mucous fluids that is secreted at rate of approximately 1L/day which is
regulated by ANS, primarily the parasympathetic nervous system; has many functions that include:
▪ helps keep the oral cavity moist
o Mucin – a proteoglycan from mucous secretion that gives a lubricating quality to the
secretions of glands
▪ contains enzymes that begin the process of digestion (See table 16.1)
o Salivary Amylase – breaks down starch
▪ prevents bacterial infections in mouth with a mildly antibacterial enzyme called lysozyme
▪ neutralize pH
Mastication / Chewing – begins the process of mechanical digestion, breaking down large particles into
smaller ones.
Pharynx – only oropharynx & laryngopharynx carry food to esophagus (Discussed in Chapter 15. Do a
recall.)
Esophagus – muscular tube (about 25 cm long) that passes from pharynx to stomach; contains vital
sphincters:
▪ Upper Esophageal Sphincter – located at upper ends that regulate the movement of food into
esophagus
▪ Lower Esophageal / Cardiac Sphincter - located at lower ends that regulate movement of food
out esophagus
Secretions of Stomach:
▪ Hydrochloric Acid – produce pH of about 2.0 (acidic) that kills microorganisms & activates the
pepsin
▪ Pepsin – active form of pepsinogen that breaks down protein
▪ Mucus – forms thick layer that lubricates & protects epithelial cells from damaging effects of acidic
chyme & pepsin; secretions can be stimulated by stomach irritation
▪ Intrinsic Factor – binds with vitamin B12 to be readily absorbed in small intestine
Phases of Regulation of Stomach Secretions: (See figure 16.11 & table 16.2)
Both involve nervous (CNS reflexes integrated within medulla oblongata & enteric plexus) and hormonal
mechanism.
1. Cephalic Phase – “get started”; stomach secretions are increased in anticipation of incoming food
2. Gastric Phase – “go for it”; greatest volume of gastric secretion occurs due to presence of food in
stomach
3. Intestinal Phase – “slow down”; inhibits gastric acid secretions as the acidic chyme enters into
duodenum
Hormones Functions
Gastrin enters blood & carried back to stomach; stimulates additional secretory activity
Histamine enters blood to stimulate gastric gland secretory activity; most potent stimulator of HCl secretion
Secretin released from duodenum in response to low pH; inhibits gastric secretions
Cholecystokinin activated by fatty acids & peptides in duodenum; inhibits gastric secretions
Hunger Pangs – “growling” stomach; uncomfortable sensations that can build up to prolonged or tetanic
contractions; peristaltic waves triggered by low blood glucose levels from empty stomach; occur for about
2-3 minutes
Distention of Stomach Wall – major stimulus gastric motility & emptying and must be regulated
▪ Too fast, efficiency of digestion & absorption in small intestine is reduced
▪ Too slow, highly acidic contents damage stomach wall
You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be
given to the correct answer and another one (1) point for the correct ratio. Superimpositions or erasures
in your answer/ratio is not allowed. You are given 20 minutes for this activity.
Multiple Choice
1. Which one of the following represents the correct order through which food passes in the digestive
tract?
a. mouth, pharynx, esophagus, stomach, large intestine, small intestine
b. mouth, esophagus, pharynx, stomach, small intestine, large intestine
c. pharynx, mouth, esophagus, stomach, large intestine, small intestine
d. mouth, pharynx, esophagus, stomach, small intestine, large intestine
e. mouth, pharynx, esophagus, small intestine, stomach, large intestine
ANSWER: ________
RATIO:______________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
_______________________________________
3. Which of the following phases of swallowing involves the epiglottis covering the opening of the larynx?
a. Voluntary phase
b. Esophageal phase
c. Pharyngeal phase
d. None of these are correct
ANSWER: ________
RATIO:______________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
_______________________________________
6. Which of the following hormones does not inhibit gastric gland secretions?
a. secretin
b. gastrin
7. Which of the following does not occur during the gastric phase of gastric secretion?
a. Gastrin begins to be secreted by the lower part of the stomach.
b. Hydrochloric acid and pepsin secretion are stimulated in the upper and middle parts of the
stomach.
c. Peptides stimulate the secretion of gastrin.
d. Tactile sensation of food in the mouth sends nervous impulses to the medulla oblongata.
e. All of the choices are correct
ANSWER: ________
RATIO:______________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
_______________________________________
8. The medulla oblongata controls gastric secretion both by the parasympathetic branch of the nervous
system and the endocrine system.
a. The statement is true.
b. The statement is false.
ANSWER: ________
RATIO:______________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
_______________________________________
9. The anterior chisel-shaped teeth that are adapted for cutting are called:
a. incisors
b. canines
c. premolars
d. molars
e. wisdom teeth
ANSWER: ________
RATIO:______________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
_______________________________________
10. Pepper woke up in the morning with an intense urge to defecate. As she observed her feces, she
noticed leafy green residues and remembered that she ate a lot of cabbages in her dinner. She realized
that there was no need to call for an emergency. She knows that cabbage is not easily digested
because it is rich in:
a. Sucrose
b. Fats
c. Starch
d. Cellulose
e. Protein
ANSWER: ________
RATIO:______________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
_______________________________________
C. LESSON WRAP-UP
This activity is an effective way for you to practice and clarify the learnings. With every review test, you can
see how much content you have already learned. You have to answer the set of review questions posted
below. Use the space provided in writing your answer. After completing the answers, immediately check
their work against the provided correct answer from your Main Lesson. Correct your own answers using a
different color of pen to see the differences. To make this activity worthy, make sure to follow the instructions
accordingly. Enjoy!
1. The organ that connects the pharynx to the stomach is the __________.
Answer: ______________________
3. The upper, expanded part of the stomach lateral to the cardiac region is called the ______.
Answer: ______________________
4. Large wrinkle-like folds in the stomach lining, present when the stomach is empty, that allow for
expansion when the stomach is filling are called __________.
Answer: ______________________
6. This is the hormone responsible for promoting the release of pepsinogens, mucus, & HCl acid in
the stomach.
Answer: ______________________
8. The substance secreted by the chief cells of the gastric glands is called _________.
Answer: ______________________
9. The _________ is responsible for movement of chyme towards the small intestine.
Answer: ______________________
10. The site where the starch digestion begins is in the __________.
Answer: ______________________