Nutrition and Diet Therapy – Lecture

BS NURSING / SECOND YEAR

Session # 5
STUDENT ACTIVITY SHEET

LESSON TITLE: Digestion and Absorption Materials:

Pen and notebook
LEARNING OUTCOMES:

At the end of the lesson, you can:

1. Identify the path that food takes during digestion and
describe the muscular actions of digestion;
2. Describe the actions and origins of the digestive
secretions;
3. Describe the anatomical details of the GI tract and the Reference:
features and activities of intestinal cells that facilitate DeBruyne, L.K., Pinna, K., & Whitney E.,
nutrient absorption; and, (2016). Nutrition and diet therapy: Principles
4. Explain how nutrients are delivered from the GI tract to and practice (9th ed.). USA: Cengage Learning.
body cells by the vascular system and describe the
different types of lipoproteins.

LESSON PREVIEW/REVIEW
Let us have a review of what you have learned from the previous lesson. Kindly answer the following questions on the
space provided. You may use the back page of this sheet, if necessary. Have fun!

Instruction: Fill the table below:

Severe Acute MalnutritionChronic Malnutrition

Food Deprivation

Physical Features

World Prevalence < 5 y/o

MAIN LESSON
You will study and read their book, if available, about this lesson.

Anatomy of the Digestive Tract

A. The Digestive Organs

The process of digestion begins in the mouth. As you chew, your teeth crush and soften the food, while saliva mixes with
the food mass and moistens it for comfortable swallowing. Saliva also helps dissolve the food so that you can taste it; only
particles in solution can react with taste buds.

The tongue allows you not only to taste food but also to move food around the mouth, facilitating chewing and swallowing.
When you swallow a mouthful of food, it passes through the pharynx, a short tube that is shared by both the digestive
system and the respiratory system.

Mouth to the Esophagus. Once a mouthful of food has been chewed and swallowed, it is called a bolus. Each bolus first
slides across your epiglottis, bypassing the entrance to your lungs. During each swallow, the epiglottis closes off your
trachea, the air passageway to the lungs, so that you do not choke.

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Esophagus to the Stomach. The esophagus has a sphincter muscle at each end. During a swallow, the upper
esophageal sphincter opens. The bolus then slides down the esophagus, which conducts it through the diaphragm to the
stomach. The lower esophageal sphincter closes behind the bolus so that it cannot slip back. The stomach retains the
bolus for a while, adds juices to it and transforms it into a semiliquid mass called chyme. Then, bit by bit, the stomach
releases the chyme through another sphincter, the pyloric sphincter, which opens into the small intestine and then closes
after the chyme passes through.

The Small Intestine. At the beginning of the small intestine, the chyme passes by an opening from the common bile duct,
which secretes digestive fluids into the small intestine from two organs outside the GI tract—the gallbladder and the
pancreas. The chyme travels on down the small intestine through its three segments—the duodenum, the jejunum, and
the ileum. Together, the segments amount to a total of about 10 feet of tubing coiled within the abdomen. * Digestion is
completed within the small intestine.

The Large Intestine. (Colon) Having traveled the length of the small intestine, what remains of the intestinal contents
passes through another sphincter, the ileocecal valve, into the beginning of the large intestine (colon) in the lower
right-hand side of the abdomen. Upon entering the colon, the contents pass another opening. Should any intestinal
contents slip into this opening, they would end up in the appendix, a blind sac about the size of your little finger. Normally,
the contents bypass this opening, however, and travel up the right-hand side of the abdomen, across the front to the
left-hand side, down to the lower left-hand side, and finally below the other folds of the intestines to the back side of the
body above the rectum.

The Rectum. As the intestinal contents pass to the rectum, the colon withdraws water, leaving semi solid waste. The
strong muscles of the rectum hold back this waste until it is time to defecate. Then the rectal muscles relax, and the last
sphincter in the system, the anus, opens to allow the wastes to pass. Thus, food travels through the digestive tract in this
order: mouth, esophagus, lower esophageal sphincter (or cardiac sphincter), stomach, pyloric sphincter, duodenum
(common bile duct enters here), jejunum, ileum, ileocecal valve, large intestine (colon), rectum, and anus.

B. The Involuntary Muscles and the Glands

Gastrointestinal Motility. Once you have swallowed, materials are moved through the rest of the GI tract by involuntary
muscular contractions. This motion, known as gastrointestinal motility, consists of two types of movement: ⎯ Peristalsis -
propels, or pushes
⎯ Segmentation - mixes, with more gradual pushing

Liquefying Process. Besides forcing the intestinal contents along, the muscles of the GI tract help to liquefy them to
chyme so that the digestive juices will have access to all their nutrients. The mouth initiates this liquefying process by
chewing, adding saliva, and stirring with the tongue to reduce the food to a coarse mesh suitable for swallowing. The
stomach then further mixes and kneads the food.

C. The Process of Digestion

Digestion in the Mouth. Digestion of carbohydrate begins in the mouth, where the salivary glands secrete saliva, which
contains water, salts, and enzymes (including salivary amylase) that break the bonds in the chains of starch. Saliva also
protects the tooth surfaces and linings of the mouth, esophagus, and stomach from attack by molecules that might harm
them.
Digestion in the Stomach. Gastric juice, secreted by the gastric glands, is composed of water, enzymes, and
hydrochloric acid. The acid is so strong that it burns the throat if it happens to reflux into the upper esophagus and
mouth. The stomach’s strong acidity prevents bacterial growth and kills most bacteria that enter the body along with food.
You might expect that the stomach’s acid would attack the stomach itself, but the cells of the stomach wall secrete mucus,
a thick, slimy, white polysaccharide that coats and protects the stomach’s lining.

The major digestive event in the stomach is the initial breakdown of proteins. Both the enzyme pepsin and the stomach
acid itself act as catalysts in the process. Minor events are the digestion of some fat by a gastric lipase, the digestion of
sucrose (to a very small extent) by the stomach acid, and the attachment of a protein carrier to vitamin B12

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Digestion in the Small and Large Intestines

Digestive Enzymes. Pancreatic juice contributes enzymes that digest fats, proteins, and carbohydrates. Glands in the
intestinal wall also secrete digestive enzymes.
Bicarbonate. Pancreatic juice also contains sodium bicarbonate, which neutralizes the acidic chyme as it enters the small
intestine. From this point on, the digestive tract contents are neutral or slightly alkaline. The enzymes of both the intestine
and the pancreas work best in this environment.
Bile is secreted continuously by the liver and is concentrated and stored in the gallbladder. The gallbladder squirts bile into
the duodenum whenever fat arrives there. Bile is not an enzyme but an emulsifier that brings fats into suspension in water.
After the fats are emulsified, enzymes can work on them, and they can be absorbed. Thanks to all these secretions, all
three energy-yielding nutrients are digested in the small intestine.

The Rate of Digestion of the energy nutrients depends on the meal contents. If the meal is high in simple sugars,
digestion proceeds fairly rapidly. On the other hand, if it is rich in fat, digestion is slower.

Protective Factors. The intestines contain bacteria that produce a variety of vitamins, including biotin and vitamin K
(although bacteria alone cannot meet the need for these vitamins). The GI bacteria also protect people from infections.
Provided that the normal intestinal flora is thriving, infectious bacteria have a hard time getting established and launching
an attack on the system.

D. The Absorptive System

⎯ The many folds and villi of the small intestine dramatically increase its surface area, facilitating nutrient absorption.
⎯ Nutrients pass through the cells of the villi and enter either the blood (if they are water soluble or small fat
fragments) or the lymph (if they are fat soluble)

E. Absorption of Nutrients and Transport of Nutrients

⎯ Nutrients leaving the digestive system via the blood are routed directly to the liver before being transported to the
body’s cells. Those leaving via the lymphatic system eventually enter the vascular system, but they bypass the
liver at first.
⎯ Within the circulatory system, lipids travel bundled with proteins as lipoproteins. Different types of lipoproteins
include chylomicrons, very-low-density lipoproteins (VLDL), low-density lipoproteins (LDL), and high-density
lipoproteins (HDL).
1. Very-low-density lipoproteins (VLDL): the type of lipoproteins made primarily by liver cells to transport
lipids to various tissues in the body; composed primarily of triglycerides.
2. Low-density lipoproteins (LDL): the type of lipoproteins derived from VLDL as cells remove triglycerides
from them. LDL carries cholesterol and triglycerides from the liver to the cells of the body and are
composed primarily of cholesterol.
3. High-density lipoproteins (HDL): the type of lipoproteins that transport cholesterol back to the liver from
peripheral cells; composed primarily of protein.
⎯ Elevated blood concentrations of LDL are associated with a high risk of heart disease, as are low levels of HDL.
CHECK FOR UNDERSTANDING
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.

1. Once food is swallowed; it travels through the digestive tract in this order:
a. esophagus, stomach, large intestine, liver.
b. esophagus, stomach, small intestine, large intestine.
c. small intestine, stomach, esophagus, large intestine.
d. small intestine, large intestine, stomach, esophagus.
B.
ANSWER: ________
RATIO:___________________________________________________________________________________________
Food travels through the digestive tract from the esophagus, stomach, small intestine, large intestine.
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2. Once chyme travels the length of the small intestine; it passes through the ileocecal valve at the beginning of the:
a. large intestine.
b. stomach.
c. esophagus.
d. jejunum.
A.
ANSWER: ________
RATIO:___________________________________________________________________________________________
Chyme travels from the stomach enters and travels to the small intestines it then travels through the ileocecal valve at the beginning of the
large intestine.
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3. The periodic squeezing or partitioning of the intestine by its circular muscles that both mixes and slowly pushes the
contents along is known as:
a. secretion.
b. absorption.
c. peristalsis.
d. segmentation
D.
ANSWER: ________
RATIO:___________________________________________________________________________________________
Segmentation mixes with utility in the G.I
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4. Within the circulatory system, lipids travel from place to place bundled with proteins as:
a. microvilli.
b. chylomicrons.
c. lipoproteins.
d. phospholipids.
C.
ANSWER: ________
RATIO:___________________________________________________________________________________________
Lipoprotiens include VLDL, LDL, and HDL.
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5. Elevated LDL concentrations in the blood are associated with:

a. a high-protein diet.
b. a low risk of diabetes.
c. regular physical activity.
d. a high risk of heart disease.
D.
ANSWER: ________
Elevated LDL is associated with a high risk of heart disease due to handling too arch cholesterol in the blood.
RATIO:___________________________________________________________________________________________
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RATIONALIZATION ACTIVITY
The instructor will now provide you the rationalization to these questions. You can now ask questions and debate among
yourselves. Write the correct answer and correct/additional ratio in the space provided.
1. ANSWER: ________
RATIO:________________________________________________________________________________________
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2. ANSWER: ________
RATIO:________________________________________________________________________________________
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3. ANSWER: ________
RATIO:________________________________________________________________________________________
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4. ANSWER: ________
RATIO:________________________________________________________________________________________
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5. ANSWER: ________
RATIO:________________________________________________________________________________________
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LESSON WRAP-UP

You will now mark (encircle) the session you have finished today in the tracker below. This is simply a visual to help you
track how much work you have accomplished and how much work there is left to do.

You are done with the session! Let’s track your progress.

AL Activity: CAT: MINUTE PAPER

This strategy provides feedback on whether or not you understand the lesson. Use the space provided in this activity
sheet to answer the following questions. Make sure to not miss a tiny detail!

How would you illustrate the mechanism of digestion and absorption?

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