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    Pharynx Esophagus and Stomach Part 2

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    Naveela
    The 3 main phases that regulate gastric secretion are the cephalic, gastric, and intestinal phases. The cephalic phase occurs before eating and is triggered by the sight, smell, or thought of food. The gastric phase begins when food enters the stomach and stimulates the release of gastrin which increases hydrochloric acid secretion. The intestinal phase is stimulated by food in the duodenum and works to reduce gastric secretion and motility through the hormones secretin and cholecystokinin.

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    Pharynx Esophagus and Stomach Part 2

    Uploaded by

    Naveela
    43 views28 pages
    The 3 main phases that regulate gastric secretion are the cephalic, gastric, and intestinal phases. The cephalic phase occurs before eating and is triggered by the sight, smell, or thought of food. The gastric phase begins when food enters the stomach and stimulates the release of gastrin which increases hydrochloric acid secretion. The intestinal phase is stimulated by food in the duodenum and works to reduce gastric secretion and motility through the hormones secretin and cholecystokinin.

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    Anatomy And Physiology for Nurses

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    The 3 main phases that regulate gastric secretion are the cephalic, gastric, and intestinal phases. The cephalic phase occurs before eating and is triggered by the sight, smell, or thought of food. The gastric phase begins when food enters the stomach and stimulates the release of gastrin which increases hydrochloric acid secretion. The intestinal phase is stimulated by food in the duodenum and works to reduce gastric secretion and motility through the hormones secretin and cholecystokinin.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    43 views28 pages

    Pharynx Esophagus and Stomach Part 2

    Uploaded by

    Naveela
    The 3 main phases that regulate gastric secretion are the cephalic, gastric, and intestinal phases. The cephalic phase occurs before eating and is triggered by the sight, smell, or thought of food. The gastric phase begins when food enters the stomach and stimulates the release of gastrin which increases hydrochloric acid secretion. The intestinal phase is stimulated by food in the duodenum and works to reduce gastric secretion and motility through the hormones secretin and cholecystokinin.

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    © All Rights Reserved
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    Download as pdf or txt
    of 28

    Digestive System

    Tanveer Saeed
    Assistant Professor
    AKU-SONAM
    Pharynx
    • 12-14 cm long
    • Extends from the
    base of the skull to
    the level of 6th.
    cervical vertebra.
    Divided into three
    parts:
    • Nasopharynx
    • Oropharynx
    • Laryngopharynx
    Tanveer Saeed
    Structure of Pharynx

    Pharynx composed of three layers:


    1. Mucosa varies slightly in different parts:
    • Nasopharynx lined by ciliated columnar
    epithelium.
    • Oro and laryngopharynx, mucosa is formed
    by squamous epithelium.
    2. Fibrous tissue: middle layer
    3. Muscle tissue: consists of several
    involuntary constrictor muscles help in
    deglutition or swallowing.
    Tanveer Saeed
    Esophagus
    • about 25 cm long,2 cm
    wide extends from
    pharynx to stomach.
    • It lies in the median plan
    in the thorax in front of the
    vertebral column behind
    the trachea and the heart.

    • upper esophageal or
    Cricopharyngeal
    sphincter,regulatesfood
    passing from
    laryngopharynx to
    esophagus
    • LOS or cardiac sphincter
    prevents regurgitation
    from stomach to
    esophagus.
    Tanveer Saeed
    Lower esophageal sphincter controls the passage into the stomach and
    only opens up when the peristaltic wave reaches this sphincter
    Heart burn occurs when gastric juices regurgitate into the esophagus
    Tanveer Saeed
    General Plan for Esophagus
    The layers of the esophagus are as follows:
    1. mucosa
    – nonkeratinized stratified squamous epithelium
    – lamina propria
    – muscularis mucosae: smooth muscle

    2. submucosa: Contains the mucous secreting glands


    (esophageal glands).

    3. muscularis externa (or "muscularis propria"): composition


    varies in different parts of the esophagus, to correspond with
    the conscious control over swallowing in the upper portions
    and the autonomic control in the lower portions:
    – upper third, or superior part: striated muscle
    – middle third, smooth muscle and striated muscle,
    4. adventitia
    Functions of the Esophagus
    • Food is passed through
    the esophagus by
    using the process of
    peristalsis.
    • The esophagus is
    deeply lined with
    muscle that acts with
    peristaltic action to
    move swallowed food
    down to the stomach.
    • Acid Reflux is also known as:
    Gastroesophageal reflux or heart burn.
    • You may feel a burning in the chest or throat
    called heartburn. Sometimes, you can taste
    stomach fluid in the back of the mouth. This is
    acid indigestion. If you have these symptoms
    more than twice a week, you may have
    GERD.
    Esophagus and Swallowing Reflex
    • The swallowing reflex is coordinated by the medulla oblongata,
    which stimulates the appropriate sequence of contraction and
    relaxation in the participating skeletal muscle, sphincters, and
    smooth muscle groups.

    • Swallowing = deglutination

    Three phases

    • Buccal Phase

    • Pharyngeal Phase

    • Esophageal Phase

    Tanveer Saeed
    The swallowing reflex is coordinated by the medulla oblongata, which
    stimulates the appropriate sequence of contraction and relaxation in the
    participating skeletal muscle, sphincters, and smooth muscle groups.

    Buccal Phase

    Tanveer Saeed
    Pharyngeal Phase Esophageal Phase

    Tanveer Saeed
    Structure of Stomach
    • J-shaped
    • Located in
    epigastric, umbilical
    and left
    hypochondriacregio
    ns of the AC.
    • Enlarged segment of
    digestive tract.
    • Lesser curvature
    • Greater curvature
    • Pyloric sphincter

    Tanveer Saeed
    Stomach
    Stomach consists of four parts:

    • Cardiac / Cardia: Surrounds the superior • Enlarged segment of digestive


    opening of the stomach. tract.
    • Fundus: Rounded portion above and to • Stores up to 2 liters of food.
    the left of the cardia.
    • Gastric glands within the
    • Body: Large central portion.
    stomach produce secretions
    • Pylorus: Inferior part of stomach called gastric juice.
    connects to the duodenum.
    • The muscular walls of the
    • Pyloric Sphincter: Guards exit from stomach contract vigorously to
    stomach
    mix food with gastric juice,
    producing a mixture called
    chyme.

    Tanveer Saeed
    Histology of the Stomach

    Specialized cells in the lining of the stomach synthesize and secrete


    mucous fluid, enzyme precursors, hydrochloric
    Tanveer Saeed acid, and hormones.
    The Layers of the Stomach
    • Serous layer – the visceral layer of the peritoneum is
    the outermost.
    • Muscular layer – this consists of smooth muscle fibers,
    the outer being longitudinal, the middle being circular and
    the inner being oblique.
    • Sub mucous layer – this is composed of loose areolar
    tissue.
    • Mucous membrane – this is honeycombed in
    appearance because of the presence of the gastric
    glands and their openings.
    • The mucous membrane has numerous folds, called
    rugae, which run longitudinally and which flatten out
    when the stomach is full.
    • The mucus secreted by the goblet cells helps to lubricate
    the food.
    The Stomach

    Tanveer Saeed
    Layers of Stomach

    Tanveer Saeed
    Stomach
    • Rugae are the extensive folds in the
    stomach lining in relaxed stomach that
    allow for expansion and increases surface
    area for digestion.
    • These folds can stretch to accommodate
    an increase in stomach volume with
    consumption of a meal.
    • They also help direct the food downward
    toward the pylorus as a result of stomach
    motility.
    Tanveer Saeed
    Tanveer Saeed
    Gastric Juice

    Composition: 2-3 L
    (2000ml- 3000ml)

    • Water
    • Mineral Salts
    • Mucus
    • Hydrochloric acid (Hcl)
    • Intrinsic factor (protein
    compound)
    • Inactive enzyme
    precursor pepsinogen
    • Mucus cells secrete
    mucus

    Tanveer Saeed
    • Hcl secreted by parietal /
    oxyntic cells
    zymogen (chief) cells release Functions of Stomach
    *pepsinogen and Food storage
    *(Inactive enzyme precursor) Mixing of food with gastric juice yielding
    chyme.
    Chemical digestion of proteins.
    • Intrinsic factor secreted by Mechanical digestion ( Churning)
    cells in gastric glands. Nonspecific immune defense.
    Secretion of intrinsic factor.
    Onward movement of the contents to the
    • Pepsinogen is converted by
    pyloric end of the stomach.
    HCl into pepsin ---- acts on
    proteins and converts them
    to polypeptided.
    Pepsin: pH 1.5 ----- 3.5

    Tanveer Saeed
    Function of Hydrochloric Acid
    • Dissolves the food fibers

    • Kills microorganisms

    • Activate enzyme pepsin

    • Acidifies the food and stops the action of


    salivary amylase
    Tanveer Saeed
    REGULATION OF GASTRIC SECRETION

    The important stimulatory signals are :


    • Autonomic nerves
    • Release acetylcholine (Ach) Stimulates
    smooth muscle contraction, also
    stimulates chief and parietal cells.

    Tanveer Saeed
    REGULATION OF GASTRIC SECRETION
    Three phases are recognized :
    • Cephalic phase prepares stomach to
    receive ingested material.
    • Gastric phase begins with the arrival of
    food in the stomach.
    • Neural, hormonal, and local responses
    • Intestinal phase controls the rate of
    gastric emptying.

    Tanveer Saeed
    Tanveer Saeed
    Cephalic Phase
    • Occurs before food enters
    the stomach; initiated by
    smell, taste,sight, thought
    (conditioned reflex ).
    • Impulses from olfactory,
    chemical and other receptors
    activate the vagal nuclei in the
    medulla (via Hypothalamus)
    • This triggers motor impulses to
    travel via the vagus nerve to
    the parasympathetic
    submucosal plexus this in turn
    stimulate stomach glands
    ( gastric glands) •
    Tanveer Saeed
    Gastric Phase

    • Starts when food reaches the


    stomach and responsible for
    2/3 of the juice released.
    • An increase in pH (thus, ‘less’
    acidity), presence of
    peptides,caffeine, alcohol,
    activates the G-cells
    • This results in Gastrin being
    released. Gastrin, being a
    hormone, needs to enter the
    blood stream and return to the
    stomach before it can act.
    • Gastrin acts on parietal cells
    that start secreting HCl.
    • The increase in HCl promotes
    pepsin production and protein
    degradation.
    Tanveer Saeed
    Intestinal Phase
    • Food in duodenum stimulates secretion of
    *enterogasterone.
    • EG in blood reduces gastric motility and
    secretion of gastric juice.
    • *Enterogasterone is a hormone complex
    formed by two hormones
    • Secretin and Cholecystokinin ( CCK)

    Tanveer Saeed

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