Lecture Notes Flashcards
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Large Intestine
Function: storage of feces and water reabsorption.
If the large intestine doesn't function correctly, it can lead to diarrhea.
Also known as the colon. Entrance regulated by the ileocecal valve.
Ileocecal Valve: Regulates the passage of fecal matter from the ileum (small intestine) to the cecum (large intestine).
Cecum: A pouch that receives fecal matter.
Ascending Colon: Transports fecal matter upwards.
Transverse Colon: Moves fecal matter from right to left.
Descending Colon: Moves fecal matter downwards.
Sigmoid Colon: S-shaped colon (named after the Latin shape Sigma).
The sigmoid colon structure requires upward and downward movement of fecal matter.
The levator ani muscle assists in defecation by lifting the sigmoid colon to facilitate easier passage of fecal matter.
Squatty Potties
Help facilitate defecation.
Assist the sigmoid colon to have more of a descending shape.
Rectum: Stores fecal matter before defecation.
Stretch receptors in the walls of the rectum trigger the defecation reflex.
Anus: The opening for fecal matter to leave the body, controlled by two sphincters:
Internal Anal Sphincter: Made of smooth muscle; relaxes involuntarily when stretch receptors are triggered.
External Anal Sphincter: Made of skeletal muscle; can be controlled voluntarily.
Smooth muscles are capable of staying contracted for long periods of time without needing to use energy, this is called latched states.
Appendix: A vestigial structure with no known function, but can cause problems like appendicitis.
Histology of the Large Intestine
Mucosal Epithelium: Made up of simple columnar epithelium and goblet cells.
Goblet cells produce mucus, providing a protective layer against bacteria and digestive enzymes in feces.
Mucus also lubricates the movement of feces.
Intestinal Glands: Produce new cells and goblet cells.
Lamina Propria: Areolar connective tissue.
Muscularis Mucosae.
Submucosa.
Muscularis Externa:
Circular layer.
Outer longitudinal layer is organized into units called taenia coli, which prevent segmentation.
Taenia Coli prevent segmentation because in the large intestine, mechanical digestion is unnecessary.
Diarrhea vs. Constipation
Diarrhea: Fecal matter moves too quickly through the large intestine, resulting in insufficient water reabsorption.
Constipation: Fecal matter moves too slowly, leading to over-reabsorption of water, causing dry and hard feces.
Recommendation for constipation: increase fiber intake.
Fiber cannot be digested, providing a solid consistency to prevent over-reabsorption of water.
Serosa Layer: Visceral peritoneum, parietal peritoneum, and peritoneal cavity filled with serous fluid.
The rectum is surrounded by adventitia rather than serosa.
The population of bacteria depends on things such as sex, ethnicity, race, location, and food intake.
E. Coli
E. Coli is a type of bacteria.
Once E. Coli is in the digestive system it will cause immune response, such as vomiting.
Appendicitis
Inflammation of the appendix.
The appendix walls get thicker as a result, closing the opening from the cecum to the appendix.
Bacteria inside produce gas, causing appendix to burst.
Burst appendix can lead to peritonitis (inflammation of the peritoneum) which can be fatal if untreated.
Most common in ages 18-34. Age is just statistical significance, doesn't mean people outside of that can't experience appendicitis.
Treatment: remove the appendix; if the appendix has burst, a longer hospital stay is required to flush out the fecal matter and bacteria from the peritoneal cavity.
Some people have a wide opening in their appendix, which prevents appendicitis from occurring.
Diverticulitis
Pouches (diverticula) form in the large intestine, which can become inflamed if fecal matter gets stuck inside.
Symptoms: pain, constipation, abdominal soreness, nausea, vomiting.
These pouches are much stronger than the appendix.
Colitis
Inflammation of the entire colon.
Associated with diseases like Crohn's disease (autoimmune disorder where the immune system attacks the large intestine).
Can also be caused by bacterial or viral infections.
Colon Cancer
Rapidly becoming the number one cancer killer in the United States because people dying from lung cancer is dropping.
Often asymptomatic, requiring regular check-ups.
Statistics: One in six people may develop colon cancer, and 50% of those with colon cancer die from it.
Detection methods:
Colonoscopy: Tube with a camera is inserted through the anus to look for polyps (growths that can turn into cancer).
Fecal Sample: Analyzed for epithelial cells with genetic mutations indicative of cancer.
Diverticula are pouches that come out of the large intestine, while polyps projecting into the lumen.
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The Liver
Largest internal organ with over 500 functions.
Makes all blood proteins (clotting factors, albumin, etc.), except antibodies.
Regulates blood glucose levels.
Processes fats, amino acids, and carbohydrates.
Makes cholesterol.
Converts hemoglobin into bilirubin, which is used to make bile (an emulsifier for fat).
Hepatocytes (liver cells) replicate quickly.
A person can donate part of their liver because it grows back. It can only be donated once before abnormal growth.
Liver Lobule Structure/Hepatic Portal Triad
Functional Units of the Liver = Liver Lobule.
Hepatic Portal Triad consists of:
Hepatic artery (brings blood in).
Hepatic portal vein (brings blood from the digestive system and spleen).
Bile duct.
Blood from the hepatic artery and hepatic portal vein is processed in the liver lobule.
Central vein returns blood to the inferior vena cava via the hepatic vein.
Hepatic sinusoids are the spaces between hepatocytes where blood travels.
Hepatocytes process the blood and can remove substances like alcohol.
As blood flows, it can enter the hepatocyte and then the hepatocyte can spit back the processed material into the sinusoid.
Bile Canaliculi: Structures next to hepatocytes that receive bile.
Bile is made from broken-down hemoglobin, bilirubin, cholesterol, etc.
Kupffer Cells: Macrophages fixed in the sinusoids that break down red blood cells.
Red blood cell parts are then processed by hepatocytes into bile.
Liver Diseases
Cirrhosis: Death of liver lobules, often caused by excessive alcohol consumption.
Alcohol is a toxic substance that the liver tries to remove, but it damages hepatocytes.
The liver can recover if alcohol consumption stops, unless there's significant scar tissue.
Hepatitis: Inflammation of the liver, usually due to viral or bacterial infections, leading to the death of hepatocytes and cirrhosis.
Liver Cancer also leads to the death of hepatocytes.
Build up of Bilirubin
Jaundice: Yellowing of the skin and sclera due to the buildup of bilirubin, an orange-colored substance.
Bilirubin build up happens due to the death of hepatocytes, and kupffer cells remain and break down old red blood cells.
Jaundice is a sign of liver disease.
It isn't the disease itself.
Neonatal Jaundice: Common in newborns due to the breakdown of fetal red blood cells.
UV light can help remove bilirubin.
Pathway of Bile
The liver has four lobes.
The Liver makes bile and then sends it to the gallbladder for storage.
Left and right hepatic ducts bring bile from the liver and then joins to become the common hepatic duct
Cystic duct leads to the gallbladder.
Common bile duct - cystic duct as well as the common hepatic ducts are going to be able to send bile over to the duodenum.
Sphincter of Oddi - the common bile duct and the pancreatic duct send their secretions to.
If Sphincter of Oddi is closed, the bile rises up into the gallbladder.
Gallbladder's function other than holding bile is to concentrate bile.
Gallstones
If the gallbladder concentrates bile too much, it can crystallize and form gallstones.
Gallstones cause pain, and typically the gallbladder is removed by tying off the cystic duct.
An incision cannot be done to save the gallbladder, as that may leak bile and cause peritonitis.
If no gallbladder =
The Liver will be asked to produce more bile quickly.
The Liver would just secrete bile, so you'll have to watch out for high fat foods.
Peritoneal Cavity
Parietal Peritoneum: Membrane attached to the walls of the abdominal cavity.
Visceral Peritoneum: Membrane attached to the gastrointestinal tracts.
Mesentery: Formed by the parietal peritoneum; supports blood vessels and nerves.
Omentum: Similar to mesentery but larger and surrounds organs like the liver.
The visceral peritoneum and the parietal are made up of simple squamous epithelium.
The space between the Parietal Peritoneum and Visceral Peritoneum forms the Peritoneal Cavity.
Burst appendix affect this a lot.
Retroperitoneal Cavity: Space behind the peritoneum.
Mid-Sagittal Sections:
Peritoneal Cavity - purple region
Greater Omentum - yellow structure.
Retroperitoneal Cavity - yellow region which has the kidneys and aorta.
Infra Peritoneal cavity-red region which has the bladder and uterus.
Mesenteries are used to deliver blood vessels and nerves.
Nerve endings in the Mesenteries = potential hypotheses for cramps during period.
Omentum surrounds organs for compartmentalization.
Urinary System Functions
Removal of metabolic wastes like urea.
Regulation of ion concentration (sodium, potassium, calcium).
Blood pH Balance regulation that is done by hydrogen ion concentration.
Regulation of blood volume.
Regulation of blood pressure. Blood volume is going to affect Blood pressure.
Kidneys found in retroperitoneal space T12-L2.
The Adrenal Glands are found on top of the kidneys.
Kidney Structure
Renal Capsule: Made of dense irregular connective tissue to protect the kidney.
Adipose Tissue cushions the organ, is never use for energy storage.
Renal Fascia: Renal fascia of moderately dense connective tissue, anchors the kidney.
Renal Cortex: Filters blood (more on function). Renal columns allow blood vessels to travel.
Renal Medulla: Process/Create Urine. Has Renald Columns inside and Renal Pyramids in between.
Renal Pyramids: Function in processing and production of urine.
Calyx: Made from the Renal pyramid the kidney is sent throught the opening which is known as Calyx.
Renal Pelvis: urine that we just produced goes into.
Ureter: Sends urine from the renal pelvis toward the bladder.
The Retroperitoneal Cavity is the space behind the peritoneum. In mid-sagittal sections, it includes the kidneys and aorta.
Bile is an emulsifier for fat, made by the liver from broken-down hemoglobin, bilirubin, cholesterol, etc.
The liver has four lobes.
The Liver makes bile and then sends it to the gallbladder for storage.
Left and right hepatic ducts bring bile from the liver and then joins to become the common hepatic duct
Cystic duct leads to the gallbladder.
Common bile duct - cystic duct as well as the common hepatic ducts are going to be able to send bile over to the duodenum.
Sphincter of Oddi - the common bile duct and the pancreatic duct send their secretions to.
If Sphincter of Oddi is closed, the bile rises up into the gallbladder.
Gallbladder's function other than holding bile is to concentrate bile.