The Digestive System the Human Digestive System Is an Extended Tube with Specialized Parts Between Two Openings, the Mouth and the Anus
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Relationships Between the Autonomic Nervous System and the Pancreas Including Regulation of Regeneration and Apoptosis Recent Developments
ORIGINAL ARTICLE Relationships Between the Autonomic Nervous System and the Pancreas Including Regulation of Regeneration and Apoptosis Recent Developments Takayoshi Kiba, MD, PhD organ at birth, reaches its adult size and morphology after Abstract: Substantial new information has accumulated on the weaning (3 weeks of age). mechanisms of secretion, the development, and regulation of the gene In pancreatic regeneration after cholecystokinin analog expression, and the role of growth factors in the differentiation, growth, and regeneration of the pancreas. Many genes that are re- cerulein-induced acute pancreatitis, 2 separate peaks of DNA quired for pancreas formation are active after birth and participate in synthesis have been reported. The first peak corresponded with endocrine and exocrine cell functions. Although the factors that nor- duct cell and mesenchymal cell proliferation, and the second mally regulate the proliferation of the pancreas largely remain elu- peak was associated with acinar cell proliferation.1 However, sive, several factors to influence the growth have been identified. It in this model, islet cells did not regenerate. Formation of new was also reported that the pancreas was sensitive to a number of apop-  cells can take place via 2 pathways: replication of already totic stimuli. The autonomic nervous system influences many of the differentiated  cells and neogenesis from putative islet stem functions of the body, including the pancreas. In fact, the parasympa- cells. It is generally admitted that neogenesis mostly takes thetic nervous system and the sympathetic nervous system have op- place during fetal and neonatal life. In adulthood, little increase posing effects on insulin secretion from islet  cells; feeding-induced in the -cell number seems to occur. -
Papilla with Separate Bile and Pancreatic Duct Orifices
JOP. J Pancreas (Online) 2013 May 10; 14(3):302-303. MULTIMEDIA ARTICLE – Clinical Imaging Papilla with Separate Bile and Pancreatic Duct Orifices Surinder Singh Rana, Deepak Kumar Bhasin Department of Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER). Chandigarh, India A 32-year-old male, a known case of alcohol related Conflict of interest The authors have no potential chronic non calcific pancreatitis, was referred to us for conflicts of interest pancreatic endotherapy for relief of intractable abdominal pain. The cross sectional imaging studies References had revealed an irregularly dilated main pancreatic duct. The examination of the major duodenal papilla 1. Silvis SE, Vennes JA, Dreyer M. Variation in the normal duodenal papilla. Gastrointest Endosc 1983; 29:132-133 [PMID; revealed the presence of two separate orifices at 6852473] endoscopic retrograde cholangiopancreatography (ERCP) (Image). The cranial orifice was located at 11- 12 clock position whereas the caudal orifice was located at 4-5 clock position. The caudal orifice was selectively cannulated and the injection of the contrast revealed presence of an irregularly dilated main pancreatic duct. The cannula and the guide wire introduced through the caudal orifice selectively entered the pancreatic duct and did not come out through the cranial orifice. During ERCP, bile could be seen coming out of the cranial orifice, confirming it to be the orifice of common bile duct. Following selective cannulation of the main pancreatic duct, a 5-Fr stent was placed into the pancreatic duct. Following this, the patient had complete pain relief and is planned for further sessions of pancreatic endotherapy along with pancreatic sphincterotomy. -
Angina Bullosa Haemorrhagica (Oral Blood Blister) (PDF)
Patient Information Maxillo-facial Angina Bullosa Haemorrhagica (Oral Blood Blister) What is Angina Bullosa Haemorrhagica? Angina Bullosa Hemorrhagica (ABH) is a condition where an often painful, but benign blood-filled blister suddenly develops in the mouth. The blisters are generally not due to a blood clotting disorder or any other medical disorder. It is a fairly common, sudden onset and benign blood blistering oral (mouth) disorder. It mainly affects people over 45 years and both males and females are equally affected. Usually there is no family history of the condition. It may be associated with Type 2 Diabetes, a family history of diabetes or Hyperglycaemia. What are the signs and symptoms of ABH? The first indication is a stinging pain or burning sensation just before the appearance of a blood blister The blisters last only a few minutes and then spontaneously rupture (burst), leaving a shallow ulcer that heals without scarring, discomfort or pain They can reach an average size of one to three centimetres in diameter The Soft Palate (back of the mouth) is the most affected site If they occur on the palate and are relatively big, they may need to be de-roofed (cut and drained) to ease the sensation of choking Patient Information Occasionally blisters can occur in the buccal mucosa (cheek) and tongue Approximately one third of the patients have blood blisters in more than one location. What are the causes of ABH? More than 50% of cases are related to minor trauma caused by: hot foods, restorative dentistry (fillings, crowns etc) or Periodontal Therapy (treatment of gum disease). -
Physiology of the Pancreas
LECTURE IV: Physiology of the Pancreas EDITING FILE IMPORTANT MALE SLIDES EXTRA FEMALE SLIDES LECTURER’S NOTES 1 PHYSIOLOGY OF THE PANCREAS Lecture Four OBJECTIVES ● Functional Anatomy ● Major components of pancreatic juice and their physiologic roles ● Cellular mechanisms of bicarbonate secretion ● Cellular mechanisms of enzyme secretion ● Activation of pancreatic enzymes ● Hormonal & neural regulation of pancreatic secretion ● Potentiation of the secretory response Pancreas Lying parallel to and beneath the stomach, it is a large compound gland with most of its internal structure similar to that of the salivary glands. It is composed of: Figure 4-1 Endocrine portion 1-2% Exocrine portion 95% (Made of Islets of Langerhans) (Acinar gland tissues) Secrete hormones into the blood Made of acinar & ductal cells.1 - ● Insulin (beta cells; 60%) secretes digestive enzymes, HCO3 ● Glucagon (alpha cells; 25%) and water into the duodenum . ● Somatostatin (delta cells; 10%). Figure 4-2 Figure 4-3 ● The pancreatic digestive enzymes are secreted by pancreatic acini. ● Large volumes of sodium bicarbonate solution are secreted by the small ductules and larger ducts leading from the acini. ● Pancreatic juice is secreted in response to the presence of chyme in the upper portions of the small intestine. ● Insulin and Glucagon are crucial for normal regulation of glucose, lipid, and protein metabolism. FOOTNOTES 1. Acinar cells arrange themselves like clusters of grapes, that eventually release their secretions into ducts. Collection of acinar cells is called acinus, acinus and duct constitute one exocrine gland. 2 PHYSIOLOGY OF THE PANCREAS Lecture Four Pancreatic Secretion: ● Amount ≈ 1.5 L/day in an adult human. ● The major functions of pancreatic secretion: To neutralize the acids in the duodenal chyme to optimum range 1 (pH=7.0-8.0) for activity of pancreatic enzymes. -
Vestibule Lingual Frenulum Tongue Hyoid Bone Trachea (A) Soft Palate
Mouth (oral cavity) Parotid gland Tongue Sublingual gland Salivary Submandibular glands gland Esophagus Pharynx Stomach Pancreas (Spleen) Liver Gallbladder Transverse colon Duodenum Descending colon Small Jejunum Ascending colon intestine Ileum Large Cecum intestine Sigmoid colon Rectum Appendix Anus Anal canal © 2018 Pearson Education, Inc. 1 Nasopharynx Hard palate Soft palate Oral cavity Uvula Lips (labia) Palatine tonsil Vestibule Lingual tonsil Oropharynx Lingual frenulum Epiglottis Tongue Laryngopharynx Hyoid bone Esophagus Trachea (a) © 2018 Pearson Education, Inc. 2 Upper lip Gingivae Hard palate (gums) Soft palate Uvula Palatine tonsil Oropharynx Tongue (b) © 2018 Pearson Education, Inc. 3 Nasopharynx Hard palate Soft palate Oral cavity Uvula Lips (labia) Palatine tonsil Vestibule Lingual tonsil Oropharynx Lingual frenulum Epiglottis Tongue Laryngopharynx Hyoid bone Esophagus Trachea (a) © 2018 Pearson Education, Inc. 4 Visceral peritoneum Intrinsic nerve plexuses • Myenteric nerve plexus • Submucosal nerve plexus Submucosal glands Mucosa • Surface epithelium • Lamina propria • Muscle layer Submucosa Muscularis externa • Longitudinal muscle layer • Circular muscle layer Serosa (visceral peritoneum) Nerve Gland in Lumen Artery mucosa Mesentery Vein Duct oF gland Lymphoid tissue outside alimentary canal © 2018 Pearson Education, Inc. 5 Diaphragm Falciform ligament Lesser Liver omentum Spleen Pancreas Gallbladder Stomach Duodenum Visceral peritoneum Transverse colon Greater omentum Mesenteries Parietal peritoneum Small intestine Peritoneal cavity Uterus Large intestine Cecum Rectum Anus Urinary bladder (a) (b) © 2018 Pearson Education, Inc. 6 Cardia Fundus Esophagus Muscularis Serosa externa • Longitudinal layer • Circular layer • Oblique layer Body Lesser Rugae curvature of Pylorus mucosa Greater curvature Duodenum Pyloric Pyloric sphincter antrum (a) (valve) © 2018 Pearson Education, Inc. 7 Fundus Body Rugae of mucosa Pyloric Pyloric (b) sphincter antrum © 2018 Pearson Education, Inc. -
Head and Neck
DEFINITION OF ANATOMIC SITES WITHIN THE HEAD AND NECK adapted from the Summary Staging Guide 1977 published by the SEER Program, and the AJCC Cancer Staging Manual Fifth Edition published by the American Joint Committee on Cancer Staging. Note: Not all sites in the lip, oral cavity, pharynx and salivary glands are listed below. All sites to which a Summary Stage scheme applies are listed at the begining of the scheme. ORAL CAVITY AND ORAL PHARYNX (in ICD-O-3 sequence) The oral cavity extends from the skin-vermilion junction of the lips to the junction of the hard and soft palate above and to the line of circumvallate papillae below. The oral pharynx (oropharynx) is that portion of the continuity of the pharynx extending from the plane of the inferior surface of the soft palate to the plane of the superior surface of the hyoid bone (or floor of the vallecula) and includes the base of tongue, inferior surface of the soft palate and the uvula, the anterior and posterior tonsillar pillars, the glossotonsillar sulci, the pharyngeal tonsils, and the lateral and posterior walls. The oral cavity and oral pharynx are divided into the following specific areas: LIPS (C00._; vermilion surface, mucosal lip, labial mucosa) upper and lower, form the upper and lower anterior wall of the oral cavity. They consist of an exposed surface of modified epider- mis beginning at the junction of the vermilion border with the skin and including only the vermilion surface or that portion of the lip that comes into contact with the opposing lip. -
Fact Sheet - Symptoms of Pancreatic Cancer
Fact Sheet - Symptoms of Pancreatic Cancer Diagnosis Pancreatic cancer is often difficult to diagnose, because the pancreas lies deep in the abdomen, behind the stomach, so tumors are not felt during a physical exam. Pancreatic cancer is often called the “silent” cancer because the tumor can grow for many years before it causes pressure, pain, or other signs of illness. When symptoms do appear, they can vary depending on the size of the tumor and where it is located on the pancreas. For these reasons, the symptoms of pancreatic cancer are seldom recognized until the cancer has progressed to an advanced stage and often spread to other areas of the body. General Symptoms Pain The first symptom of pancreatic cancer is often pain, because the tumors invade nerve clusters. Pain can be felt in the stomach area and/or in the back. The pain is generally worse after eating and when lying down, and is sometimes relieved by bending forward. Pain is more common in cancers of the body and tail of the pancreas. The abdomen may also be generally tender or painful if the liver, pancreas or gall bladder are inflamed or enlarged. It is important to keep in mind that there are many other causes of abdominal and back pain! Jaundice More than half of pancreatic cancer sufferers have jaundice, a yellowing of the skin and whites of the eyes. Jaundice is caused by a build-up bilirubin, a substance which is made in the liver and a component of bile. Bilirubin contains a lot of yellow pigment, and gives bile it’s color. -
Common Bile Duct Exploration
Education Common Bile Duct Exploration What is a common bile duct exploration? The common bile duct is a tube that connects the liver, gallbladder, and pancreas to the small intestine. It helps deliver fluids for digestion. A common bile duct exploration is a procedure used to see if a stone is blocking the flow of bile from your liver and gallbladder to your intestine. When is it used? When a stone gets stuck in the common bile duct it may cause bile to back up into the liver. This causes jaundice. Jaundice is a condition in which the skin and the whites of the eyes become yellowish. If the stone is not removed, the common bile duct may become infected and need emergency surgery. It can also cause pancreatitis, a reaction in the pancreas that can be life threatening. Common bile duct exploration is often done during surgery to remove the gallbladder. An alternative procedure is an endoscopic retrograde cholangiopancreatography (ERCP). When an ERCP is done, a tube is inserted through your mouth and stomach into the small intestine. The tube can be used to put contrast dye into the duct to look for stones with x-rays. If there are stones, a small opening is made in the common duct to allow the stone or stones to pass into the intestine. You should ask your health care provider about these choices. How do I prepare for a common bile duct exploration? Plan for your care and recovery after the operation. Allow for time to rest and try to find people to help you with your day-to- day duties. -
Macroanatomical Investigations on the Oral Cavity of Male Porcupines (Hystrix Cristata)
Walaa Fadil Obead et al /J. Pharm. Sci. & Res. Vol. 10(3), 2018, 623-626 Macroanatomical investigations on the oral cavity of male Porcupines (Hystrix cristata) Walaa Fadil Obead1, Abdularazzaq baqer kadhim2 , fatimha Swadi zghair2 1Department of Anatomy and Histology, Faculty of Veterinary Medicine'' University of Kerbala, Iraq. 2Division of Anatomy and Histology'', Faculty of Veterinary Medicine'' University of Qadysiah, Iraq. Abstract: ''Six adult males hystrix crestate was utilizes to decide the district anatomy of their mouth. The mouth was the advent via disjunct the temporo-mandibular united and the topographically and Morphometric tagged of the tongue, cheek pouch, major salivary glands, palate, lips and teeth were studied. The upper flange discovered a philtrum rollover from ''the median bulkhead of the nostrils and terminating at the oral chapping in a dissimilarity triangle to depiction the elongated incisors''. The lower flange bent a smooth arch ventral to the upper flange. A standard number of jagged Palatine ridges are eight. Histological appearance of the tongue was confirmed after staining of the eosin and the haematoxylin. The parotid, the mandibular, and the sublingual are major salivary glands were well developed''. This labor information baseline investigates data on the anatomy of the Hystrix cristata mouth and will have usefulness informative the adaptive appearance in this rodent to its lifestyle, habitat and diet. Keyword: Oral cavity, Tongue, Salivary gland, Palate, Hystrix crestate. INTRODUCTION sublingual organs be inverse and fine urbanized.'' (9, 10).The aim ''Rodents include main and the majority varied collection of of the study anatomy and histology of oral cavity of porcupian. mammals through over 1700 dissimilar types (1). -
CDIBC 11 Digestivehepato SG Download Resource
Key Diseases Associated with the Digestive and Hepatobiliary Systems Study Guide 1.1 Key Diseases Associated with the Digestive, Hepatobiliary and Urinary Systems © 2017 HCPro. All rights reserved. These materials may not be duplicated without the express written permission of HCPro. 1.3 Human Digestive System 1.4 Documentation for GI Conditions (cont.) © 2017 HCPro. All rights reserved. These materials may not be duplicated without the express written permission of HCPro. 1.5 Abdominal Pain 1.6 Conditions Associated W/Abdominal Pain © 2017 HCPro. All rights reserved. These materials may not be duplicated without the express written permission of HCPro. 1.7 MS-DRG 391, 392 1.8 Abdominal Pain: Epigastric © 2017 HCPro. All rights reserved. These materials may not be duplicated without the express written permission of HCPro. 1.9 Abdominal Pain: Epigastric (cont.) 1.10 Abdominal Pain: Gastritis © 2017 HCPro. All rights reserved. These materials may not be duplicated without the express written permission of HCPro. 1.11 Gastritis/Duodenitis/Gastroduodenitis 1.12 Gastritis © 2017 HCPro. All rights reserved. These materials may not be duplicated without the express written permission of HCPro. 1.13 Ulcerative Colitis 1.14 Ulcerative Colitis: K51 © 2017 HCPro. All rights reserved. These materials may not be duplicated without the express written permission of HCPro. 1.15 Crohn’s Disease 1.16 Coding Clinic, 4th Quarter 2012 © 2017 HCPro. All rights reserved. These materials may not be duplicated without the express written permission of HCPro. 1.17 Coding Clinic, 4th Quarter 2012 (cont.) 1.18 Ulcer of the Intestine © 2017 HCPro. All rights reserved. -
Enteric Nervous System (ENS): 1) Myenteric (Auerbach) Plexus & 2
Enteric Nervous System (ENS): 1) Myenteric (Auerbach) plexus & 2) Submucosal (Meissner’s) plexus à both triggered by sensory neurons with chemo- and mechanoreceptors in the mucosal epithelium; effector motors neurons of the myenteric plexus control contraction/motility of the GI tract, and effector motor neurons of the submucosal plexus control secretion of GI mucosa & organs. Although ENS neurons can function independently, they are subject to regulation by ANS. Autonomic Nervous System (ANS): 1) parasympathetic (rest & digest) – can innervate the GI tract and form connections with ENS neurons that promote motility and secretion, enhancing/speeding up the process of digestion 2) sympathetic (fight or flight) – can innervate the GI tract and inhibit motility & secretion by inhibiting neurons of the ENS Sections and dimensions of the GI tract (alimentary canal): Esophagus à ~ 10 inches Stomach à ~ 12 inches and holds ~ 1-2 L (full) up to ~ 3-4 L (distended) Duodenum à first 10 inches of the small intestine Jejunum à next 3 feet of small intestine (when smooth muscle tone is lost upon death, extends to 8 feet) Ileum à final 6 feet of small intestine (when smooth muscle tone is lost upon death, extends to 12 feet) Large intestine à 5 feet General Histology of the GI Tract: 4 layers – Mucosa, Submucosa, Muscularis Externa, and Serosa Mucosa à epithelium, lamina propria (areolar connective tissue), & muscularis mucosae Submucosa à areolar connective tissue Muscularis externa à skeletal muscle (in select parts of the tract); smooth muscle (at least 2 layers – inner layer of circular muscle and outer layer of longitudinal muscle; stomach has a third layer of oblique muscle under the circular layer) Serosa à superficial layer made of areolar connective tissue and simple squamous epithelium (a.k.a. -
Bile Duct Cancer Causes, Risk Factors, and Prevention Risk Factors
cancer.org | 1.800.227.2345 Bile Duct Cancer Causes, Risk Factors, and Prevention Risk Factors A risk factor is anything that affects your chance of getting a disease such as cancer. Learn more about the risk factors for bile duct cancer. ● Bile Duct Risk Factors ● What Causes Bile Duct Cancer? Prevention There's no way to completely prevent cancer. But there are things you can do that might help lower your risk. Learn more. ● Can Bile Duct Cancer Be Prevented? Bile Duct Risk Factors A risk factor is anything that affects your chance of getting a disease like cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed. Others, like a person’s age or family history, can’t be changed. But having a risk factor, or even many risk factors, does not mean that a person will get 1 ____________________________________________________________________________________American Cancer Society cancer.org | 1.800.227.2345 the disease. And many people who get the disease have few or no known risk factors. Researchers have found some risk factors that make a person more likely to develop bile duct cancer. Certain diseases of the liver or bile ducts People who have chronic (long-standing) inflammation of the bile ducts have an increased risk of developing bile duct cancer. Certain conditions of the liver or bile ducts can cause this, these include: ● Primary sclerosing cholangitis (PSC), a condition in which inflammation of the bile ducts (cholangitis) leads to the formation of scar tissue (sclerosis). People with PSC have an increased risk of bile duct cancer.