ANATOMY & PHYSIOLOGY

THE DIGESTIVE SYSTEM

 The human digestive system is a complex series of organs and

glands that processes food. In order to use the food we eat, our

body has to break the food down into smaller molecules, and it also

has to excrete waste.

Most of the digestive organs (like the stomach and the

intestines) are tube-like and contain the food as it makes its way

through the body. The digestive system is essentially a long,

twisting tube that runs from the mouth to the anus, plus few other

organs (like the liver and pancreas) that produce or store digestive

enzymes.

THE DIGESTIVE PROCESS

The digestive process begins in the mouth. Food is partly broken

down by the process of chewing and by chemical action of salivary

enzymes (these enzymes are produced by the salivary glands and

break down starches into smaller molecules).

After being chewed and swallowed, the food enters the

esophagus. The esophagus is a long tube that runs from the mouth

to the stomach. It uses rhythmic, wave-like muscle movements.

 Then, food enters the stomach which is a large, sac-like organ

that churns the food and bathes it in a very strong acid (gastric acid).

Food in the stomach that is partly digested and mixed with stomach

acids is called chyme.

After being in the stomach, food enters the jejunum, the

duodenum and then the ileum of the small intestine. In the small

intestine, bile (produced in the liver and stored in the bladder),

pancreatic enzymes and other digestive enzymes produced by the

inner wall of the small intestine help in the break down of food.

After passing through the small intestine, food passes into the

large intestines. Here, some of the water and electrolytes are removed

from the food. Many microbes (like Bacteroides, Lactobacillus

acidophilus, Escherichia coli and Klebsiella) in the large intestines

help in the digestion process. The first part of the large intestine is

called cecum in which the appendix is connected, food then travels

upward in the ascending colon, then travels across the abdomen in

the transverse colon to the descending colon then to the sigmoid

colon.
 Solid waste is then stored in the rectum until excreted via the

anus.

The illustration above shows two cycles occurring separately to

maintain homeostasis in the body. When glucose levels are too high

the pancreas secretes insulin to convert excess glucose to gycogen

for storage. When glucose levels are too low the pancreas produces

glucagon to convert stored glycogen to glucose, resulting in an

increase in glucose levels.

 Type 2 diabetes mellitus has major problems of insulin
resistance and impaired insulin secretion.
Insulin could not bind with the special receptors so insulin becomes
less effective at stimulating glucose uptake and at regulating the
glucose release.
There must be increased amounts of insulin to maintain glucose level
at a normal or slightly elevated level.
However, there is enough insulin to prevent the breakdown of fats and
production of ketones.
Uncontrolled type 2 diabetes could lead to hyperglycemic,
hyperosmolar nonketotic syndrome.
 The usual symptoms that the patient may feel are polyuria, polydipsia,
polyphagia, fatigue, irritability, poorly healing skin wounds, vaginal
infections, or blurred vision.

HYPERTENSION

Anatomy and Physiology

The circulatory system is comprised of the heart, aorta, arteries, arterioles, capillary beds,
and the veins. Blood pressure is maintained by the systolic contractions of the left ventricle
of the heart. Blood ejected from the heart passes through one-way valves into the aorta.
Systolic pressure peaks immediately following each contraction of the left heart.

This systolic pressure is measured in the clinic and the laboratory in terms of mmHg. The
pressure exerted is measured by a column of the heavy liquid metal known as mercury.
Mercury (Hg) is a heavy metal like gold. A systolic pressure of 120 mmHg would
approximately equal the downward force of roughly 30 inches (120 cm) of this heavy metal.
To put this into perspective, the weight of the column of air that is pressing down on each of
us (one "atmosphere" of pressure) is 760 mmHg.

Diastolic pressure is the pressure that remains in the arterial system approximately one
second later and immediately before the next systolic contraction of the heart. During this
intervening second, arterial blood pressure drops as blood is filtered through the capillary
bed. The degree of vasoconstriction of these vascular smooth muscles determines the rate
at which blood perfuses through the capillary beds at all tissues and into the venous
system. The endothelial cells that line the inside of these capillaries are particularly
susceptible to the long-term effects of hypertension, especially when these capillaries
supply blood to the tissues of the heart, kidney, brain, and eye. Smooth muscle cells
surrounding the capillary beds play an important role in the regulation of blood pressure and
are targets for many of the medications used to treat hypertension.

Pathophysiology

In a normal circulation, pressure is transferred from the heart muscle to the

blood each time the heart contracts and then pressure is exerted by the blood
as it flows through the blood vessels.

The pathophysiology of hypertension follows.

 Hypertension is a multifactorial
When there is excess sodium intake, renal sodium retention occurs,
which increases fluid volume resulting in increased preload and
increase in contractility.
Obesity is also a factor in hypertension because hyperinsulinemia
develops and structural hypertrophy results leading to increased
peripheral vascular resistance.
Genetic alteration also plays a role in the development of
hypertension because when there is cell membrane alteration,
functional constriction may follow and also results in increased
peripheral vascular resistance.

Clinical Manifestations

Many people who have hypertension are asymptomatic at first. Physical

examination may reveal no abnormalities except for an elevated blood pressure,
so one must be prepared to recognize hypertension at its earliest.

Headache. The red blood cells carrying oxygen is having a hard time
reaching the brain because of constricted vessels, causing headache.
Dizziness occurs due to the low concentration of oxygen that
reaches the brain.
Chest pain. Chest pain occurs also due to decreased oxygen levels.
Blurred vision. Blurred vision may occur later on because of too
much constriction in the blood vessels of the eye that red blood
cells carrying oxygen cannot pass through.