MARIAN DIAMOND: All right.
Good morning.
Can you hear me?
You can't so they can't.
Can you turn it up please?
Is that better?
There it goes.
Now it's up.
Very nice.
I'm sorry.
We always have a little
trouble as we get started.
Just two quick announcements.
We'll have the key for the
exam up on the website.
So if you want to
see how you did,
we'll give your
exams back on Monday.
So they'll be out there at
Monday for you to pick up.
And on the whole, you
obviously did very well.
But it's amazing how many
students didn't, and you just
don't know why.
But it's just not a giveaway.
So Monday you'll pick them up.
We start a new system,
the digestive system.
And we're going to see that
it's a simple tube from mouth
to anus.
And it's designed to--
it's designed to prepare
food, to digest food,
and to absorb food,
and to eliminate waste.
So we'll see all the changes
that occur in this simple tube
to carry out these functions.
So we'll give the basic names.
We've had them.
Nothing difficult about it.
But we'll start with
the oral cavity.
What follows the oral cavity?
No.
STUDENT: The pharynx.
STUDENT: Pharynx.
MARIAN DIAMOND: What
part of the pharynx?
Nasal pharynx?
STUDENT: Oral.
MARIAN DIAMOND: Oral pharynx.
Let's be correct.
Oral pharynx.
And then the esophagus.
And then what?
What's next?
STUDENT: Stomach.
MARIAN DIAMOND: Pardon?
STUDENT: Stomach.
MARIAN DIAMOND: Stomach.
Stomach.
Sure.
And after the stomach?
STUDENT: Small intestine.
MARIAN DIAMOND: Small intestine.
After small intestine?
STUDENT: Large intestine.
[LAUGH]
MARIAN DIAMOND: Large intestine.
And then the rectum.
And then the anus.
So we'll see how
these will change
what their basic picture
is, and how they differ.
In the oral cavity, we're
going to have glands.
So we'll have salivary
glands come pouring in.
And for the small intestine,
we'll have glands.
What plans will pour
their secretions
into the small intestine?
STUDENT: Pancreatic.
MARIAN DIAMOND: Pancreatic.
And?
STUDENT: [INAUDIBLE]
MARIAN DIAMOND: The liver.
The liver forms the bile, right?
The liver is a gland.
It will form bile, and bile will
go into the small intestine.
So this gives you the basic,
basic fundamental divisions.
So let's start and work
down from the mouth.
So we'll go from the mouth.
And we'll have first the lips.
What muscle forms the lips?
The orbicularis oris.
Right.
And it's covered
with epithelium.
What kind of epithelium
are you going to put?
STUDENT: Stratified squamous.
MARIAN DIAMOND:
Stratified squamous.
But this time, a special
type of stratified squamous.
What's it going to be?
STUDENT: [INAUDIBLE]
MARIAN DIAMOND: Keratinized.
So we'll have the epithelium
is keratinized stratified
squamous.
And what is keratin?
Keratin is an insoluble protein.
Insoluble protein.
And as we leave the lips
and go into the oral cavity,
the oral cavity will have just
plain stratified squamous.
And you can feel a transition.
Put your tongue on
your lips, and then
bring it back into your mouth.
You feel the sharp transition
between the keratinized
and the smooth mucous
membrane in the mouth.
Did you ever know that before?
Something so simple.
Now let's look at
structures within the mouth,
in the oral cavity.
Let's start with teeth.
Teeth are the hardest
structures in the body,
so that if there's a
fire and the body burns,
the only thing that will
be left will be the teeth.
Did you know that?
No?
STUDENT: [INAUDIBLE]
MARIAN DIAMOND: Sure.
So that's how they
identify individuals
with your dental records if
something so severe happens.
So we're going to see that we
have several kinds of teeth
for certain purposes at
different stages in your life.
So we're going to
start first with--
this will be types.
And we'll have deciduous,
and you'll have 20 of these.
What's the other
word for deciduous
in your mouth for a tooth?
Baby teeth.
Does anybody still
have baby teeth?
STUDENT: [INAUDIBLE]
MARIAN DIAMOND: Yeah, sure.
I usually-- there
are exceptions.
Two of you?
Did you know that?
They erupt about six
months and continue
to erupt until about the
second and a half year.
And then we have
the permanent teeth.
How many of those do we have?
32.
And they begin to erupt
about six years of age,
and continue till when?
About age 21 years,
plus or minus.
So let's look at our permanent
teeth, what kinds we have
and why we have them.
So we'll have first incisors.
How many of those do we have?
Eight.
And what are they for?
Just put your
tongue between them.
What do they do?
They cut.
That sharp edge.
Right?
So they're for cutting.
And then we have canines.
How many of those do we have?
Four.
What are they for?
Tearing.
You get a really
tough piece of meat,
and you put it there
and pull on it, right?
Or a candy bar or whatever.
[LAUGH]
So they're for tearing.
Then the next type
will be the premolars.
And we'll have eight of those.
What are they doing?
STUDENT: Grinding.
MARIAN DIAMOND: Grinding.
Right.
You ever looked
in a cow's mouth?
They don't need the tearing
and the cutting, do they?
They have just molars for
cutting their vegetarian diet.
And then we have molars.
And how many of
those do we have?
12.
And for grinding.
How many have all
of their molars?
All of your wisdom teeth too?
How many don't have
all their wisdom teeth?
Isn't that fascinating?
Part of a modern
generation in evolution.
Evidently, we're beginning
to lose our third molar
because we don't use
our jaws for tearing--
I mean for chewing.
We have such bland foods.
So let's then look at an
example of a type of tooth,
and I've picked the
canine to work with.
So this'll be the
structure of the tooth.
And we'll take a
canine as our example.
And we'll put some
gum on the side.
Here's the gum layer.
What's the technical
term for gum?
STUDENT: Gingiva.
MARIAN DIAMOND: Gingiva.
Gingiva.
So when we get inflammation of
our gums, what do we call it?
STUDENT: Gingivitis.
MARIAN DIAMOND: Gingivitis.
Good for you.
All right with this.
Let's start to fill it in.
The part that's superior
to the gum is called what?
A crown.
The part where the gum comes
and meets the tooth is the neck.
And below the gum is what?
STUDENT: The root.
MARIAN DIAMOND: The root.
Let's put in a little more.
Let's follow the root canal
up the center of the tooth.
This will be our root canal.
And it will expand
into a pulp cavity.
Pulp cavity.
What will we find
in the pulp cavity?
Blood vessels and nerves.
And now we can begin
with the layers.
We'll have the outermost
layer, the enamel.
And then we will
have the dentine.
And then cementum.
And next is what?
Periodontal membrane.
Periodontal-- around
the tooth-- membrane.
Periodontal membrane.
For some reason, some techs
will call it a ligament,
so we'll put ligament
in parentheses.
All right.
Let's color these in.
Let's start with enamel.
And it will be our
outermost layer
that projects above the gum.
It comes down a little
bit below the gum.
And then let's go down
to the dentine, which
will be most of the tooth.
[SNEEZE]
Blessings.
And next the cementum.
And next, the periodontal--
[HIGH-PITCHED NOISE]
Ooh.
Sorry.
And that gives a basic
structure of a tooth.
Each tooth will have the
same four components.
Now what adheres the
tooth to the bone?
This is bone out here.
It's the periodontal membrane.
As you can see, it's adjacent
to bone, so adheres to tooth.
Periodontal membrane.
So what three structures
keep the tooth in its socket
so it doesn't fall out?
Keeps tooth in socket.
Well, one, the gingiva.
Two, cementum.
And three, periodontal membrane.
So you lose all those,
you lose your tooth.
As people get older,
they lose their teeth,
because the bone resorbs
around the tooth.
With aging, bone resorbs.
So how are you going to
keep your bone healthy?
Use it.
How are you going to use it?
I'll tell you a little story.
[LAUGH]
I use the heavy rubber
bands around vegetables
like broccoli.
When you take a shower, you
chew those heavy rubber bands.
I still have all my teeth.
[LAUGHTER]
And I wrote to
Wrigley's at one time,
and I said, why don't you
make a therapeutic gum
so everybody that didn't want
to chew these old rubber bands,
give them something that tastes
good to chew while they're
taking their showers.
And they said, our
customers are very
pleased with our
soft Wrigley's gum.
And they sent s a huge carton--
[LAUGHTER]
--of Wrigley's gum.
So it tells, if you have
ideas and you want a product,
suggest a change and
see what you get.
We'll take a-- anyhow.
Point of the story was that the
soft gum doesn't do anything
for keeping.
But the blood flow,
that's what you see here.
It's just like the brain.
We learned You use
it or you lose it.
Your muscles, you lose
them if you don't use them.
Your bones do the same thing,
so you have to use your bones.
This is our health course.
We want you all to be very
healthy, so keep your teeth.
Now teeth will erode
through certain substances
that you put in the mouth.
You call those dental cavities.
Technically you
call them caries.
So a cavity equals--
these are caries.
Cavities-- let's
make it plural--
are caries.
And we've asked this
before in class.
How many don't have any
dental caries at all?
You have to turn around and see.
It's a nice group of them.
How many only have one?
How many only have two?
And the rest of us all
have many more, right?
[LAUGHTER]
But it shows.
And what do we put in our
toothpaste and drinking water
today to prevent these?
STUDENT: Fluoride.
MARIAN DIAMOND: Fluoride.
What country have
you been to where
the toothpaste says, absolutely
no fluoride in our toothpaste?
I saw that in Kenya.
Because their soil has so much
fluoride that their teeth are
mottled because of
too much already,
so they want a guarantee
that their toothpaste
has no fluoride.
So different ways
to look at things.
The teeth are very
dynamic, and we
want you to maintain
healthy ones so you can chew
your food so it can digest.
Now let's go to the
tongue, another structure
within the mouth,
the oral cavity.
STUDENT: I have a question.
MARIAN DIAMOND: Please.
STUDENT: Is calcium [INAUDIBLE]?
MARIAN DIAMOND: It
can be, definitely,
because you need the calcium
for making your strong bones,
right?
Strong teeth, strong nervous
system, strong muscles.
We've learned a lot about
calcium and its essential role.
So now we're going
to go to the tongue.
And you say, well,
it's just a muscle
mass covered with epithelium.
Let's see how dynamic
this tongue is.
So we have epithelium
covering it.
What kind are you going to have?
Stratified squamous, sure.
Stratified squamous.
But you'll see little
rises in it on the surface.
If we look at the side
view or a section,
we'll see that there are
these little projections
on the surface of the tongue.
Projections on tongue surface.
What do we call them?
Papillae.
Papillae.
Papillae is plural.
Singular, just an A.
Now they're important
for many reasons.
We're going to have them
covered with epithelium,
so they're going to have
stratified squamous epithelium
on these projections.
But it's on the sides
of these papillae
that one sees taste buds.
So we'll see little
epithelial designed buds here
on the sides of our papillae.
The epithelium's designed so
they look like little buds.
The nucleus down here.
This will be a taste bud.
And then it will have it
nerve fibers surrounding it.
So substances will come in,
and this is my taste bud.
We have many different
types of papillae.
I'm just giving one example.
I'll show some pictures
of different types.
But what supplies the
anterior 2/3 taste buds?
STUDENT: [INAUDIBLE]
MARIAN DIAMOND: Pardon?
STUDENT: [INAUDIBLE]
MARIAN DIAMOND:
Seventh nerve, right.
What supplies the posterior
one third of the tongue's taste
buds?
No.
STUDENT: [INAUDIBLE]
MARIAN DIAMOND: No.
No.
STUDENT: [INAUDIBLE]
MARIAN DIAMOND: How
quickly you forget.
STUDENT: [INAUDIBLE]
MARIAN DIAMOND: Pardon?
STUDENT: [INAUDIBLE]
MARIAN DIAMOND:
Glossopharyngeal, sure.
I heard it way back there.
Did you say it
here in the front?
We didn't hear you.
Sorry.
I apologize.
Right.
You do remember.
All right.
Well, now we've talked
about the epithelium.
There is skeletal
muscle In the tongue,
and it goes in many directions.
The tongue is very
versatile in its movement.
So what is the purpose
of your tongue?
Well, first it's
important with chewing.
Purpose one, chewing.
Just try to chew without
using your tongue.
Your jaw just goes up
and down, doesn't it?
So all the food will
come crunching out.
So all the time you're
chewing, that tongue
is pushing the food
back between the teeth,
between the upper
and lower teeth.
So it pushes-- just basic
things to appreciate--
food between upper
and lower jaws.
Then another
function, swallowing.
Try to swallow.
Sit there.
Try to swallow without
moving your tongue.
You feel sort of
helpless, don't you?
Nothing happens.
You can't swallow without
moving your tongue.
So swallowing.
Just fundamental.
And the purpose
of swallowing then
is to take the food back
into the oral pharynx.
Pushes food back
in oral pharynx.
Now another very important
function is speaking.
Turn to the person
sitting next to you
and try saying a sentence
without moving your tongue.
[GIBBERISH]
You feel sort of stupid?
[LAUGH]
Isn't it amazing?
And then tell the
person to say a sentence
and watch what that tongue does.
While I'm talking to you,
mine's out, it's in, it's back,
it's forth.
It's going all
over all the time.
Tremendously versatile
function, something you've never
probably thought about.
All right.
So now we're ready to bring
the food back from the mouth
into our digestive tract.
Let's look at the layers
of the digestive tract.
See, the difference between
the digestive system
and the nervous system is
that the nervous system, you
have to think of
everything, because you
don't know what it looks like.
Here these are everyday
things that you learned
in kindergarten,
but you've never
really thought about them,
but you know where they are.
All right.
So layers of digestive system.
So we're going to have a mucosa,
a submucosa, a muscularis,
and a serosa.
And these are found throughout
your digestive tract,
but they'll have certain
characteristics that
are only found in the stomach.
They'll differ when they
get to the small intestine.
But we'll always
have the four layers.
The mucosa then will
be the mucous membrane,
which is the epithelium.
And it will have connective
tissue in the mucosa,
it will have glands, and
it will have blood vessels.
The submucosa will differ
because of its amount
of connective
tissue, because it's
the part that will allow
swelling of the tube.
If you swallow a big piece
of apple, it's got to expand,
and it's because of
the connective tissue.
So we have loose CT.
I want to put smooth
muscles also here.
I know they're blood vessels.
But we'll leave blood vessels,
but we'll put smooth muscle
here too in our mucosa.
Sorry.
And now we come down to
loose connective tissue,
blood vessels, and nerves.
And then our muscularis
will be smooth muscle.
And all of the tract will
have at least two layers,
an inner circular and
an outer longitudinal.
And we'll have waves
of contraction.
They're seen very clearly.
I'll show a picture of waves of
contraction in these muscles.
Whoops.
The circular will be more for
the position in this direction,
and then the
longitudinal will have
waves to pass the food on in
a process called peristalsis.
Peristalsis.
It's the muscle contraction
to pass food along.
When we get to
the stomach, we'll
see that the stomach has three
layers, because the stomach has
the function of churning.
Not only to pass it along,
but to churn, to mix.
So three layers in stomach.
The rest of the
tract only has two.
So the sirosa now will be--
let's write it over here--
will be epithelium.
No, it won't.
It'll be connective tissue.
It'll be adipose tissue.
That's where the fat is stored.
And then we'll have
blood vessels as well.
This is just main to show
the primary differences
between having fat, muscle,
lots of loose connective tissue,
and glands as we
go down the tract.
So now let's take a
part of the tract.
Let's take the esophagus.
How long is your esophagus?
About 10 inches.
It's extending from C6 to T11.
So you can measure on the
back to see how long it is.
And it will be-- what will be
posterior to the esophagus?
Bodies of thoracic vertebra.
Bodies of thoracic vertebra.
What will be anterior
to the esophagus?
Trachea.
Good for you.
Remember those tracheal rings?
So the esophagus then
is a continuation
from the oral pharynx down to--
where is it going?
Stomach.
Now the esophagus will have
stratified squamous epithelium,
no different from the mouth.
The oral cavity,
stratified squamous epi.
Now what will be different
from our basic four layers
will be the muscularis layer.
It will have first
skeletal muscle.
That's for the first third.
The second third, it will have
a mixture of skeletal muscle
and smooth muscle.
And the lower third will
have all smooth muscle.
What's the advantage here?
You've got the oral
pharynx up here.
You have your big
piece of apple.
It starts down the tube, and
it realizes it can't make it.
Voluntarily cough,
bring it back up again.
If it gets down here,
you can't touch it.
It's smooth muscle, involuntary.
So it's a protective
device to have
the skeletal muscle
in the superior aspect
of the esophagus.
So now let's look
at just a few words
as we start into the
abdominal cavity.
One thing I want to add here,
though, while we have it here,
we said the stomach was here.
What's the pH of the gastric
juice in your stomach?
One.
So you've got a pH
of one down here.
You've got HCL.
And sometimes for some
people, more often than not,
that HCL will get into the
lower part of the esophagus.
What do we
erroneously call that?
STUDENT: Heartburn.
MARIAN DIAMOND: Heartburn.
It has nothing to
do with the heart,
but it's close to the
heart, so felt here
when the person came in.
Must be they didn't
know their anatomy.
So HCL in lower esophagus
equals heartburn.
So with that, let's move
on down to the stomach.
People, when they ask--
they have a
stomachache they always
point to the area
around their umbilicus,
and you know how wrong that is.
So let's find out
as young anatomists
where your stomach really is.
So position, we're going to
have inferior to the diaphragm,
and we're going
to have a midline,
and we're coming in
with our esophagus.
And so where it's
ending was about T11.
And we put in our stomach.
So we see that it's about
5/6 to left of midline.
And we now can put in the parts.
So we'll have a one,
two, three, and four.
So one is called
the cardia again.
Cardia.
And all of you know what two is.
What's two?
STUDENT: The fundus.
MARIAN DIAMOND: The fundus.
Sure.
What did we say about the
fundus and another organ?
STUDENT: [INAUDIBLE]
MARIAN DIAMOND: Pardon?
STUDENT: [INAUDIBLE]
MARIAN DIAMOND: My goodness,
that was very first lecture.
Well, what sits up here between
the diaphragm and the fundus?
STUDENT: [INAUDIBLE]
MARIAN DIAMOND: I hear
you, but back there?
STUDENT: Spleen.
MARIAN DIAMOND: Spleen.
Thank you.
So two is spleen.
All right.
Three-- my, we've got to hurry.
Three is what?
STUDENT: Body.
MARIAN DIAMOND: It's
the body of the stomach.
See if you've got an
ulcer of the stomach,
you have to explain where it is.
Which part of the stomach?
And the pylorus is for--
and here we have a valve.
What do we call this valve?
STUDENT: [INAUDIBLE]
MARIAN DIAMOND:
Pyloric sphincter.
And what's it doing?
It's allowing the
chyme from the stomach
to go into the duedenum.
Chyme goes into small intestine.
And at the beginning,
it's called the duedenum.
Duodenum.
All right.
Well, we'll have to stop
there and show slides.
Do these move?
Oh.
Somewhere-- thank you.
We're missing one today.
Thank you very much.
All right.
Let's review our
digestive system.
Our oral cavity,
our lips up here.
The orbicularis oris covered
with keratinzed stratified
squamous epithelium coming back
in with the tongue on the floor
of the oral cavity.
The oral pharynx.
Here's the esophagus coming
down into the stomach.
You can see it curved to
the left of the midline.
And then we'll join
the duodenum here.
And the next one.
This is the lip showing
stratified squamous epithelium.
And the next one.
These, this is a scanning EM.
Of the tongue surface.
So you can see the papillae.
They're different
kinds, different names.
Circumvallate,
filiform, and so forth.
I just gave you an example.
Next one.
And here is your papillae
with your stratified squamous
epithelium, and here are the
taste buds along the side.
And the next one.
This is a scanning EM.
What does it look like to you?
STUDENT: [INAUDIBLE].
MARIAN DIAMOND: A rose?
How about a cabbage?
This is a type of papillae.
Isn't that amazing?
You see why it's important
to brush your tongue as well
as your teeth?
All these crevices here.
This is a type of papillae.
This is another type with
all these layers around them.
Next one.
And we're coming in showing
the tongue attached to muscles.
It's got complex muscles
to give it movement,
as we said when we were talking.
It's going to swallow, push
the epiglottis down, and go
into the esophagus.
Next one.
Where are we?
Esophagus showing
stratified squamous
epithelium, connective
tissue, smooth muscle,
and glands, blood vessels.
Next one.
This is peristalsis
showing muscle contraction,
waves of muscle contractions.
Skeletal muscle
doesn't have waves.
Smooth muscle has.
We need it all the time,
bringing substances
down our GI track.
When we were in
Africa, we learned
that the common
carotid of the giraffe
has peristalsis to get that
blood up that 15-foot neck.
All these adaptations.
And the next one.
And where are we?
This is esophagus.
Look at the transition
when we get to the stomach.
We're going to change
entirely with the stomach.
We had no digestion going
on up here to speak of,
except from the
saliva coming down.
But here we've got to
have lots of glands.
So next time, we'll learn
all about the glands
in the stomach that will be
producing the gastric juice
to start massive digestion.
All right?
And we have our 131 A on
speech pathology today.
She's terrific.
