Chapter 24 A&P2

control of energy metabolism, Mitochondria breaks down small carbon compounds to make ATP

Which organic molecules are used depends on hormones and availability of nutrients

final enzymatic steps in digestive process are accomplished by...

brush border enzymes of intestinal microvilli

3 phases of swallowing

buccal, pharyngeal, and esophageal controlled by swallowing centers of medulla oblongata

sympathetic response:

fight or flight, stress, ulcers, prepares body for intense physical activity, contains chiefly adrenergic fibers and tends to depress secretion (cant poop), decrease the tone and contractility of smooth muscle, and increase heart rate.

Neural tissue is insulin-________ and cells take up glucose for energy

independent

sympathetic stimulation effect on duodenal glands

inhibits duodenal glands that produce mucus and bicarbonate, leaving the duodenal lining unprepared for arrival of chyme.

Absorptive period

insulin secreted most cells use glucose for energy Nutrients enter the blood as intestinal absorption proceeds and insulin is secreted by beta cells of pancreas

how does large meal affect pH of blood leaving the stomach?

large meals stimulate stomach acid secretion. when gastric glands are secreting, bicarbonate ions enter the blood stream and increase the blood pH

lipids are broken down by...

lingual and pancreatic lipases in oral cavity, which then denatures in stomach eventually. bile salts in duodenum take over to emulsify lipids and form micelles. micelles diffuse into epithelial cells. chylomicron releasd by exocytosis from epithelial cells and enter lacteals

intestinal juice..

moistens chyme, helps buffer acids, and keeps digestive enzymes and products of digestion in solution. most arrives through osmosis , rest is secreted by intestinal glands stimulated by touch and stretch receptors of the intestinal walls

neural tissue in post absorptive state

neural tissue requires glucose for energy, Liver cells break down glycogen and synthesize glucose (gluconeogenesis), releasing glucose into blood

if small intestine didnt produce secretin...

pH levels would be much lower than usual in the intestinal contents

primary digestive functions of pancreas, liver and gallbladder.

pancreas provides digestive enzymes and bicarbonate ions that elevate pH of chyme, liver produces bile and is primary organ in regulating composition of blood, gallbladder stores and releases bile that aids in digestion and absorption

pancreatic enzymes include:

pancreatic amylase; starch to disaccharides. pancreatic lipase; lipid to fatty acids. nucleases; DNA and RNA to nucleotides. proteolytic enzymes; protease and peptidase to amino acids

parasympathetic response:

rest and digest, relaxes the body, inhibits or slows high energy functions. conserves energy, slows heart rate, increases intestinal and gland activity, and relaxes sphincter muscles in the gastrointestinal tract. speeds up local peristalsis and segmentation

126) A proenzyme secreted by the pancreas is A) trypsinogen. B) amylase. C) lipase. D) carboxypeptidase. E) All of the answers are correct.

A) trypsinogen.

Chylomicrons - triglycerides degraded to fatty acids and monoglycerides by capillary lipases

Absorbed by adipose tissue for storage, stimulated by insulin Absorbed by skeletal muscle for energy, stimulated by insulin

201) Sucrose is hydrolyzed by sucrase into glucose and A) maltose. B) lactose. C) fructose. D) glucose. E) galactose

C) fructose

125) Bile is stored in the A) appendix. B) pancreas. C) gallbladder. D) liver. E) duodenum.

C) gallbladder.

104) Peyer's patches are characteristic of the A) stomach. B) colon. C) ileum. D) jejunum. E) duodenum.

C) ileum.

140) Tom has hepatitis, an inflammation of the liver. Which of the following symptoms would you expect to observe in Tom? A) impaired digestion of protein B) blood in the feces C) jaundice D) elevated levels of blood glucose E) overproduction of blood plasma albumin

C) jaundice

103) The villi are most developed in the A) cecum. B) duodenum. C) jejunum. D) gallbladder. E) stomach

C) jejunum.

25) What provides access for blood vessels entering and leaving the liver? A) greater omentum B) mesentery proper C) lesser omentum D) falciform ligament E) diaphragm

C) lesser omentum

53) The connection of the anterior portion of the tongue to the underlying epithelium is the A) glossal septum. B) labial frenulum. C) lingual frenulum. D) faux. E) uvula.

C) lingual frenulum.

193) Identify the incorrect pairing. A) gallbladder; stores bile B) pancreas; secretes amylases C) liver; produces intrinsic factor D) esophagus; transports material to stomach E) stomach; has an alkaline lining

C) liver; produces intrinsic factor

82) Distension of the gastric wall leads to secretion of histamines from the lamina propria. This is an example of ________ response. A) neural B) muscular C) local D) hormonal E) None of the answers is correct.

C) local

161) The taenia coli are A) ridges in the mucosa of the colon. B) tumors normally confined in the sigmoid colon. C) longitudinal bands of smooth muscle in the colon wall. D) tears of the colon. E) polyps that obstruct the sigmoid colon.

C) longitudinal bands of smooth muscle in the colon wall.

172) Products of fat digestion are transported initially by A) capillaries. B) veins. C) lymphatic vessels. D) the arterioles. E) the interstitial fluid.

C) lymphatic vessels.

200) Maltose is hydrolyzed into monosaccharides by the enzyme A) sucrase. B) galactase. C) maltase. D) dextrase. E) lactase.

C) maltase

3) Digestion refers to the A) mechanical breakdown of food. B) chemical breakdown of food. C) mechanical and chemical breakdown of food. D) progressive dehydration of indigestible residue. E) All of the answers are correct

C) mechanical and chemical breakdown of food.

9) The lamina propria and mucous epithelium are components of the A) muscularis mucosa. B) submucosa. C) mucosa. D) serosa. E) adventitia.

C) mucosa.

58) Which of the following is not a pharyngeal muscle involved in swallowing? A) palatopharyngeus B) pharyngeal constrictor muscle C) omohyoid D) stylopharyngeus E) They are all pharyngeal muscles involved in swallowing.

C) omohyoid

118) The exocrine portion of the pancreas is composed of A) pancreatic crypts. B) triads. C) pancreatic acini. D) islets of Langerhans. E) pancreatic lobules.

C) pancreatic acini.

36) Functions of the tongue include all of the following except A) aiding in speech. B) sensory analysis of food. C) partitioning the oropharynx from the nasopharynx. D) mechanical processing of food. E) manipulation of food.

C) partitioning the oropharynx from the nasopharynx.

66) Chief cells secrete A) mucus. B) hydrochloric acid. C) pepsinogen. D) intrinsic factor. E) gastrin.

C) pepsinogen.

6) Waves of muscular contractions that propel the contents of the digestive tract are called A) segmentation. B) pendular movements. C) peristalsis. D) mastication. E) churning movements.

C) peristalsis.

159) Approximately the last 15 cm of the digestive tract is the A) sigmoid colon. B) anal canal. C) rectum. D) rectal column. E) anus.

C) rectum.

92) What is the function of the structure labeled "6"? A) controls contraction of stomach muscles B) strains materials entering the stomach C) regulates gastric emptying D) mixes stomach juice into food E) prevents food from entering the esophagus

C) regulates gastric emptying

166) The defecation reflex involves A) conscious control of both the internal and external anal sphincters. B) sympathetic nerves. C) relaxation of both the internal and external anal sphincters. D) relaxation of the ileocecal valve to move feces into the rectum. E) parasympathetic nerve control from sacral nerves.

C) relaxation of both the internal and external anal sphincters.

87) The stomach is able to distend a great deal as it receives food because of the presence of A) skeletal muscle. B) an alkaline lining. C) rugae. D) gastric pits. E) the serosa

C) rugae.

47) Which of the following is not a function of the tongue? A) passing food across occlusal surfaces B) manipulation to assist with chewing C) secretion of mucins D) mechanical processing E) All of these are functions of the tongue.

C) secretion of mucins

179) The oral cavity performs (a) ________ prior to swallowing. A) taste scrutiny B) humidity investigation C) sensory analysis D) volume evaluation E) pH examination

C) sensory analysis

151) What type of epithelium covers the structure labeled "6"? A) simple cuboidal B) pseudostratified ciliated columnar C) simple columnar D) simple squamous E) stratified squamous

C) simple columnar

20) What organ is primarily responsible for water absorption? A) esophagus B) stomach C) small intestine D) large intestine E) pancreas

C) small intestine

15) Large blood vessels and lymphatics are found in the A) adventitia. B) serosa. C) submucosa. D) mucosa. E) muscularis.

C) submucosa.

13) Sensory nerve cells, parasympathetic ganglia, and sympathetic postganglionic fibers can be found in the A) mucosa. B) lamina propria. C) submucosal plexus. D) adventitia. E) serosa

C) submucosal plexus.

197) In the large intestine the wall has three strips of longitudinal muscle called the A) muscularis mucosa. B) muscularis interna. C) taenia coli. D) haustral bands. E) muscularis externa.

C) taenia coli.

168) An enzyme that digests proteins into peptides is A) amylase. B) nuclease. C) trypsin. D) lipase. E) maltase

C) trypsin

bile release from gallbladder into duodenum occurs only under stimulation of...

CCK, Cholecystokinin

59) The epithelium lining the oropharynx is A) simple columnar. B) pseudostratified squamous. C) simple cuboidal. D) stratified squamous. E) simple squamous.

D) stratified squamous.

63) Muscles known as the pharyngeal constrictors function in A) opening the cardiac sphincter. B) moving the tongue. C) mastication. D) swallowing. E) esophageal peristalsis.

D) swallowing.

35) A structure that helps prevent food from entering the pharynx prematurely is the A) pharyngeal arch. B) epiglottis. C) palatopharyngeal arch. D) uvula. E) palatoglossal arch.

D) uvula.

51) The space between the cheeks or lips and the teeth is called the 51) A) pharynx. B) fauces. C) larynx. D) vestibule. E) dip sulcus

D) vestibule.

145) Which of the following descriptions best matches the term duodenal ampulla? A) stimulates pancreas to secrete bicarbonate-rich fluid B) carries absorbed sugars and amino acids C) stimulates gastric secretion D) where pancreatic juice and bile enter duodenum E) causes gallbladder to contract

D) where pancreatic juice and bile enter duodenum

sources of cholesterol

Dietary cholesterol - 20% synthesis in liver from fatty acids Essential for cell membranes, steroid hormones, bile salts

185) The secondary dentition usually comprises ________ teeth. A) 20 B) 34 C) 28 D) 25 E) 32

E) 32

42) If the lingual frenulum is too restrictive, an individual A) cannot speak normally. B) has difficulty eating. C) cannot protract the tongue as far as most individuals. D) has a condition called ankyloglossia. E) All of the answers are correct

E) All of the answers are correct

7) The activities of the digestive system are regulated by A) hormones. B) parasympathetic and sympathetic neurons. C) intrinsic nerve plexuses. D) the contents of the digestive tract. E) All of the answers are correct

E) All of the answers are correct

105) Which of the following enhance the absorptive effectiveness of the small intestine? A) the circular folds B) intestinal movements C) the microvilli D) the villi E) All of the answers are correct.

E) All of the answers are correct.

122) The Kupffer cells of the liver A) present antigens. B) destroy damaged RBCs. C) are phagocytic. D) destroy bacteria. E) All of the answers are correct.

E) All of the answers are correct.

123) The pancreas produces A) nucleases. B) sodium bicarbonate. C) peptidases and proteinases. D) lipases and amylase. E) All of the answers are correct.

E) All of the answers are correct.

131) Enterogastric reflexes A) involve the enteric nervous system. B) inhibit gastric secretion. C) are triggered by chyme entering the duodenum. D) inhibit gastric motility. E) All of the answers are correct.

E) All of the answers are correct.

135) The essential functions of the liver include A) albumin production for blood osmotic pressure. B) bile production. C) metabolic regulation. D) hematological regulation. E) All of the answers are correct.

E) All of the answers are correct.

137) A drug that blocks the action of the hormone cholecystokinin would affect A) the composition of pancreatic secretions. B) acid production by the stomach. C) digestion of lipids and proteins. D) the delivery of bile. E) All of the answers are correct.

E) All of the answers are correct.

143) Tony is a chronic alcoholic with cirrhosis of the liver, a condition in which liver cells die and are replaced by connective tissue. Which of the following signs would you expect to observe in Tony? A) decrease in plasma protein production B) increased clotting time C) portal hypertension and ascites D) jaundice E) All of the answers are correct.

E) All of the answers are correct.

155) The structure labeled "5" A) has a simple squamous epithelium. B) is called the serosa. C) is part of the visceral peritoneum. D) contributes to the mesentery of the small intestine. E) All of the answers are correct.

E) All of the answers are correct.

174) Absorption of glucose from the gut lumen depends on A) cotransporter proteins in the apical membrane of the epithelial cell. B) sodium-linked cotransport. C) the sodium-potassium pump in the basolateral membrane of the epithelial cell. D) higher sodium ion concentration in the lumen than in the epithelial cell. E) All of the answers are correct.

E) All of the answers are correct.

30) The serous membrane that lines the peritoneal cavity A) decreases friction. B) lubricates the cavity. C) prevents irritation. D) secretes peritoneal fluid. E) All of the answers are correct.

E) All of the answers are correct.

49) Functions of teeth include A) clipping. B) crushing. C) tearing. D) cutting. E) All of the answers are correct.

E) All of the answers are correct.

50) The roof of the oral cavity is formed by the A) palatine bones. B) soft palate. C) hard palate. D) palatine processes of the maxillary bones. E) All of the answers are correct.

E) All of the answers are correct.

60) During deglutition, A) the soft palate elevates. B) smooth muscle contracts. C) the lower esophageal sphincter opens. D) the larynx elevates and the epiglottis closes. E) All of the answers are correct.

E) All of the answers are correct.

121) ________ are arranged within a lobule of the liver into a series of irregular plates converging toward a central vein. A) Kupffer cells B) Portal areas C) Hepatic ducts D) Bile canaliculi E) Hepatocytes

E) Hepatocytes

33) ________ pair(s) of salivary glands secrete into the oral cavity. A) Two B) One C) Six to Ten D) Four E) Three

E) Three

84) Mary had her stomach mostly removed to try to overcome obesity. As a result, you would expect Mary to be at risk for A) protein malnutrition. B) an ulcer. C) dehydration. D) diarrhea. E) abnormal erythropoiesis.

E) abnormal erythropoiesis.

32) The functions of the oral cavity include all of the following except A) sensory analysis of material before swallowing. B) lubrication. C) mechanical processing of food. D) digestion of carbohydrates. E) absorption of monosaccharides.

E) absorption of monosaccharides.

139) If the pancreatic duct was obstructed, you would expect to see elevated blood levels of A) gastrin. B) cholecystokinin. C) secretin. D) bilirubin. E) amylase

E) amylase

199) The enzyme that digests starch into disaccharides and trisaccharides is A) saccharase. B) lipase. C) rennin. D) lactase. E) amylase.

E) amylase.

133) In response to the arrival of acidic chyme in the duodenum, the A) blood levels of enterocrinin fall. B) blood levels of cholecystokinin fall. C) liver releases enzymes for chemical digestion. D) blood levels of gastrin rise. E) blood levels of secretin rise.

E) blood levels of secretin rise.

112) An intestinal hormone that stimulates the gallbladder to release bile is A) gastrin. B) GIP. C) enteropeptidase. D) secretin. E) cholecystokinin.

E) cholecystokinin.

177) The circumferential folds that encircle the digestive tract are known as A) adventitia. B) rugae. C) muscularis externa. D) serosa. E) circular folds

E) circular folds

94) Identify the structure labeled "4." A) submucosa B) longitudinal muscle layer C) oblique muscle layer D) rugae E) circular muscle layer

E) circular muscle layer

150) Contraction of the muscle layer labeled "9" causes the digestive tract to A) secrete enzymes. B) fold for increased surface area. C) shorten. D) dilate. E) constrict.

E) constrict.

183) The first teeth to appear are the ________ teeth. A) temporary B) transitory C) transitional D) provisional E) deciduous

E) deciduous

101) Submucosal glands that secrete mucus are characteristic of the A) ileum. B) liver. C) pancreas. D) jejunum. E) duodenum.

E) duodenum.

40) The crown of a tooth is covered by A) cementum. B) dentin. C) pulp. D) periodontium. E) enamel

E) enamel

124) The structure that marks the division between the right and left lobes of the liver is the A) lesser omentum. B) greater omentum. C) hepatic ligament. D) ligamentum teres. E) falciform ligament.

E) falciform ligament.

198) The clinical term for the gas produced by bacteria in the colon as they metabolize indigestible carbohydrates is called A) vapors. B) wind. C) fumes. D) gust. E) flatus.

E) flatus.

115) The human liver is composed of ________ lobe(s). A) one B) two large and four small C) three D) two E) four

E) four

113) An intestinal hormone that stimulates the release of insulin from the pancreatic islet cells is A) cholecystokinin. B) secretin. C) enteropeptidase. D) enterocrinin. E) gastric inhibitory peptide (GIP).

E) gastric inhibitory peptide (GIP).

114) An intestinal hormone that stimulates gastric secretion is A) cholecystokinin. B) secretin. C) gastric inhibitory peptide (GIP). D) enteropeptidase. E) gastrin.

E) gastrin.

67) G cells of the stomach secrete A) enteropeptidase. B) cholecystokinin. C) secretin. D) pepsin. E) gastrin.

E) gastrin.

83) The hormone that stimulates secretion and contraction by the stomach is A) enteropeptidase. B) CCK. C) cholecystokinin. D) secretin. E) gastrin.

E) gastrin.

21) Which of the following contains adipose tissue and provides padding for the anterior and lateral portions of the abdomen? A) diaphragm B) mesentery proper C) falciform ligament D) lesser omentum E) greater omentum

E) greater omentum

108) The portion of the small intestine that attaches to the cecum is the A) haustrum. B) appendix. C) jejunum. D) duodenum. E) ileum.

E) ileum.

100) Circular folds and intestinal villi A) produce new cells for the mucosa of the small intestine. B) carry products of digestion that will not pass through the walls of blood capillaries. C) produce hormones. D) secrete digestive enzymes. E) increase the surface area of the mucosa of the small intestine.

E) increase the surface area of the mucosa of the small intestine.

79) During the cephalic phase of gastric secretion, A) secretin inhibits parietal and chief cells. B) the intestinal reflex inhibits gastric emptying. C) production of gastric juice slows down. D) the stomach responds to distention. E) increased production of gastric juice occurs.

E) increased production of gastric juice occurs.

23) Which organ is responsible for dehydration and compaction of indigestible materials? A) stomach B) small intestine C) anus D) esophagus E) large intestine

E) large intestine

120) The basic functional units of the liver are the A) hepatocytes. B) Kupffer cells. C) portal areas. D) bile canaliculi. E) lobules.

E) lobules.

19) The ________ supports all but 25 cm of the small intestine and provides stability and limited movement. A) falciform ligament B) lesser omentum C) diaphragm D) greater omentum E) mesentery proper

E) mesentery proper

152) What is the layer labeled "4"? A) mucosa B) submucusa C) muscularis mucosae D) serosa E) muscularis externa

E) muscularis externa

61) The esophagus has several variations from the standard plan of the GI tract. These include A) epithelium of mucosa is simple columnar and muscularis externa may be striated muscle. B) epithelium of mucosa is stratified squamous and simple columnar. C) epithelium of mucosa is simple columnar. D) epithelium of mucosa is stratified squamous. E) muscularis externa has some skeletal muscle.

E) muscularis externa has some skeletal muscle.

11) Contraction of the ________ alters the shape of the intestinal lumen and moves epithelial pleats and folds. A) submucosal plexus B) adventitia C) mucosa D) submucosa E) muscularis mucosa

E) muscularis mucosa

72) The prominent ridges in the lining of the empty stomach are called A) papillae. B) villi. C) plicae. D) cardia. E) rugae

E) rugae

27) The oral mucosa has ________ epithelium. A) simple squamous B) pseudostratified C) stratified columnar D) transitional E) stratified squamous

E) stratified squamous

138) An obstruction of the common bile duct often results in A) hepatitis. B) a decrease in production of pancreatic juice. C) cirrhosis of the liver. D) inability to digest protein. E) undigested fat in the feces.

E) undigested fat in the feces.

Postabsorptive period

From the end of the absorptive state to the next meal, body relies on reserves for energy production in cells insulin secretion stops Glucagon (alpha cells of pancreas), glucocorticoids (adrenal cortex), epinephrine (adrenal medulla) are secreted to control cellular metabolism

Postabsorptive period

Glucagon, glucocorticoids, epinephrine are secreted many cells use fatty acids and amino acids for energy

why i sHDL good for you

HDL's reduce the amount of fat, including cholesterol, in the blood stream by transporting it to the liver for storage or excretion in the bile

chylomicron

Lipid bound to a protein (made of mostly triglycerides) so that it can move throughout bloodstream. moves into lymph system from the lacteal, because it is too big for capillary, then it is dumped into blood.

Brush border enzymes for disaccharides

Maltase, sucrase, lactase-sugars

Absorption of nutrients following breakdown of macromolecules...

Monomers are absorbed on lumen side of epithelial cells monomers are releases from epithelial cells into interstitial fluids nutrients diffuse from interstitial fluids into capillaries of vascular system or lacteals of lymphatic system

Brush border enzymes for nucleic acids

Nucleases-nucleic acids

protein break down...

Pepsin, trypsin, chymotrypsin, elastase, carboxypeptidase, brush border enzymes turn proteins>>polypeptides>>amino acids

Brush border enzymes for small peptides

Peptidases-protein

Defecation reflex triggered by distention of rectal walls

Relaxation of internal anal sphincter unconsciously controlled by ANS Somatic conscious control of relaxation of external anal sphincter

Secretin

Released in response to acid chyme Inhibit stomach secretions & motility Stimulate pancreas to release buffers Stimulate liver to increase bile secretion

Cholecystokinin (CCK)

Released in response to lipids & proteins Inhibit stomach secretions & motility Stimulate secretion of pancreatic enzymes Stimulate contraction of gallbladder Stimulate relaxation of hepatopancreatic sphincter

removal of stomach would interfere with which vitammin

vitamin B12. parietal cells are the source of intrinsic factor which is required for B12 absorption

vitamins generated by bacteria in colon are..

vitamin k, biotin, and pantothenic acid.

Bilirubin

waste pigment formed from heme of red blood cells phagocytized and recycled by liver

when a person suffers from chronic gastric ulcers, branches of Vagus nerve that supply stomach are sometimes cut to provide relief. why is this effective?

vagus nerve has parasympathetic motor fibers that increase gastric secretions even when food is not in stomach. by cutting this off release of gastrin may be reduced, lessening chances of ulcer.

41) ________ are also known as canines. A) Cuspids B) Molars C) Incisors D) Bicuspids E) Secondary teeth

A) Cuspids

large intestine

5 feet long, smooth inner surface, no villi, many mucus secreting cells, longitudinal muscles of muscularis layer reduced to 3 longitudinal bands of muscle

144) Approximately ________ liters of fluid are secreted by the small intestine each day. A) 2 B) 10 C) 1 D) 20 E) 7

A) 2

184) There are normally a total of ________ primary teeth. A) 20 B) 18 C) 28 D) 32 E) 25

A) 20

171) Which of the following is false concerning the process known as cotransport? A) Only neutral compounds such as sugars are transported. B) ATP is not required by the transport protein. C) More than one molecule or ion is moved through the cell membrane at one time. D) Molecules can be moved against a concentration gradient.

A) Only neutral compounds such as sugars are transported.

64) Functions of the stomach include all of the following except A) absorption of triglycerides. B) denaturation of proteins. C) mechanical breakdown of food. D) initiation of protein digestion. E) storage of ingested food.

A) absorption of triglycerides.

119) Each of the following is a function of the liver except A) antibody production. B) storage of glycogen and iron reserves. C) synthesis of plasma proteins. D) inactivation of toxins. E) synthesis and secretion of bile.

A) antibody production.

192) Your patient with liver failure has a firm, rounded abdomen due to accumulation of fluid. This is known clinically as A) ascites. B) cirrhosis. C) hepatitis B. D) hepatitis C. E) gastritis.

A) ascites.

70) The part of the stomach that functions as a mixing chamber for food and secretions is the A) body. B) antrum. C) pylorus. D) fundus. E) cardia.

A) body

39) The root of a tooth is covered by A) cementum. B) the root canal. C) dentin. D) pulp. E) enamel.

A) cementum.

191) The ________ duct is formed by the union of the cystic duct and the common hepatic duct. A) common bile B) pancreatic C) duodenal D) hepatopancreatic E) gastric

A) common bile

10) Which of the following descriptions best matches the term myenteric plexus? A) coordinates activity of muscularis externa B) secretes a watery fluid C) component of mucosa D) sensory neural network E) loose connective tissue layer containing blood vessels

A) coordinates activity of muscularis externa

29) A disease that attacks and disables the myenteric plexus would A) decrease intestinal motility. B) increase gastric secretion. C) decrease gastric secretion. D) increase intestinal motility. E) interfere with both intestinal motility and gastric secretion.

A) decrease intestinal motility.

162) At the splenic flexure, the colon becomes the A) descending colon. B) transverse colon. C) sigmoid colon. D) rectum. E) ascending colon.

A) descending colon.

4) Which of the following is not a function of the digestive system? A) filtration B) secretion C) ingestion D) mechanical processing E) absorption

A) filtration

96) Identify the stomach region labeled "12". A) fundus B) pylorus C) body D) cardia E) rugae

A) fundus

62) During deglutition, which of the following phases is not present? A) gastric B) buccal C) pharyngeal D) esophageal E) They are all present during deglutition.

A) gastric

194) The middle segment of the small intestine is called the A) jejunum. B) hilum. C) duodenum. D) cecum. E) ileum.

A) jejunum.

202) People who lack the enzyme ________ often experience GI upset after consuming milk and other dairy products. A) lactase B) maltase C) galactase D) lipase E) sucrase

A) lactase

16) The layer of loose connective tissue that directly supports the digestive epithelium is the A) lamina propria. B) muscularis mucosae. C) submucosa. D) myenteric plexus. E) submucosal plexus.

A) lamina propria.

203) Complexes of fatty acids, monoglycerides, and bile salts are called A) micelles. B) countertransporters. C) varicosities. D) vesicles. E) chylomicrons

A) micelles.

153) What is the layer labeled "2"? A) muscularis mucosae B) longitudinal muscle C) muscularis externa D) lamina propria E) circular muscle

A) muscularis mucosae

147) Which digestive juice contains enzymes that breakdown carbohydrates, lipids, and proteins? A) pancreatic juice B) bile C) gastric juice D) intestinal juice E) saliva

A) pancreatic juice

34) The ________ gland empties into the oral cavity at the level of the second upper molar. A) parotid B) sublingual C) submaxillary D) submandibular E) vestibular

A) parotid

167) The enzyme amylase digests A) polysaccharides. B) triglycerides. C) peptides. D) nucleotides. E) disaccharides.

A) polysaccharides.

148) What is the function of the structure labeled "7"? A) protection from bacteria B) production of pepsinogen C) production of lipase D) production of hydrochloric acid E) production of sodium bicarbonate

A) protection from bacteria

38) The part of a tooth that contains blood vessels and nerves is the A) pulp cavity. B) cementum. C) dentin. D) enamel. E) periodontium.

A) pulp cavity.

71) The region of the stomach that empties into the duodenum is the A) pylorus. B) cardia. C) body. D) fundus. E) antrum

A) pylorus.

76) An enzyme secreted by the gastric mucosa of a newborn that coagulates milk proteins is A) rennin. B) cholecystokinin. C) pepsin. D) gastrin. E) trypsin.

A) rennin.

142) In response to the hormone cholecystokinin, the pancreas secretes a fluid A) rich in enzymes. B) rich in bile. C) rich in bicarbonate. D) rich in mucus. E) that contains only amylase.

A) rich in enzymes.

111) The intestinal hormone that stimulates the pancreas to release a watery, bicarbonate-rich fluid is A) secretin. B) gastrin. C) enterocrinin. D) GIP. E) cholecystokinin.

A) secretin.

73) The stomach secretes the hormone ghrelin which functions to A) stimulate hunger. B) regulate the digestion of lipids. C) initiate secretion of gastric juice containing enzymes and acid. D) inhibit hunger. E) stimulate secretion of mucus from submucosal glands.

A) stimulate hunger.

154) What is the layer labeled "3"? A) submucosa B) muscularis externa C) muscularis mucosae D) serosa E) mucosa

A) submucosa

other tissues in post absorptive state

All other tissues can switch to use of fatty acids for energy production No insulin so can not take in glucose lipolysis increases in adipose tissue and liver fatty acids released into blood stream Muscle cells use fatty acids while at rest and use glycogen reserves when active Tissues can make use of amino acid breakdown products for energy production if fatty acids are not available

postabsorptive

Amino acids are de-aminated by the liver to produce ketone acids that can be used in mitochondria for ATP synthesis by most cells. Liver can use amino acids for gluconeogenesis to supply glucose to neural tissue

68) To which region of the stomach does the esophagus connect? A) pylorus B) cardia C) body D) antrum E) fundus

B) cardia

Pancreatic exocrine secretions

Are released into pancreatic duct that connects to duodenum Produces alkaline buffers to raise pH of chyme Produces digestive enzymes to breakdown macromolecules Mainly an exocrine organ, endocrine cells produce insulin and glucagon The exocrine cells secrete pancreatic juice.

136) Match the proenzyme on the left (1-3) with the correct enzyme activator on the right (4-6) 1. pepsinogen 4. enterokinase 2. trypsinogen 5. hydrochloric acid 3. procarboxypeptidase 6. trypsin 136) A) 1 and 5; 2 and 6; 3 and 4 B) 1 and 5; 2 and 4; 3 and 6 C) 1 and 4; 2 and 5; 3 and 6 D) 1 and 4; 2 and 6; 3 and 5 E) 1 and 6; 2 and 5; 3 and 4

B) 1 and 5; 2 and 4; 3 and 6

149) Which structure controls the contraction of the muscularis externa? A) 9 B) 10 C) 8 D) 2 E) 11

B) 10

31) Put the following layers of the digestive tract wall in order from the lumen to the deepest layer. 1. lamina propria 4. digestive (mucous) epithelium 2. muscularis externa 5. serosa 3. submucosa 6. muscularis mucosae A) 5, 2, 3, 6, 1, 4 B) 4, 1, 6, 3, 2, 5 C) 5, 4, 2, 6, 1, 3 D) 1, 4, 3, 6, 2, 5 E) 4, 6, 3, 1, 2, 5

B) 4, 1, 6, 3, 2, 5

57) ________ are teeth with flattened crowns and prominent ridges that are adapted for crushing and grinding. A) Cuspids B) Molars C) Canines D) Eye teeth E) Dentins

B) Molars

28) The greater omentum is A) attached to the stomach at the lesser curvature. B) a fatty sheet that hangs like an apron over the abdominal viscera. C) important in the digestion of fats. D) the entrance to the stomach. E) a sheet of mesentery that attaches to the liver.

B) a fatty sheet that hangs like an apron over the abdominal viscera.

146) Hydrochloric acid from the stomach is neutralized in the small intestine by A) trypsin. B) bicarbonate from the pancreas. C) water that was ingested with the food. D) bile from the liver. E) enzymes from the intestinal crypts.

B) bicarbonate from the pancreas.

1) Each of the following organs is a component of the digestive tract except the A) colon. B) bladder. C) pharynx. D) esophagus. E) stomach.

B) bladder.

182) The oral cavity is also known as the ________ cavity. A) lingual B) buccal C) digestive D) gingivae E) pharyngeal

B) buccal

175) Which of the following descriptions best matches the term cholecystokinin (CCK)? A) stimulates gastric secretion B) causes gallbladder to contract C) carries absorbed sugars and amino acids D) stimulates pancreas to secrete bicarbonate-rich fluid E) where pancreatic juice and bile enter duodenum

B) causes gallbladder to contract

163) The pouchlike structure that joins the ileum at the ileocecal valve is the A) appendix. B) cecum. C) sigmoid colon. D) haustra. E) rectum.

B) cecum.

102) The duodenal ampulla receives secretions from the A) duodenum and the pylorus. B) common bile duct and the pancreatic duct. C) duodenum and the jejunum. D) duodenum and the common bile duct. E) duodenum and the pancreatic duct.

B) common bile duct and the pancreatic duct.

77) The pylorus empties into the A) jejunum. B) duodenum. C) colon. D) cecum. E) ileum.

B) duodenum.

190) Bile salts aid in the digestion of fats by ________ large fat droplets. A) dehydrating B) emulsifying C) combining D) binding E) anabolizing

B) emulsifying

160) Haustra are A) glands in the large intestine that secrete mucus. B) expansible pouches of the colon. C) the source of colon hormones. D) compact feces stored in the rectum. E) strips of muscle in the colon.

B) expansible pouches of the colon.

69) The portion of the stomach that is superior to the junction between the stomach and the esophagus is the A) cardia. B) fundus. C) pylorus. D) antrum. E) body.

B) fundus

86) The term "alkaline tide" implies that the pH of the blood in gastric veins is A) constant because of buffering. B) greater during digestion of a large meal than following a 24-hour fast. C) greater following a 24-hour fast than during digestion of a large meal. D) None of the answers are correct.

B) greater during digestion of a large meal than following a 24-hour fast.

88) The stomach is different from other digestive organs in that it A) has folds in the mucosa. B) has three layers of muscle in the muscularis externa. C) secretes digestive juice. D) secretes digestive hormones. E) moves by peristalsis.

B) has three layers of muscle in the muscularis externa.

65) Parietal cells secrete A) gastrin. B) hydrochloric acid. C) pepsinogen. D) enteropeptidase. E) mucus.

B) hydrochloric acid.

43) A blockage of the ducts from the parotid glands would A) inhibit the secretion of saliva from other glands. B) interfere with carbohydrate digestion in the mouth. C) occur when too much protein is ingested. D) prevent emulsification of lipids. E) cause mumps.

B) interfere with carbohydrate digestion in the mouth.

107) The middle segment of the small intestine is the A) pylorus. B) jejunum. C) ileum. D) duodenum. E) cecum.

B) jejunum.

170) If digestion of a carbohydrate results in equal amounts of glucose and galactose, this carbohydrate is probably A) cellulose. B) lactose. C) maltose. D) glycogen. E) sucrose.

B) lactose.

97) Identify the stomach region labeled "5." A) fundus B) lesser curvature C) greater curvature D) cardia E) pylorus

B) lesser curvature

95) Identify the structure labeled "3." A) circular muscle layer B) longitudinal muscle layer C) submucosa D) rugae E) oblique muscle layer

B) longitudinal muscle layer

165) Movements unique to the large intestine are ________ movements. A) segmentation B) mass C) writhing D) peristaltic E) pendular

B) mass

156) Powerful peristaltic contractions that occur a few times each day in the colon are called A) haustral churning. B) mass movements. C) segmentation. D) defecation. E) pendular movements.

B) mass movements.

186) The technical term for chewing is A) deglutition. B) mastication. C) segmentation. D) peristalsis. E) borborygmus.

B) mastication.

12) The ________ are double sheets of peritoneal membrane that suspend the visceral organs and carry nerves, lymphatics, and blood vessels. A) serosa B) mesenteries C) fibrosa D) adventitia E) lamina propria

B) mesenteries

24) The double-layer sheets of serous membrane that support the viscera are called A) the diaphragm. B) mesenteries. C) peritoneal sheets. D) ascites. E) the dorsal and ventral frenulums.

B) mesenteries.

169) Carbohydrate digestion begins in the A) duodenum. B) mouth. C) ileum. D) stomach. E) esophagus.

B) mouth

127) The gastroileal reflex A) promotes gastric secretion. B) moves some chyme to the colon. C) decreases peristaltic activity. D) empties the duodenum. E) is relayed through the CNS.

B) moves some chyme to the colon.

188) Upon swallowing, food moves from the mouth directly into the A) oral mucosae. B) oropharynx. C) sublingual space. D) oral vestibule. E) buccal cavity.

B) oropharynx.

2) Which of the following is an accessory organ of digestion? A) colon B) pancreas C) spleen D) appendix E) esophagus

B) pancreas

44) Increased secretion by all the salivary glands results from A) myenteric reflexes. B) parasympathetic stimulation. C) sympathetic stimulation. D) hunger. E) hormonal stimulation.

B) parasympathetic stimulation.

109) Circular folds are A) ridges in the wall of the stomach. B) pleats in the lining of the small intestine. C) abnormal structures formed by excessive pressure in the small intestine. D) sacculations in the colon. E) fingerlike projections on the surface of the mucosa of the small intestine.

B) pleats in the lining of the small intestine.

54) The uvula is located at the A) posterior of the tongue. B) posterior margin of the soft palate. C) base of a tooth. D) margin of the vestibule. E) margin of the oropharynx and the laryngopharynx.

B) posterior margin of the soft palate.

134) Blockage of the common hepatic duct would interfere with digestion of A) vitamins. B) complex carbohydrates. C) fats. D) disaccharides. E) proteins.

C) fats.

81) All of the following are true of the intestinal phase of gastric digestion except that it A) involves both neural and endocrine reflexes. B) precedes the gastric phase. C) helps ensure that the functions of the small intestine proceed with relative efficiency. D) functions to control the rate of gastric emptying. E) begins when chyme enters the small intestine.

B) precedes the gastric phase.

99) Identify the stomach region labeled "7." A) greater curvature B) pylorus C) lesser curvature D) esophagus E) cardia

B) pylorus

46) The ________ salivary glands are covered by the mucous membrane in the floor of the mouth. A) mandibular B) sublingual C) submandibular D) lingual E) parotid

B) sublingual

158) At the hepatic flexure, the colon becomes A) ascending colon. B) transverse colon. C) sigmoid colon. D) rectum. E) descending colon.

B) transverse colon

180) The dangling process that aids in keeping food out of the nasopharynx is known as the A) soft palate. B) uvula. C) pharyngeal tonsil. D) tongue. E) palatine tonsil.

B) uvula.

90) Put the following steps of stomach acid production in the correct order starting with the reaction that requires an enzyme. 1. H2CO3 dissociates. 2. Chloride ion combines with H+ in the gastric lumen. 3. Water and CO2 combine to form carbonic acid. 4. H+ and bicarbonate ion are transported into the gastric lumen. 5. Cl- diffuses into the gastric lumen. A) 3, 1, 2, 5, 4 B) 4, 5, 1, 2, 3 C) 3, 1, 4, 5, 2 D) 4, 5, 3, 1, 2 E) 1, 3, 5, 2, 4

C) 3, 1, 4, 5, 2

98) Which structure(s) help(s) the stomach to stretch as it fills with food? A) 5 B) 6 C) 9 D) 4 E) 3

C) 9

56) ________ are pointed teeth that are adapted for tearing and slashing. A) Premolars B) Incisors C) Cuspids D) Molars E) Bicuspids

C) Cuspids

55) ________ are blade-shaped teeth that function in cutting or clipping. A) Bicuspids B) Canines C) Incisors D) Cuspids E) Molars

C) Incisors

176) Which of the following is true regarding lactose intolerance? A) The enzyme maltase begins to digest lactose. B) Lactose-intolerant infants cannot digest dairy fat and are at risk of starvation. C) The intestinal crypts are not producing the enzyme lactase. D) The person cannot digest any type of monosaccharide. E) The stomach produces inadequate amounts of lactase.

C) The intestinal crypts are not producing the enzyme lactase.

91) A drug that blocks the action of carbonic anhydrase in parietal cells would result in A) a lower pH during gastric digestion. B) increased protein digestion in the stomach. C) a higher pH during gastric digestion. D) decreased production of pepsinogen by chief cells. E) decreased gastrin production.

C) a higher pH during gastric digestion.

164) A small, wormlike structure attached to A) pancreas. B) haustra. C) appendix. D) gallbladder. E) ileum.

C) appendix.

37) The bulk of each tooth consists of a mineralized matrix similar to that of bone called A) enamel. B) cementum. C) dentin. D) periodontium. E) pulp.

C) dentin.

178) Within the oral cavity, both mechanical and chemical ________ begin. A) deglutition B) ingestion C) digestion D) mastication E) secretions

C) digestion

106) Brunner glands are characteristic of the A) ileum. B) colon. C) duodenum. D) jejunum. E) stomach.

C) duodenum.

110) An intestinal hormone that stimulates mucin production by the submucosal duodenal glands is A) secretin. B) GIP. C) enterocrinin. D) cholecystokinin. E) gastrin.

C) enterocrinin.

80) The gastric phase of gastric secretion is triggered by the A) release of cholecystokinin and secretin by the small intestine. B) sight, thought, or smell of food. C) entry of food into the stomach. D) entry of chyme into the small intestine. E) entry of chyme into the large intestine.

C) entry of food into the stomach.

26) All of the following contain mucous cells in the epithelium except the A) stomach. B) transverse colon. C) esophagus. D) large intestine. E) small intestine.

C) esophagus.

196) The pancreas has endocrine cells that produce hormones and ________ cells that produce digestive enzymes. A) mucosal B) smooth muscle C) exocrine D) hepatic E) gastric

C) exocrine

89) Match the gastric phase on the left (1-3) with the correct description on the right (4-6): 1. intestinal phase 4. prepares stomach for arrival of food 2. gastric phase 5. stomach empties and decreases secretions 3. cephalic phase 6. stomach secretes juice and mixes food into chyme A) 1 and 6; 2 and 5; 3 and 4 B) 1 and 5; 2 and 4; 3 and 6 C) 1 and 6; 2 and 4; 3 and 5 D) 1 and 5; 2 and 6; 3 and 4 E) 1 and 4; 2 and 5; 3 and 6

D) 1 and 5; 2 and 6; 3 and 4

8) The digestive tract is also referred to as the A) alimentary canal. B) GI tract. C) esophagus. D) alimentary canal and the GI tract. E) All of the answers are correct.

D) alimentary canal and the GI tract.

187) The small, semisolid mass of food formed during mastication is called a A) pill. B) chunk. C) morsel. D) bolus. E) chime

D) bolus.

130) Which of the following is not a component of the portal triad found at the edges of a liver lobule? A) hepatic portal vein B) hepatic artery C) bile duct D) central vein

D) central vein

117) In the center of a liver lobule there is a A) portal area. B) sinusoid. C) hepatic duct. D) central vein. E) portal vein.

D) central vein.

189) After food and gastric juices combine, the gastric contents are referred to as A) bolus. B) segments. C) chunk. D) chyme. E) feces

D) chyme

18) A feature of the digestive tract wall that increases surface area available for absorption is the A) elastic cells. B) rugae. C) muscularis mucosa. D) circular folds. E) transitional cells.

D) circular folds.

116) The fusion of the common hepatic duct and the cystic duct forms the A) porta hepatis. B) hepatic portal vein. C) common pancreatic duct. D) common bile duct. E) bile canaliculus.

D) common bile duct.

173) The absorption of some sugars in the small intestine involves A) osmosis. B) phagocytosis. C) diffusion. D) cotransport. E) pinocytosis.

D) cotransport.

195) Pancreatic juice enters the small intestine at the A) cystic duct. B) pyloric sphincter. C) hepatic duct. D) duodenal papilla. E) ileocecal valve.

D) duodenal papilla.

132) The part of the small intestine most likely to develop an ulcer from exposure to gastric juice is the A) ileum. B) caecum. C) pylorus. D) duodenum. E) jejunum

D) duodenum.

129) Which of the following has an association with the fetal umbilical vein? A) lesser omentum B) diaphragm C) mesentery proper D) falciform ligament E) greater omentum

D) falciform ligament

52) The ridge of oral mucosa that surrounds the base of a tooth is the A) alveolus. B) faux. C) vestibule. D) gingiva. E) uvula.

D) gingiva.

128) A surgical procedure to promote rapid weight loss is removal of most of the A) duodenum. B) pancreas. C) liver. D) jejunum. E) ileum.

D) jejunum.

22) Which layer of the digestive tract has a layer of areolar tissue that surrounds the muscularis mucosae? A) mucosa B) digestive epithelium C) muscularis mucosae D) lamina propria E) submucosa

D) lamina propria

181) A viral infection that often involves the parotid glands, which swell noticeably, is A) gingivitis. B) parotiditis. C) dysphagia. D) mumps. E) polyps

D) mumps.

14) Sandwiched between the layer of circular and longitudinal muscle in the muscularis externa is the A) submucosal plexus. B) mucosa. C) submucosa. D) myenteric plexus. E) muscularis mucosa.

D) myenteric plexus.

93) Identify the structure labeled "10." A) submucosa B) circular muscle layer C) rugae D) oblique muscle layer E) longitudinal muscle layer

D) oblique muscle layer

74) Gastric pits are A) ridges in the body of the stomach. B) involved in absorption of liquids from the stomach. C) acid scars in the esophagus. D) openings into gastric glands. E) hollows where proteins are stored.

D) openings into gastric glands.

45) In most cases, the mumps is a viral infection of the ________ glands. 45) A) mandibular B) sublingual C) lingual D) parotid E) submandibular

D) parotid

48) Which salivary gland produces a serous secretion containing large amounts of salivary amylase? A) sublingual B) submandibular C) lingual D) parotid E) mandibular

D) parotid

75) The enzyme pepsin digests A) carbohydrates. B) lipids. C) vitamins. D) proteins. E) nucleic acids.

D) proteins

Functions of the large intestine include A) most of the chemical breakdown of food. B) production of gas to move waste toward the rectum. C) secretion of vitamins. D) reabsorption of water and compaction of feces. E) absorption of bile salts.

D) reabsorption of water and compaction of feces.

85) All of the following are true of the lining of the stomach except that it A) has a simple columnar epithelium. B) is covered by a thick, viscous mucus. C) is constantly being replaced. D) recycles bile. E) contains gastric pits.

D) recycles bile.

141) In response to the hormone secretin, the pancreas secretes a fluid A) that contains only amylase. B) rich in mucus. C) rich in enzymes. D) rich in bicarbonate ion. E) rich in bile

D) rich in bicarbonate ion.

5) Which of the following descriptions best matches the term submucosal plexus? A) component of mucosa B) coordinates activity of muscularis externa C) loose connective tissue layer containing blood vessels D) sensory neural network E) secretes a watery fluid

D) sensory neural network

78) Which of the following descriptions best matches the term gastrin? A) where pancreatic juice and bile enter duodenum B) causes gallbladder to contract C) stimulates pancreas to secrete bicarbonate-rich fluid D) stimulates gastric secretion E) carries absorbed sugars and amino acids

D) stimulates gastric secretion

17) A stratified squamous epithelial lining can be found in all of the following except in the A) oropharynx. B) oral cavity. C) esophagus. D) stomach. E) anal canal.

D) stomach.

High-density lipoproteins (HDLs) above 35

Transport cholesterol diffusing out of peripheral cells back to liver

Low-density lipoproteins (LDLs) below 130

Transport of cholesterol peripheral tissues Enter cells by receptor mediated endocytosis

Very low-density lipoproteins (VLDLs)

Transport of triglycerides to peripheral tissues Fatty acids released by lipoprotein lipase Remaining Intermediate-density lipoproteins (IDLs) returns to liver

Lipoprotein produced by the liver

Very low-density lipoproteins (VLDLs) Low-density lipoproteins (LDLs) High-density lipoproteins (HDLs)

Absorption of water

Water moves out of lumen, into body -moves down its concentration gradient as solutes are absorbed out of lumen, osmolarity decreases, water moves out

branch of hepatic portal vein, hepatic artery proper, and branch of bile duct form...

a portal area

how is epithelial of stomach protected from digestion

alkaline mucous layer, and neural and hormonal control over times and rates of acid secretion.

absorption of amino acids into epithelium by...

amino acid specific transport proteins. amino acids are then released to interstitial fluid by AA specific transport proteins and diffuse into blood capillaries to be taken to liver

amino acids...

are absorbed by most cells for protein synthesis, stimulated by insulin, growth hormone, androgen, and estrogen

function of large intestine

bacterial activity: Bacteria living in large intestine breakdown various organic molecules Convert bilirubin to urobilinogens and stercobilinogens Break down peptides to ammonium ions, indole, skatole, hydrogen sulfide Digest carbohydrates to methane gas Absorption of: water Vitamins - K, biotin, and B5 synthesized by bacteria of large intestine Bile salts Organic wastes and toxins Formation and expulsion of feces :absorb water, compact feces, peristalsis triggers and defecation reflex.

brush border enzymes for carbohydrates...

cleave disaccharides, and glucose then binds to proteins on the epithelial cell to go into blood stream by facillitated or co transport diffusion. only released into interstitial fluid by specific transport proteins. once in the blood, they are transported to liver

Hepatopancreatic sphincter

controls release of bile and pancreatic secretions

what does mucus do in duodenal glands?

duodenal glands produce copious amounts of mucus when chyme arrives from stomach. mucus protects epithelium from acidity of chyme, and contains bicarbonate ions that raise pH of chyme as it travels the length of the duodenum 1-2 to 7-8pH

which hormones produced by enteroendocrine cells effectively coordinate digestive function?

eneterocrinin, secretin, CCK, GIP, VIP, gastrin, and motilin

drop in pH below 4.5 in duodenum stimulates secretion of...

secretin.

outer layer of digestive tract is known as

serosa

most of digestive tract is lined by...

simple columnar epithelium

what body systems would be affected by inadequate Ca2+ absorption

skeletal, muscular, nervous, endocrine, and cardiovascular systems would all be affected by inadequate absorption of calcium

during defecation...

stretch receptors in rectal wall initiate series of peristaltic contractions in colon and rectum. and stretch receptors in rectal wall activate parasympathetic centers in sacral region of spinal cord

digestion of which nutrient would be most impaired by damage to exocrine pancreas

would most impair digestion of fats (lipids) because it is the primary source of lipases. salivary glands and small intestine would still produce digestive enzymes for carbs and proteins, but lipases are produced by exocrine pancreas.