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ANATOMO - PHYSIOLOGICAL CHARACTERISTICS OF THE DIGESTIVE SYSTEM IN CHILDREN (LITERATURE REVIEW)
Ortik Ismoilovich Ismoilov
Associate Professor, Department of Anatomy and Human Anatomy, Samarkand State Medical Institute Saidkosim Murodkosimovich Murodkosimov Associate Professor, Department of Epidemiology, Samarkand State Medical Institute
Malika Ilkhomovna Kamalova Assistant to the Department of Anatomy and Human Anatomy at Samarkand State Medical Institute
ABSTRACT
The digestive organs include the oral cavity, esophagus, stomach and intestines. The pancreas and liver are involved in digestion. The digestive organs are established during the first 4 weeks of gestation and by 8 weeks of gestation all digestive organs are identified. The foetus begins to swallow amniotic fluid by 1620 weeks of pregnancy. Digestive processes take place in the fetal intestines, where an accumulation of primiparous feces - meconium.
Keywords: digestive system, anatomy, physiology.
Органы пищеварения включают ротовую полость, пищевод, желудок и кишечник. Поджелудочная железа и печень участвуют в пищеварении. Органы пищеварения устанавливаются в течение первых 4 недель беременности, а к 8 неделе беременности идентифицируются все органы пищеварения. Плод начинает заглатывать околоплодные воды к 16-20 неделе беременности. Пищеварительные процессы проходят в кишечнике плода, где происходит скопление первородящих фекалий - мекония.
Ключевые слова: пищеварительная система, анатомия, физиология.
The main function of the baby's oral cavity after birth is to ensure the act of sucking. These features are: small size of the mouth, large tongue, well developed lip muscles and chewing muscles, transverse folds in the mucous membrane of the lips, gum thickening, and the cheeks contain lumps of fat (Biches lumps) which
АННОТАЦИЯ
INTRODUCTION
Peculiarities of the oral cavity in children
Oriental Renaissance: Innovative, R VOLUME 1 | ISSUE 7
educational, natural and social sciences ( ) ISSN 2181-1784
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give the cheeks a firmness. Salivary glands in children after birth are insufficiently developed; little saliva is excreted in the first 3 months. Development of the salivary glands is complete by 3 months of age.
DISCUSSION AND RESULTS
Peculiarities of the oesophagus in children
The oesophagus in young children is spindle-shaped, narrow and short. It is only 10 cm long in a newborn baby, 12 cm at 1 year of age and 18 cm at 10 years of age. Its width is respectively 8 mm at 7 years of age and 15 mm at 12 years. The mucous membrane of the oesophagus has no glands. It has thin walls, poorly developed muscular and elastic tissues and is well supplied with blood. The entrance to the oesophagus is high. There are no physiological constrictions.
Peculiarities of the stomach in children
In infancy, the stomach is positioned horizontally. With growth and development during the period when the child starts to walk, the stomach gradually assumes an upright position and by 7-10 years of age it is positioned in the same way as in adults. The capacity of the stomach gradually increases: at birth it is 7 ml, at 10 days it is 80 ml, at one year it is 250 ml, at 3 years it is 400-500 ml and at 10 years it is 1500 ml. The volume of a single meal for children in the first year of life can be calculated using N.F. Filatov's formula:
V = 30 ma + 30 x n, where n is the age in months
A characteristic feature of the child's stomach is the poor development of its fundus and cardiac sphincter against a background of good pyloric development. This contributes to frequent regurgitation in the child, especially when air enters the stomach during sucking. The gastric mucosa is relatively thick and the gastric glands are poorly developed. The active glands of the gastric mucosa form as the child grows and become 25 times as large as in the adult state. Because of these characteristics the secretory apparatus in children of the first year of life is underdeveloped. The composition of gastric juice in children is similar to that of adults, but its acid and enzymatic activity is much lower. The barrier activity of gastric juice is low.
The main active enzyme in gastric juice is rennet (labyrinthine enzyme), which enables the first phase of digestion - the fermentation of milk.
The stomach of an infant produces very little lipase. This deficiency is made up for by the presence of lipase in the breast milk as well as in the baby's pancreatic juice. If the baby receives cow's milk, its fats are not broken down in the stomach.
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Absorption in the stomach is insignificant and concerns substances such as salt, water, glucose and only partially absorbed products of protein breakdown. The timing of the evacuation of food from the stomach depends on the type of feeding. Women's milk stays in the stomach for 2-3 hours.
The pancreas is small in size. It is 5-6 cm in length at birth and tripled in size by the age of 10 years. The pancreas is located deep in the abdominal cavity at the level of the X thoracic vertebra, while at an older age it is located at the level of the I lumbar vertebra. It is growing rapidly up to the age of 14.
Dimensions of the pancreas in children in the first year of life (cm):
1. Newborn - 6.0 x 1.3 x 0.5;
2. 5 months - 7.0 x 1.5 x 0.8;
3. 1 year old - 9.5 x 2.0 x 1.0.
The pancreas is rich in blood vessels. Its capsule is less dense than in adults and consists of thin fibre structures. The ducts are wide, allowing good drainage.
The child's pancreas has external secretory and intrasecretory functions. It produces pancreatic juice consisting of albumin, globulin, trace elements and electrolytes, and enzymes needed to digest food. Enzymes include proteolytic enzymes - trypsin, chymotrypsin, elastase - as well as lipolytic enzymes and amylolytic enzymes. The pancreas is regulated by secretin, which stimulates the secretion of the liquid part of the pancreatic juice, and pancreozymin, which enhances enzyme secretion along with other hormone-like substances that are produced by the duodenal and small intestine mucosa. The intrasecretory function of the pancreas is performed by the synthesis of hormones responsible for the regulation of carbohydrate and fat metabolism.
The liver of the newborn is the largest organ, occupying 1/3 of the abdominal cavity volume. At 11 months of age its mass doubles, by 2-3 years of age it triples, by age 8 it increases 5 times, and by age 16-17 it becomes 10 times bigger. The liver has the following functions:
1)produces bile, which is involved in intestinal digestion;
2) it stimulates intestinal motility through the action of bile;
3) stores nutrients;
4) it performs a barrier function;
5) participates in metabolism, including the transformation of vitamins A, D, C, B12 and K;
Peculiarities of the pancreas in children
Peculiarities of the liver in children
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6) during the foetal period it is a hematopoietic organ.
After birth the liver is further formed. The functional capacity of the liver is low in infants: the metabolism of non-direct bilirubin is incomplete in newborn infants.
The gallbladder is under the right lobe of the liver and is spindle-shaped, reaching a length of 3 cm. It is typically pear-shaped by 7 months of age and reaches the edge of the liver by 2 years of age. The main function of the gallbladder is to collect and release hepatic bile. The composition of the child's bile is different from that of an adult. It contains little bile acids, cholesterol, salts, a lot of water, mucin and pigments. During infancy bile is rich in urea. Glycocholic acid predominates in the baby's bile and enhances the bactericidal effect of the bile and accelerates the pancreatic juice secretion. Bile emulsifies fats, dissolves fatty acids and improves peristalsis. With age, the size of the gallbladder increases and bile begins to be secreted in a different way than in younger children. The length of the common bile duct increases with age.
The size of the gallbladder in children (Chapova O.I., 2005):
1)newborn - 3.5 x 1.0 x 0.68 cm;
2)1 year old - 5.0 x 1.6 x 1.0 cm;
3)5 years - 7,0 x 1,8 x 1,2 cm;
4)12 years - 7.7 x 3.7 x 1.5 cm.
The small intestine in children is relatively longer than in adults. The ratio of small intestine length to body length in the newborn is 8.3 : 1, in the first year of life 7.6 : 1, at 16 years of age 6.6 : 1. The length of the small intestine in the first year of life is 1.2 to 2.8 m. The size of the inner surface of the small intestine in the first week of life is 85 cm2, in an adult it is 3.3 x 103 cm2. The area of the small intestine increases due to the development of epithelium and microvilli. The small intestine is anatomically divided into 3 divisions. The first division is the duodenum, which is 10 cm long in newborn babies and reaches 30 cm in adults. It has three sphincters whose main function is to create a low pressure area where food comes into contact with pancreatic enzymes. The second and third are the small intestine and ileum. Small intestine is 2/5 of the length up to the ileocecal angle, the ileum is the remaining 3/5.
Digestion of food and absorption of its ingredients takes place in small intestine. The mucous membrane of the intestine is rich in blood vessels, the
Features of the gallbladder in children
Features of the small intestine in children
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epithelium of the small intestine is rapidly renewed. The intestinal glands in children are larger and lymphoid tissue is scattered throughout the intestine. Peyer's plaques form as the child grows.
The small intestine in children is relatively longer than in adults. The ratio of small intestine length to body length in the newborn is 8.3 : 1, in the first year of life 7.6 : 1, at 16 years of age 6.6 : 1. The length of the small intestine in the first year of life is 1.2 to 2.8 m. The size of the inner surface of the small intestine in the first week of life is 85 cm2, in an adult it is 3.3 x 103 cm2. The area of the small intestine increases due to the development of epithelium and microvilli. The small intestine is anatomically divided into 3 divisions. The first division is the duodenum, which is 10 cm long in newborn babies and reaches 30 cm in adults. It has three sphincters whose main function is to create a low pressure area where food comes into contact with pancreatic enzymes. The second and third are the small intestine and ileum. Small intestine is 2/5 of the length up to the ileocecal angle, the ileum is the remaining 3/5.
Digestion of food and absorption of its ingredients takes place in small intestine. The mucous membrane of the intestine is rich in blood vessels, the epithelium of the small intestine is rapidly renewed. The intestinal glands in children are larger and lymphoid tissue is scattered throughout the intestine. Peyer's plaques form as the child grows.
The gastrointestinal tract of the foetus is sterile. When the baby comes into contact with the environment its microflora is colonised. In the stomach and duodenum the microflora is scanty. In the small and large intestine the number of microbes increases and depends on the type of feeding. The main microflora is B. bifidum, whose growth is stimulated by lactose from breast milk. The intestine is dominated by conditionally pathogenic Gram-negative E. coli during artificial feeding. The normal intestinal flora has two main functions:
1) creation of an immunological barrier;
2) synthesis of vitamins and enzymes.
Peculiarities of digestion in young children
Nutrients that come with the mother's milk and are digested at the expense of substances contained in the mother's milk itself are crucial for children in the first months of life. With the introduction of complementary foods the enzyme system mechanisms of the child are stimulated. The absorption of food ingredients in young
Features of the small intestine in children
Peculiarities of the intestinal microflora in children
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children has its own peculiarities. Casein is first fermented in the stomach under the influence of a foreign enzyme. In the small intestine it begins to break down into amino acids, which are activated and absorbed.Fat digestion depends on the type of feeding. Cow's milk fats contain long-chain fats, which are broken down by pancreatic lipase in the presence of fatty acids. Fat absorption occurs in the terminal and middle sections of the small intestine. The breakdown of milk sugar in children takes place in the fringe of the intestinal epithelium. Women's milk contains lactose and cow's milk contains lactose. In this regard, artificial feeding alters the carbohydrate composition of food. Vitamins are also absorbed in the small intestine.
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