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Chapter 24 (Digestive System)

Human Anatomy and Physiology (Athabasca University)

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Chapter 24: Digestive System

24.1 Overview of the Digestive System

Digestive System

 Organs involved in breakdown of food.

 Two groups of organs:
1. Gastrointestinal (GI) Tract
2. Accessory digestive organs

Gastrointestinal (GI) Tract/Alimentary Canal

 Continuous tube from mouth to anus.

 GI tract muscles contract to breakdown food.
 Includes (6):
o Mouth, Pharynx, Esophagus, Stomach, Small/Large Intestines.

Accessory Digestive Organs

 Aids in chemical and physical breakdown.

 Secretes enzymes.
 Includes (6):
o Teeth, tongue, salivary glands, liver, gallbladder, pancreas.

Six Functions:

1. Ingestion
2. Secretion
3. Mixing and propulsion
 Motility: the ability of GI tract to move material.
4. Digestion
 Mechanical/Chemical Digestion
5. Absorption
 The intake of ingested food/minerals/ions.
6. Defacation
 The release of feces; materials that were not absorbed.

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24.2 Layers of the GI Tract

4 layers of GI Tract:

 Mucosa (deep)
 Submucosa
 Muscularis
 Serosa/adventitia (superficial)

Mucosa (Deep)

 Inner lining of GI tract, is a mucous membrane.

 3 layers: (1) layer of epithelium, (2) lamina propria, (3) muscularis mucosae.

1. Epithelium

 Protection, secretion and absorption, and seal.

 Enteroendocrine cells secrete hormones.

2. Lamina Propria

 Contains vessels for nutrient absorption.

 Contains Mucosa associated lymphatic tissue (MALT), which is for immune system.

3. Muscularis Mucosae

 Folds for increased surface area for digestion and absorption.

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Submucosa

 Blood and lymphatic vessels for food molecule absorption.

 Contains submucosal plexus.

Muscularis

 Skeletal muscles for swallowing food and shitting.

 Smooth muscles for involuntary contractions.

Serosa

 Portion of GI tract suspended in abdominal cavity; areolar connective tissue.

 Also called Visceral Peritoneum because it forms part of peritoneum.
 Adventitia is the superficial layer of esophagus; only 1 layer of areolar tissue.

24.3 Neural Innervation of the GI Tract

Enteric Nervous System (ENS)

 “Brain of the gut”

 Arranged in two plexuses:
o Myenteric Plexus/Plexus of Auerbach
o Submucosal Plexus/Plexus of Meissner
 Wall contains 2 receptors: (1) Chemoreceptors, (2) Mechanoreceptors

Myenteric Plexus/Plexus of Auerbach

 Between longitudinal and circular smooth muscle.

 Controls GI tract motility (movement), such as strength and contraction frequency.

Submucosal Plexus/Plexus of Meissner

 Found within the submucosa.

 Controls the secretion of organs in GI tract.

Autonomic Nervous System

 Vagus (X) nerve supply parasympathetic parts of GI tract.

o Stimulation of parasympathetic nerves causes an increase in GI tract secretion and
motility.
 Sympathetic nerves arise from thoracic and upper lumbar of spinal cord.
o Stimulation causes a decrease in secretion and motility.

Gastrointestinal Reflex Pathways

 Regulate secretion and motility.

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24.4 Peritoneum
Peritoneum

 Largest serous membrane of body.

 Divided into: (1) Parietal peritoneum, (2) Visceral peritoneum.

Parietal Peritoneum

 Lines the wall of abdominal cavity.

Visceral Peritoneum

 Covers some organs in abdomen and is their serosa.

Peritoneal Cavity

 Slim space containing lubricating fluid; between parietal and visceral.

Retroperitoneal

 Organs on the posterior abdominal wall which is covered by peritoneum only on their anterior
side.
 Kidneys, ascending/descending colons of large intestine, duodenum of small intestine, pancreas.

5 Peritoneal Folds:

1. Greater Omentum
 Largest peritoneal fold, with four layers.
 Adipose tissue that can greatly expand.
2. Falciform Ligament
 Attaches liver to anterior abdominal wall (liver is the only anterior organ).
3. Lesser Omentum
 Anterior fold in serosa of stomach and duodenum.
 Pathway for blood vessels to liver.
4. Mesentery
 Binds jejunum and ileum (small intestine) to posterior abdominal wall.
 Typically, full of fat which forms two layers.
5. Mesocolon
 Bind transverse and sigmoid colon (large intestine) to posterior abdominal wall.
 Carries blood and lymphatic vessels to intestines.

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24.5 Mouth
Mouth/Oral (Buccal) Cavity

 Formed by cheeks, hard and soft plates, and tongue.

Cheeks

 Covered by skin (external) and mucous membrane (internal).

 Buccinator muscles and connective tissue lie between skin and mucous membrane.

Lips/Labia

 Folds surrounding the opening; contain orbicularis oris muscle.

Labial Frenulum

 Midline fold that attaches each lip to the gums.

Oral Vestibule

 Space between gum, teeth, cheeks, and lips. It’s the fucking hole mate.

Oral Cavity Proper

 Space between gums/teeth to fauces (throat entrance).

Hard Plate

 Anterior portion of roof of mouth.

 Bony partition between oral and nasal cavities; maxillae and palatine bones.

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Soft Plate

 Posterior roof of mouth.

 Muscular partition between oropharynx and nasopharynx, lined with mucous membrane.

Uvula

 Fingerlike muscular structure which prevents food and liquids from entering nasal cavity.

Salivary Glands

Salivary Glands

 Gland that releases saliva in oral cavity.

 Lubrication, chemical breakdown of food.
 Major salivary glands (4):
o Parotid Glands
o Submandibular Glands
o Sublingual Glands
o Lesser sublingual Glands

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Composition and Functions of Saliva

Saliva

 99.5% water and 0.5% solutes.

o Contains ions and enzymes (salivary amylase).
 Main functions:
o Dissolution of food (salivary amylase)
o Buffer acidic food
o Remove waste molecules
o Lubrication
o Fights bacteria

Salivary amylase

 Activated by Cl- ions.

 Breakdown of starch into maltose, maltotriose, a-dextrin.

Salivation

 Secretion of saliva, controlled by autonomic nervous system.

 Parasympathetic promotes continuous secretion.
 Sympathetic dominates during stress, resulting in dryness.
 Feel and food taste stimulates salivation.

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Tongue

Tongue

 Accessory digestive organ made of skeletal muscles.

 Divided into symmetrical lateral halves (median septum).

Extrinsic Muscles of Tongue

 Move the tongue side to side and in and out for chewing; hold the tongue in position.
 Includes hyoglossus, genioglossus, styloglossus.

Intrinsic Muscles of Tongue

 Shape and size for speech and swallowing.

 Longitudinalis superior, inferior, transversus linguae, verticalis linguae.

Lingual Frenulum

 Attached to floor of mouth; limits the posterior movement of tongue.

Papillae

 Contains taste buds, while some contain receptors for touch and increase friction.

Lingual glands

 Secrete mucus and watery serous fluid containing enzymes (lingual lipase).

Lingual lipase

 Enzyme that acts on triglycerides and converts them to simpler fatty acids.

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Teeth

Dentitions

 Two sets of teeth: (1) Deciduous, (2) Permanent

Deciduous Teeth/Primary/Milk/Baby Teeth

 Begin to come at 6 months, ~2 teeth each month, until 20 teeth.

Deciduous Teeth:

 Central Incisor
 Lateral Incisor
 Canine/cuspids
 First molar
 Second molar

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Permanent (Secondary) Teeth

 Appear between 6 – 12 years; contains 34 teeth.

 Deciduous molars are replaced by first/second premolars (bicuspids).

 First Permanent Molar appear at age 6.

 Second Permanent Molar appear at age 12.
 Third Permanent Molar (wisdom teeth) appear after 17 or not.

Permanent Teeth:

 Central Incisor
 Lateral Incisor
 Canine
 First premolar (bicuspid)
 Second Premolar (bicuspid)
 1st molar
 2nd molar

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 3rd molar (wisdom)

Mechanical and Chemical Digestion in the Mouth

Mastication

 Chewing; food is manipulated by tongue, ground by teeth, and mixed in saliva.

Bolus

 Soft, flexible mass of food; Result of mastication.

Salivary Amylase

 Secreted by salivary glands.

 Chemical breakdown of food into monosaccharides.

Lingual Lipase

 Secreted by lingual glands in tongue.

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 Activates in the stomach (acidic), and breaks down triglycerides (fat and oil) into fatty acids and
diglycerides.

24.6 Pharynx
Pharynx

 From internal nares to esophagus (posteriorly) and larynx (anteriorly).

 Nasopharynx (respiratory), Oropharynx (respiratory/digestive), laryngopharynx
(respiratory/digestive).
 Helps propel food into the esophagus and stomach.

24.7 Esophagus
Esophagus

 Collapsible muscular tube, posterior to trachea.

 Begins inferior of laryngopharynx and ends in the stomach.

Esophageal Hiatus

 Opening in the diaphragm that the esophagus passes through to reach stomach.

Histology of the Esophagus

Mucosa

 Nonkeratinized stratified squamous epithelium, lamina propria, and muscularis mucosae.

 Protection against abrasion and wear and tear from food.

Submucosa

 Areolar connective tissue, blood vessels, and mucous glands.

Muscularis

 Mix of skeletal and smooth muscles.

 Forms upper/lower esophageal sphincters.

Upper Esophageal Sphincter (UES)

 Consists of skeletal muscles.

 Regulates movement of food from pharynx to esophagus.

Lower Esophageal Sphincter (LES)

 Consists of smooth muscles.

 Regulates movement from esophagus to stomach.

Adventitia

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 Superficial layer of esophagus (instead of serosa).

 Attaches esophagus to surrounding structures.

Physiology of Esophagus

 Secretes mucus and transports food into stomach.

 Does not produce digestive enzymes or absorb.

24.8 Deglutition
Deglutition

 Movement of food to stomach; act of swallowing.

 Three stages:
o Voluntary stage
o Pharyngeal stage
o Esophageal stage.

Voluntary Stage

 Movement of bolus by tongue to the oropharynx.

Pharyngeal Stage

 Involuntary swallowing.
 Bolus stimulates receptors in oropharynx and sends impulses to Deglutition center (in medulla
oblongata and lower pons).
 Pharynx and epiglottis closes preventing water and food to enter nasal cavity and respiratory
tract.

Esophageal Stage

 Starts once bolus enters esophagus.

 Peristalsis begins.
o Progression of coordinated muscular contractions to push bolus down.

24.9 Stomach
Anatomy of the Stomach

Cardia

 Surrounds the opening of esophagus into stomach.

Fundus

 Rounded portion superior to and left of cardia.

Body

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 Central portion of stomach, inferior to fundus.

Pyloric Antrum

 Connects to body of stomach.

Pyloric Canal

 Leads to the pylorus.

Pylorus

 Connects to duodenum.

Rugae

 Large folds of stomach.

Pyloric Sphincter

 Smooth muscle; communication between pylorus and duodenum.

Lesser Curvature

 Concave medial border of stomach.

Greater Curvature

 Convex lateral border.

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Histology of the Stomach

Mucosa

Surface mucous cells

 Surface of the mucosa; simple columnar epithelial cells.

Lamina propria

 Areolar connective tissue.

Muscularis mucosae

 Smooth muscles.

Gastric glands

 Columns of secretory cells in the lamina propria.

 Empties into gastric pits.

Gastric Glands

 Contains 3 types of exocrine gland cells: (1) mucous neck, (2) chief, (3) parietal cells.

Mucous neck cells

 Secrete mucus.

Parietal cells

 Produce intrinsic factor and hydrochloric acid.

Chief cells

 Pepsinogen and gastric lipase.

Gastric Juice

 Made up of the secretions of mucous, parietal, and chief cells (2 – 3L /day).

G Cell

 Enteroendocrine cell that secretes gastrin into the bloodstream.

Submucosa

 Areolar connective tissue.

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Muscularis

 Three layers of smooth muscles: outer longitudinal, middle circular, inner oblique layer.

Serosa

 Simple squamous epithelium and areolar connective tissue.

Mechanical and Chemical Digestion in the Stomach

Propulsion

 Movement of gastric content from stomach to antrum via peristalsis.

Retropulsion

 Movement of food back into the stomach because too big.

Chyme

 Liquefied food due to breakdown with gastric juice.

Gastric emptying

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 Movement of chime through the pyloric sphincter.

Proton Pumps

 Transports H+ into the lumen while bringing K+ into the cell.

 Uses H+-K+ ATPases.

Pepsin

 Protein digesting enzyme in the stomach; Secreted by chief cells.

 Breaks amino acids into peptide fragments.
 Not active at pH <2.

Gastric Lipase

 Breaks down triglycerides (fats and oils) into fatty acids and monoglycerides.

24.10 Pancreas
Anatomy of the Pancreas

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Histology of the Pancreas

Acini (99%)

 Exocrine cells of the pancreas.

 Secretes fluid and digestive enzymes (pancreatic juice).

Pancreatic Islets (Islets of Langerhans) (1%)

 Endocrine cells.
 Secretes glucagon, insulin, somatostatin, pancreatic polypeptide.

Composition and Functions of Pancreatic Juice

Pancreatic Amylase

 Enzymes that digest starch.

Trypsin, Chymotrypsin, carboxypeptidase, and elastase

 Digest proteins into peptides.

Pancreatic Lipase

 Digests triglycerides.

Ribonuclease, deoxyribonuclease

 Digests RNA and DNA into nucleotides.

Trypsinogen

 Inactive form of Trypsin.

Enterokinase

 Enzyme that activates trypsinogen into trypsin.

 Trypsin then activates other digestive proteins.

24.11 Liver and Gallbladder

Anatomy of Liver and Gallbladder

Liver parts (5):

 Right/left lobe, quadrate/caudate lobe (part of left), ligamentum teres (umbilical cord remains).

Gallbladder parts (3):

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 Fundus, body, neck.

Histology of the Liver and Gallbladder

Hepatocytes

 Functional cells of liver for metabolic, secretory, and endocrine functions.

 Secretes bile.

Bile Canaliculi

 Spaces where bile collects in.

Bile canaliculi -> bile ductules -> bile ducts -> right/left hepatic ducts -> common hepatic duct -> cystic
duct -> common bile duct -> duodenum.

Hepatic Sinusoids

 Highly permeable blood capillaries between hepatocytes; oxygen/CO 2 exchange.

Central Vein

 Receives blood from hepatic sinusoids, and bring blood to hepatic veins.

Anatomical/functional units of hepatocytes (3):

Hepatic Lobule

 Each hepatic lobule is hexagon.

Portal Lobule

 Emphasizes bile secretion; triangle shape.

Hepatic Acinus

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Blood Supply of the Liver

 Two sources:
o Hepatic artery (oxygenated blood)
o Hepatic portal vein (deoxygenated blood)

Role and Composition of Bile

 Consist mainly of:

o Water, bile salts, cholesterol, lecithin, bile pigments, and ions.
 Primary function: absorption of dietary fats.
 Bilirubin is the principal pigment of bile.
 Emulsification is the breakdown of large lipid globules into a suspension; aided by bile salts.

Functions of the Liver (9):

1. Carbohydrate metabolism
2. Lipid metabolism
3. Protein metabolism
4. Processing of drugs and hormones
5. Excretion of bilirubin
6. Synthesis of bile salts
7. Storage
8. Phagocytosis
9. Activation of Vitamin D

24.12 Small Intestine

Anatomy of Small Intestine

Divided into 3 regions:

Duodenum

 First part; shortest region.

Jejunum

 2nd portion; 1 m long.

Ileum

 Last portion; 2 m long.

 Joins the large intestine through ileocecal sphincter (valve), a smooth muscle sphincter.

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Histology of Small Intestines

Mucosa

 Composed of epithelium, lamina propria, and muscularis mucosae.

Absorptive cells

 Contain microvilli (for reabsorption) and releases digestive enzymes.

Goblet cells

 Secrete mucus.

Intestinal glands/crypts of Lieberkuhn

 Secrete intestinal juice; contains enteroendocrine cells.

Paneth Cells

 Secrete bacterial lysozyme.

3 hormones secreted by enteroendocrine cells:

1. Secretin
2. Cholecystokinin (CKK)
3. Glucose-dependent insulinotropic peptide (GIP)

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Solitary Lymphatic Nodules

 Numerous in distal ileum.

Aggregated Lymphatic Follicles/ Peyer’s Patches

 Groups of lymphatic nodules; present in the ileum.

Submucosa contains:

Duodenal Glands/ Brunner’s Glands

 Secrete alkaline mucus for neutralizing gastric acid in chyme.

Muscularis of small intestine:

 Consists of two layers of smooth muscles.

Structural features of small intestine:

Circular Folds

 Folds of mucosa and submucosa.

 Enhance absorption by increasing surface area.

Villi

 Finger-like projections of the mucosa.

 Increases surface area for digestion and absorption.

Lacteal

 Lymphatic capillaries covering the villi.

Microvilli

 Projections of apical membrane of absorptive cells; increase surface area.

Brush border

 Fuzzy line of microvilli under the microscope, extending to lumen.

 Contains enzymes for digestion.

Role of Intestinal Juice and Brush-Border Enzymes

Intestinal Juice

 Aids in absorption of substances from chyme.

Brush-border enzymes

 Carbohydrate-digesting enzymes
o Dextrinase, maltase, sucrose, lactase.

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 Protein-digesting enzymes
o Aminopeptidase, dipeptidase
 Nucleotide-digesting enzymes
o Nucleosidases, phosphatases

Mechanical Digestion in Small Intestines

Two types of movements: (1) Segmentations, (2) migrating motility complexes

Segmentations

 Localized, mixing contractions with chyme and digestive juices, and makes contact with mucosa
for absorption.
 Does not move the food.

Migrating motility complexes

 Pushes chyme forward along small intestine to the ileum.

Chemical Digestion in Small Intestines

Enzymes for Carbohydrates:

 Dextrinase
 Sucrase
 Lactase
 Maltase

Enzymes for Proteins

 Peptidase
 Aminopeptidase
 Dipeptidase

Enzymes for Lipids

 Lipase
o Lingual, gastric, and pancreatic lipase.

Enzymes for Nucleic Acids

 Nucleosidases
 Phosphatases

Absorption in Small Intestine

Absorption of Monosaccharides

 Via facilitated diffusion/active transport through apical membrane.

Absorption of Amino acids, Dipeptides, and Tripeptides

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 Via active transport in duodenum and jejunum.

Absorption of Lipids and Bile Salts

 Via simple diffusion.

 Micelles are circular structures of bile salts that surround chyme.
 Chylomicrons triglyceride globules with phospholipids and cholesterol.
 Lipoprotein lipase breakdown triglycerides in chylomicrons and other lipoproteins.

Enterohepatic circulation

 Cycle of bile secretion, reabsorption, and resecretion.

Absorption of Electrolytes

 Mostly come from GI secretions.

 Active transport

Absorption of Vitamins

 Mostly simple diffusion.

 Vitamin B12 through active transport.

Absorption of Water

 Occurs via osmosis from lumen to blood capillaries.

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24.13 Large Intestine

Anatomy of the Large Intestine

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Histology of Large Intestines

Mucosa

 Simple columnar, lamina propria (areolar tissue), and muscularis mucosae (smooth muscle).
 Contains absorptive cells for water, and goblet cells to secret mucus (lubricant).
 Does not have surface area enhancers.

Submucosa

 Consists of areolar connective tissue.

Muscularis

 External smooth muscle and internal circular smooth muscle.

 Teniae coli thickened longitudinal muscles forming a band.
 Haustra pouches in the colon.

Serosa

 Part of visceral peritoneum.

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Mechanical Digestion of Large Intestines

Gastroileal Reflex

 Intensifies peristalsis and forces chyme into cecum.

 Gastrin relaxes sphincter.

Haustral Churning

 Relaxation of haustra until it becomes filled and contracts.

Mass Peristalsis

 Strong peristaltic wave from mid transverse colon into rectum.

Gastrocolic Reflex

 Initiated by food; starts the full reflex processes.

Chemical Digestion in Large Intestines

 Final stage of digestion.

 Bacterium breaks down remaining food, which produces gas.

Absorption and Feces Formation in Large Intestines

 Feces consist of water, organics, undigested materials, bacteria, etc.

 Large intestines absorb ~10% of water and some ions.

Defecation Reflex

Defecation Reflex

 Stimulated by build-up of shit in rectal wall.

 Rectal muscles contract increasing pressure.

Diarrhea

 Increase in frequency, volume, and fluid content of feces

 Due to decreased absorption and increased motility.

Constipation

 Infrequent or difficult defecation, due to decreased motility.

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24.14 Phases of Digestion

Cephalic Phase

 Prepare the mouth and stomach for food

 Increased salivation and gastric juice secretion.

Gastric Phase

 Initiates once food enters stomach.

 Regulated by neural and hormonal mechanisms.
o Neural Regulation: results in peristalsis and stimulation of gastric juice.
o Hormonal Regulation: gastric secretions are controlled by Gastrin.

Intestinal Phase

 Initiates once food enters small intestine; slows down the movement of chyme.
 Neural Regulation:
o chyme causes enterogastric reflex which inhibits gastric motility.
 Hormonal Regulation:
o CCK stimulates pancreatic juice, contraction of gallbladder, and feeling of fullness.
o Secretin stimulates pancreatic juice, enhances effects of CCK, buffering of acid.

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Disorders

Dental Caries

 Tooth decay, softening of enamel and dentin.

 Can cause infection if not treated.

Periodontal Disease

 Inflammation and degeneration of the gingivae, alveolar bone, periodontal ligament, and
cementum.

Peptic Ulcer Disease

 Lesion in membranes due to:

o Bacteria, anti-inflammatory drugs, hypersecretion of HCl.

Diverticulitis

 Inflammation of the walls of colon.

Colorectal Cancer

 Fucking cancer…

Hepatitis

 Inflammation of the liver.

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