DIGESTIVE SYSTEM

Objectives:
- Identify the organs of the digestive system and list their
major functions. (stomach, small intestine, large intestine and
salivary glands, pancreas, liver, gall bladder)
- Explain the processes by which materials move through the
digestive tract.
- Outline the mechanisms that regulate digestion.

The digestive system consists of a muscular tube, the

digestive tract, also called the gastrointestinal tract (GI) or
alimentary canal, and various accessory organs.
 The nutrition for the cells of the body must be in a simple
form: amino acids, simple sugars, and fatty acids.

The digestion process: The digestive system takes the

complex organic molecules of the foods we ingest —
proteins, carbohydrates, and fats — and break them down
into their simple form. The simple molecules (nutrients) are
absorbed from the digestive system by the cardiovascular
and lymphatic systems and transported to cells throughout
the body.
The digestive system may
divide into two parts:

- A muscular tube, known

as the alimentary canal or
digestive tract: the mouth,
pharynx, esophagus,
stomach, small intestine, and
large intestine.
- The accessory digestive
organs and glands that help
in the digestive process
include the tongue, teeth,
salivary glands, pancreas,
liver, and gall bladder.
Functions of the Digestive System :
- Ingestion occurs when materials enter the digestive tract via the mouth.
Ingestion is an active process involving conscious choice and decision making.
- Mechanical processing is crushing and shearing that makes materials
easier to propel along the digestive tract. It also increases their surface area,
making them more susceptible to enzymatic attack.
- Digestion refers to the chemical breakdown of food into small organic
fragments suitable for absorption by the digestive epithelium. Simple molecules
in food, such as glucose, can be absorbed intact, but epithelial cells cannot to
absorb molecules the size and complexity of proteins, polysaccharides, or
triglycerides. These molecules must be splitted by digestive enzymes prior to
absorption.
- Secretion is the release of water, acids, enzymes, buffers, and salts by
the epithelium of the digestive tract and by glandular organs.
- Absorption is the movement of organic substrates, electrolytes (inorganic
ions), vitamins, and water across the digestive epithelium and into the
interstitial fluid of the digestive tract.
- Excretion is the removal of waste products from body fluids.
Peristalsis :
- The muscularis externa propels materials from one portion of the
digestive tract to another by contractions knows as peristalsis.
- Peristalsis consists of waves of muscular contractions that move a
bolus, or small oval mass of digestive contents, along the length of the
digestive tract.
- During a peristaltic movement, the circular muscles contract behind
the bolus while circular muscles ahead of the bolus relax. A wave of
contraction in the circular muscles then forces the bolus forward.

Segmentation :
- Most areas of the small intestine and some portions of the large
intestine undergo cycles of contraction that churn and fragment the bolus,
mixing the contents with intestinal secretions.
- This activity, called segmentation, does not follow a set pattern, and
thus does not push materials along the tract in any one direction.
The mouth
Food enters the body through the mouth, or oral cavity. The mouth performs
the first step of digestion that is mastication (chewing).
Three pair of salivary glands open at various points into the mouth, about 1 to
2 liters of saliva are secreted each day.
Sympathetic nerves stimulate saliva production.

Saliva has many functions :

- It contains amylase which breaks down polysaccharides (a type of
carbohydrate)
- It contains mucus which moistens and lubricates the food which helps in
swallowing.
- It contains lysozyme which is an anti-bacterial enzyme.
- It helps in the stimulation of the taste buds.
- It aids speech by moistening the lips and tongue.
- It helps keep mouth and teeth clean.
- It buffers acidic foods.
Nervous Regulation of Salivary Secretion
Figure 64–3 shows the parasympathetic nervous pathways for regulating salivation,
demonstrating that the salivary glands are controlled mainly by parasympathetic nervous
signals all the way from the superior and inferior salivatory nuclei in the brain stem.
The salivatory nuclei are located approximately at the juncture of the medulla and pons and
are excited by both taste and tactile stimuli from the tongue and other areas of the mouth and
pharynx. Many taste stimuli, especially the sour taste (caused by acids), elicit copious
secretion of saliva—often 8 to 20 times the basal rate of secretion. Also, certain tactile
stimuli, such as the presence of smooth objects in the mouth (e.g., a pebble), cause marked
salivation, whereas rough objects cause less salivation and occasionally even inhibit
salivation.
Salivation can also be stimulated or inhibited by nervous signals arriving in the salivatory
nuclei from higher centers of the central nervous system. For instance, when a person smells
or eats favorite foods, salivation is greater than when disliked food is smelled or eaten. The
appetite area of the brain, which partially regulates these effects, is located in proximity to the
parasympathetic centers of the anterior hypothalamus, and it functions to a great extent in
response to signals from the taste and smell areas of the cerebral cortex or amygdala.
Sympathetic stimulation can also increase salivation a slight amount, much less so
than does parasympathetic stimulation. The sympathetic nerves originate from the
superior cervical ganglia and travel along the surfaces of the blood vessel walls to
the salivary
glands.
A secondary factor that also affects salivary secretion is the blood supply to the
glands because secretion always requires adequate nutrients from the blood.
The parasympathetic nerve signals that induce copious salivation also moderately
dilate the blood vessels. In addition, salivation itself directly dilates the blood vessels,
thus providing increased salivatory gland nutrition as needed by the secreting cells.
Part of this additional vasodilator effect is caused by kallikrein secreted by the
activated salivary cells, which in turn acts as an enzyme to split one of the blood
proteins, an alpha2-globulin, to form bradykinin, a strong vasodilator.
The pharynx:
A common passage way for solid
food, liquids, and air.
Food normally passed through the
oropharynx and laryngopharynx on its
way to the esophagus.
The epithelial lining and regions of
the pharynx – the nasopharynx, the
oropharynx, and laryngopharynx.
The esophagus:
- The esophagus is a hollow
muscular tube with a length of
approximately 25 cm (10 in.) and a
diameter of about 2 cm (0.80 in.) at its
widest point.
- The primary function of the
esophagus is to convey solid food and
liquids to the stomach.
Esophageal Secretion

The esophageal secretions are entirely mucous in character and principally

provide lubrication for swallowing. The main body of the esophagus is lined
with many simple mucous glands. At the gastric end and to a lesser extent in
the initial portion of the esophagus, there are also many compound mucous
glands. The mucus secreted by the compound glands in the upper
esophagus prevents mucosal excoriation by newly entering food, whereas
the compound glands located near the esophagogastric junction protect the
esophageal wall from digestion by acidic gastric juices that often reflux from
the stomach back into the lower esophagus.
Despite this protection, a peptic ulcer at times can still occur at the gastric
end of the esophagus.
The stomach

The stomach performs 4 major functions :

1) storage of ingested food
2) mechanical breakdown of ingested food
3) disruption of chemical bonds in food material through the action of acids and
enzymes
4) production of intrinsic factor, a glycoprotein whose presence in the digestive
tract is required for the absorption of vitamin B12 in the small intestine.
+ In an “average” stomach, the lesser
curvature has a length of approximately 10 cm,
and the greater curvature measures about 40
cm.

+ In the fundus and body of the stomach, each

gastric pit communicates with several gastric
glands. Gastric glands are dominated by 2
types of secretory cells :
+ parietal cells: secrete hydrochloric
acid (HCl).
+ chief cells: are more abundant near
the base of a gastric gland. These cells secrete
pepsinogen, an inactive proenzyme.
Pepsinogen is converted by the acid in the
gastric lumen to pepsin, an active proteolytic
enzyme.
HCl Secretion
A major function of the parietal cells is secretion of HCl, which acidifies the gastric contents to between
pH 1 and 2. Physiologically, the function of this low gastric pH is to convert inactive pepsinogen, which
is secreted by the nearby chief cells, to its active form, pepsin, a protease that begins the process of
protein digestion.

SUBSTANCES THAT ALTER HCL SECRETION

Three substances stimulate H+ secretion by gastric parietal cells: histamine (a paracrine), ACh (a
neurocrine), and gastrin (a hormone). Each substance binds to a different receptor on the parietal cell
and has a different cellular mechanism of action (Fig. 8.18). In addition, there are indirect effects of ACh
and gastrin via stimulation of histamine release.
♦ Histamine is released from ECL cells in the gastric mucosa and diffuses via a paracrine
mechanism to the nearby parietal cells, where it binds to H2 receptors. The second messenger for
histamine is cAMP. Histamine binds to H2 receptors, which are coupled to adenylyl cyclase by a Gs
protein. When adenylyl cyclase is activated, there is increased production of cAMP. cAMP activates
protein kinase A, leading to secretion of H+ by the parietal cells. Cimetidine blocks H2 receptors and
blocks the action of histamine on parietal cells
 ♦ ACh is released from vagus nerves innervating the gastric mucosa and binds directly to muscarinic
(M3) receptors on the parietal cells. The second messengers for ACh are IP3/Ca2+. When ACh binds to
muscarinic receptors, phospholipase C is activated. Phospholipase C liberates diacylglycerol and IP3
from
membrane phospholipids, and IP3 then releases Ca2+ from intracellular stores. Ca2+ and diacylglycerol
activate protein kinases that produce the final physiologic action: H+ secretion by the parietal cells.
Atropine
blocks muscarinic receptors on parietal cells and, accordingly, blocks the action of ACh. ACh also
increases H+ secretion indirectly by stimulating ECL cells to release histamine, which then acts on the
parietal cells as described earlier.
♦ Gastrin is secreted into the circulation by G cells in the stomach antrum. Gastrin reaches the
parietal
cells by an endocrine mechanism, not by local diffusion within the stomach. Thus gastrin is secreted from
the stomach antrum into the systemic circulation and then delivered back to the stomach via the
circulation. Gastrin binds to cholecystokinin B (CCKB) receptors on the parietal cells. (The CCKB
receptor has equal affinity for gastrin and CCK, whereas the cholecystokinin A [CCKA] receptor is
specific for CCK.) Like ACh, gastrin stimulates H+
secretion through the IP3/Ca2+ second messenger system.
Briefly, these stimuli are distention of the stomach, presence of small peptides and amino acids, and
stimulation of the vagus nerves. Like ACh, gastrin also stimulates H+ secretion indirectly by causing
release of histamine from ECL cells.
Gastric juice contains hydrochloric acid and pepsin.

- Pepsin is an enzyme that breaks down proteins.

- Hydrochloric acid kills microorganisms and breaks down cell walls and
connective tissue in food.

The acid is strong enough to burn a hole in carpet, yet the mucus
produced by the mucous membrane protects the lining of the stomach.
Even so, the cells of the mucous membrane wear out quickly: the entire
stomach lining is replaced every three days. Mucus also aids in digestion by
keeping food moist.
Regulation of Gastric Activity :
The production of acid and enzymes by the gastric mucosa can be :
1) controlled by the CNS
2) regulated by short reflexes of the enteric nervous system (in the wall of
the stomach)
3) regulated by hormones of the digestive tract.

- The Cephalic Phase:

The cephalic phase of gastric secretion begins when you see, smell, taste, or
think of food. This stage, which is directed by the CNS, prepares the stomach to
receive food.
- The Gastric Phase:
The gastric phase begins with the arrival of food in the stomach.
- The Intestinal Phase:
The intestinal phase of gastric secretion begins when chyme first enters the
small intestine. The intestinal phase generally starts after several hours of mixing
contractions of the stomach.
Digestion and Absorption in the stomach:
+ The stomach performs preliminary digestion of proteins by pepsin and,
permits the digestion of carbohydrates and lipids by salivary amylase and
lingual lipase.
+ As the stomach contents become more fluid and the pH approaches 2.0,
pepsin activity increases in the stomach.

Key :
+ The stomach is a storage site that provides time for the physical
breakdown of food that must precede chemical digestion.
+ Protein digestion begins in the acid environment of the stomach through
the action of pepsin.
+ Carbohydrate digestion, which began with the release of salivary amylase
by the salivary glands before swallowing.
The pancreas:
+ The pancreas is primarily an exocrine organ, producing digestive
enzymes and buffers. The large pancreatic duct (duct of Wirsung) delivers
these secretions to the deodenum.
+ The pancreas has 2 distinct functions, one endocrine and the other
exocrine.
- The endocrine cells of the pancreatic islets secrete insulin and
glucagon into the bloodstream.
- The exocrine cells include an acinar cells and the epithelial cells that
line the duct system.
The exocrine pancreas produces a mixture of buffers and enzymes
essential for normal digestion.
- Pancreatic secretion occurs in response to the release of regulatory
hormones (CCK and secretin) by the duodenum.
Physiology of the Pancreas : (exocrine)
+ Each day, the pancreas secretes about 1000 ml of pancreatic juice. The
secretory activities are controlled primarily by hormones from the deodenum.
+ The specific pancreatic enzymes involved include the following :
- Pancreatic alpha-amylase, a carbohydrase - an enzyme that breaks
down certain starches, pancreatic alpha-amylase is almost identical to salivary
amylase.
- Pancreatic lipase, which breaks down certain complex lipids, releasing
products (such as fatty acids) that can be easily absorbed.
- Nucleases, which break down nucleic acids.
- Proteolytic enzymes, which break certain proteins apart. The proteolytic
enzymes of the pancreas include proteases, which break apart large protein
complexes, and peptidases, which break small peptide chains into amino acids.
Proteolytic enzymes account for about 70% of total pancreatic enzyme
production. The enzymes are secreted as inactive proenzymes and are
activated only after they reach the small intestine.
The liver :
The liver, the largest visceral organ, is one of the most versatile organs
in the body. Most of its mass lies in the right hypo-diaphragm and epigastric
regions.
The liver weighs about 1.2 kg. This large, firm, reddish-brown organ
performs essential metabolic and synthetic functions.
The Physiology of the liver :
The liver is responsible for 3 general categories of functions :
1) Metabolic regulation
2) Hematological regulation
3) Bile production.
Metabolic Regulation : The liver is a primary organ involved in
regulating the composition of circulating blood.
+ Liver cells extract nutrients or toxins from the blood before it
reaches the systemic circulation through the hepatic veins.
+ The liver removes and stores excess nutrients, and it corrects
nutrient deficiencies by mobilizing stored reserves or performing
synthetic activities. The liver’s regulatory activities affect the following :
- Carbohydrate metabolism: The liver stabilized blood glucose
levels at about 90-110 mg/dl. If blood glucose levels drop, hepatocytes
break down glycogen reserves and release glucose into the
bloodstream.
- Lipid metabolism: the liver regulated circulating levels of
triglycerides, fatty acids, and cholesterol. When those levels decline,
the liver breaks down its lipid reserves and releases the breakdown
products into the bloodstream.
 - Amino acid metabolism: The liver removes excess amino acids
from the bloodstream. These amino acids can be used to synthesize
proteins or can be converted to lipids or glucose for storage.
- Waste product removal: When converting amino acids to lipids or
carbohydrates, or when breaking down amino acids to get energy, the
liver strips off the amino groups, a process called deamination.
- Vitamin storage: Fat-soluble vitamins (A, D, E and K) and vitamin
are absorbed from the blood and stored in the liver. These reserves are
called on when your diet contains inadequate amounts of those
vitamins.
- Mineral storage: The liver converts iron reserves to ferritin and
stores this protein-iron complex.
- Drug inactivation: The liver removes and breaks down circulating
drugs, thereby limiting the duration of their effects.
Hematological regulation: The liver, the largest blood reservoir in
your body, receives about 25% of cardiac output. As blood passes
through it, the liver performs the following functions:
- Phagocytosis and antigen presentation: Kupffer cells in the
liver sinusoids engulf old or damaged red blood cells, cellular debris,
and pathogens, removing them from the bloodstream. Kupffer cells
are antigen-presenting cells that can stimulate an immune response.
- Synthesis of plasma proteins: Hepatocytes synthesize and
release most of the plasma proteins, including the albumins (which
contribute to the osmotic concentration of the blood), the various types
of transport proteins, clotting proteins, and complement proteins.
- Removal or circulating hormones: The liver is the primary site
for the absorption and recycling of epinephrine, norepinephrine,
insulin, thyroid hormones, and steroid hormones, such as the sex
hormones (estrogens and androgens) and corticosteroids.
 - Removal of antibodies: The liver absorbs and breaks down
antibodies, releasing amino acids for recycling.
- Removal or accumulation of toxins: Lipid-soluble toxins in the
diet, such as the insecticide DDT, are absorbed by the liver and
stored in lipid deposits, where they do not disrupt cellular functions.
Other toxins are removed from the bloodstream and are either
broken down or excreted in the bile.

The Synthesis and Secretion of Bile:

Bile is synthesized in the liver and excreted into the lumen of the
duodenum. Bile consists mostly of water, with minor amounts of
irons, bilirubin (a pigment derived from hemoglobin), cholesterol, and
lipids collectively known as a bile salts.

Bile is essential for the digestion of lipids; it breaks down large lipid
droplets so that individual lipid molecules can be attacked by
digestive enzymes.
The Gallbladder:
Physiology of the Gallbladder:
- A major function of the gallbladder is
bile storage. Bile is secreted continuously –
about 1 liter is produced each day – but it is
released into the deodenum only under the
stimulation of the intestinal hormone CCK.
- The gallbladder also functions in bile
modification. When full, the gallbladder
contains 40-70 ml of bile. The composition of
bile gradually changes as it remains in the
gallbladder. Much of the water is absorbed,
and the bile salts and other components of
bile become increasingly concentrated.
The small intestine
+ The small intestine plays the key role in the digestion and absorption of
nutrients. 90% of nutrient absorption occurs in the small intestine; most of the
rest occurs in the large intestine.
- The duodenum, 25 cm in length, is the segment closest to the stomach.
This portion of the small intestine is a “mixing bowl” that receives chyme from
the stomach and digestive secretions from the pancreas and liver.
- The jejunum is about 2.5 meters long. The bulk of chemical digestion
and nutrient absorption occurs in the jejunum.
- The ileum, the final segment of the small intestine, is also the longest,
averaging 3.5 meters in length.
+ The small intestine receives and raises the pH of materials from the
stomach.
+ It then absorbs water, ions, vitamins, and the chemical products released
by the action of digestive enzymes produced by intestinal glands and the
exocrine glands of the pancreas.
The small intestine:
The intestinal tract secretes a variety of peptide hormones with similar
chemical structures. Many of these hormones have multiple effects in
several regions of the digestive tract, and in the accessory glandular organs
as well.
Duodenal enteroendocrine cells produce the following hormones known to
coordinate digestive functions:
- Secretin in released when chyme arrives in the duodenum. Secretin’s
primary effect is an increase in the secretion of bile and buffers by the liver
and pancreas.
- Cholecystokinin (CCK) is secreted when chyme arrives in the
duodenum, especially when the chyme contains lipids and partially digested
proteins, has a very potent effect in increasing contractility of the gallbladder,
thus expelling bile into the small intestine.
 - Gastric inhibitory peptide (GIP) is secreted when fats and
carbohydrates – especially glucose – enter the small intestine, has a mild
effect in decreasing motor activity of the stomach, therefore slowing the
gastric contents into the duodenum when it is oversupplied with food
products.
- Vasoactive intestinal peptide (VIP) stimulates the secretion of
intestinal glands, dilates regional capillaries, and inhibits acid production in
the stomach.
- Gastrin in secreted by G cells in the duodenum when they are
exposed to large quantities of incompletely digested proteins. The functions
of gastrin include promoting increased stomach motility and stimulating the
production of acids and enzymes.
- Enterocrinin, a hormone released when chyme enters the small
intestine, stimulates mucin production by the submucosal glands of the
duodenum.
Physiology of the Large Intestine:
- Less than 10% of the nutrient absorption in the digestive tract occurs in
the large intestine.
- The large intestine also prepares fecal material for ejection from the
body.
- The reabsorption of water is an important function of the large intestine.
Although about 1500 ml of material enters the colon each day, only about
200 ml of feces is ejected.
- In addition to reabsorbing water, the large intestine absorbs a number of
other substances that remain in the feces or were secreted into the
digestion tract along its length.
- Most of the bile salts entering the large intestine are promptly
reabsorbed in the cecum and transported in blood to the liver for secretion
into bile.
- Vitamins or organic molecules that are
important as cofactors or coenzymes in
many metabolic pathways. The normal
bacterial residents of the colon generate 3
vitamins that supplement out dietary
supply:
+ Vitamin K: a fat-soluble vitamin the
liver requires for synthesizing 4 clotting
factors, including prothrombin. Intestinal
bacteria produce about half of your daily
vitamin K requirements.
+ Biotin: a water-soluble vitamin
important in various reactions, notably
those of glucose metabolism.
+ Pantothenic acid: a water-soluble
vitamin required in the manufacture of
steroid hormones and some
neurotransmitters.
Thank you