THE DIGESTIVE SYSTEM

Composed of the gastrointestinal

(GI) tract and the accessory digestive
organs.
The gastrointestinal (GI) tract, or
alimentary canal , is a continuous
tube that extends from the mouth to
the anus (about 5–7 meters )
Organs of the gastrointestinal tract
include the mouth, most of the
pharynx, esophagus, stomach, small
intestine, and large intestine.
The accessory digestive organs
include the teeth, tongue, salivary
FUNCTIONS OF THE DIGESTIVE SYSTEM
1. Ingestion: taking food into mouth.
2. Secretion: release of water, acid, buffers,
and enzymes into lumen of GI tract.
3. Mixing and propulsion: churning and
propulsion of food through GI tract.
4. Digestion: mechanical and chemical
breakdown of food.
5. Absorption: passage of digested products
from GI tract into blood and lymph.
6. Defecation: elimination of feces from GI
tract.
LAYERS OF THE GI TRACT
The wall of the GI tract from the lower esophagus
to the anal canal has the same basic, four-layered
arrangement of tissues.
The four layers of the tract, from deep to
superficial, are the mucosa, submucosa,
muscularis, and serosa/adventitia
Mucosa
The mucosa, or inner lining of the GI tract, is a
mucous membrane.
It is composed of
 (1) a layer of epithelium in direct contact with the
contents of the GI tract,
(2) a layer of connective tissue called the lamina
propria
(3) a thin layer of smooth muscle (muscularis
mucosae).
Submucosa
consists of areolar connective tissue
that binds the mucosa to the
muscularis. It contains many blood
and lymphatic vessels that receive
absorbed food molecules.
Also located in the submucosa is an
extensive network of neurons known
as the submucosal plexus.
The submucosa may also contain
glands and lymphatic tissue.
Muscularis
The muscularis of the mouth, pharynx, and
superior and middle parts of the esophagus contains
skeletal muscle that produces voluntary swallowing.
Skeletal muscle also forms the external anal
sphincter, which permits voluntary control of
defecation.
Throughout the rest of the tract, the muscularis
consists of smooth muscles that is generally found in
two sheets: an inner sheet of circular fibers and an
outer sheet of longitudinal fibers. Involuntary
contractions of the smooth muscle help break down
food, mix it with digestive secretions, and propel it
along the tract
Between the layers of the muscularis is a second
plexus of neurons—the myenteric plexus.
Serosa
As its name implies, the serosa is a
serous membrane composed of
areolar connective tissue and simple
squamous epithelium
The serosa is also called the visceral
peritoneum
The esophagus lacks a serosa; instead
only a single layer of areolar
connective tissue called the adventitia
forms the superficial layer of this
organ
The gastrointestinal tract is
regulated by an intrinsic set of
nerves known as the enteric
nervous system and by an extrinsic
set of nerves that are part of the
autonomic nervous system.
PERITONEUM
The peritoneum is divided into the parietal
peritoneum, which lines the wall of the
abdominopelvic cavity, and the visceral
peritoneum, which covers some of the
organs in the cavity.
The slim space containing lubricating
serous fluid that is between the parietal and
visceral portions of the peritoneum is called
the peritoneal cavity
In certain diseases, the peritoneal cavity
may become distended by the accumulation
of several liters of fluid, a condition called
ascites
MOUTH
Also referred to as the oral or buccal
cavity
is formed by the cheeks, hard and soft palates,
and tongue
The lips or labia are fleshy folds
surrounding the opening of the mouth.
The oral vestibule of the oral cavity is the
space bounded externally by the cheeks and
lips and internally by the gums and teeth.
The oral cavity proper is the space that
extends from the gums and teeth to the
fauces (passages), the opening between the
oral cavity and the oropharynx
The palate is a wall or septum
that separates the oral cavity
from the nasal cavity, and forms the
roof of the mouth. The hard palate
—the anterior portion; The soft
palate, which forms the posterior
portion
the free border of the soft palate is
the uvula
the soft palate and uvula, close off
the nasopharynx and prevent
swallowed foods and liquids from
Salivary Glands
There are three pairs of major salivary
glands: the parotid, submandibular, and
sublingual glands
The parotid gland are located inferior and
anterior to the ears, between the skin and
the masseter muscle.
The submandibular gland of the mouth;
they are medial and partly inferior to the
body of the mandible
The sublingual glands are beneath the
tongue and superior to the submandibular
glands.
Composition and Functions of Saliva
Chemically, saliva is 99.5% water and
0.5% solutes, Also present are some
dissolved gases and various organic
substances, including urea and uric acid,
mucus, immunoglobulin A, the
bacteriolytic enzyme lysozyme, and
salivary amylase, a digestive enzyme
that acts on starch.
 Salivary amylase, an enzyme that
starts the breakdown of starch in the
mouth into maltose, maltotriose, and -
dextrin.
Tongue
The tongue is an accessory
digestive organ composed of skeletal
muscle covered with mucous
membrane.
It forms the food bolus and help in
swallowing
It also contains the taste buds
Teeth
The teeth, or dentes , are accessory
digestive organs located in sockets of the
alveolar processes of the mandible and
maxillae.
A typical tooth has three major external
regions: the crown, root, and neck.
Humans have two dentitions, or sets of
teeth: deciduous and permanent.
The first of these—the deciduous teeth, also
called primary teeth, milk teeth, or baby teeth
—begin to erupt at about 6 months of age,
and approximately two teeth appear each
month thereafter, until all 20 are present
All the deciduous teeth are lost—generally
between ages 6 and 12 years—and are replaced by
the permanent (secondary) teeth
The permanent dentition contains 32 teeth that
erupt between age 6 and adulthood
Mechanical and chemical digestion in the mouth
Mechanical digestion in the mouth results
from chewing, or mastication, in which food
is manipulated by the tongue, ground by the
teeth, and mixed with Saliva
Two enzymes, salivary amylase and lingual
lipase, contribute to chemical digestion in the
mouth
Lingual glands Secrete lingual lipase.
Triglycerides broken down into fatty acids
and diglycerides
PHARYNX
Both the oropharynx and
laryngopharynx have digestive as
well as respiratory functions.
Swallowed food passes from the
mouth into the oropharynx and
laryngopharynx; the muscular
contractions of these areas help
propel food into the esophagus and
then into the stomach.
ESOPHAGUS
The esophagus is a collapsible
muscular tube, about 25 cm (10 in.)
long, that lies posterior to the trachea.
At each end of the esophagus, the
muscularis becomes slightly more
prominent and forms two sphincters—
the upper esophageal sphincter or
valve, which consists of skeletal
muscle, and the lower esophageal
sphincter (LES) or valve, which
consists of smooth muscle
DEGLUTITION
The movement of food from the
mouth into the stomach is achieved
by the act of swallowing, or
deglution.
Deglutition is facilitated by the
secretion of saliva and mucus and
involves the mouth, pharynx, and
esophagus.
Swallowing occurs in three stages:
(1) the voluntary stage, in which the
bolus is passed into the oropharynx;
(2) the pharyngeal stage, the
involuntary passage of the bolus
through the pharynx into the
esophagus; and
(3) the esophageal stage, the
involuntary passage of the bolus
through the esophagus into the
stomach.
STOMACH
The stomach is a J-shaped
enlargement of the GI tract directly
inferior to the diaphragm in the
abdomen
In the stomach, digestion of starch
and triglycerides continues,
digestion of proteins begins, the
semisolid bolus is converted to a
liquid, and certain substances are
absorbed
Anatomy of the Stomach
FUNCTIONS OF THE STOMACH
1. Mixes saliva, food, and gastric
juice to form chyme.
2. Serves as reservoir for food
before release into small intestine.
3. Secretes gastric juice, which
contains HCl (kills bacteria and
denatures protein), pepsin (begins
the digestion of proteins), intrinsic
factor (aids absorption of vitamin
B12), and gastric lipase (aids
digestion of triglycerides).
Histology of the Stomach
The stomach wall is composed of the same
basic layers as the rest of the GI tract, with
certain modifications.
Epithelial cells extend down into the lamina
propria, where they form columns of secretory
cells called gastric glands.
The gastric glands contain three types of
exocrine gland cells
 mucous neck cells secrete mucus
 Parietal cells produce intrinsic factor and
hydrochloric acid.
 The chief cells secrete pepsinogen and
 The secretions of the mucous, parietal,
and chief cells form gastric juice,
which totals 2000–3000 mL per day.
 In addition, enteroendocrine cell, the G
cell, which is located mainly in the
pyloric antrum secretes the hormone
gastrin into the bloodstream.
Mechanical and Chemical Digestion in the
Stomach
Mixing waves macerate food, mix it with
secretions of the gastric glands, and
reduce it to a soupy liquid called chyme
each mixing wave periodically forces
about 3 mL of chyme into the duodenum
through the pyloric sphincter, a
phenomenon known as gastric emptying.
the churning action mixes chyme with
acidic gastric juice, inactivating salivary
amylase and activating lingual lipase,
which starts to digest triglycerides into
fatty acids and diglyceride
Only a small amount of nutrients are
absorbed in the stomach because its
epithelial cells are impermeable to most
materials.
Foods rich in carbohydrate spend the
least time in the stomach; high-protein
foods remain somewhat longer, and
emptying is slowest after a fat-laden meal
containing large amounts of triglycerides.
Secretion of gastric juice
There are three phases of secretion of gastric
juice
1. Cephalic phase. This flow of juice occurs
before food reaches the stomach and is due to
reflex stimulation of the vagus nerves
initiated by the sight, smell or taste of food.
2. Gastric phase.
It is stimulated by the presence of food, the
enteroendocrine cells in the pyloric antrum and
duodenum secrete gastrin, a hormone which passes
directly into the circulating blood.
 Gastrin, circulating in the blood which supplies the
stomach, stimulates the gastric glands to produce
more gastric juice. In this way the secretion of
digestive juice is continued after the completion of
the meal and the end of the cephalic phase. Gastrin
secretion is suppressed when the pH in the pyloric
antrum falls to about 1.5.
3. Intestinal phase.
When the partially digested contents of the
stomach reach the small intestine, a hormone
complex enterogastrone* is produced by
endocrine cells in the intestinal mucosa,
which slows down the secretion of gastric
juice and reduces gastric motility.
Two of the hormones forming this complex
are secretin and cholecystokinin (CCK).
 PANCREAS
Chemical digestion in the small intestine depends
on activities of the pancreas, liver, and gallbladder
Anatomy of the Pancreas
a retroperitoneal gland that is about 12–15 cm
(5–6 in.) long and 2.5 cm (1 in.) thick,
 lies posterior to the greater curvature of the
stomach.
 it consists of a head, a body, and a tail and is
usually connected to the duodenum by two ducts.
Pancreatic juices are secreted by exocrine cells into
small ducts that ultimately unite to form two larger
ducts, the pancreatic duct and the accessory duct .
These in turn convey the secretions
into the small intestine.
pancreatic duct joins the common
bile duct from the liver and
gallbladder and enters the
duodenum as a dilated common duct
called the hepatopancreatic
ampulla or ampulla of Vater
The passage of pancreatic juice and
bile into the small intestine is
regulated by sphincter of Oddi
Histology of the Pancreas
 About 99% of the clusters, called
acini, constitute the exocrine
portion of the organ.
The cells within acini secrete a
mixture of fluid and digestive enzymes
called pancreatic juice.
The remaining 1% of the clusters,
called pancreatic islets (islets of
Langerhans), form the endocrine
portion of the pancreas.
Composition and Functions of
Pancreatic Juice
Each day the pancreas produces
1200–1500 mL of pancreatic juice
consists mostly of water, some salts,
sodium bicarbonate, and several
enzymes.
The sodium bicarbonate gives
pancreatic juice a slightly alkaline
pH (7.1–8.2) that buffers acidic
gastric juice in chyme, stops the
action of pepsin from the stomach,
 The enzymes include
a starch-digesting enzyme called pancreatic
amylase;
several enzymes that digest proteins into
peptides called trypsin , chymotrypsin ,
carboxypeptidase, and elastase;
 the principal triglyceride (fat and oil)-
digesting enzyme in adults, called
pancreatic lipase;
and nucleic acid– digesting enzymes called
ribonuclease and deoxyribonuclease that
digest ribonucleic acid (RNA) and
deoxyribonucleic acid (DNA) into nucleotides.
The protein-digesting enzymes of
the pancreas are produced in an
inactive form just as pepsin is
produced in the stomach as
pepsinogen.
 Trypsin is secreted in an inactive
form called trypsinogen.
Pancreatic acinar cells also
secrete a protein called trypsin
inhibitor that combines with any
trypsin formed accidentally in the
pancreas or in pancreatic juice and
 trypsinogen in the lumen of the
small intestine, is activated by
brushborder enzyme called
enterokinase, to form trypsin
In turn, trypsin acts on the inactive
precursors (called
chymotrypsinogen,
procarboxypeptidase, and
proelastase) to produce
chymotrypsin carboxypeptidase, and
elastase, respectively.
 LIVER AND GALLBLADDER
The liver is the heaviest gland of the
body, weighing about 1.4 kg in an
average adult.
The liver is inferior to the diaphragm and
occupies most of the right hypochondriac
and part of the epigastric regions of the
abdominopelvic cavity
The gallbladder is a pear-shaped sac
that is located in a depression of the
posterior surface of the liver. It is 7–10
cm (3–4 in.) long and typically hangs
Anatomy of the Liver and Gallbladder
The liver is divided into two principal
lobes—a large right lobe and a
smaller left lobe and the smaller
quadrate lobe and a posterior
caudate lobe
The parts of the gallbladder include
the broad fundus, which projects
inferiorly beyond the inferior border of
the liver; the body, the central
portion; and the neck, the tapered
portion
The portal fissure
This is the name given to the region on the
posterior surface of the liver where various
structures enter and leave the gland.
The portal vein enters, carrying blood from
the stomach, spleen, pancreas and the small
and large intestines.
The hepatic artery enters, carrying arterial
blood. It is a branch from the coeliac artery
which is a branch from the abdominal aorta.
 Histology of the Liver and Gallbladder
Hepatocytes are the major functional cells of
the liver and perform a wide array of metabolic,
secretory, and endocrine functions.
Bile canaliculi are small ducts between
hepatocytes that collect bile produced by the
hepatocytes.
 Hepatic sinusoids are highly permeable
blood capillaries between rows of hepatocytes
that receive oxygenated blood from branches of
the hepatic artery and nutrient-rich
deoxygenated blood from branches of the
hepatic portal vein.
They converge and deliver blood into a central vein
then the hepatic vein which drain into the inferior
venacava
 Bile leaves the lobes of the liver by two ducts that
merge to form the common hepatic duct. After
collecting bile from the gallbladder, this duct, now
called the common bile duct, delivers it into the
duodenum
When chyme enters the duodenum, the gall bladder
contracts, squeezing bile through the cystic duct and
into the common bile duct, leading to the duodenum
Also present in the hepatic sinusoids are fixed
phagocytes called stellate reticuloendothelial
(Kupffer) cells which destroy worn-out white and red
blood cells, bacteria, and other foreign matter in the
venous blood draining from the gastrointestinal tract.
Together, a bile duct, branch of the
hepatic artery, and branch of the
hepatic vein are referred to as a
portal triad.
The hepatic acinus is the smallest
structural and functional unit of the
liver.
The functions of the gallbladder are
to store and concentrate the bile
produced by the liver (up to tenfold)
until it is needed in the small
intestine. In the concentration
process, water and ions are absorbed
by the gallbladder mucosa.
Blood Supply of the Liver
The liver receives blood from two
sources:
From the hepatic artery it obtains
oxygenated blood, and
 from the hepatic portal vein it
receives deoxygenated blood
containing newly absorbed nutrients,
drugs, and possibly microbes and
toxins from the gastrointestinal tract
Branches of both the hepatic artery
and the hepatic portal vein carry
blood into liver sinusoids,
 Because blood from the
gastrointestinal tract passes through
the liver as part of the hepatic portal
circulation, the liver is often a site
for metastasis of cancer that
originates in the GI tract.
SMALL INTESTINE
Most digestion and absorption of
nutrients occur in the small
intestine
Its structure is specially adapted for
these functions.
large surface area for digestion and
absorption,
 circular folds, villi, and microvilli.
It averages 2.5 cm (1 in.) in diameter;
its length is about 3 m (10 ft)
Anatomy of the Small Intestine
Extends from the pyloric sphincter
and ends at the ileocaecal valve
Divided into three regions:
The duodenum
The jejunum
the ileum.
Histology of the Small Intestine
The wall of the small intestine is composed of
the same four layers that make up most of the
GI tract: mucosa, submucosa, muscularis, and
serosa
Absorptive cells of the epithelium digest and
absorb nutrients in small intestinal chyme.
 Also present in the epithelium are goblet cells,
which secrete mucus.
 The small intestinal mucosa contains many
deep crevices lined with glandular epithelium.
Cells lining the crevices form the intestinal
glands, or crypts of Lieberkühn, and
secrete intestinal juice.
Besides absorptive cells and goblet
cells, the intestinal glands also contain
paneth cells and enteroendocrine
cells.
Paneth cells secrete lysozyme, a
bactericidal enzyme, and are capable
of phagocytosis.
Three types of enteroendocrine cells
are found in the intestinal glands of the
small intestine: S cells, CCK and K
cells, which secrete the hormones
secretin and cholecystokinin
Special structural features of the
small intestine facilitate the process
of digestion and absorption.
These structural features include
circular folds, villi, and microvilli.
Circular folds or plicae
circulares are folds of the mucosa
and submucosa
Role of Intestinal Juice and Brush-Border
Enzymes
About 1–2 liters of intestinal juice, a clear
yellow fluid, is secreted each day.
 Intestinal juice contains water and mucus
and is slightly alkaline (pH 7.6).
The absorptive cells of the small intestine
synthesize several digestive enzymes, called
brush-border enzymes, and insert them
in the plasma membrane of the microvilli.
 Thus, some enzymatic digestion occurs at
the surface of the absorptive cells that line
the villi, rather than in the lumen exclusively,
as occurs in other parts of the GI tract..
Among the brush-border enzymes are:
 Four Carbohydrate digesting enzymes called
-dextrinase, maltase, sucrase, and lactase;
 protein-digesting enzymes called peptidases
(aminopeptidase and dipeptidase);
 and two types of nucleotide-digesting
enzymes, nucleosidases and phosphatases.
Also, as absorptive cells slough off into the
lumen of the small intestine, they break apart
and release enzymes that help digest
nutrients in the chyme
LARGE INTESTINE
The large intestine is the terminal
portion of the GI tract.
The overall functions of the large
intestine are:
1. the completion of absorption,
2. the production of certain vitamins,
3. the formation of feces,
4. expulsion of feces from the body
Anatomy of the large intestine
The large intestine is about 1.5 m (5
ft) long and 6.5 cm (2.5 in.) in diameter,
 Hanging inferior to the ileocecal valve is
the cecum
Is divided into ascending, transverse,
descending, and sigmoid portions. Both
the ascending and descending colon are
retroperitoneal; the transverse and
sigmoid colon are not.
 The Defecation Reflex
distension of the rectal wall stimulates
stretch receptors, which initiates a
defecation reflex that empties the
rectum.
The defecation reflex occurs as follows:
In response to distension of the rectal
wall, the receptors send sensory nerve
impulses to the sacral spinal cord.
Motor impulses from the cord travel
along parasympathetic nerves back to
the descending colon, sigmoid colon,
The resulting contraction of the
longitudinal rectal muscles shortens the
rectum, thereby increasing the pressure
within it.
This pressure, along with voluntary
contractions of the diaphragm and
abdominal muscles, plus parasympathetic
stimulation, opens the internal anal
sphincter.
The external anal sphincter is voluntarily
controlled. If it is voluntarily relaxed,
defecation occurs and the feces are
expelled through the anus;
In infants, the defecation reflex
causes automatic emptying of the
rectum because voluntary control of
the external anal sphincter has not
yet developed
The normal range of bowel activity
varies from two or three bowel
movements per day to three or four
bowel movements per week.
Diarrhea is an increase in the
frequency, volume, and fluid content
of the feces caused by increased
Constipation refers to infrequent
or difficult defecation caused by
decreased motility of the intestines.
Because the feces remain in the
colon for prolonged periods,
excessive water absorption occurs,
and the feces become dry and hard.
Phases of Digestion
 Digestive activities occur in three
overlapping phases: cephalic phase,
gastric phase, and intestinal phase.
Cephalic Phase
During this phase, the smell, sight,
thought, or initial taste of food activates
neural centers in the cerebral cortex,
hypothalamus, and brain stem.
The salivary glands secrete saliva and
gastric glands secrete gastric juice in
order to prepare the mouth and stomach
for food that is about to be eaten.
 Gastric Phase
Once food reaches the stomach, the gastric
phase of digestion begins.
Neural and hormonal mechanisms regulate
the gastric phase of digestion to promote
gastric secretion and gastric motility.
o Neural regulation.
 distention of the stomach stimulates
stretch receptors in its walls
Chemoreceptors are activated by increase in
PH
The resulting nerve impulses cause waves of
peristalsis and continue to stimulate the flow
of gastric juice from gastric glands.
o Hormonal regulation.
 by the hormone gastrin.
 Gastrin is released from the G
cells of the gastric glands in
response to several stimuli:
distension of the stomach by chyme,
partially digested proteins in chyme,
the high pH of chyme due to the
presence of food in the stomach,
caffeine in gastric chyme, and
acetylcholine released from
 Gastrin stimulates gastric glands to
secrete large amounts of gastric
juice.
 It also strengthens the contraction
of the lower esophageal sphincter to
prevent reflux of acid chyme into the
esophagus, increases motility of the
stomach, and relaxes the pyloric
sphincter, which promotes gastric
emptying.
Gastrin secretion is inhibited when
Intestinal Phase
The intestinal phase of digestion begins
once food enters the small intestine.
During the intestinal phase of
digestion, food is digested in the small
intestine.
In addition, gastric motility and gastric
secretion decrease in order to slow the
exit of chyme from the stomach, which
prevents the small intestine from being
overloaded with more chyme than it can
handle.
Hormones of the Digestive System
 Secretin
Stimulated by Acidic (high H level) chyme
that enters small intestine secreted by
enteroendocrine S cells in the mucosa of
duodenum.
Major effects: Stimulates secretion of
pancreatic juice and bile that are rich in
HCO3 (bicarbonate ions).
 Minor effects: Inhibits secretion of gastric
juice, promotes normal growth and
maintenance of pancreas, enhances effects
of CCK.
Cholecystokinin
Stimulus; Partially digested proteins
(amino acids), triglycerides, and fattyacids
Secreted by enteroendocrine CCK cells in
mucosa of small intestine
Major effects: Stimulates secretion of
pancreatic juice rich in digestive
enzymes, causes ejection of bile from
gallbladder and opening of sphincter of
Oddi), induces satiety (feeling full to
satisfaction).
Minor effects: Inhibits gastric
emptying, promotes normal growth
Other Hormones of the Digestive System
 They include motilin, substance P, and
bombesin, which stimulate motility of the
intestines;
vasoactive intestinal polypeptide (VIP),
which stimulates secretion of ions and
water by the intestines and inhibits gastric
acid secretion;
 gastrin-releasing peptide, which
stimulates release of gastrin; and
 somatostatin, which inhibits gastrin
release.