PHYSIOLOGY OF THE DIGESTIVE SYSTEM CREATED BY ELENA ANTON Presented by Tochukwu Unigwe
Introduction
Food contains a variety of nutrients—molecules needed for building new body tissues, repairing damaged tissues, and sustaining needed chemical reactions. Most food cannot be used as a source of cellular energy. It must first be broken down into molecules small enough to cross the plasma membranes of cells. This breakdown process is known as digestion. The passage smaller molecules through cells into the blood and lymph is termed absorption. The digestive system forms from the embryonic gut tube, extends from the mouth to the anus, forms an extensive surface area and is closely associated with the cardiovascular system.
Overview
The gastrointestinal (GI) tract, or alimentary canal is a continuous tube that extends from the mouth to the anus through the thoracic and abdominopelvic cavities. Consists of mouth, pharynx, esophagus, stomach, small intestine, and large intestine. The length of the GI tract is variable, ranging from about 5-15 meters (15 ft to 30 ft). The accessory digestive organs include the teeth, tongue, salivary glands, liver, gallbladder, and pancreas
Function of Digestive System Six basic functions: 1. Ingestion. Foods and liquids into the mouth (eating). 2. Secretion. Digestive organs secrete a total of about 7 liters of water, acid, buffers, and enzymes into the lumen of the tract. 3. Mixing and propulsion. Alternating contraction and relaxation of smooth muscle in the walls of the GI tract mix food and secretions and propel them toward the anus. 4. Digestion. Mechanical and chemical processes break down ingested food into small molecules. 5. Absorption. The entrance of ingested and secreted fluids, ions, and the products of digestion into the epithelial cells lining the lumen of the GI tract. The absorbed substances pass into the blood or lymph and circulate to cells throughout the body. 6. Defecation. Wastes, indigestible substances, bacteria, cells sloughed from the lining of the GI tract, and digested materials that were not absorbed leave the body through the anus in a process called defecation.
Mucosa of GI Tract The mucosa is a mucous membrane composed of: 1. The epithelium in the mouth, pharynx, esophagus, and anal canal is mainly nonkeratinized stratified squamous epithelium that serves a protective function. Located among the epithelial cells are exocrine cells that secrete mucus and fluid into the lumen of the tract, enteroendocrine cells, secrete hormones. 2. The lamina propria is an areolar connective tissue layer containing many blood and lymphatic vessels that carry the nutrients absorbed by the GI tract to the other tissues of the body. The lamina propria contains mucosaassociated lymphoid tissue (MALT ). MALT is present all along the GI tract, especially in the tonsils, small intestine, appendix, and large intestine, and it contains about as many immune cells 3. Muscularis mucosae is a thin layer of smooth muscle fibers that causes the mucous membrane of the stomach and small intestine to form many small folds, increasing the surface area for digestion and absorption
Submucosa
The submucosa is a thin meshwork of collagenous fibers, nerves, and blood vessels. Areolar connective tissue binds the mucosa to the middle layer, the muscularis. Is highly vascular and contains the submucosal plexus, or plexus of Meissner, a portion of the enteric nervous system (ENS). The submucosal plexus contains sensory and motor enteric neurons, plus parasympathetic and sympathetic postganglionic fibers that innervate the mucosa and submucosa. Regulates movements of the mucosa and vasoconstriction of blood vessels. Secretory cells of mucosal glands, and the submucosal plexus is important in controlling secretions of the GI tract.
Muscularis
The muscularis of the mouth, pharynx, and superior and middle parts of the esophagus contains skeletal muscle. Skeletal muscle also forms the external anal sphincter, which permits voluntary control of defecation. The muscularis consists of smooth muscle an inner sheet of circular fibers and an outer sheet of longitudinal fibers. An oblique layer is present but limited primarily to the stomach, allowing the stomach to more effectively churn and mix the food. Involuntary contractions of the smooth muscles assist in the mechanical breakdown of food, mix it with digestive secretions, and propel it along the tract. The muscularis also contains myenteric plexus, or plexus of Auerbach, which contains enteric neurons, parasympathetic ganglia and postganglionic fibers, and sympathetic postganglionic fibers that are vasomotor to the blood vessels of this layer. This plexus mostly controls GI tract motility (movement)
Serosa
Superficial layer of those portions of the GI tract that are suspended in the abdominopelvic cavity. A serous membrane composed of areolar connective tissue and simple squamous epithelium (mesothelium). The serous membrane secretes a serous fluid, a watery solution of electrolytes, white blood cells, and other solutes derived from interstitial fluid of the adjacent tissues and blood plasma from local capillaries. The epithelial portion is also called the visceral peritoneum, as it forms the portion of the peritoneum that surrounds the organs that are suspended in the peritoneal cavity, which we will examine in detail shortly.
Layers of the GI Tract
Peritoneum
The largest serous membrane of the body; it consists of a layer of simple squamous epithelium (mesothelium) with an underlying supporting layer of connective tissue.
1. Parietal peritoneum lines the wall of the abdominopelvic cavity 2. Visceral peritoneum or serosa, covers some of the organs in the cavity
Organs that lie against the posterior abdominal wall and do not project into the peritoneal cavity, are called retroperitoneal organs, are covered by peritoneum only on their anterior surfaces (ascending and descending colon, duodenum, and pancreas) or are separated from the peritoneum by fat (kidney and adrenal glands).
5 Major Peritoneal Folds
The greater omentum, the largest peritoneal fold, drapes over the transverse colon and coils over the small intestine like a “fatty apron”. The falciform ligament attaches the liver to the anterior abdominal wall and diaphragm. The lesser omentum arises as an anterior fold of the serosa of the stomach and duodenum. It suspends the stomach and duodenum from the liver. The mesentery, is fan-shaped and binds the jejunum and ileum of the small intestine to the posterior abdominal wall The mesocolon bind the transverse colon (transverse mesocolon) and sigmoid colons (sigmoid mesocolon) of the large intestine to the posterior abdominal
Mouth
The mouth, oral or buccal cavity; is formed by the cheeks, hard and soft palates, and tongue. The cheeks form the lateral walls of the oral cavity. They are covered externally by skin and internally by a mucous membrane, which consists of nonkeratinized stratified squamous epithelium. Buccinator muscles and connective tissue lie between the skin and mucous membranes of the cheeks. The lips or labia surrounding the opening of the mouth.They contain the orbicularis oris muscle and are covered externally by skin and internally by mucous membrane. The inner surface is attached to its corresponding gum by a midline fold of mucous membrane called the labial frenulum.
3 Pairs of Major Salivary Glands
The parotid glands are located inferior and anterior to the ears, between the skin and the masseter muscle. Parotid (Stensen’s) duct pierces the buccinator muscle to open into the vestibule opposite the second maxillary (upper) molar tooth. The submandibular glands at the base of the tongue; are medial and partly inferior to the mandible. Their ducts, the submandibular (Wharton’s) ducts, run under the mucosa on either side of the midline of the floor of the mouth and enter the oral cavity proper lateral to the lingual frenulum. The sublingual glands are superior to the submandibular glands. The lesser sublingual (Rivinus’) ducts, open into the floor of the mouth in the oral cavity proper.
Salivary glands
The salivary glands receive both sympathetic and parasympathetic innervation. The fluids secreted by the buccal glands, minor salivary glands, and the three pairs of major salivary glands constitute saliva. Amounts of saliva secreted daily range from 1000 to 1500 mL (1 to 1.6 qt). Chemically, saliva is 99.5% water and 0.5% solutes and has a slightly acidic pH (6.35 to 6.85). The solute portion includes mucus, an enzyme that destroys bacteria (lysozyme), the digestive enzymes salivary amylase and lingual lipase, and traces of salts, proteins, and other organic compounds. Salivary amylase plays a minor role in the breakdown of starch in the mouth. Lingual lipase and mucus are secreted by lingual glands, which is active in the stomach, can digest as much as 30% of dietary triglycerides (fats) into simpler fatty acids and monoglycerides.
Salivary Glands
Tongue
The tongue is an accessory digestive organ composed of skeletal muscle covered with mucous membrane. The tongue is divided into symmetrical lateral halves by a median septum that extends its entire length. The extrinsic muscles of the tongue, which originate outside the tongue (attach to bones in the area) and insert into connective tissues in the tongue, include the hyoglossus, genioglossus, and styloglossus muscles. The extrinsic muscles move the tongue from side to side and in and out, and force the food to the back of the mouth for swallowing. They also form the floor of the mouth, hold the tongue in position, and assist in speech. The intrinsic muscles originate in and insert into connective tissue within the tongue and alter the shape and size of the tongue for speech and swallowing. The lingual frenulum , a fold of mucous membrane in the midline of the undersurface of the tongue, and aids in limiting the movement of the tongue posteriorly.
Taste Buds: Receptors for Gustation
Papillae: projections of the lamina propria covered with stratified squamous epithelium on surfaces of the tongue. Fungiform papillae: elevations distributed among the more numerous filiform papillae. They are scattered over the dorsum of the tongue, are concentrated mainly around the margins of the tongue. Vallate (circumvallate) papillae: arranged in an inverted V shape on the posterior surface of the tongue; all of them contain taste buds. The Foliate papillae: located in the lateral margins of the tongue. Filiform papillae: pointed, threadlike projections distributed in parallel rows over the anterior two- thirds of the tongue. Filiform papillae lack taste buds, they contain receptors for touch and increase friction between the tongue and food.
Teeth
Gingivae cover alveolar processes extend into each socket to form the gingival sulcus. The sockets are lined by the periodontal ligament or membrane, consists of dense fibrous connective tissue that anchors teeth in position and acts as a shock absorber. 1-3 roots are embedded in each socket. The neck is the constricted junction of the crown and root near the gum line. Internally, the dentin forms most of the tooth, consists of calcified connective tissue. The crown of a tooth is covered by enamel, primarily composed of calcium phosphate and calcium carbonate. Enamel is also harder than bone because of its even higher content of calcium salts
Digestive process
Several minutes after food enters the stomach, gentle, rippling,peristaltic movements called mixing waves pass over the stomach every 15–25 seconds the soupy liquid is reduced to chyme The enzymatic digestion of proteins begins in the stomach. The enzyme pepsin, secreted by chief cells in an inactive form called pepsinogen. Pepsin breaks certain peptide bonds between the amino acids making up proteins. Gastric lipase splits the short-chain triglycerides (fats) in butterfat molecules found in milk. The enzyme has a limited role in the adult stomach. To digest fats, adults rely almost exclusively on the lingual lipase secreted by salivary glands in the mouth, and pancreatic lipase, an enzyme secreted by the pancreas into the small intestine. Within 2–4 hours after eating a meal, the stomach has emptied its contents into the duodenum. Foods rich in carbohydrates spend the least time in the stomach; high-protein foods remain somewhat longer; and emptying is slowest after a fatladen meal containing large amounts of triglycerides.
Pancreas
The pancreas is made up of glandular epithelial cells, about 99% are arranged in clusters called acini (exocrine cells). The acini secrete a mixture of fluid and digestive enzymes called pancreatic juice. 1% of the cells are organized into clusters called pancreatic islets (islets of Langerhans), the endocrine cells of the pancreas. These cells secrete the glucagon, insulin, somatostatin, and pancreatic polypeptide. Each day the pancreas produces 1200–1500 mL (about 1.2–1.5 qt) of pancreatic juice, consisting 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. Pancreatic amylase, trypsin, chymotrypsin, Carboxypeptidase, and elastase; the principal triglyceride-digesting enzyme in adults, called pancreatic lipase; and nucleic acid– digesting enzymes called ribonuclease and deoxyribonuclease are produced by the pancreas.
Pancreas
1. Hepatocytes are the major functional cells of the liver and perform a metabolic, secretory, and endocrine functions. Hepatocytes form complex three-dimensional arrangements called hepatic laminae. The hepatic laminae are plates of hepatocytes, grooves in the cell membranes between neighboring hepatocytes provide spaces for canaliculi into which bile is secreted. 2. Bile canaliculi small ducts between hepatocytes passes into bile ductules and then bile ducts. The bile ducts merge and eventually form the larger right and left hepatic ducts, unite and exit the liver as the common hepatic duct. The common hepatic duct joins the cystic duct from the gallbladder to form the common bile duct. 3. Hepatic sinusoids 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. Hepatic sinusoids converge and deliver blood into a central vein. From central veins the blood flows into the hepatic veins, which drain into the inferior vena cava.
3 Regions of the Small Intestine
The Duodenum, the shortest region, is retroperitoneal and extends about 25 cm (10 in.). The Jejunum is about 1 m (3 ft) long and extends to the ileum. The Ileum is the longest region of the small intestine, measures about 2 m (6 ft) and joins the large intestine at a smooth muscle sphincter called the ileocecal sphincter.
Small Intestine
The mucosa is composed of a layer of epithelium, lamina propria, and muscularis mucosae. The epithelial layer of the small intestinal mucosa consists of simple columnar epithelium that contains many types of cells. Absorptive cells of the epithelium digest and absorb nutrients in small intestinal chyme. Goblet cells secrete mucus. The small intestinal mucosa contains many deep crevices lined with glandular epithelium. Cells lining the crevices form the intestinal glands (crypts of Lieberkuhn) and secrete intestinal juice. Paneth cells secrete lysozyme, a bactericidal enzyme, and are capable of phagocytosis. May have a role in regulating the microbial population in the small intestine.
Small Intestine
Three types of enteroendocrine cells are found in the intestinal glands of the small intestine: S cells, CCK cells, and K cells, which secrete the hormones secretin , cholecystokinin ( CCK ), and glucose-dependent insulinotropic peptide (GIP). The lamina propria of the small intestinal mucosa contains areolar connective tissue and has an abundance of mucosa- associated lymphoid tissue (MALT). Solitary lymphatic nodules are most numerous in the distal part of the ileum. Groups of lymphatic nodules referred to as aggregated lymphatic follicles (Peyer’s patches) are also present in the ileum. The muscularis mucosae consists of smooth muscle. The submucosa of the duodenum contains duodenal (Brunner’s) glands, which secrete an alkaline mucus that helps neutralize gastric acid in the chyme. The muscularis of the small intestine consists of two layers of smooth muscle. The outer, thinner layer contains longitudinalfibers; the inner, thicker layer contains circular fibers. Except fora major portio
Small Intestine
The completion of the digestion occurs in the small intestine.
Intestinal juice is a clear yellow fluid secreted.
Segmentations are localized, mixing contractions that occur in portions of the intestine distended by a large volume of chyme with the digestive juices and bring the particles of food into contact with the mucosa for absorption. The absorptive epithelial cells synthesize several digestive enzymes, called brush-border enzymes. Carbohydrate-digesting enzymes: a-dextrinase, maltase, sucrase, and lactase. Protein-digesting enzymes: peptidases (aminopeptidase and dipeptidase) Nucleotide digesting enzymes, nucleosidases and phosphatases.
Large Intestine
As chyme moves through the large intestine, bacteria act on it and water, ions, and vitamins are absorbed The large intestine, is about 1.5 m (5 ft) long and 6.5 cm (2.5 in.) in diameter, extends from the ileum to the anus. The ascending colon and descending colon are retroperitoneal, while the the colon and cecum are attached to the posterior abdominal wall by their mesocolon, a double layer of peritoneum connecting the parietal peritoneum to the visceral peritoneum. The four principal regions are the cecum, colon, rectum, and anal canal. The opening from the ileum into the large intestine is ileocecal sphincter or valve, which allows materials from the small intestine to pass into the large intestine. The cecum, a small pouch about 6 cm (2.4 in.) long. Attached to the cecum is the the appendix or vermiform appendix. The mesentery of the appendix, called the mesoappendix, attaches the appendix to the inferior part of the mesentery of the ileum.
Large Intestine
The wall of the large intestine contains the typical four layers found in the rest of the GI tract: mucosa, submucosa, muscularis, and serosa. The mucosa consists of simple columnar epithelium, lamina propria (areolar connective tissue), and muscularis mucosae (smooth muscle). Both absorptive and goblet cells are located in long, straight, tubular intestinal glands (crypts of Lieberkühn) that extend the full thickness of the mucosa. The submucosa consists of areolar connective tissue. The muscularis consists of an external layer of longitudinal smooth muscle and an internal layer of circular smooth muscle. Unlike other parts of the GI tract, portions of the longitudinal muscles are thickened, forming three conspicuous bands called the teniae coli that run most of the length of the large intestine or no longitudinal muscle. Tonic contractions of the bands gather the colon into a series of pouches called haustra, which give the colon a puckered appearance. A single layer of circular smooth muscle lies deep to the teniae coli.
Large Intestine
The passage of chyme from the ileum into the cecum is regulated by the action of the ileocecal sphincter. One movement characteristic of the large intestine is haustral churning. In this process, the haustra remain relaxed and distended while they fill up. When the distension reaches a certain point, the wall contracts and squeezes the contents into the next haustrum. Peristalsis also occurs, although at a slower rate (3 to 12 contractions per minute) than in other portions of the tract. A final type of movement is mass peristalsis, a strong peristaltic wave that begins at about the middle of the transverse colon and quickly drives the colonic contents into the rectum. Mass peristalsis usually takes place 3-4 times a day, during or after a meal. The final stage of digestion occurs in the colon through the activity of bacteria that inhabit the lumen
Large Intestine
Mucus is secreted by the glands of the large intestine, but no enzymes are secreted. Chyme is prepared for elimination by the action of bacteria, which ferment any remaining carbohydrates and release hydrogen, carbon dioxide, and methane gases. These gases contribute to flatus (gas) in the colon, termed flatulence when it is excessive. Bacteria also convert any remaining proteins to amino acids and break down the amino acids into simpler substances: indole, skatole, hydrogen sulfide, and fatty acids Bacteria also decompose bilirubin to simpler pigments, including stercobilin, which give feces their brown color. Several vitamins needed for normal metabolism, including some B vitamins and vitamin K, are bacterial products that are absorbed in the colon. By the time chyme has remained in the large intestine 3–10 hours, it has become solid or semisolid as a result of water absorption and is now called feces.
