Lecture on Digestive system physiology

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This Lecture will facilitate the understanding of human digestive system physiology. Entire lecture is well supported with approprite pictures of various parts of GIT.

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Lavkush Dwivedi Bundelkhand Univesity, Jhansi Institute of Biomedical Sciences lk dwivedi BU/BMS, IN Components of the Digestive System   Gastrointestinal (GI) tract or alimentary canal Is a muscular tube Extends from oral cavity to anus lk dwivedi BU/BMS, IN 1. Ingestion: occurs when materials enter digestive tract via the mouth 2. Mechanical processing: crushing and shearing makes materials easier to propel along digestive tract 3. Digestion: is the chemical breakdown of food into small organic fragments for absorption by digestive epithelium lk dwivedi BU/BMS, IN 4. Secretion: is the release of water, acids, enzymes, buffers, and salts by epithelium of digestive tract by glandular organs 5. Absorption: movement of organic substrates, electrolytes, vitamins, and water across digestive epithelium into interstitial fluid of digestive tract 6. Excretion: removal of waste products from body fluids lk dwivedi BU/BMS, IN  Protects surrounding tissues against: corrosive effects of digestive acids and enzymes mechanical stresses, such as abrasion bacteria    Is ingested with food or resides in digestive tract Attacked by macrophages, and immune system cells In lamina propria (underlying layer of areolar tissue) Peritoneal Cavity  Is located within the abdominopelvic cavity  Lined with serous membrane consisting of: superficial mesothelium covering a layer of areolar tissue Divisions of the Serous Membrane  Serosa, or visceral peritoneum  covers organs within peritoneal cavity  Parietal peritoneum: lines inner surfaces of body wall  1. 2. 3. 4. Peritoneal fluid Is produced by serous membrane lining Provides essential lubrication Separates parietal and visceral surfaces Allows sliding without friction or lk dwivedi BU/BMS, IN irritation lk dwivedi BU/BMS, IN Figure 24–2c, d lk dwivedi BU/BMS, IN  Major layers of the digestive tract:  mucosa  submucosa  muscularis externa  serosa lk dwivedi BU/BMS, IN  Is the inner lining of digestive tract  Is a mucous membrane consisting of:  epithelium, moistened by glandular secretions  Lamina propria composed of areolar tissue The Digestive Epithelium  Mucosal epithelium is simple or stratified:  depending on location, function, and stresses •Oral cavity, pharynx, and esophagus: •mechanical stresses •lined by stratified squamous epithelium •Stomach, small intestine, and most of large intestine: •Absorption •simple columnar epithelium with goblet cells lk dwivedi BU/BMS, IN  Folding increases surface area for absorption: 1. 2. longitudinal folds, disappear as digestive tract fills permanent transverse folds (plicae) lk dwivedi BU/BMS, IN  Consists of a layer of areolar tissue that contains:      blood vessels sensory nerve endings lymphatic vessels smooth muscle cells scattered areas of lymphoid tissue lk dwivedi BU/BMS, IN   Narrow band of smooth muscle and elastic fibers in lamina propria Smooth muscle cells arranged in 2 concentric layers: lk dwivedi BU/BMS, IN     Is a layer of dense irregular connective tissue Surrounds muscularis mucosae Has large blood vessels and lymphatic vessels May contain exocrine glands:  secrete buffers and enzymes into digestive tract Submucosal Plexus   Also called plexus of Meissner Innervates the mucosa and submucosa lk dwivedi BU/BMS, IN   Is dominated by smooth muscle cells Involved in: mechanical processing  movement of materials along digestive tract   Movements coordinated by enteric nervous system (ENS) The Serosa  Serous membrane covering muscularis externa:  except in oral cavity, pharynx, esophagus, and rectum lk dwivedi BU/BMS, IN  By muscular layers of digestive tract:  consist of visceral smooth muscle tissue Smooth Muscle  Along digestive tract:   has rhythmic cycles of activity controlled by pacesetter cells triggering wave of contraction through entire muscular sheet  Cells undergo spontaneous depolarization:  Pacesetter Cells  Located in muscularis mucosae and muscularis externa:  surrounding lumen of digestive tract lk dwivedi BU/BMS, IN Consists of waves of muscular contractions  Moves a bolus along the length of the digestive tract  Bolus is a small, oval mass of digestive contents Peristaltic Motion  Circular muscles contract behind bolus: while circular muscles ahead of bolus relax Longitudinal muscles ahead of bolus contract: shortening adjacent segments Wave of contraction in circular muscles: forces bolus forward Segmentation  Cycles of contraction:  Churn and fragment bolus  mix contents with intestinal secretions  Does not follow a set pattern:  does not push materials in any 1 direction lk dwivedi BU/BMS, IN Control of Digestive Function    Neural mechanisms Hormonal mechanisms Local mechanisms  Control:  movement of materials along digestive tract  secretory functions control smooth muscle contraction and glandular secretion  located in myenteric plexus   Motor neurons: Digestive Hormones Mechanisms  At least 18 hormones that affect:   most aspects of digestive function activities of other systems    Are peptides Are produced by enteroendocrine cells in digestive tract Reach target organs after distribution in bloodstream lk dwivedi BU/BMS, IN Local Mechanisms    Prostaglandins, histamine, and other chemicals Released into interstitial fluid Affect adjacent cells within small segment of digestive tract  Coordinating response to changing conditions:  e.g., variations in local pH, chemical, or physical stimuli  Affect only a portion of tract lk dwivedi BU/BMS, IN  Lubrication:  mixing with mucus and salivary gland secretions of carbohydrates and lipids  Limited digestion:   Sensory analysis:  of material before swallowing through actions of teeth, tongue, and palatal surfaces  Mechanical processing:  Oral Mucosa   Lining of oral cavity Has stratified squamous epithelium Layer of Keratinized Cells  Covers only regions exposed to severe abrasion The Epithelial Lining  Of cheeks, lips, and inferior surface of tongue:  is relatively thin, nonkeratinized, and delicate lk dwivedi BU/BMS, IN  Is thin and vascular enough to rapidly absorb lipid-soluble drugs The Mucosae of the Cheeks  Are supported by pads of fat and the buccinator muscles Also called lips Anteriorly, the mucosa of each cheek is continuous with that of the lips Labia   Vestibule  Space between the cheeks (or lips) and the teeth Gingivae (Gums)   Ridges of oral mucosa Surround base of each tooth on alveolar processes of maxillary bones and mandible The Oral Cavity   Roof formed by hard and soft palates Tongue dominates the floor lk dwivedi BU/BMS, IN  Lies between palatoglossal and palatopharyngeal arches, on each side lk dwivedi BU/BMS, IN   Manipulates materials inside mouth May bring foods into oral cavity Mechanical processing:  compression, abrasion, and distortion Manipulation:  assists in chewing  prepares material for swallowing Sensory analysis:  touch, temperature, and taste receptors Secretion:  mucins  enzyme lingual lipase 4 Functions of the Tongue 1. 2. 3. 4. Sublingual Glands    Small glands extend into underlying lamina propria Secretions flush tongue’s epithelium Contain water, mucins, and enzyme lingual lipase lk dwivedi BU/BMS, IN   3 pairs secrete into oral cavity Each pair has distinctive cellular organization:  and produces saliva with different properties lk dwivedi BU/BMS, IN   Inferior to zygomatic arch Produce serous secretion:  enzyme salivary amylase (breaks down starches) which empties into vestibule at second molar  Drained by parotid duct (Stensen’s duct):  Sublingual Salivary Glands    Covered by mucous membrane of floor of mouth Produce mucous secretion:  buffer and lubricant Sublingual ducts (Rivinus’ ducts):  either side of lingual frenulum Submandibular Salivary Glands     In floor of mouth Within mandibular groove Secrete buffers, glycoproteins (mucins), and salivary amylase Submandibular ducts (Wharton’s ducts):  open immediately posterior to teeth  either side of lingual frenulum lk dwivedi BU/BMS, IN  Produce 1.0–1.5 liters of saliva each day: 70% by submandibular glands  25% by parotids  5% by sublingual glands  Saliva   99.4% water 0.6% includes:       electrolytes (Na+, Cl—, and HCO3—) buffers glycoproteins (mucins) antibodies enzymes waste products 4 Functions of Saliva 1. 2. 3.   Lubricating the mouth Moistening and lubricating materials in the mouth Dissolving chemicals that: stimulate taste buds provide sensory information 4. Initiate digestion of:  complex carbohydrates by enzyme salivary amylase (ptyalin or alpha-amylase)  lipids by enzyme lingual lipase lk dwivedi BU/BMS, IN   Tongue movements pass food across occlusal surfaces of teeth Chew (masticate) food Tooth Structure  Dentin:  a mineralized matrix similar to that of bone  does not contain cells  Pulp cavity:  receives blood vessels and nerves through the root canal lk dwivedi BU/BMS, IN Dental Arches  Contain 4 types of teeth: 1. 2. 3. 4. incisors cuspids (canines) bicuspids (premolars) molars     Blade-shaped teeth Located at front of mouth Used for clipping or cutting Have a single root lk dwivedi BU/BMS, IN      Conical Sharp ridgeline Pointed tip Used for tearing or slashing Have a single root Bicuspids (Premolars)     Flattened crowns Prominent ridges Used to crush, mash, and grind Have 1 or 2 roots Molars     Very large, flat crowns With prominent ridges Used for crushing and grinding Have 3 or more roots lk dwivedi BU/BMS, IN Permanent Dentition     Also called secondary dentition Replaces deciduous teeth 32 permanent teeth 8 on each side, upper and lower  2 incisors  1 cuspid  5 molars lk dwivedi BU/BMS, IN   Also called chewing Food is forced from oral cavity to vestibule and back:  crossing and recrossing occlusal surfaces Muscles of Mastication    Close the jaws Slide or rock lower jaw from side to side Chewing involves mandibular:  elevation and depression  protraction and retraction  medial and lateral movement The Pharynx  A common passageway for solid food, liquids, and air Nasopharynx Oropharynx Laryngopharynx Food passes through oropharynx and laryngopharynx to esophagus lk dwivedi BU/BMS, IN Regions of the Pharynx     The Esophagus      A hollow muscular tube About 25 cm long and 2 cm wide Conveys solid food and liquids to the stomach Begins posterior to cricoid cartilage lk dwivedi BU/BMS, IN Is innervated by fibers from the esophageal plexus 1. Mucosa contains:  nonkeratinized and stratified squamous epithelium Mucosa and submucosa:  form large folds that extend the length of the esophagus Muscularis mucosae:  consists of irregular layer of smooth muscle Submucosa contains esophageal glands:  which produce mucous secretion  reduces friction between bolus and esophageal lining Muscularis externa:  has usual inner circular and outer longitudinal layers 2. 3. 4. 5. lk dwivedi BU/BMS, IN     Also called deglutition Can be initiated voluntarily Proceeds automatically Is divided in 3 phases:  Buccal      Pharyngeal  Bolus contacts:  palatoglossal arches  palatopharyngeal arches  posterior pharyngeal wall Esophogeal  Compression of bolus against hard palate Retraction of tongue forces bolus into oropharynx: assists elevation of soft palate seals off nasopharynx  lk dwivedi BU/BMS, IN Contraction of pharyngeal muscles forces bolus through entrance to esophagus 1. 2. Storage of ingested food Mechanical breakdown of ingested food Disruption of chemical bonds in food material:  3. by acids and enzymes glycoprotein required for absorption of vitamin B12 in small intestine 4. Production of intrinsic factor:  lk dwivedi BU/BMS, IN  Muscularis mucosae and muscularis externa: contain extra layers of smooth muscle cells  in addition to circular and longitudinal layers  Gastric Pits   Are shallow depressions that open onto the gastric surface Mucous cells:  at base, or neck, of each gastric pit  actively divide, replacing superficial cells Gastric Glands  In fundus and body of stomach:  extend deep into underlying lamina propria  Each gastric pit communicates with several gastric glands 2 Types of Secretory Cells  In gastric glands: both secrete HCl   parietal cells chief cells lk dwivedi BU/BMS, IN  Stomach:     Pancreas:   gastric juices stomach acids pepsin digestive enzymes buffers  Liver:    Bile  Produced in liver  Contains buffers and bile salts Stored in gallbladder Discharge into small intestine lk dwivedi BU/BMS, IN lk dwivedi BU/BMS, IN   Plays key role in digestion and absorption of nutrients 90% of nutrient absorption occurs in the small intestine The segment of small intestine closest to stomach 25 cm (10 in.) long ―Mixing bowl‖ that receives:  The Duodenum    chyme from stomach (Mixture of secretions and food in the stomach)  digestive secretions from pancreas and liver The Jejunum    Is the middle segment of small intestine 2.5 meters (8.2 ft) long Is the location of most:  chemical digestion  nutrient absorption The ILeum   The final segment of small intestine 3.5 meters (11.48 ft) long lk dwivedi BU/BMS, IN    Also called plicae circulares Transverse folds in intestinal lining Are permanent features:  Intestinal Villi   Do not disappear when small intestine fills A series of fingerlike projections: in mucosa of small intestine  Covered by simple columnar epithelium:  covered with microvilli Intestinal Glands   Goblet cells between columnar epithelial cells Eject mucins onto intestinal surfaces lk dwivedi BU/BMS, IN   Functions of the Duodenum   Has few plicae Small villi To receive chyme from stomach To neutralize acids before they can damage the absorptive surfaces of the smal intestine Watery intestinal juice 1.8 liters per day enter intestinal lumen Moistens chyme Assists in buffering acids Keeps digestive enzymes and products of digestion in solution Intestinal Secretions      Intestinal Movements   Chyme arrives in duodenum Weak peristaltic contractions move it slowly toward jejunum lk dwivedi BU/BMS, IN  A compound tubuloalveolar gland lk dwivedi BU/BMS, IN Figure 24–18  Lies posterior to stomach:  from duodenum toward spleen   Is bound to posterior wall of abdominal cavity Is wrapped in thin, connective-tissue capsule Regions of the Pancreas  Head:  broad  in loop of duodenum  Body:  slender  extends toward spleen  Tail:  short and rounded Duct of Wirsung   Large pancreatic duct Delivers digestive enzymes and buffers to duodenum lk dwivedi BU/BMS, IN   From the liver and gallbladder Meets pancreatic duct near duodenum Duodenal Ampulla  Chamber that receives secretions from:  common bile duct  pancreatic duct  Located halfway along length of duodenum Lobules of the Pancreas    Are separated by connective tissue partitions (septa) Contain blood vessels and tributaries of pancreatic ducts In each lobule:  ducts branch repeatedly  end in blind pockets-pancreatic acini - Blind pockets   Are lined with simple cuboidal epithelium Contain scattered pancreatic islets  Endocrine tissues of pancreas Scattered (1% of pancreatic cells) lk dwivedi BU/BMS, IN 1. Endocrine cells:   of pancreatic islets secrete insulin and glucagon into bloodstream 2. Exocrine cells:   acinar cells epithelial cells of duct system Pancreatic Secretions    1000 ml (1 qt) pancreatic juice per day Controlled by hormones from duodenum Contain pancreatic enzymes Pancreatic Enzymes   Pancreatic alpha-amylase:  •Pancreatic lipase: • breaks down complex lipids • releases products (e.g., fatty acids) that are easily absorbed •Nucleases: •break down nucleic acids lk dwivedi BU/BMS, IN a carbohydrase  breaks down starches  similar to salivary amylase Proteolytic enzymes:  break certain proteins apart  proteases break large protein complexes  peptidases break small peptides into amino acids        Is the largest visceral organ (1.5 kg) Lies in right hypochondriac and epigastric regions Extends to left hypochondriac and umbilical regions Performs essential metabolic and synthetic functions Is wrapped in tough fibrous capsule Is covered by visceral peritoneum Is divided into lobes lk dwivedi BU/BMS, IN  Liver secretes bile fluid: into a network of narrow channels (bile canaliculi)  between opposing membranes of adjacent liver cells  Bile Canaliculi   Extend outward, away from central vein Connect with fine bile ductules:  which carry bile to bile ducts in nearest portal area The Right and Left Hepatic Ducts   Collect bile from all bile ducts of liver lobes Unite to form common hepatic duct which leaves the liver  Bile Flow From common hepatic duct to either:  the common bile duct, which empties into duodenal ampulla  the cystic duct, which leads to gallbladder The Common Bile Duct  Is formed by union of:  cystic duct  common hepatic duct    Passes within the lesser omentum toward stomach Penetrates wall of duodenum Meets pancreatic duct at duodenal ampulla lk dwivedi BU/BMS, IN 1. 2. 3. Metabolic regulation Hematological regulation Bile production Metabolic Regulation  1. 2. 3. 4. 5. The liver regulates: composition of circulating blood nutrient metabolism waste product removal nutrient storage drug inactivation Metabolic Activities of the Liver        Carbohydrate metabolism Lipid metabolism Amino acid metabolism Waste product removal Vitamin storage Mineral storage Drug inactivation lk dwivedi BU/BMS, IN  All blood leaving absorptive surfaces of digestive tract: enters hepatic portal system  flows into the liver    Liver cells extract nutrients or toxins from blood:  before it reaches systemic circulation through hepatic veins corrects nutrient deficiencies by mobilizing stored reserves or performing synthetic activities Liver removes and stores excess nutrients:  The Liver and Hematological Regulation    Largest blood reservoir in body Receives 25% of cardiac output Performs 6 hematological regulation functions 1. 2. 3. 4. 5. 6. Phagocytosis and antigen presentation Synthesis of plasma proteins Removal of circulating hormones Removal of antibodies Removal or storage of toxins Synthesis and secretion of bile lk dwivedi BU/BMS, IN    Dietary lipids are not water soluble Mechanical processing in stomach creates large drops containing lipids Pancreatic lipase is not lipid soluble:  interacts only at surface of lipid droplet Functions of Bile  Bile salts break droplets apart (emulsification):  increases surface area exposed to enzymatic attack  creates tiny emulsion droplets coated with bile salts The Gallbladder    Is a pear-shaped, muscular sac Stores and concentrates bile prior to excretion into small intestine Is located in the fossa on the posterior surface of the liver’s right lobe lk dwivedi BU/BMS, IN    Fundus Body Neck The Cystic Duct   The Duodenal Ampulla  Extends from gallbladder Union with common hepatic duct forms common bile duct Receives:  buffers and enzymes from pancreas  bile from the liver and gallbladder  The Common Bile Duct   Opens into duodenum at duodenal papilla Meets pancreatic duct at duodenum: lk dwivedi BU/BMS, before emptying into duodenal ampulla IN   Stores bile Releases bile into duodenum:  only under stimulation of hormone cholecystokinin (CCK) The Gallbladder & Bile Modification   Full gallbladder contains 40–70 ml bile Bile composition gradually changes in gallbladder:  water is absorbed  bile salts and solutes become concentrated Gallstones    Are crystals of insoluble minerals and salts Form if bile is too concentrated Small stones may be flushed through bile duct and excreted lk dwivedi BU/BMS, IN lk dwivedi BU/BMS, IN Figure 24–22  Intestinal tract secretes peptide hormones with multiple effects: in several regions of digestive tract  in accessory glandular organs  Secretin   Is released when chyme arrives in duodenum Increases secretion of bile and buffers by liver and pancreas Cholecystokinin (CCK)  Is secreted in duodenum:  when chyme contains lipids and partially digested proteins   Accelerates pancreatic production and secretion of digestive enzymes Cholecystokinin (CCK) Relaxes hepatopancreatic sphincter and gallbladder:  ejecting bile and pancreatic juice into duodenum Gastric Inhibitory Peptide (GIP)  Is secreted when fats and carbohydrates enter small intestine Stimulates secretion of intestinal glands Dilates regional capillaries Inhibits acid production in stomach lk dwivedi BU/BMS, IN Vasoactive Intestinal Peptide (VIP)     Is secreted by G cells in duodenum:  when exposed to incompletely digested proteins   Promotes increased stomach motility Stimulates acids and enzyme production Intestinal Absorption  It takes about 5 hours for materials to pass:  from duodenum  to end of ileum  Movements of the mucosa increases absorptive effectiveness:  stir and mix intestinal contents  constantly change environment around epithelial cells lk dwivedi BU/BMS, IN       Is horseshoe-shaped Extends from end of ileum to anus Lies inferior to stomach and liver Frames the small intestine Also called large bowel Is about 1.5 meters long and 7.5 cm wide Reabsorption of water Compaction of intestinal contents into feces Absorption of important vitamins produced by bacteria Storage of fecal material prior to defecation Functions of the Large Intestine     lk dwivedi BU/BMS, IN 1.  Cecum: the pouch like first portion 2.  Colon: the largest portion 3.     Rectum: the last 15 cm of digestive tract The Cecum Is an expanded pouch Receives material arriving from the ileum Stores materials and begins compaction The Appendix     Also called vermiform appendix Is a slender, hollow appendage (about 9 cm long) Is dominated by lymphoid nodules (a lymphoid organ) Is attached to posteromedial surface of cecum:  mesoappendix connects lk dwivedi BU/BMS, IN appendix to ileum and cecum   Has a larger diameter and thinner wall than small intestine The wall of the colon: forms a series of pouches (haustra)  Haustra permit expansion and elongation of colon  Colon Muscles  3 longitudinal bands of smooth muscle (taeniae coli):  run along outer surfaces of colon  deep to the serosa  similar to outer layer of muscularis externa  Muscle tone in taeniae coli creates the haustra Serous Membrane of the Colon  Contains numerous teardropshaped sacs of fat:  fatty appendices or epiploic appendages lk dwivedi BU/BMS, IN 1. 2. 3. 4. Ascending colon Transverse colon Descending colon Sigmoid colon The Rectum    Forms last 15 cm of digestive tract Is an expandable organ for temporary storage of feces Movement of fecal material into rectum triggers urge to defecate Is the last portion of the rectum Contains small longitudinal folds called anal columns Also called anal orifice Is exit of the anal canal The Anal Canal   The Anus   lk dwivedi BU/BMS, IN  Internal anal sphincter: circular muscle layer of muscularis externa  has smooth muscle cells, not under voluntary control   External anal sphincter: encircles distal portion of anal canal  a ring of skeletal muscle fibers, under voluntary control  Characteristics of the Colon  Lack of villi  Abundance of goblet cells  Presence distinctive intestinal glands Glands of the Large Intestine   Absorption in the Large Intestine   Reabsorption of water Reabsorption of bile salts:  in the cecum  transported in blood to liver   Are deeper than glands of small intestine Are dominated by goblet cells Mucosa of the Large Intestine  Absorption of vitamins produced by bacteria Absorption of organic wastes  Does not produce enzymes Provides lubrication for fecal material lk dwivedi BU/BMS, IN 1. Vitamin K:   a fat-soluble vitamin required by liver for synthesizing 4 clotting factors, including prothrombin 2. Biotin:   a water-soluble vitamin important in glucose metabolism a water-soluble vitamin required in manufacture of steroid hormones and some neurotransmitters 3. Pantothenic acid:   Organic Wastes   Bacteria convert bilirubin to urobilinogens and stercobilinogens: Bacteria break down peptides in feces and generate:    ammonia:  as soluble ammonium ions nitrogen compounds responsible for odor of feces gas that produces ―rotten egg‖ odor indole and skatole:  hydrogen sulfide:   Bacteria feed on indigestible carbohydrates (complex polysaccharides):  produce flatus, or intestinal gas, in large intestine lk dwivedi BU/BMS, IN lk dwivedi BU/BMS, IN Figure 24–26  The digestive system: breaks down physical structure of food  disassembles component molecules   Molecules released into bloodstream are:  absorbed by cells used to synthesize carbohydrates, proteins, and lipids  Broken down to provide energy for ATP synthesis:  Digestive Enzymes   Are secreted by:  Are divided into classes by targets:  salivary glands  tongue  stomach  pancreas  carbohydrases:  break bonds between simple sugars break bonds between amino acids  proteases:  Break molecular bonds in large organic molecules:  carbohydrates, proteins, lipids, and nucleic acids  in a process called hydrolysis  lipases:  separate fatty acids from glycerides lk dwivedi BU/BMS, IN Thank you lk dwivedi BU/BMS, IN

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