C A G AY A N S T AT E U NI VE R S IT Y

CARIG CAMPUS
COLLEGE OF MEDICINE AND SURGERY

PHYSIOLOGY LABORATORY EXPERIMENT

GASTROINTESTINAL PHYSIOLOGY

Submitted by:
MD 1A – GROUP 3

AGLEHAM, TRISHA LYN G.

BERNAL, NOREEN O.
CASTRO, GERARD
DE OCAMPO, JAKE M.
MACALINTAL, BYRON LOUIE C.
SALUCON, KLONDY C.
SANTOS, RUTH ANNE SHARMAINE L.

Submitted to:

TEODORO JAMES B. MALLABO, RN, MSN, MD

MARCH 2018

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 GASTROINTESTINAL PHYSIOLOGY

INTRODUCTION

The gastrointestinal system consists of the gastrointestinal tract and the

accessory exocrine glands. The gastrointestinal tract includes the mouth, the
esophagus, the stomach, the small intestine, and the large intestine. The
major accessory glands are the salivary glands, the liver, the gallbladder, and
the pancreas.
In order for the nutrients in food to be absorbed, they must first be
broken down into particles that are small enough to be transported through
carrier proteins into the epithelial cells that form the mucosal lining of the
digestive tract. This process of breaking down food is called digestion, and
occurs primarily within three particular segments of the digestive tract: the
mouth, the stomach, and the small intestine. Digestion occurs through two
different processes: physical digestion, where large chunks of food are
ground into tiny particles, and chemical digestion, whereby through the use
of enzymes released into the digestive tract large polymeric biomolecules
are broken into individual monomers or oligomers (e.g. dimers or trimers).
Chemical digestion is essential for breaking food into particles that can be
absorbed by the epithelium of the small and large intestine, and will be the
focus of this lab exercise.
The most important substances secreted for the purpose of digestion
are the digestive enzymes. Digestive enzymes greatly enhance the rate at
which the covalent bonds that link subunits together to form polymeric
biomolecules are broken. Indeed, without the presence of these enzymes,
chemical digestion would essentially not occur.
The major functions of the gastrointestinal system are assimilation of
nutrients and excretion of waste products via the biliary system. Movement of
food through the gastrointestinal system (motility) is carefully coordinated
with the delivery of appropriate fluid and enzyme solutions (secretion) so that
the macromolecules in food can be hydrolyzed (digestion) and the nutrient
molecules, which are liberated, can be transported into the circulatory
system (absorption). Coordinating multiple organs and physiologic processes
is a significant challenge that must be solved to achieve the overall functions
of the gastrointestinal system. Elaborate control mechanisms are provided by
the enteric nervous system (ENS), a large intrinsic network of neurons in the
wall of the gastrointestinal tract, and by several hormones.

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 RESULT AND DISCUSSIONS

FIGURE 1

Left side going downward

1. Tongue
2. Parotid
3. Sublingual
4. Submandibular
5. Pharynx
6. Stomach
7. Pancreas
8. Spleen
9. Transverse colon
10. Descending colon
11. Ascending colon
12. Cecum
13. Sigmoid colon
14. Rectum
15. Vermiform appendix
16. Anal canal

Right side going downward

1. Oral region
2. Esophagus
3. Liver
4. Gallbladder
5. Duodenum
6. Jejunum
7. Ileum
8. Distal anal canal

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FIGURE 2

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Area Assessed Technique Normal Findings Abnormal Findings Interpretation
Used

Skin integrity Inspection Unblemished skin Presence of rash or Ascites

Uniform color lesions Edema
Silver-white striae or Tense, glistening skin Cushing’s disease
surgical scars Purple striae
Abdominal Inspection Symmetric movements Limited movements Abdominal aortic
Movement caused by respiration; Visible peristalsis in aneurysm
visible peristalsis in nonlean clients
every lean people; Marked aortic pulsations
aortic pulsations in thin
persons at epigastric
area
Bowel Sounds Auscultation Audible bowel sound Hypoactive Paralytic ileus
Absence of arterial Hyperactive Diarrhea
bruits
Absence of friction rub
Contour and Inspection Rounded, no Asymmetric contour Hernia
symmetry and evidenced of Tumor
Palpation enlargement of liver
and spleen
Presence of Percussion Tympany over stomach Large dull areas Presence of fluid
tympany and gas-filled bowels Board-like abdomen or tumor
Dullness, over liver and Ascites
spleen, or a full bladder
Areas of Palpation No tenderness Tenderness and Cholecystitis
tenderness or Relax abdomen with hypersensitivity Appendicitis
smooth and consistent Localized areas of Hepatitis
muscle tension increase tension Peritonitis
guarding Superficial masses Gastroenteritis
PUD
Urinary Palpation Not palpable Distended and palpable Urinary retention
bladder as smooth, round, tense Benign Prostatic
mass Hypertrophy

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FIGURE 3
RIGHT UPPER QUADRANT
Liver right lobe
Gallbladder
Stomach pylorus
Duodenum parts 1to 3
Head of pancreas
Right suprarenal gland
Right kidney
Right colic flexure
Ascending colon superior part
Transverse colon right half
RIGHT LOWER QUADRANT
Cecum
Appendix
Most of ileum
Ascending colon inferior part
Right ovary
Right uterine tube
Right ureter
Right spermatic cord
Uterus if enlarged
Urinary bladder
LEFT UPPER QUADRANT
Liver left lobe
Spleen
Stomach
Jejunum and proximal ileum
Pancreas body and tail
Left kidney
Left suprarenal gland
Left colic flexure
Transverse colon left half
Descending colon superior part
LEFT LOWER QUADRANT
Sigmoid colon
Descending colon inferior part
Left ovary
Left uterine tube
Left ureter
Left spermatic cord
Uterus if enlarged
Urinary bladder if very full
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FIGURE 4

Abdominal Region Organs

Right hypochondria Right lobe of liver
Gallbladder
Right suprarenal gland
Right kidney
Right colic flexure
Left hypochondria Fundus and superior part of the greater
curvature of stomach
Spleen
Tail of pancreas
Left suprarenal gland
Left kidney
Left colic flexure
Epigastrium Left lobe of liver
Fundus of stomach
Head and body of pancreas
Duodenum
Parts of the transverse colon
Right lumbar region Ascending colon
Parts of the jejunum
Left lumbar region Descending colon
Parts of the jejunum
Umbilical region Jejunum
Ileum
Parts of the greater curvature of stomach
Parts of the transverse colon
Right iliac region Cecum
Appendix
Distal ileum
Hypogastrium Parts of jejunum
Parts of ileum
Bladder
Ureter
Parts of the sigmoid colon

TASTE TEST
Time- 9 seconds
Amylase is an enzyme in the saliva that will break-down starch to
sugar. As the individual chews on a saltine cracker, it takes nine seconds as
she began to taste the sweetness of the cracker. This is the time when
amylase acted upon the cracker to break down the starch in to glucose
sugar.

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LUGOL’S TEST

LUGOL' SOLUTION
DISTILLED LUGOL' COLORIMETRIC
TEST TUBE WATER BISCUIT CRACKER SOLUTION RESULT
1 5ML CRUSHED CRACKER 2-3 DROPS BLUE
2 5ML PARTIALLY DIGESTED 2-3 DROPS BROWN
3 5ML PARTIALLY DIGESTED 2-3 DROPS PURPLE

Lugol’s iodine (IKI) test for the presence of starch: Iodine dissolved in an
aqueous solution of potassium iodide – reacts with starch producing a deep
blue-black colour. This reaction is the result of the formation of polyiodide
chains from the reaction of starch and iodine.
In test tube 1 - A deep blue/black solution is present which indicates the
presence of starch in the solution
In test tube 3 – brown and purple colour, the change in colour indicates that
the starch is breakdown into sugars with the aid of salivary amylase
(hydrolysis)

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BENEDICT’S TEST

BENEDICT’S TEST
TEST DISTILLED BENEDICT’S COLORIMETRIC
BISCUIT CRACKER
TUBE WATER SOLUTION RESULT
1 5mL Crushed Cracker 5mL Blue
2 5mL Partially Digested 5mL Green
3 5mL Fully Digested 5mL Yellow

Benedict’s test is used to test for simple sugar. It identifies reducing

sugars (monosaccharide and some disaccharides), which have free ketone
or aldehyde functional group. Some sugars such as glucose are called
reducing sugars because they are capable of transferring hydrogen to other
compounds, a process called reduction. When reducing sugars are mixed
with Benedict ’s reagent and heated. A reduction reaction causes the
reagent to change in colour. The colour varies from green to dark red (brick)
or rusty-brown, depending on the amount of and type of sugar.
In test tube 1 the solution remains blue which indicates no maltose
present in the solution
In test tube 2 the solution has a greenish coloration which indicates
small amount of maltose is present.
In test tube 3 the solution has a yellowish coloration which indicates
moderate amount of maltose.

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 ANSWERS TO QUESTIONS

1. What are the mechanisms involve in digestion?

The processes of digestion include six activities: ingestion, propulsion,

mechanical or physical digestion, chemical digestion, absorption, and
defecation.
Ingestion, refers to the entry of food into the alimentary canal through
the mouth.
Food leaves the mouth when the tongue and pharyngeal muscles
propel it into the esophagus. This act of swallowing, the last voluntary act until
defecation, is an example of propulsion, which refers to the movement of
food through the digestive tract.
Mechanical digestion is a purely physical process that does not
change the chemical nature of the food. Instead, it makes the food smaller
to increase both surface area and mobility.
In chemical digestion, starting in the mouth, digestive secretions break
down complex food molecules into their chemical building blocks (for
example, proteins into separate amino acids).
Food that has been broken down is of no value to the body unless it
enters the bloodstream and its nutrients are put to work. This occurs through
the process of absorption, which takes place primarily within the small
intestine.
In defecation, the final step in digestion, undigested materials are
removed from the body as feces.

2. In theory, would lipase activity be active in the mouth and/or stomach?

Explain your answer.

Fats are digested by lipases that hydrolyze the glycerol fatty acid
bonds. Of particular importance in fat digestion and absorption are the bile
salts, which emulsify the fats to allow for their solution as micelles in the
chyme, and increase the surface area for the pancreatic lipases to operate.
Lipases are found in the mouth, the stomach, and the pancreas.
Because the lingual lipase is inactivated by stomach acid, it is formally
believed to be mainly present for oral hygiene and for its anti-bacterial effect
in the mouth. However, it can continue to operate on food stored in the
fundus of the stomach, and as much as 30% of the fats can be digested by
this lipase.
Gastric lipase is of little importance in humans. Pancreatic lipase
accounts for the majority of fat digestion and operates in conjunction with
the bile salts.

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3. How is swallowing initiated? Why it is called a reflex?

Swallowing, sometimes called deglutition is the process that allows for a

substance to pass from the mouth, to the pharynx, and into the esophagus,
while shutting the epiglottis.
Begins, with the compression of the bolus against the hard palate.
Subsequent retraction of the tongue then forces the bolus into the
oropharynx and assist in the elevation of the soft palate, thereby sealing off
the nasopharynx. Once the bolus enters the oropharynx, reflex responses
begin and the bolus is moved toward the stomach.
Swallowing is a complex mechanism using both skeletal muscle
(tongue) and smooth muscles of the pharynx and esophagus. The autonomic
nervous system (ANS) coordinates this process in the pharyngeal and
esophageal phases.
The swallowing reflex consists of afferent pathways, central integration,
and efferent pathways. Swallowing plays, not only an important role in food
digestion, but also a major role in preventing the entrance of food and/or
other materials into the lower respiratory tract. To achieve this, precise
coordination is necessary between breathing and swallowing since the
pharynx serves as a common pathway for both respiration and digestion.

4. Where does initial chemical digestion occur?

Chemical digestion occurs when acids, enzymes and other secretions

break down the food we eat into nutrients. Chemical digestion starts in the
mouth and continues in the stomach, but most of the process occurs in the
small intestine.

5. What are the organs involve in digestion? Explain.

ORGAN MAJOR FUNCTION MINOR FUNCTION

MOUTH  Ingests food  Moistens and dissolves food,
 Chews and mixes food allowing you to taste it
 Begins chemical breakdown  Cleans and lubricates the
of carbohydrates teeth and oral cavity
 Moves food into the pharynx  Has some antimicrobial
 Begins breakdown of lipids via activity
lingual lipase
PHARYNX  Propels food from the oral  Lubricates food and
cavity to the esophagus passageways
ESOPHAGUS  Propels food to the stomach  Lubricates food and
passageways
STOMACH  Mixes and churns food with  Stimulates protein-digesting
gastric juices to form chyme enzymes
 Begins chemical breakdown  Secretes intrinsic factor
of proteins required for vitamin
 Releases food into the B12absorption in small
duodenum as chyme intestine
 Absorbs some fat-soluble

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 substances (for example,
alcohol, aspirin)
 Possesses antimicrobial
functions
SMALL INTESTINE  Mixes chyme with digestive  Provides optimal medium for
juices enzymatic activity
 Propels food at a rate slow
enough for digestion and
absorption
 Absorbs breakdown products
of carbohydrates, proteins,
lipids, and nucleic acids,
along with vitamins, minerals,
and water
 Performs physical digestion via
segmentation
ACCESSORY  Liver: produces bile salts,  Bicarbonate-rich pancreatic
ORGANS which emulsify lipids, aiding juices help neutralize acidic
their digestion and absorption chyme and provide optimal
 Gallbladder: stores, environment for enzymatic
concentrates, and releases activity
bile
 Pancreas: produces digestive
enzymes and bicarbonate
LARGE INTESTINE  Further breaks down food  Food residue is concentrated
residues and temporarily stored prior
 Absorbs most residual water, to defecation
electrolytes, and vitamins  Mucus eases passage of
produced by enteric bacteria feces through colon
 Propels feces toward rectum
 Eliminates feces

6. Differentiate submucosal/ Meissner’s from Myenteric/ Auerbach’s plexus?

The Enteric Nervous system lies in the wall of the gut, beginning in the
esophagus and extending all the way to the anus. Also, controls the
gastrointestinal movement and secretions.

a. an outer plexus lying between the longitudinal and circular muscle

layers, called the myenteric plexus or the Auerbach plexus. Controls mainly
the gastrointestinal movements.
b. an inner plexus, called the submucosal plexus or the Meissner’s
plexus that lies in the submucosa. Controls mainly the gastrointestinal
secretion and local blood flow.

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7. During normal digestion and during vomiting, what are the basic motor
pattern of the following.

Pylorus Fundus
Digestion Peristaltic waves Relaxation (to tonic
(phasic pattern of contraction)
powerful contractions)
Vomiting Retrograde contraction Relaxation

8. Discuss how the stomach empty and the factors affecting it.

Volume of Ingested As volume increases initially an increase then a

Material decrease. Bulky material tends to empty more
slowly than liquids
Type of Meal Gastric emptying rate: carbohydrates > proteins
> fats
Temperature of Food Increase in temperature, increase in emptying
rate
Body Position Lying on the left side decreases emptying rate
and right side promotes it
Git PH Retarded at low stomach PH and promoted at
higher alkaline PH
Emotional state Anxiety promotes whereas depression retards it
Disease states gastric ulcer, hypothyroidism retards it, while
duodenal ulcer, hyperthyroidism promotes it.

9. what are the different cells found in the stomach/ duodenum/ pancreas /
liver and their function?

STOMACH a. Mucous neck cells - secretes mucus (protects

lining)
b. Parietal cells – secretes gastric acid (HCL),
intrinsic factor (calcium absorption)
c. Enterochromaffin like cell – secretes histamine
which stimulates acid secretion
d. Chief cells – secretes Pepsinogen and Gastri
lipase
e. D cells – secretes Somatostatin which inhibits
gastric acid secretion
f. G cells – secretes Gastrin which stimulates
gastric secretions
DUODENUM Brunner's glands, and the goblet cells in the
duodenum secrete mucus. The mucus secreted
by Brunner's glands is alkaline, and helps to
neutralize the acid chyme produced by the

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 stomach, to produce chyme with a pH suitable
for the digestive enzymes of the small intestine.
PANCREAS a. Acinar cells - exocrine cells that produce
digestive enzymes
b. Alpha cells - endocrine cell that produces
glucagon, raises blood glucose levels
c. Beta cells - endocrine cell that produces
insulin, lowers blood glucose levels
d. Delta cells - endocrine cell that produces
somatostatin, inhibits growth hormone release
e. PP cells - endocrine cell that produces
Pancreatic polypeptide, regulates digestive
secretion and motility
f. Epsilon cells - endocrine cell that produces
Ghrelin, orexigenic (appetite stimulant)
LIVER a. Hepatocytes – functional unit of the liver
b. Ito cells – store body's supply of vitamin A and
a variety of other lipids
c. Kupffer cells - specialized stellate
macrophages
d. Sinusoidal Endothelial cells – form the wall of
blood vessels (sinusoids)

10. Construct a flowchart indicating specific enzymes of digestion, their site of

production, and their site of action for each nutrient class.

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