Chapter 17 – Digestive system

• Digestion – mechanical ( larger to smaller

particles) and chemical ( complex to simple
chemicals) breakdown of foods into forms
that cells can absorb
 Digestive System
• DIGESTIVE TRACT – tube ~ 9 m long
• Gastrointestinal tract or Alimentary canal
• DIGESTIVE ORGANS - Oral cavity,
pharynx, esophagus, stomach, small
intestine, large intestine, anal canal
• ACCESSORY ORGANS - teeth, tongue,
salivary glands, liver, gallbladder, pancreas
 Digestive functions & processes
• FOUR FUNCTIONS
• 1. Ingestion – selective intake of nutrients
• 2. Digestion – breakdown of molecules;
mechanical & chemical
• 3. Absorption – uptake of nutrients by
digestive tract, blood & lymph
• 4. Defecation – elimination of undigested
residue
 Digestive Processes
• 1. Motility – muscle contractions
– Break up food – mastication, churning of
stomach
– Propel thru canal - peristalsis
– Mix with digestive enzymes - segmentation
• 2. Secretion – enzymes, hormones to carry
out or regulate digestion
• 3. Membrane transport – absorbing
nutrients to blood and lymph
 Stages of Digestion
• MECHANICAL DIGESTION
• Physical breakdown
• Teeth – cutting and grinding - mastication
–(chewing)
• Churning – stomach & small intestine
• Action of digestive enzymes – food to small
particles
• CHEMICAL DIGESTION
• Macromolecules to monomers
• Polysaccharides to monosaccharides
• Proteins to amino acids
• Fats to glycerol and fatty acids
• Nucleic acids to nucleotides
• Done by digestive enzymes produced by:
• Salivary glands, stomach, pancreas, small intestine
• Absorbed – no digestion – vitamins, free amino
acids, minerals, cholesterol, water
 Mouth
• Oral or Buccal cavity
• Receives food
• Begins mechanical digestion
• Ingestion, taste, mastication ( chewing),
chemical digestion( starch) , deglutition
( swallowing), speech , respiration
• Enclosed by cheeks, lips, palate, tongue
• Lined – non-keratinized stratified squamous
epithelium
 Cheeks & Lips
• Form lateral walls of mouth – skin, adipose,
muscles
• Retain food; mastication; Speech articulation
• Sucking and blowing actions
• SUPERIOR AND INFERIOR LABIAL
FRENULUM attaches lip to gum
• VESTIBULE – space between cheeks and lips,
external to teeth
• Lips – surround mouth opening; skeletal muscle
& sensory receptors – temperature & food texture
 Tongue
• Muscular, bulky, thick
• Manipulates food, moves food to pharynx
• Lingual papillae – bumps & projections,
taste buds, provides friction
• Lingual tonsils (lymphatic tissue) at root
which attaches to hyoid bone
• Lingual frenulum – membranous fold
attaches body to floor of mouth
 Palate Fig 17.7
• Separates oral cavity and nasal cavity
• Anterior – bony palate; Posterior – soft
palate; uvula(cone shaped projection)
• Palatine tonsils on each side of oral cavity
– swollen can block swallowing & breathing
– Protect body against infections
During swallowing soft palate rises to block nasal
cavity
Pharyngeal tonsils ( adenoids) – posterior wall –
pharynx; above soft palate
 Teeth
Fig 17.9; Table 17.2
• Called dentition; Adults – 32 teeth
• On each side of jaw –
– Incisors – 2 – chisel-like cutting
– Canines – 1 – puncture & shred
– Premolar – 2 & molar – 3 – crushing & grinding
• Children – 20 deciduous teeth
– Erupt 6 to 30 months
• Between 6 yrs and 25 yrs lost and replaced =
permanent teeth
• Wisdom teeth – 17 and 25 yrs
• Fig 17.10
• Alveolus – socket for tooth
• Alveolus lined with peridontal ligament –
anchors tooth
• Gingiva – gum covers alveolar bone
• Crown – tooth above gumline
• Neck – from gum to alveolar bone
• Root – in alveolus
• Dentin – hard, yellowish tissue; most of tooth
• Enamel – covers crown and neck
• Cementum – covers root
• Dentin & cementum – living; Enamel , not
• Internally – tooth –
• Pulp cavity – crown
• Root canal – root
• Contain pulp – loose connective tissue, blood &
lymphatic vessels, nerves

• Plaque  bacteria + sugars  acids dental

caries
• Plaque calcifies = tartar  gingivitis  peridontal
disease = 80 to 90 % adult tooth loss
• Includes Inflammation of gum & dental pulp
 Saliva
• Moistens mouth & food
• Digest some starch and fat
• Cleanses teeth
• Inhibits bacterial growth
• Stimulates taste buds
• Moistens food
• Binds food particles to aid swallowing
 Saliva
• Mostly water 97 to 99.5% pH = 6.8 to 7.0
• Solutes:
• Salivary amylase – begins starch digestion,
starch to disaccharides
• Lingual lipase – digest fats in stomach;
needs low pH
• Mucus – binds & lubricates food mass;
dissolves food chemicals
• Major Salivary Glands Fig 17.11
• EXTRINSIC SALIVARY GLANDS 1 –
1.5 liters of saliva /day
• Exocrine glands
• 1.PAROTID GLANDS – anterior &
inferior to ear
– clear, watery saliva & amylase
– Stenson’s duct – enters opposite 2nd upper
molar
• MUMPS – viral inflammation & swelling
• 2. SUBMANDIBULAR GLANDS - body
of mandible
• Secretes serous fluid – serous cells
• Wharton’s Ducts – open inferior to tongue
near frenulum
• 3. SUBLINGUAL GLANDS – floor of
mouth
– Multiple ducts posterior to submandibular duct
( Rivinus ducts)
– Mucous secretions – mucous cells – thick &
stringy
 Pharynx
• Connects nasal and oral cavities with larynx
& esophagus
• Divisions _ nasopharynx, oropharynx,
laryngopharynx Fig 17.7
• Superior, middle, inferior PHARYNGEAL
CONSTRICTORS – circular – force food
down during swallowing Fig 17.13
 Divisions
• Nasopharynx - air
– Most superior to soft palate
• Oropharynx - Food & air
– Posterior to mouth
– Soft palate to esophagus
• Laryngopharynx - food
– Esophagus to cricoid cartilage
– Passageway to esophagus;
 Wall of alimentary canal
• Four tissue layers Table 17.1
• 1. Mucosa or mucous membrane –
nonkeratinized stratified squamous
epithelium; underlying connective tissue,
smooth muscle
• Protection, secretion, absorption
• Folds & projections > absorptive surface
area
• Glands secrete mucus & enzymes
• 2. Submucosa – loose connective tissue,
vessels, nerve plexuses, esophageal glands
• Vessels nourish tissue & carry away
absorbed materials

• 3. Muscularis externa – inner layer –

circular; outer layer – longitudinal; provides
movement of tube
• 4. Adventitia ( above diaphragm ) or
Serosa ( below diaphragm)
• Connective tissue – adventitia
• Simple squamous mesothelium and areolar
tissue – serosa
• Visceral peritoneum – epithelium - outside,
connective tissue – inside
• Protects; secretes serous fluid – moistens
and lubricates
 Innervation of tube
• ENTERIC NERVOUS SYSTEM –
regulates motility, secretion, and blood flow
• Location – esophagus,stomach, intestines
• Two plexuses – submucosal & myenteric –
control motility and secretion
 Swallowing
• Deglutition
• Coordinated by SWALLOWING CENTER
in medulla oblongata & pons
• Three stages Fig. 17.14
• 1. buccal stage; voluntary; tongue collects
food; pressed against palate = bolus;
mastication; push back to oropharynx
• 2. Pharyngeal – esophageal phase – bolus
stimulates tactile receptors;
• Swallowing reflex
• A. Soft palate rises, blocks nasopharynx
• B. Root of tongue blocks oral cavity
• C. Larynx pulls up , epiglottis covers opening,
vestibular folds adduct and close airway
• Pharyngeal constrictors push bolus downward;
bolus into esophagus & triggers PERISTALSIS
• 3. Peristalsis
• wavelike muscular contraction, pushes food
down esophagus, no matter position of
body; occurs from pharynx to anus
• Liquid – 1-2 sec Bolus – 4 – 8 sec
• Esophagus

• Straight muscular tube 25 to 30 cm;

passageway for food
• Begins at cricoid cartilage
• Thru mediastinum
• Thru diaphragm – esophageal hiatus
• Meets stomach – cardiac orifice
• Cardiac orifice – muscular lower
esophageal sphincter to close off area
 Stomach
• Bolus reaches stomach – LOWER
ESOPHAGEAL SPHINCTER relaxes and
bolus enters.
• Muscular sac in LUQ , inferior to
diaphragm
• Mechanically breaks up food
• Chemical breakdown of proteins & fats
• Produces CHYME – soupy or pasty mixture
of semidigested food
 Parts of stomach
• J – shaped
• Regions of stomach:
• A.Cardiac region – immediately inside cardiac
orifice
• B.Fundus – dome shaped portion
• C.Body – greatest part inferior to cardiac orifice,
main part of stomach
• D.Pyloric region – inferior end pouch; antrum –
funnel like area narrows to pylorus which is
surrounded by pyloric sphincter – regulates
chyme into s.i.
 Stomach Wall
• Mucosa – simple columnar glandular
epithelium
• Mucosa & submucosa - flat and smooth
when stomach filled; longitudinal wrinkles
when empty = RUGAE
• Muscularis externa – Three layers –
– Outer – longitudinal
– Middle – circular
– Inner - oblique
• MUCOSA – gastric pits – depressions of
columnar epithelium
• Cell types include –
• Mucous cells – mucus - c & p glands;
gastric glands called mucous neck cells
• Regenerative cells – produce new cells ,
base of pit & neck of gland
• Parietal cells – upper half of gland, HCl &
Intrinsic Factor; most gastric glands, few
pyloric glands
• Chief cells – rennin & lipase – infancy;
pepsinogen throughout life; lower half
gastric glands, none in cardiac or pyloric
glands
• Enteroendocrine cells – lower end of
gland, chemical messengers to regulate
digestion
 Gastric Secretions
• 2-3- liters gastric juice/day
• Hydrochloric Acid – parietal cells
• Gastric juice pH = .8
• To keep stomach from being “burned’ by acid
• Parietal cells take carbon dioxide from blood &
combine with water ( carbonic anhydrase) 
carbonic acid
• Carbonic acid  bicarbonate ion + Hydrogen ion
• Hydrogen ion pumped into lumen of stomach &
exchanged for K by H-K ATP ase
• Bicarbonate ion returns to blood and
exchanged for a Cl ion which enters lumen
• H ion + Cl ion  HCl
• HCl accumulates in stomach & bicarbonate
ions accumulate in blood
• pH > in blood leaving stomach when
digestion is occurring – called ALKALINE
TIDE
 Stomach acid functions
• Activates pepsin & lingual lipase (enzymes)
• Breaks up connective tissue & plant cell
walls
• Converts Fe ions to usable form for
hemoglobin synthesis
• Destroys ingested bacteria & other
pathogens
 Intrinsic Factor
• From parietal cells
• Essential in absorption of vitamin B12 by
small intestine
• No vitamin B 12 – no hemoglobin –
pernicious anemia
• Pernicious anemia risk > age d/t atrophy of
gastric mucosa
 Pepsin
• Zymogens – inactive proteins ( enzymes),
general term
• Chief cells – pepsinogen
• HCl – parietal cells – converts pepsinogen
to pepsin
• Pepsin digests proteins to shorter peptide
chains – digest complete in duodenum
 Chemical messengers
• Gastric and pyloric glands –
enteroendocrine cells – hormones (20)
• Some secretions –stimulate gastric mucosa
within short distance
• Some act neurotransmitters – produced by
neurons
• Ex. Gastrin, serotonin, histamine,
somatostatin Table 25.2
 Gastric Motility
• Swallowing signals stomach to relax –
signals from swallowing center of M.O.
• Arrival of food stretches stomach -
activates receptive – relaxation response –
stomach briefly resists stretching , then
relaxes to accommodate more food
• Peristaltic contractions - churn food, mix
with gastric juice, which promotes physical
breakup & chemical digestion
• ~3 ml of chyme enters duodenum at a time
• Duodenum neutralizes stomach acid &
digests nutrients
• Meal is emptied from stomach ~ 4 hours
• Less time – more liquid
• More time – more fat
 Protection of Stomach
• 1. Mucous coat – thick, highly alkaline
• 2. Epithelial cell replacement – replaced
rapidly – 3 to 6 days
• 3. Tight junctions – keep gastric juices
from seeping between epithelial cells
 Gastric functions
• Gastric juices are produced continuously;
rates vary; neural and hormonal control
• Parietal cells secrete somatostatin - inhibits
gastric secretions
• ACh from parasympathetic impulses
suppress SS and stimulate gastric
secretions – HCL & pepsinogen
• Stomach cells – pyloric region – release
gastrin ( peptide hormone) - > gastric gland
activity
• Parasympathetic impulses & gastrin cause
release of histamine ( gastric mucosal cells)
which stimulate additional gastric secretions
Fig 17.21
• Gastrin – hormone produced in pyloric
glands; bloodstream; cause release of HCl
by parietal cells and pepsinogen by chief
cells
 Regulation of Gastric function
• Three stages
• 1. CEPHALIC PHASE
• M.O. signals stomach by vagus nerve >
gastric secretions & motility
• Sight, small, taste thought of food =
stimulus
• Gastric secretions stimulated before food is
swallowed
• 2. GASTRIC PHASE
• Swallowed food & semi-digested proteins
activate gastric activity
• 2/3 of gastric secretions occur now
• Stretching of stomach & raising pH of
contents  stimulates gastric activity
• Gastric secretions is stimulated by –
acetylcholine, histamine, gastrin
• As protein is digested , more gastrin
secreted ( positive feedback system ) ,
protein digestion accelerated
• Below pH = 2 stomach acid inhibits parietal
cells– negative feedback loop
• And gastric phase ends as the need for
pepsin and HCl <
• 3. INTESTINAL PHASE
• Duodenum receives chyme
• reflex - stimulate stomach and enhances gastric
secretions
• Acid & semidigested fats – duodenum –
ENTEROGASTRIC REFLEX –inhibit stomach
• Chyme causes enteroendocrine cells of duodenum
to release secretin, gastric inhibitory peptide, &
cholecystokinin to suppress gastric secretions &
motility
• Duodenum can now process chyme already
received
 Gastric absorption
• Gastric enzymes ( pepsin) breaksdown
proteins
• Limited absorption – only water, salts, some
lipid soluble drugs, alcohol
• Most absorption – small intestines
 Mixing and emptying actions
• Food enters stomach; Smooth muscles
stretch
• Too much food – Stomachache C.A. 17.2
• Mixing movements of stomach wall
produces semi-fluid paste = chyme
• 5-15 ml moves into S. I. when pyloric
sphincter relaxes
• Lower esophageal sphincter prevents reflux
of stomach contents into esophagus Fig
17.22
• Rate of stomach emptying – fluidity & type
of food
• Liquids
• Carbohydrates
• Proteins
• Fats
• Chyme fills duodenum; > intestinal
pressure; intestinal wall stretches
• Enterogastric Reflex Fig 17.23
• Begins – intestine; ends – stomach
• < parasympathetic impulses; peristalsis
inhibited; < intestine filling
• Chyme – fatty – CCK released – inhibit
peristalsis
• Chyme enters duodenum – pancreas, liver,
gall bladder add secretions
• VOMITING
Excess stretch of stomach
• Psychological stimuli
• Chemical irritants
– Alcohol
– Bacterial toxins
• Emetic center – in m.o. causes lower
esophageal sphincter to relax , diaphragm &
abdominal muscles contract and stomach
contents are expelled
• Severe vomiting = contents of s.i. expelled
 Liver, Gallbladder, Pancreas
• LIVER
• Reddish, brown gland, inferior to diaphragm,
largest gland
• Secretes bile
• GROSS ANATOMY –four lobes – right , left,
caudate, quadrate
• Left and right lobe separated by falciform
ligament
• Round ligament – reminant of umbilical vein
 Microscopic anatomy
• Hepatic lobules – tiny cylinders make up interior
of liver; functional units of liver
• Lobule – central vein; surrounded by radiating
sheets of cuboidal cells – hepatocytes
• Between plates of hepatocytes – blood filled
channels – hepatic sinusoids
• Blood filtering between hepatocytes comes from
intestines
• Sinusoids – Kupffer cells – hepatic macrophages;
removes bacteria & debris from blood
• Hepatic triad – 3 or more lobules meet ;
contains 2 blood vessels and 1 bile duct
• After filtering thru sinusoids blood collects
in central vein
• Flows into L & R hepatic veins and enters
inferior vena cava
• Bile canaliculi - narrow channels between
sheets of hepatocytes ; liver secretes bile
here
• Bile passes into bile ductules of triads &
into R & L hepatic ducts
• Hepatic ducts merge  Common hepatic
duct
• Common hepatic duct + Cystic duct from
gallbladder join  Bile duct
• Bile duct joins Pancreatic duct at
Hepatopancreatic ampulla and enters
duodenum
• Hepatopancreatic sphincter regulates
passage of bile and pancreatic juices into
duodenum
 Gallbladder & Bile
• Sac on underside of liver
• Stores and concentrates bile
• Bile – yellow – green fluid
• Contains minerals, cholesterol, neutral fats,
phospholipids, bile pigments, bile acids (salts)
• Bile salts aid in digestion of fats
• Excessively concentrated = gallstones
• 80% bile salts recycled
• 20% bile – excreted in feces
 Pancreas
• Spongy gland – retroperitoneal
• Posterior to stomach
• Endocrine & exocrine function
• Exocrine cells – acinar cells produce 1200
to 1500 ml pancreatic juice /day
• Pancreatic duct delivers juices to duodenum
• At hepatopancreatic ampulla
 Pancreatic juices
• Water
• Enzymes – pancreatic amylase, pancreatic lipase,
nucleases
• Zymogens – trypsinogen, chymotrypsinogen,
procarboxypeptidase( intestinal lumen -
trypsinogen activated to trypsin by enterokinase ;
trypsin converts chymotrypsinogen 
chymotrypsin and procarboxypeptidase 
carboxypeptidase = protein digestion)
• Sodium bicarbonate – buffers HCl from stomach
 Secretion Regulation
• Bile & pancreatic juices secreted –
parasympathetic and inhibited by
sympathetic; stimulated by gastrin, CCK,
secretin
• Acid & fat enter duodenum – CCK secreted
– gallbladder contracts – bile; pancreatic
enzymes secreted; h-p sphincter relaxes
• Chyme – duodenum – secretes secretin –
hepatic bile ducts& pancreatic ducts secrete
bicarbonate to neutralize acid in duodenum
 Small Intestine
• Nearly all chemical digestion & nutrient
absorption occurs here
• Longest part of digestive tract
• Circular folds of mucosa , villi, and
microvilli – enhance surface area for
absorption of nutrients
 Gross anatomy
• Three regions: Fig 17.33
• Duodenum - first 25 cm
• Jejunum – next 2.5 m
• Ileum – last 3.6 m ; ends at ileocecal
junction – joins cecum of large intestine
 Microscopic anatomy
• Largest folds – circular folds – mucosa &
submucosa – plicae circularis
• From duodenum to middle ileum – mixing
& nutrient absorption
• Mucosa – projections – villi – largest in
duodenum & get smaller – covered by
absorptive cells and goblet cells
• Core of villus – arteriole, capillary, venule,
lacteal
• Absorptive cells of villus – microvilli –
making a brush border of small intestine - >
absorptive area & contains enzymes –
enterokinase and enzymes that need chyme
to touch brush border ( contact digestion)
• Duodenal glands – secrete bicarbonate rich
mucus
 Intestinal motility
• 1. Mixes chyme with intestinal juices, bile,
pancreatic juice
• 2. Churn chyme, aide contact digestion and
absorption
• 3. Moves residue into large intestine
• SEGMENTATION – kneads and churns
contents; mixes food & digestive
secretions; enhances contact digestion
• When most nutrients absorbed,
segmentation declines and peristalsis begins
• Food in stomach triggers release of gastrin
and GASTROILEAL REFLEX - both
enhance segmentation in ileum and
relaxation of ileocecal valve
• CARBOHYDRATES – begin in mouth;
completed in S.I.; enters blood by active
transport or facilitated diffusion
• Glucose – main sugar; galactose; fructose
• PROTEINS – begin in stomach; completed
in S. I. ;facilitated diffusion – capillaries
• Enzymes of pancreas most important in
digestion
• LIPIDS – lipases; lingual & pancreatic
• EMULSIFICATION – Bile salts & lecithin
• Break up large fat globules to droplets and
pancreatic lipases act on droplets
• Triglycerides are coated with bile salts and
form droplets called MICELLES which
pass into absorptive cells
• FFA’s & monoglycerides reform
triglycerides - golgi complex coats
triglycerides = CHYLOMICRONS – enter
lacteal of villus
• NUCLEIC ACIDS – decompose to phosphate
ions, nitrogenous bases and sugars ( DNA or
RNA); Enter capillary
• VITAMINS – Fat soluble vitamins – D, E, A, K
enter as all lipids do; need fat containing food
present to aid in absorption
• Water soluble – B complex & vitamin C – simple
diffusion; B12 – must be bound to intrinsic factor
& taken up by receptor mediated endocytosis in
distal ileum
• MINERALS – electrolytes; active transport &
simple diffusion
WATER – 9 L. - 8 L. reabsorbed by s.I. And .8 L
by L.I.; .2 L voided
Water is absorbed by osmosis

Diarrhea – L.I. Absorbs too little water d/t

intestinal irritation or high solute concentration

Constipation - fecal movement moves too

slowly; too much water reabsorbed d/t lack of
fiber or exercise; emotional upset; long – term
laxative abuse
 Large intestine
• 1.5 m long
• Cecum – blind pouch in LRQ
• Vermiform appendix – blind tube at lower end of
cecum
• Ascending colon – ileocecal valve , along right
side of abdominal cavity
• Right colic ( hepatic ) flexure – right angle turn
near right lobe of liver
• Transverse colon – across upper abdominal
cavity,
• Left colic (splenic) flexure – right angle turn
downward near spleen
• Descending colon – down left side of abdominal
cavity
• Sigmoid colon – S-shaped portion
• Rectum – in pelvic cavity; stores feces
• Anal canal – mucosa forms anal columns,
• Distension of veins in this area =
HEMORRHOIDS
• Anal canal terminates at ANUS
• Anus – two sphincters – internal anal sphincter (
smooth muscle) & external anal sphincter
( skeletal muscle)
 Microscopic Anatomy
• Mucosa of large intestine = simple
columnar epithelium except anal canal =
nonkeratinized stratified squamous
epithelium
• No circular folds
• No villi
 Bacterial flora & Intestinal Gas
• Bacterial flora
• Ferment cellulose
• Synthesize vitamin B & K

• Flatus – 500 ml / day = gas

• N, CO2, H, methane, H2S, two amines –
indole & skatole
 Absorption & Motility
• Reabsorbs water and electrolytes
• Mass movements – 1-3 times per day; after
a meal in transverse and sigmoid colon,
moving residue to rectum
 Defecation
• Stretching of rectum stimulates defecation reflexes
• Intrinsic defecation reflex – stretch signals
• Transmit impulses to spinal cord
• Spinal reflex causes contraction of rectum and
relaxation of internal anal sphincter
• Relaxation of external anal sphincter is under
voluntary control & can be suppressed
• With relaxation of the external anal sphincter,
fecal material can pass to the outside