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Prof.FerdinandP.Kionisala,MD.,FPSGS.,FPCS
TrainingOfficer
DepartmentofSurgery
Components of
the Digestive System
Digestive Tract
Gastrointestinal
(GI) tract or
alimentary canal
Is a muscular tube
Extends from oral
cavity to anus
2. Mechanical processing:
3. Digestion:
4. Secretion:
5. Absorption:
6. Excretion:
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
Peritoneal Fluid
Mesenteries
Figure 242c, d
Mesenteries
Are double sheets of
peritoneal membrane
Suspend portions of
digestive tract within
peritoneal cavity by
sheets of serous
membrane:
that connect parietal
peritoneum
with visceral
peritoneum
Mesenteries
Areolar tissue
between
mesothelial
surfaces
Prevent intestines
from becoming
entangled
mucosa
submucosa
muscularis externa
serosa
The Mucosa
Is the inner lining of digestive tract
Is a mucous membrane consisting of:
epithelium, moistened by glandular
secretions
mechanical stresses
lined by stratified squamous epithelium
Lining of Digestive
Tract
Folding increases
surface area for
absorption:
1. longitudinal folds,
disappear as digestive
tract fills
2. permanent transverse
folds (plicae)
Muscularis Mucosae
Narrow band of smooth
muscle and elastic
fibers in lamina
propria
Smooth muscle cells
arranged in 2
concentric layers:
The Submucosa
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
Muscularis
Externa Structure
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
Smooth Muscle
Along digestive tract:
has rhythmic cycles of activity
controlled by pacesetter cells
Pacesetter Cells
Located in
muscularis mucosae
and muscularis
externa:
surrounding lumen of
digestive tract
Peristalsis
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
Figure 244
Peristaltic Motion
1. Circular muscles contract behind bolus:
Segmentation
Cycles of contraction:
Churn and fragment bolus
mix contents with intestinal secretions
Neural Mechanisms
Control:
movement of
materials along
digestive tract
secretory functions
Motor neurons:
control smooth
muscle contraction
and glandular
secretion
located in
myenteric plexus
Are peptides
Are produced by enteroendocrine cells in
digestive tract
Reach target organs after distribution in
bloodstream
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
Figure 246
Limited digestion:
of carbohydrates and lipids
Sensory analysis:
of material before swallowing
Mechanical processing:
through actions of teeth, tongue, and palatal
surfaces
Oral Mucosa
Lining of oral cavity
Has stratified squamous epithelium
Labia
Also called lips
Anteriorly, the mucosa of each cheek is
continuous with that of the lips
Vestibule
Space between the cheeks (or lips) and the
teeth
Gingivae (Gums)
Is formed by:
Hard Palate
Raphe
Prominent central ridge
Extends along midline of hard palate
Mucosae
Soft Palate
Uvula
A dangling process
Helps prevent food from entering pharynx
prematurely
Is supported by posterior margin of soft palate
Tonsil
The Tongue
4
Functions
of
the
Tongue
Mechanical processing:
Lingual Papillae
Circumvallate Papillae
In the oropharynx
A V-shaped line
Rough boundary between body and root of
tongue
Lingual Frenulum
Sublingual Glands
Small glands extend into underlying lamina
propria
Secretions flush tongues epithelium
Contain water, mucins, and enzyme lingual
lipase
Salivary Glands
99.4% water
0.6% includes:
Saliva
4 Functions of Saliva
1. Lubricating the mouth
2. Moistening and lubricating materials in the mouth
Teeth
Figure 248
The Teeth
Tooth Structure
Pulp cavity:
receives blood vessels and nerves through the root
canal
Root Canal
A narrow tunnel
located at root
of tooth
Blood vessels and
nerves enter root
canal through
apical foramen
to supply pulp
cavity
The Root
The Neck
Of the tooth
marks boundary
between root and
crown
The Crown
Exposed portion of
tooth
Projects beyond
soft tissue of
gingiva
Dentin covered by
layer of enamel
Gingival Sulcus
A shallow groove
surrounding the
neck of each
tooth
Dental Arches
Contain 4 types of teeth:
1.
2.
3.
4.
incisors
cuspids (canines)
bicuspids (premolars)
molars
Incisors
Blade-shaped teeth
Located at front of mouth
Used for clipping or cutting
Have a single root
Cuspids (Canines)
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
Primary and
Secondary Dentitions
Figure 249
Dental Succession
Deciduous Teeth
Permanent Dentition
Mastication
Muscles of Mastication
Nasopharynx
Oropharynx
Laryngopharynx
Food passes through oropharynx and
laryngopharynx to esophagus
The Esophagus
Figure 2411
Swallowing
Pharyngeal
Bolus contacts:
palatoglossal arches
palatopharyngeal arches
posterior pharyngeal wall
Esophogeal
Stomach
4 Functions of the Stomach
1. Storage of ingested food
2. Mechanical breakdown of ingested food
3. Disruption of chemical bonds in food
material:
The Stomach
Figure 2412a
Cardia
Fundus
Body
Pylorus
Smooth Muscle
Muscularis
mucosae and
muscularis
externa:
contain extra
layers of
smooth
muscle cells
in addition to
circular and
longitudinal
layers
Are shallow
depressions that
open onto the
gastric surface
Mucous cells:
at base, or neck,
of each gastric pit
actively divide,
replacing
superficial cells
Figure 2413
Gastric Glands
In fundus and body of stomach:
extend deep into underlying lamina propria
Pancreas:
digestive enzymes
buffers
Liver:
Bile
Produced in liver
Figure 2416
The Duodenum
The Jejunum
The Ileum
The final segment of small intestine
3.5 meters (11.48 ft) long
Plicae
Intestinal Villi
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
The Duodenum
Intestinal Secretions
Intestinal Movements
Chyme arrives in duodenum
Weak peristaltic contractions move it slowly
toward jejunum
The Pancreas
Figure 2418
The Pancreas
Body:
slender
extends toward spleen
Tail:
short and rounded
Duct of Wirsung
Large pancreatic duct
Delivers digestive enzymes and buffers
to duodenum
Duodenal Ampulla
of pancreatic islets
secrete insulin and glucagon into bloodstream
2. Exocrine cells:
acinar cells
epithelial cells of duct system
Pancreatic Secretions
Pancreatic Enzymes
Pancreatic alpha-amylase:
a carbohydrase
breaks down starches
similar to salivary amylase
Pancreatic lipase:
breaks down complex lipids
releases products (e.g., fatty acids) that are easily
absorbed
Nucleases:
Proteolytic enzymes:
break certain proteins apart
proteases break large protein complexes
peptidases break small peptides into amino acids
Proteolytic Enzymes
70% of all pancreatic enzyme
production
Secreted as inactive proenzymes
Activated after reaching small
intestine
The Liver
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
On anterior surface
Divides left lobe and right lobe
Bile Canaliculi
Bile Flow
From common hepatic duct to either:
the common bile duct, which empties into
duodenal ampulla
the cystic duct, which leads to gallbladder
Metabolic Regulation
Carbohydrate metabolism
Lipid metabolism
Amino acid metabolism
Waste product removal
Vitamin storage
Mineral storage
Drug inactivation
Functions of Bile
The Gallbladder
Receives:
The Gallbladder
Stores bile
Releases bile into duodenum:
only under stimulation of hormone
cholecystokinin (CCK)
Gallstones
Activities of Major
Digestive Tract Hormones
Figure 2422
Intestinal Hormones
Intestinal tract secretes peptide
hormones with multiple effects:
in several regions of digestive tract
in accessory glandular organs
Secretin
Cholecystokinin (CCK)
Is secreted in duodenum:
Cholecystokinin (CCK)
Relaxes hepatopancreatic sphincter and
gallbladder:
ejecting bile and pancreatic juice into duodenum
Gastrin
Intestinal Absorption
2. Colon:
3. Rectum:
the last 15 cm of
digestive tract
The Ileum
Attaches to the
medial surface of
cecum
Opens into the cecum
at the ileocecal valve
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 appendix to ileum and
cecum
The Colon
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
teardrop-shaped
sacs of fat:
fatty appendices or
epiploic
appendages
4 Colon Regions
1. Ascending colon
2. Transverse
colon
3. Descending
colon
4. Sigmoid colon
The Rectum
The Anus
Anal Sphincters
Internal anal sphincter:
circular muscle layer of muscularis externa
has smooth muscle cells, not under
voluntary control
a fat-soluble vitamin
required by liver for synthesizing 4 clotting
factors, including prothrombin
2. Biotin:
a water-soluble vitamin
important in glucose metabolism
3. Pantothenic acid:
a water-soluble vitamin
required in manufacture of steroid
hormones and some neurotransmitters
Organic Wastes
Bacteria convert bilirubin to urobilinogens and
stercobilinogens:
Bacteria break down peptides in feces and
generate:
ammonia:
as soluble ammonium ions
hydrogen sulfide:
gas that produces rotten egg odor
Figure 2426
Processing Nutrients
The digestive system:
breaks down physical structure of food
disassembles component molecules
Digestive Enzymes
Are secreted by:
salivary glands
tongue
stomach
pancreas
proteases:
break bonds between amino acids
lipases:
separate fatty acids from glycerides