DIGESTIVE SYSTEM
ANATOMY TWO PARTS OF DIGESTIVE SYSTEM
1.) ALIMENTARY CANAL/TRACT
DIGESTIVE SYSTEM Alimentary means “nourishment”
The system involved in the breaking down Length: 5-7 m (16.5-23 ft)
of food Cadaver: 7-9 m (23-29.5 ft)
Gastroenterology: deals with the structure, Mouth – for mastication and
function, diagnosis and treatment of insalivation of food
diseases of the stomach and intestine Pharynx – organ of swallowing
Proctology: deals with diagnosis and Esophagus – organ of swallowing
treatment of disorders of the rectum and Stomach – where digestive process
anus begins
Small intestine – where digestive
FUNCTIONS OF DIGESTIVE SYSTEM process complete
Breaking down of food Large intestine – organ of egestion and
Absorption of water, vitamins and minerals water absorption
Elimination of waste products 2.) ACCESSORY GLANDS
Teeth – aid in physical breakdown of
SIX BASIC PROCESSES foods
Ingestion – taking of foods and liquids into Tongue – assists in chewing and
the mouth (eating) swallowing
Secretion – release of water, acid, buffers Salivary glands – produce saliva
and enzymes into the lumen of the GI tract Liver – produces bile
o Total: 7 L Gall bladder – stores bile
Mixing and propulsion – churning and Pancreas – produces pancreatic juices
propulsion of food through GI tract General: they secrete digestive enzymes
o Motility: capability of the GI tract to into the alimentary canal
mix and move material along its
length
MOUTH
Digestion – mechanical and chemical Oral or buccal cavity
processes break down of ingested food
Formed by: cheeks, hard and soft palate
o Mechanical: teeth cut and grind
and tongue
food
Lips/labia: fleshy folds
o Chemical: digestive enzymes
Labial frenulum: folds of mucous
produced by accessory glands
membrane; b/n inner surface of lip and gums
Absorption – passage of digested products
Oral vestibule: space bounded by
from the GI tract into blood and lymph
o Cheeks and lips (externally)
Defecation – the elimination of feces in the
o Gums and teeth (internally)
GI tract
Oral cavity proper: space from gums and
o Feces: the eliminated material
teeth to fauces
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DIGESTIVE SYSTEM
Fauces: opening b/n oral cavity and Gingivae: gums
oropharynx (throat) Three major external regions:
Palate: wall/septum o Crown – visible portion above the
o Separates oral cavity from nasal gums
cavity o Root – embedded in the socket
Hard palate: anterior portion of roof of the o Neck – constricted junction of crown
mouth and root
Soft palate: posterior portion of roof of the Dentin: forms majority of the tooth
mouth (internally)
Uvula (little grape): conical muscular o Gives tooth its shape and rigidity
process o Harder than bone
o Function: helps prevent foods and Rationale: contains 70% of
liquids from entering the nasal cavity calcium salts
during swallowing Enamel: covered the dentin of the crown
Two muscular folds: o Hardest substance in the body
o Palatoglossal arch Rationale: contains 90% of
Anteriorly calcium salts
Side of the base of the tongue o Protects the tooth from wear and tear
o Palatopharyngeal arch o Protects tooth from acid
Posteriorly Cementum: covered the dentin of the root
Side of the pharynx Pulp cavity: space within the crown
Tongue: forms the floor of oral cavity o Contains pulp
o Lingual frenulum: Root canals: narrow extension of pulp
Folds of mucous membrane cavity
Attached to floor of the Apical foramen: opening at the base of root
mouth canal
Aids in limiting the Endodontics: prevention, diagnosis, and
movement of tongue treatment of disease affecting pulp, root,
posteriorly periodontal ligament and alveolar bone
o Ankyloglossia: abnormally short or Orthodontics: prevention and correction of
rigid lingual frenulum abnormally aligned teeth
o Papillae: nipple-shaped projections Periodontics: treatment of abnormal
Contains taste buds conditions of tissues surrounding the teeth
o Taste buds: the receptor for Two dentition/sets of teeth:
gustation (taste) o Deciduous teeth
o Lingual glands: secrete mucus and Decidu = “falling out”
water serous fluid Primary, milk, or baby teeth
Enzyme: lingual lipase 20 teeth
Appear: 6 months old
TEETH/DENTES Lost: 6-12 y/o
Accessory digestive organs o Permanent teeth
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DIGESTIVE SYSTEM
Secondary teeth FOUR LAYERS OF ESOPHAGUS
32 teeth From deep to superficial
Appear: 6 y/o or adulthood 1.) MUCOSA
First premolar (bicuspids): Contains mucous glands
For crushing and Layers: epithelium, lamina propia,
grinding muscularis mucosae
Appear: 9-10 y/o Epithelium layer:
Second premolar o Stratified squamous epithelium:
(bicuspid): serves a protective function against
For crushing and wear-and-tear from food particles
grinding Lamina propria:
Appear: 10-12 y/o Muscularis mucosae: smooth muscle fibers
Permanent molars: 2.) SUBMUCOSA
1st molar – 6-7 y/o Contains areolar connective tissue, blood
2nd molar – 12-13 y/o vessels and mucous glands
3rd molar – 17-21 y/o 3.) MUSCULARIS
or not at all Superior third: skeletal muscle
Intermediate third: skeletal and smooth
ESOPHAGUS muscles
Long muscular tube Two sphincters:
Carries food and saliva (laryngopharynx to o Upper esophageal sphincter
the stomach) (UES): skeletal muscle (voluntary)
Physiology: Regulates movement of food
o Secretes mucus from pharynx into esophagus
o Transports food into stomach o Lower esophageal sphincter
o Does not produce digestive enzymes (LES): smooth muscle (involuntary)
o Does not carry on absorption Regulates movement of food
Length: 10 in. from esophagus into stomach
Diameter: ¾ in. (1.9 cm) 4.) ADVENTITIA (not serosa)
Level: C6-T11 Superficial layer of esophagus
Location: Attaches the esophagus to the surrounding
o Anterior to the vertebral bodies structures
o Posterior to the trachea and heart
Esophagastric junction: T11 PHARYNX
Cardiac antrum: expanded portion of the Funnel-shaped tube
terminal esophagus Location: internal nares to esophagus
Three parts:
o Nasopharynx – respiratory function
only
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DIGESTIVE SYSTEM
o Oropharynx – both respiratory and o Left hypochondriac region
digestive functions Four main regions:
o Laryngopharynx – both respiratory o Cardia – surrounds esophageal
and digestive functions opening
o Fundus – superior portion of the
DEGLUTITION stomach
Act of swallowing Upright: filled with gas
Three phases: bubbles/magenblase
o Voluntary stage – bolus passed into o Body – large central portion; inferior
oropharynx to fundus
o Pharyngeal stage – involuntary o Pyloric portion – distal portion of the
passage of bolus from pharynx to stomach
esophagus Pyloric antrum
o Esophageal stage – involuntary Pyloric canal
passage of bolus from esophagus to Curvatures:
stomach o Lesser curvature
Deglutition center: Right border of the stomach
o Medulla oblongata Level: esophagastric junction
o Lower pons of brain stem to pylorus
o Greater curvature
STOMACH Left and inferior border of
Most distensible part of GI tract the stomach
Shapes: J-shaped or large sausage (when Level: cardiac notch to
empty) pylorus
Functions: Length: 4-5 times longer
o Mixes saliva, food, and gastric juice than lesser curvature
to form chime Cardiac orifice: opening b/n esophagus and
o Serves as a reservoir for food before stomach
release into small intestine Cardiac sphincter: muscle that controls
o Secretes gastric juice, opening of cardiac orifice
HCl – kills bacteria and Pyloric orifice: opening b/n stomach and
denatures protein) small intestine
Pepsin – begins the digestion Pyloric sphincter: muscle that controls
of proteins opening of pyloric orifice
Intrinsic factor – aids
absorption of vitamin B12) FOUR LAYERS OF THE STOMACH
Gastric lipase – aids digestion From deep to superficial
of triglycerides 1.) MUCOSA
o Secretes gastrin into blood Inner lining of the GI tract
Location: Cell renewal rate: rapid (5-7 days)
o Inferior to diaphragm
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DIGESTIVE SYSTEM
Layers: epithelium, lamina propia, Skeletal muscle (voluntary):
muscularis mucosae o muscularis of mouth, pharynx,
Epithelium layer: superior and middle parts of
o Stratified squamous epithelium: esophagus – produces voluntary
serves a protective function swallowing
o Simple columnar epithelium: for o external anal sphincter – voluntary
secretion and absorption control of defecation
o Gastic glands: columns of secretory Smooth muscle (involuntary):
cells o Inner sheets – circular fibers
o Mucous neck cells: secretes mucus o Outer sheets – longitudinal fibers
o Parietal cells: produce intrinsic o Functions: break down, mix and
factor (needed for absorption of propel foods
Vitamin B12) & HCl 4.) SEROSA
o Chief cells: secrete pepsinogen and Superficial layer
gastric lipase Composed of:
o G-cell (in pyloric antrum): o Simple squamous epithelium
secretes gastrin (mesothelium)
o Gastric juices: 2000-3000 mL/day o Areolar connective tissue
(2-3 qt/day) Other name: visceral peritoneum
o Gastric pits: narrow channel at the Esophagus: no serosa
bottom of gastric glands o Adventitia – its superficial layer (not
Lamina propria: serosa)
o Connective tissue layer
o Contains many blood and lymphatic PANCREAS
vessels Pan = “all”; creas = “flesh”
o Contains MALT (mucosa-associated Retroperitoneal organ
lymphatic tissue) Length: 12-15 cm (5-6 in.)
Protection against disease
Thickness: 2.5 cm (1 in.)
Muscularis mucosae: smooth muscle fibers Location: posterior to greater curvature of
2.) SUBMUCOSA stomach
Contains many blood and lymphatic vessels
Consists of:
Received absorbed food molecules o Head – expanded portion
Contains submucosal plexus (plexus of o Body – central portion
Meissner) o Tail – tapered end
3.) MUSCULARIS Exocrine cells: secretes pancreatic juices
Three smooth muscle layers Pancreatic duct: duct of Wirsung
o Longitudinal layer Accessory pancreatic duct: duct of
o Middle layer Santorini
o Inner oblique layer
Hepatopancreatic ampulla: ampulla of
Contains myenteric plexus (plexus of Vater
Auerbach)
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DIGESTIVE SYSTEM
o Opens on major duodenal papilla LIVER
Sphincter of Oddi: sphincter of Heaviest gland
hepatopancreatic ampula Largest internal organ
Acini: clusters of glandular epithelial cells Second largest organ
o Secretes fluid and digestive enzymes Skin: largest organ in the body
o Pancreatic juice – 99% Weight: 1.4 kg (3 lb)
1200-1500 mL/day (1.2-1.5 Functions:
qt/day) o Carbohydrate metabolism
o Pancreatic islets (islets of o Lipid metabolism
Langerhans) – 1% o Protein metabolism
Secretes glucagon, insulin, o Processing of drugs and hormones
somatostatin & pancreatic Detoxification
polypeptide Chemically alter or excrete
Enzymes in pancreatic juice: thyroid hormone & steroid
o Pancreatic amylase – starch- hormones (estrogen &
digesting enzymes aldosterone)
o Trypsin, chymotrypsin, o Excretion of bilibrubin
carboxypeptidase, elastase – o Synthesized bile salts
protein-digesting enzymes o Storage site of vitamins
o Pancreatic lipase – principal Glycogen
tryglycerides-digesting enzymes in ADEK & B12
adults Iron and copper (minerals)
o Ribonuclease & deoxyribonuclease – o Phagocytosis – Kupffer cells
nucleic acid-digesting enzymes o Activation of Vitamin D
Same as skin and kidneys
DUCT CARRYING BILE FROM LIVER AND Two principal lobes:
GALLBLADDER AND PANCREATIC JUICE o Right lobe (large)
FROM PANCREAS TO THE DUODENUM o Left lobe (small)
Quadrate lobe (inferior)
Caudate lobe (posterior)
Falciform ligament:
o A fold of mesentery
o Divides liver into right & left lobes
Ligamentum teres (round ligament):
o Remnant of umbilical vein of the
fetus
HISTOLOGY OF THE LIVER
Hepatocytes: major functional cells
o Secretes bile
o 800-1000 mL/day (1 qt/day)
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DIGESTIVE SYSTEM
Bile: deoxygenated blood) Liver
o Yellow, brownish or olive-green sinusoids Central vein Hepatic
liquid vein Inferior vena cava Right
o pH: 7.6-8.6 atrium
o Composition:
Water GALLBLADDER
Bile salts – Na & K salts Pear-shaped sac
For emulsification Posterior to liver
and absorption of Hangs from anterior-inferior margin of the
lipids liver
Cholesterol Length: 7-10 cm (3-4 in.)
Lecithin (phospholipid) Parts:
Bile pigments o Fundus – broad portion; projects
Several ions inferiorly
o Bilibrubin: principal bile pigment o Body – central portion; projects
Stercobilin: gives feces their superiorly
normal brown color o Neck – tapered end; projects
Hepatic laminae: plates of hepatocytes superiorly
Bile canaliculi: small ducts between
hepatocytes SMALL INTESTINE
Hepatic sinusoids: highly permeable blood Functions:
capillaries between rows of hepatocytes o Mechanical and chemical digestion
o Has Stellate reticuloendothelial of food
cells (Kupffer cells): fixed o Completes the digestion of
phagocytes carbohydrates, proteins, and lipids
Destroy worn-out blood o Begins and completes the digestion
WBC & RBC, bacteria & of nucleic acids.
foreign body o Absorption of nutrients
Portal triad: Two movements:
o Bile duct o Segmentation
o Branch of hepatic artery Localized mixing
o Branch of hepatic vein contractions
Hepatic lobule: functional unit of the liver Duodenum: most rapid
Portal lobule: 12 times/minute
o Emphasize the exocrine function of Ileum: slow
the liver (bile secretion) 8 times/minute
Hepatic acinus: the preferred structural and o Peristalsis
functional unit of the liver Migrating motility complex
Blood supply: (MMC) – type of peristalsis
o Hepatic artery (oxygenated blood) & Pushes chyme
Hepatic portal vein (nutrient-rich forward
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DIGESTIVE SYSTEM
Reaches the end of Supports
ileum in 90-120 duodenojejunal
minutes flexure
o Chyme: remains in the SI in 3-5 o Jejunum
hours It means “empty”
Length: 10 ft (3 m) Rationale: found
o Cadaver: 21 ft (10 m) empty at death
Diameter: 1 in. (2.5 cm) Upper two fifths of small
Level: pyloric sphincter to ileocecal valve intestine
Three portions: Length: 1 m (3 ft)
o Duodenum o Ileum
It means “12” Largest portion
Rationale: as long as Lower two fifths
width of 12 fingers Length: 2 m (6 ft)
Shortest and widest portion o Gyri: freely movable loops (jejunum
Fixed in position and ileum)
Shape: C-shaped o Mesentery: attached jejunum and
Location: retroperitoneal ileum to the posterior wall of the
Length: 10 in. (25 cm) abdomen
Four regions: Intestinal juice: clear yellow fluid
Superior/duodenal o 1-2 L/day (1-2 qt/day)
bulb Total fluid ingested and secreted:
Descending/duodenal o 9.3 L/day
loop Ingested – 2.3 L
o Fixed part GI secretions – 7 L
Horizontal/inferior Saliva (1 L)
Ascending Gastric juice (2 L)
o Joins the Bile (1 L)
jejunum Pancreatic juice (2 L)
(duodenojejun Intestinal juice (1 L)
al flexure) 0.1 L/day: excreted in feces
Hepatopancreatic ampulla 1.5 L/day: excreted in urine
Union of pancreatic Total fluid absorbed:
and common bile o 8.3 L: absorbed by SI
ducts o 0.9 L: absorbed by LI
Open on duodenal
papilla
Ligament of Treitz
Suspensory muscle of
the duodenum
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DIGESTIVE SYSTEM
FOUR LAYERS OF SMALL INTESTINE Completely surrounds the small intestine
o From deep to superficial
1.) MUCOSAL SPECIAL STRUCTURES IN SMALL
Epithelial layer INTESTINE
o Absorptive cells – digest & absorb 1.) CIRCULAR FOLDS
nutrients Plicae circularis
o Goblet cells – secrete mucus Folds of mucosa and submucosa
o Paneth cells – secrete lysozyme Enhance absorption by:
o Lysozyme: bactericidal enzyme; o Increasing the surface area
capable of phagocytosis o Causing the chime to move in spiral
o Intestinal glands (Crypt of motion
Lieberkuhn): long, straight tubular 2.) VILLI
glands “tufts of hair”
Contains 3 types of Fingerlike projection of the mucosa
enteroendocrine cells – S For digestion and absorption
cells, CCK cells & K cells Length: 0.5-1.0 mm
o S cells – secrete secretin
Surface area: 20-40/mm2
o CCK cells – secrete cholecystokinin
Lacteal (milky): a lymphatic capillary
o K cells – secrete glucose-dependent
3.) MICROVILLI
insulinotropic peptide (GIP)
Small fingerlike projection in the absorptive
Lamina propria
cells
o Contains MALT
Forms the brush border
o Lymphatic nodules: present in
distal ileum
LARGE INTESTINE
o Peyer’s Patches (Aggregated
Terminal portion of the GI tract
lymphatic follicles): groups of
lymphatic cells Overall Functions:
Present in ileum o Completion of absorption
Absorbs water, ions &
Muscularis mucosae
vitamins
2.) SUBMUCOSA
More absorption occurs in SI
Contains duodenal glands (Bruner’s
than LI
glands)
o Production of certain vitamins
o Secrete alkaline mucus
Convert protein to amino
o Helps neutralize gastric acid in
acids
chime
Breakdown amino acid to
3.) MUSCULARIS
produce B vitamin and
Two layers of smooth muscle
vitamin K
o Inner – circular fibers (thicker)
o Formation of feces
o Outer – longitudinal fibers (thinner)
o Expulsion of feces from the body
4.) SEROSA
Defecation
Visceral peritoneum
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DIGESTIVE SYSTEM
Emptying the rectum o Junction of
Mechanical movements: ascending and
haustral churning, peristalsis, transverse
mass peristalsis Transverse portion
Drive the contents of Longest and most
the colon into the movable
rectum Left colic/spleenic
Level: ileocecal valve to anus flexure
Length: 5 ft (1.5 m) o Junction of
Diameter: 6.5 cm (2.5 in) transverse and
Mesocolon: double layer of peritoneum descending
o Attached LI to posterior abdominal Descending portion
wall Retroperitoneal
Ileocecal sphincter/valve: opening b/n Sigmoid portion
ileum and LI S-shaped loop
o Allows material from SI to pass LI Ends at rectum (S3)
Four major region: cecum, colon, rectum o Rectum
and anal canal Anterior to sacrum and
o Cecum coccyx
A small pouch (6 cm long) Level: sigmoid colon to the
Inferior to ileocecal valve anal canal
Length: 2.5 in. (6 cm) Length: 8 in. (20 cm)
Diameter: 3 in. (7.6 cm) Distal portion: 1 in
Appendix/Vermiform (2.5 cm)
appendix: Rectal ampulla: dilation
Attached to cecum above the anal canal
Vermiform = “worm- o Anal canal
shaped” Terminal of the rectum
Mesoappendix: mesentery of Terminates at the anus
appendix Length: 2-3 cm (1 in)
Attaches appendix to Anus: opening of the anal
inferior part of canal to the exterior
mesentery of ileum Internal anal sphincter:
o Colon Smooth muscle
Colon = “food passage” Involuntary
Ascending portion External anal
Retroperitoneal sphincter:
Right colic/hepatic Skeletal muscle
flexure Voluntary
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DIGESTIVE SYSTEM
o Two AP curves of rectum and anal Muscularis mucosae
canal: must be remembered during 2.) SUBMUCOSA
enema tip insertion Contains areolar connective tissue
Passes inferiorly and 3.) MUSCULARIS
posteriorly to level of pelvic Two layers of smooth muscle
floor o Inner – circular fibers
Bends anteriorly and o Outer – longitudinal fibers
inferiorly into anal canal Teniae coli – three
Bacterial action: last stage of chemical longitudinal bands of muscle
digestion in LI Haustra/haustrum: series of pouches
Gastrin: relaxes the sphincter caused by tonic contraction of teniae coli
Occult blood: refers to blood that is hidden Haustration: the process of formation of
o Occult blood testing: to screen for haustrum
colorectal cancer 4.) SEROSA
Examined: feces and urine Visceral peritoneum
Chyme: remain in the LI in 3-10 hours Omental (fatty) appendices: small pouches
Diarrhea: increased in frequency, volume filled with fat
and fluid content of the feces o Attached to teniae coli
o Increased motility and decreased
absorption of intestine
Constipation: infrequent or difficult “If you want to become successful, join
defecation successful people”
o Decreased motility of intestine 05/23/14
FOUR LAYERS OF LARGE INTESTINE
From deep to superficial
1.) MUCOSAL
No circular folds
No villi
Has microvilli (in absorptive cells)
Layers: epithelium, lamina propia,
muscularis mucosae
Epithelial layer:
o Simple columnar epithelium
o Contains absorptive and goblet cells
located in Intestinal glands
(Crypt of Lieberkuhn)
Absorptive cells – water
absorption (primary function)
Goblet cells – secrete mucus
Lamina propria
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