LARGE INTESTINE

◾ wider diameter
◾ ± 1.5 m long
◾ anatomical parts - mesenteric attachments
 LARGE INTESTINE

◾ caecum & appendix

◾ ascending colon
◾ transverse colon
◾ descending colon
◾ sigmoid colon
◾ rectum
◾ continues below pelvic floor as anal canal
 LARGE
INTESTINE
caecum:L caecus blind sac
◾ 8x8 cm
◾ right iliac fossa

appendix:
◾ 8 cm long
◾ mesoappendix
◾ appendicular artery
◾ abundant lymphoid tissue
 LARGE INTESTINE

taeniae coli - longitudinal muscle bands

haustra – L.recess:pouches caused by taeniae coli

*waste residue fills haustra

*contraction moves waste to next haustrum

appendices epiploicae - fatty tags

 NERVE SUPPLY TO THE GIT

◾ enteric nervous system

◾ nerve plexuses/networks distributed in esophagus, stomach & intestines
◾ regulates digestive tract motility,secretion & blood flow
◾ ±100 million neurons
◾ can function independently of central nervous system [CNS]
◾ C N S exerts influence on its action
◾ considered part of autonomic nervous system
◾ smooth muscle
 NERVE SUPPLY TO THE GIT

Enteric nervous system comprises two networks of neurons

◾ Submucosal plexus: in submucosa of gut lining
◾ controls glandular secretions of mucosa
◾ controls movements of muscularis mucosae
◾ Myenteric plexus:
◾ parasympathetic ganglia & nerve fibers between the two layers of the
muscularis externa
◾ controls peristalsis & other contractions of muscularis externa

◾ Vagus nerve [CN X] also plays major role in regulating activities in GIT
 LEARNING OUTCOMES
By the end of this lecture you should be able to:

 Identify the major structures of the digestive tract and their functions√
 Outline the process of swallowing √
 Outline the arrangement & functions of the peritoneum √
 Describe the gross anatomy of the major sections of the gut tube√
 Describe the histological layers [microscopic anatomy] of the digestive tract
 Explain the processes of peristalsis and segmentation
 Describe the accessory organs of the GIT
 Describe the vasculature of the digestive system
THE FOUR TISSUE LAYERS OF THE
DIGESTIVE TRACT
 MUCOSA

Most specialized

3 layers

◾ epithelium

◾ lamina propria

◾ muscularis mucosa
 SUBMUCOSA

◾ blood vessels

◾ loose areolar tissue

◾ Meissner’s [submucosal] nerve plexus

 MUSCULARIS EXTERNA

◾ inner circular layer

◾ outer longitudinal layer

◾ Auerbach’s [myenteric]nerve plexus lies

between these layers

◾ additional oblique layer in stomach

◾ contract to move food/components along GIT

 ADVENTITIA

◾ outermost layer

◾ loose,ill-defined connective tissue

◾ larger branches of blood vessels

◾ serosa
 MICROSCOPIC ANATOMY OF GIT:OESOPHAGUS
◾Mucosa: stratified squamous epithelium
lymphatic tissue in lamina propria

◾ Submucosa
◾ connective tissue
◾ oesophageal glands,lymphatics,nerves

◾ Muscularis externa

◾ Adventitia (not serosa)

 MICROSCOPIC A N ATOMY OF GIT:STO M ACH

Stomach
◾ same 4 layers
MUCOSA OF THE
STOMACH WALL
 SECRETORY CELLS: GASTRIC
PITS & GLANDS
Gastric pits
◾ depressions in gastric mucosa
◾ lined with simple columnar epithelium
◾ two or three tubular glands open into
the bottom of each gastric pit
◾ cardiac glands in cardiac part
◾ pyloric glands in pyloric part
◾ gastric glands in remainder of
stomach
 SECRETORY CELLS: GASTRIC
GLANDS & PITS
Six cell types in gastric glands
1. surface mucous cells:alkaline mucus –
protective coat over epithelium
2. mucous neck cells:secrete when
stimulated by vagus nerve
3. parietal [oxyntic] cells: HCl & intrinsic
factor [B12] & grehlin pH 1-2
4. chief cells: pepsinogen, gastric lipase
5. enteroendocrine cells: histamine,
serotonin,somatostatin & gastrin
6. stem cells
SECRETORY CELLS: GASTRIC
GLANDS & PITS
Stimulates acid secretion

Inhibits
• acid secretion
• gastrin & pepsin release
• pancreatic exocrine secretions

Stimulates acid secretion

 REGULATION OF GASTRIC
FUNCTION

1) Cephalic phase

Hypothalamus relays signals to medulla 2) Gastric phase

3) Intestinal phase
oblongata. Vagus nerves stimulate Food stretches stomach & activates
myenteric & vagovagal reflexes. These Intestinal gastrin briefly stimulates stomach.
enteric system of stomach - gastric stimulate gastric secretion. ACh, Secretin, CCK & enterogastric reflex then
secretion - 40% of acid secretion histamine & gastrin also stimulate acid inhibit gastric secretion & motility while
& enzyme secretion.
duodenum processes chyme already in it.
Sympathetic nerve fibers suppress gastric
activity, while vagal (parasympathetic)
stimulation of the stomach is now inhibited.
PHASES OF
GASTRIC ACTIVITY
 INHIBITION OF ACID SECRETIO N
◾ negative feedback mechanism
◾ if contents too acidic (pH 3 or less)
◾ acidity inhibits gastrin release
◾ stimulates D cells to release somatostatin
◾ somatostatin inhibits gastrin & histamine release
◾ paracrine & systemic effects on G cells & parietal cells
 PEPSIN
◾ Zymogens - digestive enzymes secreted as inactive proteins
◾ converted to active enzymes by removing some of their amino acids
◾ Pepsinogen - zymogen secreted by chief cells
◾ HCL removes some of its amino acids & forms pepsin that digests proteins
◾ autocatalytic effect - as pepsin forms it converts more pepsinogen into pepsin
◾ protein digestion is completed in small intestine
 GASTRIC LIPASE & INTRINSIC FAC TOR
◾ produced by chief cells
◾ lingual & gastric lipases play minor role in digesting dietary fats
◾ digest 10% -15% of dietary fats in stomach – remainder in small intestine

Intrinsic factor - glycoprotein secreted by parietal cells

◾ essential to absorption of vitamin B12 by small intestine
◾ binds vitamin B12 & intestinal cells absorb this complex
◾ Vitamin B12 is essential for synthesis of haemoglobin
◾ deficiency results in pernicious anemia

◾ Secretion of intrinsic factor is the only indispensable function of the stomach

◾ digestion can continue if stomach is removed (gastrectomy),but B12
supplements will be needed
 MICROSCOPIC ANATOMY OF
SMALL
◾ Duodenal INTESTINE
glands - in submucosa of duodenum
◾ secrete an abundance of bicarbonate-rich mucus
◾ neutralises stomach acid & protects mucosa

◾ large population of lymphocytes throughout lamina propria & submucosa of

small intestine
◾ intercept pathogens before they can invade bloodstream
◾ aggregated into lymphatic nodules in ileum
◾ Peyer’s patches
 MICROSCOPIC ANATOMY OF
SMALL INTESTINE
◾ designed for nutrient digestion & absorption
◾ lumen lined with simple columnar epithelium
◾ muscularis externa - thick inner circular layer & thinner outer longitudinal layer
◾ large internal surface area - increased length & internal folds or projections
◾ circular folds (plicae circulares) - increase surface area by factor of 2-3
◾ villi - increase surface area by factor of 10
◾ microvilli - increase surface area by factor of 20
 MICROSCOPIC ANATOMY OF
SMALL INTESTINE
◾ plicae circulares up to 10 mm high
◾ involve mucosa & submucosa
◾ in duodenum to middle of ileum
◾ relatively small & sparse in ileum -
most nutrient absorption is in jejunum
◾ cause chyme flow in spiral path
causing more contact with mucosa
◾ promote more thorough mixing and
nutrient absorption
 MICROSCOPIC ANATOMY OF
SMALL INTESTINE
◾ villi - finger-like projections 0.5-1 mm tall
◾ covered with two types of epithelial cells
◾ absorptive cells (enterocytes)
◾ goblet cells - secrete mucus
◾ epithelia joined by tight junctions
◾ prevent digestive enzymes from seeping
between cells
◾ core of villus - areolar tissue of lamina
propria
◾ contains arteriole,capillaries,venule,&
lymphatic capillary called a lacteal
THE
INTESTINAL
VILLI
 MICROSCOPIC ANATOMY OF
SMALL INTESTINE
◾ Microvilli form a brush border on apical surface
of each absorptive cell
◾ 1 μm high
◾ increases absorptive surface area
◾ brush border enzymes - contained in plasma
membrane of microvilli
◾ perform final stages of enzymatic digestion
◾ enzymes not released into the lumen
◾ contact digestion: chyme must contact the
brush border for digestion to occur
◾ intestinal churning of chyme ensures contact
with the mucosa
 MICROSCOPIC ANATOMY OF
SMALL INTESTINE
◾ intestinal crypts - numerous pores that open into tubular glands on floor of
small intestine between bases of the villi
◾ in upper section, have enterocytes & goblet cells like the villi
◾ in lower part,dominated by dividing stem cells
◾ life span of 3 to 6 days
◾ new epithelial cells migrate up the crypt to tip of the villus where they are
sloughed off & digested
◾ Paneth cells clustered at base of each crypt secrete lysozyme, phospholipase
& defensive proteins that resist bacterial invasion of the mucosa
 INTESTINAL SECRETION
◾ intestinal crypts secrete 1-2 L of fluid per day
◾ in response to acid,hypertonic chyme & distension of intestines
◾ pH of 7.4-7.8
◾ contains water,mucus & enzymes
◾ most enzymes that function in small intestine are found in brush border &
pancreatic secretions
 MICROSCOPIC ANATOMY OF
LARGE INTESTINE
◾ mucosa - simple columnar epithelium with absorptive cells
◾ high density of mucus-secreting goblet cells
◾ lamina propria & submucosa have abundant lymphatic tissue
◾ provides protection from large population of bacteria in large intestine
◾ water absorption
NEURAL CONTROL OF
DEFECATION
1) Faeces stretch the rectum & stimulate
stretch receptors,which transmit signals to
spinal cord.

2) A spinal reflex stimulates contraction of

rectum.

3)The spinal reflex also relaxes the internal anal

sphincter.

4)Impulses from brain prevent untimely

defecation by keeping external anal sphincter
contracted. Defecation occurs only if this
sphincter also relaxes.
 LEARNING OUTCOMES
By the end of this lecture you should be able to:

 Identify the major structures of the digestive tract and their functions√
 Outline the process of swallowing √
 Outline the arrangement & functions of the peritoneum √
 Describe the gross anatomy of the major sections of the gut tube√
 Describe the histological layers [microscopic anatomy] of the digestive tract√
 Explain the processes of peristalsis and segmentation
 Describe the accessory organs of the GIT
 Describe the vasculature of the digestive system
 INTESTINAL MOTILITY

◾ contractions of small intestine serve several functions

◾ mix chyme with intestinal juice,bile & pancreatic secretions
◾ neutralize acid
◾ digest nutrients more effectively
◾ to churn chyme & bring it in contact with mucosa for contact digestion &
nutrient absorption
◾ to move residue toward large intestine
 INTESTINAL MOTILITY
◾ Segmentation - movement in which stationary ring-like constrictions appear in
several places along the intestine
◾ they relax & new constrictions form elsewhere in tube
◾ most common kind of intestinal contraction
◾ enteric pacemaker cells in muscularis externa set rhythm of segmentation
◾ contractions 12x per minute in the duodenum
◾ 8-9 times per minute in the ileum
◾ when most nutrients absorbed & only undigested residue remains,
segmentation declines & peristalsis begins
CONTRACTIONS OF THE
SMALL INTESTINE

(a) Segmentation Figure 25.26a

 INTESTINAL
MOTILITY
◾ peristalsis moves contents of small intestine toward colon
◾ peristaltic waves (triggered by motilin) begin in duodenum,travel 10-70 cm
◾ followed by another wave starting further down the tract
◾ migrating motor complex - successive, overlapping waves of contraction
◾ move chyme toward colon over a period of 2 hours

(b) Peristalsis
 INTESTINAL MOTILITY
◾ Ileocecal valve usually closed
◾ food in stomach triggers gastroileal reflex that enhances segmentation in
the ileum & relaxes the valve
◾ as caecum fills with residue, pressure pinches the valve shut
◾ prevents reflux of caecal contents into the ileum
 LEARNING OUTCOMES
By the end of this lecture you should be able to:

 Identify the major structures of the digestive tract and their functions√
 Outline the process of swallowing √
 Outline the arrangement & functions of the peritoneum √
 Describe the gross anatomy of the major sections of the gut tube√
 Describe the histological layers [microscopic anatomy] of the digestive tract√
 Explain the processes of peristalsis and segmentation √
 Describe the accessory organs of the GIT
 Describe the vasculature of the digestive system
 LIVER

 ± 1.3 kg
 right upper quadrant of abdomen
 intraperitoneal
 four lobes
 diaphragmatic & visceral surfaces
 LIV
Right lobe ER
Left lobe

Q uadrate lobe Caudate lobe

 GALL BLADDER
• attached to visceral surface of liver

• small pear-shaped,sac-like organ

• stores & concentrates bile

BILIARY SYSTEM
OR TREE
 PANCREAS
◾ elongated,lobulated gland

◾ retroperitoneal

◾ head,neck,body & tail

◾ head & neck related to major blood

vessels

◾ tail related to spleen

 PANCREATIC ENZYMES IN
SMALL INTESTINE
 exocrine & endocrine functions

Exocrine:
 digestive secretions into
duodenum via duct
 secretes 1.2-1.5L per day from
secretory acini

Endocrine:
 Insulin
 THE PANCREAS

Pancreatic secretions:
◾ alkaline mixture of water,enzymes, zymogens,
sodium bicarbonate & other electrolytes
◾ acini secrete the enzymes & zymogens
◾ ducts secrete bicarbonate

◾ bicarbonate buffers HCl arriving from stomach

 THE PANCREAS

Pancreatic zymogens:
◾ Trypsinogen
◾ secreted into intestinal lumen & converted to trypsin by enteropeptidase
secreted by mucosa of small intestine
◾ trypsin is autocatalytic - converts trypsinogen into still more trypsin
◾ Pancreatic amylase:digests starch
◾ Pancreatic lipase:digests fat
 REGULATION OF SECRETION
Three stimuli responsible for release of pancreatic secretions & bile:
Acetylcholine (ACh):
◾ from vagus & enteric nerves
◾ stimulates cells to secrete enzymes during cephalic phase of gastric control
◾ enzymes remain in acini & ducts until chyme enters the duodenum

Cholecystokinin (CCK):
◾ secreted by mucosa of duodenum in response to fats in small intestine
◾ stimulates pancreatic acini to secrete enzymes & stimulates gallbladder
◾ induces contractions of gallbladder & relaxation of hepatopancreatic
sphincter to discharge bile into duodenum
 REGULATION OF SECRETION
• Secretin:
◾ released from duodenum in response to acidic chyme arriving from the
stomach
◾ stimulates ducts of liver & pancreas to secrete more sodium bicarbonate
◾ raises pH to level required for activity of pancreatic & intestinal digestive enzymes
 LEARNING OUTCOMES
By the end of this lecture you should be able to:

 Identify the major structures of the digestive tract and their functions√
 Outline the process of swallowing √
 Outline the arrangement & functions of the peritoneum √
 Describe the gross anatomy of the major sections of the gut tube√
 Describe the histological layers [microscopic anatomy] of the digestive tract√
 Explain the processes of peristalsis and segmentation √
 Describe the accessory organs of the GIT √
 Describe the vasculature of the digestive system
 ARTERIAL BLOOD SUPPLY TO THE GIT

◾ 3 unpaired branches of aorta

(i) coeliac trunk

(ii) superior mesenteric artery

(iii) inferior mesenteric artery

 ARTERIAL BLOOD SUPPLY TO THE GIT
Supply reflected by development of GIT
Foregut:coeliac trunk
 oesophagus,stomach
 1st part duodenum,liver,gall bladder &
pancreas

Midgut:superior mesenteric artery

 duodenum,SI,
 proximal 1/2 transverse colon

Hindgut:inferior mesenteric artery

 distal 1/2TC, descending colon, sigmoid
colon,rectum Solomon
 VENOUS DRAINAGE OF GIT

◾ veins accompany arteries

◾ splenic,SMV & IMV
◾ portal vein – liver
◾ portal system

Solomon
 PORTAL SYSTEM

◾ venous

◾ 2 capillary beds

◾ liver sinusoids
 LEARNING OUTCOMES
By the end of this lecture you should be able to:

 Identify the major structures of the digestive tract and their functions√
 Outline the process of swallowing √
 Outline the arrangement & functions of the peritoneum √
 Describe the gross anatomy of the major sections of the gut tube√
 Describe the histological layers [microscopic anatomy] of the digestive tract√
 Explain the processes of peristalsis and segmentation √
 Describe the accessory organs of the GIT √
 Describe the vasculature of the digestive system √