Chapter 14.

The Digestive System and Body Metabolism

Anatomy of the Digestive System
- Two main groups:
1) Organs forming the alimentary canal
 Performs all the digestive
functions: ingests, digests,
absorbs, and defecates
 Propels the foodstuffs along its
tract
2) Accessory digestive organs
 Assist the process of digestive
breakdown in various ways
 Teeth, tongue, and several large
digestive glands

Organs of the Alimentary Canal

Alimentary Canal
- Also called “gastrointestinal (GI) tract” or “gut”
- Its organs are the mouth, pharynx, esophagus, stomach, small intestine, and large intestine
- Continuous, coiled, hollow muscular tube that winds through the ventral body cavity from the stomach to the
anus
o Cadaver: approximately 9 meters or 30 feet long
o Living person: considerably shorter due to muscle tone
- Food material within this tube is technically outside the body because it has contact only with cells lining the
tract and the tube is open to the external environment at both ends
- Contain two important intrinsic nerve plexuses that are part of the ANS and regulate the mobility and
secretory activity of GI tract organs:
1) Submucosal nerve plexus
2) Myenteric nerve plexus
Mouth
- Also called “oral cavity”
- Where food enters to get into the digestive tract
- Mucous membrane-lined cavity
- As the food enters the mouth, it is mixed with saliva and then masticated or chewed
- The breakdown of food begins before the food has even left the mouth

Lips
- Also called “labia”
- Protects the anterior opening of the mouth
- Closes to hold the food between the teeth during chewing along with the cheeks
Cheeks
- Form the mouth’s lateral walls
- Hold the food between the teeth during chewing along with the closing of the lips
Hard palate
- Form the mouth’s anterior roof
Soft palate
- Form the mouth’s posterior roof
Uvula
- Fleshy fingerlike projection of the soft palate
- Extends inferiorly from the posterior edge of the soft palate
Vestibule
- The space between the lips and cheeks externally and the teeth and gums internally
Oral cavity proper
- Area contained by the teeth
Tongue
- Muscular and occupies the floor of the mouth
- Continuously mixes food with saliva during chewing and initiates swallowing
- Has several bony attachments with two attached to the hyoid bone and the styloid processes of the skull
Lingual frenulum
- A fold of mucous membrane
- Secures the tongue to the floor of the mouth and limits its posterior movements
Palatine tonsils
- Paired masses of lymphatic tissue
- Found at the posterior end of the oral cavity
Lingual tonsils
- Covers the base of the tongue just beyond
Pharynx
- Subdivided into three parts:
1) Nasopharynx
 Part of the respiratory passageway
2) Oropharynx
 Posterior to the oral cavity
3) Laryngopharynx
 Continuous with the esophagus below
- From the mouth, food passes posteriorly into the oropharynx and laryngopharynx, both of which are common
passageways for food, fluids, and air
- Its walls contain two skeletal muscle layers
o Cells of the inner layer run longitudinally
o Cells of the outer layer, the constrictor muscles, run around in a circular fashion
- Alternating contractions of these two muscle layers propel food through the pharynx into the esophagus below
Esophagus
- Also called “gullet”
- About 25 cm or 10 inches long
- Runs from the pharynx through the diaphragm to the stomach
- Essentially a passageway that conducts food by peristalsis to the stomach
- Made up of four basic tissue layers:
1) Mucosa
 Innermost layer
 Most membrane that lines the cavity or lumen of the organ
 Consists primarily of surface epithelium, a small amount of connective tissue (lamina
propria), and a scanty smooth muscle layer
 Mostly simple columnar and has friction-resisting stratified squamous epithelium beyond the
esophagus
2) Submucosa
 Found just beneath the mucosa
 Soft connective tissue layer containing blood vessels, nerve endings, mucosa-associated
lymphoid tissue, and lymphatic vessels
3) Muscularis externa
 A muscle layer
 Typically made up of an inner circular layer and an outer longitudinal layer of smooth muscle
cells
4) Serosa
 Outermost layer
 Consists of the visceral peritoneum
 Visceral peritoneum
o A single layer of flat, serous fluid-producing cells
o Continuous with the parietal peritoneum
 Parietal peritoneum
o Slick, slippery
o Lines the abdominopelvic cavity by way of a membrane extension called the
“mesentery
Stomach
- C-shaped
- Where the chemical breakdown of proteins begins
- Acts as a temporary storage tank for food and a site for food
breakdown
- Its wall contains an additional third, obliquely arranged layer
called the “muscularis externa” which allows the stomach to
churn, mix, and pummel food and physically break it down
into smaller fragments
- Found on the left side of the abdominal cavity, nearly hidden
by the liver and diaphragm
- Varies from 15 to 25 cm or 6 to 10 inches in length, but its
diameter and volume depend on how much food it contains
o When full: can hold about 4 liters or 1 gallon of food
o When empty: collapses inward on itself and its
mucosa is thrown into large folds called “rugae”
- Has two surfaces:
1) Greater curvature: convex lateral surface
2) Lesser curvature: concave medial surface
- Has different regions:
1) Cardial region / cardia
 Near the heart
 Surrounds the cardioesophageal sphincter through which food enters the stomach from the
esophagus
2) Fundus
 Expanded part of the stomach
 Lateral to the cardial region
3) Body
 Midportion
 Narrows inferiorly and becomes the
pyloric antrum
4) Pylorus
 Funnel-shaped
 Terminal part of the stomach
 Continuous with the small intestine
through the pyloric sphincter or valve
 Most digestive activity occurs in the pyloric region and after the food has been
processed, it resembles a heavy cream called “chyme” which enters the small
intestine through the pyloric sphincter
- Its mucosa is a simple columnar epithelium composed entirely of mucous cells that produce a protective layer
of bicarbonate-rich alkaline mucus that clings to the stomach mucosa and protects the stomach wall from
being damaged by acid and digested by enzymes
- The smooth lining is dotted with millions of deep gastric pits, which lead into gastric glands that secrete the
solution called gastric juice
o Some stomach cells produce intrinsic factor
needed for the absorption of vitamin B12
from the small intestine
o Chief cells produce protein-digesting
enzymes, mostly pepsinogens
o Parietal cells produce corrosive hydrochloric
acid that makes the stomach contents acidic
and activates the enzymes
o Mucous neck cells produce a thin acidic
mucus that is different from that secreted by
the mucous cells of the mucosa
o Enteroendocrine cells produce local
hormones, such as gastrin, that are important
to the digestive activities of the stomach
Lesser omentum
- Double layer of peritoneum
- Extends from the liver to the lesser curvature
Greater omentum
- Another extension of the peritoneum
- Riddled with fat, which helps to insulate, cushion, and
protect the abdominal organs
- Has large collections of lymphoid follicles containing
macrophages and defensive cells of the immune system
- Drapes downward and covers the abdominal organs like a
lacy apron before attaching to the posterior body wall
Small Intestine
- The body’s major digestive organ
- A muscular tube extending from the pyloric sphincter to
the large intestine
- It is encircled and framed in the abdominal cavity by the
large intestine
- Where usable food is prepared for its journey into the
cells of the body
- Chemical digestion of foods begins earnest and it can
only process a small amount of food at one time
- Longest section of the alimentary tube with an average
length of 2 to 4 meters or 7 to 13 feet
- The initial part of the small intestine lies in a
retroperitoneal position posterior to the parietal
peritoneum
- The rest hangs in sausage-like coils in the abdominal
cavity suspended from the posterior abdominal wall by the fan-shaped mesentery
- Has three subdivisions:
 1) Duodenum
 Contribute 5% of the length
 C-shaped and the shortest subdivision
 Twelve finger widths long
 Has the most interesting features
 Enzymes produced by the pancreas are ducted here through the pancreatic ducts
where they complete the chemical breakdown of foods in the small intestine
 Bile formed by the liver also enters here through the bile duct in the same area
 The main pancreatic and bile ducts join to form the flask-like hepatopancreatic
ampulla or the liver-pancreatic enlargement and the bile and pancreatic juice travel
through the duodenal papilla and enter here together
2) Jejunum
 Contribute almost 40% of the length
 Empty
3) Ileum
 Contribute almost 60% of the length
 Twisted intestine
 Meets the large intestine at the ileocecal valve
 Ileocecal valve: joins the large and small intestines
- Has three structures that increase its absorptive surface tremendously:
1) Microvilli
 Also called “brush border”
 Tiny projections of the plasma membrane of the mucosa cells
 Give the cell surface a fuzzy appearance
 Plasma membranes bear enzymes called “brush border enzymes” which complete the
digestion of proteins and carbohydrates
2) Villi
 Fingerlike projections of the mucosa
 Gives it a velvety appearance and feel, much like the soft nap of a towel
 Digested foodstuffs are absorbed through the mucosal cells into both the capillaries and the
lacteal
 Lacteal: a rich capillary bed and a modified lymphatic capillary found within each
villus
3) Circular folds
 Also called “plicae circulares”
 Deep folds of both mucosa and submucosa layers
 Do not disappear when food fills the small intestine unlike the rugae of the stomach

- Structural modifications which increase the surface area decrease in number toward the end of the small
intestine
 - Local collections of lymphatic tissue or Peyer’s patches found in the submucosa increase in number toward
the end of the small intestine
o Reflects the fact that the remaining undigested food residue in the intestine contains huge numbers of
bacteria, which must be prevented from entering the bloodstream if possible
Pyloric sphincter
- Literally “gatekeeper”
- Prevents the small intestine from being overwhelmed
- Controls food movement into the small intestine from the stomach
Large Intestine
- About 1.5 meters or 5 feet long
- Extends from the ileocecal valve to the anus
- Much larger in diameter but shorter in length than
the small intestine
- Dry out the indigestible food residue by absorbing
water and eliminate them from the body as feces
- Contains tremendous numbers of goblet cells in its
mucosa that produce alkaline or bicarbonate-rich
mucus which lubricates the passage of feces to the
end of the digestive tract
- Does not contain villi because most nutrients have
already been absorbed before the large intestine is
reached
- Its longitudinal muscle layer of the muscularis
externa is reduced to three bands of muscle called “tenae coli”
o Tenae coli
 Means “ribbons of the colon”
 Muscle bands that usually display some degree of tone and are partially contracted
 Cause the wall to pucker into small pocketlike sacs called “haustra”
- Has five subdivisions:
1) Cecum
 Saclike
 First part of the large intestine
2) Appendix
 Wormlike or vermiform
 Hanging from the cecum
 Usually twisted, making it an ideal location for bacteria to accumulate
3) Colon
 Divided into several distinct regions
 Ascending colon
 Travels up the right side of the abdominal cavity
 Makes a turn at the right colic or hepatic flexure
 Transverse colon
 Travels across the abdominal cavity after the right colic flexure
 Makes a turn at the left colic or splenic flexure
 Descending colon
 Continues down the left side after the left colic flexure
 Enters the pelvis
 Sigmoid colon
 S-shaped
 Lie in the pelvis along with the rectum and anal canal
4) Rectum
 Lies in the pelvis
5) Anal canal
 Lies in the pelvis
 Ends at the anus which opens to the exterior
 Has two sphincters that are ordinarily closed except during defecation and act like purse
strings to open and close the anus:
 i. External anal sphincter: an external voluntary sphincter formed by skeletal muscle
ii. Internal anal sphincter: an internal voluntary sphincter formed by smooth muscle

Accessory Digestive Organs

Teeth
- Tear and grind the food, breaking it down into smaller fragments
- Consist of two major regions connected by the neck:
1) Crown
 Exposed part of the tooth above the gingiva or gum
 Enamel-covered
 Enamel: ceramic-like substance as thick as a dime,
directly bears the force of chewing, and is the hardest
substance in the body and is fairly brittle because it is
heavily mineralized with calcium salts
 Dentin: bonelike material that underlies the enamel
and forms the bulk of the tooth and surrounds a central
pulp cavity
 Pulp: contains a number of structures, such as connective tissue, blood vessels, and
nerve fibers, and supplies nutrients to the tooth tissues and provides for tooth
sensations
 Root canal: pulp cavity extended into the root, provides a route for blood vessels,
nerves, and other pulp structures to enter the pulp cavity of the tooth
2) Root
 Portion of the tooth embedded in the jawbone
 Its outer surface is covered by cement, which attaches the tooth to the periodontal membrane
or ligament
 Ligament: holds the tooth in place in the bony jaw
- Classified according to shape and function:
1) Incisors
 Chisel-shaped
 For cutting
2) Canines
 Also called “eyeteeth”
 Fanglike
 For tearing or piercing
3) Premolars
 Also called “bicuspids”
 Have broad crowns with rounded cusps or tips
 Best suited for grinding
4) Molars
 Have broad crowns with rounded cusps or tips
 Best suited for grinding
- By the age of 21, two sets of teeth have been formed:
1) Deciduous teeth
 Also called “baby teeth” or “milk teeth”
 First to appear are the lower central incisors
 6 months: begin to erupt
 2 years: full set of 20 teeth is complete
 6-12 years: loosen and fall out
2) Permanent teeth
 Reabsorbs the roots of the milk teeth as they enlarge
and develop
 A full set is composed of 32 permanent teeth, but the third molars or wisdom teeth often fail
to erupt or are completely absent
 End of adolescence: all except third molars have erupted
 17-25 years: third molars emerge
Salivary Glands
 - Three pairs of salivary glands empty their secretions into the mouth:
1) Parotid glands
 Large
 Lie anterior to the ears
2) Submandibular glands
 Empty their secretions into the floor of the mouth through tiny ducts
3) Sublingual glands
 Empty their secretions into the floor of the mouth through tiny ducts
- Produces saliva
o Saliva
 A mixture of mucus and serous fluids
 The mucus moistens and helps to bind food together into a mass called a “bolus,”
making chewing and swallowing easier
 The clear serous contains an enzyme called “salivary amylase” in a bicarbonate-rich
alkaline juice that begins the process of starch digestion in the mouth
 Dissolves food chemicals so they can be tasted
 Also contains substances such as lysozyme and antibodies (IgA) that inhibit bacteria, hence
its protective function
Pancreas
- Soft, pink, triangular gland
- Extends across the abdomen from the spleen to the duodenum
- Most of it lies posterior to the parietal peritoneum, hence its location is referred to as “retroperitoneal”
- The only organ that produces enzymes that break down all categories of digestible foods
o The pancreatic enzymes are secreted into the duodenum in an alkaline fluid that neutralizes the acidic
chyme coming in from the stomach
- Also has an endocrine function by producing the hormones insulin and glucagon
Liver and Gallbladder
Liver
- Largest gland in the body and has four lobes
- Suspended from the diaphragm and abdominal wall by a delicate mesentery cord called the “falciform
ligament”
- Its digestive function is to produce bile
o Bile
 Yellow-to-green, watery solution containing bile salts, bile pigments, cholesterol,
phospholipids, and a variety of electrolytes
 Bile pigments: chiefly contain bilirubin, a breakdown product of hemoglobin
 Bile salts: emulsify fats by physically breaking large fat globules into smaller ones,
providing more surface area for the fat-digesting enzymes to work on
 Leaves the liver through the common hepatic duct and enters the duodenum through the bile
duct
 Necessary for the absorption of fats and the fat-soluble vitamins, K, D, E, and A, which are
absorbed along with them from the intestinal tract
 Acts like a detergent to emulsify, or mechanically break down, large fat globules into
thousands of tiny ones, providing a much greater surface area for the pancreatic lipases to
work on
Gallbladder
- Small, thin-walled green sac
- Snuggles in a shallow fossa in the inferior surface of the liver
- Stores bile when food digestion is not occurring
o The bile also backs up the cystic duct
- Makes the bile concentrated by the removal of water
- Prompted by a hormonal stimulus to contract and spurt out stored when fatty food enters the duodenum

Functions of the Digestive System

Gastrointestinal Processes and Controls
- The major functions of the digestive tract: digestion and absorption
- The essential activities of the GI tract include the following six processes:
1) Ingestion
 An active, voluntary process
 Food is placed into the mouth for it to be acted on
2) Propulsion
 Foods are propelled from one organ to the next to be processed by the digestive organs
 Swallowing is one example of food movement that depends largely on the propulsive process
called “peristalsis”
 Peristalsis
 Involuntary
 Involves alternating waves of contraction and relaxation
of the muscles in the organ well
 Its net effect is to squeeze the food along the tract
3) Food breakdown: Mechanical breakdown
 Mixing of food in the mouth by the tongue, churning of the food in the stomach, and
segmentation in the small intestines
 Segmentation
 May help proper foodstuffs through the small intestine
 Normally moves food only back and forth across the
internal wall of the organ, serving to mix it with the
digestive juices
 More on mechanical digestion than propulsion
 Prepares food for further degradation by enzymes by physically fragmenting the foods into
smaller particles
4) Food breakdown: Digestion
 Large food molecules are chemically broken down to their building blocks by enzymes which
are protein molecules that act as catalysts
 Carbohydrates are digested to their building blocks, the monosaccharides or simple sugars,
which include:
i. Glucose
 Most important
 The “sugar” being referred to when talking about blood sugar levels
ii. Fructose
 Most abundant sugar in fruits
iii. Galactose
 Found in milk
 The only carbohydrates that our digestive system digests or breaks down to simple sugars are:
i. Sucrose
 Table sugar
 Disaccharide or double sugars
 Consists of two simple sugars linked together
ii. Lactose
 Milk sugar
 Disaccharide or double sugars
 Consists of two simple sugars linked together
iii. Maltose
 Malt sugar
 Disaccharide or double sugars
 Consists of two simple sugars linked together
iv. Starch
 Polysaccharide
 Formed of hundreds of glucose units
 Indigestible polysaccharides such as cellulose do not provide us with
nutrients but help move the foodstuffs along the gastrointestinal tract
by providing bulk or fiber in our diet
 Proteins are digested to their building blocks, the amino acids, whose intermediate products
are:
 i. Polypeptides
ii. Peptides
 Lipids or fats are digested and yield two different types of building blocks, fatty acids and an
alcohol called “glycerol”
5) Absorption
 Transport of the end products from the lumen of the GI tract to the blood or lymph
 Digested foods must first enter the mucosal cells by active or passive transport processes
 The small intestine is the major absorptive site
6) Defecation
 Elimination of indigestible residues from the GI tract via the anus in the form of feces
- Some of these processes are the job of a single organ
o Ingestion is only done by the mouth
o Defecation is only done by the large intestine
- Digestive activity is mostly controlled by reflexes via the
parasympathetic division of the ANS
- The sensors (mechanoreceptors, chemoreceptors) involved in these
reflexes are located in the walls of the alimentary canal organs and
respond to a number of stimuli:
1) Stretch of the organ by food in its lumen
2) pH of the contents
3) Presence of certain breakdown products of digestion
- When these receptors are activated, they trigger reflexes that active
or inhibit:
1) The glands that secrete digestive juices into the lumen or
hormones into the blood
2) The smooth muscles of the muscularis that mix and propel
the foods along the tract

Activities in the Mouth, Pharynx, and Esophagus

Food Ingestion and Breakdown
Mouth
- Once food has been placed in the mouth, both mechanical breakdown
and digestion begin
1) Food is physically broken down into smaller particles by chewing
2) Food is then mixed with saliva and salivary amylase begins the digestion starch, chemically breaking
it down into maltose
- When we chew a piece of food for a few minutes before swallowing it, it begins to taste sweet as the sugars
are released
- Saliva is normally secreted continuously to keep the mouth moist, but saliva secretion could also be
stimulated by the following:
1) When food enters the mouth
2) The simple pressure of anything put in the mouth and chewed
3) Emotional stimuli such as the mere thought of a hot fudge sundae
- All these reflexes, through initiated by different stimuli, are brought about by parasympathetic fibers in cranial
nerves VII and IX
- Essentially, no food absorption occurs in the mouth, however, some drugs, such as nitroglycerine, are
absorbed easily through the oral mucosa
Pharynx and Esophagus
- Have no digestive function
 - Simply provide passageways to carry food to the next processing site, which is the stomach

Food Propulsion: Swallowing and Peristalsis

Swallowing
- Also called “deglutition”
- A complex process that involves the coordinated activity of several structures including the tongue, soft
palate, pharynx, and esophagus
- Has two major phases:
1) Buccal phase
 Voluntary first phase
 Occurs in the mouth
 Once the food has been chewed and well mixed with saliva, the bolus or food mass is forced
into the pharynx by the tongue
 As food enters the pharynx, it passes out of our control and into the realm of reflex activity
2) Pharyngeal-esophageal phase
 Involuntary second phase
 Transports food through the pharynx and esophagus
  The parasympathetic division of the ANS, primarily the vagus nerves, controls this phase and
promotes the mobility of the digestive organs from this point on
 All routes that the food might take, except the desired route distal into the digestive tract, are
blocked off
 The tongue blocks off the mouth, the soft palate closes the nasal passages, and the larynx rises
so that its opening is covered by the flaplike epiglottis
 Food is moved through the pharynx and then into the esophagus below by wavelike peristaltic
contractions of their muscular walls, the longitudinal muscles and circular muscles
 Short-circuited routing mechanisms occur when we try to talk while swallowing and
food may enter the respiratory passages, which triggers coughing
 Once food reaches the distal end of the esophagus, it presses against the cardioesophageal
sphincter, causing it to pen and the food enters the stomach

Activities of the Stomach

Food Breakdown
- Neural and hormonal factors regulate the secretion of gastric juice
- The sight, smell, and taste of food stimulate parasympathetic nervous system reflexes, which increase the
secretion of gastric juice by the stomach glands
- As food enters and fills the stomach, its wall begins to stretch as the gastric juices are secreted
- Little chemical digestion also occurs but no absorption occurs through the stomach walls except for aspirin
and alcohol which seem to have a special pass
- The presence of food and a rising pH in the stomach stimulates the stomach cells to release the hormone
called “gastrin”
o Gastrin
 2 to 3 liters of gastric juice are normally produced every day
 Prods the stomach glands to produce:
i. Hydrochloric acid
 Makes the stomach contents very acidic
 Is dangerous due to its ability to digest the stomach itself, causing ulcers
 Produces an extremely acidic environment necessary for activating
pepsinogen to pepsin
ii. Protein-digesting enzymes (pepsinogens)
 Is dangerous due to its ability to digest the stomach itself, causing ulcers
iii. Mucus
 Enough amount makes the stomach “safe” and will remain it unharmed
o Pepsin
 An active protein-digesting enzyme
o Rennin
 Second protein-digesting enzyme produced by the stomach
 Works primarily on milk protein and converts it to a substance that looks like sour milk
 Produced in large amounts in infants, but it is not believed to be produced in adults
- Semifluid chyme is formed when food is continuously mixed with enzyme-containing gastric juice
Food Propulsion
- Once food has been well mixed, a rippling peristalsis begins in the upper half of the stomach
 - Contractions increase in force as the food approaches the pyloric valve
- The pylorus of the stomach holds about 30 mL of chyme and acts like a meter that allows only liquids and
very small particles to pass through the pyloric sphincter
- Because the pyloric sphincter barely opens, each contraction of the stomach muscle squirts 3 mL or less of
chyme into the small intestine and closes the valve so the rest of the chyme, about 27 mL, is propelled
backward into the stomach for more mixing, a process called “retropulsion”
o Enterogastric reflex
 A nervous reflex
 Occurs when the duodenum is filled with chyme and its wall is stretched
 Puts the brakes on gastric activity and slows the emptying of the stomach by inhibiting the
vagus nerves and tightening the pyloric sphincter, allowing time for intestinal processing to
catch up
 Well-balanced meal: 4 hours for the stomach to empty
 High fat content meal: 6 hours or more

Activities of the Small Intestine

Food Breakdown and Absorption
- Food reaching the small intestine is only partially digested
o Carbohydrate and protein digestion has begun
o No fats have been digested
- Here the process of chemical food digestion is accelerated as the food now takes a 3- to 6-hour journey
through the looping coils and twists of the small intestine
- By the time the food reaches the end of the small intestine, digestion is complete, and nearly all food
absorption has occurred
- The microvilli of small intestine cells bear a few important enzymes:
1) Brush border enzymes: break down double sugars into simple sugars and complete protein digestion
2) Intestinal juice: relatively enzyme poor, a protective mucus that is the most important intestinal gland
secretion
- Foods entering the small intestine are deluged with enzyme-rich pancreatic juice ducted in from the pancreas,
as well as bile from the liver
- The vagus nerves and local hormones stimulate the release of pancreatic juice into the duodenum which
contain enzymes that:
1) Along with brush border enzymes, complete the digestion of starch or pancreatic amylase
2) Carry out about half of the protein digestion via the action of trypsin, chymotrypsin,
carboxypeptidase, and others
3) Are totally responsible for fat digestion because the pancreas is essentially the only source of lipases
4) Digest nucleic acids or nucleases
- Pancreatic juice contains a rich supply of bicarbonate, which makes it very basic, about pH 8, neutralizing the
acidic chyme coming in from the stomach, providing the proper environment for activation and activity of
intestinal and pancreatic digestive enzymes
 - When chyme enters the small intestine, it stimulates the mucosa cells to produce several hormones that
influence the release of pancreatic juice and bile:
1) Secretin: causes the liver to increase its output of bile
2) Cholecystokinin (CCK): causes the gallbladder to contract and release stored bile into the bile duct so
that bile and pancreatic juice enter the small intestine together
- These hormones enter the blood and circulate to their target organs, the pancreas, liver, and gallbladder and
work together to stimulate the pancreas to release its enzyme- and bicarbonate-rich product
- Absorption of water and of the end products of digestion occurs all along the length of the small intestine
o Most substances are absorbed through the intestinal cell plasma membranes by the process of active
transport and then enter the capillary beds in the villi to be transported in the blood to the liver via the
hepatic portal vein
o Lipids, or fats, which are absorbed passively by the process of diffusion
o Lipid breakdown products enter both the capillary beds and the lacteals in the villi and are carried to
the liver by both blood and lymphatic fluids
- At the end of the ileum, all that remains is some water, indigestible food materials (plant fibers such as
cellulose), and large amounts of bacteria which enter the large intestine through the ileocecal valve

Food Propulsion
- Peristalsis is the major means of propelling food through the digestive tract and involves waves of contraction
that move along the length of the intestine, followed by waves of relaxation
- The net effect is that the food is moved through the small intestine in much the same way that toothpaste is
squeezed from a tube
- Rhythmic segmental movements produce local constrictions of the intestine that mix the chyme with the
digestive juices, and help to propel food through the intestine

Activities of the Large Intestine

Food Breakdown and Absorption
- Residue delivered to the large intestine contains few nutrients, but still has 12 to 24 hours more to spend there
- Bacteria residing in the large intestine also make some vitamins: vitamin K and some B vitamins
- Absorption by the large intestine is limited to the absorption of these vitamins, some ions, and most of the
remaining water
- The colon produces no digestive enzymes but the “resident” bacteria that live in its lumen metabolize some of
the remaining nutrients, releasing gases (methane and hydrogen sulfide) that contribute to the odor of feces.
- About 500 ml of gas or flatus is produced each day, much more when certain carbohydrate-rich foods, such as
beans, are eaten
 - Feces, the more or less solid product delivered to the rectum, contain undigested food residues, mucus,
millions of bacteria, and just enough water to allow their smooth passage
Propulsion of the Residue and Defecation
- When presented with food residue, the colon begins contractions, but they are sluggish or short-lived
1) Haustral contractions
 Movements most seen in the colon
 Slow segmenting movements lasting about 1 minute that occur every 30 minutes or so
 As a haustrum fills with food residue, the distension stimulates its muscle to contract, which
propels the luminal contents into the next haustrum
 Mixes the residue, which aids in water absorption
2) Mass movements
 Long, slow-moving
 Powerful contractile waves that move over large areas of the colon 3 or 4 times daily and
force the contents toward the rectum
 Typically occur during or just after eating, when food begins to fill the stomach and small
intestine
- Bulk or fiber in the diet increases the strength of colon contractions and softens the stool, allowing the colon
to act as a well-oiled machine
- The rectum is generally empty, but when feces are forced into it by mass movements and its wall is stretched,
the defecation reflex is initiated
o Defecation reflex
 A spinal or sacral region reflex
 Causes the walls of the sigmoid colon and the rectum to contract and the anal sphincters to
relax
- As the feces are forced through the anal canal, messages reach the brain giving us time to decide whether the
external voluntary sphincter should remain open or be constricted to stop passage of feces
- If it is not convenient, defecation or the “moving the bowels” can be delayed temporarily
- Within a few seconds, the reflex contractions end, and the rectal walls relax, and with the next mass
movement, the defecation reflex is initiated again
Nutrition
Nutrient
- A substance in food that is used by the body to promote normal growth, maintenance, and repair
- Divided into six categories:
1) Major nutrients
 Make up the bulk of what we eat
i. Carbohydrates
ii. Lipids
iii. Proteins
iv. Water: accounts for about 60 percent of the volume of the food we eat, is also
considered to be a major nutrient but is an important solvent in many other aspects of
body functioning
2) Minor nutrients
 While equally crucial for health, are required in minute amounts
i. Vitamins
ii. Minerals
- Most foods offer a combination of nutrients
- A diet consisting of foods selected from each of the five food groups normally guarantees adequate amounts
of all the needed nutrients

- Nutrition advice is constantly in flux and often mired in the self-interest of food companies
- Nonetheless, basic dietary principles have not changed in years and are not in dispute:
o Eat less overall
o Eat plenty of fruits, vegetables, and whole grains
o Avoid junk food
o Exercise regularly
Healthy Eating Pyramid
- The version issued in 1992 by Walter Willett
- Uses the traditional horizontal orientation of food groups
- Looks at six major food groups, subdividing some of them
further
- Emphasizes eating whole-grain foods and lots of fruits and
vegetables and recommends substituting plant oils for animal
fats and restricting red meat, sweets, and starchy foods
MyPlate
- Issued by the United States Department of Agriculture (USDA) in 2011
- A food guide with a completely new symbol: a round dinner plate
- Shows food categories in healthy proportions in sections of a place setting
rather than as segments of a pyramid
o Occupying half the plate are fruits and vegetables (more vegetable
than fruit)
o The other half shows grains and proteins (more grain than protein)
o A glass represents dairy, the fifth food group
- You can personalize your MyPlate diet by age, sex, and activity level by
going to the MyPlate website

Dietary Sources of the Major Nutrients

Carbohydrates
- Milk sugar (lactose) and small amounts of glycogen are derived from meats
- Sugars and starches we ingest are derived from plants
o Sugars: come mainly from fruits, sugar cane, and milk
o Starch: polysaccharide found in grains, legumes, and root vegetables
o Cellulose: polysaccharide plentiful in most vegetables, is not digested by humans, but it provides
roughage, or fiber, which increases the bulk of the stool and aids defecation
Lipids
- Most dietary lipids are triglycerides or neutral fats, but we also ingest cholesterol and phospholipids
o Saturated fats: present in animal products such as meat and dairy foods and in a few plant products,
such as coconut
o Unsaturated fats: present in seeds, nuts, and most vegetable oils
- Major sources of cholesterol:
1) Egg yolk
2) Meats
3) Milk products
Proteins
- The essential amino acids are the eight amino acids that our body
cannot make, hence we must take these amino acids in through the
diet
- As you can see, strict vegetarians must carefully plan their diets to
obtain all the essential amino acids and prevent protein malnutrition
1) Animal products: contain the highest-quality proteins,
molecules that are basically amino acid polymers
2) Eggs, milk, fish, and most meat: have complete proteins that meet all of the body’s amino acid
requirements for tissue maintenance and growth
3) Legumes (beans and peas), nuts, and cereals: protein-rich but their proteins are nutritionally
incomplete because they are low in one or more of the essential amino acids
4) Cereal grains and legumes: when ingested together provide all the needed amino acids, and some
variety of this combination is found in the diets of all cultures (most obviously in the rice and beans
seen on nearly every plate in a Mexican restaurant)
Vitamins
 - Are organic nutrients of various forms that the body requires in small amounts
- Most vitamins function as coenzymes or parts of coenzymes, where they act with an enzyme to accomplish a
particular type of catalysis
- Vitamins A, C, and E appear to have anticancer effects, hence, diets rich in broccoli, cabbage, and brussels
sprouts, good sources of vitamins A and C, appear to reduce cancer risk
- Although vitamins are found in all major food groups, no one food contains all the required vitamins, hence a
balanced diet is the best way to ensure a full vitamin complement
Minerals
- The body also requires adequate supplies of seven minerals and trace amounts of about a dozen others
1) Calcium
2) Phosphorus
3) Potassium
4) Sulfur
5) Sodium
6) Chloride
7) Magnesium
- Fats and sugars have practically no minerals
- Cereals and grains are poor sources of minerals
- Vegetables, legumes, milk, and some meats are the most mineral-rich foods

Metabolism
- A broad term referring to all chemical reactions that are necessary to maintain life
- Involves the two processes:
1) Catabolism
 The breakdown of substances to simpler substances
 Bond energy of foods is released and captured to make ATP, the energy-rich molecule used to
energize all cellular activities, including catabolic reactions
2) Anabolism
 The building of larger molecules or structures from smaller ones

Carbohydrate, Fat, and Protein Metabolism in Body Cells

- Not all foodstuffs are treated in the same way by body cells
o Carbohydrates, particularly glucose, are usually broken down to make ATP
o Fats are used to build cell membranes, make myelin sheaths, and insulate the body with a fatty
cushion and are used as the body’s main energy fuel for making ATP when there are inadequate
carbohydrates in the diet
o Proteins tend to be carefully conserved and even hoarded by the body cells as the major structural
materials used for building cell structures
Carbohydrate Metabolism

- The cells of the body use carbohydrates as their preferred fuel to produce cellular energy (ATP)
Glucose
- Also called "blood sugar"
- Major breakdown product of carbohydrate digestion
- Major fuel used for making ATP in most body cells, except the liver which uses fats
 - Broken apart piece by piece, and some of the chemical energy released when its bonds are broken is captured
and used to bind phosphate to ADP molecules to make ATP

Cellular respiration
- Oxygen-using events
- Carbon atoms released leave the cells as carbon dioxide
- Hydrogen atoms removed which contain energy-rich electrons are eventually combined with oxygen to form
water
- Involves three main metabolic pathways:
1) Glycolysis
 Takes place in the cytosol
 Major role is oxidation via the
removal of hydrogen atoms
 Also energizes each glucose
molecule so that it can be split
into two pyruvic acid
molecules and yield a small
amount of ATP in the process
2) Krebs cycle
 Occurs in the mitochondria
 Major role is oxidation via the
removal of hydrogen atoms
 Produces virtually all the
carbon dioxide that results during cell respiration
 Yields a small amount of ATP by transferring high-energy phosphate groups directly from
phosphorylated substances to ADP, a process called "substrate-level phosphorylation”
 Free oxygen is not involved
3) Electron transport chain
 Is where the action is for ATP production
 The hydrogen atoms removed during the
first two metabolic phases are loaded with
energy and are delivered by the
coenzymes to the protein carriers of the
electron transport chain, which form part
of the mitochondrial cristae membranes
 The hydrogen atoms are split into hydrogen ions (H+) and electrons (e−)
 Electrons
 Fall down an energy hill going from each carrier to a carrier of lower energy
 Give off their load of energy in a series of steps in small enough amounts to
enable the cell to attach phosphate to ADP and make ATP
 Oxidative phosphorylation
 More complicated process of ATP formation
 Occurs when free oxygen is reduced, the electrons and hydrogen ions are
united with molecular oxygen, forming water and a large amount of ATP
 The beauty of this system is that, unlike the explosive reaction that usually happens when
fuels are burned when O2 is combined with hydrogen, relatively small amounts of energy are
lost as heat and light
- Because glucose is the major fuel for making ATP, homeostasis of blood glucose levels is critically important
o Hyperglycemia
 Excessively high levels of glucose in the blood
 Some of the excess is stored in body cells, particularly liver and muscle cells, as glycogen
 If blood glucose levels are still too high, excesses are converted to fat
 There is no question that eating large amounts of empty-calorie foods such as candy and other
sugary sweets causes a rapid deposit of fat in the body’s adipose tissues
 o Hypoglycemia
 When blood glucose levels are too low
 The liver breaks down stored glycogen and releases glucose to the blood for cellular use

Fat Metabolism

- The liver handles most lipid or fat metabolism that goes on in the body and the liver cells use some fats to
make ATP for their own use:
o Some are used to synthesize lipoproteins, thromboplastin (a clotting protein), and cholesterol
o The rest are released to the blood in the form of relatively small fat-breakdown products
Fats
- Used to form myelin sheaths of neurons and fatty cushions around body organs
- Are the body’s most concentrated source of energy
o Catabolism of 1 gram of fat yields twice as much energy as the breakdown of 1 gram of carbohydrate
or protein
- For fat products to be used for ATP synthesis, they must first be broken down to acetic acid, which will be
completely oxidized within the mitochondria, forming carbon dioxide, water, and ATP
- Larger amounts are used to produce ATP when there is not enough glucose to fuel the needs of the cells for
energy
o Under such conditions, fat oxidation is fast but incomplete, and some of the intermediate products,
such as acetoacetic acid and acetone, begin to accumulate in the blood
o This causes the blood to become acidic, a condition called “acidosis,” wherein breath takes on a fruity
odor as acetone diffuses from the lungs and the body is forced to rely almost totally on fats to fuel its
energy needs
- Excess fats are stored in fat depots such as the hips, abdomen, breasts, and subcutaneous tissues
o Although the fat in subcutaneous tissue is important as insulation for the deeper body organs,
excessive amounts restrict movement and place greater demands on the circulatory system
- However, cholesterol is never used as a cellular fuel and ts importance lies in the functional molecules and in
the structures it helps to form
Protein Metabolism

The Central Role of the Liver in Metabolism

- The liver is one of the most versatile and complex organs in the body, without it, we would die within 24
hours
 - Because of the liver’s key roles, nature has provided us with a surplus of liver tissue, we have much more than
we need, and even if part of it is damaged or removed, it is one of the few body organs that can regenerate
rapidly and easily
- Its role in digestion, which is the manufacture of bile, is important to the digestive process to be sure, but it is
only one of the many functions of liver cells
o Liver cells
 Play a central role in metabolism as they process nearly every class of nutrient
 Detoxify drugs and alcohol, degrade hormones, and make many substances vital to the body
as a whole: cholesterol, blood proteins such as albumin and clotting proteins, and lipoproteins
o Hepatic portal circulation
 A unique circulation
 Ensures that the liver’s needs will be met first
 Brings nutrient-rich blood draining from the digestive viscera directly to the liver
 As blood circulates slowly through the liver, liver cells remove amino acids, fatty acids, and
glucose from the blood which are stored for later use or processed in various ways
 At the same time, the liver’s phagocytic cells remove and destroy bacteria that have managed
to get through the walls of the digestive tract and into the blood
General Metabolic Functions
- The liver is vitally important in helping to maintain blood
glucose levels within normal range, around 100 mg
glucose/100 ml of blood)
- Hormones such as thyroxine, insulin, and glucagon are
vitally important in controlling the blood sugar levels and in
the handling of glucose in all body cells
o Glycogen
 Large polysaccharide molecules
 Formed when thousands of glucose
molecules are removed from the blood and
combined after a carbohydrate-rich meal
 Stored in the liver
o Glycogenesis
 Formation of glycogen
o Glycogenolysis
 Glycogen spitting
 Liver cells break down the stored glycogen
 Occurs when the body cells continue to remove glucose from the blood to meet their needs
and blood glucose levels begin to drop
 The liver cells then release glucose bit by bit to the blood to maintain homeostasis of blood
glucose levels
o Gluconeogenesis
 Formation of new sugar
 Occurs when the liver makes glucose from noncarbohydrate substances, such as fats and
proteins
- Some of the fats and fatty acids picked up by the liver cells are oxidized for energy to make ATP for use by
the liver cells themselves
- The rest are broken down to simpler substances such as acetic acid and acetoacetic acid (two acetic acids
linked together) and released into the blood or are stored as fat reserves in the liver
- All blood proteins made by the liver are built from the amino acids its cells pick up from the blood and are
then released back into the blood to travel throughout the circulation
o Albumin
 Most abundant protein in blood
 Holds fluids in the bloodstream
 When insufficient, fluid leaves the bloodstream and accumulates in the tissue spaces, causing
edema
- Nutrients not needed by the liver cells, as well as the products of liver metabolism, are released into the blood
and drain from the liver in the hepatic vein to enter the systemic circulation, where they become available to
other body cells
Cholesterol Metabolism and Transport
Cholesterol
- A major building block of plasma membranes
- 15% comes from our diet, 85% is made by the liver
- Serves as the structural basis of steroid hormones and vitamin D
- Lost from the body when it is broken down and secreted in bile salts, which eventually leave the body in feces
Lipoproteins
- One class of proteins made by the liver
- Play an important role in fat and cholesterol transport
- Small lipid-protein complexes containing fatty acids, fats, and cholesterols that are insoluble in water and
cannot circulate freely in the blood stream
- Known by the buzzwords:
1) Low-density lipoproteins (LDLs)
 Lipoproteins that transport cholesterol and other lipids to body cells, where they are used in
various ways
 High LDL levels increase the chance of atherosclerosis and fatty substances will be deposited
on the arterial walls, hence being tagged as “bad lipoproteins”
2) High-density lipoproteins (HDLs)
 Lipoproteins that transport cholesterol from the tissue cells or arteries to the liver for disposal
in bile
 High HDL levels are considered “good” because the cholesterol is destined to be broken
down and eliminated from the body
- Aerobic exercise, a diet low in saturated fats and cholesterol, and abstaining from smoking and drinking
coffee all appear to favor a desirable HDL and LDL ratio
Body Energy Balance
- A dynamic balance exists between the body’s energy intake and its energy output
- Energy intake = total energy output = heat + work + energy storage
Energy intake
- The energy liberated during food oxidation during the reactions of glycolysis, the Krebs cycle, and the
electron transport chain
Energy output
- Includes the energy we immediately lose as heat (about 60% of the total) + the energy used to do work (driven
by ATP) + energy that is stored in the form of fat or glycogen
o Energy storage
 Important only during periods of growth and during net fat deposit
Regulation of Food Intake
- When energy intake and energy output are balanced, body weight remains stable
- When energy intake and energy output are not balanced, we either gain or lose weight
- Because body weight in most people is surprisingly stable, mechanisms that control food intake or heat
production or both must exist
- Unhappily for many people, the body’s weight-controlling systems appear to be designed more to protect us
against weight loss than weight gain
- It has been known for some time that the hypothalamus releases several peptides that influence feeding
behavior
- Current theories of how feeding behavior and hunger are regulated focus mostly on neural signals from the
digestive tract, bloodborne signals related to body energy stores, and hormones
- To a smaller degree, body temperature and psychological factors also seem to play a role and appear to
operate through feedback signals to the feeding centers of the brain
o Brain receptors include thermoreceptors, chemoreceptors (for glucose, insulin, and others), and
receptors that respond to leptin and other peptides
o Sensors in peripheral locations have also been suggested, with the liver and gut or alimentary canal as
the prime candidates
Metabolic Rate and Body Heat Production
- When nutrients are broken down to produce cellular energy (ATP), they yield different amounts of energy
o Carbohydrates and proteins each yield 4 kcal/gram
o Fats yield 9 kcal/gram when broken down for energy production
- Most meals, and even many individual foods, are mixtures of carbohydrates, fats, and proteins
- To determine the caloric value of a meal, we must know how many grams of each type of foodstuff it contains
and approximations can easily be made with the help of a simple, calorie-values guide available in most
drugstores
Basal Metabolic Rate (BMR)
- The amount of heat produced by the body per unit of time when it is under basal conditions or at rest
- Reflects the energy supply a person’s body needs just to perform essential life activities such as breathing,
maintaining the heartbeat, and kidney function
- An average 70-kg (154-pound) adult has a BMR of about 60 to 72 kcal/hour
- Influenced by many factors including:
1) Surface area
 Increased: large surface area in relation to body volume or thin, small individuals
 Decreased: small surface area in relation to body volume or large, heavy individuals
2) Sex
 Increased: male
 Decreased: female
3) Thyroxine production
 Increased: increased thyroxine production
 Decreased: decreased thyroxine production
 Most important factor in determining a person’s BMR, hence thyroxine being dubbed the
“metabolic hormone”
  The more thyroxine produced, the higher the oxygen consumption and ATP use and the
higher the metabolic rate
4) Age
 Increased: young age, rapid growth
 Decreased: aging, elderly
5) Strong emotions and infections
 Increased
Total Metabolic Rate (TMR)
-
Body Temperature Regulation

Developmental Aspects
Homeostatic Imbalances
Tongue-tied
- Children born with an extremely short lingual frenulum
- Movement of the tongue is restricted, leading to distorted speech
- Can be corrected surgically by cutting the frenulum
Peritonitis
- Infected peritoneum
- Peritoneal membranes tend to stick together around the infection site
- Hels seal off and localize many intraperitoneal infections, providing time for macrophages in the lymphatic
tissue to mount an attack
Appendicitis
- Inflammation of the appendix
- Caused by accumulation of bacteria
Impacted teeth
- When teeth remain embedded in the jawbone
- Exert pressure and cause a good deal of pain and must be removed surgically
- Commonly occurs in wisdom teeth
Mumps
- Common childhood disease
- Inflammation of the parotid glands
- Hurts to open the mouth or chew
Gallstones
- Formed when bile is stored in the gallbladder for too long or if too much water is removed, and the cholesterol
crystallizes
- Tend to be quite sharp, causing agonizing pain when the gallbladder contracts
Jaundice
- Yellowing of tissues
- Could be caused by blockage of the ducts, circulating of bile pigments through the body, or most often from
liver problems, such as hepatitis or cirrhosis
Hepatitis
- An inflammation of the liver
- Most often due to viral infection from drinking contaminated water or transmitted in blood via transfusion or
contaminated needles
Cirrhosis
- Chronic inflammatory condition
- A common consequence of severe hepatitis
- Liver is severely damaged and becomes hard and fibrous
- Almost guaranteed when someone drinks alcoholic beverages in excess for many years
Heart burn
- A characteristic pain that could lead to esophagitis or even ulceration of the esophagus
- Occurs when the cardioesophageal sphincter fails to close tightly and gastric juice backs up into the
esophagus, which has little mucus protection
- Common cause is hiatal hernia
Esophagitis
- Inflammation of the esophagus
Hiatal hernia
- Structural abnormality
- The superior part of the stomach protrudes slightly above the diaphragm
- Causes the gastric juice to flow into the unprotected esophagus
- Conservative treatment involves restricting food intake after the evening meal, taking antacids, and sleeping
with the head elevated
Vomiting
- Also called “emesis”
- When the emetic center in the brain, the medulla, activates
- Occurs when there is a local irritation of the stomach due to bacterial food poisoning or a disturbance of the
equilibrium apparatus of the inner ear
- Essentially a reverse peristalsis occurring in the stomach and perhaps the small intestine, accompanied by
contraction of the abdominal muscles and diaphragm, which increases the pressure on the abdominal organs
Pancreatitis
- A rare but extremely serious inflammation of the pancreas
- Results from activation of pancreatic enzymes in the pancreatic duct
- This painful condition can lead to nutritional deficiencies, because pancreatic enzymes are essential for
digestion in the small intestine
Diverticulosis
- When the mucosa protrudes through the colon walls
- Occurs when the diet lacks bulk, the colon narrows and its circular muscles contract more powerfully,
increasing the pressure on its walls, which encourages formation of diverticula
Diverticulitis
- A condition in which the diverticula become inflamed
- Can be life-threatening if ruptures occur
Diarrhea
- Also called “watery stools”
- Irritation of the colon by bacteria
- Result from any condition that rushes food residue through the large intestine before that organ has had
sufficient time to absorb the water
- Because fluids and ions are lost from the body, prolonged diarrhea may result in dehydration and electrolyte
imbalance which, if severe, can be fatal
Constipation
- Occurs when food residue remains in the large intestine for extended periods
- Too much water is absorbed and the stool becomes hard and difficult to pass
- May result from lack of fiber in the diet, poor bowel habits, failing to heed the call, and laxative abuse