Digestive system

THE DIGESTIVE SYSTEM

The process by which food is broken down into molecules that are small enough to enter body cells is known as digestion. The organs
involved in the breakdown of food is together called the digestive system
Two groups of organs makeup the digestive system: the gastrointestinal (GI) tract and the accessory digestive organs.

The gastrointestinal (GI) tract, or alimentary canal,

 It is a continuous tube that extends from the mouth to the anus through the thoracic and abdominopelvic cavities.
 It includes the mouth, most of the pharynx, esophagus, stomach, small intestine, and large intestine.
The accessory digestive organs
 It includes the teeth, tongue, salivary glands, liver, gallbladder, and pancreas.
 Teeth help in the physical breakdown of food, and the tongue helps in chewing and swallowing. The other accessory
digestive organs never come into direct contact with food. They produce or store secretions that flow into the GI tract through
ducts.

THE GASTROINTESTINAL TRACT

LAYERS OF THE G.I TRACT

The wall of the GI tract from the lower esophagus to the anal canal has the same basic, four-layered arrangement of tissues. The four
layers of the tract, from deep to superficial, are the mucosa, submucosa, muscularis, and serosa.

Mucosa
The mucosa, or inner lining of the GI tract, is a mucous membrane. It is composed of:-
(1) A layer of epithelium in direct contact with the contents of the GI tract,
(2) A layer of connective tissue called the lamina propria,
(3) A thin layer of smooth muscle (muscularis mucosae).

1. The Epithelium
 In the mouth, pharynx, esophagus, and anal canal, it is mainly nonkeratinized stratified squamous epithelium that serves a
protective function. Simple columnar epithelium, which functions in secretion and absorption, lines the stomach and
intestines.
 Located among the epithelial cells are exocrine cells that secrete mucus and fluid into the lumen of the tract, and several
types of endocrine cell called enteroendocrine cells, which secrete hormones.
2. The lamina propria
 It is the areolar connective tissue containing many blood and lymphatic vessels, which are the routes by which nutrients
absorbed into the GI tract reach the other tissues of the body.
 It also contains the majority of the cells of the mucosaassociated lymphatic tissue (MALT).
3. Muscularis mucosae: - It increases the surface area for digestion and absorption.

Submucosa
 The submucosa contains many blood and lymphatic vessels that receive absorbed food molecules.
 Also located in the submucosa is an extensive network of neurons known as the submucosal plexus.
Muscularis
 The muscularis of the mouth, pharynx, and superior and middle parts of the esophagus contains skeletal muscle that
produces voluntary swallowing.
 The muscularis also consists of smooth muscle. Involuntary contractions of the smooth muscle help break down food, mix it
with digestive secretions, and move it along the tract.
 Between the layers of the muscularis is a second plexus of neurons—the myenteric plexus.
Serosa
Great amount of movements such as muscular contractions mix and move the luminar contents along GIT

MOUTH
 The mouth, also referred to as the oral or buccal cavity, is formed by the cheeks, hard and soft palates, and tongue.
 The cheeks form the lateral walls of the oral cavity.
 The lips or labia are fleshy folds surrounding the opening of the mouth.
The oral cavity proper is the space that extends from the gums and teeth to the fauces, the opening between the oral cavity and the
oropharynx
 The palate is a wall or septum that separates the oral cavity from the nasal cavity, and forms the roof of the mouth. This
important structure makes it possible to chew and breathe at the same time.
 Digestive system
 The hard palate—the anterior portion of the roof of the mouth—is formed by the maxillae and palatine bones and is covered
by a mucous membrane; it forms a bony partition between the oral and nasal cavities.
 The soft palate, which forms the posterior portion of the roof of the mouth, is an arch-shaped muscular partition between the
oropharynx and nasopharynx that is lined with mucous membrane.

 Hanging from the free border of the soft palate is a conical muscular process called the uvula.
 During swallowing, the soft palate and uvula are drawn superiorly, closing off the nasopharynx and preventing swallowed
foods and liquids from entering the nasal cavity.

Salivary Glands
A salivary gland is a gland that releases a secretion called saliva into the oral cavity.
When food enters the mouth,secretion of saliva increases, and it lubricates, dissolves, and begins the chemical
breakdown of the food. The mucous membrane of the mouth and tongue contains many small salivary glands that open directly, or
indirectly via short ducts, to the oral cavity.
These glands include labial, buccal, and palatal glands in the lips, cheeks, and palate, respectively, and lingual glands in the tongue,
all of which make a small contribution to saliva.
However, most saliva is secreted by the major salivary glands, which lie beyond the oral mucosa, into ducts that lead to the oral
cavity.
There are three pairs of major salivary glands:-
The parotid glands are located inferior and anterior to the ears, between the skin and the masseter muscle.
The submandibular glands are found in the floor of the mouth; they are medial and partly inferior to the body of the mandible..
The sublingual glands are beneath the tongue and superior to the submandibular glands.

Composition and Functions of Saliva

Chemically, saliva is 99.5% water and 0.5% solutes. Among the solutes are ions, including sodium, potassium, chloride, bicarbonate,
and phosphate. Also present are some dissolved gases and various organic substances, including urea and uric acid, mucus,
immunoglobulin A, the bacteriolytic enzyme lysozyme, and salivary amylase, a digestive enzyme that acts on starch.

(1) The water in saliva provides a medium for dissolving foods so that they can be tasted by gustatory receptors and so that
digestive reactions can begin.
(2) Chloride ions in the saliva activate salivary amylase, an enzyme that starts the breakdown of starch in the mouth into
maltose, maltotriose, and _-dextrin.
(3) Bicarbonate and phosphate ions buffer acidic foods that enter the mouth, so saliva is only slightly acidic (pH 6.35–6.85).
(4) Salivary glands (like the sweat glands of the skin) help remove waste molecules from the body, which accounts for the
presence of urea and uric acid in saliva.
(5) Mucus lubricates food so it can be moved around easily in the mouth, formed into a ball, and swallowed.
(6) Immunoglobulin A (IgA) prevents attachment of microbes so they cannot penetrate the epithelium the enzyme lysozyme kills
bacteria;

Mechanical and Chemical Digestion in the Mouth

(1) Mechanical digestion in the mouth results from chewing, or mastication, in which food is manipulated by the tongue, ground
by the teeth, and mixed with saliva.
(2) As a result, the food is reduced to a soft, flexible, easily swallowed mass called a bolus.
 Digestive system
(3) Food molecules begin to dissolve in the water in saliva, an important activity because enzymes can react with food molecules
in a liquid medium only.
(4) Two enzymes, salivary amylase and lingual lipase, contribute to chemical digestion in the mouth.
A. The function of salivary amylase is to begin starch digestion by breaking down starch into smaller molecules such as the
disaccharide maltose, the trisaccharide maltotriose, and short-chain glucose polymers called _-dextrins.
B. Saliva also contains lingual lipase which becomes activated in the acidic environment of the stomach and thus starts to work
after food is swallowed. It breaks down dietary triglycerides (fats and oils) into fatty acids and diglycerides. A diglyceride
consists of a glycerol molecule that is attached to two fatty acids.

DEGLUTITION

The movement of food from the mouth into the stomach is achieved by the act of swallowing, or deglutition
Deglutition is facilitated by the secretion of saliva and mucus and involves the mouth, pharynx, and esophagus.
Swallowing occurs in three stages:
(1) The voluntary stage, in which the bolus is passed into the oropharynx;
(2) The pharyngeal stage, the involuntary passage of the bolus through the pharynx into the esophagus; and
(3) The esophageal stage, the involuntary passage of the bolus through the esophagus into the stomach.

 Swallowing starts when the bolus is forced to the back of the oral cavity and into the oropharynx by the movement of the
tongue upward and backward against the palate; these actions constitute the voluntary stage of swallowing.

 With the passage of the bolus into the oropharynx, the involuntary pharyngeal stage of swallowing begins.

 The bolus stimulates receptors in the oropharynx, which send impulses to the deglutition center in the medulla oblongata and
lower pons of the brain stem.
 The returning impulses cause the soft palate and uvula to move upward to close off the nasopharynx, which prevents
swallowed foods and liquids from entering the nasal cavity.
 In addition, the epiglottis closes off the opening to the larynx, which prevents the bolus from entering the rest of the
respiratory tract.
 The bolus moves through the oropharynx and the laryngopharynx. Once the upper esophageal sphincter relaxes, the bolus
moves into the esophagus.

 The esophageal stage of swallowing begins once the bolus enters the esophagus.
 During this phase, peristalsis pushes the bolus onward.
 In the section of the esophagus just superior to the bolus, the circular muscle fibers contract, constricting the
esophageal wall and squeezing the bolus toward the stomach.
 The contractions are repeated in waves that push the food toward the stomach. As the bolus approaches the end of
the esophagus, the lower esophageal sphincter relaxes and the bolus moves into the stomach.
 Mucus secreted by esophageal glands lubricates the bolus and reduces friction.
 The passage of solid or semisolid food from the mouth to the stomach takes 4 to 8 seconds; very soft foods and
liquids pass through in about 1 second.

STOMACH

The stomach is a J-shaped enlargement of the GI tract inferior to the diaphragm in the abdomen. The stomach connects the esophagus
to the duodenum, the first part of the small intestine. One of the functions of the stomach is to serve as a mixing chamber and holding
reservoir.
Anatomy of the Stomach
 The stomach has four main regions: the cardia, fundus, body, and pyloric part.
 The cardia surrounds the superior opening of the stomach.
 The rounded portion superior to and to the left of the cardia is the fundus.
 Inferior to the fundus is the large central portion of the stomach, the body.
 The pyloric part is divisible into three regions.
 The first region, the pyloric antrum, connects to the body of the stomach.
 The second region, the pyloric canal, leads to the third region, the pylorus, which in turn connects to the duodenun.
When the stomach is empty, the mucosa lies in large folds, or rugae, that can be seen with the unaided eye.
The pylorus communicates with the duodenum of the small intestine via a smooth muscle sphincter called the pyloric sphincter.

 The concave medial border of the stomach is called the lesser curvature; the convex lateral border is called the greater
curvature.
 Digestive system
Mechanical and Chemical Digestion in the Stomach
(1) Several minutes after food enters the stomach, gentle, rippling, peristaltic movements called mixing waves pass over the
stomach every 15 to 25 seconds. These waves breakdown food, mix it with secretions of the gastric glands, and reduce it to a
soupy liquid called chime.
(2) More vigorous mixing waves begin at the body of the stomach and reach the pylorus. The pyloric sphincter normally remains
almost, but not completely, closed. As food reaches the pylorus, each mixing wave forces about 3 mL of chyme into the
duodenum through the pyloric sphincter, a phenomenon known as gastric emptying. The waves pushes the chyme forward
again and forces a little more into the duodenum.These forward and backward movements of the gastric contents are
responsible for most mixing in the stomach.
(3) Foods may remain in the fundus for about an hour without becoming mixed with gastric juice. During this time, digestion by
salivary amylase continues. Soon, however, the churning action mixes chyme with acidic gastric juice, inactivating salivary
amylase and activating lingual lipase, which starts to digest triglycerides into fatty acids and diglycerides.
(4) Although parietal cells secrete H +ions and cl- ion separately into the stomach lumen, the net effect is secretion of
hydrochloric acid (HCl). Proton pumps powered by H/K ATPases actively transport H+into the lumen while bringing K+
into the cell
(5) At the same time, Cl and K diffuse out into the lumen through its channels in the apical membrane. The enzyme carbonic
anhydrase, catalyzes the formation of carbonic acid from water and carbon dioxide . As carbonic acid dissociates, it provides
a ready source of H or the proton pumps but also generates bicarbonate ions.
(6) As HCO builds up in the cytosol, it exits the parietal cell in exchange for Cl via Cl /HCO antiporters in the basolateral
membrane. HCO diffuses into nearby blood capillaries. This “alkaline tide” of bicarbonate ions entering the bloodstream
after a meal may be large enough to elevate blood pH slightly and make urine more alkaline.
(7) Receptors are present in the plasma membrane of parietal cells. The histamine receptors on parietal cells called H2 receptors
mediate different responses
(8) HCl partially unfolds proteins in food and stimulates the secretion of hormones that promote the flow of bile and pancreatic
juice.The only proteolytic (protein-digesting) enzyme in the stomach is pepsin, which is secreted by chief cells.
(9) Another enzyme of the stomach is gastric lipase, which splits the short-chain triglycerides (fats and oils) in fat molecules
(such as those found in milk) into fatty acids and monoglycerides.
More important than either lingual lipase or gastric lipase is pancreatic lipase, an enzyme secreted by the pancreas into the
small intestine.
(10) Only a small amount of nutrients are absorbed in the stomach because its epithelial cells are impermeable to most materials.
However, mucous cells of the stomach absorb some water, ions, and short-chain fatty acids, as well as certain drugs and
alcohol.
Within 2 to 4 hours after eating a meal, the stomach has emptied its contents into the duodenum.

PANCREAS

 The pancreas is a pale grey gland that is about 12–15 cm long and 2.5 cm thick lies posterior to the greater curvature of the
stomach.
 The pancreas consists of a head, a body, and a tail and is usually connected to the duodenum by two ducts.
 The head is the expanded portion of the organ near the curve of the duodenum; superior to and to the left of the head are the
central body and the tapering tail.
 Pancreatic juices are secreted by exocrine cells into small ducts that unite to form two larger ducts, the pancreatic duct and
the accessory duct.
The pancreatic duct, or duct of Wirsung, is the larger of the two ducts. The pancreatic duct joins the common bile duct from the
liver and gallbladder and enters the duodenum as a dilated common duct called the hepatopancreatic ampulla, or ampulla of
Vater.
 The passage of pancreatic juice and bile through the hepatopancreatic ampulla into the small intestine is regulated by a mass
of smooth muscle surrounding the ampulla known as the sphincter of the hepatopancreatic ampulla, or sphincter of Oddi .
The other major duct of the pancreas, the accessory duct (duct of Santorini), leads from the pancreas and empties into the
duodenum about 2.5 cm superior to the hepatopancreatic ampulla.

LIVER

 The liver is the heaviest gland of the body, weighing about 1.4 kg in an average adult
 The liver is almost completely covered by visceral peritoneum and is completely covered by a dense irregular connective
tissue layer that lies deep to the peritoneum.
 The liver is divided into two principal lobes—a large right lobe and a smaller left lobe—by the falciform ligament.
 The falciform ligament extends from the undersurface of the diaphragm between the two principal lobes of the liver to the
superior surface of the liver, helping to suspend the liver in the abdominal cavity.
 In the free border of the falciform ligament is the ligamentum teres (round ligament), a remnant of the umbilical vein of the
fetus; this fibrous cord extends from the liver to the umbilicus.
 Digestive system
 The right and left coronary ligaments are narrow extensions of the parietal peritoneum that suspend the liver from the
diaphragm.

DIGESTION
Digestion of Carbohydrates
 Though the action of salivary amylase may continue in the stomach for a while, the acidic pH of the stomach destroys
salivary amylase and ends its activity.
 Thus, only a few starches are broken down by the time chyme leaves the stomach. Those starches not already broken down
into maltose, maltotriose, and dextrins are cleaved by pancreatic amylase, an enzyme in pancreatic juice that acts in the
small intestine.
 After amylase has split starch into smaller fragments, a brush-border enzyme called dextrinase acts on the resulting dextrins,
spltting one glucose unit at a time. Ingested molecules of sucrose, lactose, and maltose—three disaccharides—are not acted
on until they reach the small intestine.
 Three brush-border enzymes digest the disaccharides into monosaccharides- Sucrase,lactase and maltase
 Digestion of carbohydrates ends with the production of monosaccharides, which the digestive system is able to absorb.

Digestion of Proteins
 Enzymes in pancreatic juice—trypsin, chymotrypsin, carboxypeptidase, and elastase—continue to break down proteins
into peptides.
 Although all these enzymes convert whole proteins into peptides, their actions differ somewhat because each splits peptide
bonds between different amino acids.
 Protein digestion is completed by two peptidases in the brush border: aminopeptidase and dipeptidase.

Digestion of Lipids
 Enzymes that split triglycerides and phospholipids are called lipases. There are three types of lipases that can participate in
lipid digestion: lingual lipase, gastric lipase, and pancreatic lipase.
 Although some lipid digestion occurs in the stomach through the action of lingual and gastric lipases, most occurs in the
small intestine through the action of pancreatic lipase.
 Triglycerides are broken down by pancreatic lipase into fatty acids and monoglycerides. The liberated fatty acids can be
either short-chain fatty acids (with fewer than 10–12 carbons) or long-chain fatty acids.
 Before a large lipid globule containing triglycerides can be digested in the small intestine, it must first undergo
emulsification— a process in which the large lipid globule is broken down into several small lipid globules.
 The small lipid globules formed from emulsification provide a large surface area that allows pancreatic lipase to function
more effectively.

ABSORPTION
Absorption of Monosaccharides
$ All carbohydrates are absorbed as monosaccharides.
$ Monosaccharides pass from the lumen through the apical membrane via facilitated diffusion or active transport.
$ The transporter has binding sites for one glucose molecule and two sodium ions; unless all three sites are filled,
neither substance is transported. Monosaccharides then move out of the absorptive cells through their basolateral surfaces via
facilitated diffusion and enter the capillaries of the villi.

Absorption of Amino Acids, Dipeptides, and Tripeptides

 Most proteins are absorbed as amino acids via active transport processes that occur mainly in the duodenum and jejunum.
 About half of the absorbed amino acids are present in food; the other half come from the body itself as proteins in digestive
juices and dead cells that slough off the mucosal surface
 Normally, 95–98% of the protein present in the small intestine is digested and absorbed.
 Different transporters carry different types of amino acids.
 Amino acids move out of the absorptive cells via diffusion and enter capillaries of the villus.
 Both monosaccharides and amino acids are transported in the blood to the liver by way of the hepatic portal system.
Absorption of Lipids
 All dietary lipids are absorbed via simple diffusion
 As a result of their emulsification and digestion, triglycerides are mainly broken down into monoglycerides and fatty acids.
 The bile salts in intestinal chyme surround them, forming tiny spheres called micelles
 Once formed, the micelles move from the interior of the small intestinal lumen to the brush border of the absorptive cells. At
that point, the large short-chain fatty acids, long-chain fatty acids, and monoglycerides diffuse out of the micelles into the
absorptive cells, leaving the micelles behind in the chyme.
 Once inside the absorptive cells, long-chain fatty acids and monoglycerides are recombined to form triglycerides, which
aggregate into globules along with phospholipids and cholesterol and become coated with proteins. These large spherical
masses are called chylomicrons. Because they are so large and bulky, they enter lacteals, which have much larger pores than
 Digestive system
blood capillaries. From lacteals, chylomicrons are transported by way of lymphatic vessels to the thoracic duct and enter the
blood at the left subclavian vein. The hydrophilic protein coat that surrounds each chylomicron keeps the chylomicrons
suspended in blood and prevents them from sticking to each other. Within 10 minutes after absorption, about half of the
chylomicrons have already been removed from the blood as they pass through blood capillaries in the liver and adipose
tissue.
 This removal is accomplished by an enzyme attached lipoprotein lipase that breaks down triglycerides in chylomicrons and
other lipoproteins into fatty acids and glycerol. The fatty acids diffuse into hepatocytes and adipose cells and combine with
glycerol during resynthesis of triglycerides.
 Two or three hours after a meal, few chylomicron remain in the blood. After participating in the emulsification and
absorption of lipids, 90–95% of the bile salts are reabsorbed by active transport in the final segment of the small intestine
(ileum) and returned by the blood to the liver through the hepatic portal system for recycling. This cycle of bile salt secretion
by hepatocytes into bile, reabsorption by the ileum, and resecretion into bile is called the enterohepatic circulation.

Absorption of Water
 The small intestine absorbs about 8.3 liters of the fluid; the remainder passes into the large intestine, where most of the rest of
it about is also absorbed.
 Only 0.1 liter of water is excreted in the feces each day.
 All water absorption in the GI tract occurs via osmosis from the lumen of the intestines through absorptive cells and into
blood capillaries.
 Because water can move across the intestinal mucosa in both directions, the absorption of water from the small intestine
depends on the absorption of electrolytes and nutrients to maintain an osmotic balance with the blood.

MOVEMENTS OF INTESTINE

In the Small Intestine

The two types of movements of the small intestine—segmentations and a type of peristalsis called migrating motility complexes— are
governed mainly by the myenteric plexus.
 Segmentations are localized, mixing contractions that occur in portions of intestine by a large volume of chyme.
Segmentations mix chime with the digestive juices and bring the particles of food into contact with the mucosa for
absorption.
Segmentation starts with the contractions of circular muscle fibers in a portion of the small intestine, an action that
constricts the intestine into segments.
Next, muscle fibers that encircle the middle of each segment also contract, dividing each segment again.
Finally, the fibers that first contracted relax, and each small segment unites with an adjoining small segment so that
large segments are formed again. As this sequence of events repeats, the chyme moves back and forth.
Segmentations occur most rapidly in the duodenum, about 12 times per minute, and slow to about 8 times per minute in the ileum.
 After most of a meal has been absorbed, which lessens distension of the wall of the small intestine, segmentation stops and
peristalsis begins. The type of peristalsis that occurs in the small intestine, termed a migrating motility complex (MMC),
begins in the lower portion of the stomach and pushes chyme forward along a short stretch of small intestine before dying
out.
The MMC slowly migrates down the small intestine, reaching the end of the ileum in 90–120 minutes. Then another MMC begins in
the stomach. Altogether, chyme remains in the small intestine for 3–5 hours

In the Large Intestine

 One movement characteristic of the large intestine is haustral churning. In this process, the haustra remain relaxed and
become distended while they fill up. When the distension reaches a certain point, the walls contract and squeeze the contents
into the next haustrum.
 Peristalsis also occurs, although at a slower rate than in more proximal portions of the tract.
 A final type of movement is mass peristalsis, a strong peristaltic wave that begins at about the middle of the transverse colon
and quickly drives the contents of the colon into the rectum. Because food in the stomach initiates this gastrocolic reflex
inthe colon, mass peristalsis usually takes place three or four times a day, during or immediately after a meal.

HORMONES OF THE DIGESTIVE SYSTEM

 Gastrin, CCK, and Secretin

 They include Motilin, Substance P, and Bombesin, which stimulate motility of the intestines;
 Vasoactive intestinal polypeptide (VIP), which stimulates secretion of ions and water by the intestines and inhibits gastric
acid secretion;
 Gastrin-releasing peptide, which stimulates release of gastrin; and
 Somatostatin, which inhibits gastrin release.
 Digestive system
University Questions

 Draw a labeled diagram showing various parts of GI tract.explain the fuctions of various digestive enzymes.define any 2
disorders related to digestion
 Discuss the diferrent phases of deglutition
 Describe the composition and functions of gastric juice
 Mention the various enzymes involved in the digestion of carbohydrates.explain its site of secretion,regulation and function
 Mechanical and chemical digestion in stomach
 Explain the process of digestion in stomach
 Different types of salivary glands and explain the functions of saliva
 Explain protein digestion
 Explain about digestion of fats and carbohydrates