FUNGSI MEKANIK

SISTEM PENCERNAAN
Rahmatina B. Herman
Bagian Fisiologi
Fakultas Kedokteran Universitas
Andalas

Introduction
The primary function of the digestive
system is to transfer nutrients, water
and electrolytes from the ingested food
into the bodys internal environment
The ingested food is essential as:
- an energy source from which the cells
can generate ATP to carry out their
particular energy-dependent activities
- a source of building supplies for the
renewal and addition of body tissues

..Introduction
The digestive system performs:
Four basic digestive processes:
1. Motility along
gastrointestinal tract
2. Secretion of digestive juices
3. Digestion of food
4. Absorption the small
absorbable units
Excretion of the waste materials
Regulation of digestive function through
neural reflexes and hormonal pathways
Protection against any damages

General Principle of
Gastrointestinal Motility
Characteristics of gastrointestinal
wall:
Layers of the wall (inward):
-

Serosa: continues onto mesentery

- Muscularis: smooth muscles
> longitudinal layer: outer
> circular layer: inner
- Submucous: smooth muscles
> muscularis mucosae, usually
longitudinal
- Mucosa

..General Principle of
Gastrointestinal Motility

..General Principle of
Gastrointestinal Motility

Basic Electrical Activity

Slow Waves:
- undulating changes in the resting
membrane potential (-50 - 60 mVolts)
- intensity: 5 15 mVolts
- frequency: 3-12/min (3 in the body of
the stomach,
12 in the duodenum, 8-9 in
the terminal ileum)
- might be caused by a slow undulation
of the sodium-potassium pumping activities
- rarely cause muscle contraction
- Basic Electrical Rhythm (BER) control
the appearance of intermittent peristaltic

..Basic Electrical Activity

Spike Potential:
- is true action potential
- generated at the peaks of the slow waves,
when the peaks rise above - 40 mVolts
- the depolarizing portion of each spike
potential is due to Ca++ influx through Ca-Na
channel and
repolarizing portion is due to
K+ efflux
- stimulation by stretch, acetylcholine,
parasympathetics, and specific GI hormones
- rate: 1-10/minute
- duration: 10-20 msecond

..Basic Electrical Activity

Contraction of GI Smooth
Muscles
Rhythmic:
- during the spike potentials
generated at the peaks of the slow
waves, the large quantities of Ca++
enter the fibers through Ca-Na
channel
- Ca++ acting through a calmodulin
control mechanism, activate the
myosin filaments attractive forces
between the myosin and the actin
filaments muscle contraction

..Contraction of GI Smooth
Muscles
Tonic:
- is continuous contraction, often lasting
several minutes or even several hours
- not associated with the BER
- often decreases or increases in intensity, but
continues
- might be caused by:
> repetitive spike potential
> hormones or other factors that bring about
continuous depolarization of the smooth muscle
membrane, without causing action potentials
> continuous Ca++ influx, bought about in ways
not associated with changes in the membrane
potential

..Contraction of GI Smooth
Muscles

Gastrointestinal Motility
Propulsive movement
- The basic propulsive movement is
peristalsis
- Reflex response through myenteric
plexus that is initiated by distention
peristaltic reflex or myenteric reflex
- Constriction at the upper of the stretch
and relaxation (receptive relaxation) at the
lower of the stretch
- The wave contraction moves in an oral-toanal direction
- The peristaltic reflex plus the anal-ward
direction of the peristalsis movement is
called the law of gut

..Gastrointestinal Motility
Mixing:
- The reflex initiated by stretching of the gut
wall
- Quite different in in different parts of the gut
- Segmentation contraction and relaxation in a
rhythmic pattern
- Local constriction occurs in every few
centimeters
- The next constriction occurs at the next site,
so that the chyme is divided and push back
and forth which mixes the luminal content
- Mixing process is also performed by
peristalsis and sphincter activities

Migrating Motor Complex

Modification of the pattern of electrical and
motor activity in GI smooth muscle during
fasting or between periods of digestion
The cycles of motor activity migrate from
corpus of stomach to the distal ileum
They migrate slowly at a rate of 6-12 cm/
minute and occur at intervals 1.5-2 hours
Each wave end within 6-10 minutes
Function: to clear the stomach and small
intestines of luminal contents in preparation
for the next meal
Immediately stopped by ingestion of food and
return to peristalsis

Basic Principle of GI
Regulation
Neural regulation:
The enteric nervous system (ENS):
- the myenteric plexus (Auerbach)
- the submucosal plexus (Meissner)

The autonomic nervous system (ANS):

- the parasympathetic
> cranial division: cranial nerves
> sacral division: SII SIV
> excitation through the ENS

- the sympathetic
> TV LII
> dual action
> direct excitation and also through the ENS

..Basic Principle of GI Regulation

Neural regulation..
Afferent sensory nerve fibers from the gut:
1. terminate in the ENS
2. cell bodies in the ENS, sends its axon through the ANS
to terminate in the prevertebral sympathetic ganglia:
celiac,
mesenteric, and hypogastric ganglia
3. cell bodies in the dorsal root ganglia of the spinal
cord or in the cranial nerve ganglia, transmit signals
directly into the spinal cord or brain stem, traveling in
the same nerve
trunks along with the sympathetic or
parasympathetic nerve fibers (80% of vagus nerves are
afferent)
- stimulated by:
> irritation of the mucosa
> excessive distention of the wall
> the presence of specific chemical substances

..Basic Principle of GI Regulation

Neural regulation..
Reflexes:
1. Reflexes that occur entirely within the ENS
2. Reflexes from the gut to the prevertebral
sympathetic ganglia and then back to the GIT
- gastrocolic reflex, enterogastric reflex, colonileal
reflex

3. Reflexes from the gut to the spinal cord or

brainstem then back to the GIT
- the stomach and duodenum brainstem stomach
through vagus, to control gastric activities
- pain reflexes that cause general inhibition of the GIT
- defecation reflex: rectum spinal cord to produce
colonic, rectal, and abdominal contractions

..Basic Principle of GI Regulation

Diagram of Efferent Autonomic Pathways

..Basic Principle of GI Regulation

Hormonal regulation..
May affect motility, but mainly for controlling
secretion
- Gastrin

> secreted by cells in gastric and duodenal mucosa

in
response to the presence of food

- Cholecystokinin

> secreted by I cells in duodenal and jejunal mucosa

in
response to breakdown products of fat

- Secretin

> secreted by S cells in the mucosa of duodenum in

response to acidic gastric juice

- Gastric inhibitory peptide

> secreted by the mucosa of upper small intestine in

response to fatty acid, amino acid and to a lesser
extent in response to carbohydrate

..Basic Principle of GI Regulation

Hormonal regulation:
- secreted by enteroendocrine cells
- mainly to control secretion
> true hormone: secretin, gastric

cholecystokinin,

inhibitory peptide (GIP),

gastrin,

> candidate hormone:

pancreatic polypeptide,

- motilin,
enteroglucagon

> paracrine: - somatostatin,

prostaglandin,

histamine

> neurocrine:

- vasoactive inhibitory
peptide (VIP) bombesin, enkephalin

Pathways Controlling Digestive System

Local changes in
Digestive Tract (DT)

External influences

Receptors in DT

Extrinsic (ANS)

Intrinsic (ENS)

GI Hormones

Smooth Muscle (self excitable)

Exocrine gland cells (digestive juices)
Endocrine gland cells (GI & Pancreatic Hormones

Mastication (Chewing)
Reflex
Rhythmic: by motor branch of the 5th
cranial nerve
Important for digestion of all foods,
especially:
- cellulose membrane of fruits and
vegetables
- grinding the food to a very fine
particulate consistency
- increases the total surface area of
food exposed to the intestinal secretion
-

increases the ease of enzymatic

Swallowing (Deglutition)
A.Voluntary stage:
squeezed into pharynx by pressure of tongue
B.

Pharyngeal stage (involuntary): reflex

- soft palate is pulled upward to close posterior nares

- form a palatopharyngeal slit by palatopharyngeal folds
- prevent passage of food into trachea by epiglottis and
vocal cords
- pharyngoesophageal sphincter relaxes
- the food is propelled into esophagus

C.

Esophageal stage (involuntary)

peristaltic:
primary peristalsis: continuation from pharynx
secondary peristalsis: due to distention of
esophagus

The swallowing center inhibits the respiratory center

..Swallowing (Deglutition)

Gastroesophageal Sphincter
2-5 cm above the junction of esophagus-stomach
Normally remains tonically constricted
Prevention of stomach content reflux into esophagus
Additional prevention of reflux by valve-like closure
of the distal end of the esophagus
- valve-like mechanism of the short portion of esophagus
that lies immediately beneath diaphragm before
reaching stomach
- increased intra-abdominal pressure caves the
esophagus inward at this point at the same time that
this pressure increase the intra-gastric pressure
- the valve-like closure of the lower esophagus prevents
from forcing stomach contents into esophagus (during
walking, coughing, or breathing hard)

Motor Functions of The

Stomach
A.Storage of large quantities of food
- As food enters the stomach, it forms concentric circles
- Vagovagal reflex: reduces the tone in the muscular wall
of the body of the stomach

B.Mixing the food with the gastric secretions until it forms

a semifluid mixture
- peristaltic constrictor rings
- propulsive movement toward pylorus
- retropulsion

C.Emptying of the stomach

- role of antrum: constriction movement
- role of pylorus (pyloric sphincter): pyloric pump

Hunger contractions: hunger pang

- usually do not begin until 12-24 hours after the last ingestion
- reach greatest intensity in 3-4 days and the gradually weaken

..Motor Functions of The Stomach

Regulation of Stomach
Emptying
The weak gastric factors that promote
emptying:
- Effect of gastric food volume on rate of emptying
> vagovagal and myenteric reflexes

- Effect of hormone gastrin

The powerful duodenal factors that inhibit

emptying:
- Enterogastric nervous reflexes from duodenum

> degree of distention of duodenum

> especially sensitive to the presence of irritant and
acids > also breakdown products of protein digestion
> degree of osmolality

- Hormonal feedback from duodenum

cholecystokinin, secretin, gastric inhibitory peptide

Motor Function of The Small

Intestine
A.Mixing contractions (segmentation contractions)
- BER with background excitation by the ENS

B.Propulsive movements (peristalsis)

- increased due to:

distention
gastroenteric reflexes through the ENS
hormone gastrin, cholecystokinin, insulin,
serotonin
irritation
peristaltic rush
diarrhea

- decreased due to:

hormone secretin and glucagon
peristalsis in the fasting: migrating motor
complex

C.Movements caused by the muscularis mucosa and

muscle fibers of the villi

..Motor Function of The Small

Intestine

Segmentation movement of the small

Motor Function of The Colon

A.Mixing movements - haustrations
B.Propulsive movements mass movements
- slow analward movement of haustral
contractions
- mass movement : modification of peristalsis
initiated by:
gastrocolic and duodenocolic reflexes
irritation and distention
parasympathetic stimulation

C.Defecation :
- intrinsic defecation reflex
- parasympathetic defecation reflex
- internal anal sphincter
- external anal sphincter (voluntary)

..Motor Function of The Colon

Defecation reflex

Autonomic Reflexes That

Affect GIT
Autonomic reflexes that affect bowel
activity:
From internal GIT
-

gastrocolic and duodenocolic reflexes

gastroileal reflex
enterogastric reflex
defecation reflex

From external GIT: inhibition

-

peritoneo-intestinal reflex
reno-intestinal reflex
vesico-intestinal reflex
somato-intestinal reflex

THANK
YOU