Professional Documents
Culture Documents
Digestive
System-
Chapters 62-
66; 70; 78
Figure 62-1; Guyton & Hall 1
Digestive Processes
Ingestion
Propulsion
Digestion: Mechanical and
Chemical digestion
Absorption- nutrients and
water
Defecation
2
Layers Alimentary Canal
1. Serosa
2. Longitudinal muscle
(muscularis externa)
3. Myenteric
(Auerbachs) nerve
plexus
4. Circular muscle
5. Submucosa
6. Submucosal
(Meissners) nerve
plexus
7. Muscularis mucosae
8. Mucosa
9. Epithelial lining
3
Autonomic nerve
fibers
Both divisions found in myenteric
and submucosal nerve plexi
What do they do?
Sensory neurons that monitor
tension, and efferent visceral
motor fibers. OWN SYSTEM!
Myenteric-GI motility control
Stimulatoryinfluences
toniccontraction(tone)
contractionfrequency/
intensity(propulsion)
Inhibitoryinfluences
DecreasedSphinctertone
(relax)pyloricsphincter,
ileocecalsphincter,LES
Submucosal- Local control
Secretion
Absorption
Contractionofmuscularismucosa
4
Control of the digestive
system
Movement of materials
along the digestive
tract is controlled by:
Neural mechanisms
Parasympathetic (Ach)
and local reflexes
Hormonal mechanisms
Enhance or inhibit
smooth muscle
contraction
Local mechanisms
Coordinate response to
changes in pH or
chemical stimuli and
stretching
5
Digestive Enzymes
Salivary glands Intestinal Mucosa
-amylase enterokinase
sucrase
lingual lipase maltase
lactase
Stomach Pancreas
pepsin amylase amino-
trypsin oligopeptidase
chymotrypsin dipeptidase
carboxypeptidase
lipase
cholesterolesterase
6
The mouth opens into the Primary Secretion
7
Digestion and absorption in
the stomach
Short-term storage
reservoir
Secretion of intrinsic
factor
Pepsinogen
gastrin
Chemical and enzymatic
digestion is initiated,
particularly of proteins
Liquefaction of food
Slowly released into the
small intestine for further
processing
8
Gastric glands
Two types glands -
Gastric HCl
(oxyntic) pepsinogen
intrinsicfactor
mucus
Pyloric gastrin
mucus
9
Gastric glands- 3 types of
cells
Mucous Neck cell
(goblet)- release
mucus to protect 80%
mucosa from acid and
pepsin
Parietal cells- HCl and
intrinsic factor (B12
absorption by small
intestine).
Chief- numerous and
release pepsinogen
10
Acid production and
secretion
BLOOD LUMEN
H2O HO- + H
+
CO2 CO2
C.A. Final Results
HCO HCO P
H +
HCl - 155 mEq/L
3 + 3 K+ K+ K +
KCl - 15 mEq/L
K H2O
P NaCl - 3 mEq.L
Na+ Na+ Na+ P Na+
Cl-
P pH = 0.8
Cl- Cl Cl-
-
H2O
osmosis
11
2 cell types of Pyloric gland
Gcellsreleasegastrin
Enteroendocrine cells
-stimulates parietal
cells to secrete acid
and increases pyloric
contraction; relaxes 20%
pyloric sphincter
Mucusneckcells
mucous
12
Gastric and
Duodenal ulcers
Weakens
H.pylori,aspirin,ethanol,
NSAIDs,
Strengthens
bilesalts mucus,HCO3secretion,
gastrin,PGs,epidermalgrowth
factor
Gramnegativebacterium
HighureaseactivityhighNH4+activity
- can withstand acid environment
- NH4+ damages epithelial cells (GU)
- Increases acid secretion (DU)
15
Treatment of Peptic Ulcers
Antacids
H2 receptor blockers - Rantidine (Zantac)
- Cimetidine (Tagamet)
Proton pump inhibitors - Omeparazole
(Prilosec)
Antibiotics
Surgical (rare) - vagotomy
- antrectomy
16
Stimulation of acid
secretion Seeing, smelling and anticipating food is perceived in brain. Brain tells stomach to
prepare for receipt of meal
Accounts for 30% of acid response to meal
Gastric secretion is
stimulated by local
(distention), neural, and
endocrine mechanisms
Acetylcholine - HCl
secretion
- mucus, pepsinogen, and
gastrin 60%
Histamine - HCl
secretion
Gastrin - HCl
secretion (1500x more
powerful compared to 10%
histamine)
17
Small intestine
Important digestive and
absorptive functions
Secretions and buffers
provided by pancreas,
liver, gall bladder
Three subdivisions:
Duodenum
Jejunum
Ileum
Ileocecal sphincter
Transition between small
and large intestine
18
Histology of the small intestine
Plicae
Transverse folds of the intestinal lining
Villi
Fingerlike projections of the mucosa
Lacteals
Terminal lymphatic in villus
Microvilli
Brush border: increases surface area 20-fold
19
Intestinal glands
secretin to stimulate
pancreas to release
bicarbonate mucus
cholecystokinin to
stimulate pancreas
and gallbladder
Gastric Inhibitory
peptide (GIP)-
inhibits gastrin
secretion and
decreases stomach
emptying
Duodenal glands-
bicarbonate mucus.
20
The Activities of Major Digestive Tract
Hormones
21
Figure 24.22
Small Intestine- digestive
enzymes
Maltase- splits maltose into 2 glucose
units
Lactase- splits lactose into glucose
and galactose
Sucrase- splits sucrose into glucose
and fructose
Peptidase- breaks down small
peptides into amino acids
Intestinal lipase- breaks down
triglycerides into free fatty acids and
monoglycerides
Enterokinase- Activates trypsinogen
to trypsin (trypsin then activates
chymotrypsinogen and
procarboxypeptidase)
22
Pancreas
As chyme floods into small intestine two
things must happen:
Acidmustbeneutralizedtopreventdamageto
duodenalmucosa
Macromolecularnutrientsproteins,fatsandstarch
mustbebrokendownmuchfurthersotheir
constituentscanbeabsorbed
Pancreas plays vital role in accomplishing both objectives
24
The Pancreas
Exocrine function
(98%)
Acinar cells make,
store, and secrete
pancreatic enzymes
Endocrine function
( cells) release
somatostatin (inhibitory
to gastrin and insulin and
glucagon)
-cells release insulin
-cells-Release glucagon
25
The Pancreas as an Endocrine
Gland
Insulin
Beta cells
Skeletal muscle and
adipose tissue need it to
make glucose receptors
Promotes glucose uptake
Prevents fat and glycogen
breakdown and inhibits
gluconeogenesis
Epi/Norepi inhibit insulin!
Increases protein Help maintain glucose levels
synthesis during times of stress and
Promotes fat storage increase lipase activity in
order to conserve glucose
levels
26
Picture from:http://www.dkimages.com/discover/Home/Health-and-Beauty/Human-Body/Endocrine-System/Pancreas/Pancreas-1.html
The Pancreas as an Endocrine
Gland
Glucagon
Maintains blood glucose
between meals and during
periods of fasting.
Nervous tissue (brain) do
not need insulin; but are
heavily dependent on
glucose levels!
Increases blood glucose
levels.
Initiates glycogenolysis in
liver (within minutes)
Stimulates amino acid
transport to liver to Image from: http://www.dkimages.com/discover/previews/768/74261.JPG
stimulate gluconeogenesis
27
Disorders of the Pancreas:
Diabetes Mellitus
Gestational Diabetes
Type I diabetes develops
suddenly, usually before
age 15
Destruction of the beta cells
Skeletal tissue and adipose
cells must use alternative
fuel and this leads to
ketoacidosis
Hyperglycemia results in
diabetic coma
28
Disorders of the Pancreas:
Diabetes Mellitus
Type II diabetes and
metabolic syndrome
adult onset
Usually occurs after age
40
Cells have lowered
sensitivity to insulin
Controlled by dietary
changes and regular
exercise
29
30
Pancreatic Failure
Digestion is abnormal when pancreas
fails
to secrete normal amounts of
enzymes.
Pancreatitis
Removalofpancreaticheadmalignancy
31
Pancreatitis
Pancreatitis means inflammation of pancreas.
Autodigestion theory can explain condition.
33
Sodium Absorption in Small
Intestine 1 Na Na + +
Na+ S
2 S Na+ Na+ Na+
P
Na+ K+ K+
3 Cl-
Cl- Na+
4 Na+
H+ Na+
Aldosterone H+
increases
Cl- Cl-
Na+ reabsorption
and K+ secretion in
S.I. and colon. 34
Chemical Digestion:
Carbohydrates
Begins in the mouth (minimal) and
mostly occurs in small intestine when
pancreatic enzymes are released
Absorption of monosaccharides occurs
across the intestinal epithelia
Absorption: via cotransport with Na+,
and facilitated diffusion
Enter the capillary bed in the villi
Transported to the liver via the hepatic
portal vein lumen
36
Lipid digestion and
absorption
Lipid digestion utilizes
lingual and pancreatic
lipases, cholesterol esterase
(cleaves ester bond to
release cholesterol) and
phospholipases release fatty
acids and monoglycerides.
Bile salts improve chemical
digestion by emulsifying lipid
drops
Lipid-bile salt complexes called
micelles are formed
37
Fatty Acid
Absorption
Fatty acids and
monoglycerides enter
intestinal cells via
diffusion; bile salts can be
reused to ferry more
monoglycerides
They are combined with
proteins within the cells
Resulting chylomicrons are
extruded
They enter lacteals and are
transported to the
circulation via lymph
38
Sprue
Diseases that result in decreased
absorption even when food is well digested
are often classified as sprue -
- Nontropical sprue - also called celiac disease
allergictogluten(wheat,rye)
- destroys microvilli and sometimes
villi
- Tropical sprue - bacterium (?)
- treated with antibacterial agents
39
Fluid Entering and Exiting the
Gut Volume Volume 95% of water is
10 entering absorbed in the small
absorbed intestines by osmosis
Duodenum Water moves in both
8
Volume(L/day)
Pancreas(1)
2 Volume
S.I.(2) Excreted
Colon(1.4) 100200ml
0 40
The Liver
Digestive function bile
production; emulsifies fats
Bilirubin- decomposed
hemoglobin
Urobilinogen- by-
product of bilirubin
metabolism
bile salts- keep
cholesterol dissolved
in bile
Performs many metabolic
functions- stores vitamins,
processes fats, detoxifies,
makes blood proteins
41
Physiology of the large
intestine
Reabsorption in the large
intestine includes:
Water and electrolets
Bacteria make: Vitamins
K, biotin, and B5
Organic wastes
urobilinogens and
sterobilinogens
Bile salts
Toxins
Mass movements of material
through colon and rectum
Defecation reflex triggered
by distention of rectal walls
42
Figure 8-18 Agents that stimulate and inhibit H+ secretion by gastric parietal cells. ACh, Acetylcholine; cAMP, cyclic adenosine monophosphate;
CCK, cholecystokinin; ECL, enterochromaffin-like; IP3, inositol 1,4,5-triphosphate; M, muscarinic.