CHAPTER 16
DIGESTIVE SYSTEM I: ORAL CAVITY AND ASSOCIATED
STRUCTURES
I. OVERVIEW OF THE DIGESTIVE SYSTEM
Digestive system – (+) alimentary canal and its associated
organs (tongue, teeth, salivary glands, pancreas, liver, and
gallbladder)
Function:
- transport of ingested water and food along the
alimentary canal;
- secretion of fluids, electrolytes, and digestive
enzymes;
- digestion and absorption of digested products; and -
- excretion of indigestible remains.
The lumen of the alimentary canal is physically and
functionally external to the body.
Food – passes through alimentary canal → physically and
chemically broken down/ maceration and moistening (can be
absorbed into the body) → formation of BOLUS (action: by
structures of oral cavity and secretion of salivary glands) →
pharynx (rapid passage keeps it clear for the passage of air)
→ esophagus → stomach and small intestine/major
alterations associated with digestion, solubilization, and
absorption occur (GIT: slow passage aided by the secretion
of digestive juices that may amount to 7 L or so per day)
- + water: 2L are ingested into the body each day
- Undigested food: other substances within the alimentary
canal, such as mucus, bacteria, desquamated cells, and
bile pigments are excreted as solids (feces).
The ALIMENTARY MUCOSA is the surface across which most
substances enter the body.
(Lining of Alimentary Canal)
Function:
- Secretion - digestive enzymes, hydrochloric acid, mucin,
and antibodies
- Absorption - epithelium absorbs metabolic substrates
(e.g., the breakdown products of digestion) as well as
vitamins, water, electrolytes, recyclable materials such as
bile components and cholesterol, and other substances
essential to the functions of the body
- Barrier - prevent the entry of noxious substances,
antigens, and pathogenic organisms.
- Immunologic protection - Lymphatic tissue within serves
as the body’s first line of immune defense
II. ORAL CAVITY
The oral cavity consists of the mouth and its structures,
which include the tongue, teeth and their supporting
structures (periodontium), major and minor salivary glands,
and tonsils.
Oral Cavity – (÷)
- Vestibule: space between the lips, cheeks, and teeth.
- Oral Cavity Proper: lies behind the teeth and is bounded
by the hard and soft palates superiorly, the tongue and
the floor of the mouth inferiorly, and the entrance to the
oropharynx posteriorly
3 Major Salivary Glands
1. Parotid Gland – largest; @infratemporal region of
the head
- Parotid (Stensen’s) Duct: PG’s excretory duct; opens at
the parotid papilla: a small elevation on the mucosal
surface of the cheek opposite the second upper molar
tooth
2. Submandibular Gland- @ submandibular triangle of
the neck. Its excretory duct, the
- Submandibular (Wharton’s) Duct – (excretory duct)
opens at a small fleshy prominence (the sublingual
caruncle) on each side of the lingual frenulum on the
floor of the oral cavity
3. Sublingual Gland- lying inferior to the tongue within
the sublingual folds at the floor of the oral cavity
- has a number of small excretory ducts; some enter the
submandibular duct, and others enter individually into
the oral cavity.
The tonsils consist of aggregations of lymphatic nodules that
are clustered around the posterior opening of the oral and
nasal cavities.
Tonsillar (Waldeyer’s) Ring – organized lymphatic tissue @
shared entrance to the digestive and respiratory tracts
- Surrounds the posterior orifice of the oral and nasal
cavities and contains aggregates of lymphatic nodules:
a. Palatine tonsils, or simply the tonsils, @ either side of
the entrance to the oropharynx between the
palatopharyngeal and palatoglossal arches
b. Tubal tonsils, @ the lateral walls of the nasopharynx
posterior to the opening of the auditory tube
c. Pharyngeal tonsil, or adenoid, which is located in the
roof of the nasopharynx
d. Lingual tonsil, which is located at the base of the
tongue on its superior surface
The oral cavity is lined by the oral mucosa that consists of
masticatory mucosa, lining mucosa, and specialized mucosa.
Masticatory Mucosa - found on the gingiva (gums)
and the hard palate.
- keratinized : lacks stratum lucidum
- in some areas, a parakeratinized stratified squamous e
[superficial cells do not lose their nuclei and their
 cytoplasm does not stain intensely with eosin; nuclei of
the parakeratinized cells are pyknotic (highly condensed)
and remain until the cell is exfoliated]
- Skin: depth and no. of CT papillae contribute to the
relative immobility of the masticatory mucosa, thus
protecting it from frictional and shearing stress
- Palatine Raphe: (midline of the hard palate) mucosa
adheres firmly to the underlying bone
- Reticular Layer of the Lamina Propria: blends w/ the
periosteum and thus, there is no submucosa
- Gingiva: adipose tissue anteriorly (fatty zone) and
mucous glands posteriorly (glandular zone) that are
continuous with those of the soft palate
- Submucosal Regions: thick collagenous bands extend
from the mucosa to the bone.
Lining Mucosa - At these sites, it covers striated muscle
(lips, cheeks, and tongue), bone (alveolar mucosa), and
glands(soft palate, cheeks, inferior surface of the tongue
- has fewer and shorter papillae so that it can adjust tothe
movement of its underlying muscles.
- Epithelium is non-keratinzed although in some places it is
parakeratinized.
- The nonkeratinized lining epithelium is thicker than
keratinized epithelium. It consists of only three layers:
• Stratum basale, a single layer of cells resting on the basal
lamina
• Stratum spinosum, which is several cells thick
• Stratum superficiale, the most superfi cial layer of cells,
also referred to as the surface layer of the mucosa
- submucosa underlies the lining mucosa except on the
inferior surface of the tongue. Th is layer contains large
bands of collagen and elastic fi bers that bind the mucosa
to the underlying muscle; it also contains the many minor
salivary glands of the lips, tongue, and cheeks.
- Fordyce Spots- visible to the eye; sebaceous glands not
associated with a hair follicle are found in the submucosa
just lateral to the corner of the mouth and in the cheeks
opposite the molar teeth.
Specialized mucosa - associated with the sensation
of taste and is restricted to the dorsal surface of the tongue.
It contains papillae and taste buds responsible for generating
the chemical sensation of taste.
Oral mucosa - forms an important protective barrier
between the external environment of the oral cavity and
internal environments of the surrounding tissues. It is
resistant to the pathogenic organisms that enter the oral
cavity and to indigenous microorganisms residing there as
microbial flora.
III. TONGUE
Tongue - muscular organ projecting into the oral cavity from
its inferior surface
Lingual muscles- muscles of the tongue (striated)
- arranged in bundles that generally run in three planes,
with each arranged at right angles to the other two;
allows enormous flexibility and precision in the
movements of the tongue, which are essential to human
speech as well as to its role in digestion and swallowing.
: Extrinsic - having one attachment outside of the
tongue
: Intrinsic - confined entirely to the tongue, without
external attachment
Dorsal Surface of the Tongue – (÷) by sulcus terminalis, a V-
shaped depression
- anterior two-thirds
- posterior one-third
Foramen Cecum - @ the apex of the V
- the remnant of the site from which an evagination of the
floor of the embryonic pharynx occurred to form the
thyroid gland
Papillae cover the dorsal surface of the tongue.
Lingual Papillae – mucosal irregularities and elevations
- cover the dorsal surface of the tongue anterior to the
sulcus terminalis
4 Types of Papillae:
1. Filiform papillae - smallest and most numerous; are
conical, elongated projections of CT that are covered
with highly KSSE ;does not contain taste buds.
- distributed over the entire anterior dorsal surface of the
tongue; tips pointing backward; form rows that diverge
to the left and right from the midline and that parallel
the arms of the sulcus terminalis
2. Fungiform papillae, -mushroom- shaped projections @
dorsal surface; project above the filiform papillae,
among which they are scattered, and are just visible to
the unaided eye as small; more numerous near the tip of
the tongue. Taste buds are present in SSE on the dorsal
surface of these papillae.
3. Circumvallate papillae - large, dome-shaped structures
that reside in the mucosa just anterior to the sulcus
terminalis.
Human Tongue – (+) 8 to 12 of these papillae. Each
papilla is surrounded by a moat-like invagination lined
with stratified squamous epithelium that contains
numerous taste. Ducts of lingual salivary (von Ebner’s)
glands empty their serous secretion into the base of the
moats. This secretion presumably flushes material from
the moat to enable the taste buds to respond rapidly to
changing stimuli.
4. Foliate papillae consist of parallel low ridges separated
by deep mucosal clefts , which are aligned at right angles
 to the long axis of the tongue. They occur on the lateral
edge of the tongue.
 Aged Individuals - the foliate papillae may not be
recognized;
 Younger Individuals - easily found on the posterior
lateral surface of the tongue and contain many taste
buds in the epithelium of the facing walls of
neighboring papillae.
 Small serous glands - empty into the clefts.
Lingual Tonsils – its presences is reflected as smooth bulges
at dorsal surface of the base of the tongue in the lamina
propria.
Taste buds are present on fungiform, foliate, and
circumvallate papillae.
Taste Buds - appear as oval, pale-staining bodies that extend
through the thickness of the epithelium
- also present on the glossopalatine arch, the soft palate,
the posterior surface of the epiglottis, and the posterior
wall of the pharynx down to the level of the cricoids
cartilage.
Taste Pore - A small opening onto the epithelial surface at the
apex of the taste bud
3 Principal Cell Types Found in Taste Buds
1. Neuroepithelial (sensory) cells - most numerous cells in
the taste bud; elongated cells; extend from the basal
lamina of the epithelium to the taste cell extends
microvilli, Near their apical surface, they are connected
to neighboring neuroepithelial or supporting cells by
tight junctions. At their base, they form a synapse with
the processes of afferent sensory neurons of the facial
CN VII), glossopharyngeal (CN IX), or vagus (CN X)
nerves. The turnover time of neuroepithelial cells is
about 10 days.
2. Supporting cells - less numerous; elongated cells; extend
from the basal lamina to the taste pore. Like
neuroepithelial cells, they contain microvilli on their
apical surface and possess tight junctions, but they do
not synapse with the nerve cells. Th e turnover time of
supporting cells is also about 10 days.
3. Basal cells are small cells located in the basal portion of
the taste bud, near the basal lamina. They are the stem
cells for the two other cell types.
Taste is a chemical sensation in which various chemicals
elicit stimuli from neuroepithelial cells of taste buds.
Taste - a chemical sensation in which various tastants (taste-
stimulating substances) contained in food or beverages
interact with taste receptors located at the apical surface of
the neuroepithelial cells. Th ese cells react to five basic
stimuli: sweet, salty, bitter, sour, and umami [Jap. delicious].
Molecular Action of Tastants
 Salt and Sour- opening and passing through ion channels
 Sour - closing ion channels
 Bitter, Sweet and Umami – acting on a specific G
protein-coupled taste receptor
Stimulation of bitter, sweet, and umami receptors activates
G protein–coupled taste receptors that belong to T1R and
T2R chemosensory receptor families.
Sodium ions and hydrogen protons, which are responsible
for salty and sour taste, respectively, act directly on ion
channels.
Some areas of the tongue are more responsive to certain
tastes than others.
Taste Buds:
 at the tip of the tongue detect sweet stimuli
 immediately posterolateral to the tip detect salty
stimuli
 more posterolateral detect sour- tasting stimuli
 on the circumvallate papillae detect bitter and umami
stimuli.
Sensitivity to all tastes is distributed across the entire tongue,
but some areas are indeed more responsive to certain tastes
than others.
The lingual tonsil consists of accumulations of lymphatic
tissue at the base of the tongue.
Lingual Tonsil - @ the lamina propria of the root or base of
the tongue. It is found posterior to the sulcus terminalis
- contains diffuse lymphatic tissue with lymphatic nodules
containing germinal centers
Epithelial crypts - usually invaginate into the lingual tonsil.
Mucous lingual salivary glands - may be seen within the
lingual tonsil and may extend into the muscle of the base of
the tongue.
The complex nerve supply of the tongue is provided by
cranial nerves and the autonomic nervous system.
General sensation:
- for the Anterior Two-Thirds Of The Tongue (anterior to
the sulcus terminalis)- carried in the mandibular division
of the trigeminal nerve ( CN V).
- for the Posterior One-third Of The Tongue - carried in
the glossopharyngeal nerve (CN IX) and the vagus nerve
(CN X).

Taste sensation:

- carried by the chorda tympani, a branch of the facial

nerve (CN VII) anterior to the sulcus terminalis, and by
the glossopharyngeal nerve (CN IX) and vagus nerve (CN
X) posterior to the sulcus.

Motor innervations:

- for the musculature of the tongue - supplied by the

hypoglossal nerve (cranial nerveCN XII).

Vascular and glandular innervations:

- Sympathetic And Parasympathetic Nerves – provide

innervations; supply blood vessels and small salivary
glands of the tongue.
- Ganglion cells - often seen within the tongue; belong to
postsynaptic parasympathetic neurons and are destined
for the minor salivary glands within the tongue.
- Cell Bodies Of Sympathetic Postsynaptic Neurons - are
located in the superior cervical ganglion.

IV. TEETH AND SUPPORTING TISSUES

Teeth - major component of the oral cavity; essential for

the beginning of the digestive process;
embedded in and attached to the alveolar
processes of the maxilla and mandible.

10 Deciduous (Primary, Milk) Teeth

 Medial (Central) Incisor – 1st tooth to erupt
(usually in the mandible) at ~ 6 months of
age (in some infants, the fi rst teeth may
not erupt until 12or 13 months of age)
 Lateral Incisor - erupts at ~ 8 months
 Canine Tooth - erupts at ~15 months
 Molar Teeth (2) - the first of which erupts at 10 to 19
months and the second of which erupts at
20 to 31 months

16 Permanent (Secondary) Teeth

- usually beginning at about age 6 and ending at about age
12 or 13, replaces DT gradually
 Medial (Central) Incisor- erupts at age 7 or 8
 Lateral Incisor - erupts at age 8 or 9
 Canine Tooth - erupts at age 10 to 12
 Premolar Teeth (2) - erupt between ages 10 and 12
 Molar Teeth (3) - erupt at diff erent times; the fi st molar
usually erupts at age 6, the second molar in the early
teens, and the third molar (wisdom teeth) during the
late teens or early twenties
,