SMALL INTESTINE &

LARGE INTESTINE

HISTOLOGY

1.
2.
.
3.

4.

4 layers
Outermost serosa
Muscular covering - ext longitudinal
Int- circilar b/w myenteric plexus,
Submucosa bl vess, lymphatics,
nerves- meissners plexus
Mucosal layer folds- villus contain
epithelial cells, microvilli- increase
surface area

villi

VILLI
Lined
1.

2.
3.
4.
5.

by :
Columnar cells absorption of
food products
Goblet cells- produce mucus
Paneth cells- phagocytic
Ec cells- serotonin
Zymogen cells- enzymes

Intestinal Secretion: Crypts of

Lieberkuhn

Surface epithelium
Goblet cells
(mucus)
. Lubrication,
protection

Enterocytes
. Secrete water and
electrolytes (crypts)
. Reabsorb water,
electrolytes and end
products of digestion
(villi)

GLANDS OF SI
1.

2.

CRYPTS OF LEBERKUHN : In
b/w villi lined by columnar
epithelium. Contributesuccus entericus
BRUNNERS glands esp in
duodenum. Submucosal coat
- Contribute- succus
entericus

SUCCUS ENTERICUS
Composition & function :
2lit/

day
Water : 99% : solids 1%
Organic : mucus enzymes:
enterokinase,amylase,
peptidases,invertse, maltase ,
isomaltase & nucleotidases
Inorganic : Na, K, Ca,Mg,HCO 3
,Cl,PO4, SO42

ENZYMES

Enterokinase : secreted by duodenal

mucosa

Activating- trypnogen to trypsin

proteolytic produced by pancreas

Peptidases acts on di & tri peptides - aa

Sucrase- sucrose- glu+fructose

Maltase maltose to glucose+ glucose

Iactase acts on lactose - glucose-

Digestion of lipids
Emulsification of fats
Bile salts participate in lipid digestion
Lipase enzyme triglycerides to
mpnoglycerides
ABSORPTION OF LIPIDS:
Digested lipids along with bile salts- micelles
These micelles enter the enterocyte
Medium chain FA & glycerol directly reach
portal system liver
Long chain FA & cholesterol via lymph into
systemic circulation

mucus

It is lubricant & by goblet cells

It neutralises acid chyme entering from the

stomach

REGULATION

OF SECRETION :

NEURAL :parasympathetic increase

Sympathetic : not clear

Local : increases the succus entricus

MECHANICAL : mechanical irritation increases

secretion

Movements of small
intestine
3 types of movements
1. Rhythmic segmental
contractions or Pendular
movements
2. Peristalsis
3. Movements of Villi

HUMORAL REGULATION
Gastrin

, Secretin , CCKPZ,VIP, stimulates S

entericus secretion
ENTEROCRININ : REGULATES
crypts of liberkuhn
Somatostatin : inhibit S
entericus

FUNCTIONS OF SUCCUS
ENTERICUS
MECHANICAL : mixing of food with s entericus

HORMONAL SECRETION : hormones regulate

secretion of GIT CCK, PZ,GIP,VIP

ENZYME SECRETION : Enterokinase,

dipeptidase, disaccharidases & other enzymes

DIGESTIVE FUNCTION: Proteins,CHO,Lipids

ACTIVATION OF ENZYMES : enterokinase

activates trypsinogen to trypsin

Small Intestine Function

Duodenum
. Stimulation of release of bile and
pancreatic secretions
. Active site of digestion

Jejunum
. Active site of nutrient absorption

Ileum
. Active site of nutrient absorption
. Water, vitamins & minerals

Applied physiology
Mal absorption syndrome
:resection of small intestine
interfere with digestion &
absorption
Gastro colic fistula : bypassing
the food from stomach to colon
Manifest : pernicious anemia vit
B12 def.
Defective absorption protein
muscle weakness

Sprue : defective absorption due to

lack of digestive enzymes or removal
of the part of SI due to lack of folic
acid deficiency

LARGE INTESTINE

FUNCTIONAL ORGANIZATION
It

is a tube about 6 cm in diameter.

Caecum is a blind ended sac into
which opens the lower end of
ileum.
Appendix is a worm shaped tube
vestigial organ.
Ascending colon , transverse colon,
descending colon, , sigmoid colon ,
rectum and anal canal

STRUCTURAL CHARACTERISTICS
Mucosa

of large intestine is
characterised by :-

Absence

of plica circulates and villi .

A large number of simple tubular glands
(crypts of liberkuhn) lined by simple
columnar epithelium secrete mucus .
The tenia coli are shorter in length
than other layers of the walls of
colon (also called haustrations).

MOTILITY OF LARGE
INTESTINE
1.

Haustal contractions

2.

Propulsive movements

3.

Mass peristalsis and

4.

Colonic reflexes

LARGE INTESTINAL
SECRETIONS
Secretions

mainly comprise of
mucus secreted by the goblet
cells and some water and a lot of
bicarbonate.
The mucus - liberates the faecal
matter and also protects the mucus
membrane of LI.
Bicarbonate present in mucoid
secretions neutralize the acid formed
by the bacterial action on the faecal

INTESTINAL BACTERIAL
ACTIVITY
Harmless bacteria such as E.coli and
enterobactor aerogenes and
Potentially dangerous bacteria such as
bacteriods fragelli , various types of
cocci and gas gangrene bacilli.
Intestinal bacterial activities can be
grouped as:

1.
2.
3.

beneficial bacterial activities

Indifferent bacterial activities
detrimental bacterial activities

Beneficial bacterial
activities
Synthesis

of vitamin C, Bcomplex & folic acid

Trophic effect : unabsobed CHO
converted into short chain FA by
colonic bacteria
Play role in cholesterol
metabolism- decrease plasma
cholesterol & LDL

Indifferent bacterial activities

production

of intestinal gases : CO2,

hydrogen sulphide, hydrogen - flatus

Secretion

of Ig A antibodies localised

protection of intestinal mucosa

Substances

responsible for the odour of

the faeces indole, skatole, mercaptans

Pigments

of faeces

formed- bile pigments colour

Detrimental bacterial
activities
Consumption

of nutrients like
vit- C, vit-B12 & choline by
some bacteria- deficiency
Production of ammonia

Functions of LI
SECRETORY FUNCTIONS: mucin lubricate
the faecal matter
Alkaline nature neutralize the acids
SYNTHESIS FUNCTIONS : Folic acid, Vit
B12& Vit- K
ABSORPTIVE FUNCTION : water &
electrolytes- caecum ,proximal part of colon
Glucose , alcohol & some drugs
EXCRETORY FUNCTION : heavy metals
-mercury, lead excreted- through faeces

Defecation

This is the a reflex phenomenon with a

voluntary control.

The centre for defecation is present

in the sacral portion of the spinal
cord, which is influenced by higher
centre.
Receptors for defecation reflex are
stretch receptors present in the wall
of rectum.
They convey information to
sacral segment (S3) of spinal
cord via pelvic nerve

Pathway of defecation
reflex
Intrinsic reflex : distension of
rectum initiate afferent signal
spread through the myentric plexus

Initiate peristaltic movements in

colon- pushes the faeces towards the
anus
Relaxation of internal anal sphincter
by inhibitory signals from the
myentric plexus

Spinal cord reflex

Distension of rectum by faeces

transmission of afferent impulses
through the pelvic nerves to the sacral
seg of sp cord
Induces parasympathetic discharge
cause:

Intensification of colonic peristaltic

contractions
Raise the intrarectal pressure
Further relaxation of internal & ext
anal sphincter as well

Hirschsprungs disease
Aganglionic

megacolonabsecnce of Auerbachs
plexes in the wall of
rectosigmoid colon

Difficult

to pass the faecesaccumulate in LI

i.e.

- megacolon

constipation
Failure

of voiding of faecesdiscomfort
Due to infrequent mass movement of
colon
Faecal matter remains in the colon
for long time
Large amount of water absorbed &
faeces become hard & dry
Diarrhoea : frequent defecation

BLIND LOOP SYNDROME

Seen in surgically created blind loop of SI.
OR stasis of the contents of the small
intestine
Causes over growth of bacteria in SI( LUMEN)

Causes- :
1.
2.
.

malabsorption of Vit B12

Steatorrhoea : increase of faecal fat
content- 40-50gm/day
Stools are bulky, foul smelling, pale &
greasy