Chapter 1:

PHYSIOLOGY
OF
DIGESTIVE SYSTEM

Shimelis M.
2017
 Introduction
The gastrointestinal system carries out the following activities:
 Ingestion: food intake, which is controlled by the feeding and
satiety center in the HT.
 Mastication or chewing: mechanical grinding of food with the
aid of the teeth.
 Swallowing or deglutition: propulsion of food from the mouth to
the stomach.
 Chemical digestion of food
 Secretion of enzymes, electrolytes (HCl, NaHCO3), mucus, and
hormones
 Absorption of nutrients, water and electrolytes into the blood
 Elimination: excretion of fecal matter through the process of
defecation
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3
 Functional Structures of Digestive System
 Organs involved in the process of digestion are:

Principal structures that make up the alimentary canal: –

mouth, pharynx, esophagus, stomach, small intestine and
large intestine
Accessory structures: – teeth, tongue, gallbladder, salivary
glands, liver and pancreas
 Teeth aids mechanical breakdown of food

 Tongue assists chewing and swallowing

 Other accessory organs produce and send secretions that

facilitate chemical breakdown of food

4
 Digestive organs

5
 Histology of the Alimentary Canal
 From esophagus to the anal canal the walls of the GIT have
the same four layers (from the lumen to outward)
1. Mucosa,
2. Submucosa ,
3. Muscularis externa, and
4. Serosa
 Each layer has a predominant tissue type and a specific
digestive function

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7
A. Mucosa

 Moist epithelial layer that lines the lumen of the alimentary canal

 Its three major functions are:

Secretion of mucus

Absorption of the end products of digestion

Protection against infectious diseases

 Consists of three layers:

1. A lining epithelium,

2. Lamina propria, and

3. Muscularis mucosae
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1. Epithelial Lining:
Two types of epithelial cells along the GIT:
i. Non-keratinized stratified squamous epithelium: mouth,
esophagus and anal canal
Function: protection
ii. Simple columnar epithelium: through out the rest of the
tract Function: absorption and secretion
The mucus secretions:
 Protect digestive organs from digesting themselves
 Ease food along the tract
Stomach and small intestine mucosa contain:
 Enzyme-secreting cells
 Hormone-secreting cells (enteroendocrine cells)

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2. Lamina Propria:
Contains connective tissues, blood vessels and lymph vessels

Nourishes the epithelium and absorbs nutrients

Contains lymph nodes important in defense against bacteria

3. Muscularis mucosae
Smooth muscle cells that produce local movements of mucosa

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 B. Sub-mucosal layer
 Consists of loose connective tissues, secretory glands, lymph
nodes and blood vessels
 The sub mucosal layer contains enteric nerve plexus
(Submucosal plexus (plexus of Meissner))
 This plexus controls secretions by the GIT.
C. Muscularis externa
 The muscularis of the mouth, pharynx, and upper esophagus
consists of skeletal muscles that produce voluntary swallowing.
 The skeletal muscle also forms the external anal sphincter,
which permits voluntary control of defecation.

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 Through out the rest of the tract, the muscularis consists of
smooth muscles that is generally found in two sheets:
 Inner sheet of circular fibers and
 Outer sheet of longitudinal fibers
 Involuntary contraction of both smooth muscles help
breakdown of food physically, mix it with digestive
secretions, and propel it along the tract.
 The muscularis also contains the major nerve supply to the
GIT; the myenteric plexus (plexus of Auer Bach), which
consists of fibers from both autonomic divisions.
 This plexus mostly controls GIT motility.

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D. Serosa

 The serosa is the outer most layer of the GIT

 It is a serous membrane composed of connective tissue
and epithelium.
 Below the diaphragm, this layer is also called the
visceral peritoneum.

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 Regulation of GIT
 Regulation of digestion involves:
1. Mechanical and chemical stimuli:– stretch receptors,
osmolarity, and presence of substrate in the lumen
2. Extrinsic control system by ANS
Sympathetic NS = ↓GI function
Parasympathetic NS = ↑GI function
3. Intrinsic control system by enteric NS
 Submucosal plexus (plexus of Meissner): controls GI
secretory activities
 Myenteric plexus (plexus of auerbach): controls
motility of the gut
4. The GIT hormonal system

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 GIT reflexes
1. Reflexes that occur entirely within the ENS →these include
reflexes that control GI-secretion, peristalsis, mixing
contractions, local inhibitory effects.
2. Reflexes that arise from the gut go to the sympathetic ganglia
and then back to the GI-tract.
Examples:
a. The gastro-colic reflex: signals send from the stomach →to
cause evacuation of the colon.
b. The entero-gastric reflexes: signals from the colon and small
intestine →to inhibit stomach motility and secretion.
c. The colono-ileal reflex: reflexes from the colon →to inhibit
emptying of ileal contents into the colon.
3. Reflexes from the gut to the spinal cord or brain stem and then
back to GIT.
15 Example: defecation reflex
Hormonal control of GI function
Intero-endocrine cells: produce several GIT hormones → capable
of regulation of motility and secretory activities.
A. Cholecytokinin (CCK, 33aas) (intestinal and pancriozymine)
Secreted by the mucosa of the duodenum and jejunum in
response to the presence of fatty food in the intestine.
Has a very potent effect on gall bladder contractility→ for
expelling bile into the intestine in order to facilitate fat digestion
and absorption.
Inhibits stomach motility in order to give adequate time for fat
digestion.
B. Secretin (27aas)
Secreted by the mucosa of the duodenum in response to acidic
gastric juice pumped from the stomach.
 It increases NaHCO secretion by the pancreas and other
3
pancreatic secretions.
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 Blood Supply to Digestive System
 The blood vessels of the GI-system are part of a more extensive
system called the splanchnic circulation.
Splanchnic BF =1000 ml/min
 Includes blood flow through the GIT plus through the spleen,
pancreas and the liver.
 All of the blood that flows through the gut, spleen and pancreas
then passes into the liver by way of the portal vein.
 In the liver, blood passes through millions of liver sinusoids and
finally leaves the liver by way of the hepatic veins that empty into
the inferior vena cava of the general circulation.
 The advantage of sinusoidal passage of blood is that:
The reticulo-endothelial cells in the liver remove bacteria and
other particles → entering the blood from the GIT & preventing
pathogens
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 Blood Supply to… cont’d

 The superior mesenteric and inferior mesenteric arteries: supply

blood to the wall of small and large intestine.

 The celiac artery: supplies blood to the stomach.

 Big arteries are branched and re-branched to encircle and penetrate

deep into the mucosal villi layers of the gut wall.

 Blood flow to the GIT is increased by 100% during meal time.

 Possible causes:
 The release of vasodilator GI hormones during digestive
processes.
 E.g. CCK, VIP, gastrin, secretin, bradykinin, nitric oxide.

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Blood Supply to GIT (cont’d)

19
 Blood Supply For GIT

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 Functional types of movements in the GIT
Two basic types of movements occur in the GIT:
1. Propulsive movements: which cause food to move forward along
the tract at an appropriate rate for digestion and absorption.
2. Mixing movements: which keep the GI contents thoroughly
mixed at all times.

A. Propulsive Movements (Peristalsis):

(Peristalsis)
 Peristalsis is the basic propulsive movements of the GIT that
appears in the form of contractile rings around the gut and
propels to the anal ward direction.
 It is an inherent property of the smooth muscles in the GIT that
generate action potential rhythmically (basic electrical rhythm,
BER).

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 Peristalsis Segmentation

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 B. Mixing Movements
Segmentation
Most areas of the small intestine.
These movements churn and fragment the digestive
materials, mixing the contents with intestinal secretions.
Haustration
At the same time, the longitudinal muscle of the colon,
which is aggregated into three longitudinal strips called the
teniae coli, contracts.
These combined contractions of the circular and
longitudinal strips of muscle cause the unstimulated portion
of the large intestine to bulge outward into baglike sacs
called haustrations.

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Tongue
 Occupies the floor of the mouth and fills the oral cavity when

mouth is closed
 Functions include:

Gripping and repositioning food during chewing

Mixing food with saliva and forming the bolus

Initiation of swallowing, and speech

Contains taste buds

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Teeth
 There are two sets of teeth:
1. Primary/deciduous
2. Permanent

 Primary: 20 deciduous teeth that erupt at intervals between 6 and

24 months
 Permanent: enlarge and develop causing the root of deciduous
teeth to be reabsorbed and fall out between the ages of 6 and 12
years
 All but the third molars have erupted by the end of adolescence
 Usually 32 permanent teeth
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 Types of Teeth
 Incisors:
 Useful for clipping or cutting
 Have a single root.
 The cuspids, or canines:
 Used for tearing or slashing
 Have a single root.
 Bicuspids, or premolars:
 Used for crushing, mashing, and
grinding.
 Have one or two roots.
 Molars:
 Crushing and grinding
 Typically have three or more roots.
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Deciduous teeth Permanent teeth

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Dental Formula: Permanent Teeth
 A shorthand way of indicating the number and relative position of

teeth
 Written as ratio of upper to lower teeth for the mouth

 Deciduous: 2I (incisors), 1C (canine), 2M (molars) = 20

 Permanent: 2I, 1C, 2PM (premolars), 3M =32

2I 1C 2PM 3M X 2 =(32 teeth)

2I 1C 2PM 3M

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 Digestive processes in the mouth
 After food is ingested
 Mechanical digestion begins → chewing/mastication
 Propulsion is initiated → by swallowing
 Salivary amylase begins chemical breakdown of starch
 The pharynx and esophagus serve as conduits to pass food from
the mouth to the stomach

Mastication (Chewing)
 It is a process of mechanical breakdown of food.
 Salivary secretion containing amylase involves chemical digestion
and lubrication of the food.
 Teeth, tongue, jaws and lips are involved in chewing.

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Chewing (Mastication)…cont’d
 Teeth are well adapted for this function as: incisors for cutting,
canine for tearing, molars and premolars for grinding.
 Mastication muscles are supplied mainly by the motor branch of
the trigeminal nerve.
 Chewing center is located in the pons
 The movement of these organs are controlled by such centers
located in the brainstem, hypothalamus, amygdala and cerebral
cortex.
 Chewing reflex:
The presence of food in the mouth→ reflex relaxation of the
mastication muscle → drop of the mandible → stimulation of the
stretch receptors → reflex contraction of the mastication muscle →
bolus of food pressed against the jaws→→→ the process
continues like this.
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 Deglutition (Swallowing)
 It is the propulsion of food from mouth to the esophagus i.e.
controlled by the swallowing center in the medulla.
 Involves the coordinated activity of the tongue, soft palate, pharynx,
esophagus and 22 separate muscle groups.
 Has 3 stages
1. Voluntary stage of swallowing:
 Buccal/oral phase→bolus is forced into the oropharynx
voluntarily.
2. Pharyngeal stage of swallowing:
 It is the involuntary process and contributes the passage of food
through the pharynx to the esophagus.
 Controlled by the medulla and lower pons.
3. The esophageal stage of swallowing:
 Involuntary phase, promotes the passage of food to the stomach.
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 Deglutition (Swallowing)….cont’d
Bolus of food

Tongue
Uvula
Pharynx Bolus
Epiglottis
Epiglottis

Trachea Esophagus Bolus

(a) Voluntary stage, oral (b) Involuntary, (c) Esophageal stage of

phase of swallowing pharyngeal stage of swallowing
swallowing
Relaxed Relaxed
muscles Circular muscles contract,
muscles
constricting passageway
and pushing bolus down Gastroesophage
Bolus of food al sphincter
open
Longitudinal
muscles contract, Gastroesophageal reflux?
shortening Achalasia?
passageway ahead
Gastroesophageal
of bolus
sphincter closed Stomach

(d) (e)
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 Lower esophageal (Gastro-esophageal) sphincter
It is a thickened circular smooth muscle at the junction b/n
the esophagus and the stomach.
Function: prevents the reflux of gastric contents into the
esophagus.
Gastro-esophageal reflux:
It is the entry of gastric contents into the lower part of the
esophagus due to incompetence of the LES → that leads to
ulcer of the mucosa of lower esophagus.
Achalasia:
Failure of LES to be relaxed, swallowing is inhibited.
Caused by increased in tone of LES due to high sensitivity
to gastrin, weak esophageal peristalsis
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Lower esophageal sphincter… GEFD

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 Functional structure of the stomach
 Chemical breakdown of proteins begins and food is converted to

chyme.
Cardiac region: surrounds the cardiac orifice
Fundus: dome-shaped region beneath the diaphragm
Body: midportion of the stomach
Pyloric region: made up of the antrum and canal which
terminates at the pylorus
The pylorus is continuous with the duodenum through the
pyloric sphincter

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Stomach Structure…cont’d
 Greater curvature:
 entire extent of the
convex lateral
surface
 Lesser curvature:
 concave medial
surface

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 Function of the stomach
Storage of large quantities of food until it can be pumped
into the duodenum.
Stomach can accommodate large amount of food up to 1.5
Liters.
Mixing of food with gastric secretion to form a semi-fluid
chyme.
Slow emptying the food from the stomach into the small
intestine at a rate suitable for proper digestion and
absorption by the small intestine.
Secretory function: HCl, mucous, pepsin, gastrin, IF
Sterilization, digestion, absorption
Facilitates defecation
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 Glands distribution in Stomach
Body of stomach secretes:
 Parietal cells (HCl, IF)
 Chief cells (pepsinogen)
Antrum
 G-cells (gastrin)
 Chief cells (pepsinogen)
Mucus producing cells: all parts

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 Gross Anatomy of Small Intestine
 Runs from pyloric sphincter to
the ileocecal valve
 20 feet long &1 inch in diameter
 Large surface area for majority
of absorption
 Has three subdivisions:
Duodenum: the bile duct and
main pancreatic duct join the
duodenum
Jejunum: extends from the
duodenum to the ileum
Ileum: joins the large
intestine at the ileocecal valve
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 Microscopic Anatomy of SI
 Structural modifications
of the small intestine
wall increase surface
area
 Plicae circularis: deep
circular folds of the
mucosa and sub mucosa
 Villi: finger-like
extensions of the mucosa
 Microvilli: tiny
projections of absorptive
mucosal cells’ plasma
membranes
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 …cont’d

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 Ileocecal sphincter
 Function: prevents back flow of fecal matter from the cecum to

the ileum
 Factors regulating the sphincter

Pressure and chemical irritation of ileum relax it and initiates

peristalsis
Pressure and chemical irritation of cecum inhibit peristalsis of

ileum and closes the sphincter

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 Large Intestine

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 Movement in the large intestine
 Two types of movements

 Mixing movements

 Propulsive movements (mass movements)

 Mass movement is initiated by local distension → gastro-colic

reflex
 Poor motility of the transverse colon causes → greater

absorption and constipation

 Excess motility of the sigmoid colon → causes less absorption

and diarrhea or loose stool

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45
 Defecation reflex

 Rectal Stimulation
distension of myenteric plexus

Initiates peristaltic waves in

descending colon,
sigmoid colon and rectum

Relaxation of IAS by
 parasym. Stimulation
 myenteric plexus

Peristaltic wave
Voluntary forces feces
Relaxation to the anus
of EAS

46 Defecation
 SECRETORY FUNCTIONS OF GIT
 Primary secretory products of GIT are:
 Digestive enzymes
 GI-hormones
 Mucus
 Electrolytes, HCl, NaHCO3
 GIT secretory glands
1. Goblet cells: mucous producing glands
2. Brunner’s gland: mucous glands
3. Crypts of Lieberkuhn: water and electrolytes
4. Gastric glands: Oxyntic, pyloric and mucous glands
5. Complex glands: salivary, pancreatic glands and liver
6. Enteroendocrine cells: produce hormones
• Secretory volume: 6~8 L/ day
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 …cont’d

48
 Factors stimulating GIT secretions
 Local mechanical factors: distension, irritation, pH
 Nervous stimulation: ANS, ENS
Sympathetic stimulation: inhibits GIT-secretions
Parasympathetic stimulation: increases GIT-secretions
Meissner’s plexus: increases GIT-secretion
 Hormonal mechanisms:
Gastrin: increases HCl secretion
Secretin: increases NaHCO3 secretion from pancreas

Mucus
FunctionComposition
 Lubrication - Water
 Protection - Electrolytes
- Glycoproteins
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- Polysaccharides
 Salivary Glands
Produce and secrete saliva
Saliva:
is a fluid that is continuously secreted into the mouth for
moistening, lubrication, dissolving and chemical
breaking down of food.
Saliva contains two major types of protein secretion:
(1)A serous secretion : contains ptyalin (an α-amylase) (pH:
6-7) → for starch digestion
(2)Mucus secretion: contains mucin → for lubrication and
surface protection

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 …cont’d
 Three pairs of extrinsic salivary glands:
1. Parotid
2. Submandibular and
3. Sublingual
 Intrinsic salivary glands (buccal glands): scattered throughout
the oral mucosa
 Functions of Saliva:
 Cleanses the mouth
 Moistens and dissolves food chemicals
 Aids in bolus formation
 Contains enzymes that break down starch
 Contains antimicrobial agents for protection

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 …cont’d
1. The parotid glands:
 Located inferior and anterior to the ears b/n the skin and the
masseter muscle.
 They secrete saliva into the mouth through the parotid ducts
(Stensen’s ducts) that pierces the buccinators muscle to open
into the second maxillary molars.
2. The sub-mandibular glands:
 Found beneath the base of the tongue in the posterior part of
the floor of the mouth.
 Their ducts, the submandibular (Wharton’s) ducts and
opened at the base of the lingual frenulum.
3. Sublingual glands:
 Located superior to the submandibular glands.
 Their ducts, the lesser sublingual (Rivinus) ducts open in to
the floor of the mouth.
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53
 …cont’d
 Daily secretion of saliva 1000 - 1500 ml/day
 Secretion is controlled by:
 Nervous parasympathetic stimulation  salivary output
 Chemical stimulation of taste buds
 Mechanical stimulation
 Psychic stimulation → smell, sight, hearing about food
Source and Composition of Saliva:
 Secreted from serous and mucous cells of salivary glands
 A 97-99.5% water, hypo-osmotic, slightly acidic solution
containing
 Electrolytes: Na+, K+, Cl–, PO42–, HCO3–
 Digestive enzyme: salivary amylase
 Proteins: mucin, lysozyme, defensins, and IgA
 Metabolic wastes: urea and uric acid
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 Regulation of salivary secretion
 Totally controlled by the PNS

 Integrated at the salivatory centre in the medulla

 The salivatory nuclei control salivary glands

 Are stimulated by impulses from

 Sensory impulses from the tongue (taste, touch)

 Sensory impulses from esophagus, stomach, SI

 Impulses from the cerebral cortex (sight, smell)

 Impulses from the feeding centre in the hypothalamus

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 Regulation of salivary secretion...cont’d
Appetite Sight
Centre (HT) Cortex Smell
+ + Sound

Superior salivatory nucleus

Inferior salivatory nucleus

Medulla GPN
Ob.
Parotid

+ FN
VN SMG
Taste FN
Touch +
Temperature Lower esophagus SLG
Stomach
Upper SI

FN=facial N, VN= Vagus, GPN=Glossopharyngeal N Saliva

56 SLG=sublingual gland, SMG=submandibular gland
 Gastric Secretion
 The stomach mucosa has two important types of tubular
glands:
i. Oxyntic glands/gastric glands/acid-forming glands:
 secrete HCl, pepsinogen, IF and mucus.
 located on the inside surfaces of the body and fundus of
the stomach
 Constituting the proximal 80% of the stomach.
ii. Pyloric glands:
 secrete mucus for protection of the pyloric mucosa from
the stomach acid.
 also secrete the hormone gastrin.
 located in the antral portion of the stomach, the distal
20% of the stomach
57
 …cont’d
Areas of the Stomach, Cell types in each, and their Secretions
STOMACH REGIONS CELL TYPE SECRETIONS
Oxyntic gland area Parietal (oxyntic) cells Acid, instrinsic factor
Chief (peptic) cells Pepsinogen, gastric lipase
Pyloric gland area G cells Gastrin
(antrum) Mucus cells Mucus, Pepsinogen
D cells Somatostatin
This table lists the stomach areas, the cell types present in each area, and the
secretions of the cell types.

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59
 …cont’d
 Pepsinogen:
Secreted by the peptic and mucous cells of the gastric glands
It comes in contact with hydrochloric acid, it is activated to form
active pepsin.
 Pepsin:
An active proteolytic enzyme in a highly acid medium (optimum
pH 1.8 to 3.5)
but above a pH of about 5 it has almost no proteolytic activity
 Intrinsic factor:
Essential for absorption of vitamin B12 in the ileum,
Pernicious anemia developed because of failure of maturation of
the RBCs in the absence of vitamin B12 stimulation of the bone
marrow.
 Gastrin: plays a key role in controlling gastric secretion
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 Function of pepsinogen

protein
HCl
Pepsinogen Pepsin
pH 2-3.5
peptone

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 Regulation of Gastric Secretion
 Neural, hormonal and mechanical mechanisms regulate
the release of gastric juice
 Stimulatory and inhibitory events occur in three phases
1. Cephalic (reflex) phase: prior to food entry

2. Gastric phase: once food enters the stomach

3. Intestinal phase: as partially digested food enters the

duodenum

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63
 Secretion of the Small Intestine
Mucosa of the SI secretes:
 Digestive enzymes
 Mucous: protective and lubricant
 Electrolytes Intestinal secretory out put = 2-3 L/d, pH=7.0
 Hormones
Intestinal secretory glands:
1. Brunner’s gland: mucous glands, duodenal in distribution
2. Crypts of Lieberkun: mucous and electrolytes. Distributed in the
SI below the duodenum and in the LI.
3. Goblet cells: mucous glands
4. Enterocytes: digestive enzymes
5. Enteroendocrine cells: produce hormones
6. Enterochromaffin cells: serotonin producing cells
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 Digestive enzymes secreted in the SI
1. Peptidase: splits peptides into amino acids
2. Four enzymes hydrolyzing dissaccharides into
monosaccharides: sucrase, maltase, isomaltase and lactase
3. Intestinal lipase: splits neutral fats into glycerol and fatty
acids.

Regulation of SI secretion
1. Local factors: tactile, distension, irritation, pH.
2. Hormonal: secretin, CCK, VIP, glucagon, GIP
3. Nervous:
 Vagal stimulation increases intestinal secretion
 Sympathetic stimulation decreases intestinal secretion
65
 Secretion of the large intestine

Glands

 Crypts of Lieberkuhn Secrete H2O, electrolytes

 Goblet cells and mucous

 Regulated by local (tactile) factors

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 THE PANCREAS
Pancreas Location:
 Lies deep to the greater curvature of the stomach
 Divided into: Head, body and tail
 The head is encircled by the duodenum and the tail abuts
the spleen
 Connected to the duodenum via the pancreatic duct (duct
of Wirsung) and accessory duct (duct of Santorini).

Pancreas contains two types of secretory glands:

1. Endocrine cells (islets of Langerhans): secrete hormones and
2. Exocrine cells (acinar and duct cells): secrete a mixture of
fluid rich in NaHCO3 and digestive enzymes called pancreatic
67 juice.
 …cont’d

68
 Composition and Functions of Pancreatic Juice
Out put: 1-2 L/day, pH of 7.1 to 8.2
Contains water, low Cl-, digestive enzymes & high sodium
bicarbonate ion
Isotonic due to high water permeability to ducts

Digestive enzymes
1. Proteolytic enzymes:
Trypsinogen---activated by enterokinase (also a brush
border enzyme in the small intestine) = trypsin
Chymotrypsinogen----activated by trypsin
Carboxypeptidase---activated by trypsin
Elastase---activated by trypsin

69
 …cont’d
Trypsin inhibitor---combines with any trypsin produced

inside the pancreas

Ribonuclease---- to digest nucleic acids
Deoxyribonuclease

Collagenase

2. Pancreatic enzymes involved in CHO digestion: pancreatic

amylase

3. Pancreatic enzymes involved in fat digestion: pancreatic

lipase, cholesterol esterase, phospholipase
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 Regulation of Pancreatic Secretions
 Secretin
 Acidity in intestine
causes increased
sodium bicarbonate
release
 GIP
 Fatty acids & sugar
causes increased
insulin release
 CCK
 fats and proteins
cause increased
digestive enzyme
release

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 LIVER and GALL BLADDER

 The liver is the heaviest gland in the body and the

second largest organ in the body after the skin.

 The liver is divisible into left and right lobes, separated

by the falciform ligament.

 Associated with the right lobe are the caudate and

quadrate lobes.
 The gallbladder is a sac located in a depression on the

posterior surface of the liver.

72
 Functions of the Liver
1. On Carbohydrate Metabolism:
 It is the site of glycogenesis, gluconeogenesis and
glycogenolysis
 Turns proteins into glucose
 Turns triglycerides into glucose
 Turns excess glucose into glycogen & stores
 Turns glycogen back into glucose as needed
2. On Lipid Metabolism
 It is the site of β-oxidation, formation of phospholipids,
lipoproteins, synthesis of cholesterol, and conversion of
CHO into fat
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 …cont’d
3. Protein Metabolism
Deamination of amino acids = removes NH2 (amine
group) from amino acids so can use what is left as energy
source
Converts resulting toxic ammonia (NH3) into urea for
excretion by the kidney
Synthesizes plasma proteins utilized in the clotting
mechanism and immune system
Converts one amino acid to another

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 Other Functions of the liver
4. Inactivation of drugs & hormones (Sulfonamide,
penicillin, thyroid, steroids)
5. Removes the waste product; bilirubin
6. Releases bile salts
7. Stores fat soluble vitamins: A, B12, D, E, K
8. Stores iron and copper
9. Filtration of blood: phagocytizes worn out blood cells
& bacteria. Removes blood clots and toxins from
portal circulation
10. Activates vitamin D
11. Storage of blood: a major blood reservoir
12. Synthesis of blood clotting factors (F-I, II, VII, IX, X)
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 Secretion of Bile
Bile is secreted by hepatocytes in the liver for two purposes
1. It facilitates fat digestion and absorption of fat
2. Serves as a means of excretion of waste products (bilirubin
and cholesterol)

Bile secretion has two stages:

1. Primary secretion: contains bile salt, cholesterol, lecithin,
electrolytes (Na, Ca, K ions)
2. Secondary secretions: contains primary secretions plus
water, NaHCO3, Cl-.
 Average biliary out put: 600 -1200 ml/day
 yellow-green in color b/c of bilirubin & pH = 7.6 - 8.6
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 Secretion of Bile by the Liver; Functions of the Biliary Tree

77
 Regulation of Bile Secretion

78
 Secretion of Mucus by the Large Intestine
The mucosa of the large intestine, has many crypts of
Lieberkühn but, there are no villi.
The epithelial cells secrete almost no digestive enzymes.
Instead, they contain mucous cells that secrete only mucus.
This mucus contains moderate amounts of bicarbonate ions
secreted by a few non-mucus-secreting epithelial cells.
The rate of secretion of mucus is regulated principally by:
Direct stimulation
Tactile stimulation of the epithelial cells lining the large
intestine and
Local nervous reflexes to the mucous cells in the crypts
of Lieberkühn.
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 Digestion of Carbohydrates
 Mouth---salivary amylase
 Esophagus & stomach---nothing happens
 Duodenum----pancreatic amylase
 Brush border enzymes (maltase, sucrase & lactase)
Act on disaccharide and produce monosaccharides--
fructose, glucose & galactose
Lactose intolerance (no lactase enzyme; bacteria ferment
sugar)--gas & diarrhea

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 …cont’d

81
 Digestion of Proteins

82
 Digestion of Lipids
 Mouth: lingual lipase

 Most lipid digestion, in an adult, occurs in the small intestine.

Emulsification by bile of globules of triglycerides

pancreatic lipase: splits triglycerides into fatty acids &
monoglycerides

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 …cont’d
Dietary source of fat
 Neutral fats (triglycerides)
 Cholesterol and cholesterol esters
 Phospholipids
Fat Emulsified fat
-Lingual lipase
-Pancreatic lipase
-Enteric lipase
FFA + Glycerides
Cholesterol and Bile salt FFA +
Cholesterol esters Cholesterol Glycerides
Esterase
Phospholipase FFA +
Phospholipids-A2 Phopholipids
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 Absorption in the Small Intestine

85
 Where will the absorbed nutrients go?

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 Absorption of Monosaccharides
 Absorption into epithelial cell
 Glucose & galactose by active transport
 Fructose by facilitated diffusion

 Movement out of epithelial cell into bloodstream by facilitated

diffusion

 Glucose and Galactose are transported by a sodium co-transport

mechanism SGLUT-1 and fructose by GLUT-5.

 Glucose, galactose and fructose are transported out of the

enterocyte through another hexose transporter (called GLUT-2)
in the basolateral membrane.
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