DIGESTIVE SYSTEM

CONTENT
• Introduction
• Functions of the Digestive system
• Anatomy of the digestive system
• The mouth
• Pharynx
• Oesophagus
• Stomach
• Small intestine
• Large intestine
• Accesory organs of the digestive system (liver, pancreas, gall
bladder).
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INTRODUCTION
• The digestive system is essentially a disassembly line and its primary purpose is to break
nutrients down into forms that can be used by the body, and to absorb them so they can be
distributed to the tissues.

• Most of what we eat cannot be used in the form found in the food.

• Nutrients must be broken down into smaller components, such as amino acids and
monosaccharides, that are universal to all species.

• Consider what happens if you eat a piece of cow meat, for example.

• The myosin of cow meat differs very little from that of human muscles, but the two are not
identical, and even if they were, cow meat myosin could not be absorbed, transported in the
blood, and incorporated into our muscles.

• Like any other dietary protein, it must be broken down into amino acids before it can be used.
Since cow meat and human proteins are made of the same 20 amino acids, those of cow meat
proteins might indeed become part of our myosin but could equally well wind up in our insulin,
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fibrinogen, collagen, or any other protein.
FUNCTIONS OF THE DIGESTIVE SYSTEM
• The digestive system is the organ system that processes food, extracts nutrients
from it, and eliminates the residue.
• It does this in five stages:

• 1. ingestion, the selective intake of food;

• 2. digestion, the mechanical and chemical breakdown of food into a form usable
by the body;

• 3. absorption, the uptake of nutrients into the blood and lymph;

• 4. compaction, absorbing water and consolidating the indigestible residue into

feces; and finally

• 5. defecation, the elimination of feces.

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 Anatomy of the Digestive System
• The digestive system has two anatomical subdivisions, the digestive tract and the
accessory organs.

• The digestive tract is a muscular tube extending from mouth to anus, measuring about 9 m
long in a death body. It is also known as the alimentary canal or gut.
• It includes the mouth, pharynx, esophagus, stomach, small intestine, and large intestine.
• The gastrointestinal (GI) tract = the stomach and intestines.

• The accessory organs are the teeth, tongue, salivary glands, liver, gallbladder, and
pancreas.

• Most of the digestive tract follows a basic structural plan, with a wall composed of the
following tissue layers, in order from the inner to the outer surface:
• Mucosa,
• submucosa
• Muscularis externa and
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• serosa (serous membrane).
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 Anatomy of the Digestive System
• Slight variations on this theme are found in different regions of the tract.

• The mucosa (mucous membrane):It lines the lumen and runs from the mouth to the anus.
- An inner epithelium, a lamina propria; a loose connective tissue layer and muscularis mucosa; a thin layer of smooth muscle. .
-Its functions; It secretes mucous, digestive enzymes & hormones, it absorbs nutrients and protects from disease & from the GI contents

• The submucosa is a thicker layer of loose connective tissue containing blood vessels, lymphatic vessels, a nerve plexus, and in some places,
mucous glands.

• The muscularis externa: It consists of usually two layers of smooth muscle near the outer surface.
- Cells of the inner layer encircle the tract (circular muscle) and those of the outer layer run longitudinally (longitudinal muscle).
- In some places, the circular layer is thickened to form valves (sphincters) that regulate the passage of material through the digestive tract.
- It is responsible for the motility that propels food and residue through the tract.

• The serosa is composed of a thin layer of areolar tissue topped by a simple squamous mesothelium.
- It begins in the lower 3 to 4 cm of the esophagus and ends just before the rectum.
- The pharynx, most of the esophagus, and the rectum are surrounded by a fibrous connective tissue layer called the adventitia, which blends into
the adjacent connective tissues of other organs.

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Nerve supply to the digestive tract
• Tongue movements, mastication and the initial actions of swallowing employ skeletal
muscles innervated by somatic fibres from six of the cranial nerves.

• The salivary glands are innervated by sympathetic fibres from cervical ganglion and
parasympathetic from cranial nerves.

• From the lower esophagus to the anal canal, most of the muscle is smooth muscle (except
external anal sphincter) and therefore receives only autonomic innervations.

• Parasympathetic innervation dominates the digestive tract and comes mainly from the vagus
nerves. The parasympathetic nervous system relaxes sphincter muscles and stimulates
gastrointestinal motility and secretion. Thus, in general, it promotes digestion.

• The sympathetic nervous system plays a lesser role, but in general it inhibits motility and
secretion and keeps the gastrointestinal sphincters contracted and closed. Thus, it inhibits
digestion.

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There is an extensive enteric nervous system that controls the oesophagus, stomach and intestines.
9
So these organs can function even if nerves from the NS are severed. (second brain)
• Intrinsic: (Local): Short reflex

- Submucosal nerve plexus: regulates glands & mucosal muscle

- Myenteric plexus: controls GI wall & GI motility

• Extrinsic: (CNS): Long reflex

- Parasympathetic NS: enhances gut motility & secretion

- Sympathetic Nervous System: inhibits gut motility & secretion

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 THE MOUTH
• It is known as the oral or buccal cavity.

• Its functions include ingestion, taste and other sensory responses to food, chewing,
chemical digestion, swallowing, speech and respiration.

• It is enclosed by the cheeks, lips, palate and tongue.

• Its anterior opening between lips is the oral fissure and its posterior opening into the
throat is the fauces.
• Lined with stratified squamous epithelium.

• It is keratinized in areas subject to the highest abrasion, such as gums and hard palate,
and non-keratinized in other areas such as floor of the mouth, soft palate and the inside of
the cheeks and lips.

• The cheeks and lips retain food and push it between the teeth for mastication, and are
essentially for articulate speech and for sucking and blowing
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 The Tongue
• A muscular and bulky organ,
• Agile and sensitive organ with several functions:
- Food intake
- Has sensory receptors for taste, texture and temperature that are
important in the acceptance or rejection of food
- Compresses and breaks up food
-Mixes food between teeth for mastication
- Secretes mucus and enzymes
- Compresses the chewed food into a bolus, that is easier to swallow
- Initiates swallowing
• Its surface is covered with non-keratinized stratified squamous
epithelium and exhibits bumps and projections called lingual
papillae, the site of the taste buds.

• They include;
• filiform papillae: rough surface
• foliate papillae: posterolateral, house taste buds
• Fungiform: house taste buds
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• vallate (circumvallate) papillae: house taste buds
 The Palate
• It separates the oral cavity and makes it
possible to breathe while chewing food.

• Anterior portion, the hard (bony)

palate
• Posterior portion, the soft palate

• The uvula helps to retain food in the

mouth until one is ready to swallow.

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 The Teeth
• Collectively called dentition.

• They serve to masticate food, breaking it into smaller pieces. This is not
just to make the food easier to swallow, but to expose more surface area to the
action of digestive enzymes and thus speeds up chemical digestion.

• Incisors are chisel-like cutting teeth used to bite off a piece of food.
• The canines are more pointed and act to puncture and shred it.
• The premolars and molars have relatively broad surfaces adapted for
crushing and grinding.

• Parts of teeth: Crown, neck and root.

- Dentine (hard yellowish tissue)
- Enamel (tissue covering of the tooth)
- Cementum (living connective tissue)
- Pulp (mass of loose connective tissue, blood and lymphatic vessels, nerves)
- Apical foramen (a pore through which nerves and vessels enter the tooth)

• Primary (decidious): 2I 1C 2M x 2 = 20
2I 1C 2M
• Permanent: 2I 1C 2PM 3M x 2 = 32
2I 1C 2PM 3M
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 The Salivary Glands
• There are two kinds of salivary glands, intrinsic and
extrinsic.

• Intrinsic salivary glands

-They are an indefinite number of small glands scattered
throughout the buccal cavity mucosa
- They include lingual glands in the tongue, labial glands
on the inside of the lips, and buccal glands on the inside
of the cheeks.
- They secrete saliva at a fairly constant rate whether we are
eating or not, but in relatively small amounts.
- This saliva keeps the mouth moist and inhibits bacterial
growth.

• Extrinsic salivary glands

- They are three pairs of larger, more discrete organs located
outside of the buccal cavity.
- They supply most of the saliva
- They communicate with the oral cavity by way of ducts.
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- They include: parotid gland, submandibular gland 15
 Saliva
Functions of saliva
- Moistens the mouth and food, - Inhibits bacterial growth,
- Digests a small amount of starch and fat, - Dissolves molecules so they can stimulate the taste buds,
- Cleanses the teeth, - Binds particles together to aid in swallowing.

Composition of saliva (pH 6.75-7.0)

- 97-99.5% water

- Electrolytes and mineral salts including sodium, potassium, chloride, phosphate, and bicarbonate salts.

- mucus, which binds and lubricates the food mass and aids in swallowing

- Salivary Amylase, an enzyme that begins starch digestion in the mouth

- Lysozyme, an enzyme that kills bacteria.

- Immunoglobulin A (IgA), an antibody that inhibits bacterial growth

- lingual lipase, an enzyme that is activated by stomach acid and digests fat after the food is swallowed;
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• Salivation is controlled by groups of neurons called salivatory
nuclei in the medulla oblongata and pons.

• They receive signals from sensory receptors in the mouth as well

as from higher brain centers that respond to the odor, sight, or
thought of food.

• Salivation is mostly under the control of parasympathetic fibers

in cranial nerves VII and IX, which stimulate the secretion of
watery, enzyme-rich saliva.

• Sympathetic fibers from cervical ganglia stimulate the secretion

of thicker, mucus-rich saliva.
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 THE PHARYNX
• The pharynx is part of the throat situated immediately inferior to the
mouth and nasal cavities, and superior to the larynx and esophagus.

• It is conventionally divided into 3 sections; nasopharynx,

oropharynx, and laryngopharynx.

• The first is exclusively respiratory; the last two are shared by the
respiratory and digestive tracts

• The nasopharynx: It is the portion of the pharynx most closer to the

head. It extends from the base of the skull to the upper surface of the soft
palate. It includes the space between the internal nares and the soft
palate and lies superior to the oral cavity.

• The oropharynx: It lies behind the oral cavity and extends from the
uvula to the level of the hyoid bone. Because both food and air pass
through the pharynx, a flap of connective tissue called the epiglottis
closes over the glottis (tracheal opening) when food is swallowed to
prevent accidental inhalation.

• The hypopharynx or laryngopharynx: It is the caudal (most

inferior) part of the pharynx; it is the part that connects to the esophagus.
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It lies inferior to the epiglottis and extends to the location where this
THE ESOPHAGUS
• The esophagus is a 25-cm long muscular tube that connects
the pharynx to the stomach.

• The length of the esophagus at birth varies between 8 and

10 cm and measures about 19 cm at age 15 years.

• Its opening into the stomach is called the cardiac orifice

(for its proximity to the heart).

• Food pauses briefly at this point before entering the

stomach because of a constriction called the lower
esophageal sphincter (LES).

• The LES is also a physiological rather than an anatomical

sphincter, and thus is not found in the cadaver.

• The LES prevents stomach contents from regurgitating into

the esophagus, thus protecting the esophageal mucosa
from the corrosive effect of the stomach acid.
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THE ESOPHAGUS
• The wall of the esophagus is organized into the tissue layers, with some regional
specializations.

• The mucosa has a non-keratinized stratified squamous epithelium.

• The submucosa contains esophageal glands, which secrete lubricating mucus

into the lumen. When the esophagus is empty, the mucosa and submucosa are
deeply folded into longitudinal ridges, giving the lumen a star-like shape in
cross section.

• The muscularis externa is composed of skeletal muscle in the upper one-third of

the esophagus, a mixture of skeletal and smooth muscle in the middle one-
third, and only smooth muscle in the lower one-third. This transition
corresponds to a shift from voluntary to involuntary phases of swallowing as
food passes down the esophagus.
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 STOMACH
• The stomach is a muscular sac in the upper left abdominal cavity
immediately inferior to the diaphragm.

• It functions primarily as a food storage organ, with an internal volume of

about 50 mL when empty and 1.0 to 1.5 L after a typical meal.

• When extremely full, it may hold up to 4 L and extend nearly as far as the
pelvis.

• The stomach mechanically breaks up food particles, liquefies the food, and
begins the chemical digestion of proteins and a small amount of fat. This
produces a soupy or pasty mixture of semi-digested food called chyme.

• Most digestion occurs after the chyme passes on to the small intestine.

• The stomach is somewhat J-shaped and vertical in tall people, whereas in

short people it is more nearly horizontal.

• The lesser curvature of the stomach extends the short distance (about
10 cm) from esophagus to duodenum along the medial to superior aspect,
facing the liver, and the greater curvature extends the longer distance
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(about 40 cm) from esophagus to duodenum on the lateral to inferior
 STOMACH

• The stomach is divided into four regions:

• (1) The cardiac region (cardia) is the small area within
about 3 cm of the cardiac orifice.

• (2) The fundic region (fundus) is the dome-shaped

portion superior to the esophageal attachment.

• (3) The body (corpus) makes up the greatest part of the

stomach distal to the cardiac orifice.

• (4) The pyloric region is a slightly narrower pouch at the

distal end; it is subdivided into a funnel-like antrum and a
narrower pyloric canal.
• The latter terminates at the pylorus, a narrow passage into
the duodenum. The pylorus is surrounded by a thick ring of
smooth muscle, the pyloric (gastroduodenal) sphincter,
which regulates the passage of chyme into the duodenum.

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 STOMACH TISSUE LAYERS

• The stomach wall has tissue layers similar to those of the esophagus, with
some variations.

• The surface of the mucosa is a simple columnar glandular epithelium. The

apical regions of its surface cells are filled with mucin. After it is secreted,
mucin swells with water and becomes mucus.

• When the stomach is full, the mucosa and submucosa are flat and smooth,
but as it empties, these layers fold into longitudinal wrinkles called gastric
rugae.

• The lamina propria is almost entirely occupied by tubular glands.

• The muscularis externa has three layers, rather than two—an outer
longitudinal, middle circular, and inner oblique layer.

• The gastric mucosa is pocked with depressions called gastric pit.

• Two or three tubular glands open into the bottom of each gastric pit and
span the rest of the lamina propria.

• In the cardiac and pyloric regions, they are called cardiac glands and
pyloric glands, respectively. In the rest of the stomach, they are called
gastric glands.
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CELLS OF THE STOMACH
• Collectively, the glands have the following cell types:
• Mucous cells: They secrete mucus and predominate in the cardiac and pyloric glands. In gastric glands,
they are called mucous neck cells and are concentrated in the neck of the gland.

• Regenerative (stem) cells: They are found in the base of the pit and neck of the gland. They divide
rapidly and form a continual supply of new cells. Newly generated cells migrate upward into the glands to
replace cells that die and fall off into the lumen of the stomach.

• Parietal cells: They are found mostly in the upper half of the gland, secrete hydrochloric acid and
intrinsic factor. They are found mostly in the gastric glands, but a few occur in the pyloric glands.

• Chief cells: They are the most numerous, secrete chymosin (formerly called rennin) and lipase in
infancy and pepsinogen throughout life. They dominate the lower half of the gastric glands but are absent
from cardiac and pyloric glands.

• Enteroendocrine cells: They are concentrated especially in the lower end of a gland; secrete hormones
and paracrine messengers that regulate digestion. They are found in all regions of the stomach, but are most
numerous in the gastric and pyloric glands. These are at least 8 different kinds in the stomach, each of which
produces a different chemical messenger. G cells for example, secrete a hormone gastrin which stimulates
the exocrine cells of the gastric glands to secrete acid and enzymes.

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In general, the cardiac and pyloric glands secrete mainly mucus; acid and enzymes secretions occur
24
predominantly in the gastric glands; and hormones are secreted throughout the stomach.
• With the numbers of chemicals secreted in the stomach, it could easily be digested
itself; but it is protected from self digestion in 3 ways:

• Mucous coat: A tick, highly alkaline mucus resists the action of acid and enzymes.

• Tight junctions: The epithelial cells are joined by tight junctions which prevent
gastric juice from seeping between them digesting the connective tissue of the lamina
propria or beyond.

• Epithelial cell replacement: In spite of these other projections, the stomach’s

epithelial cells live only 3 to 6 days and are then sloughed off into the chime and
digested with the food. They are replaced just as rapidly, however, by the division of
stem cells in the gastric pits.

• The breakdown of these protective mechanisms can result in inflammation and peptic
ulcer.
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 SMALL INTESTINE
• The stomach sends about 3 ml of chyme at a time into the small intestine.

• In the small intestine the chemical digestion of food is completed and absorption of
most nutrients takes place. To perform these roles efficiently, the small intestine
must have a large surface area exposed to the chyme. This surface area is imparted to
it by extensive folding of the mucosa, and by the great length of the small intestine.

• The small intestine comprises of three continuous parts.

• The duodenum
• The jejunum
• The ileum and ends at the ileocaecal valve, which controls the flow of material from
the ileum to the caecum, and prevents regurgitation.

• The walls of the small intestine are composed of the four layers of tissue with some
modifications of the peritoneum (mesenteries) and the mucosa (villi, microvilli
etc…).
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 Functions of the small intestine

• Secretion of intestinal juice, also increased by parasympathetic

stimulation.
• Completion of chemical digestion of carbohydrates, proteins and fats in
the enterocytes of the villi.
• Protection against infection by microbes that have survived the
antimicrobial action of hydrochloric acid in the stomach.
• Secretion of hormones cholecystokinine (CCK) and secretin.
• Absorption of nutrients
• When the acid chime passes into the small intestine, it is mixed with
pancreatic juice, bile and intestinal juice and is in contact with the
enterocytes of the villi.

• In the small intestine, digestion of all nutrients is completed:

- Carbohydrates are broken down to monosaccharides
- Proteins are broken down to amino acids
- Fats are broken down to fatty acids and glycerol.
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THE LARGE INTESTINE

• The large intestine receives about 500ml of indigestible food

residue per day, reduces it to about 150 ml of faeces by absorbing
water and salts and eliminates the feaces by defaecation.

• It begins with the caecum and terminates at the rectum and anal
canal deep in the pelvis.
•
• For descriptive purposes the large intestine is divided into the
caecum, colon, sigmoid colon, rectum and anal canal.

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THE LARGE INTESTINE
• The caecum is the first part of the large intestine. It is a dilated region which has a
blind end inferiorly (appendix) and is continuous with the ascending colon superiorly.
Just beneath the junction of the two, ileocaecal valve opens from the ileum.

• The colon has four parts which have the same structure and functions; ascending
colon, transverse colon, descending colon and sigmoid colon.

• The rectum is a highly dilated section of the large intestine about 13 cm long. It leads
from the sigmoid colon and terminates in the anal canal.

• The anal canal is a short passage about 3.8 cm long in the adult and leads from the
rectum to the exterior. Two sphincters muscles control the anus; the internal anal
sphincter consisting of smooth muscle, is under the control of the autonomic nervous
system and the external sphincter formed by skeletal muscle, is under voluntary
control.
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Functions of the large intestine
• Absorption: In the large intestine, absorption of water by osmosis continues
until the familiar semisolid consistency of faeces is achieved.

• Microbial activity: The large intestine is heavily colonized by certains types of

bacteria which synthesize vitamin K and folic acid. They include Escherichia coli,
Streptococcus faecalis.

• Mass movement: The large intestine does not exhibit peristaltic movement as
in other parts of the tract. Only at fairly long intervals (about twice an hour) does
a wave of strong peristalsis sweep along the transverse colon forcing its contents
into the descending and sigmoid colons. This is known as mass movement.

• Defaecation: Usually the rectum is empty, but when a mass movement forces
the contents of the sigmoid colon into the rectum the nerve in its walls are
stimulated by stretch. In infants, defaecation occurs by reflex (involuntary)
action.
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Accessory Organs
• The liver
• It is a reddish brown gland located immediately inferior to
the diaphragm

• It has numerous functions in digestion

• Has four lobes. The two most obvious are the large right
lobe and the smaller left lobe. The other two, the caudate
and quadrate lobes, are areas on the posterior surface.

- Portal fissure: point of entry for the hepatic portal vein and
hepatic arteries and a point of exit of the bile duct.
- Lobules: Tiny functional units of the liver
- Hepatocytes: Cubical-shaped cells of the liver.
- Kupffer cells: Hepatic macrophages.
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Functions of the liver
• Carbohydrate metabolism: Maintaining plamsa glucose levels i.e. produce and
store glucose.

• Protein metabolism: Deamination of a.a (removal of the nitrogenous portion from

the a.as), transamination (removal of the nitrogenous portion of the a.as and
attachment of a carbohydrate molecule), synthesis of plasma proteins and most of the
blood clotting factors.

• Fat metabolism: Convert fat molecules to provide energy.

• Defense: Clearing out worned-out cells and foreing microorganisms.

• Detoxification of drugs and toxic substances.
• Inactivation of hormones
• Main heat-producing organ
• Bile secretion
• Storage organ e.g glycogen, vitamins etc…
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Pancreas
- Pancreatic enzymes carry out most digestion
- Pancreas is a pale-grey spongy digestive gland posterior to the greater curvature of
the stomach.
- It is both an endocrine and exocrine gland.

- Exocrine function is to produce produce pancreatic juice containing enzymes that

digest carbohydrates, protein and fat.

- Parasympathetic stimulation increases secretion of the pancreatic juice and

sympathetic stimulation depresses it.

- The pancreatic juice consists of water, mineral salts, enzymes, inactive enzyme
precursors (trypsinogen and chymotrypsinogen).

- Pancreatic juice has Ph=8, pancreatic enzymes, amylase and lipase act more
effectively at this Ph.
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Gall bladder

• It is a pear-shaped sac attached to the posterior surface of the

liver.

• Functions
- Bile reservoir
- Concentrates bile
- Release bile when needed.

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Carbohydrates
• The digestion of carbohydrates begins in the mouth.

• The salivary enzyme amylase begins the breakdown of food starches into maltose, a
disaccharide.

• As the bolus of food travels through the esophagus to the stomach, no significant
digestion of carbohydrates takes place. The esophagus produces no digestive
enzymes but does produce mucous for lubrication.

• The acidic environment in the stomach stops the action of the amylase enzyme.

• The next step of carbohydrate digestion takes place in the duodenum.

• Recall that the chyme from the stomach enters the duodenum and mixes with the
digestive secretion from the pancreas, liver, and gallbladder.

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• Pancreatic juices also contain amylase, which continues the breakdown of starch
Carbohydrates Digestion

• The disaccharides are broken down into monosaccharides by enzymes

called maltases, sucrases, and lactases, which are also present in the
brush border of the small intestinal wall.

• Maltase breaks down maltose into glucose.

• Other disaccharides, such as sucrose and lactose are broken down by
sucrase and lactase, respectively. Sucrase breaks down sucrose (or “table
sugar”) into glucose and fructose, and lactase breaks down lactose (or
“milk sugar”) into glucose and galactose.

• The monosaccharides (glucose) thus produced are absorbed and then can
be used in metabolic pathways to harness energy. The monosaccharides
are transported across the intestinal epithelium into the bloodstream to be
transported to the different cells in the body.
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 Digestion of carbohydrates is performed by several enzymes.

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Protein Digestion
• A large part of protein digestion takes place in the stomach.

• The enzyme pepsin plays an important role in the digestion of proteins by breaking
down the intact protein to peptides, which are short chains of four to nine amino acids.

• In the duodenum, other enzymes— trypsin, elastase, and chymotrypsin—act on the

peptides reducing them to smaller peptides.

• Trypsin, elastase, carboxypeptidase, and chymotrypsin are produced by the pancreas and
released into the duodenum where they act on the chyme.

• Further breakdown of peptides to single amino acids is aided by enzymes called

peptidases (those that break down peptides).

• Specifically, carboxypeptidase, dipeptidase, and aminopeptidase play important

roles in reducing the peptides to free amino acids. The amino acids are absorbed into the
bloodstream through the small intestines.
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Digestion of Protein
Substrate Acting
Enzyme Produced By Site of Action End Products
On

Stomach chief
Pepsin Stomach Proteins Peptides
cells

•Trypsin
•Elastase Pancreas Small intestine Proteins Peptides
Chymotrypsin

Carboxypeptidas Amino acids and

Pancreas Small intestine Peptides
e peptides

•Aminopeptidase Lining of
Small intestine Peptides Amino acids
•Dipeptidase intestine

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Lipids Digestion
• Lipid digestion begins in the stomach with the aid of lingual lipase and gastric
lipase.

• However, the bulk of lipid digestion occurs in the small intestine due to pancreatic
lipase.

• When chyme enters the duodenum, the hormonal responses trigger the release of bile,
which is produced in the liver and stored in the gallbladder.

• Bile aids in the digestion of lipids, primarily triglycerides by emulsification.

• Emulsification is a process in which large lipid globules are broken down into several
small lipid globules. These small globules are more widely distributed in the chyme
rather than forming large aggregates. Lipids are hydrophobic substances: in the
presence of water, they will aggregate to form globules to minimize exposure to water.

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By forming an emulsion, bile salts increase the available surface area of the lipids many
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