ANATOMY

DIGESTIVE SYSTEM

M. MANSYUR ROMI
 Organs
 I. Tractus Alimentarius
 Cavum oris
 Pharynx
 Oesophagus
 Gaster / ventriculus
 Intestinum tenue: duodenum, jejunum, ileum
 Intestinum crassum: coecum, colon ascendens,
c.transversum, c.descendens, c.sigmoideum
 Rectum
 Anus
 II. Acessory / Related Organs:
Dentes
Lingua
Gld. Salivarii
Gld. Gastrica
Gld. intestinales
Hepar, vesica felea
Pancreas
 Digestive System Function
 Acquires nutrients from environment
 Anabolism
 Uses raw materials to synthesize essential
compounds

 Catabolism
 Decomposes substances to provide energy cells need
to function
Quantities of material processed per day:

1200ml water 1500 ml saliva

800g food

500ml bile
2000ml
1500ml gastric juice
pancr.juice

1500ml
8500ml
intest.secret intest. abs
350ml
colon abs

100ml water
50g solids
 Actions of Digestive (GI) Tract
 Ingestion
 Occurs when material
enters via the mouth
 Mechanical Processing
 Crushing / Shearing –
makes material easier to
move through the tract
 Digestion
 Chemical breakdown of
food into small organic
compounds for
absorption
 Secretion
 Release of water acids,
buffers, enzymes & salts
by epithelium of GI tract
and glandular organs
 Absorption
 Movement of organic
substrates, electrolytes,
vitamins & water across
digestive epithelium
 Excretion
 Removal of waste
products from body
fluids
 Regulation of ingestion
 Hunger includes two sensations:
 From the stomach: hunger contractions/pangs
 Associated with low levels of nutrients in the blood
 Alimentary regulation: concerned with
immediate effects of feeding on the GIT
 Nutritional regulation: concerned with the
maintenance of normal stores of fat and
glycogen in the body
 Coordinated by: feeding & satiety centres
 Feeding centre: in the lateral hypothalamus
 Stimulation  hyperphagia

 Lesions  lack of appetite & progressive inanition (loss

of weight)
 Satiety centre: in the ventromedial nuclei of hypothalamus
 Stimulation  complete satiety (aphagia)

 Lesions  voracious eating & obesity

 Operates primarily by inhibiting the feeding centre

 Appetite: a desire for specific food

 Control of appetite via higher centres including:
 areas in the amygdala where sensations of smell have an

important role
 cortical areas of limbic system
 Cavum oris
Struktur :
•Labium
•Bucca
•Palatum
•Diaphragma oris
•Dentes
•Lingua
•Gld. salivarii

Fungsi :
•Mastikasi
•Gustasi
•Digesti
•Lubrikasi
•Deglutisi
•Artikulasi suara
 Mastikasi / Chewing
 Movements of the jaw (temporomandibular joint)
and the tongue
 Muscles involved:
 M.masseter (M)
 M.pterygoideus lateralis (PL)
 M.pterygoideus medialis (PM)
 M.temporalis (T)
 Mm.suprahyoid (SH)
 Mm.infrahyoid (IH)
 Movements: Muscles:

 Elevation M, T, PM
 Depression PL, SH, IH
 Protrution M, PL, PM
 Retrution M, T
 Side-gliding M, T(c.l), P(i.l)
 The tongue
 The body: free movable portion
 The base/root (radix): attached to the floor
of the oral cavity and forms part of the
anterior wall of the pharynx
 It is divided by sulcus terminalis: ant & post
 Muscles:
 Intrinsic: vertical, transversal, longitudinal (s & i)
 Extrinsic: originate outside, mainly on mandible and
hyoid, and pass into the tongue
 The tongue

 Lingual glands:
 The body: mainly serous
 The base: mainly mucous
 The tip: are mixed
 Papillae:
 Anterior & lateral: fungiform & foliate
 The base: circumvalate
 Taste buds: several thousands in tongue and
palate & epiglottis
 Nerves of the tongue

 General afferent: branch of n.mandibularis

(3rd. C.n. V)
 Special afferent, differentiate:
 Anterior :chorda tympani (c.n. VII)
 Posterior: glossopharyngeal (c.n. IX)
 Palate & epiglottis: vagus (c.n. X)
 Efferent to intrinsic muscles: hypoglossus
(c.n. XII)
 Salivary glands
 The parotid:
 contains only serous cells
 produce a watery secretion, high amylase
 Stenson’s duct: vestibulum oris M2
 The submandibular:
 mostly serous, some mucous & mixed
 produce a weak amylase, contain lysozyme
 Wharton’s duct: caruncula sublingualis
 The sublingual:
 mainly mucous, some serous
 produce a particularly thick mucous
 Ducts: each gland opens beneath the tongue
 DIGESTIVE SYSTEM
Location of salivary glands
 Control of secretion
 Autonomic nerves:
 Sympathetic:
 Cell body in the gln.cervicale superior
 Stimulate a more transient effect
 Release noradrenalin -> vasoconstriction -> dry
mouth when frightened
 Parasympathetic:
 Pregln.fibers in the branches of c.n. VII & IX
 Provide a stronger & long lasting stimulus
 Release: acetylcholine, subst.P, vasoactive
intestinal peptide (VIP)
 PHARYNX
 A muscular tube, 12 – 14 cm long
 Extends frm: cranial base – 6th cerv. vert. and
the lwer border of the cricoid cartilage
 Nasopharynx
 Behind the choana, above the isthmus pharyngis
 Opening of eustachian tube, tonsils
 Oropharynx
 Behind the isthmus faucium, above the epiglottis
 Triangular fossa with palatina tonsils
 Laryngopharynx
Larynx & Pharynx
 OESOPHAGUS
 A muscular tube about 25cm,
 It is constricted:
 At its commencement, 15cm from incisor teeth
 Where crossed by aortic arch (22.5cm from–id-)
 Where crossed by left bronchus (27.5cm –id-)
 As it transverse the diaphragm (40cm –id-)
 The top 1/3: surrounded by skeletal muscle
 The lower two-third: smooth muscle
 Both muscles are under the control of vagus
MUSCLES AT
COLLI REGIONS
 OESOPHAGUS
 The upper esophageal sphincter:
(hypopharyngeal sphinct/m.cricopharyngeus)
thickening of circular skeletal muscle
 The lower sphincter: the last 1-2 cm, not
anatomically distinguishable as a sphincter
but the pressure is greater than in the
stomach
 A functional external sphincter provided by
crural diaphragm, usually the right crus
VENTRICULUS / GASTER
 STOMACH
 Rugae: folds present on the inner surface of
the empty stomach, flatten out as fills
 An additional oblique muscle layer present
 The muscle layers are not evenly distributed
 It is highly developed in the pylorus where it
becomes a sphincter which regulates stomach
emptying
 The stomach is separated from the duodenal
bulb by the pyloric sphincter
 Stomach Function
 Major Functions of the Stomach
 Storage of ingested food
 Mechanical breakdown of ingested food
 Disruption of chemical bonds in food material by acid
and enzymes
 Production of intrinsic factor, a glycoprotein required
for absorption of vitamin B12 in small intestine
 Small Intestine
 90% of absorption occurs in the small intestine
 Small Intestine
 The Duodenum
 The segment of small intestine closest to stomach
 25 cm (10 in.) long
 “Mixing bowl” that receives chyme from stomach and
digestive secretions from pancreas and liver
 Functions of the duodenum
• To receive chyme from stomach
• To neutralize acids before they can damage the absorptive
surfaces of the small intestine
 Small Intestine
 The Jejunum
 Is the middle segment of small intestine
 2.5 meters (8.2 ft) long
 Is the location of most
• Chemical digestion
• Nutrient absorption
 Has few plicae circulares
 Small villi
 The Ileum
 The final segment of small intestine
 3.5 meters (11.48 ft) long
 Ends at the ileocecal valve, a sphincter that controls flow of
material from the ileum into the large intestine
 Small Intestine
 Intestinal Secretions
 Watery intestinal juice
 1.8 liters per day enter
intestinal lumen
 Moisten chyme
 Assist in buffering acids
 Keep digestive enzymes
and products of digestion
in solution
 Intestinal Movements
 Chyme arrives in
duodenum
 Weak peristaltic
contractions move it slowly
toward jejunum
• Myenteric reflexes
• Not under CNS control
• Parasympathetic stimulation
accelerates local peristalsis
and segmentation
 Pancreas
 Lies posterior to stomach
 From duodenum toward
spleen
 Is bound to posterior wall of
abdominal cavity
 Is wrapped in thin,
connective tissue capsule
Functions of the Pancreas
1. Endocrine cells of the
pancreatic islets:
• Secrete insulin and
glucagon into bloodstream
2. Exocrine cells:
• Acinar cells and epithelial
cells of duct system
secrete pancreatic juice
 Pancreas
 Pancreatic Enzymes
 Pancreatic alpha-amylase
• A carbohydrase
• Breaks down starches
• Similar to salivary amylase
 Pancreatic lipase
• Breaks down complex lipids
• Releases products (e.g., fatty
acids) that are easily
absorbed
 Pancreatic Enzymes
 Nucleases
• Break down nucleic acids
 Proteolytic enzymes
• Break certain proteins apart
• Proteases break large
protein complexes
• Peptidases break small
peptides into amino acids
• 70% of all pancreatic enzyme
production
• Secreted as inactive
proenzymes
• Activated after reaching small
intestine
PANCREAS AND LIEN
Liver
 Liver
 Hepatocytes
 Are liver cells
 Adjust circulating levels of nutrients
• Through selective absorption and secretion
 In a liver lobule form a series of irregular plates
arranged like wheel spokes
 Many Kupffer cells (stellate reticuloendothelial cells)
are located in sinusoidal lining
 As blood flows through sinusoids
• Hepatocytes absorb solutes from plasma
• And secrete materials such as plasma proteins
Liver
 Liver Function
The Physiology of the Liver
1. Metabolic regulation
2. Hematological regulation
3. Bile production
 Liver Function
 Metabolic Regulation
 The liver regulates:
1. Composition of circulating blood
2. Nutrient metabolism (carbohydrate, lipid & amino
acid)
3. Waste product removal
4. Vitamin Storage (A, D, E & K)
5. Nutrient storage (iron)
6. Drug inactivation
 Liver Function
 Composition of Circulating Blood
 All blood leaving absorptive surfaces of digestive tract
• Enters hepatic portal system
• Flows into the liver
 Liver cells extract nutrients or toxins from blood
• Before they reach systemic circulation through hepatic veins
 Liver removes and stores excess nutrients
• Corrects nutrient deficiencies by mobilizing stored reserves
or performing synthetic activities
V. PORTA
 Liver Function
 Hematological Regulation
 Largest blood reservoir in the body
 Receives 25% of cardiac output
 Functions of Hematological Regulation
1. Phagocytosis and antigen presentation
2. Synthesis of plasma proteins
3. Removal of circulating hormones
4. Removal of antibodies
5. Removal or storage of toxins
6. Synthesis and secretion of bile
 Gallbladder
 Is a pear-shaped, muscular sac
 Stores and concentrates bile prior to
excretion into small intestine
 Is located in the fossa on the posterior
surface of the liver’s right lobe
 The Cystic Duct
 Extends from gallbladder
 Union with common hepatic duct forms
common bile duct
INTESTINUM CRASSUM
 Large Intestine
 Is horseshoe shaped
 Extends from end of ileum to anus
 Lies inferior to stomach and liver
 Frames the small intestine
 Also called large bowel
 Is about 1.5 meters (4.9 ft) long and 7.5 cm
(3 in.) wide
 Parts of Large Intestine
 The Cecum
 Is an expanded pouch
 Receives material arriving
from the ileum
 Stores materials and begins
compaction
 Appendix
 Also called vermiform
appendix
 Is a slender, hollow appendage
about 9 cm (3.6 in.) long
 Is dominated by lymphoid
nodules (a lymphoid organ)
 Parts of Colon
 Ascending Colon
 Begins at superior border of cecum
 Ascends along right lateral and posterior wall of peritoneal
cavity to inferior surface of the liver and bends at right colic
flexure (hepatic flexure)
 Transverse Colon
 Crosses abdomen from right to left; turns at left colic flexure
(splenic flexure)
 Is supported by transverse mesocolon
 Is separated from anterior abdominal wall by greater
omentum
 Parts of Colon
 The Descending Colon
 Proceeds inferiorly along left side to the iliac fossa
(inner surface of left ilium)
 Is retroperitoneal, firmly attached to abdominal wall
 The Sigmoid Colon
 Is an S-shaped segment, about 15 cm (6 in.) long
 Starts at sigmoid flexure
 Lies posterior to urinary bladder
 Is suspended from sigmoid mesocolon
 Empties into rectum
 Parts of Large Intestine
 The Rectum
 Forms last 15 cm (6 in.) of
digestive tract
 Is an expandable organ for
temporary storage of feces
 Movement of fecal material into
rectum triggers urge to defecate
 The anal canal is the last portion of
the rectum
 Contains small longitudinal folds called
anal columns
 Anus
 Also called anal orifice
 Is exit of the anal canal
 Has keratinized epidermis like
skin
 Large Intestine Functions
 Reabsorption of water
 Compaction of
intestinal contents
into feces
 Absorption of
important vitamins
produced by bacteria
 Storage of fecal
material prior to
defecation
 Motility of The Digestive Tract
Skeletal muscle:
 mouth,
 pharynx,
 upper 1/3 of esophagus,
 external anal sphincter
Smooth muscle: in the remaining tracts, consist
of two layers:
 Outer longitudinal coat
 Inner circular coat
• RECTUM - ANUS
• internal and
• external anal sphincter
 Smooth muscle of GIT
 Two types:
 Phasic
 Tonic

Phasic:
 contract & relax in a matter of seconds,
 present in:
 main body of esophagus,
 gastric anthrum,
 small intestine
Tonic:
 contract in a slow & sustained (mnts – hrs),
 present in: lower esophageal sphincter, ileocecal
sphincter, internal anal sphincter

Action potentials are triggered in a few

‘pacemaker’ cells, which most numerous in the
longitudinal layer, then transmitted throughout
the muscle sheet
 DIGESTIVE SYSTEM
Caecum and Terminal Ileum
 Control of secretion & motility
 Mechanism: neural, hormonal & paracrin
Neural:
 Extrinsic: autonomic nervous system
 Intrinsic:
 Myenteric (Auerbach’s) plexus between
longitudinal & circular layers, control of GIT
motility
 Submucous (Meissner’s) plexus, control
secretion & blood flow
 DIGESTIVE SYSTEM
Sources of intestinal secretions
 SWALLOWING
The bolus of food is passed back
into the oropharynx by the tongue
1
 Respiration is reflexly inhibited
 Isthmus between nasopharynx and oropharynx is
closed
 The larynx is carried upward and forward by the
suprahyoid muscles
 Opening the laryngopharynx is closed
 The airway is firmly closed
(by the aryepiglottic, vestibular and vocal cords)
2
1
SWALLOWING
As the food passes into the oropharynx:
2
 Epiglottis is bent back (almost to horizontal position)
 Food is deflected by the epiglottis into the piriform fossae
 Carried down into the laryngopharynx and esophagus

(The very sensitive mucosa of the larynx ensures that any

material that does enter the airway stimulates coughing)
 VOMITING (emesis)
 The forceful ejection of gastric contents, and
sometimes duodenal contents
 Part of the protective role from ingested toxic
substances
 A reflex, usually preceded by nausea
 Start: deep inspiration glottis closure 
esophagus distention  soft palate elevation
 expiration against closed glottis with
simultaneous contraction of the abdominal
skeletal muscles
 VOMITING (emesis) controlled by:

 The center in the reticular formation (med.obl.)

 The chemoreceptor trigger zone (CTZ) in the area
postrema (in the floor of the 4 th ventricle near the
vagal nuclei)
 CTZ is affected by:
 Opoid analgesics morphine and apomorphine
 Glycosides such as digitalis
 High concentration of urea (uremia) associated with renal
failure