Anatomy and physiology of the

Gastrointestinal Tract
DR CARPENTER
Main topics
Anatomy of the digestive system
Digestive function and processes
Phases of digestion
Motility
Structures of the GI tract

Oral cavity
Oesophagus
Stomach
Small intestine
Large intestine
Rectum & anus
Accessory organs: e.g., Liver Pancreas
GIT tissue: Main tissue layers
(inside to outside of tract)
Mucosa: Specialised epithelial cells line the inside of the tract
Lamina propria: Support, blood and lymph vessels, lymphatic tissue
Mucularis mucosa: Smooth muscle
Submucosa: Glands, blood vessels, adipose tissue, nerve fibres
(submucosal plexus)
Muscularis externa: Inner circular, myenteric plexus, outer
longitudinal smooth muscle
Serosa (Adventitia): Adipose tissue, connective tissue.
Main Functions and Processes
Ingestion & Deglutition (swallowing)
Digestion (mechanical and chemical)
Absorption (water and nutrients)
Excretion (waste and water)
Motility (types of movement)
Defence (against pathogens)
Protection (against tissue damage)
Ingestion and deglutition

Oral cavity
Oesophagus
Stomach
Small intestine
Large intestine
Rectum & anus
Oral cavity and Oesophagus: Functions
Motility
Digestion
Protection
Defence
Taste/sensation
Cleaning
Oral cavity
Cephalic phase: Anticipatory reflexes and senses start the process
(feed forward phase).
Controlled by medulla via ANS to saliva glands and gut >Secretions
and motility stimulated.
Voluntary mastication mixes saliva with smaller food particles for
easy passage as semi solid Bolus.
Three saliva glands: Water, ions, mucus, amylase, lysozyme, IGs.
Deglutition: The swallowing reflex
Tongue pushes bolus against soft palate and
back of mouth, triggering swallowing reflex.

Soft palate elevates, closing

off the nasopharynx.

Hard palate

Tongue

Bolus

Epiglottis

Glottis

Larynx moves up and forward.

Tonically contracted upper

esophageal sphincter
Breathing is inhibited as the bolus passes
the closed airway.

Epiglottis folds down to help

keep swallowed material out
of the airways.

Upper esophageal sphincter relaxes.

Food moves downward into the esophagus,
propelled by peristaltic waves and aided by gravity.
Oesophagus: Motility
•Muscular conducting tube; Pharynx to stomach
•Peristaltic waves move food bolus down
•Two sphincters Peristaltic contractions are responsible for forward movement.

Upper and lower oesophageal Direction of movement

Bolus

Contraction Receiving segment relaxes.

Seconds later

Bolus moves
forward
Gross Anatomy
Oral cavity
Oesophagus
Stomach
Small intestine
Large intestine
Rectum & anus
 Stomach

Esophagus
Diaphragm

FUNCTIONS: Fundus

Storage
Digestion Body

Defence Antrum
Protection
(Absorption)
Pylorus
Rugae: Surface folding
increases area
 Sectional View of the Stomach

In the stomach, surface area is

increased by invaginations called
gastric glands.

Opening to
gastric gland

Mucosa
Epithelium

Lymph vessel

Lamina propria

Muscularis mucosae Artery and vein

Submucosa

Oblique muscle

Muscularis Circular muscle

externa
Myenteric plexus
Longitudinal muscle
Serosa
The three phases of digestion
Cephalic phase
Gastric phase
Intestinal phase
Cephalic and gastric phase reflexes
Stomach: Summary
Functions?
Four regions?
Other structural features?
Gastric phase: Series of short reflexes stimulated by food in gastric
lumen
Gastric motility: Muscular churning and mixing of contents to form
Chyme
Gastric secretions: Gastric Acid (HCL), Pepsinogen, Lipase, mucus,
HCO3
Gross Anatomy
Oral cavity
Oesophagus
Stomach
Small intestine
Large intestine
Rectum & anus
Small intestine: Functions
Motility
Digestion
Absorption
Protection
Defence
Small intestine lumen: Macroscopic
structure
Structure of the Small Intestine

Mesentery

Mucosa
Submucosa

Circular muscle

Longitudinal
muscle
Serosa

Plica
Submucosal
glands Villi
 Small intestine: Microscopic structure
Sectional View of the Small Intestine
Intestinal surface area is enhanced
by fingerlike villi and invaginations
called crypts.
Villi

Crypt
Peyer’s patch

Mucosa
Lymph vessel
Muscularis mucosa
Submucosa Submucosal plexus

Circular muscle Myenteric plexus

Muscularis
externa
Longitudinal
muscle
Serosa

Submucosal
artery and vein
Small intestine: Mucosa structure Brush border
Microvilli

Enterocyte
Enterocytes transport nutrients and
ions.
Capillaries transport most
absorbed nutrients.

Goblet cells secrete mucus.

Crypt
lumen
Lacteals transport most fats
to the lymph.

Stem cells divide to replace

Lamina propria damaged cells.
Crypt cells secrete ions and water.
Endocrine cells secrete hormones.
Muscularis mucosae
The intestinal phase:
•~6 litres of food, fluid, secretions enter small intestine from stomach, 3 litres of
secretions added by intestinal cells, liver and pancreas
•Regulated by enteroendocrine cells and PNS in small intestine.
•Bicarbonate (from pancreas) neutralises acidic pH
•Movement of chyme slow: Controlled by peristaltic and segmental contractions
•Digestive Enzymes (from pancreas) and Bile (from liver) allow main chemical
digestion of nutrients
•Nutrient Absorption high in villi (large SA)
•Nutrients pass into epithelial cells> blood or lymph
•Hepatic portal vein carries nutrients to liver for processing
Anatomy of the Exocrine and Endocrine Pancreas
Hormonal Regulation in small intestine
GIT Motility
Pacemaker cells in smooth muscle
Regulated by myenteric plexus.
Peristaltic (fast propulsion waves)
Segmental contractions (mixing, churning, slow propulsion)
 GIT Motility

Migrating motor complex

Fasted state
Slow contractions: ~ every 90 min
From stomach to large intestine

‘Sweeps’ food remnants and bacteria out

of upper GI into large intestine
 Digestion of nutrients: Carbs
Digestive enzyme and fluid release under neural, hormonal and
paracrine control
Carbohydrate digestive enzymes
Salivary and Pancreatic amylase; digestion of starch>maltose
Disaccharidases digest; maltose, lactose, sucrose to
monosaccharides (e.g., glucose, galactose and fructose)
Digestion of nutrients: Proteins
Protein digestion
Endopeptidases (proteases); secreted as zymogens from SI
epithelial cells and pancreas. E.g., Pepsinogen, Trypsinogen,
chymotrypsinogen.
Pepsin, Trypsin & Chymotrypsin digest polypeptides to
peptides
Exopeptidases; Carboxypeptidases (main role),
aminopeptidases digest peptides to amino acids
 Digestion of nutrients: Fat
Fat digestion
Enzymes Salivary lipase, gastric lipase and pancreatic lipase
90% are triglycerides
Bile salts act as detergent to emulsify fats forming micelles and make
them soluble for digestion
Enzymes: Salivary lipase, gastric lipase and pancreatic lipase
Lipase and colipase act together to digest TGs into 2 FFA and 1 MG
packaged into Chylomicrons (lipoproteins) in intestinal cells.
Gross Anatomy

Oral cavity
Oesophagus
Stomach
Small intestine
Large intestine
Rectum & anus
Large intestine: Functions
Motility
Protection
Defence
Excretion
Defecation
Large intestine: Anatomy
Hepatic portal vein Aorta Tenia coli Lymphoid Intestinal glands are
nodule the site of fluid secretion.
Inferior vena cava
Transverse colon

Muscularis mucosae
Submucosa

Ascending
colon
Longitudinal layer
Descendin (tenia coli)
Muscularis
Food enters the g Circular muscle externa
large intestine through colon
the ileocecal valve. Ileum Haustra
Cecum
Appendix Sigmoid colon

Rectum Rectum The defecation reflex

begins with distension
of the rectal wall.

Internal anal sphincter

External anal sphincter
Anus
Reading guide for Core text book
Chapter 14
Pgs 489-500 (upto ‘accessory digestive organs’)
Pgs 503-513 (upto ‘nutrition and metabolism’)
Pg 531