M.digestive System PDF

The Digestive System Anatomy of the
Digestive System
We need food for cellular utilization:
organs of digestive system form essentially a long
!nutrients as building blocks for synthesis continuous tube open at both ends
!sugars, etc to break down for energy ! alimentary canal (gastrointestinal tract)
most food that we eat cannot be directly used by the mouth! pharynx! esophagus! stomach!
body small intestine! large intestine
!too large and complex to be absorbed attached to this tube are assorted accessory organs
and structures that aid in the digestive processes
!chemical composition must be modified to
be useable by cells salivary glands
teeth
digestive system functions to altered the chemical and liver
physical composition of food so that it can be gall bladder
absorbed and used by the body; ie pancreas
mesenteries
Functions of Digestive System:
The GI tract (digestive system) is located mainly in
1. physical and chemical digestion abdominopelvic cavity
2. absorption surrounded by serous membrane

= visceral peritoneum
3. collect & eliminate nonuseable
components of food this serous membrane is continuous with parietal
peritoneum and extends between digestive organs
as mesenteries
! hold organs in place, prevent tangling
Human Anatomy & Physiology: Digestive System; Ziser Lecture Notes, 2014.4 1 Human Anatomy & Physiology: Digestive System; Ziser Lecture Notes, 2014.4 2
is suspended from rear of soft palate

The wall of the alimentary canal consists of 4 layers: blocks nasal passages when swallowing
outer serosa: tongue

visceral peritoneum,
mainly fibrous and areolar CT
lines ventral border of mouth cavity
with some pockets of adipose CT is skeletal muscle covered with mucous membrane
muscularis contains taste buds

several layers of smooth muscle
frenulum is thin fold of mucous membrane on

submucosa
blood vessels, lymphatic vessels, nerves, ventral surface of tongue that anchors the
connective tissue tongue to the floor of the mouth
inner mucosa: short frenulum ! tongue tied

small band of muscle tissue, muscularis
mucosa Teeth
mucus membrane lining two sets
contains goblet cells that secrete mucous for
protection
deciduous (=baby teeth) (20)
these layers are modified within various organs begin at 6 months; shed 6-13 yrs
! some have muscle layers well developed permanent teeth (32)
! some with mucous lining modified for secretion each tooth has a
of digestive juices
! some with mucous lining modified for absorption crown (above gum)
neck is where crown, gum and root meet
1. Mouth (Buccal Cavity, Oral Cavity) root (below gum)
bordered above by hard and soft palate

forms partition between mouth and nasal passages
imbedded in socket
gingivitis = inflammation of gum surrounding teeth; can lead to
uvula
periodontal disease Salivary Glands
kinds of teeth modified for specific functions 3 Pairs of salivary glands:
incisors 4+4; cut, knip sublingual

canines 2+2; holding onto prey submandibular
premolars 4+4; cutting, crushing parotid
molars 6+6; chewing, grinding, crushing
largest, below ears
mumps = acute infection of parotid gland
each tooth is composed of several layers:
secrete saliva (enzymes and mucous for
enamel
digestion)
very hard
outer surface 2. Pharynx (throat)
on upper exposed crown only
resists bacterial attack
cannot regenerate if damaged already discussed
dentin 3. Esophagus
below enamel
less hard, similar to bone matrix collapsible tube ~ 10 long
decays quickly of enamel is penetrated
extends from pharynx to stomach
pulp
!gets food through thorax to abdominal cavity
living portion of tooth
consists of blood vessels, nerves posterior to trachea and heart
cementum pierces diaphragm

on root of tooth only
outer surface uses peristalsis to move food to stomach
holds root into socket in jaws
! can swallow upsidedown
drains into stomach through the cardiac orifice Muscle layers are very well developed in stomach
surrounded by the lower esophageal sphincter
circular
longitudinal
4. Stomach oblique
muscular sac just below diaphragm and liver Help to break up food by churning action
alimentary canal expands to form stomach results in milky white liquid = chyme
50 mL when empty; up to 1.5 L after meal sphincter muscles close both stomach openings:
Major functions of stomach:
cardioesphageal sphincter
(=lower esophageal sphincter)
1. physical digestion churning action
heartburn !doesnt close properly
2. chemical digestion esp proteins
pyloric sphincter
3. limited absorption (some water, alcohol, certain drugs)
cholic in babies ! doesnt open properly
given smooth muscle relaxers
divided into 4 regions:
cardiac mucosal lining of stomach is folded into rugae to
fundus allow for expansion with a meal
body
pyloris within the mucous lining of stomach are glandular
tubes called gastric pits
cardioesophageal sphincter
lesser curvature cardiac
fundus !within gastric pits are numerous microscopic
gastric glands:
pyloric
sphincter body ! secrete mucous for protection
greater curvature
! secretes various digestive enzymes
pyloris
! secretes HCl
central portion
mostly in umbilical region
5. Small Intestine especially rich blood supply
most digestion and absorption occurs here
absorbs most nutrients, water & salts
longest part of alimentary canal:
ileum
! 1 diameter x 10 long (living) or 20 long (cadaver)
~5
mainly in hypogastric region
Major functions of small intestine: joins to caecum of large intestine
absorbs and reclaims bile salts and some additional
1. most chemical digestion of food nutrients
(duodenum)
mucosal lining of the small intestine is folded into
plicae
2. secretes hormones which direct secretion of
digestive juices by stomach, gall bladder,
the intestinal mucosa also contains small finger-like
pancreas
projections = villi
3. most absorption of digested foodstuffs ~1mm tall
(jejunum & ileum)
each villus contains absorptive epithelial cells
small intestine fills most of abdominal cavity and goblet cells
held in place by mesenteries (=serous membranes) core of villus is filled with areolar tissue of
lamina propria
subdivided into 3 functional regions:
within this is an arteriole, capillary bed, venule
duodenum and
~10 long lymphatic capillary = lacteal
uppermost
drains pyloric stomach
receives ducts from gall bladder and pancreas
6. Large Intestine
jejunum 2.5 diameter x 6 long

~4
valve-like sphincter separates small from large

intestine = ileocecal valve on the outer surface of the large intestine are
3 longitudinal bands of muscle tissue
Major functions of large intestine: = taenia coli
1. absorb additional water as needed by body ! muscle tone within these bands
produces pouches = haustrae
2. absorb small amount of additional nutrients that allow distention
some Vit K and Bs made by bacteria in lg intestine rectum

3. collects, concentrates and rids body of
last 7-8
undigested wastes
ends at anus
subdivided into 3 regions:
held shut by two anal sphincters:
cecum
internal anal sphincter of smooth muscle
external anal sphincter of skeletal muscle
blind ended sac that extends from point of
attachment to small intestine Intestinal Flora
contains appendix ! ~3.5 (9cm) long our bacterial symbionts exist as a complex interacting
significant source of lymphocytes community with specific characteristics
colon were finding that each person has a unique set of

microorganisms on their skin and in their guts
subdivided into:
the abundance of certain bacteria in your feces correlates
with your age, gender, body mass index, and
ascending colon nationality
transverse colon
descending colon our gut bacteria provide many benefits:
sigmoid colon
!help break down hard to digest fibers and starches use of antibiotics can cause dramatic and long term
!make essential vitamins and additional nutrients
changes in our gut flora and increase risk of some
chronic diseases
!protect us from pathogens, toxins and some carcinogens
in the future:
!activate our immune systems to better resist infections
eg. might be able to test for changes in kinds and numbers of
gut bacteria change and adapt as your foods change species as an early indication of certain diseases
eg. doctors may prescribe bacterial supplements to improve

! those better able to metabolize dominant food tend to
physical health
increase
eg. fecal transplants: restores bowel flora to a healthy state
gut bacteria affect our mood and behavior:
correlations have been found between gut flora and some
7. Serous Membranes
psychiatric disorders such as depression, autism and
schizophrenia body wall and organs of abdomen are lined with
peritoneum
obesity, diabetes, Crohns disease, colitis, celiac
disease, irritable bowel syndrome all may be the !parietal peritoneum
result of an imbalanced microbial ecosystem in our !visceral peritoneum
guts
most, but not all, of the visceral organs are completely
some forms of severe malnutrition have been linked to lined with visceral peritoneum
a particulary group of intestinal bacteria
these layers are continuous with thin flaps of serous
promising research has found that fecal transplants tissues = mesenteries
have cured symptoms of Parkinsons, diabetes and
obesity mesenteries allow free movement while holding
organs in place and prevent them from tangling
eg. 100% cure rate for C. difficile infections, a deadly disease
common in patients on antibiotic therapy
greater omentum
fold of mesentery extending from stomach and

duodenum
blood leaving the liver enters the Hepatic Vein to the
loosely covers the small intestine like an apron Vena Cava
contains fat deposits bile leaves the liver through the Hepatic Bile Duct
lesser omentum B. Gall Bladder
smaller fold of mesentery between liver and lies on undersurface of liver

stomach 3-4 long and 1.5 wide
liver produces 0.6 1.2L of bile/day
Accessory Organs of Digestive Tract
bile travels up Cystic Duct to gall bladder for
A. Liver storage
is the largest gland in body can hold 30-50 ml of bile
gall bladder stores and concentrates bile

lies immediately under the diaphragm
When needed bile travels down Cystic Duct to
consist of 2 lobes separated by falciform
Common bile Duct to the duodenum
ligament
C. Pancreas
receives blood from the Hepatic Artery and the
Hepatic Portal Vein most digestion is carried out by pancreatic
enzymes
Hepatic Artery Hepatic Vein

in curve of duodenum and dorsal to greater
curvature of the stomach (retroperitoneal)
Liver
Hepatic Portal Hepatic Bile Duct 6-9 long
Vein
composed of 2 kinds of glandular tissue: Digestive Physiology
endocrine ! secretes hormones Muscular Movements (=motility) in GI Tract
islets = 2% of total mass of pancreas
as materials are being processed they are moved
their secretions pass into circulatory system through alimentary canal by by several muscular
secrete insulin and glucagon
processes:
exocrine ! digestive function
chewing
voluntary movements of skeletal muscles
pancreatic digestive secretions average ~2L/day
swallowing
! mainly on demand, in short timespans coordinated activity of skeletal and smooth muscles
reflex controlled by medulla
pancreatic secretions are collected in pancreatic duct pharynx to esophagus
and usually a smaller accessory pancreatic duct
that both drain into the duodenum peristalsis
propulsive movements
sequential smooth muscle contractions in adjacent
segments
!pushes food forward
esophagus, stomach, small intestine, large intestine
segmentation
mixing movements
alternating contractions and relaxations of adjoining
portions of intestine
food is moved backward and foreward
!helps to physically break up and mix contents
for better digestion & absorption
mass movements
occur 1-3 times/day when all circular muscle constricts in a
long stretch of intestine to push food toward anus
! main propulsive force in large intestine
sphincters 2. Pharynx
tonic contractions of smooth and skeletal muscles that
control the emptying and filling of various portions of
the GI tract
bolus is swallowed
uvula closes off nares
Digestion epiglottis closes off glottis of larynx
digestion = all food changes that occur in the 3. Esophagus

alimentary canal
wave of reflex contractions = peristalsis
need to convert food into a form that can be absorbed
and used by body cells 4. Stomach
two types of digestion: muscular contractions separate and mix food

particles and move them toward the pylorus
physical digestion
breaking large pieces down into smaller pieces in stomach bolus is mixed with gastric juices
gastric juices low pH ~2
chemical digestion
breaking large molecules
(proteins, fats, starches, etc) ! ideal for breaking proteins into
into small molecules smaller fragments
(amino acids, fatty acids, sugars, etc)
gastric ulcers: Helicobacter pylori
part of normal flora of stomach
1. Mouth can neutralize stomach acids
excessive growth can irritate stomach lining to produce
food entering mouth is physically broken down ulcers
teeth
mixed with saliva physical digestion is completed in stomach
lubricant
enzyme = amylase once digestion in stomach is competed have a
! begins carbohydrate digestion white milky liquid = chyme
at end of digestion in mouth, food = bolus stomach takes about 2-6 hours to empty after a meal
gastric emptying is controlled by enterogastric reflex: hard masses of cholesterol, calcium carbonate &
periodic opening/ closing of pyloric valve bilirubin
prevents overburdening smaller duodenum
may block cystic duct
5. Duodenum
jaundice = bile ducts obstructed
!body cant get rid of bile
all physical digestion has been completed !bile is absorbed into blood
!causes yellowing of skin
!most chemical digestion occurs here
droplets to speed their digestion
receives digestive juices from pancreas and gall
bladder 95% of bile secreted by gall bladder is
reabsorbed after it is used in digestion
also produces its own set of enzymes
! recycled back to liver
a. Bile
fiber inhibits reabsorption or bile
bile contains no enzymes ! fiber rich diets help to lower cholesterol
does contain bile salts, cholesterol and b. Pancreatic Juices

other lipids
pancreas is an endocrine gland (insulin,
most lipids are very insoluble in water glucagon)
! must be made somewhat soluble before but 98% of its tissues make and secrete
they can be digested and absorbed digestive juices through ducts to the
duodenum
bile is a surfactant
c. Duodenal Secretions
! emulsifies fats into smaller fat
gall stones
secrete additional enzymes that help to Absorption

complete the breakdown of organic
molecules ~9-10 liters (2.5 gallons) of food, liquids and
GI secretions enter tract/day
peristaltic movements keep the food moving along
the small intestine as it is digested and ~1000 ml reaches the large intestine
nutrients are absorbed
150 ml is expelled as feces
6. Large Intestine
~half of that is bacteria from intestines
contains a mixture of remnants of several meals
eaten over a day or two ! 75 ml wastes/d
food is mixed and compacted by segmentation absorption occurs throughout digestive tract
peristaltic contractions propel food toward anus ~90% occurs in small intestine
mass movements occur 1-3 times/day when all ~10% in large intestine and stomach
circular muscle constricts in a long stretch of
intestine to push food toward anus Stomach
! main propulsive force in large intestine some water
alcohol
some digestion occurs here due to bacteria a few drugs (eg. aspirin)
!esp in caecum
Small Intestine
absorb ~90% of materials
as feces enters rectum, stretch receptors trigger absorbs virtually all foodstuffs
the awareness of need for defecation absorbs 80% of electrolytes
absorbs most water
defecation proceeds by coordinated activity of
Jejunum
smooth and skeletal muscles in the all food stuffs
defecation reflex most water
most electrolytes
Large Intestine
Ileum
reclaims some additional bile salts
additional water if body needs it
Small intestine is greatly modified for
absorption some Vit K and Bs made by bacteria there
1. epithelial cells are joined by tight Mechanisms of Absorption

junctions
absorption can be an active or passive process:
better control of what is absorbed
substances cant move between cells 1. most nutrients are absorbed by active transport
materials must pass through cells to get to
interstitial spaces eg. glucose
(=transepithelial transport) amino acids
some minerals
2. surface area is greatly increased for
more efficient absorption of nutrients: 2. water is absorbed by osmosis
1 diameter x 10 long
! if smooth tube = 0.33 m2 (3 sq ft) 3. large molecules are absorbed by pinocytosis
but: interior is folded eg. a few large fats and proteins; fats passed to lacteals
! increases area ~3 xs with other fats
also: fingerlike projections = villi 4. some lipids are absorbed by diffusion to lacteals
~1mm tall
contain capillary beds
contain lacteals
Feces = residue of digestion
! increases area another 10xs
cellulose
connective tissues, fibers, toxins from meats
also: each epithelial cell of villus has microvilli undigested fats and mucous
up to 1700/cell =brush border bacteria (~50%)
! increases area another 20xs feces may also contain recognizable remnants of poorly
digested foods: corn, peanuts, peas, carrots, cereals,
Total Area = 200m2 (1800 sq ft) beans
Liver Processing
Liver Lobule
the liver is main organ for metabolic regulation in
the body lobule is functional unit of liver
! over 200 specific functions !each liver lobe is divided into 1000s of
lobules
1. stores iron, vitamin A, B12 & D
tiny hexagonal cylinders (~2mm x 1mm)
2. helps stabilize blood glucose levels by storing
~ 1 million lobules in human liver
excess glucose or synthesizing glucose if
needed small branches of hepatic vein extend through middle of
each lobule as central vein
3. carries out most of bodys fat synthesis
sinusoid spaces lined with hepatic cells extend outward
including cholesterol and phospholipids from central vein
4. synthesizes plasma proteins & degrades around periphery of each lobule are branches of
hepatic portal vein
excess amino acids hepatic artery
hepatic bile ducts
5. phagocytes remove old/damaged blood cells
and pathogens ! arterial blood brings oxygen to liver cells
6. detoxify blood from digestive system ! venous blood from hepatic portal vein delivers
removes drugs, alcohol, antibiotics, etc blood through lobule for inspection:
7. is largest blood reservoir in body a. phagocytic cells remove toxic compounds

and convert them to nontoxic compounds
receives 25% of cardiac output
b. some vitamins and nutrients are removed and stored
8. collects and removes metabolic wastes such as
c. synthesis of starches, lipids and proteins for storage
cholesterol, products of RBC destruction, etc
! cholesterol, bile pigments and bile salts are
9. secrete bile to aid in digestion (~1pt /day) secreted
into bile ducts for later use in digestion of fats The Aging Digestive System
hepatic bile ducts join cystic duct ! store bile in shows significant senescence in old age:
gall bladder less saliva
sinusoids
! food less flavorful, harder swallowing
Hepatic Artery Hepatic Vein
oxygen
~half of those over 65 yrs wear dentures
removes toxins
Hepatic Portal Hepatic Bile Ducts
Vein stores vitamins gastric mucosa secretes less acid
stores nutrients
Hepatic Duct ! reduces absorption of Calcium iron, zinc and folic acid
gastric mucosa secretes less intrinsic factor

Cystic Duct ! reduces absorption of vitamin B12
! leads to pernicious anemia
Common Bile Duct
Heartburn becomes more common
most common digestive complaint of older people is

constipation
!due to:
less muscle tone
weaker colon peristalsis
reduced sensitivity to neurotransmitters
less fiber & water in diet
less exercise
activity of liver, gall bladder and pancreas are reduced

only slightly in old age
Digestive Problems Colonic Irrigation

alternative medical practice
1. Choking potentially harmful
food in air passages unneccessary
usually meats, hot dogs, grapes, carrots, hard can rupture the intestine
candy, popcorn, peanut butter
may not be able to make a sound frequent use of laxatives and enemas:
DONT hit on back can lead to dependency
upset bodys fluid balance
2. Vomiting mineral oil
symptom of many diseases
can interfere with absorption of fat soluble vitamins
waves of reverse peristalsis
if severe may empty duodenum as well
rest and drink small amounts of fluids 6. Belching
guard against massive fluid loss results from swallowed air
carbonated drinks and chewing gums can
contribute
3. Bulemia occasionally can be a sign of a more serious
self induced vomiting
disorder: gall bladder pain, colonic distress
may cause damage and infection of esophagus,
eat slowly, chew thoroughly
pharynx, or salivary glands
relax while eating
erosion of teeth, more dental caries
esophagus may rupture or tear
7. Hiccups
repeated spasms of diaphragm
4. Diarrhea may be triggered by eating or drinking too fast
frequent loose watery stool
intestinal contents moving too fast for fluid
absorption to occur 8. Gas
main danger is fluid loss large intestine generates 7-10 L of gas/day and
also upsets acid/base balance normally we expel ~500ml of gas/day
the rest is reabsorbed
most is odorless
5. Constipation 1% are volatile gasses
caused by:
high carb foods known to produce excess gas
lifestyle ! inadequate water input
lack of physical activity
side effect of medication 9. Heartburn (& gastroesophageal reflux
disease)
controlled by increase in fiber, prunes, laxatives cardiac sphincter doesnt close properly
! attracts water ! softens stool affects 50% of US, esp white males
eat or drink too much
clothing too tight 12. Pica
cure: eat small meals the compulsion to swallow nonfood items
drink liquids 1 hr before or 1 hr after meal
dont lie down or bend over pica behavior is normal for infants
lose weight if overweight !they explore their world through their mouths
dont smoke
use antacids but sparingly in adults it could become dangerous or even life threatening
10. Peptic Ulcers eg. pregnant women - rich smell of soil drove them to eat it
a lesion of stomach or duodenum caused by acids or pepsin
! duodenal ulcers are the most common eg. another pregnant woman was eating almost half a kg of
perforated ulcer extend through entire wall of GI tract baking soda each day
caused by:
bacterial infection, Helicobacter pylori, is important cause of eg. compulsive consumption of ice is often associated with iron
most ulcers deficiency
!in all patients with duodenal ulcers
!in 80% of patients with gastric ulcers eg. 9 year old girl routinely ate cloth an string was helped by
probably disrupt mucosal barrier taking vitamin supplements
use of some antiinflammatory drugs
disorders that cause excessive gastric secretions eg. soil eating is common in many traditional societies
reduced mucosal defense ! may be instinctive way to get trace minerals like Fe or Zn
diet therapy used to be main cure, now antibiotics
also advised to stop smoking and avoid alcohol and caffeine pica is also common among people with cognitive or psychiatric
disorders such as autism and schizophrenia
11. Celiac Disease eg. a compulsion to eat cigarette lighters or $650 worth of
chronic disorder in which the mucosa of small intestine is
coins
damaged by ingestio fo certain cereal grains, eg. wheat,
barley, rye, & oats
disease 1st reported in second century by Aretaeus of Gall Stones
Cappadochia
these grains have large amounts of a protein, =gluten,
calculi can form in kidney, urinary bladder and
causes loss of villi & brush border, and increased numbers of
WBCs gall bladder
leads to inadequate intestinal absorption
symptoms: diarrhea, weight loss, abdominal distension and seed becomes surrounded by layers of crystalline
bloating and weakness
due to genetic and environmental factors deposits
patients with such sensitivity must adhere to gluten-free diet
substitute: corn, millet, buckwheat, sorghum & rice if large enough can block cystic duct or common
bile duct and cause jaundice
Human Anatomy & Physiology: Digestive System; Ziser Lecture Notes, 2014.4 35

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The Digestive System Anatomy of the

2. absorption surrounded by serous membrane

is suspended from rear of soft palate

outer serosa: tongue

muscularis contains taste buds

frenulum is thin fold of mucous membrane on

inner mucosa: short frenulum ! tongue tied

! some have muscle layers well developed permanent teeth (32)

bordered above by hard and soft palate

kinds of teeth modified for specific functions 3 Pairs of salivary glands:

incisors 4+4; cut, knip sublingual

cementum pierces diaphragm

jejunum 2.5 diameter x 6 long

valve-like sphincter separates small from large

some Vit K and Bs made by bacteria in lg intestine rectum

colon were finding that each person has a unique set of

eg. doctors may prescribe bacterial supplements to improve

fold of mesentery extending from stomach and

lesser omentum B. Gall Bladder

smaller fold of mesentery between liver and lies on undersurface of liver

is the largest gland in body can hold 30-50 ml of bile

gall bladder stores and concentrates bile

Hepatic Artery Hepatic Vein

digestion = all food changes that occur in the 3. Esophagus

two types of digestion: muscular contractions separate and mix food

bile contains no enzymes ! fiber rich diets help to lower cholesterol

does contain bile salts, cholesterol and b. Pancreatic Juices

secrete additional enzymes that help to Absorption

1. epithelial cells are joined by tight Mechanisms of Absorption

7. is largest blood reservoir in body a. phagocytic cells remove toxic compounds

gastric mucosa secretes less intrinsic factor

most common digestive complaint of older people is

activity of liver, gall bladder and pancreas are reduced

Digestive Problems Colonic Irrigation

bile duct and cause jaundice

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