Carbohydrates: simple or complex. Fructose, galactose and glucose simple sugars can be digested through the cell wall.

. Hitch a ride with another ion which has a channel (such as sodium). corn syrup, table sugar, lactose complex sugars need to be broken down first before they can be absorbed. Enzymes throughout the digestive system break down complex carbs. Salivary amylase in the mouth, pancreatic amylase in the small intestine. Break complex carbs into oligosacharides which are then broken down into monosaccharide (simple sugars). Lipids salivary lipase start breakdown process, then most digestion occurs in the small intestine. Bile is made in the liver and stored in the gall bladder. It contains salts that emulsify fats. Bile salts act like dishwashing detergent breaking down fat into micelles. The pancreas releases pancreatic lipase which facilitate breakdown of the bonds within the fat molecules so that they may be utilized in the body. Protein & Nucleic Acids: proteins must be catabolized to its amino acid building blocks. Pepsin digests protein in the stomach. Peptidases in the small intestine. Pepsin works on the food in the highly acidic environment of the stomach. Breaks the bonds. In the small intestine enzymes (pancreatic proteases) tripson and chymotripson cut proteins into even smaller pieces, and then brush border enzymes finish the job. Nucleic Acids: DNA & RNA components are broken down into building blocks by pancreatic nucleiase enzymes. Brush border enzymes complete the job by breaking the nucleotides into three bases, pentose sugars and phosphate ions. Summary: carbs are easiest to breakdown. They are broken down by amylases in the small intestine. Lipids are more difficult to digest because they are insoluble in water. The process begins in the mouth with salivary lipase, once the lipids enter the small intestine they are emulsified by bile that is synthesized in the liver and stored in the gall bladder. After emulsification, pancreatic lipases complete the digestion of lipids into their base components which can now be used. Proteins are broken down in the stomach through the action of pepsin. The digestion process finishes in the small intestines where pancreatic peptidases and brush border enzymes break the peptide fragment into amino acids. Nucleic acids are broken down in the small intestine into nucleotides through

the action of pancreatic nuclease enzymes (brush borders complete the breakdown) into three bases, sugars and phosphates. Absorption: In order to understand the process of absorption, one must know the histology of the cells that line that digestive tract. The cells along the lumen are on the apical surface. The cells that are on the flip side rich in blood vessels are in the basal layer. It is through the basal layer that the food materials can enter circulation. Monosaccharides are absorbed through the intestinal lining. At the most basic level, these monosaccharides travel through specialized channels on the cell membrane on the apical side, hitching a ride with sodium. Once inside the intestinal epithelial cell, they travel to the basal surface where they are released through diffusion into the capillaries and general circulation. Lipids are emulsified and form micelles. Water soluble portion faces outside, while the lipid soluble portion faces the inside or center. This allows the micelles to readily interact with the cell's surface. (Cholesterol and lipid soluble vitamins are also located inside the micelle.) Most of this process takes place in the ileum the last portion of the small intestine. Any unabsorbed fat is shunted out as feces. Inside the epithelial cell, the absorbed fats combined with cholesterol and acquire a protein coating. This forms a water soluble lipo-protein called a chylomicron. Chylomicrons are further processed and then sent to the lymphatic system first, where they join general circulation near the superior vena cava just above the right atrium of the heart. Proteins broken down into amino acids are small enough to pass through the intestinal wall and out the other side of the epithelial cells unchanged. Once in circulation, the amino acids can diffuse through the cell membrane. Depending upon the body's needs the amino acids will be used to make a particular protein. Nucleic acids are actively transported through the intestinal wall by special carrier proteins and enter the blood vessels to be released into general circulation. The body must also absorb vitamins, electrolytes and water. Lipid soluble vitamins are bundled into micelles. Water soluble vitamins readily diffuse through the epithelial cell membranes or are carried by transport molecules. Most electrolytes are absorbed throughout the intestines. The two exceptions are iron and calcium, which are primarily absorbed in the duodenum, the beginning of the small intestine. Water: About 9 L of water enter the digestive system daily. Most is in the form of digestive secretions. Small intestine will reabsorb 95% of this water through osmosis, following concentration gradients. Summary of absorption: Carbohydrate monomers and amino acids from proteins diffuse through the epithelial cell membranes of the digestive lining and go into general circulation. Lipids are

converted to chylomicrons, which are picked up by the lymphatic system first and enter venous circulation near the superior vena cava. Nucleic acids are actively transported through the intestinal wall by special carrier proteins and enter the blood vessels to be released into general circulation. Water-soluble vitamins diffuse through the cell membrane, and lipid soluble vitamins are delivered via micelles. Electrolytes are small enough to diffuse through the intestinal epithelium. Water is reabsorbed through osmosis following concentration gradients. 2/24/11 (absent) Teeth continued: There are 20 deciduous teeth and 32 adult teeth. Incisors cutting and tearing Pre-molars, bicuspids cutting and tearing *wisdom teeth: taken out if jaw is too small Molars grinding The only chemical digestion in the mouth is saliva (amylase) which breaks starch into maltose. Swallowing (or deglutination) Process of digestion begins as a voluntary action. Buccal phase: Tongue hard palate Forcing the bolus oropharynx Pushing soft palate up, blocking nasopharynx Larynx rises so the glottis is covered by the epiglottis. Vocal cords pull together o Note: respiratory passage closed off so food (solids/liquids) cannot enter. Esophageal phase: Voluntary skeletal muscle at beginning of esophagus pushes the bolus into the esophagus Smooth muscle (involuntary) pushes the bolus toward the stomach (peristalsis) ~1 sec for bolus to enter the esophagus.

Pharyngeal phase:

What if something loges in the pharynx? It could prevent breathing. Need Heimlich hug to dislodge

Esophagus: A muscular tube of about 10 inches long. Pharynx: Leads into the mediastinum in front of the vertebral column. 2 bands of muscle one longitudinal and the other circular. Stratified epithelium for protection through the diaphragm stomach. Passage: Stratified squamous (non-keratinized) o Mucous lubricates o Smooth muscle propels bolus o Semisolids processed in 4-8 sec o Soft foods and liquids processed in about 1 sec. 1. Cardiac sphincter prevents regurgitation. Stomach: o Size of a large sausage when empty. But can distend considerably 2-3 L o Entrance: cardiac sphincter o Exit: pyloric sphincter Regions: o Cardiac around sphincter o Fundus above cardiac o Body main region o Pylorous around pylorus sphincter o Rugae folds of mucosa when empty (for stretching) 3 muscle groups of the stomach: 1. longitudinal 2. circular 3. oblique churn food

Chime after the bolus leaves the stomach, this is the term used. Mucosa: (of stomach) Contains gastric glands open to surface i.e. glands at the base of pits. We can tell the difference between areas of the stomach based on histological information: differences in pits and glands. Note: the pit opens in the gland. Regions of the gland have different cells which have different functions. o Mucous cells top, middle o Parietal cells middle, scattered o Chief cells bottom o Enzyme production Mucus cells: make mucous for protection. Parietal cells: make intrinsic factor (vitamin B12 absorption pernicious anemia), HCl production. Recall: CO2 transport in the blood. CO2 + H2O H2CO3 H+ + HCO3A chief cell will take CO2 from the blood and do the same H+ + HCO3-, put bicarbonate back in the blood, chloride shift, So Cl and H+ = HCl Puking: Gets rid of HCl, have to make more causing more bicarbonate to build up in the blood alkalosis suppresses the nervous system causes jitteriness.

Chief cells enzyme production Protein (pepsin) peptides Pepsin secreted in inactive form (zymogen) b pepsinogen. Pepsinogen (HCl) pepsin Q: Why arent the cells of the pit of the stomach inured or digested by the HCl or pepsin? 1. 2. 3. Mucous NH4 (ammonia neutralizes HCl) Zymogen (pepsinogen)

Infants have 2 other enzymes which are produced: o Gastric lipase o Renin (milk protein casein coagulates) o Less HCl stomach has pH of 4-5 o Compared with adult stomach pH of 1-2 Controls over gastric secretion: 1. Cephalic phase thought, sight smell Parasympathetic nervous system (vagus nerve) Increases contractions Increases gastric juice production 2. Gastric phase bolus enters stomach Stretch (distention) Neural reflex stimulates secretion and contraction and or Food chemicals (especially secretogogurs e.g. caffeine, cinnamon) cause G cells in the pylorus to secrete gastrin hormone which increases secretion of HCl and also increases motility and pepsinogen. 3. Intestinal Phase Chyme leaves stomach duodenum If pH in duodenum is > 3 Duodenum produces gastrin which causes the stomach to increase gastric juice production. Q: What will inhibit gastric secretion and emptying? 1. Loss of appetite, depression

2.

Excess acidity (pH of less than 2, decreased gastrin production)

3. Emotional upset ( sympathetic responses inhibit digestive tract secretions and motility) 4. Enterogastric reflex (-distention of duodenum, fatty/acidic/hypertonic/increased o.p. chime duodenum will inhibit contractions and secretion. 5. Hormones secretin, cholecystokinin (CCK), gastric inhibitory peptide (GIP), enterogastrone (produced by the duodenum in response to distention and fatty/acidic/hypertonic chime) Rate of stomach emptying: (depends on) 1. 2. 3. 4. Fluidity of the chime Type of food (fats could take up to 6 hours while carbs could take only 3 hours) Age infant vs. adult Enterogastric reflex

Chime leaving the stomach duodenum Stretch reflex to inhibit Emptying by decreasing motility 5. 6. Fatty chime duodenum Low pH in the duodenum slows emptying by decreasing stomach peristalsis. Hormones (gastrin inhibiting peptide, secretin, cholecystokinin)

Absorption in the stomach: Very little, some water, ions, alcohol, some drugs (aspirin) Enzyme in stomach mucous which breakdown. Alcohol If stomach empties slower less alcohol blood (small intestine longer surface area for absorption) women produce less of the enzyme and become drunk faster. Asian people also have less of the enzymes than other men and larger people. Liver removes alcohol and breaks it down. -liver susceptible to damage. This poison develops c.t to replace damaged cells (cirrhosis of the liver) Peptic Ulcer: Often sore in mucosa Begins in gastritis (inflammation of mucosa)

Most common cause: bacteria Weakening mucosa causes the pepsin acting to digest stomach Other contributing factors foods, alcohol, aspirin, and drugs Antibiotics recommended if it is caused by bacteria. Duodenal Ulcers: Chime duodenum Emotional distress causes the pH of the chime to go down and the gastric juice between meals in the duodenum is less acidic. Pepsin acts on the duodenum. How to treat: remove source of problem (surgery) or in some cases take care of emotional distresses. Small intestine: -major digestive organ which completes digestion. Most of the absorption but needs help from the liver and the pancreas. Pyloric sphincter ileocecal valve 6-7m (20 ft long) 1 inch in diameter. 3 divisions: Duodenum (shortest, most digestion here), jejunum (longest, most absorption here), ileum Goblet cells: mucous glands As intestine increases goblet cells to lubricate Surface area estimates 200 m2 -plicae circularis -villi cone w/ blood vessels and lacteals -microvilli (villi on the villi)

Mucosa: Columnar epithelium absorption Goblet cells mucous Endocrine cells gastrin, secretion, CCK, GIP Secretory ells intestinal juices. Active in mitosis (at base of each villous) -replace lining every 6 days Note: prescription for cancer targets, rapidly dividing cells intestinal tract affected (nausea, vomiting, diarrhea, wt loss) Peyers patches small intestine, filter the lymph Duodenal glands alkaline secretion acts on the chime Content of intestinal juices enzymes and mainly water (urea too) Liver: One of the most important organs in the body (largest internal) Has about 212 functions! But only limited digestive value (bile necessary for fat digestion) Weighs about 3 lbs -hepatic artery and hepatic portal vein -hepatic vein Histology: Lobules w/ helatocytes Radiating out from central vein Sinusoids toward central vein Blood from hepatic arteries and hepatic portal vein drain through sinusoids central

vein Lined with hepatocytes and kupffer cells (macrophages) Some functions of the liver: Carbohydrate metabolism glucose to glycogen (glucagon, glucocorticoids, growth hormones) Gluconeogenesis Aa glucose With byproduct of NH2

3/1/2011 9:30 am next Tuesday, review previous exams. T: know the hormones in the pancreas that regulate blood sugar Carbohydrate metabolism: Glucose glycogen A.A. Metabolism: excess A.A. Removed from blood and deaminated. AA keto acid glucose, fat NH2 urea Lipid metabolism: (In the liver) Triglycerides FFA + glycerol Removes excess lipids from circulation, e.g. HDL The liver is also involved in: Removing toxins and drugs Vitamin storage (Fat sol. Vitamins A, D, E, K) + Vitamin B12

Mineral storage Plasma protein synthesis (e.g. albumin, prothrombin, fibrinogen, angiotensinogen) Removing antibodies from circulation Removing circulating hormones. Bile synthesis w/ bile salts Hormone: somatomedin Bile 500-1000 mLs / 24 hours H2O Yellow/green pigment bili rubin Alkaline Bile salts (synthesized from cholesterol produces emulsification of fats) cholesterol phospholipids electrolytes toxins

Stimulus bile hormone: secretin (comes from duodenum produced by influence of fatty chyme)

Gallstones can accumulate if the cystic and common bile ducts are backed up. The gallbladder will produce bile that is more and more concentrated leading to gallstones. (This happens while the gallbladder is absorbing too much water, which is why it's so concentrated). Control of Bile Secretion: Hormonal: secretin H2O & bicarbonate ion Neural: -parasympathetic increase blood flow through the liver which produces more bile Bile Salts: Positive feedback Bile duodenum (fat emulsification) Digested fats and bile salts absorbed. Bile salts are then returned to the liver for

recycling.

Cholecystokinin (CCK) Stimulates the gall bladder contractions releasing stored bile Gall bladder can store 40-70 ml bile H2O, electrolytes absorbed conc. Bile 5-10x (may become too concentrated gall stones) (E.g. drastic dieting leads to not releasing enough bile stones)

Q: What is the involvement of the liver in digestion? A: bile salts Pancreas: Endocrine islets Exocrine acini cells pancreatic juice, full of rough endoplasmic reticulum (rough ER) Pancreatic juice 1200 to 1500 ml/day primarily water enzymes (stimulated by CCK) electrolytes bicarbonate (pH: 8) (stimulated by secretin) parasympathetic stimulation

Enzymes: 1. Trypsinogen (inactive) Chymotrypsinogen (inactive) Primocarboxypetidase all are Proteinases Amylase (starch maltose) Lipase Nuclease All of these enzymes are carried via the pancreatic ducts. proteolytic

Pancreatic enzymes continued: trypsinogen trypsin (this rxn is activated by enterokinase, an enzyme in the duodenal mucosa) protein polypeptides (trypsin activates this rxn, ph: 8) 2. 3. chymotrypsinogen chymotrypsin (converted by trypsin) procarboxypeptidase carboxypeptidase (via trypsin) protein polypeptides (via chymotrypsin) peptide chain breaking off the terminal amino acid from carboxyl end of the peptide. (via carboxypeptidase)

Lipase: acts on lipids free fatty acids, glycerol or monoglycerides can't absorb a lipid must be broken down into these 3 smaller components. Bicarbonate: co2 from the blood pancreas acini cell carbonic acid free hydrogen ions and sodium bicarbonate sodium bicarbonate pancreatic juice duodenum Small Intestine: role: digestion, absorption surface area: plicae circuloris, villi, microvilla (without these .5m^2) (with= 1.25 acres) villi- trap chyme in between. 2-4 hours

digestion and absorption take place through the simple columnar epithelium c.t. circulatory system hepatic portal vein liver simple sugars amino acids minerals water soluble vitamins water

Lymph: Lacteals at subclavian vein. Primarily fat and fat soluble vitamins.

Enzymes of the duodenum: notice that the enzyme is named for that which it acts on. maltase maltose glucose sucrase sucrose glucose + fructose lactase lactose glucose + galactose aminopeptidase acts on the amino end of peptides elastase acts on elastic fibers RNA'ase (nuclease) DNA'ase (nuclease) Enterokinase activates trypsin (from pancreas)

most absorption happens in the duodenum. Absorption happens in the jejunum mostly. Absorption: Absorption w/in the small intestine. >90% water amino acids FA/glycerol/monoglycerides simple sugars minerals & vitamins

Simple diffusion? Some. Facilitated diffusion? Amino acids Active transport? (what happens in the epithelial cell?) must make it yours rather than whatever organism it came from. HDL and LDL moves into the lymph. *look up in book Water absorption most occurs in the small intestine. ~7L of liquid secretions of various glands per day.

Review:

Mouth: ingestion mechanical digestion chemical digestion mechanical digestion chemical digestion (protein peptides via pepsin enzyme) liver bile salts in fat digestion acini cells make the enzymes bicarbonate trypsinogen duodenum CCK stomach: decrease motility, decrease gastric juice liver: increase bile production gall bladder contraction opening sphincter of oddi pancreas: pancreatic enzyme production Secretin stomach: decrease motility, decrease gastric juice production gallbladder: increase contractions (opening of the sphincter) pancreas: increase production of bicarbonate GIP (gastric inhibitory peptide) inhibits motility, gastric juice production

Stomach:

Small intestine:

Pancreas:

Hormones:

gastrin will be produced in the stomach if the ph is 3 or above. When gastrin acts on the stomach it increases motility and gastric juice production. Lactose intolerance: decrease in lactase (in some) during late childhood. Creates intolerance to milk. As a result lactose is not digested in the small intestine.

In the large intestine, bacteria utilize and variety of acids, increased intestinal motility leads to diarrhea. Lactose intolerance is most common in those of Asian or African decent (80%) Starch availability

many plants

ileocecal valve: separates the ileum from the cecum. So many worms here that if you cecum and you shall find them.

Mechanical digestion: o Mechanical digestion is the actual physical break down of food into smaller pieces. (chewing) which occurs in the mouth by the teeth, which act to cut and grind food into smaller pieces. This makes them easier to later digest as it increases the SA of the food molecules. A certain type of food is made of lots of different chemicals but certain chemicals are found in the center. The chewing breaks it apart and exposes these chemicals so that they can be broken down quicker/easier. Another form of mechanical digestion is peristalsis; succesive contractions of muscles in the alimentary canal which form a wave of constriction that moves food along. In the stomach, there are three layers of muscle (which is unique as the rest of the alimentary canal only has 2). It has longatudinal, circular and oblique muscle which togther contract and relax to form the churning motion which mixes food around. This aids in digestion as it slightly breaks up the food and also increases the contact the food has with enzymes and acids in the gastric juice. Bile salts (which are found in bile secreted from the liver) also act to emulsify large fat globules into smaller fat droplets. Its sort of like how detergent works and it breaks up all molecules and then puts a 'soapy' sheild around them so they cant join back together. This increases the SA of the molecule of fat so that enzymes (particulary pancreatic lipase) can act on it and break it down to smaller, simpler forms are body can absorb. Chemical digestion on the other hand, is the chemical break down of foods into smaller pieces. An example of this is how enzymes break them down. In particular, the enzyme salivary amylase is found in our saliva which acts to break down starch into simpler forms (polysaccharides --> dissaccharides). Another form of this digestion is how the HCl acid in the stomach helps to break down food and destroy any micro-organisms that accompanied the food.