Chapter 22

Digestive
System:
Part A
 Overview
• Digestion: breakdown of foods and absorption
of ________________
• Digestive organs carry out _____________ and
chemical ________________
– ________________digestion breaks down large molecules to
smaller pieces
– __________________ digestion breaks down foods by chemical
substances
Figure 22-1 The digestive system.
 Alimentary Canal
• Muscular tube, eight meters long, through thoracic
and abdominopelvic cavities
• Two groups of organs
– Alimentary canal (_______________ or _______)
o Mouth to anus
o Digests food and absorbs substances
o Mouth, __________, esophagus, stomach,
small intestine, and ___________________
 Alimentary Canal
• Accessory digestive organs
– ______________
– ______________
– ______________
• Digestive glands
– Salivary glands
– Liver
– Pancreas
 Digestive System Functions
• Seven essential steps
– ____________________
– Propulsion
– Mechanical breakdown
– _____________________
– Secretion
– _____________________
– Excretion
 Movement of Digestive Materials
• Two motor functions
– ______________________
– ______________________
• Smooth muscles contract in rhythm for mixing
• Contraction waves mix food with digestive juices
• In small intestine, mixing movements are aided
by _______________________
• Peristalsis consists of propelling, wave-like movements of the tube
Figure 22-4 Peristalsis.
Figure 22-4 Peristalsis.
 Blood Supply
• Splanchnic circulation
– From abdominal aorta
• Serves digestive organs, hepatic portal circulation
• Venous blood, rich in nutrients, collected and transported to liver
 Mouth
• ___________ (buccal) cavity
– Chamber between palate and tongue,
surrounded by lips and cheeks
• ___________: between teeth, cheeks, and lips
– Cheeks form lateral walls
– Lips surround mouth opening
 Tongue
• Covered by mucous membrane, connected to floor of mouth by
membranous fold (____________________)
• Body of tongue made up of mostly skeletal muscle
• Mixes food particles into ___________, with saliva, during chewing
• _______________ muscles—within tongue, not attached to bones
• _______________ muscles—originate on skull bones or soft palate,
extend to tongue
 Tongue
• Rough _____________project from surface for friction
– Filiform: make tongue surface rougher
– ________________: reddish, scattered over tongue; contain taste
buds
– Vallate: V-shaped row in back of tongue; contain taste buds
– __________________: on lateral aspects of posterior tongue,
contain taste buds that function primarily in infants and tongue
Figure 22-5 Surface of the tongue.
 Palate
• _______________ palate: anterior roof of the oral cavity
– Palatine bones
• _______________ palate: posterior, formed mostly of skeletal muscle
– Uvula: cone-shaped projection downward from its free edge
 Salivary Glands
• Function of saliva
– Moistens food
– Dissolves food chemicals for taste
– Cleanses mouth
– Digests carbohydrates with enzymes
 Salivary Glands
• Produce saliva
• Major salivary glands are
– ___________________
– ___________________
– ___________________
 Salivary Glands
• Parotid gland
– Largest, anterior to ear, external to
masseter muscle
– Parotid duct opens into oral vestibule next to second upper molar
 Salivary Glands
• Submandibular gland
– Located lower jaw (_________________________)
– Duct opens at base of lingual frenulum
• Sublingual gland
– Inferior tongue
– Open via many ducts into floor of mouth
Figure 22-6 The major salivary glands.
 Salivary Glands

• Two types of secretory cells

– __________________ cells
o Watery, enzyme (amylase), ions, mucin
– _________________ cells
o Mucus
 Salivary Composition

• 99% water
– Electrolytes: potassium, sodium, chloride, bicarbonate, and
phosphate
– Salivary amylase and lingual lipase
– Lysozyme, IgA, defensins that protect against microorganisms
 Halitosis
• Bad breath, due to increased bacteria and decomposition of food
particles
• Tooth decay occurs from inhibited saliva secretion
• Odor comes mostly from back of tongue
– Hydrogen sulfide
– Cadaverine
– Methyl mercaptan
 Teeth
• Tear and grind food for digestion
• Primary and permanent dentitions formed by age 21
• Two sets form during life
– _______ primary (deciduous) teeth erupt
(6-24 months of age)
– _______ secondary (permanent) teeth push
primary teeth out of their sockets
o Beginning between ages 6 and 12 years of age
o Permanent teeth fully formed by age 21;
third ____________ may not erupt
 Teeth
• Incisors
– Chisel-shape for cutting
• Canines
– Cuspids or eyeteeth: cone-shaped, resemble
fangs
• Premolars
– Bicuspids: broad crowns, rounded cusps
– ____________ and _______________
• Molars
– Broad crowns, rounded cusps
– Crushing and grinding
Figure 22-7 The teeth. (A) the oral cavity.
 Tooth Disease
• Dental caries (cavities)
– Demineralization of enamel and dentin from bacterial action
– Dental plaque (film of sugar, bacteria, and debris) adheres
– Acid from bacteria dissolves calcium salts
– Untreated periodontal disease may be linked to heart disease and
stroke
– Risk factors: smoking, diabetes mellitus,
oral piercing
 Gum Disease
• Plaque calcifies to form calculus (_______________)
• Calculus disrupts seal between gingivae and teeth
• Anaerobic bacteria infect gums
• Infection is reversible if calculus is removed
 Pharynx
• Food passes from mouth into ____________ then _________________
– Allows passage of food, fluids, and air
– Is located posterior mouth
– Does not digest food
– Muscular walls aid swallowing
 Esophagus
• Hollow muscular tube from ____________________ to ____________
• Basically straight but collapsible tube
• Passes solid food and liquids to stomach
• Penetrates diaphragm at esophageal hiatus
• Joins stomach at cardial orifice
• Gastroesophageal (__________) sphincter
– Surrounds cardial orifice
 Esophagus
• Contains four basic layers
– Mucosa contains stratified squamous epithelium
– Submucosa, which secretes mucus
– Muscularis externa
– Adventitia instead of serosa
 Heartburn
• Burning substernal pain that radiates
– Occurs when stomach acid is regurgitated into esophagus
– Symptoms mimic myocardial infarction
– Linked to excessive eating or drinking, extreme obesity, pregnancy,
running
• First symptom of ______________ __________ _______ (GERD)
– May cause Barrett’s esophagus
– Linked to hiatal hernia
 Processes of Digestion
• Ingestion
• Mechanical breakdown
• Swallowing (_______________)—propulsion of
food
• Digestion (polysaccharides) by salivary amylases
– No absorption, except for a few drugs
(nitroglycerine)
 Mastication
• Opening and closing jaws and moving jaws side to
side
• Tongue mixes food with saliva
• Teeth cut and grind
 Deglutition
• Involves tongue, soft palate, pharynx, esophagus
• ________________ stage
– Voluntary contraction of tongue
– Mixed with saliva, becomes bolus
• _________________________ phase
– Involuntary—primarily vagus nerve
– Control center in the medulla and lower pons
 Stomach
• Pouch-like organ shaped like a “J”
• Hangs inferior to diaphragm, in upper left
abdominal cavity
• Holds about one liter of food or liquid
• Thick folds (____________) of mucosal and
submucosal layers
• Mixes food with _______ __________, begins
protein digestion, limited absorption, moves food
into small intestine
 Stomach
• Regions include
– ____________, near esophageal opening; this stomach portion
attaches to esophagus
– ____________ balloons superior to cardiac region; is a temporary
storage area
– Body, mid portion
– Pyloric
 Stomach
• Pyloric region
– Antrum (_________________) becomes pyloric canal, terminates at
pylorus
– Pylorus continuous with duodenum through pyloric __________
(sphincter controlling stomach emptying)
Figure 22-8 The stomach.
 Stomach
• ______________ curvature—convex lateral surface
• ______________ curvature—concave medial surface
• Two mesenteries (omenta) extend from curvatures
– Help tie stomach to body wall, other digestive organs
– Individually named
o Lesser omentum—links lesser curvature
to liver
o Greater omentum—covers small intestine
 Stomach: Microscopic Anatomy
• Four tunics
– Muscularis and mucosa have specialized functions
– Muscularis externa
o Three layers of smooth muscle
o Inner oblique layer allows to mix, move, and physically break
down food
 Stomach: Microscopic Anatomy
• Mucosa
– Simple columnar epithelium composed of mucous cells
o Secretes two-layer coat of cloudy alkaline mucus
o Top layer of mucus keeps second layer trapped beneath it—rich
in bicarbonate
– Many small gastric pits at ends of gastric __________
o Gastric glands produce gastric __________
 Gastric Glands
• Cell types
– Mucous neck cells (secrete thin, acidic mucus of unknown function)
– Parietal cells
– Chief cells
– Enteroendocrine cells
 Gastric Gland Secretions
• Glands in fundus and body produce most stomach juice
• Mucous neck cells are located in neck and more basal regions of
stomach glands
– Produce thinner, more soluble mucus
 Gastric Gland Secretions
• Parietal cell secretions
– Hydrochloric acid (HCl)
– pH 1.5 to 3.5, activates pepsin, breaks down plant cell walls, kills
many bacteria
– Intrinsic factor
o Glycoprotein is required for absorption of vitamin B12 in small
intestine
 Gastric Gland Secretions
• Chief cell secretions
– Pepsinogen, an inactive proenzyme
o Converted to pepsin by HCl and by pepsin itself
– Lipases
o Digest about 15% of lipids
 Gastric Gland Secretions
• Enteroendocrine cells
– Secrete chemical messengers into lamina propria
o Act as paracrines
– Serotonin and histamine
o Hormones
– Somatostatin (also acts as paracrine) and gastrin
Figure 22-9 Pathway leading to the release of the HCl by the stomach.
 Small Intestine
• Plays major role in digestion and absorption
– _______ of nutrient absorption occurs here
• Largest portion of digestive system
• 6 to 7 meters long; from pyloric sphincter to ileocecal valve
 Small Intestine
• Subdivisions
– Duodenum (____________________)
– ____________ (attached posteriorly by mesentery)
– ___________ (attached posteriorly by mesentery)
 Small Intestine
• Duodenum: 25 cm long, shortest part, “C”-shaped path
– Joins at hepatopancreatic ampulla
– Enters duodenum at major duodenal papilla
– Entry controlled by hepatopancreatic sphincter
 Jejunum and Ileum
• Jejunum
– Extends from duodenum to ileum
– About 2.5 m long
• Ileum
– Joins _______________ at _____________valve
– About 3.6 m long
– Peyer’s patches are similar to lymph nodes
o Protect ileum from pathogenic microorganisms
Figure 22-10 The three portions of the small intestine.
 Mesentery
• Double fold of peritoneal membrane
• Suspends jejunum, ileum from posterior
abdominal wall
Figure 22-11 The mesentery, formed by folds of peritoneal membrane, suspends portions
of the small intestines from the posterior abdominal wall.
 Small Intestine
• Parasympathetic (vagus) nerve and sympathetics
from thoracic splanchnic nerves serve small intestine
• Superior mesenteric artery brings blood supply
• Veins (carry __________ and ____________) drain
into superior mesenteric veins, then into hepatic
portal vein and liver
 Small Intestine
• Modifications: provides large surface area of
proximal part for nutrient absorption
– Circular folds
– Villi
– Microvilli
 Small Intestine
• Intestinal ________: projections of mucous
membrane from inner wall.
• Each villus has a layer of
o absorptive _____________
o connective tissue core with capillaries
o a lacteal (lymphatic capillary)
o nerve fibers
• Most numerous in duodenum, proximal jejunum
• Contact intestinal contents, increase surface area of
intestinal lining to aid in absorption
– Long, densely packed ___________found in
mucosal cells (__________ _____________)
Figure 22-12 The small intestine mucosa is folded into villi and crypts. The epithelium
covers the lamina propria, connective tissue containing abundant blood vessels and
lymphatic vessels.
 Small Intestine
• Circular folds
– Permanent folds (about 1 cm deep) that force
chyme into spiraling movement through lumen,
causing more nutrient absorption
• Villi
– Extensions (about 1 mm high) of mucosa with
capillary bed and lacteal for absorption
• Microvilli (brush border)
– Contain enzymes for carbohydrate and
protein digestion
 Major Digestive Enzymes
• _____________ – begins protein digestion
• Enterokinase – converts trypsinogen into trypsin
• Intestinal lipase – breaks down fats
• ______________ – breaks down peptides
• Sucrose, maltase, lactase – break down
disaccharides
 Small Intestine
• Nutrients carried away by capillaries and lacteals
• ___________ __________ between bases of adjacent villi—extend
down into mucous membrane
• For carbohydrate metabolism, glucose is broken down to
_________acid (pyruvate) via ______________
• Protein digestion via mucosa and pancreatic enzymes
• Fatty acids are resynthesized into fats encased
in proteins
– Form chylomicrons, transport dietary fats to muscle and adipose
cells
 Liver
• Hepatic lobules
– Functional units
– Composed of hepatocytes (liver cells)
– Central vein in longitudinal axis
Figure 22-14 The liver.
 Liver
• Portal triad at each corner of lobule
– Branch of hepatic artery supplies oxygen
– Branch of hepatic portal vein brings nutrient rich
blood
– Bile duct receives __________
• Hepatic sinusoides—plate-like groups of hepatic
cells separated by vascular channels
• _____________ (Kupffer cells in liver sinusoids
remove debris, bacteria, and old RBCs)
 Liver
• Liver functions
– Processes bloodborne nutrients
– Stores fat-soluble vitamins
– Performs detoxification
– Produces bile
 Gallbladder
• Pear-shaped muscular sac on inferior surface of liver
• Stores and concentrates bile
• Muscular contractions release bile via ________ ________, which joins
common ____________ duct
 Bile
• Yellow-green, alkaline solution containing
– _________________: pigment formed from heme
o Bacteria break down in intestine to urobilinogens and stercobilin,
causes brown color of ___________
– Cholesterol, triglycerides, phospholipids, and electrolytes
 Cirrhosis
• Irreversible, chronic disease
• Normal hepatocytes replaced with fibrous
scar tissue
• Liver becomes nodular, has abnormal circulation
• Causes
– Alcohol, viral hepatitis, congestive heart failure
• Outcomes
– _____________, ascites, jaundice, hemorrhage, edema, varicosities,
hepatic encephalopathy, portal hypertension
Figure 22-15 Gross anatomy of the human liver and gallbladder.
 Pancreas
• Location
– Posterior to _______________
– Head encircled by ________________; tail toward spleen
– Retroperitoneal
Figure 22-16 The pancreas.
 Pancreas
• Endocrine
– Pancreatic islets secrete ____________ and _______________
• Exocrine function
– Acini (clusters of secretory cells) secrete pancreatic juice
 Pancreas
• As acidic chyme enters duodenum
– _______________ released from mucous membrane into
bloodstream
– Stimulates pancreatic juice with high levels of released bicarbonate
ions, neutralizing chyme
– Triggers secretion of a watery buffer solution with pH of 7.5–8.8
 Pancreas

• Enzymes
– Amylase, lipases, nucleases secreted in active form, but require ions
or bile for optimal activity
– Proteases secreted in inactive form
 Pancreas
• Bile activates lipase to break down fats
• Proteases activate in duodenum
– Trypsinogen activated to trypsin by enterokinase
 Pancreatic Cancer
• Fourth leading cause of cancer-related death in U.S.
• Risk factors
– Family history, smoking, increased age, diabetes
• Symptoms
– Often mimic other conditions
– Pain, jaundice, weight loss, nausea, loss of
appetite, changes in bowl habits
• Once diagnosed, usually too late for surgery
 Digestion in the Small Intestine
• Chyme from stomach contains
– Partially digested carbohydrates and proteins
– Undigested fats
• __________ hours in small intestine
– Most water absorbed
– Almost all ______________ absorbed
• Small intestine, no role in ingestion or defecation
 Digestion in the Small Intestine
• Slow delivery of acidic, hypertonic chyme
• Delivery of bile, enzymes, and bicarbonate ions from liver and pancreas
• Mixing
 Segmentation
• Most common ______________ of small intestine
• Initiated by intrinsic pacemaker cells in circular smooth muscle
• Mixes and moves contents toward ileum
 Large Intestine
• Function
– Absorbs ___________ and electrolytes from chyme
– Forms and stores __________
– Absorbs ______________, made by bacteria
 Large Intestine

• Regions
– Cecum
– Appendix
– Colon
– Rectum
– Anal canal
Figure 22-17 The large intestine.
 Large Intestine
• Cecum
– Dilated, pouch-like structure hanging below
ileocecal opening
• Appendix
– Masses of lymphoid tissue
– Part of _______________ system
 Colon
• Consists of four parts
– ___________________: continues upward, right side, colic flexure
(right colic hepatic)
– __________________: longest part, left colic (splenic)
– __________________: left side
– __________________: final portion, becomes the rectum
 Rectum and Anus
• Rectum
– Next to sacrum, resembles its curvature
– Ends below tip of ___________
• Anal canal
– Last segment of large intestine
– Open to body exterior at anus
• Sphincters
– Internal anal sphincter (_____________ muscle)
– External anal sphincter (______________ muscle)
 Colorectal Cancer
• Third most common after age 60
• After age 50, colonoscopy recommended every 10 years
• Early diagnosis by endoscopy, colonography, and barium enema
 Large Intestine
• No ________, digestive secretions
• Abundant deep crypts, __________ cells
• Mucus helps pH (_______________)
 Large Intestine
• Unique features
– Teniae coli
o Three bands of longitudinal smooth muscle
– Haustra
o Pocket-like sacs caused by tone of teniae coli
– Epiploic appendages
o Small fat-filled pouches of visceral peritoneum
 Large Intestine
• Chyme contains undigested, unabsorbed materials,
electrolytes, mucus, bacteria, and water
• Substances remaining in proximal half of large
intestine form feces (stored in distal large intestine)
• Intestinal walls constrict vigorously, forcing contents
toward rectum
• Defecation reflex can be voluntarily initiated by
holding a deep breath and contracting abdominal
wall muscles
 Intestinal Flora
• Enter from small intestine or anus
• Synthesize B complex vitamins and vitamin K
• Ferment indigestible (cellulose) carbohydrates
 Diverticular Diseases
• Diverticulosis
– ___________ outpouchings of (usually) the
sigmoid colon
– Affects about half of people over age _______
 Diverticular Diseases
• Diverticulitis
– When a ________________ becomes inflamed
– Pain usually on left side of abdomen
– Changes in bowel habits, fever, nausea
– If diverticulum ruptures—______________
(inflammation of peritoneum) may develop
– Treatments: emergency surgery, intensive
antibiotics
 Digestion of Nutrients
• Digestion
– Breaks down large molecules before absorption
– __________________: carbohydrates, lipids, and
proteins
– ___________________: vitamins and minerals
 Calorie
• Amount of heat needed to raise temperature of a
gram of water by 1 degree Celsius
– Technically referred to as kilocalories
• Cellular oxidation causes these calorie releases
o 1 gram of carbohydrate: 4 calories
o 1 gram of protein: 4 calories
o 1 gram of fat: 9 calories
 Digestion of Carbohydrates
• Only monosaccharides can be _____________
• Monosaccharides absorbed as _____________
– Glucose, fructose, galactose
• Digestive enzymes
– Salivary amylase, pancreatic amylase, and brush
border enzymes
– Break down disaccharides sucrose, lactose,
maltose; polysaccharides glycogen and starch
 Digestion of Lipids
• Fat-like substances: cholesterol, phospholipids, and
lipoproteins
• Triglycerides: most common lipids (found in plant
and animal sources)
• Cholesterol: found in animal products
• Two types of lipids
– Saturated
– Unsaturated
• Enzymes: pancreatic lipases
 Digestion of Lipids
• Triglyceride molecules must undergo hydrolysis (breakdown in
presence of water) before releasing energy
• Some fatty acid portions react, form molecules of acetyl coenzyme A
via beta-oxidation
• Excess amounts of this coenzyme convert into ketone bodies (acetone,
others); can be reconverted in reverse
 Digestion of Proteins
• Source is dietary, digestive enzymes, mucosal cells
• Digested to amino acids
• Two types of amino acids
– Essential
– Nonessential
 Amino Acids

• Essential amino acids—cannot be synthesized by

the body alone, include
– Valine: peanuts – Methionine: meats
– Isoleucine: nuts – Phenylalanine: bananas
– Leucine: beans – Lysine: cheese
– Threonine: cottage cheese
– Tryptophan: meats
– Histidine: dairy products
 Vitamins

• Two types
– __________-soluble vitamins: A, D, E, and K
– ___________-soluble vitamins: B-vitamin group and vitamin C
 Minerals
• Divided into two groups
– ______________ minerals: calcium, chlorine, magnesium, sodium,
potassium, phosphorus, and sulfur
– ______________ minerals: iron, iodine, zinc, fluorine, copper,
cobalt, chromium, and selenium
 Effects of Aging on
the Digestive System
• Digestive epithelium more susceptible to damage;
likelihood of peptic ulcers increased
• Fecal movement slows due to weaker peristaltic
contractions; constipation more common
• Teeth gradually lost (cavities or gingivitis)