Accessory Digestive Glands

The Pancreas

is positioned
retroperitoneally on the
posterior wall of the
abdominal cavity at the
level of the second and
third lumbar vertebrae.

has no distinct capsule,
but is covered by a thin
layer of loose connective
tissue.
 Pancreas

Lies behind stomach

Gland
− 99% of pancreas = exocrine organ

produces digestive enzymes and buffers

delivered to duodenum (small intestine) by the pancreatic duct
− 1% of pancreas = endocrine organ

produce glucagon and insulin

regulate blood glucose levels

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 The Pancreas

iThe exocrine part produces about 1.5 l of pancreatic
juice every day.

The endocrine part, consists of the cells of the islands of
Langerhans. These cells produce insulin, glucagon and a
number of other hormones.
Components of the exocrine pancreas

consists of tubuloacinar glands.

A single layer of pyramidal shaped cells forms the
secretory acini. The apical cytoplasm (towards the lumen
of the acini) is filled with secretory vesicles containing the
precursors of digestive enzymes.

The first portion of the duct system extends into the centre
of the acini, which is lined by small centroacinar cells.

These cells form the first part of intercalated ducts.
Intercalated ducts are lined by low columnar or cuboidal
epithelium. They empty into interlobular ducts, which are
lined by a columnar epithelium. Interlobular ducts in turn
empty into the main pancreatic duct (of Wirsung), which is
lined by a tall columnar epithelium.

The main pancreatic duct opens into the
summit of the major duodenal papilla, usually in
common with the bile duct.

A duct draining the lower parts of the head of
the pancreas, the accessory pancreatic duct (of
Santorini), is very variable. If present, it may
open into the minor duodenal papilla ~2 cm
above the major papilla in the duodenum.

Pancreatic juice is a clear alkaline fluid which contains
the precursors of enzymes of all classes necessary to
break down the main components of the diet:
− trypsin, chymotrypsin and carboxypeptidase
hydrolyse proteins into smaller peptides or amino
acids;
− ribonuclease and deoxyribonuclease split the
corresponding nucleic acids;
− pancreatic amylase hydrolyses starch and glycogen
to glucose and small saccharides;
− pancreatic lipase hydrolyses triglycerides into fatty
acids and monoglycerides;
− cholesterol esterase breaks down cholesterol esters
into cholesterol and a fatty acid.
 Components of the Endocrine
Pancreas

Islands of Langerhans,
usually containing several
hundred endocrine cells,
are scattered throughout
the exocrine tissue of the
pancreas. The
vascularization, composed
of many fenestrated
capillaries, is more
extensive than that of the
exocrine tissue.

the typical quantitative cellular composition of
the islands
− 75% beta-cells which secrete insulin. Insulin
stimulates the synthesis of glycogen, protein
and fatty acids. It also facilitates the uptake
of glucose into cells and activates
glucokinase in liver cells.
− 20% alpha-cells which secrete glucagon.
The effects of glucagon are generally
opposite to those of insulin.
− 5% delta-cells which secrete somatostatin, a
locally acting hormone which inhibits other
endocrine cells.

other endocrine cells of the
islands secrete
− pancreatic polypeptide,
which stimulates chief cell
in gastric glands and
inhibits bile and bicarbonate
secretion,
− vasoactive intestinal
peptide, which has effects
similar to glucagon, but also
stimulates the exocrine
function of the pancreas,
− secretin, which stimulates
the exocrine pancreas, and
− motilin, which increases
GIT motility.

three fundamental roles of
the liver: The Liver
− Vascular functions,
including formation of
lymph and the hepatic
phagocytic system.
− Metabolic
achievements in
control of synthesis
and utilization of
carbohydrates, lipids
and proteins.
− Secretory and
excretory functions,
particularly with
respect to the
 The Liver

is the largest gland of the body (about 2% of the body
weight in an adult).

receives both venous blood, through the portal vein
(~75% of the blood supply), and arterial blood, through
the hepatic artery (~25% of the blood supply).

is surrounded by a well defined but thin capsule of
connective tissue. The connective tissue extends into
the liver parenchyma and divides it into the basic
structural units of the liver, the "classical" liver lobules.

functions as an exocrine gland because it secretes
bile.
 Organization of the Liver

the lobule is filled by cords of hepatic parenchymal
cells, hepatocytes, which radiate from the central vein
and are separated by vascular sinusoids.

portal triads
− Portal triads are a key feature of the organization of
the liver
− Portal triads are embedded in interlobular
connective tissue.
− a branch of the portal vein, a branch of the hepatic
artery and a branch of the bile duct
The Liver Lobule

Hepatocytes are separated from the
bloodstream by a thin discontinuous simple
squamous epithelium, which lines the
sinusoids.

Between the hepatocytes and the epithelial
cells is a narrow perisinusoidal space (of
Disse).

Contents of the blood plasma can freely enter
the perisinusoidal space through the openings
in the epithelium lining the sinusoids.

Fixed macrophages, Kupffer cells, are attached
to the epithelium

central vein
− drains the liver lobule
which open into the
intercalated or
sublobular veins of
the liver. These in
turn coalesce to form
the hepatic veins.
− eventually empty into
the inferior vena
cava.

Adjoining liver cells form the walls of the bile
canaliculi , which form a three dimensional
network within the sheets of hepatocytes.

Bile canaliculi connect via very short canals to
terminal bile ducts (cholangioles) which empty
into the interlobular bile ducts found in the
portal triads.

Hepatocytes

make up about 80% of the cells in the liver.

are typically large polyhedral cells, with large round
centrally located nuclei. Hepatocytes are frequently
polyploid.

function in the storage of glucose in the form of glycogen
(SER), vitamin A (possibly in specialized adipocytes),
vitamin B12, folic acid and iron.

participate in the turnover and transport of lipids. The
synthesis of plasmalipoproteins takes place almost
exclusively in the liver (RER/SER).

synthesize some of the plasma proteins (albumin, α and β
globulins, prothrombin, fibrinogen; RER).

metabolize/detoxify fat soluble compounds (drugs,
insecticides; SER).

participate in the turnover of steroid hormones.

secrete bile (up to 1 liter per day).
 The Portal Triad

The portal vein, hepatic artery and bile duct enter the
liver through the porta hepatis.

If one of these vessels gives off a branch it is usually
accompanied by branches of the other two vessels.
Terminal branches of one of the vessels will
consequently be accompanied by terminal branches of
the other two vessels.

These groups of three tubes - a branch of the portal
vein, a branch of the hepatic artery and a branch of the
bile duct - are called portal triads.
Arhitecture of the Hepatic Tissue
The Liver Lobule
The Biliary System
 Biliary System

Bile contains both
− organic components (e.g. lecithin, cholesterol and
bilirubin - the latter is a breakdown product of
haemoglobin and accumulates in the blood in
jaundice)
− and inorganic components (bile salts). The bile salts
facilitate the digestion and absorption of fat in the
small intestine.

Terminal bile ducts merge to form
− interlobular, intrahepatic bile ducts, which
eventually coalesce to form first the
− left and right hepatic ducts and then the common
hepatic duct, which connects to the cystic duct and
the bile duct (ductus choledochus).
− The bile duct carries the bile to the duodenum. The
cystic duct leads to the gall bladder.

Terminal bile ducts are lined by a cuboidal
epithelium.

All other parts of the biliary system are lined by
a tall columnar epithelium.

In the gall bladder the epithelium is often folded
and "caved". The gall bladder functions in the
storage and concentration of bile. Microvilli on
the apical surface of the epithelial cells facilitate
the resorption of water from the bile.

The epithelium lining the biliary system does
not contain mucus-producing cells and a
muscularis mucosae is absent.

These features distinguishes the gall bladder
from other parts of the gastrointestinal tract.

Many of the components of bile are not
secretory products of the hepatocytes in a strict
sense.

They are reabsorbed in the gut and return to
the liver through the portal vein.

Here they are taken up by the hepatocytes and
excreted again - a phenomenon called
enterohepatic circulation