DIGESTIVE SYSTEM:

The digestive system is made up of the digestive tract—a series of hollow organs joined in a long,
twisting tube from the mouth to the anus—and other organs that help the body break down and
absorb food

Organs that make up the digestive tract are the mouth, esophagus, stomach, small intestine, large
intestine—also called the colon—rectum, and anus. Inside these hollow organs is a lining called the
mucosa. In the mouth, stomach, and small intestine, the mucosa contains tiny glands that produce
juices to help digest food. The digestive tract also contains a layer of smooth muscle that helps break
down food and move it along the tract.

Two “solid” digestive organs, the liver and the pancreas, produce digestive juices that reach the
intestine through small tubes called ducts. The gallbladder stores the liver’s digestive juices until they
are needed in the intestine. Parts of the nervous and circulatory systems also play major roles in the
digestive system.

The mouth:

The mouth, buccal cavity, or oral cavity is the first portion of the alimentary canal that receives food
and begins digestion by mechanically breaking up the solid food particles into smaller pieces and
mixing them with saliva.
The mouth, or oral cavity, is the first part of the digestive tract. It is adapted to receive food by
ingestion, break it into small particles by mastication, and mix it with saliva. The lips, cheeks, and palate
form the boundaries. The oral cavity contains the teeth and tongue and receives the secretions from
the salivary glands.

Pharynx

The pharynx is a fibromuscular passageway that connects the nasal and oral cavities to the larynx and
esophagus. It serves both the respiratory and digestive systems as a channel for air and food. The
upper region, the nasopharynx, is posterior to the nasal cavity. It contains the pharyngeal tonsils, or
adenoids, functions as a passageway for air, and has no function in the digestive system. The middle
region posterior to the oral cavity is the oropharynx. This is the first region food enters when it is
swallowed. The opening from the oral cavity into the oropharynx is called the fauces. Masses of
lymphoid tissue, the palatine tonsils, are near the fauces. The lower region, posterior to the larynx, is
the laryngopharynx, or hypopharynx. The laryngopharynx opens into both the esophagus and the
larynx.

Food is forced into the pharynx by the tongue. When food reaches the opening, sensory receptors
around the fauces respond and initiate an involuntary swallowing reflex. This reflex action has several
parts. The uvula is elevated to prevent food from entering the nasopharynx. The epiglottis drops
downward to prevent food from entering the larynx and trachea in order to direct the food into the
esophagus. Peristaltic movements propel the food from the pharynx into the esophagus.

Esophagus

The esophagus is a collapsible muscular tube that serves as a passageway between the pharynx and
stomach. As it descends, it is posterior to the trachea and anterior to the vertebral column. It passes
through an opening in the diaphragm, called the esophageal hiatus, and then empties into the
stomach. The mucosa has glands that secrete mucus to keep the lining moist and well lubricated to
ease the passage of food. 
The muscular layers of the esophagus are normally pinched together at both the upper and lower ends
by muscles called sphincters. When a person swallows, the sphincters relax automatically to allow food
or drink to pass from the mouth into the stomach. The muscles then close rapidly to prevent the
swallowed food or drink from leaking out of the stomach back into the esophagus or into the mouth.
These sphincters make it possible to swallow while lying down or even upside-down. When people
belch to release swallowed air or gas from carbonated beverages, the sphincters relax and small
amounts of food or drink may come back up briefly; this condition is called reflux. The esophagus
quickly squeezes the material back into the stomach. This amount of reflux and the reaction to it by the
esophagus are considered normal.

Stomach

The stomach, which receives food from the esophagus, is located in the upper left quadrant of the
abdomen. The stomach is divided into the fundic, cardiac, body, and pyloric regions. The lesser and
greater curvatures are on the right and left sides, respectively, of the stomach.

Small Intestine
The small intestine extends from the pyloric sphincter to the ileocecal valve, where it empties into the
large intestine. The small intestine finishes the process of digestion, absorbs the nutrients, and passes
the residue on to the large intestine. The liver, gallbladder, and pancreas are accessory organs of the
digestive system that are closely associated with the small intestine.

The small intestine is divided into the duodenum, jejunum, and ileum. The small intestine follows the
general structure of the digestive tract in that the wall has a mucosa with simple columnar epithelium,
submucosa, smooth muscle with inner circular and outer longitudinal layers, and serosa. Exocrine cells
in the mucosa of the small intestine secrete mucus, peptidase, sucrase, maltase, lactase, lipase, and
enterokinase. Endocrine cells secrete cholecystokinin and secretin.

The most important factor for regulating secretions in the small intestine is the presence of chyme.
This is largely a local reflex action in response to chemical and mechanical irritation from the chyme
and in response to distention of the intestinal wall. This is a direct reflex action, thus the greater the
amount of chyme, the greater the secretion.

Large Intestine

The large intestine is larger in diameter than the small intestine. It begins at the ileocecal junction,
where the ileum enters the large intestine, and ends at the anus. The large intestine consists of the
colon, rectum, and anal canal.

The wall of the large intestine has the same types of tissue that are found in other parts of the
digestive tract but there are some distinguishing characteristics. The mucosa has a large number of
goblet cells but does not have any villi. The longitudinal muscle layer, although present, is incomplete.
The longitudinal muscle is limited to three distinct bands, called teniae coli, that run the entire length
of the colon. Contraction of the teniae coli exerts pressure on the wall and creates a series of pouches,
called haustra, along the colon. Epiploic appendages, pieces of fat-filled connective tissue, are attached
to the outer surface of the colon.

Unlike the small intestine, the large intestine produces no digestive enzymes. Chemical digestion is
completed in the small intestine before the chyme reaches the large intestine. Functions of the large
intestine include the absorption of water and electrolytes and the elimination of feces.

Rectum and Anus

The rectum continues from the sigmoid colon to the anal canal and has a thick muscular layer. It
follows the curvature of the sacrum and is firmly attached to it by connective tissue. The rectum and
ends about 5 cm below the tip of the coccyx, at the beginning of the anal canal.

The last 2 to 3 cm of the digestive tract is the anal canal, which continues from the rectum and opens
to the outside at the anus. The mucosa of the rectum is folded to form longitudinal anal columns. The
smooth muscle layer is thick and forms the internal anal sphincter at the superior end of the anal canal.
This sphincter is under involuntary control. There is an external anal sphincter at the inferior end of the
anal canal. This sphincter is composed of skeletal muscle and is under voluntary control.

Accessory Organs

The salivary glands, liver, gallbladder, and pancreas are not part of the digestive tract, but they have a
role in digestive activities and are considered accessory organs.

Salivary Glands

Three pairs of major salivary glands (parotid, submandibular, and sublingual glands) and numerous
smaller ones secrete saliva into the oral cavity, where it is mixed with food during mastication. Saliva
contains water, mucus, and enzyme amylase.

Liver and Gallbladder

The liver is the heaviest gland of the body, weighing about 1.4 kg (about 3lb) in an average adult. Of all
the organs in the body, it is second only to the skin in size. The liver is inferior to the diaphragm and
occupies most of the right hypochondriac and part of the epigastric regions of the abdominopelvic
cavity.

The gallbladder, is a pear shaped sac that is located in a depression of the posterior surface of the liver.
It is 7-10 cm (3-4 inches) long and typically hangs from the anterior inferior margin of the liver.
Anatomy of Liver and gallbladder

The liver is almost completely covered by visceral peritoneum and is completely covered by a dense
irregular connective tissue layer that lies deep to the peritoneum. The liver is then divided into two
principal lobes. A large right lobe and a smaller left lobe – by the falciform ligament, a fold of the
peritoneum. Although the right lobe is considered by many anatomist to include an inferior quadrate
lobe and a posterior caudate lobe, based on internal morphology (primarily the distribution of blood
vessels), the quadrate lobe and caudate lobe more appropriately belongs to the left lobe. The falciform
ligament extends from the undersurface of the diaphragm between the two principal lobes of the liver,
helping to suspend the liver in the abdominal cavity. In the free border of the falciform ligament is the
ligamentum teres (round ligament), a remnant of the umbilical vein of the fetus. This fibrous cord
extends from the liver to the umbilicus. The right and left coronary ligaments are narrow extensions of
the parietal peritoneum that suspend the liver from the diaphragm.

The parts of the gallbladder include the broad fundus, which projects inferiorly beyond the inferior
border of the liver; the body, the central portion; and the neck, the tapered portion. The body and the
neck project superiorly.

Histology of the liver and gallbladder

The lobes of the liver are made up of many functional units called lobules. A lobule is a typically a six-
sided structure that consists of specialized epithelial cells, called hepatocytes, arranged in irregular,
branching, interconnected plates around a central vein. In addition, the liver lobule contains highly
permeable capillaries called sinusoids, through which blood passes. Also present in the sinusoids are
fixed phagocytes called stellate retiuloendothelial (kupffer cells), which destroys worn-out white blood
cells and red blood cells, bacteria, and other foreign matter in the venous blood draining from the
gastrointestinal tract.

Bile which is secreted by hepatocytes, enters bile canaliculi, narrow intercellular canals that empty into
small bile ductules. The ductules pass bile into bile ducts at the periphery of the lobules. The bile ducts
merge and eventually form the larger right and left hepatic ducts, which unite and exit the liver as the
common hepatic duct. The common hepatic duct joins the cystic duct from the gallbladder to form the
common bile duct.

The mucosa of the gallbladder of the gallbladder consists of simple columnar epithelium arranged in
the rugae resembling those of the stomach. The wall of the gallbladder lacks a submucosa. The middle,
muscular coat of the wall consists of the gallbladder in the cystic duct. The gallbladders outer coat is
the visceral peritoneum. The functions of the gallbladder are to store and concentrate the bile
produced by the liver until it is needed in the small intestine. In the concentration process, water and
ions are absorbed by the gallbladder mucosa.
Pancreas

The pancreas has both endocrine and exocrine functions. The endocrine portion consists of the
scattered islets of Langerhans, which secrete the hormones insulin and glucagon into the blood. The
exocrine portion is the major part of the gland. It consists of pancreatic acinar cells that secrete
digestive enzymes into tiny ducts interwoven between the cells. Pancreatic enzymes include anylase,
trypsin, peptidase, and lipase. Pancreatic secretions are controlled by the hormones secretin and
cholecystokinin.