FUNGSI MEKANIK

SISTEM PENCERNAAN

Rahmatina B. Herman
Bagian Fisiologi
Fakultas Kedokteran Universitas Andalas

Introduction
The primary function of the digestive system is to
transfer nutrients, water and electrolytes from the
ingested food into the bodys internal environment
The ingested food is essential as:

- an energy source from which the cells can

generate ATP to carry out their particular
energy-dependent activities
- a source of building supplies for the renewal
and addition of body tissues

Introduction..
The digestive system performs:
Four basic digestive processes:
1. Motility along gastrointestinal tract
2. Secretion of digestive juices
3. Digestion of food
4. Absorption the small absorbable units
Excretion of the waste materials
Regulation of digestive function through neural
reflexes and hormonal pathways
Protection against any damages

General Principle of Gastrointestinal Motility

Characteristics of gastrointestinal wall:
Layers of the wall (inward):
- Serosa: continues onto mesentery
- Muscularis: smooth muscles
> longitudinal layer: outer
> circular layer: inner
- Submucous: smooth muscles
> muscularis mucosae, usually longitudinal
- Mucosa
Each layer functions as syncytium

General Principle of Gastrointestinal Motility..

Organization of the intestine wall into functional layers

Basic Electrical Activity

Slow Waves:
- undulating changes in the resting membrane
potential (-50 - 60 mVolts)
- intensity: 5 15 mVolts
- frequency: 3-12/min (3 in the body of the stomach,
12 in the duodenum, 8-9 in the terminal ileum)
- might be caused by a slow undulation of the
sodium-potassium pumping activities
- rarely cause muscle contraction
- Basic Electrical Rhythm (BER) control the
appearance of intermittent peristaltic

Basic Electrical Activity..

Spike Potential:
- is true action potential
- generated at the peaks of the slow waves, when
the peaks rise above - 40 mVolts
- the depolarizing portion of each spike potential is
due to Ca++ influx through Ca-Na channel and
repolarizing portion is due to K+ efflux
- stimulation by stretch, acetylcholine,
parasympathetics, and specific GI hormones
- rate: 1-10/minute
- duration: 10-20 msecond

Basic Electrical Activity..

Contraction of GI Smooth Muscles

Rhythmic:
- during the spike potentials generated at the
peaks of the slow waves, the large quantities of
Ca++ enter the fibers through Ca-Na channel
- Ca++ acting through a calmodulin control
mechanism, activate the myosin filaments
attractive forces between the myosin and the
actin filaments muscle contraction

Contraction of GI Smooth Muscles..

Tonic:
- is continuous contraction, often lasting several
minutes or even several hours
- not associated with the BER
- often decreases or increases in intensity, but continues
- might be caused by:
> repetitive spike potential
> hormones or other factors that bring about
continuous depolarization of the smooth muscle
membrane, without causing action potentials
> continuous Ca++ influx, bought about in ways not
associated with changes in the membrane potential

Basic electrical rhythm (BER) relation to muscle contraction

Gastrointestinal Motility
Propulsive movement
- The basic propulsive movement is peristalsis
- Reflex response through myenteric plexus that is
initiated by distention peristaltic reflex or
myenteric reflex
- Constriction at the upper of the stretch and
relaxation (receptive relaxation) at the lower of the
stretch
- The wave contraction moves in an oral-to-anal
direction
- The peristaltic reflex plus the anal-ward direction of
the peristalsis movement is called the law of gut

Peristalsis

Gastrointestinal Motility..
Mixing:
- The reflex initiated by stretching of the gut wall
- Quite different in in different parts of the gut
- Segmentation contraction and relaxation in a
rhythmic pattern
- Local constriction occurs in every few centimeters
- The next constriction occurs at the next site, so that
the chyme is divided and push back and forth which
mixes the luminal content
- Mixing process is also performed by peristalsis and
sphincter activities

Migrating Motor Complex

Modification of the pattern of electrical and motor
activity in GI smooth muscle during fasting or
between periods of digestion
The cycles of motor activity migrate from corpus of
stomach to the distal ileum
They migrate slowly at a rate of 6-12 cm/ minute and
occur at intervals 1.5-2 hours
Each wave end within 6-10 minutes
Function: to clear the stomach and small intestines of
luminal contents in preparation for the next meal
Immediately stopped by ingestion of food and return
to peristalsis

Mastication (Chewing)
Reflex
Rhythmic: by motor branch of the 5th cranial nerve
Important for digestion of all foods, especially:
- cellulose membrane of fruits and vegetables
- grinding the food to a very fine particulate consistency
- increases the total surface area of food exposed to the
intestinal secretion

- increases the ease of enzymatic activities

- prevent excoriation of the GIT
- increases the ease with which food is emptied from the
stomach into the small intestine and succeeding
segments

Swallowing (Deglutition)
A. Voluntary stage:
squeezed into pharynx by pressure of tongue
B. Pharyngeal stage (involuntary): reflex
- soft palate is pulled upward to close posterior nares
- form a palatopharyngeal slit by palatopharyngeal folds
- prevent passage of food into trachea by epiglottis and
vocal cords
- pharyngoesophageal sphincter relaxes
- the food is propelled into esophagus

C. Esophageal stage (involuntary)

peristaltic:
primary peristalsis: continuation from pharynx
secondary peristalsis: due to distention of esophagus

The swallowing center inhibits the respiratory center

Swallowing (Deglutition)..

Gastroesophageal Sphincter
2-5 cm above the junction of esophagus-stomach
Normally remains tonically constricted
Prevention of stomach content reflux into esophagus
Additional prevention of reflux by valve-like closure of
the distal end of the esophagus
- valve-like mechanism of the short portion of esophagus
that lies immediately beneath diaphragm before
reaching stomach
- increased intra-abdominal pressure caves the esophagus
inward at this point at the same time that this pressure
increase the intra-gastric pressure
- the valve-like closure of the lower esophagus prevents
from forcing stomach contents into esophagus (during
walking, coughing, or breathing hard)

Motor Functions of The Stomach

A. Storage of large quantities of food

- As food enters the stomach, it forms concentric circles

- Vagovagal reflex: reduces the tone in the muscular wall of
the body of the stomach

B. Mixing the food with the gastric secretions until it forms

a semifluid mixture
- peristaltic constrictor rings
- propulsive movement toward pylorus
- retropulsion

C. Emptying of the stomach

- role of antrum: constriction movement

- role of pylorus (pyloric sphincter): pyloric pump

Hunger contractions: hunger pang

- usually do not begin until 12-24 hours after the last ingestion
- reach greatest intensity in 3-4 days and the gradually weaken

Motor Functions of The Stomach..

Regulation of Stomach Emptying

The weak gastric factors that promote emptying:
- Effect of gastric food volume on rate of emptying
> vagovagal and myenteric reflexes

- Effect of hormone gastrin

The powerful duodenal factors that inhibit emptying:

- Enterogastric nervous reflexes from duodenum
>
>
>
>

degree of distention of duodenum

especially sensitive to the presence of irritant and acids
also breakdown products of protein digestion
degree of osmolality

- Hormonal feedback from duodenum

cholecystokinin, secretin, gastric inhibitory peptide

Motor Function of The Small Intestine

A.Mixing contractions (segmentation contractions)
- BER with background excitation by the ENS

B. Propulsive movements (peristalsis)

- increased due to:

distention
gastroenteric reflexes through the ENS
hormone gastrin, cholecystokinin, insulin, serotonin
irritation
peristaltic rush
diarrhea

- decreased due to:

hormone secretin and glucagon
peristalsis in the fasting: migrating motor complex

C. Movements caused by the muscularis mucosa and

muscle fibers of the villi

Motor Function of The Small Intestine..

Segmentation movement of the small intestine

Motor Function of The Colon

A. Mixing movements - haustrations
B. Propulsive movements mass movements
- slow analward movement of haustral contractions
- mass movement : modification of peristalsis initiated
by:
gastrocolic and duodenocolic reflexes
irritation and distention
parasympathetic stimulation

C. Defecation :
-

intrinsic defecation reflex

parasympathetic defecation reflex
internal anal sphincter
external anal sphincter (voluntary)

Motor Function of The Colon..

Defecation reflex

Defecation
Ordinarily, defecation is initiated by defecation
reflexes
Defecation reflexes:
- intrinsic reflex: relatively weak
mediated by the local enteric nervous system
- extrinsic reflex: parasympathetic defecation reflex
mediated by parasympathetic nervous system
(sacral division)
- initiated by distention of the rectal wall

Defecation..
When feces enter the rectum distention of the
rectal wall initiated peristaltic waves
As the peristaltic waves approach the anus:
- internal anal sphincter is relaxed (receptive
relaxation by myenteric plexus
- if the external anal sphincter is consciously,
voluntarily relaxed at the same time,
defecation will occur

To be effective in causing defecation, usually must

be fortified by parasympathetic defecation reflex