Digestive system

DIGESTIVE SYSTEM
DIGESTION: it is the process under in which food must be broken down into molecules that
are small enough to enter body cells. This process is known as digestion
It is the system of the body of the organs concerned with the ingestion, digestion & absorption
of food is called digestive system
The digestive system is a group of organs which works together for converting food into energy
and basic nutrients to feed the entire body.
Gastro- Enterology: Gastro- The medical speciality that deals with the structure, functions,
diagnosis & treatment of the stomach & intestine is called Gastro- Enterology.
GASTRO------ STOMACH
ENTERO------- INTESTINE
LOGY ---------- STUDY
Division of digestive system the digestive system is divided into two groups together compose
the digestive system
1. Gastro – intestinal tract
2. Accessory digestive tract
1. Gastro- intestinal tract It is also called alimentary canal It is a continues tube that extend
from the mouth to the anus gastro- intestinal tract include many organs:
1. Pharynx
2. Esophagus
3. Stomach
4. Small intestine
5. Large intestine
2. The accessory digestive tract: The accessory digestive tract it include the organs.
1. Teeth
2. Tongue
3. Salivary glands
4. Liver
5. Gall bladder
6. Pancreas
Functions of digestive system: The digestive system functions or performs 6 basic process:
1. Ingestion 2. Secretion 3. Mixing & propulsion
4. Digestion 5. Absorption 6. Defecation

1. Ingestion: It is the process that involves taking foods & liquid into the alimentary tract. i.e.
eating and drinking.

2. Secretion: the cells within the organs of gastro intestine tract & assessory digestive organs
secrete the total amount of 7 liters of water, buffer, acids & enzymes.

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3. Mixing & propulsion: in this process there is alternating contractions & relaxation of
smooth muscles of the gastro-intestinal tract results into mixing of food with the secretions.

This mixture of the food propel them towards the anus is called propulsion. This capability of
G.I tract to mix and move material along its length is termed as motility.

4. Digestion: in this process mechanical & chemical processes break down the ingested food
into small molecules. Mechanical digestion Chemical digestion

a) Mechanical digestion in this process the teeth cuts & grind food before it is swallowed.
Then the smooth muscles of the stomach & small intestine churn the food As a result, food
molecules become dissolved & thoroughly mixed with digestive enzymes.

b) Chemical digestion in chemical digestion, the large carbohydrates, lipids, proteins &
nucleic acid molecules in food are split into smaller molecules by hydrolysis. Some substances
in food can be absorbed without chemical digestion. These include amino acids, cholesterol,
glucose, vitamins, minerals & water.

5. Absorption: Absorption the ingested food, the mixed secreted fluid & the product of
digestion enters into the lining of the lumen of g.i tract is called absorption. The absorbed
substances pass into the blood or lymph or circulate to the cells throughout the body.

6. Defecation: Defecation In this process, the waste indigested substances, bacteria, sloughed
from the lining of G.I tract & digested material. This product not absorbed &leave the body
through the anus is called defecation. The material eliminated during defecation is called Feces.

Fig. 1 Digestive system

Histology of digestive system: the wall of alimentary tract are formed by four layers of tissue:
1. Adventitia or serosa – outer layer
2. Muscle layer
3. Submucosa

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4. Mucosa – lining
1. Adventitia: outermost layer, consist of loose fibrous tissue and in the abdomen the
organs are covered by a serous membrane called peritoneum.
The parietal peritoneum, which lines the abdominal wall
The visceral peritoneum, which cover the organ.
2. Muscle layer: this consist of two layer of smooth muscle. Between these two muscle
layers are blood vessels, lymph vessel and a sympathetic or parasympathetic nerves,
called the myenteric plexus.
Contraction and relaxation of these muscle layers occurs in waves, which push the
contents of the tract outwards. (Called peristalsis) muscle contraction also mixes food
with digestive juice. Contraction of sphincters regulates forward movement.

3. Submucosa: consists of loose areolar connective tissue containing collagen and some
elastic fibres. Which bind the muscle layer to mucosa
4. Mucosa: consists of three layers.
a. Mucosa membrane: formed by columnar epithelium is the innermost layer,
function: protection, secretion, and absorption.
b. Lamina propria: consist of loose connective tissue, which support blood vessels.
c. Muscularis mucosa; provides involutions of the mucosal layer, e.g. gastric gland

Enteric nervous system:

Auerbach’s plexus: between longitudinal and circular muscle
Meissner’s plexus: submucosa

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PARTS OF GASTROINTESTINAL TRACT:

Mouth (Buccal/oral cavity): it is formed by the cheeks, hard palate, soft palate
Teeth aids helps in the breakdown of food & tongue assist in chewing & swallowing the other
accessory digestive organs do not come into direct contact with food, they produce or store
secretions & helps in chemical breakdown of food.
Teeth mechanically break down food into small pieces. Tongue mixes food with saliva
(contains amylase, which helps break down starch). Epiglottis is a flap-like structure at the
back of the throat that closes over the trachea preventing food from entering it.
The mouth also referred to as the oral or buccal cavity. It is formed:
Anteriorly: by lips posteriorly: oropharynx
Laterally: muscles of cheeks superiorly: hard & soft palate
Inferiorly: tongue

a) The Lips or Labia: The Lips or Labia these are fleshly folds surrounding the opening of
the mouth. They are covered externally by skin & internally by a mucous membrane. This
portion of the lips is nonkeratinized & the colour of the blood in the underlying blood vessels
is visible through the transparent surface layer.
During chewing, contraction of the buccinators muscles in the cheeks & orbicularis oris muscle
in the lips helps keep food between the upper & lower teeth. These muscle also assist in speech.

b) The Vestibule: The Vestibule The vestibule of mouth is the anteriormost portion of the oral
cavity. It is the space between the cheek / lips and the teeth.

c) Hard palate: the anterior portion of the roof of the mouth is called hard palate. It is formed
by the maxillae & palatine bones. It is covered by mucous membrane & forms a bony partition
between the oral & nasal cavities.

d) Soft palate: the soft palate is the soft tissue constituting the back of the roof of the mouth.
The soft palate is distinguished from the hard palate at the front of the mouth in that it does not
contain bone

e) Uvula: It is the pendant fleshy mass hanging from the soft palate. During swallowing the
soft palate & uvula drawn inferiorly. It helps in closing off the nasopharynx & prevent
swallowed feed & liquid from entering the nasal cavity.

f) Palatopharyngeal arches: Palatopharyngeal arches one of a pair of ridges or folds of

mucous membrane that pass downward from the posterior margin of the soft palate to the lateral
wall of the pharynx

g) Palatoglossal arch: Palatoglossal arch one of a pair of ridges or folds of mucous membrane
passing from the soft palate to the side of the tongue

2) Tongue: The tongue is an accessory digestive organ & it is movable muscular organ
composed of voluntary muscle. It forms floor of the oral cavity. It is attached by its base to the
hyoid bone & frenulum. Frenulum helps the tongue to move posteriorly.
The upper surface & lateral surface of the tongue is covered with three types of papillae.
Papillae are the small, round or cone-shaped protuberances on the top of the tongue that contain
taste buds

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a) Vallate (circumvallate papillae): are dome-shaped structures on the human tongue that
vary in number from eight to twelve. Each papilla consists of a projection of mucous membrane
Theses contains taste buds

b) Fungi form papillae: The fungiform papillae are situated, mainly at the tip. They appear as
the red dots on the surface of the tongue. They have taste buds on their superior (upper) surface
which can distinguish the four tastes: sweet, sour, bitter, salty,

c) Filiform papillae: Filiform papillae have lack of taste buds. They helps the tongue to move
food in the oral cavity.

d) Foliate papillae: The foliate papillae are involved in the sensations of taste and have taste
buds embedded in their surfaces.

Functions of tongue:
a) Mastication: it is the process of chewing of food. Mastication done by the helps of tongue,
teeth & saliva. The tongue mastication helps to move food under the teeth.
b) Deglutition: the movement of food from the mouth into the stomach or he act of swallowing
is called deglutition. - Tongue helps in deglutition.
c) Speech: tongue helps in speech.
d) Taste: as the taste buds are present on the tongue .so it helps to produce the sense of the
taste.

3) Salivary glands: The salivary glands in mammals are exocrine glands, which produce saliva
a salivary gland is the cells that release secretions called saliva into the oral cavity. Mostly
saliva is secreted by the major salivary glands:
The parotid gland
The submandibular gland
The sublingual gland
a) The parotid gland: The parotid gland is the largest salivary gland it is located inferior &
anterior to the ears. Each parotid gland secrete saliva into the oral cavity. It secretes saliva
through Stensen's duct into the oral cavity, to facilitate mastication and swallowing

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b) The submandibular gland: The paired submandibular glands are salivary glands located
beneath the floor of the mouth.

c) The sublingual gland: The sublingual glands are salivary glands in the mouth. The
sublingual gland are superior to the submandibular gland. They help to produce secretions in
the mouth. They are drained by 8-20 excretory ducts called the ducts of Rivinus.

Composition of saliva:
Composition of saliva. About 1.5 litres of saliva is produced daily & it consists of:
Water-------99.5% Solutes------0.5% Sodium Potassium Chloride Bicarbonate Phosphate
urea
Salivary amylase, a digestive enzyme
Uric acid Mucus Immunoglobin Enzyme lysozymes

Functions of saliva:
Functions of saliva it helps to keep mucous membrane of the mouth & pharynx moist. It helps
to dissolve food it helps to make the sense of taste. Saliva also breaks down food caught in the
teeth. Saliva digests carbohydrates, aids in chewing, and helps keep bacteria levels in the mouth
down.

Teeth: The teeth are accessory digestive organs located in the sockets of the mandible & maxillae.
Teeth (singular tooth) are small, calcified, whitish structures found in the jaws (or mouths) of many
vertebrates that are used to break down food.

Structure of teeth:
Structure of teeth the teeth contains three parts:
a) The crown: the crown is the visible portion above the level of the gums.
b) The root: the roots is the part which is embedded in the gums.
c) The neck: it is the junction & meeting point of the crown & root.

There are 16 teeth on both the top and bottom jaw each jaw consists of specific teeth, which
are incisors (cutting teeth), canines (tearing teeth) and molars (grinding teeth).

Sets of teeth:

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a) Deciduous teeth: it is also called primary teeth or milky teeth. It begins to erupt at about 6
months of age. 1 pair of teeth appears at about each month until 20 teeth are present. The 20
teeth is complete deciduous teeth.

b) Permanent teeth: it is also called secondary dentition. All the deciduous teeth are lost
generally b/w the ages of 6 -12 years, they are replaced by permanent teeth. The permanent
dentition contains 32 teeth that erupt b/w the age of 3 up to adulthood. There are 32 teeth in a
complete permanent set

JAW MOLARS PREMOLARS CANINE INCISORS INCISORS CANINE PREMOLARS MOLARS

DECIDUOUS
TEETH
UPPER 2 - 1 2 2 1 - 2
LOWER 2 - 1 2 2 1 - 2
PERMANENT
TEETH
UPPER 3 2 1 2 2 1 2 3
LOWER 3 2 1 2 2 1 2 3

Functions of teeth: The incisor & canine teeth are the cutting teeth. They are used for biting
off pieces of food. Premolars & molars are broad flat & they are used for grinding & chewing
food. To breakdown food into smaller pieces to aid in the process of digestion

3. Pharynx: 1. nasopharynx 2. Oropharynx 3. Laryngopharynx

The pharynx serves as a common passage for food and air.

4. Oesophagus: Approximately 25cm long extends from the pharynx and the stomach.
Functions include: Secrete mucus Moves food from the throat to the stomach using
muscle movement called peristalsis
The upper and lower end of oesophagus are closed by sphincters. The upper sphincters
prevents air passing into the oesophagus during inspiration and the aspiration of
oesophagus contents. The lower sphincter prevents the reflux of acid gastric contents
into the oesophagus.

5. Stomach: The stomach is an organ of digestion. It has a saclike shape and is located
between the esophagus and the intestines. The stomach is a J shaped dilated portion of
the alimentary canal. It is situated inferior to the diaphragm, superior to umbilical &
left hypochondriac region of the abdomen. The stomach connects the esophagus to the
duodenum. Food found in the stomach is called chyme.
The stomach serves as a mixing chamber & holding reservoir. The stomach forces a
small quantity of material into the first portion of the small intestine. The position &
size of the stomach vary continuously.

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Anatomy of the stomach:

Anatomy of the stomach the stomach has 4 main parts:
The Cardia The Fundus
The Body The Pylorus

Rugae Pyloric sphincter

Lesser curvature Greater curvature

a) Cardia: cardia is the anatomical term for the part of the stomach attached to the
esophagus . It is the superior opening of the stomach.

b) The fundus: The fundus of the stomach is the left portion of the stomach's body.
The rounded portion i-e superior & left of the cardia is called fundus.

c) The body: The part of the stomach that lies between the fundus and the pyloric
antrum. It is inferior to the fundus. The large central portion of the stomach is called
the body.

d) The pylorus: The pylorus the region of the stomach that connects to the duodenum
is called pylorus. It is divided into two parts: the pyloric antrum, which connects to the
body of the stomach. The pyloric canal, which connects to the duodenum. The part of
the stomach that lies between the fundus and the pyloric antrum.

e) Rugae: A fold, crease, or wrinkle, as in the lining of the stomach When stomach is
empty ,the mucosa lies in large folds

f) Pyloric sphincter: The pyloric sphincter, or valve, is a strong ring of smooth muscle
at the end of the pyloric canal and lets food pass from the stomach to the duodenum. So
it communicates with duodenum.

g) Lesser Curvature: The boundary of the stomach that in humans forms a relatively
short concave curve on the right from the opening for the esophagus to the opening into
the duodenum. It is the posterior & concave border of the stomach

h) Greater curvature: the boundary of the stomach that forms a long usually convex
curve on the left from the opening for the esophagus to the opening into the duodenum.
It is the anterior region of the stomach.

Muscles of the stomach: this consist of three layers of smooth muscle fibres.
a. An outer layer of longitudinal muscles.
b. A middle layer of Circular muscles.
c. An inner layer of Oblique muscles.

Functions of stomach:
1. It helps to mix the food with gastric juices & saliva.
2. It helps to hold the food or makes the temporary storage before entering into the small
intestine.
3. It helps to secrete gastric juices which contains HCL & pepsin.
4. HCL kills bacteria & pepsin helps in the digestion of protein. It releasing numerous
chemicals such as digestive hormones, enzymes and gastric juices which help to break

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down food molecules in the chyme & into small particles for absorption into the
bloodstream. An empty stomach has a volume of approximately 50 mL. But typically
after a meal, its capacity expands to about 1 litter of food, and may expand to hold as
much as 4 liters
5. Absorption of water, alcohol and some lipid soluble drugs.
6. The acid environment of the stomach solubilises irons salts, absorption
7. Production and secretion of intrinsic factor needed for absorption of vitamin B12

Small Intestine: Small intestines are roughly 6 meters long Lining of intestine walls has finger-
like projections called villi, to increase surface area. The villi are covered in microvilli which
further increases surface area for absorption. It includes three parts; duodenum, jejunum and
ileum.
Nutrients from the food pass into the bloodstream through the small intestine walls. Absorbs:
80% ingested water, Vitamins, Minerals, Carbohydrates, Proteins, Lipids, Secretes digestive
enzymes.
1. Duodenum: this is about 25 cm long and liver and pancreas are associated with
duodenum. The surface of duodenum has several modification that increase its surface
are about 600-fold to allow for more efficient digestion and absorption of food. Iron is
mainly absorbed in the duodenum.
2. Jejunum: this is the middle section of small intestine and about 2 meters long.
3. Ileum: about 3 meters long and controls the flow of material from the ileum to the
caecum (large intestine).
Function of small intestine:
1. Absorption of nutrients into the blood and lymph.
2. Secretion of digestive enzymes.
3. Secretion of certain hormones such as cholecystokinin, secretin, enterogastrone.
4. Completion of chemical digestion of carbohydrates, protein and fats in the enterocytes
of the villi.
5. Secretion of intestinal juice, also increased by parasympathetic stimulation.
6. Onward movement of its contents by peristalsis which is increased by parasympathetic
stimulation.

Large Intestine: Large Intestine about 5 feet long accepts what small intestines don’t absorb
Rectum (short term storage which holds feces before it is expelled).

 The last segment of the GI tract, with a large diameter (2-3 inches), extending from the
ileocecal valve to the anus.

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 Divided into cecum, ascending colon, transverse colon, descending colon, sigmoid
colon, rectum, anal canal, and anus.
 The large intestine has little or no digestive function, although it secretes mucus. Its
mucosa has no villa or microvillus, but contains numerous goblet cells for secreting
mucus to aid in the formation of feces and maintain an alkaline condition.
 Mechanical stimulation and parasympathetic impulses control the rate of mucus
secretion. The large intestine only absorbs water, electrolytes and some vitamins.
 Many bacteria inhabit the large intestine, where they break down certain indigestible
substances and synthesize certain vitamins.
 feces are formed and stored in the large intestine. Defecation involves a reflex
mechanism aided by voluntary contraction of the diaphragm, abdominal muscles, and
the external anal sphincter.
a. The caecum: first part of large intestine, it is an 8-9 cm long and contain more
lymphoid tissue.
The appendix has no digestive function.
b. The colon: four part which have same structure and function.
1. The ascending colon:
2. The transverse colon
3. The descending colon
4. The sigmoid colon
c. The rectum: it’s about 13 cm long leads from the sigmoid colon and terminates in the
anal canal.
d. The anal canal: it’s about 3.8 cm long in the adult. Two sphincter muscles control the
anus; internal sphincter. Consisting of smooth muscle, is under the control of autonomic
nervous system and the external sphincter, formed by skeletal muscle, is under
voluntary control.

 Accessory Organs: Not part of the path of food, but play a critical role. Include: Liver,
gall bladder, and pancreas

Liver: Liver directly affects digestion by producing bile. Bile helps digest fat filters out toxins
and waste including drugs and alcohol

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Liver is the largest gland in the body, weighting between 1.4 kg. It is situated in the upper part
of the abdominal cavity.
Superiorly and anteriorly- diaphragm and anterior abdominal wall
Inferiorly: stomach, bile duct, duodenum
Posteriorly: oesophagus, inferior vena cava, aorta, gall bladder
Laterally: lower ribs and diaphragm.
Anatomy: The liver is enclosed in a thin inelastic capsule. Folds of peritoneum form
supporting ligaments that attach to diaphragm.
 The liver has four lobes. The two lobes are the large right lobe and the smaller, wedge
shaped, left lobe, the other two, the caudate and quadrate lobes, are areas on the posterior
surface.
 The portal vein enters, carrying blood from the stomach, spleen, pancreas and the small
and large intestine.
 The hepatic artery enters, carrying arterial blood.
 Nerve fibres, sympathetic and parasympathetic, enter here.
 The right and left hepatic ducts leave, carrying bile from the liver to the gall bladder
 Lymph vessel leave the liver, draining lymph to abdominal and thoracic nodes.
 The lobes of liver are made up of many functional units called as lobules. A lobule is a
hexagonal structure of specialized epithelial cells called as hepatocytes arranged around
a central vein
 Lobule also contain highly permeable capillaries called as sinusoids through which
blood passes
 Kupffer cells – hepatic macrophages; removes bacteria.
 Hepatocytes secret bile into the bile canaliculi. Bile canaliculi empty into small bile
ductile which passes bile into the bile ducts at the periphery of lobule.
 Liver lobule is the basic functional units of the liver Each lobe is divided: by connective
tissue into about 100,000 liver lobules about 1 mm diameter each
 Liver: Dual blood supply Hepatic portal vein Direct input from small intestine Hepatic
artery/vein Direct links to heart

 Hepatocytes :
 Hepatocytes In a liver lobule form a series of irregular plates arranged like wheel spokes
Blood enters liver sinusoids: from small branches of hepatic portal vein from hepatic
artery proper As blood flows through sinusoids: hepatocytes absorb solutes from plasma
and secrete materials such as plasma proteins
 Hepatic triad – 3 or more lobules meet ; contains 2 blood vessels and 1 bile duct After
filtering thru sinusoids blood collects in central vein Flows into L & R hepatic veins and
enters inferior vena cava
 Hepatic ducts merge →Common hepatic duct Common hepatic duct + Cystic duct from
gallbladder join  Bile duct.
 Bile duct joins Pancreatic duct at Hepatopancreatic ampulla and enters duodenum
Hepatopancreatic sphincter regulates passage of bile and pancreatic juices into
duodenum
 Functions of the Liver:
 Functions of the Liver Bile production: 600-1000 mL/day.

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 Bile salts (bilirubin), cholesterol, fats, fat-soluble hormones, lecithin Neutralizes and
dilutes stomach acid Bile salts emulsify fats. Most are reabsorbed in the ileum.
 Secretin (from the duodenum) stimulates bile secretions, increasing water and
bicarbonate ion content of the bile Storage Glycogen, fat, vitamins, copper and iron.
 Hepatic portal blood comes to liver from small intestine. Nutrient interconversion
Amino acids to energy producing compounds
 Hydroxylation of vitamin D. Vitamin D then travels to kidney where it is hydroxylated
again into its active form Detoxification
 Hepatocytes remove ammonia and convert to urea
 Phagocytosis Kupffer cells phagocytize worn-out & dying red & white blood cells, some
bacteria Synthesis Albumins, fibrinogen, globulins, heparin, clotting factors
 Liver Detoxifies/removes Drugs Alcohol
 Stores Glycogen Vitamins (A, D, E, K) Fe and other minerals Cholesterol Activates
vitamin D Fetal RBC production Phagocytosis Metabolizes absorbed food molecules
Carbohydrates Proteins Lipids
 Carbohydrate metabolism: Maintain normal blood glucose level by when blood
glucose level is low it breaks glycogen to glucose and when blood glucose level is high
it convert glucose to glycogen and triglycerides and store them.
 Lipid metabolism: hepatocyte store some triglyceride, breaks fatty acid to generate
ATP, synthesize lipoprotein and cholesterol.

 Detoxification of the Blood:

 Detoxification of the Blood Liver can remove hormones, drugs, and other biologically
active molecules from the blood by: Excretion into the bile.
 Chemical alteration of the molecules. Ammonia is produced by deamination of amino
acids in the liver. Liver converts it into urea. Excreted in urine.
 Inactivation of steroid hormones and drugs. Conjugation of steroid hormones and
xenobiotics make them anionic. Can be transported into bile by multispecific organic
anion transport carriers. Steroid and xenobiotic receptors stimulate production of
cytochrome P450 enzymes.

 Production of Plasma Proteins:

 Production of Plasma Proteins Albumin and most of the plasma globulins (except
gamma globulins) are produced by the liver. Albumin: Constitutes 70% of the total
plasma protein. Contributes most to the colloidal osmotic pressure in the blood.
Globulins: Transport cholesterol and hormones. Produce blood clotting factors I, II, III,
V, VII, IX, XI.

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Bile juice:
Water, bile salt, bile pigment
Bile salt: sodium tourocholate, sodium glycocholate
Bile pigment: Bilirubin, biliverdin (breakdown product of RBC)
Cholesterol
Hepatic bile pH -8.6
Bile store at gall bladder water is absorbed at gall bladder and bile pH 7.4

Function of bile:
 bile is essential for complete digestion of fats
 Bile by making fatty acids, cholesterol and calcium soluble in watery content in
intestinal juice, make them easily diffusible and suitable for absorption.
 It also helps in absorption of iron, calcium and vitamin A/D/E/K.
 Bile stimulate peristalsis movement.
 Bile maintain pH of duodenal contents and maintains activity of enzymes.
 Mucin of bile act as buffer and a lubricant.

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 It helps to neutralize gastric activity and injurious effect of acid on intestinal mucosa.

Gall Bladder:
Anatomy: it is a pear-shaped sac located in depression of posterior surface of liver. It is 7-10
cm long.
Histology: Mucosa made up of simple columnar epithelium. Submucosa is absent. Middle
muscular consist of smooth muscle. Outer layer is visceral peritoneum.
Function: Gall Bladder Stores bile from the liver, releases it into the small intestine. Fatty diets
can cause gallstones

Pancreas: The pancreas is the pale grey gland weight about 60 gm. It is 12 to 15 cm long &
2.5 cm thick. It lies posterior to the greater curvature of the stomach.
Anatomy: the pancreas consists of head, a body and a tail.
the head: it is the expended portion of the organ near the curve of duodenum.
the body: the part that is superior & left of the head is called the body.
the tail: the tail lies in the front of the left kidney.

The pancreas both an exocrine gland & endocrine gland.

Exocrine gland: this consist of a large number of lobules & secreting cells. The functions of
the exocrine pancreas to produce pancreatic juices that digest carbohydrates, proteins & fats.
Trypsinogen
Chymotrypsinogen
Procarboxy peptidase
Pancreatic amylase
Proelastase
Nuclease
Lipase
Main pancreatic duct: it join to common bile duct coming from liver and gall bladder and enter
the duodenum as hepato-pancreatic duct.
Duct of santorrinis
Histology: it is made up of small cluster of glandular epithelial cells. 99% of the cluster called
acini constitute exocrine portion of pancreas. These secrete a mixture of digestive fluid and
digestive enzymes called pancreatic juice.
The remaining 1% clusters are scattered in between acini are called islets of Langerhans.
Constitutes endocrine portion which secrete the hormones like glucagon, insulin, somatostatin
and pancreatic polypeptide.
Contains both endocrine and exocrine hence they called as exo-endocrine gland.

Functions of pancreas:
Functions of pancreas formation of pancreatic juice: Each day pancreas produces 1200-1500
ml of pancreatic juices which helps in the digestion of carbohydrates, fats & proteins. It is clear
colourless liquid consist of water, salt, sodium bicarbonate & several enzymes. secretions of
hormone: The cells of the pancreas secrete the hormone like glucagon, insulin which helps to
control blood glucose level.

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Physiology of digestion:
Ingestion: intake of food, Mastication-chewing, larger particle convert into small particle
physical method, teeth chew thr food & physical breakdown.
Deglutition: swallowing, Centre located at medulla
Food bolus is pushed by the tongue involuntary muscle in pharynx are stimulated.
Larynx moves up
Epiglottis swings and cover glottis
Soft plate close nostrils
Upper oesophages relax and sphincter allow bolus moves by peristalsis.
Digestion of carbohydrate:
In mouth:
Starch -------------------→ Maltose + dextrins
In stomach: no enzymes present in stomach for carbohydrate digestion and salivary amylase
are inactive in stomach due to acidic pH.
In intestine: contain pancreatic juice which contain various enzymes for carbohydrate
digestion.
Starch--------------------→ Maltose + dextrins
Maltose-------------------→ glucose + galactose

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Dextrins -------------------→ 5-8 glucose

Lactose---------------------→ glucose + galactose

Digestion of protein:
Protein are macromolecules
Monomer units of proteins are amino acids
Protein digesting enzymes called proteases
Protein digestion start from stomach
Stomach: contain gastric juice in which HCl, Pepsinogen, prorennin

Pepsinogen ---Hcl------------→ pepsin (active)

Pepsinogen ---pepsin------------→ pepsin (active) (autocatayting agent)

Hcl
Prorennin ------- --------→ rennin (active)
 Rennin: milk protein (casein) digesting enzymes
Casein ---Rennin-------→ Paracasein
Paracasein + Ca++ → Calcium paracaseinate
pepsin
Calcium, paracaseinate ---- -------→ Peptones (small chain)
 Pepsin:
pepsin
Protein---------- ------→ peptones and proteases
Chyme: ingested food + gastric juice
Neutralization of acidic chyme occur by bile salt before entering small intestine
 Pancreatic juice: proteases inactive
Trypsinogen
Chymotrypsinogen
Procarboxypeptidase
Proelastase
Trypsinogen -----Enterokinase-----------→ Trypsin (active)
Trypsinogen -----trypsin-----------→ Trypsin (active)
Chymotrypsinogen -----trypsin-----------→ carboxytrypsin (active)
Procarboxypeptidase -----trypsin-----------→ carboxypeptidase (active)
Proelastase -----trypsin-----------→ Elastase (active)

Protein
Peptone ---------chymotrypsin Trypsin----------------------------→ peptides
Proteoses

Amino peptidase: act N terminal site

Carboxypeptidase: act C terminal site

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Tripeptidase: digestion of tripeptide

Dipeptidase: digestion of dipeptide

Digestion of Fat: Dietary fat contain Triglycerides ( 3 fatty acid + 1 glycerol) and cholesterol.
Fat digesting enzymes are called lipase
1. Lingual lipase
2. Gastric lipase
3. Intestinal lipase
4. Pancreatic lipase.
Fat globules floating on water because they are insoluble in water.
Fat globules are broken down by agitation
Bile salt which are present in bile juice they help in emulsification of fat.
Bile sale contain sodium taurocholate and sodium glycocholate.

Triglyceride----lipase----------------→ Diglyceride + fatty acid

Diglyceride--------lipase---------------→ monoglyceride + fatty acid

Monoglyceride-----lipase-----------------→ fatty acid + glycerol

Triglyceride----------------→ 3 fatty acid + glycerol

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Digestion of nucleic acid:

Nucleotides

Nucleoside Phosphate

Nitrogenous base Pentose

(Sugar)

Nuclease: enzymes which digest nucleic acid

DNA ----------------→ DNase
RNA -----------------→ RNase
(DNase and RNase are present in pancreatic juice)

Nucleic acid ---------Nucleases--------------------------------→ Nucleotides

Nucleotides------------Nucleotidase---------------------------→ Nucleosides + phosphate

Nucleosides------------Nucleoside------------------------→ Nitrogenous base + sugar phosphate

Formation of Hcl in stomach:

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Digestive system

1. Carbon di oxide with water convert into carbonic acid in presences of carbonic
anhydrase enzymes.
2. Carbonic acid dissociates to release H+ and HCo3-
3. Proton pump powered by H+/K+ ATpase activity transport H+ into lumen while
bringing K+ into the cell.
4. HCo3- by antiport in basolacteral membrane of parietal cell into blood in exchange of
Cl-
5. Cl- diffuse out into the lumen through Cl- Channel.
6. K+ diffuse out into the lumen through K+ Channel
Function of Hcl:
 Breakdown of protein
 It Convert inactive of pepsinogen to active pepsin
 Stimulate flow of bile
 Kill microbes

Regulation of digestion:
1. Neural control: Salivation is initiated by sight of food, smell of food, tasting of food.
Control by Parasympathetic nervous system stimulated while sympathetic nervous
system inhibited.

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Digestive system

2. Hormonal control:
Gastrointestinal hormones:
a. Gastrin: Secreted from mucosal cell of stomach.
Stimulate secretion of Hcl and pepsinogen.
Protein rich food in stomach increase the gastric hormone secretion.
Vagus nerve release acetylcholine which increase gastric juice secretion.
b. GIP: (gastric Inhibitory peptide): Enterogastrone
Inhibit secretion of gastric juice
Release by duodenal epithelium
In stomach it act on chime and further acid secretion block.
c. CCK: PZ(cholecystokinin) (pancrozymin)
Release by duodenal epithelium
CCK: Contraction of gall bladder release bile
PZ: Stimulates release of pancreatic enzymes.
d. Secretin: duodenal epithelium 1st to be discovered.
Stimulate pancrease to release bicarbonate ions.
Bicarbonate neutrilize acidity of chime
Inhibitory effect on Hcl secretion in stomach.
e. Enterocrinin: release from epithelium of small intestine.
f. Duocrinin: release by duodenal epithelium
Target Brunner’s gland (present in submucosa of duodenum)
Stimulate alkaline mucosa and neutrilize chime.
g. Vilikinin: movement on vili effect movement of vili
CCK:PZ act on gall bladder, Gastrin act on stomach, Secretin act of pancrese and
stomach, Duocrinin act on small intestine, GIP act on small intestine, Enterocrinin act
on small intestine, Vilikinin act on small intestine.

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Regulation of acid production by parasympathetic nervous system.

1. Cephalis phase
2. Gastric phase
3. Intestinal phase
1. Cephalis phase:

2. Gastric phase: Food-stomach

Low pH Gastric secretion declines

Emotional and distress- Sympathetic overides ↓ Hcl

nervous system parasympatheti
activates c control

3. Intestinal Phase:

Presences of low pH and

partiallydigested food in Intestinal gastrin release in blood ↑ Acid
duodenum as stomach
empties

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Distention of Local reflex

duodenum & enter gastric reflex ↓ Hcl
presence of fatty Pyloric sphinter
acidic hypertonic
Vagal nuclei in medulla
chime/ irritants

Release of intestinal hormone

Secretin, GIP, CEK,
vasoactive intestinal peptide

Absorption:
1. Carbohydrate:
Glucose and galactose are absorb by Na cotransporte by intestinal epithelial cell
Fructose by facilitated diffusion by capillary of intestinal villi
By hepatic portal system they transport to liver
Galactose convert into glucose by Uridyl transferase
Fructose convert into glucose
2. Protein:
Dipeptides and tripeptides are absorb by Na cotransport
Amino acid absorb by active transport
3. Fat: simple diffusion.
4. Vitamin: fat soluble vitamin: A/D/E/K by simple diffusion, most B complex and c by
simple diffusion.
Vitamin B12 with intrinsic factor then active transport at ileum
5. Electrolyte: active transport
6. Water: osmosis from lumen of Intestine.
Digestive gland
1. Salivary gland: parotid/Sublingual/Submandibular
Aptyalism: failure of secretion of saliva
2. Gastric gland:
Mucosa: Mucus (alkaline glycoprotein)
Oxyntic/parietal cell: intrinsic factor: responsible for vitamin B12 absorption
Hcl formation
Fe3+ doesn’t absorb soo convert into Fe2+
Pepsin cell: pepsinogen and prorennin

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Digestive system

G cell: secreate gastrin hormones ↑Hcl secretion

Argentaffin cell: secreate 5-HT -----→ serotonin-------→ vasoconstrictor
Stem cell; replace the woln out cells
Intestinal gland;
Crypts of lieberkuhn: simple tubular glands in mucosa of small intestine.
Brunner’s gland: Submucosa of duodenum only mucus secrete.
Disorder of GIT:

Constipation: Constipation is the term used to describe difficulty or infrequency in passing

stools (feces). When somebody is constipated their stools are usually small, hard, dry, and
difficult to pass. Other symptoms may include pain during a bowel movement.. There are
many different causes of constipation, such as dehydration, a lack of fiber in the diet,
pregnancy, inactivity, or certain medications (such as antidepressants, iron supplements, or
opioids). Laxatives can help relieve constipation and lifestyle changes can help prevent it
from recurring.

Crohn’s Disease: Crohn’s disease is a chronic bowel disease that causes patches of
inflammation in the GI tract anywhere between the mouth and the anus, although the area
where the small intestine joins the large intestine is most commonly affected. The exact
cause remains unknown; however, it is more common in “Westernized” countries, tends to
run in families, and diet and stress may aggravate the disease.
Symptoms may include diarrhea that persists for several weeks, abdominal pain and weight
loss. Drug treatments may include aminosalicylates, corticosteroids, immunomodulators,
and biologics.

Diarrhea: Symptoms of diarrhea include frequent, loose, watery stools (feces). Abdominal
pain or cramping may also occur, and sometimes nausea or vomiting. Viruses are a
common cause of diarrhea, particularly noroviruses which are a common cause of diarrhea
and vomiting outbreaks on cruise ships. Other common causes include bacteria, such as
salmonella, campylobacter, or Escherichia coli, giardia; certain medical conditions (such
as Celiac disease or Crohn’s disease); food intolerance or medicines. Anti-diarrhea
medications such as loperamide or diphenoxylate help slow down bowel movements, and
electrolyte solutions are beneficial for treating dehydration.

Diverticular disease: Diverticular disease is a chronic condition in which small pockets or

out-pouchings, called diverticula, occur in the bowel. Diverticula can become inflamed
when undigested food gets trapped within them, causing pain and constipation, and
sometimes fever, nausea, or cramping. This is called diverticulitis. Diverticular disease is
common, affecting half of all people over 60. A low fiber diet is thought to be the main
cause, although some people have a genetic predisposition to the disease. Treatment is
usually with a high-fiber diet and a mild pain reliever.

Gastroesophageal Reflux Disease (GERD): GERD is also known as heartburn or acid

reflux. It occurs when the ring of muscle fibers that surrounds the entrance to our stomach
(known as the lower esophageal sphincter) becomes weak, and instead of remaining tightly
closed to prevent the backflow of food back up our esophagus, it remains partially open,

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Digestive system

allowing partly digested food and stomach acid to leak back up the esophagus, causing
irritation. The primary symptoms associated with GERD are regurgitation, heartburn, chest
pain and nausea. GERD is most commonly treated with antacids, H2 blockers, or Proton
Pump Inhibitors.

Hemorrhoids and anal fissures: Hemorrhoids occur when the anal cushions (which are
small areas of vein-containing tissues that seal the anal opening, preventing incontinence)
become engorged and swollen. They can occur either externally or internally and both types
typically bleed when a bowel motion is passed. External hemorrhoids look like small
bunches of grapes and can become very red, tender, and itchy when inflamed. Internal
hemorrhoids can cause a feeling of pressure inside the rectum and are not usually visible.

Irritable Bowel Syndrome (IBS): Some people are more likely to have constipation
(constipation-predominant IBS or IBS-C), others diarrhea (diarrhea-predominant IBS or
IBS-D), while a few experience both constipation and diarrhea at different times (mixed
IBS). Symptoms are endometriosis, giardia, food allergies, or inflammatory bowel disease,
and most of these conditions need to be excluded before a diagnosis of IBS can be made.

Lactose intolerance: People with lactose intolerance do not produce enough of the enzyme
lactase, and find it difficult to digest lactose, which is a type of sugar found in cows’, goats’
and sheep milk.

Malabsorption syndromes: Malabsorption syndromes refers to a number of different

conditions in which the small intestine is unable to absorb nutrients, such as proteins,
carbohydrates, fats, vitamins or minerals. There are numerous causes of malabsorption
syndrome, such as prolonged use of antibiotics, diseases of the gallbladder, liver, or
pancreas, conditions such as Crohn’s disease, celiac disease, chronic pancreatitis, and cystic
fibrosis, and birth defects. Treatment depends on the underlying condition and the extent
of malabsorption.

Polyps and colorectal cancer: Polyps are growths that occur on the inner surface of the
colon. There are two main types. One type (adenomas or adenomatous polyps) have a high
risk of turning into colorectal cancer and should be completely removed if found.
Colorectal cancer is the third leading cause of cancer deaths among American men and
women. Most colorectal cancers grow slowly and cause few symptoms until they reach a
large size, which is why colorectal cancer screening is so important because colorectal
cancer is more common in people aged 45 through to 75 years. Treatment of colorectal
cancer depends upon which stage the cancer is found at and may include surgery,
chemotherapy, and radiation therapy.

Peptic Ulcer Disease (PUD): Peptic ulcer disease is an umbrella term used to describe both
gastric and duodenal ulcers, which are small holes that can occur in the lining of your
stomach (gastric ulcer) or upper part of your small intestine (duodenal ulcers). Duodenal
ulcers are the most common type and are more likely in men aged between 30 and 50 years.
Gastric ulcers most often affect middle-aged or elderly people.
The most common cause is an infection with a bacteria called Helicobacter pylori (H.
pylori), that is usually acquired in childhood, although most people never develop ulcers.
Overuse of anti-inflammatory drugs such as aspirin, ibuprofen, or diclofenac, excessive
acid production in the stomach, and smoking are also common causes. Symptoms typically
include abdominal pain and heartburn. Treatment usually consists of medications to reduce

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Digestive system

acid production in the stomach or to protect the stomach, and therapy to eradicate H. pylori
infection.

Ulcerative colitis: Ulcerative colitis affects only the innermost lining of the colon.
Although the colon is the only part of the bowel affected, the whole of the colon is inflamed.
Symptoms are similar to Crohn’s disease and include diarrhea and the frequent need to
have a bowel movement (also called tenesmus). Pus and mucus may also occur as a result
of ulcers that form in the colon. Other symptoms include rectal bleeding or bloody stools,
abdominal pain, tiredness, and loss of appetite. The cause remains unknown although an
abnormal immune response seems responsible for the inflammation, and diet and stress
aggravate the condition. Genetics also seem to play a role. Treatment is with
corticosteroids, antidiarrheal agents, immunomodulators and biologics, depending on
disease severity.

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