Physiology of Digestion. Absorption.

The Functional System Maintaining the Blood

Nutrients’ Level Optimal for Body Metabolism

Helena G. Ionkina
Associate Professor, MD

Department of Normal Physiology

Sechenov University
Moscow, Russia
1. Absorption
Longitudinal Section through the Small Intestine

from R. Greger, U. Windhorst, Comprehensive Human Physiology: From Cellular Mechanisms to Integration, v. 2. Springer, Berlin, 1996
Villi and Microvilli of Enterocyte
in the Small Intestine

from W. F. Ganong, Review of Medical

Physiology, McGraw-Hill, New York, 2001

from R. F Schmidt, G. Thews (Eds.), Human

Physiology, Springer, Berlin, 1989
Epithelial Cells at Rest and Absorption

from R. F Schmidt, G. Thews (Eds.), Human Physiology, Springer, Berlin, 1989

The Passive Permeability of the Epithelium

The pore size of the tight

junctions of epithelium
decreases from the
proximal to the distal part
of the intestine. The
electrical resistance of
the epithelium increases
from proximal to distal
part of the intestine

from R. F Schmidt, G. Thews (Eds.), Human Physiology, Springer, Berlin, 1989

Routes of the Epithelial Transport in Intestine

Transcellular transport
employs active and/or
passive mechanisms;
paracellular transport is
always passive

from R. F Schmidt, G. Thews (Eds.), Human Physiology, Springer, Berlin, 1989

Electrolyte Absorption in the Small Intestine

1. Electrogenic Na+ absorption

against an electrochemical gradient.
2. Coupled electrogenic Na+
transport (coupled with organic
substances by use of a common
carrier).
3. Neutral Na+ – Cl- cotransport.
4. Neutral Na+ – Cl- absorption by
double exchange for H+ and HCO3-
(particularly in the ileum).

All four absorption mechanisms are

driven by Na+ – K+ ATPase in the
basolateral membrane

from R. F Schmidt, G. Thews (Eds.), Human Physiology, Springer, Berlin, 1989

Water Absorption in Gastrointestinal Tract
Of the total amount of liquid that enters the tract, 2
l from food and 7 l from endogenous secretions,
only 100 ml leaves the body in the faeces.
Paracellular secretion of water and electrolytes

from R. F Schmidt, G. Thews (Eds.), Human Physiology, Springer, Berlin, 1989

Carbohydrate Digestion and Absorption
Hydrolysis of di- and
oligosaccharides by
enzymes in the brush
border. The end products
of pancreatic carbohydrate
digestion and the
disaccharides in food are
split into their
monosaccharide
components at the
membrane of the brush
border

from R. F Schmidt, G. Thews (Eds.), Human Physiology, Springer, Berlin, 1989

Protein Digestion and Absorption
Intestinal lumen: Splitting of the
polypeptides into oligopeptides, di-
and tripeptides and amino
acids.
Brush-border membrane: Further
splitting by specific peptidases and
uptake of the amino acids and
oligopeptides.
Cytoplasm: Splitting of di- and
oligopeptides into amino acids, by
cytosol
peptidases.
Contraluminal membrane: Release of
the amino acids from the cell into the
blood

from R. F Schmidt, G. Thews (Eds.), Human Physiology, Springer, Berlin, 1989

Structure of a Mixed Micelle

Cholesterol, lecithin, fatty acids and

monoglycerides occupy the centre of the
micelle which is surrounded by bile acids
with their hydrophilic groups toward the
surface

from R. F. Schmidt, G. Thews (Eds.), Human Physiology,

Springer, Berlin, 1989
Lipid Digestion and Absorption
In the lumen of the intestine,
colipase and lipase split
triglicerides into fatty acids
(FA) and monoglycerides
(MG) which enter solution in
micelles and pass from the
micelles into the
enterocytes. In the cells,
triglycerides (TG) are
resynthesized from long-
chain fatty acids and
monoglycerides and
enclosed in a protein
envelope to form
chylomicron which pass into
the lymph. Short- and
medium-chain fatty acids
are absorbed and released
into the blood directly.
DG denotes diglycerides.
from R. F Schmidt, G. Thews (Eds.), Human Physiology, Springer, Berlin, 1989
2. Hunger and Satiety
Systemic Mechanisms of Hunger
«Each day we are striving for the well-known substance we
need to supply our vital chemical process, feed it into
ourselves, calm down for a time, and in a few hours of the next
day to strive for capturing a new portion of that substance —
food.»
The food centre is the functional integration of a series of
neurons of different central nervous system structures which
participate in controlling various processes of the nutrient
functional system. The hypothalamus is the base and leading
structure of the food centre.
«The food centre is of quite a distance.»

Ivan P. Pavlov
Stimulation of Food Centre
Stimulation of lateral
nuclei of hypothalamus
(LH) bilaterally, centre of
hunger, results in eating of
more food of the animal
even after feeding (A).

Stimulation of ventro-
medial nuclei of
hypothalamus (VMH)
bilaterally, centre of
satiety, results in refusing
to eat even a tasty food
(B)

LH means lateral
hypothalamus, VMH is
ventro-medial
hypothalamus
A B
from K. V. Sudakov (Ed.), Human Physiology: Atlas of Dynamic Schemes,
GEOTAR-Media, Moscow, 2015
Excitation of Food Centre in Hunger
Formation of excitation of neural
structures of food centre in hunger
status by main routes of afferentation
from the receptors of oral cavity and
empty stomach

LH is lateral hypothalamus,
VMH is ventro-medial hypothalamus,
«+» means excitation,
«-» means inhibition

from K. V. Sudakov (Ed.), Human Physiology: Atlas of Dynamic Schemes,

GEOTAR-Media, Moscow, 2015
Excitation of Food Centre in Satiety
Formation of excitation of neural
structures of food centre in satiety
status after feeding by main routes of
afferentation from the receptors of
oral cavity by food and full stomach

LH is lateral hypothalamus,
VMH is ventro-medial hypothalamus,
«+» means excitation,
«-» means extinction of excitation
after feeding

from K. V. Sudakov (Ed.), Human Physiology: Atlas of Dynamic Schemes,

GEOTAR-Media, Moscow, 2015
Excitation of Food Centre in Hunger and Satiety
Propagation of
excitation through
neural structures
of food centre in
hungry animals
(A) and extinction
of excitation after
feeding (B)

LH is lateral
hypothalamus,
RF is reticular
formation of
mesencephalon

from K. V. Sudakov (Ed.), Physiology of Functional Systems, Sechenov

Moscow Medical Academy, Moscow, 2002
Regulation of Body Mass by Leptin
Proteohormone leptin produced by fat
cells is the main indicator of fat tissue.
The plasma leptin concentration rises
as fat cell mass increases. Efferent
commands reduce nutrient absorption
and increase energy consumption
when plasma leptin is high, and
increase nutrient absorption and
decrease energy consumption when
plasma leptin levels are low.
Leptin and α-melanocyte-stimulating
hormone (α-MCH) inhibit the
hypothalamic release of neuropeptide
Y (NPY), a neuropeptide that
stimulates hunger, increases the
parasympathetic activity and reduces
energy consumption

from A. Despopoulos, S. Silbernagl, Color Atlas of Physiology, Thieme,

Stuttgart, 2003
Appetite
The status of slight hunger is referred to as appetite.
Appetite is provided with preferential attitude of a hungry
person for food. The preference of the requirement in food
determines the individual’s attraction to salty, sweet or other
substances.
The individual experience to determine dietary preferences
may derive from national or family customs or cultural level, the
genetic predetermination contributing to one’s attraction to this
or that food.
Severe hunger eliminates the preferences.
3. Starvation
Types of Starvation
• Complete: no food, with water;
• Absolute: no food, no water;
• Quantitative or incomplete: caloric value of a diet is less than
metabolic requirements of the person;
• Qualitative or one-sided nutrition: deficiency or absence of
one or several nutrients in a diet of normal caloric value,
protein, lipid, carbohydrate;
Mechanisms of Self-regulation in Starvation
• Change in tissue metabolic rate;
• Nutrients’ mobilisation from depots;
• Nutrients’ redistribution in the body;
4. The Functional System of Nutrition
Functional System Maintaining the Blood
Nutrients’ Level Optimal for Body Metabolism

from K. V. Sudakov (Ed.), Physiology of Functional Systems, Sechenov Moscow Medical Academy, Moscow, 2002
Dynamics of Functional System of Nutrition
LH is lateral
hypothalamus

VMH is
ventro-medial
hypothalamus

from K. V. Sudakov (Ed.), Human Physiology: Atlas of Dynamic Schemes, GEOTAR-Media, Moscow, 2015
Mechanisms of Self-regulation in Hunger
The body requirement for nutrients produces ascending
excitation to the central nervous system neurons, food centre,
which is the basis of the food motivation, so the body is aimed
at satisfaction of its food requirements.
The food motivation is the central factor of the target-oriented
food-seeking behaviour, thereby determining the biological and
social components of the individual behaviour. It is the food
motivation which makes a living body demonstrate food-
seeking behaviour, that is, active search for food among
numerous stimuli of the external environment thus satisfying its
requirements for nutrients.
Functional System Maintaining the Blood
Nutrients’ Level Optimal for Body Metabolism

from K. V. Sudakov (Ed.), Physiology of Functional Systems, Sechenov Moscow Medical Academy, Moscow, 2002
Thank you for your attention!