ANATOMY AND PHYSIOLOGY WITH PATHOPHYSIOLOGY LABORATORY BSMLS

DIGESTIVE SYSTEM

DIGESTIVE SYSTEM

MAJOR ORGANS
o mouth
o most of the pharynx
o esophagus
o stomach MUCOSA
o small intestine  Epithelium
o large intestine o mouth, pharynx, esophagus, and anal
canal
 nonkeratinized stratified
squamous epithelium
o stomach and intestines
 simple columnar epithelium

 Lamina propria
o areolar connective tissue containing
many blood and lymphatic vessels
o contains the majority of the cells of the
mucosa associated lymphatic tissue
(MALT)

ACCESSORY ORGANS  Muscularis mucosae

o teeth
o tongue
o salivary glands
o liver
o gallbladder
o pancreas
FUNCTIONS
1. Ingestion: taking food into mouth.
2. Secretion: release of water, acid, buffers, and
enzymes into lumen of GI tract.
3. Mixing and repulsion: churning and movement
of food through GI tract.
4. Digestion: mechanical and chemical breakdown
of food.
5. Absorption: passage of digested products from
GI tract into blood and lymph.
6. Defecation: elimination of feces from GI tract.
GENERAL STRUCTURE OF THE DIGESTIVE
TRACT
LAYERS OF THE GASTROINTESTINAL TRACT
o thin layer of smooth muscle fibers
SUBMUCOSA
 consists of areolar connective tissue that binds
the mucosa to the muscularis
 contains many blood and lymphatic vessels
 extensive network of neurons known as the
submucosal plexus (Meissner’s plexus)
o controls the secretions of the organs of
the GI tract
MUSCULARIS
 mouth, pharynx, and superior and middle parts
of the esophagus
o contains skeletal muscle
 throughout the rest of the tract
o consists of smooth muscle
 inner sheet of circular fibers
 outer sheet of longitudinal fibers
 Auerbach (Myenteric plexus)
o controls GI tract motility

SUBMUCOSAL PLEXUS (MEISSNER’S PLEXUS)

AUERBACH (MYENTERIC PLEXUS)

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DIGESTIVE SYSTEM

o found in the floor of the mouth; they are

medial and partly inferior to the body of
the mandible
 sublingual glands
o beneath the tongue and superior to the
submandibular glands

SEROSA/ ADVENTITIA
 Serosa
o serous membrane composed of areolar
connective tissue and simple squamous
epithelium (mesothelium)
o adventitia if there is no mesothelium

HISTOLOGY OF SEROSA
ORGAN SEROSA
Esophagus Adventitia due to the fact
that the esophagus is not
in a cavity
Stomach Visceral Peritoneum COMPOSITION AND FUNCTIONS OF SALIVA
Small Intestine Visceral Peritoneum  99.5% water
Large Intestine Visceral Peritoneum  0.5% solutes
Anus Adventitia o ions
o lysozyme
MOUTH (ORAL CAVITY) o amylase
 formed by the cheeks, hard and soft palates, and  enzyme that acts on starch
tongue  parotid glands
o secrete a watery (serous) liquid
containing salivary amylase
 submandibular glands
o secrete a fluid that contains amylase
but is thickened with mucus
 sublingual glands
o contain mostly mucous cells, so they
secrete a much thicker fluid that
contributes only a small amount of
salivary amylase
WHAT IS THE FUNCTION OF THE UVULA?
UVULA TONGUE
 fingerlike muscular structure hanging from the  accessory digestive organ composed of skeletal
free border of the soft palate muscle
 During swallowing, the soft palate and uvula are  extrinsic muscles of the tongue
drawn superiorly, closing off the nasopharynx o Hyoglossus
and preventing swallowed foods and liquids
o Genioglossus
from entering the nasal cavity.
o Styloglossus

MAJOR SALIVARY GLANDS  longitudinalis superior

 parotid glands  longitudinalis inferior
o inferior and anterior to the ears, between  transversus linguae
the skin and the masseter muscle  verticalis linguae
 submandibular glands  consists of connective tissue and interlacing
bundles of skeletal muscle fibers
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DIGESTIVE SYSTEM
 Sulcus terminalis-V-shaped depression that
divides the dorsal surface of the tongue into an
anterior two-thirds and a posterior one-third
 Posterior portion-has lingual tonsils
 Anterior portion-has numerous lingual papillae
called filiform, fungiform, foliate and
circumvallate papillae
 PAPILLAE - covered by stratified squamous
epithelium that shows partial or incomplete
keratinization
 VENTRAL surface - nonkeratinized
 Without taste buds
o Filiform papillae
 With taste buds
o Fungiform papillae
o Circumvallate papillae
o Foliate papillae
o  incisors -chisel -shaped for cutting into food
TEETH
 accessory digestive organs located in sockets of
the alveolar processes of the mandible and
maxillae
 major external regions:
o crown- visible portion above the level
of the gums
o root -embedded in the socket
o neck -constricted junction of the crown
and root near the gum line
BSMLS
Dentin
 forms the majority of the tooth
 covered by enamel (calcium phosphate and
calcium carbonate)
o hardest substance in the body
o protect the tooth from the wear and tear
of chewing
o protect against acids
 dentin of the root is covered by cementum
o attaches the root to the periodontal
ligament
DECIDUOUS TEETH
 primary teeth, milk teeth, or baby teeth
 begin to erupt at about 6 months of age
 two teeth appear each month thereafter, until all
20 are present
 canines - used to tear and shred food
 first and second deciduous molars -crush and
grind food to prepare it for swallowing
 lost between ages 6 and 12 years
 replaced by the PERMANENT
(SECONDARY) TEETH
PERMANENT (SECONDARY) TEETH
 32 teeth that erupt between age 6 and adulthood
 pattern resembles the deciduous dentition, with
exceptions:
o deciduous molars are replaced by the
first and second premolars
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DIGESTIVE SYSTEM

o first, second and third permanent PHARYNX

molars (wisdom teeth) do not replace
any deciduous teeth
 funnel-shaped tube that extends from the
internal nares to the esophagus posteriorly and to
the larynx anteriorly
 Nasopharynx-functions only in respiration
 Oropharynx and Laryngopharynx
o have digestive as well as respiratory
functions
o muscular contractions of these areas
help propel food into the esophagus and
then into the stomach

MECHANICAL AND CHEMICAL DIGESTION IN

THE MOUTH

MECHANICAL DIGESTION
 results from chewing, or mastication
 food is manipulated by the tongue, ground by
the teeth, and mixed with saliva
 food is reduced to a soft, flexible, easily
swallowed mass called a bolus
CHEMICAL DIGESTION
 salivary amylase
o breaks down starch ESOPHAGUS MAJOR FUNCTION: to convey
 lingual lipase liquids or chewed food (bolus) from the oral cavity to
o breaks down dietary triglycerides (fats the stomach
and oils)
 muscular tube, about 25 cm (10 in.) long, that
SUMMARY OF DIGESTIVE ACTIVITIES IN THE lies posterior to the trachea
MOUTH  pierces the diaphragm through an opening called
the esophageal hiatus
STRUCTURE ACTIVITY RESULT  ends in the superior portion of the stomach
Cheeks and lips Keep food Foods uniformly chewed
between teeth. during mastication.
Salivary glands Secrete saliva. Lining of mouth and
pharynx moistened and
lubricated. Saliva
softens, moistens, and
dissolves foods and
cleanses mouth and teeth.
Salivary amylase splits
starch into smaller
fragments (maltose,
maltotriose, and a-
dextrins).
Tongue
Extrinsic tongue Move tongue Food maneuvered for
muscles from side to mastication, shaped into
side and in bolus, and maneuvered
and out. for swallowing.
Intrinsic tongue Alter shape of Swallowing and speech.
muscle tongue.
Taste buds Serve as Secretion of saliva
receptors for stimulated by nerve
gustation impulses from taste buds
(taste) and to salivatory nuclei in
presence of brain stem to salivary
food in mouth. glands.
Lingual glands Secrete lingual Triglycerides broken
lipase. down into fatty acids and
diglycerides.
Teeth Cut, tear, and Solid foods reduced to
pulverize smaller particles for
food. swallowing.
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DIGESTIVE SYSTEM

STOMACH
FUNCTION: receives, stores, mixes, digests, and
absorbs some of the ingested products

 J-shaped enlargement of the GI tract directly

inferior to the diaphragm in the abdomen
 connects the esophagus to the duodenum
 digestion of starch and triglycerides continues
 digestion of proteins begins

ESOPHAGUS
MUCOSA
 Epithelium
 nonkeratinized stratified squamous
epithelium
 Lamina propria
 Muscularis mucosae
Main regions:
SUBMUCOSA 1. Cardia
 contains small mucus-secreting glands, the o surrounds the opening of the esophagus
esophageal glands proper, which lubricate ,
into the stomach
protect the mucosa facilitates smooth passage of
2. Fundus
food material (bolus)
o rounded portion superior to and to the
MUSCULARIS EXTERNA left of the cardia
3. Body
 Upper 3rd: Skeletal Muscle
o large central portion of the stomach
 Middle 3rd: Skeletal & Smooth Muscles
inferior to the fundus
 Lower 3rd: Smooth Muscle
4. Pyloric part
SEROSA/ADVENTITIA o Pyloric antrum, Pyloric canal, Pylorus
 only the distal 1-2 cm of the esophagus, in the o Pyloric sphincter
peritoneal cavity, is covered by serosa; the rest is *lesser curvature- concave
enclosed by adventitia medial border
*greater curvature- convex
UPPER ESOPHAGEAL SPHINCTER (UES) lateral border
 consists of skeletal muscle
 regulates the movement of food from the
pharynx into the esophagus

LOWER ESOPHAGEAL (CARDIAC) SPHINCTER

(LES)
 consists of smooth muscle
 regulates the movement of food from the
esophagus into the stomach
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DIGESTIVE SYSTEM

MUCOUS NECK CELLS  Mucus secretion (less

alkaline than that of the
surface epithelial mucous
cells)
 Round nuclei and apical
secretory granules
 Shorter than surface
mucous cells
PARIETAL (OXYNTIC)  Intrinsic factor production
CELLS  Hydrochloric acid (HCl)
secretion
FUNCTIONS OF THE STOMACH  Large round or pyramidal
1. Mixes saliva, food, and gastric juice from chime. cells
2. Serves as reservoir for food before release into  Highly acidophilic (stain
small intestine. pink)
 Central rounded nuclei
3. Secretes gastric juice, which contains HCI (kills
CHIEF (ZYMOGENIC)  Pepsinogen and gastric
bacteria and denatures proteins), pepsin (begins CELLS lipase secretion
the digestion of proteins), intrinsic factor (aids  Found in lower regions of
absorption of vitamin B12), and gastric lipase gastric glands
(aids digestion of triglycerides).  Basophilic (stain blue)
4. Secretes gastrin into blood. ENTEROENDOCRINE  Gastrin (released into
CELLS/G CELLS blood)
 Single cells (don’t form
clusters)
MUCOSA
 Epithelium PARIETAL CELLS AND CHIEF CELLS
o Simple columnar/surface mucous
epithelium/foveolar epithelium
o Gastric pits- formed by invaginations
of the surface epithelium
o Gastric glands-open into the base of
gastric pits
 Three types:
 Gastric glands
properprincipal glands
found in the
fundus/body-produce
gastric juice NOTE: IN THE CARDIA AND PYLORUS REGIONS
 Pyloric glands-mucus OF THE STOMACH, THE GLANDS LACK BOTH
secreting PARIETAL AND CHIEF CELLS.
 Cardiac glands-located
only within the cardia STOMACH

MUCOSA
 lamina propria-surrounds and supports the
gastric pits and glands
 muscularis mucosae - inner circular and an
outer longitudinal layer

MUSCULARIS EXTERNA
 three poorly defined layers of smooth muscle:
an outer longitudinal layer, a middle circular
layer, and an innermost oblique layer

SUBMUCOSA & SEROSA

 The mucosa and submucosa of the empty
stomach have large, longitudinally directed
folds called RUGAE, which flatten when the
GASTRIC GLAND CELLS stomach fills with food.

LAYERS OF THE STOMACH

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DIGESTIVE SYSTEM

FUNCTIONS OF THE SMALL INTESTINE

1. Segmentations mix chyme with digestive juices
and bring food into contact with mucosa for
absorption; peristalsis propels chyme through
SUMMARY OF DIGESTIVE ACTIVITIES IN THE small intestine.
MOUTH 2. Completes digestion of carbohydrates, proteins,
STRUCTURE ACTIVITY RESULT and lipids; begins and completes digestion of
Mucosa nucleic acids.
Surface mucous Secrete mucus Forms protective barrier that
cells and prevents digestion of
3. Absorbs about 90% of nutrients and water that
mucous neck stomach wall. pass through digestive system.
cells Absorption Small quantity of water,
ions, short-chain fatty acids, SURFACE MODIFICATIONS OF SMALL
and some drugs enter INTESTINE FOR ABSORPTION
bloodstream.
Parietal cells Secrete Needed for absorption of
intrinsic factor vitamin B12 (used in red 1. PLICAE CIRCULARES
blood cell formation, or  series of permanent circular or
erythropoiesis semilunar folds consisting of mucosa
Secrete Kills microbes in food:
hydrochloric denatures proteins; converts
and submucosa
acid pepsinogen into pepsin.  best developed in the jejunum where
Chief cells Secrete Pepsin (activated form) most absorption takes place
pepsinogen breaks down proteins into
peptides
Secrete gastric Splits triglycerides into fatty
lipase acids and monoglycerides
G cells Secrete gastrin Stimulates parietal cells to
secrete HCI and chief cells
to secrete pepsinogen;
contracts lower esophageal
sphincter; increase motility
of stomach, and relaxes
pyloric sphincter.
Muscularis Mixing waves Churns and physically
(gentle breaks down food and mixes 2. VILLI
peristaltic it with gastric juice, forming
movements) chime. Forces chime  permanent finger-like projections of
through pyloric sphincter. lamina propria of the mucosa that extend
Pyloric Opens to Regulates passage of chyme into the intestinal lumen
sphincter permit passage from stomach to duodenum;  covered by a simple columnar
of chyme into prevents backflow of chyme
duodenum. from duodenum to stomach. epithelium of absorptive cells called
enterocytes, with many interspersed
goblet cells

SMALL INTESTINE
MAIN FUNCTION: digestion of gastric contents and
absorption of nutrients

 longest section of the digestive tract

 consists of three segments:
o duodenum-shortest region
o jejunum
o ileum 3. MICROVILLI
 cytoplasmic extensions that cover the
apices of the intestinal absorptive cells
 brush border
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DIGESTIVE SYSTEM

SMALL INTESTINE: DUODENUM

(TRANSVERSE SECTION)
INTESTINAL GLANDS AND CELLS
 intestinal glands (crypts of Lieberkühn )
 Absorptive cells (Enterocytes)
o most common cells in the intestinal
epithelium
o tall and columnar with a prominent
brush border of microvilli
 Goblet cells
o secrete mucus to protect and lubricate
the lining
JEJUNUM
 Paneth cells
o located at the base of intestinal glands  longer than the duodenum
o secretes lysozyme and defensins thus  contains the largest surface area for the
absorption of the digested material
provide host defense against microbes
 villi are tall and lined with simple columnar
 Enteroendocrine cells
epithelium
o secrete numerous regulatory hormones
 more goblet cells in the epithelium
for the digestive system

SMALL INTESTINE: JEJUNUM(TRANSVERSE

SECTION)
LAYERS OF THE SMALL INTESTINE SHOWING
VILLI

REGIONAL DIFFERENCES IN SMALL
INTESTINE
DUODENUM
 shortest segment of the small intestine
 villi are broad, tall, and numerous, with fewer
goblet cells in the epithelium
 CHARACTERISTIC FEATURE OF THE
DUODENUM
o branched duodenal (Brunner) glands
with mucus -secreting cells in the
submucosa
ILEUM
 contains villi that are narrow and short
 epithelium containing more goblet cells
 increased numbers of lymphocytes in the lamina
propria
 aggregated lymphatic nodules (Peyer patches) in
the lamina propria and submucosa
SMALL INTESTINE: ILEUM WITH LYMPHATIC
NODULES (PEYER PATCHES) (TRANSVERSE
SECTION)
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o goblet cells more abundant

DIGESTIVE ACTIVITIES IN THE SMALL o absence of villi, plicae circularis
INTESTINE o Lamina propria
Small intestine Major site of digestion and absorption of o Muscularis mucosae
nutrients and water in gastrointestinal tract
Mucosa/submucosa  SUBMUCOSA
Intestinal glands Secrete intestinal juice to assist absorption.  MUSCULARIS EXTERNA
Absorptive cells Digest and absorb nutrients o inner circular muscle layer
Goblet cells Secrete mucus o outer muscle layer is condensed into
Enteroendocrine Secrete secretin, cholecystokinin, and
cells (S, CCK, K) glucose-dependent insulinotropic peptide three broad, longitudinal bands called
Paneth cells Secrete lysozyme (bacterial enzyme) and taeniae coli
phagocytosis  SEROSA-transverse and sigmoid colon
Duodenal Secrete alkaline fluid to buffer stomach o ADVENTITIAascending and
(Brunner’s) glands acids, and mucus for protection and
lubrication descending colon
Circular folds Folds of mucosa and submucosa that
increase surface area for digestion and
absorption
Villi Fingerlike projections of mucosa that are
sites of absorption of digested food and
increase surface area for digestion and LAYERS OF LARGE INTESTINE
absorption
Microvilli Microscopic, membrane-covered
projections of absorptive epithelial cells
that contain brush-border enzymes and that
increase surface area for digestion and
absorption
Muscularis
Segmentation Type of peristalsis: alternating contractions
of circular smooth muscle fibers that
produce segmentation and resegmentation
of sections of small intestine; mixes chyme
with digestive juices and brings food into
contact with mucosa for absorption
Migrating motility Type of peristalsis: waves of contraction LARGE INTESTINE: COLON WALL
complex (MMC) and relaxation of circular and longitudinal (TRANSVERSE SECTION)
smooth muscle fibers passing the length of
the small intestine; moves chyme toward
ileooecal sphincter

LARGE INTESTINE
MAIN FUNCTION: absorption of water and electrolytes

 consists of:
o cecum
o colon
 ascending - retroperitoneal
 transverse
 descending - retroperitoneal
 sigmoid colon
o rectum
o anus
 internal anal sphincter of
DIGESTIVE ACTIVITIES IN THE LARGE
smooth muscle
INTESTINE
 external anal sphincter of
skeletal muscle

 MUCOSA
o simple columnar epithelium DIFFERENCES BETWEEN SMALL AND LARGE
o crypts of Lieberkühn are deeper INTESTINES (COLON)
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DIGESTIVE SYSTEM

SMALL LARGE
INTESTINE INTESTINE
LENGTH ABOUT 5 m ABOUT 1.5 m
LONG LONG
CALIBER SMALLER LARGER
GOBLET PRESENT MORE
CELLS NUMEROUS
PLICAE PRESENT ABSENT
CIRCULARES
VILLI PRESENT ABSENT
TAENIA ABSENT PRESENT PANCREATIC JUICE
COLI

PANCREAS
FUNCTION: Delivers pancreatic juice into duodenum to
assist absorption

 retroperitoneal gland , lies posterior to the

greater curvature of the stomach
 consists of head, body and tail
ENZYMES IN PANCREATIC JUICE

 pancreatic duct or duct of Wirsung

o enters the duodenum as dilated common
duct called the AMPULLA of VATER
o sphincter of Oddi
 mass of smooth muscle that
regulates the passage of
pancreatic juice and bile through
the Ampulla of Vater into the
duodenum
 accessory duct or duct of Santorini
o leads from the pancreas and empties into
the duodenum superior to the Ampulla
of Vater
LIVER AND GALLBLADDER
LIVER
 heaviest gland of the body, weighing about 1.4
kg
 inferior to the diaphragm
 Blood supply: hepatic artery and hepatic portal
vein
GALLBLADDER
 pear-shaped sac located in a depression of the
posterior surface of the liver
 typically hangs from the anterior inferior margin
of the liver

 EXOCRINE PORTION
o acini
o cells secrete pancreatic juice
 ENDOCRINE PORTION
o pancreatic islets (islets of Langerhans) LIVER
o cells secrete the hormones glucagon, FUNCTION: Produces bile (bile salts)
insulin, somatostatin, and pancreatic
polypeptide
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DIGESTIVE SYSTEM

 divided into two principal lobes —a large right

lobe and a smaller left lobe —by the falciform
ligament LIVER
 ligamentum teres (round ligament)
o remnant of the umbilical vein of the
fetus located in the free border of the
falciform ligament
 right and left coronary ligaments
o narrow extensions of the parietal
peritoneum

 The hepatocytes, bile duct system, and hepatic

sinusoids can be organized into anatomical and
functional units in three different ways:

HISTOLOGY OF THE LIVER

1. Hepatocytes
o major functional cells of the liver
o secrete bile
2. Bile canaliculi
o small ducts between hepatocytes that
collect bile
o from here, bile passes into bile ductules
and then bile ducts
o bile ducts merge form the larger right
and left hepatic ducts, which unite and GALLBLADDER
exit the liver as the common hepatic FUNCTION: stores and concentrates bile
duct
o common hepatic duct joins the cystic  Fundus
duct from the gallbladder to form the  Body
common bile duct  Neck
3. Hepatic sinusoids
o blood capillaries between rows of HISTOLOGY OF THE GALLBLADDER
hepatocytes  consists of a mucosa composed of simple
o converge and deliver blood into a central columnar epithelium and lamina propria,
vein-hepatic veinsinferior vena cava muscularis with bundles of muscle fibers and an
o hepatic macrophages or Kupffer cells external adventitia or serosa
 nondistended state-shows temporary mucosal
folds
PORTAL TRIAD  does not contain a muscularis mucosae or
 bile duct submucosa
 branch of the hepatic artery
 branch of the hepatic vein

SUMMARY OF DIGESTIVE ACTIVITIES IN THE

PANCREAS, LIVER, GALLBLADDER, AND
SMALL INTESTINE
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