ANATOMY AND PHYSIOLOGY WITH PATHOPHYSIOLOGY LABORATORY BSMLS

DIGESTIVE SYSTEM

DIGESTIVE SYSTEM

MAJOR ORGANS
o mouth
o most of the pharynx
o esophagus
o stomach
o small intestine
o large intestine

MUCOSA
 Epithelium
o mouth, pharynx, esophagus, and
anal canal
 nonkeratinized stratified
squamous epithelium
o stomach and intestines
 simple columnar
epithelium

 Lamina propria
ACCESSORY ORGANS o areolar connective tissue
o teeth containing many blood and
o tongue lymphatic vessels
o salivary glands o contains the majority of the cells
o liver of the mucosa associated
o gallbladder lymphatic tissue (MALT)
o pancreas
 Muscularis mucosae
FUNCTIONS o thin layer of smooth muscle fibers
1. Ingestion: taking food into mouth.
2. Secretion: release of water, acid, buffers, SUBMUCOSA
and enzymes into lumen of GI tract.  consists of areolar connective tissue that
3. Mixing and repulsion: churning and binds the mucosa to the muscularis
movement of food through GI tract.  contains many blood and lymphatic
4. Digestion: mechanical and chemical vessels
breakdown of food.  extensive network of neurons known as
5. Absorption: passage of digested the submucosal plexus (Meissner’s
products from GI tract into blood and plexus)
lymph. o controls the secretions of the
6. Defecation: elimination of feces from GI organs of the GI tract
tract.
MUSCULARIS
GENERAL STRUCTURE OF THE DIGESTIVE TRACT  mouth, pharynx, and superior and
middle parts of the esophagus
LAYERS OF THE GASTROINTESTINAL TRACT 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
ANATOMY AND PHYSIOLOGY WITH PATHOPHYSIOLOGY LABORATORY BSMLS
DIGESTIVE SYSTEM

SUBMUCOSAL PLEXUS (MEISSNER’S PLEXUS) the nasopharynx and preventing

swallowed foods and liquids from
entering the nasal cavity.

AUERBACH (MYENTERIC PLEXUS)

MAJOR SALIVARY GLANDS

 parotid glands
o inferior and anterior to the ears,
between the skin and the
masseter muscle
 submandibular glands
SEROSA/ ADVENTITIA o found in the floor of the mouth;
 Serosa they are medial and partly inferior
o serous membrane composed of to the body of the mandible
areolar connective tissue and  sublingual glands
simple squamous epithelium o beneath the tongue and superior
(mesothelium) to the submandibular glands
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
Small Intestine Visceral Peritoneum
Large Intestine Visceral Peritoneum
Anus Adventitia
COMPOSITION AND FUNCTIONS OF SALIVA
MOUTH (ORAL CAVITY)  99.5% water
 formed by the cheeks, hard and soft  0.5% solutes
palates, and tongue o ions
o lysozyme
o amylase
 enzyme that acts on starch
 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
WHAT IS THE FUNCTION OF THE UVULA? o contain mostly mucous cells, so
UVULA they secrete a much thicker fluid
 fingerlike muscular structure hanging that contributes only a small
from the free border of the soft palate amount of salivary amylase
 During swallowing, the soft palate and
uvula are drawn superiorly, closing off
ANATOMY AND PHYSIOLOGY WITH PATHOPHYSIOLOGY LABORATORY BSMLS
DIGESTIVE SYSTEM

TONGUE o
 accessory digestive organ composed of
skeletal muscle
 extrinsic muscles of the tongue
o Hyoglossus
o Genioglossus
o Styloglossus

TEETH
 accessory digestive organs located in
 longitudinalis superior sockets of the alveolar processes of the
 longitudinalis inferior mandible and maxillae
 transversus linguae  major external regions:
 verticalis linguae o crown- visible portion above the
 consists of connective tissue and level of the gums
interlacing bundles of skeletal muscle o root -embedded in the socket
fibers o neck -constricted junction of the
 Sulcus terminalis-V-shaped depression crown and root near the gum line
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
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

 Without taste buds

o Filiform papillae
 With taste buds
o Fungiform papillae
o Circumvallate papillae
o Foliate papillae
ANATOMY AND PHYSIOLOGY WITH PATHOPHYSIOLOGY LABORATORY BSMLS
DIGESTIVE SYSTEM

DECIDUOUS TEETH CHEMICAL DIGESTION

 primary teeth, milk teeth, or baby teeth  salivary amylase
 begin to erupt at about 6 months of age o breaks down starch
 two teeth appear each month  lingual lipase
thereafter, until all 20 are present o breaks down dietary triglycerides
 incisors -chisel -shaped for cutting into (fats and oils)
food
 canines - used to tear and shred food SUMMARY OF DIGESTIVE ACTIVITIES IN THE
 first and second deciduous molars -crush MOUTH
and grind food to prepare it for
swallowing STRUCTURE ACTIVITY RESULT
 lost between ages 6 and 12 years Cheeks and lips Keep food Foods uniformly
between chewed during
 replaced by the PERMANENT teeth. mastication.
(SECONDARY) TEETH Salivary glands Secrete Lining of mouth and
saliva. 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 Food maneuvered
muscles tongue from for mastication,
side to side shaped into bolus,
PERMANENT (SECONDARY) TEETH and in and and maneuvered for
 32 teeth that erupt between age 6 and out. swallowing.
adulthood Intrinsic tongue Alter shape Swallowing and
 pattern resembles the deciduous muscle of tongue. speech.
Taste buds Serve as Secretion of saliva
dentition, with exceptions: receptors stimulated by nerve
o deciduous molars are replaced for gustation impulses from taste
by the first and second premolars (taste) and buds to salivatory
o first, second and third permanent presence of nuclei in brain stem
molars (wisdom teeth) do not food in to salivary glands.
mouth.
replace any deciduous teeth Lingual glands Secrete Triglycerides broken
lingual down into fatty acids
lipase. and diglycerides.
Teeth Cut, tear, Solid foods reduced
and to smaller particles
pulverize for swallowing.
food.

PHARYNX
 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
MECHANICAL AND CHEMICAL DIGESTION IN respiratory functions
THE MOUTH o muscular contractions of these
areas help propel food into the
MECHANICAL DIGESTION esophagus and then into the
 results from chewing, or mastication stomach
 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
ANATOMY AND PHYSIOLOGY WITH PATHOPHYSIOLOGY LABORATORY
DIGESTIVE SYSTEM
ESOPHAGUS MAJOR FUNCTION: to convey
liquids or chewed food (bolus) from the oral
cavity to the stomach
 muscular tube, about 25 cm (10 in.) long,
that lies posterior to the trachea
 pierces the diaphragm through an
opening called the esophageal hiatus
 ends in the superior portion of the
stomach
BSMLS
ESOPHAGUS
MUCOSA
 Epithelium
 nonkeratinized stratified
squamous epithelium
 Lamina propria
 Muscularis mucosae
SUBMUCOSA
 contains small mucus-secreting glands,
the esophageal glands proper, which
lubricate , protect the mucosa facilitates
smooth passage of food material (bolus)
MUSCULARIS EXTERNA
 Upper 3rd: Skeletal Muscle
 Middle 3rd: Skeletal & Smooth Muscles
 Lower 3rd: Smooth Muscle
SEROSA/ADVENTITIA
 only the distal 1-2 cm of the esophagus,
in the peritoneal cavity, is covered by
serosa; the rest is enclosed by adventitia
UPPER ESOPHAGEAL SPHINCTER (UES)
 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
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
ANATOMY AND PHYSIOLOGY WITH PATHOPHYSIOLOGY LABORATORY BSMLS
DIGESTIVE SYSTEM

FUNCTIONS OF THE STOMACH

1. Mixes saliva, food, and gastric juice from
chime.
2. Serves as reservoir for food before
release into small intestine.
3. Secretes gastric juice, which contains
HCI (kills bacteria and denatures
proteins), pepsin (begins the digestion of
proteins), intrinsic factor (aids absorption
of vitamin B12), and gastric lipase (aids
digestion of triglycerides).
4. Secretes gastrin into blood.

Main regions: MUCOSA

1. Cardia  Epithelium
o surrounds the opening of the o Simple columnar/surface mucous
esophagus into the stomach epithelium/foveolar epithelium
2. Fundus o Gastric pits- formed by
o rounded portion superior to and invaginations of the surface
to the left of the cardia epithelium
3. Body o Gastric glands-open into the base
o large central portion of the of gastric pits
stomach inferior to the fundus  Three types:
4. Pyloric part  Gastric glands
o Pyloric antrum, Pyloric canal, properprincipal
Pylorus glands found in the
o Pyloric sphincter fundus/body-
*lesser curvature- concave produce gastric
medial border juice
*greater curvature- convex  Pyloric glands-
lateral border mucus secreting
 Cardiac glands-
located only within
the cardia

GASTRIC GLAND CELLS

ANATOMY AND PHYSIOLOGY WITH PATHOPHYSIOLOGY LABORATORY BSMLS
DIGESTIVE SYSTEM

MUCOUS NECK CELLS  Mucus secretion (less RUGAE, which flatten when the stomach
alkaline than that of fills with food.
the surface epithelial
mucous cells)
 Round nuclei and LAYERS OF THE STOMACH
apical secretory
granules
 Shorter than surface
mucous cells
PARIETAL (OXYNTIC) CELLS  Intrinsic factor
production
 Hydrochloric acid
(HCl) secretion
 Large round or
pyramidal cells
 Highly acidophilic
(stain pink)
 Central rounded
nuclei
CHIEF (ZYMOGENIC) CELLS  Pepsinogen and
gastric lipase
secretion SUMMARY OF DIGESTIVE ACTIVITIES IN THE
 Found in lower regions MOUTH
of gastric glands STRUCTURE ACTIVITY RESULT
 Basophilic (stain blue) Mucosa
ENTEROENDOCRINE  Gastrin (released into Surface Secrete Forms protective barrier
CELLS/G CELLS blood) mucous cells mucus that prevents digestion
 Single cells (don’t form and mucous of stomach wall.
clusters) neck cells Absorption Small quantity of water,
ions, short-chain fatty
PARIETAL CELLS AND CHIEF CELLS acids, and some drugs
enter bloodstream.
Parietal cells Secrete Needed for absorption
intrinsic of vitamin B12 (used in
factor red blood cell
formation, or
erythropoiesis
Secrete Kills microbes in food:
hydrochloric denatures proteins;
acid converts pepsinogen
into pepsin.
Chief cells Secrete Pepsin (activated form)
pepsinogen breaks down proteins
into peptides
Secrete Splits triglycerides into
NOTE: IN THE CARDIA AND PYLORUS REGIONS gastric fatty acids and
OF THE STOMACH, THE GLANDS LACK BOTH lipase monoglycerides
PARIETAL AND CHIEF CELLS. G cells Secrete Stimulates parietal cells
gastrin to secrete HCI and chief
cells to secrete
STOMACH pepsinogen; contracts
lower esophageal
MUCOSA sphincter; increase
 lamina propria-surrounds and supports motility of stomach, and
relaxes pyloric
the gastric pits and glands
sphincter.
 muscularis mucosae - inner circular and Muscularis Mixing Churns and physically
an outer longitudinal layer waves breaks down food and
(gentle mixes it with gastric
MUSCULARIS EXTERNA peristaltic juice, forming chime.
movements) Forces chime through
 three poorly defined layers of smooth
pyloric sphincter.
muscle: an outer longitudinal layer, a Pyloric Opens to Regulates passage of
middle circular layer, and an innermost sphincter permit chyme from stomach to
oblique layer passage of duodenum; prevents
chyme into backflow of chyme
duodenum. from duodenum to
SUBMUCOSA & SEROSA stomach.
 The mucosa and submucosa of the
empty stomach have large,
longitudinally directed folds called
ANATOMY AND PHYSIOLOGY WITH PATHOPHYSIOLOGY LABORATORY BSMLS
DIGESTIVE SYSTEM

SMALL INTESTINE  covered by a simple columnar

MAIN FUNCTION: digestion of gastric contents epithelium of absorptive cells
and absorption of nutrients called enterocytes, with many
interspersed goblet cells
 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

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 small intestine.
2. Completes digestion of carbohydrates,
proteins, and lipids; begins and
completes digestion of nucleic acids.
3. Absorbs about 90% of nutrients and INTESTINAL GLANDS AND CELLS
water that pass through digestive system.  intestinal glands (crypts of Lieberkühn )
 Absorptive cells (Enterocytes)
SURFACE MODIFICATIONS OF SMALL INTESTINE o most common cells in the
FOR ABSORPTION intestinal epithelium
o tall and columnar with a
1. PLICAE CIRCULARES prominent brush border of
 series of permanent circular or microvilli
semilunar folds consisting of  Goblet cells
mucosa and submucosa o secrete mucus to protect and
 best developed in the jejunum lubricate the lining
where most absorption takes  Paneth cells
place o located at the base of intestinal
glands
o secretes lysozyme and defensins
thus provide host defense against
microbes
 Enteroendocrine cells
o secrete numerous regulatory
hormones for the digestive system

2. VILLI
 permanent finger-like projections
of lamina propria of the mucosa
that extend into the intestinal
lumen
ANATOMY AND PHYSIOLOGY WITH PATHOPHYSIOLOGY LABORATORY BSMLS
DIGESTIVE SYSTEM

LAYERS OF THE SMALL INTESTINE SHOWING VILLI SMALL INTESTINE: JEJUNUM(TRANSVERSE

SECTION)

REGIONAL DIFFERENCES IN SMALL INTESTINE ILEUM

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

SMALL INTESTINE: DUODENUM (TRANSVERSE

SECTION)
JEJUNUM
 longer than the duodenum
 contains the largest surface area for the
absorption of the digested material
 villi are tall and lined with simple
columnar epithelium
 more goblet cells in the epithelium
DIGESTIVE ACTIVITIES IN THE SMALL INTESTINE
Small intestine Major site of digestion and
absorption of nutrients and water in
gastrointestinal tract
Mucosa/submucosa
Intestinal glands Secrete intestinal juice to assist
absorption.
Absorptive cells Digest and absorb nutrients
Goblet cells Secrete mucus
Enteroendocrine Secrete secretin, cholecystokinin,
cells (S, CCK, K) and glucose-dependent
insulinotropic peptide
Paneth cells Secrete lysozyme (bacterial
enzyme) and phagocytosis
Duodenal Secrete alkaline fluid to buffer
(Brunner’s) stomach acids, and mucus for
glands protection and lubrication
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 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
ANATOMY AND PHYSIOLOGY WITH PATHOPHYSIOLOGY LABORATORY BSMLS
DIGESTIVE SYSTEM

Segmentation Type of peristalsis: alternating LAYERS OF LARGE INTESTINE

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
complex (MMC) contraction and relaxation of
circular and longitudinal smooth
muscle fibers passing the length of
the small intestine; moves chyme
toward ileooecal sphincter

LARGE INTESTINE: COLON WALL (TRANSVERSE

LARGE INTESTINE
SECTION)
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
smooth muscle
 external anal sphincter of
skeletal muscle
DIGESTIVE ACTIVITIES IN THE LARGE INTESTINE

 MUCOSA
o simple columnar epithelium
o crypts of Lieberkühn are deeper
o goblet cells more abundant
DIFFERENCES BETWEEN SMALL AND LARGE
o absence of villi, plicae circularis
INTESTINES (COLON)
o Lamina propria
SMALL LARGE
o Muscularis mucosae
INTESTINE INTESTINE
 SUBMUCOSA
LENGTH ABOUT 5 m ABOUT 1.5 m
 MUSCULARIS EXTERNA
LONG LONG
o inner circular muscle layer
CALIBER SMALLER LARGER
o outer muscle layer is condensed
GOBLET CELLS PRESENT MORE
into three broad, longitudinal
NUMEROUS
bands called taeniae coli
 SEROSA-transverse and sigmoid colon PLICAE PRESENT ABSENT
o ADVENTITIAascending and CIRCULARES
descending colon VILLI PRESENT ABSENT
TAENIA COLI ABSENT PRESENT
ANATOMY AND PHYSIOLOGY WITH PATHOPHYSIOLOGY LABORATORY BSMLS
DIGESTIVE SYSTEM

PANCREAS PANCREATIC JUICE

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 LIVER AND GALLBLADDER
 accessory duct or duct of Santorini LIVER
o leads from the pancreas and  heaviest gland of the body, weighing
empties into the duodenum about 1.4 kg
superior to the Ampulla of Vater  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)
o cells secrete the hormones
glucagon, insulin, somatostatin,
and pancreatic polypeptide
LIVER
FUNCTION: Produces bile (bile salts)

 divided into two principal lobes —a large

right lobe and a smaller left lobe —by the
falciform ligament
 ligamentum teres (round ligament)
o remnant of the umbilical vein of
the fetus located in the free
border of the falciform ligament
ANATOMY AND PHYSIOLOGY WITH PATHOPHYSIOLOGY LABORATORY BSMLS
DIGESTIVE SYSTEM

 right and left coronary ligaments LIVER

o narrow extensions of the parietal
peritoneum

 The hepatocytes, bile duct system, and

HISTOLOGY OF THE LIVER hepatic sinusoids can be organized into
1. Hepatocytes anatomical and functional units in three
o major functional cells of the liver different ways:
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 exit the liver as the
common hepatic duct
o common hepatic duct joins the
cystic duct from the gallbladder
to form the common bile duct
3. Hepatic sinusoids
o blood capillaries between rows of GALLBLADDER
hepatocytes FUNCTION: stores and concentrates bile
o converge and deliver blood into a
central vein-hepatic veinsinferior  Fundus
vena cava  Body
o hepatic macrophages or Kupffer  Neck
cells
HISTOLOGY OF THE GALLBLADDER
 consists of a mucosa composed of
PORTAL TRIAD simple columnar epithelium and lamina
 bile duct propria, muscularis with bundles of
 branch of the hepatic artery muscle fibers and an external adventitia
 branch of the hepatic vein or serosa
 nondistended state-shows temporary
mucosal folds
 does not contain a muscularis mucosae
or submucosa
ANATOMY AND PHYSIOLOGY WITH PATHOPHYSIOLOGY LABORATORY BSMLS
DIGESTIVE SYSTEM

SUMMARY OF DIGESTIVE ACTIVITIES IN THE

PANCREAS, LIVER, GALLBLADDER, AND SMALL
INTESTINE