NUR112: ANATOMY AND PHYSIOLOGY
ISU Echague – College of Nursing
Module 8
Digestive System.
Overview
Humans are heterotrophic organisms, meaning they don’t have the ability to create their
foods unlike the plants which takes foods from sunlight. Hence, humans needs to acquire these food
products from the environment. These food products are the sources of energy for metablolism,
antioxidants and vitamins that cleanses the body from toxins, and macronutrients that helps the
body to undergo growth and repair. This complex mechanism will be the topic of this module.
Course Objectives
At the end of this module, you are expected to
1. Identify the structure and function of the digestive system and its accessory organs
2. Trace the events in the digestion of fats, proteins and carbohydrates in the different
segments of the digestive tract
3. Enumerate factors that may affect the rate of digestion of nutrients
Course Contents
The Digestive System
There are two groups of organs within the digestive system.
The digestive tract or gastrointestinal (GI) tract is a
muscular tube that winds through the body and is
responsible for the digestion and absorption of food. The
organs includes oral cavity, pharynx, esophagus, stomach,
small intestine, large intestine, and anus. The accessory
digestive organs aid in the breakdown of foodstuffs. These
includes the teeth, tongue, gallbladder, salivary glands, liver,
and pancreas. These organs works together to succeed in
ingestion, breakdown of food and absorption of nutrients
and eliminate waste products.
Histology of the Digestive Tract
The digestive tract is made of four major tunics or layers. These tunics secretes mucous that helps in
lubrication of the digestive tract and protects the digestive tract as well. They also help absorb the
end product of digestion. Stomach and small intestine mucosa contain enzyme rich secreting cells
and hormone secreting cells.
The digestive tract is composed of four tunics: mucosa, submucosa, muscularis, and serosa
or adventitia. The mucosa is the innermost layer that lines the lumen of the alimentary canal abnd
consists of a mucous epithelium, a lamina propria, and a muscularis mucosae. The Submucosa is a
Connective tissue layer containing the submucosal plexus (part of the enteric plexus), blood vessels,
and small glands. The Muscularis Consists of an inner layer of circular smooth muscle and an outer
layer of longitudinal smooth muscle. These muscles allows and facilitates movement of food
products along the GI tract. The myenteric plexus is between the two muscle layers. Myenteric
plexus is the source of innervation of the muscles and clands of the digestive tract. Serosa or
adventitia. Forms the outermost layer of the digestive tract
64
NUR112: ANATOMY AND PHYSIOLOGY
ISU Echague – College of Nursing
The Enteric Nervous System
The Enteric Nervous System Consists of
nerve plexuses within the wall of the digestive
tract. It Serves the digestive tract and regulates
digestive activity. It is composed of two major
intrinsic nerve plexuses. The Submucosal nerve
plexus regulates glands and smooth muscle in
the mucosa and the Myenteric nerve plexus is
the major nerve supply that controls GI tract
mobility.
Three major types of enteric neurons
Are Sensory neurons which detect changes in the
chemical composition of the digestive tract,
Motor neurons stimulate or inhibit smooth
muscle contraction and glandular secretion and Interneurons which connect sensory to motor
neurons. The Nervous regulation involves local reflexes in the ENS and CNS reflexes.
The Peritonium
The peritoneum is a serous membrane that lines the abdominopelvic cavity and organs. It is
made of two layers known as parietal peritoneum and visceral peritoneum. Mesenteries are
peritoneum that extend from the body wall to many of the abdominopelvic organs. These
mesenteries houses the abdominal organs and blood vessels that drain and supply the intestines.
Retroperitoneal organs are located behind the peritoneum
The Oral Cavity
The Oral cavity or mouth Is bounded by
lips, cheeks, palate, and tongue. It has the oral
orifice as its anterior opening. It is continuous
with the oropharynx posteriorly. The oral cavity
is Divided into two regions, the Vestibule, space
between the lips or cheeks and the alveolar
processes, which contain the teeth and the Oral
Cavity Proper which lies medial to the alveolar
processes. To withstand abrasions the mouth is
lined with stratified squamous epithelium.
The lips and cheeks are involved in
facial expression, mastication, and speech. The
Palate Forms the roof of the mouth. Consists of
hard and soft areas. The Hard palate assists the
tongue in chewing while the Soft palate is a
mobile organe fold formed mostly of skeletal
muscle. Projecting from the soft palate is the
uvula. It closes off the nasopharynx during
swallowing. The mouth contains accessory
glands (salivary glands) and accessory organs (teeth and tongue) which begin the digestive process.
The Tongue Occupies the floor of the mouth and fills the oral cavity when mouth is closed
Functions include gripping and repositioning food during chewing, mixing food with saliva and
forming the bolus and initiation of swallowing, and speech. The lingual frenulum secures the tongue
to the floor of the mouth.
65
NUR112: ANATOMY AND PHYSIOLOGY
ISU Echague – College of Nursing
The Teeth Tear and grind food.
Humans are born with 20 deciduous teeth
which erupt between about 6 months and
24 months of age. The deciduous teeth are
replaced by 32 permanent teeth.
Replacement starts at about 5 years and
the process is complete by about 11 years.
The types of teeth are Incisors used for
cutting, Canines used for tearing,
Premolars and Molars both are used for
grinding foods. A tooth consists of a
crown, a neck, and a root. The Crown is
the exposed part of the tooth above the
gingiva. It is made of Dentin covered by enamel. Enamel is an acellular material composed of calcium
salts and hydroxyapatite crystals; the hardest substance in the body. The root is the Portion of the
tooth embedded in the jawbone. It is composed of dentin. Within the dentin of the root is the pulp
cavity, which is filled with pulp, blood vessels, and nerves. Periodontal ligaments hold the teeth in
the alveoli.
The Salivary glands Produce and secrete
saliva that Cleanses the mouth, Moistens and
dissolves food chemicals, Aids in bolus formation,
Contains enzymes that break down starch.
Salivary glands produce serous and mucous
secretions. The three pairs of large salivary glands
are the parotid, submandibular, and sublingual.
The salivary glands produce approximately 1 liter
of saliva/day. They are secreted from serous and
mucous cells of salivary glands. Serous saliva is
made of enzymes, ions, and mucin. Mucous
glandsproduce mucous. Approximately 97-99.5%
water and slightly acidic solution containing
Electrolytes, Digestive enzyme: salivary amylase,
proteins: mucin, lysozyme, defensins, and IgA,
and metabolic wastes: urea and uric acid
The Primarily by the parasympathetic division of the autonomic nervous system. Salivary
glands secrete serous, enzyme-rich saliva in response to Ingested food which stimulates
chemoreceptors and pressoreceptors, the thought of food. A strong sympathetic stimulation inhibits
salivation and results in dry mouth
The Pharynx Consists of the nasopharynx, oropharynx, and laryngopharynx. It ensures that
Food and fluids to the esophagus and Air to the trachea. If food enters the trachea, it is called
aspiration and this is a medical emergency.
The Esophagus Connects the pharynx to the stomach The upper and lower esophageal
sphincters regulate movement. Mucous glands produce a lubricating mucus. Swallowing is the
process of moving food from the pharynx to the esophagus. During the voluntary phase of
swallowing, a bolus of food is moved by the tongue from the oral cavity to the pharynx. The
pharyngeal phase is a reflex caused by the stimulation of stretch receptors in the pharynx. The soft
palate closes the nasopharynx, and the epiglottis, vestibular folds, and vocal folds close the opening
into the larynx. Pharyngeal muscles move the bolus to the esophagus. The esophageal phase is a
reflex initiated by the stimulation of stretch receptors in the esophagus. A wave of contraction
66
NUR112: ANATOMY AND PHYSIOLOGY
ISU Echague – College of Nursing
(peristalsis) moves the food to the stomach. The wavelike movement of food materials down the
esophagus is known as Peristalsis
The Stomach
The stomach is a temporary “storage tank” where chemical breakdown of proteins begins and food
is converted from a bolus to chyme. The openings of the stomach are the Gastroesophageal opening
to the esophagus and Pyloric orifice to the duodenum. The major regions are the Cardiac part,
Fundus, Body and Pyloric part which is continuous with the duodenum through the pyloric sphincter.
The lateral sides of the stomach consist of greater and lesser curvatures. The wall of the stomach
consists of External serosa, muscle layer (longitudinal, circular, and oblique), Submucosa and Simple
columnar epithelium. Surface mucous cells are abundant which produce an alkaline mucous with
bicarbonate, which coats and protects the stomach lining. An empty stomach has a volume of 50 mL
but can hold about a gallon of food. When empty one can see the folds called rugae (submucosa and
mucosa)
There are gastric pits with glands that
produce juice. Glands include four secretory
cells. Mucous neck secrete acid mucus,
Parietal cells secrete HCl and intrinsic factor,
and Chief cells produce pepsinogen.
Pepsinogen is activated to pepsin by HCl in the
stomach and Pepsin itself via a positive
feedback mechanism. Endocrine cells in the
stomach produce regulatory hormones like
Gastrin, histamine, endorphins, serotonin,
cholecystokinin (CCK), and somatostatin into
the lamina propria.
Chyme is ingested food mixed with gastric
juice. Gastric juice includes mucus protects the
stomach lining, Pepsinogen is converted to
pepsin, which digests proteins. Hydrochloric
acid promotes pepsin activity and kills
microorganisms. Intrinsic factor is necessary
67
NUR112: ANATOMY AND PHYSIOLOGY
ISU Echague – College of Nursing
for vitamin B12 absorption and Gastrin and histamine regulate stomach secretions. A proton pump
(H+-K+ exchange pump) moves H+ out of parietal cells
There are three phases of stomach secretion. The Cephalic phase is Initiated by the sight, smell,
taste, or thought of food. Nerve impulses from the medulla stimulate hydrochloric acid, pepsinogen,
gastrin, and histamine secretion. During the Gastric phase, this is initiated by distention of the
stomach, which stimulates gastrin secretion and activates CNS and local reflexes that promote
secretion. The Gastrointestinal phase happens when Acidic chyme, which enters the duodenum and
stimulates neuronal reflexes and the secretion of hormones (secretin, cholecystokinin) that inhibit
gastric secretions.
Waves mix the stomach contents with stomach secretions to form chyme . Peristaltic waves
move the chyme into the duodenum. Hunger contractions and Vomiting are also typical movements.
The stomach contractions are so strong because its muscle layer is made of three layers.
The Small Instestine
The small intestine is the body’s major
digestive organ. This is where Digestion is
completed and absorption occurs. It runs from
pyloric sphincter to the ileocecal valve. The
small intestine has Has three subdivisions. The
duodenum approximately 10” long. The bile
and pancreatic ducts empty here. The jejunum
which is approximately 8’ long and the Ileum
which is approximately 12’ long. There are
Structural modifications of the small intestine
wall increase surface area about 600-fold. The
Circular folds are Deep folds of the mucosa and
submucosa. The Villi are Fingerlike extensions
of the mucosa. The Microvilli are tiny
projections of absorptive mucosal cells’ plasma
membranes. This forms a brush border. The
epithelium of the mucosa is simple columnar
epithelium. Between the villi the mucosa contains pits called intestinal glands
The epithelium of the mucosa is made up of bbsorptive cells and Produce digestive enzymes.
Goblet cells produce a protective mucus, Granular cells (Paneth cells) Protect the intestinal
epithelium form bacteria and Endocrine cells which Produce regulatory hormones. Peyer’s patches
(aggregated lymphoid follicles) are found in the submucosa.
The small intestines produces mucus which protects against digestive enzymes and gastric acids.
Digestive enzymes (disaccharidases and peptidases) are bound to the intestinal wall. Chemical or
tactile irritation, vagal stimulation, and secretin stimulate intestinal secretion.
The small intestines moves the food products for better absorption. Segmental contractions mix
intestinal contents. Peristaltic contractions move materials distally. Distension of the intestinal wall,
local reflexes, and the parasympathetic nervous system stimulate contractions. Distension of the
cecum initiates a reflex that stimulates contraction of the ileocecal sphincter.
The Liver
The liver has four external lobes: right, left, caudate, and quadrate. Internally, the liver is divided
into eight segments. Liver segments are divided into lobules. The Hexagonal-shaped liver lobules are
the structural and functional units of the liver. Composed of hepatocyte (liver cell) plates radiating
outward from a central vein. Portal triads are found at each of the six corners of each liver lobule.
68
NUR112: ANATOMY AND PHYSIOLOGY
ISU Echague – College of Nursing
Portal triads consist of Hepatic duct which
conduct bile toward the duodenum, Hepatic
artery: supplies oxygen-rich blood to the liver,
Hepatic portal vein which carries venous blood
with nutrients from digestive viscera, and the
hepatic cords are composed of columns of
hepatocytes separated by the bile canaliculi.
Sinusoids are enlarged spaces filled with blood
and lined with endothelium and hepatic
phagocytic cells. Kupffer cells are hepatic
macrophages found in liver sinusoids
The liver produces bile, which contains bile
salts that emulsify fats, stores and processes
nutrients, produces new molecules, and
detoxifies molecules, Hepatic phagocytic cells
phagocytize red blood cells, bacteria, and other debris and Produces blood components
The liver is very rich in blood supply. Blood coming from the intestines and blood coming from
the aorta goes to the liver. Branches of the hepatic artery and the hepatic portal vein in the portal
triads empty into hepatic sinusoids. Hepatic sinusoids empty into central veins, which join to form
the hepatic veins, which leave the liver
Bile is an important component in the digestion of fats. It emulsifies fat globules so that it can be
easily acted upon by the digestive enzyme lipase. Bile canaliculi collect bile from hepatocytes and
join the small hepatic ducts in the portal triads. Small hepatic ducts converge to form the right and
left hepatic ducts, which exit the liver. The left and right hepatic ducts join to form the common
hepatic duct. The cystic duct from the gallbladder joins the common hepatic duct to form the
common bile duct. The common bile duct and pancreatic duct join at the hepatopancreatic ampulla,
which opens into the duodenum at the major duodenal papilla .
The Gall Bladder is a small sac on the inferior surface of the liver. It stores and concentrates bile.
Bile is a yellow-green, alkaline solution containing bile salts, bile pigments, cholesterol, neutral fats,
phospholipids, and electrolytes. Bile salts are cholesterol derivatives that Emulsify fat, Facilitate fat
and cholesterol absorption, and helps make cholesterol soluble. The Enterohepatic circulation
recycles bile salts therefore they are never voided in the feces. The chief bile pigment is bilirubin, a
waste product of heme. Bilirubin is metabolized by bacteria in the small intestines and urobilogen is
produced, which gives feces its dark color
69
NUR112: ANATOMY AND PHYSIOLOGY
ISU Echague – College of Nursing
Bile secretion is regulated by various mechanisms. Acidic, fatty chyme causes the duodenum
to release Cholecystokinin (CCK) and secretin into the bloodstream. Cholecystokinin causes the
gallbladder to contract and releases bile and relaxation of the sphincters of the bile duct and
hepatopancreatic ampulla. Secretin increases bile secretion (water and bicarbonate ions) as a result,
bile enters the duodenum. Bile salts and secretin transported in blood stimulate the liver to produce
bile. Vagal stimulation causes weak contractions of the gallbladder
The Pancreas
The pancreas lies deep to the
greater curvature of the stomach. The head
is encircled by the duodenum and the tail
sits against the spleen. The pancreas has an
Exocrine function. It secretes pancreatic
juice which breaks down all categories of
foodstuff. The pancreas is divided into
lobules that contain acini. Acini are clusters
of secretory cells that contain zymogen
granules with digestive enzymes. It is
connected to a duct system that eventually
forms the pancreatic duct. The pancreatic
duct joins the hepatopancreatic ampulla.
The accessory pancreatic duct empties into
the duodenum at the minor duodenal
papilla. The pancreas also has an endocrine
function. The islets of Langerhans release of
insulin and glucagon.
Pancreatic secretions includes aqueous component of pancreatic juice is produced by the
small pancreatic ducts and contains bicarbonate ions. These are water solution of enzymes and
electrolytes (primarily HCO3–) that neutralizes acidic chyme and provides optimal environment for
pancreatic enzymes. The enzymatic component of pancreatic juice is produced by the acini and
contains enzymes that digest carbohydrates, lipids, and proteins. The Enzymes are released in
inactive form and activated in the duodenum.
The Large Intestines
The large intestines extends from the ileocecal valve to the anus. It absorbs water and
eliminate the waste via feces. Is subdivided into the
cecum, appendix, colon, rectum, and anal canal.
The cecum forms a blind sac at the junction of the
small and large intestines. The vermiform appendix
is a blind tube off the cecum. The colon has distinct
regions: ascending colon, transverse colon,
descending colon, and sigmoid colonThe sigmoid
colon joins the rectum. The anal canal, the last
segment of the large intestine, opens to the
exterior at the anus.The anal canal contains two
sphincters to allow the movement of feces. There
are three unique features. The Teniae coli are
three bands of longitudinal smooth muscle in its
muscularis. The Haustra are pocketlike sacs caused
by the tone of the teniae coli. Some Epiploic
70
NUR112: ANATOMY AND PHYSIOLOGY
ISU Echague – College of Nursing
appendages, fat-filled pouches of visceral peritoneum. The mucosal lining of the large intestine is
simple columnar epithelium with mucus-producing crypts
The Large intestine secretion includes mucus protects the intestinal lining. The bacterial flora of
the large intestine consist of bacteria surviving the small intestine that enter the cecum and those
entering via the anus. These bacteria Colonize the colon, ferment indigestible carbohydrates, release
irritating acids and gases (flatus), synthesize B complex vitamins and vitamin K and constitute about
30% of the dry weight of the feces.
Large intestinal contents moves its contents until it is evacuated. The Haustra mix the contents
and moves them slowly toward the anus. Mass movements are strong peristaltic contractions that
occur three or four times a day. Defecation is the elimination of feces. The Distension of rectal walls
caused by feces stimulates contraction of the rectal walls and relaxes the internal anal sphincter.
Reflex activity moves feces through the internal anal sphincter. Voluntary activity regulates
movement through the external anal sphincter .
Digestion, Absorption and Transport.
Digestion (mechanical and chemical) is the breakdown of organic molecules into their
component parts. Chemical digestion is the breaking of covalent chemical bonds in organic
molecules by digestive enzymes. Absorption is the uptake of digestive tract contents. Transport is
the distribution of nutrients throughout the body
Carbohydrate digestion begins in mouth with salivary amylase digesting starches and
pancreatic amylase finishes the process in the small intestine. Simple sugars are also broken down
here. Carbohydrates Include starches, glycogen, sucrose, lactose, glucose, and fructose.
Polysaccharides are broken down into monosaccharides by a number of different enzymes.
Monosaccharides are taken up by intestinal epithelial cells by symport that is powered by a Na +
gradient or by facilitated diffusion. They are carried to the liver, where the non-glucose sugars are
converted to glucose. Glucose is transported to the cells that require energy. Glucose enters the cells
through facilitated diffusion. Insulin influences the rate of glucose transport
Protein digestion results in brake down into amino acids. Begins in the stomach with pepsin.
Trypsin and chymotrypsin are also important protein digesting enzymes. Pepsin in the stomach
breaks proteins into smaller polypeptide chains. Proteolytic enzymes from the pancreas produce
small peptide chains. Peptidases, bound to the microvilli of the small intestine, break down peptides.
Tripeptides, dipeptides, and amino acids are absorbed by symport that is powered by a Na gradient .
Amino acids are transported to the liver, where the amino acids can be modified or released into the
bloodstream. Amino acids are actively transported into cells under the stimulation of growth
hormone and insulin. Amino acids are used as building blocks or for energy
Lipid digestion happens in the Small intestine and is the source of lipid digestion by lipases.
Lipase is also produced in the pancreas. It enters the lacteals and are transported to systemic
circulation via lymph. Lipids Include triglycerides, phospholipids, steroids, and fat-soluble vitamins.
Emulsification is the transformation of large lipid droplets into smaller droplets and is accomplished
by bile salts. Lipase digests lipid molecules to form fatty acids and a monoglyceride. Micelles form
around lipid digestion products and move to epithelial cells of the small intestine, where the
products pass into the cells by simple diffusion
Nucleic acids Broken down by pancreatic nucleases in the small intestine
Teaching Learning Activities
1. Look, listen, smell and taste a newly fried chicken. Describe how you feel.
2. Fast for 12 hours. Describe your experience.
3. Eat foods high in fiber such as malunggay. Measure the time until you defecate.
71
NUR112: ANATOMY AND PHYSIOLOGY
ISU Echague – College of Nursing
Assessment Task
1. Trace the path of food from the mouth to the anus and identify what happens in the food
products in each organ.
2. Discuss how the digestive system prevents digesting itself despite being able to digest proteins,
carbohydrates and fats.
References:
Geb, Elaine N. (2019), Essentials of Human Anatomy and Physiology, 8 th Edition
Philip (2009), Seely’s Principles of Anatomy and Physilogy
72
