16.

1 FUNCTIONS OF THE DIGESTIVE SYSTEM absorb small molecules of nutrients (amino acids,
Digestive system - ​complex set of organs, glands, and ducts that work monosaccharides, fatty acids, vitamins, minerals, and water)
together to transform food into nutrients for cells 4. Elimination - ​removal of undigested material
● Food is broken down into smaller and smaller particles
● Enzymes​ break the particles down, and the ​small molecules​ are 16.2 ANATOMY AND HISTOLOGY OF THE DIGESTIVE SYSTEM
absorbed into the blood and transported all over the body Digestive tract (gastrointestinal tract) (OPESSS)
● The molecules are broken down by other enzymes to ​release 1. Oral cavity (mouth)
energy​ or are assembled into ​new molecules 2. Pharynx (throat)
3. Esophagus
4. Stomach
5. Small and large intestines
6. sinus
Organs of the digestive system
1. The salivary glands
2. Liver
3. Pancreas
Liver and pancreas ​empty into the small intestine
Inner lining of digestive tract​ serves as a ​protective barrier ​to those
indigestible and harmful materials while allow ​absorption​ of specific
nutrients​ across wall of digestive tract -> nutrients enter blood and
distributed to tissues

Stomach and intestine = ​columnar​ epithelium ~ ​absorption​ of

nutrients and secretion of digestive fluids
Oral cavity and esophagus = ​stratified​ epithelium ~ ​protection​ from
abrasion of chewing and swallowing

Digestive tract consists of 4 major tunics, or layers

1. Mucosa
1. Ingestion - ​consumption ● Inner mucous epithelium
2. Digestion - ​breakdown of ​large molecules into smaller ones; ● Lamina propria - ​loose connective tissue
mechanical and chemical means ● Muscularis mucosa - ​thin outer layer of ​smooth muscle
3. Absorption - ​movement of molecules out of the digestive tract 2. Submucosa
and into the ​blood or lymphatic system.​ The ​epithelial cells ● Lies just ​outside of the mucosa

Larraine Castillo, 1NUR2

 ● Thick layer of loose connective tissue containing ​nerves,
blood vessels, and small glands
● Plexus - ​formed by an extensive network cell processes
within the submucosa; innervated by autonomic nerves
3. Muscularis
● Consists of an inner layer of circular ​smooth muscle​ and
an outer layer of ​longitudinal smooth muscle
● Another nerve plexus, also innervated by autonomic
nerves, lies between the two muscle layers
● Nerve plexuses of the submucosa and muscularis​ =
enteric nervous system​ that controls movement and
secretion within the tract
4. Serosa or an adventitia
● Serosa​ consists of the ​peritoneum​ (smooth epithelial
layer) + underlying ​connective tissue
● Regions of the digestive tract not covered by
peritoneum​ are covered by a connective tissue layer
called the ​adventitia​ (continuous with the surrounding
connective tissue) PERITONEUM
● Serous membrane associated with the ​walls​ of the abdominal
cavity and the abdominal organs
● Visceral peritoneum (serosa) - ​serous membrane that ​covers
the organs
● Parietal peritoneum - ​serous membrane that ​lines the wall​ of
the abdominal cavity
● Mesenteries - connective tissue sheets​ that hold many organs
of the abdominal cavity ​in place
○ Provide a route for blood vessels and nerves from the
abdominal wall to the organs
○ Consist of two layers of serous membranes with a thin
layer of loose connective tissue between them
○ Also applied specifically to the ​mesentery associated with
the small intestine​ = ​mesentery proper
○ Lesser omentum - ​mesentery connecting the ​lesser
curvature​ of the stomach to the ​liver and diaphragm
Larraine Castillo, 1NUR2
 ○ Greater omentum - ​mesentery connecting the​ greater
curvature​ of the stomach to the ​transverse colon and
posterior body wall
■ Long, double fold of mesentery that extends
inferiorly from the stomach before looping back
to the transverse colon to create a ​cavity or
pocket​ called the ​omental bursa
■ Adipose tissue accumulates; fat-filled apron that
covers the anterior surface of the abdominal
viscera.
● Retroperitoneal - ​abdominal organs that have ​no mesenteries
○ Lie along the abdominal wall and include the ​duodenum,
pancreas, ascending colon, descending colon, rectum,
kidneys, adrenal glands, and urinary bladder
16.3 ORAL CAVITY, PHARYNX, AND ESOPHAGUS
ANATOMY OF THE ORAL CAVITY
Oral cavity - ​or mouth; 1st part of digestive tract
● Bounded by the lips and cheeks and contains the teeth and
tongue
● Lips - ​muscular structures mostly formed by the ​orbicularis
oris muscle
○ Outer surfaces of lips are covered by skin
○ Keratinized stratified epithelium​ of the skin becomes
thin at the margin of the lips
○ Color from the underlying blood vessels can be seen
through the thin, transparent epithelium, giving a
reddish-pink appearance.
○ At the internal margin of the lips, the epithelium is
continuous with the moist stratified squamous
epithelium of the mucosa in the oral cavity.
● Cheeks - ​form the lateral walls of the oral cavity
○ Buccinator muscles​ flatten the cheeks against the teeth
● Both the lips and cheeks are important in ​mastication/chewing
Larraine Castillo, 1NUR2
○ Mastication begins​ mechanical digestion,​ which breaks
down large food particles into smaller ones
○ Lips and cheeks move food around within the oral cavity
and hold the food in place to be crushed by the teeth
○ Cheeks also help form words during the speech process.
● Tongue - ​large, muscular organ that occupies most of the oral
cavity
○ Major attachment of the tongue is in the ​posterior part
of the oral cavity​.
○ Anterior part of tongue is relatively free, except for an
anterior attachment to the floor of the mouth by a thin
fold of tissue called the ​frenulum
○ Anterior 2/3​ of the tongue is covered by ​papillae​, some
of which contain taste buds
○ Posterior 1/3 of tongue​ is ​devoid of papillae​ and has
only a few scattered taste buds
■ large amount of ​lymphatic tissue​, which helps
form the lingual tonsil
○ Moves food in the mouth and holds the food in place
during mastication; also swallowing
○ Major sensory organ for ​taste​, as well as an organ of
speech
Teeth
● 32​ in the normal adult mouth, located in the ​mandible and
maxillae
● 4 quadrants: right upper, left upper, right lower, and left lower
● Each quadrant​ contains one central and one lateral ​incisor​; one
canine​; first and second ​premolars​; and first, second, and third
molars
● Third molars are called ​wisdom teeth​ because they usually
appear in the late teens or early twenties
● Teeth of adults are called ​permanent teeth, or secondary
teeth​. Most of them are replacements for the 20 ​primary teeth,
 or deciduous teeth​, also called ​milk or baby teeth​, which are
lost during childhood
● 3 regions: ​crown ​with one or more cusps​. Neck, root
○ Crown​ is the visible portion of a tooth
○ Neck​ is the small region between the crown and the root
○ Root​ is the largest region of the tooth and anchors it in
the jawbone
● Within the center of the tooth is a ​pulp cavity​, which is filled
with blood vessels, nerves, and connective tissue, called ​pulp
○ Surrounded by a living, cellular, calcified tissue called
dentin
■ Dentin is covered by an extremely hard, acellular
substance called ​enamel​, which protects the
tooth against ​abrasion​ and acids produced by
bacteria in the mouth.
■ Surface of dentin in the root is covered with
cementum​, which helps the ​anchor​ the tooth in
the jaw
● Teeth are held in place within ​alveoli​ along the alveolar
processes of the mandible and maxillae.
○ The alveolar processes are covered by ​dense fibrous
connective tissue and moist stratified squamous
epithelium​, referred to as the ​gingiva​ or ​gums
○ Periodontal ligaments ​secure the teeth in the alveoli by
embedding into the cementum.
● dental caries​ or ​tooth decay​, - ​breakdown of enamel by acids
produced by bacteria on the tooth surface. Enamel cannot repair
itself; dental filling is necessary
● Periodontal disease - ​inflammation and degeneration of the
periodontal ligaments, gingiva, and alveolar bone.
○ Most common cause of tooth loss in adults
○ May cause enlargement of the superior ​cervical lymph
nodes​ ~ all lymphatic drainage from the face goes
through these nodes
Larraine Castillo, 1NUR2
Palate and Tonsils
● Palate​ or ​roof of the oral cavity ​separates the oral from the
nasal cavity​ and prevents food from passing into the nasal cavity
during chewing and swallowing.
● 2 parts:
○ Hard palate​ - ​anterior​ part contains ​bone
○ Soft palate - ​the ​posterior​ portion consists of s​ keletal
muscle and connective tissue
● Uvula - posterior​ extension of the s​ oft palate
● Tonsils - ​are located in the lateral posterior walls of the oral
cavity, in the nasopharynx, and in the posterior surface of the
tongue
Salivary Glands
● 3 major pairs: ​parotid glands, submandibular glands,
sublingual glands
● Salivary glands produce ​saliva​, which is a mixture of ​serous
mucous fluids
○ Are compound alveolar glands and have branching ducts
with clusters of alveoli, resembling grapes, at the ends of
the ducts
● Largest of the salivary glands, the ​parotid glands, ​are ​serous
glands​ located just anterior to each ear. Parotid ducts enter the
oral cavity adjacent to the second upper molars
● Mumps​ - inflammation of the p ​ arotid gland​ caused by a viral
infection
○ Inflamed parotid glands become swollen, often making
the cheeks large
● Submandibular glands - ​produce more ​serous​ than mucous
secretions
○ Each gland can be felt as a soft lump along the inferior
border of the mandible
○ Submandibular ducts open into the oral cavity on each
side of the frenulum of the tongue
 ● Sublingual glands - ​smallest; produce primarily ​mucous
secretions
○ Lie immediately below the mucous membrane in the
floor of the oral cavity
○ Each as 10-12 small ducts oApening onto the floor of the
oral cavity

SALIVA
● Versatile fluid; helps​ keep the oral cavity moist​ and contains
enzymes that begin the process of digestion
● Secreted approximately ​1L/day
● Serous part of saliva (parotid and submandibular glands)
contains ​salivary amylase​, which breaks down starch.
○ Breaks covalent bonds between glucose molecules in
starch and other polysaccharides
○ Produces disaccharides such as maltose and isomaltose
(sweet taste); digestion of polysaccharides by salivary ● Only about​ 5% of the total carbohydrates humans absorb are
amylase enhances the sweet taste of food digested in the mouth
● Most starches are contained in plant cells, which have the
TABLE - FUNCTIONS OF DIGESTIVE SECRETIONS polysaccharide ​cellulose
● Humans lack the necessary enzymes to digest cellulose
● Saliva has protective functions
○ Prevents bacterial infections​ in the mouth by washing
the oral cavity with a mildly antibacterial enzyme called
lysozyme
○ Saliva ​neutralizes pH​ in mouth, which reduces effects of
bacterial acids on tooth enamel

Serous part of saliva ​dissolves molecules

Mucous secretions of the submandibular and sublingual glands contain a
large amount of ​mucin​, a proteoglycan that gives a ​lubricating quality to
the secretions of the salivary glands

● Salivary gland secretion is regulated primarily by the ​ANS​, with

parasympathetic stimulation
Larraine Castillo, 1NUR2
 ● Increase in response to a variety of stimuli: tactile stimulation in
oral cavity and certain tastes (sour)
● Higher brain centers can stimulate ​parasympathetic activity
and increase activity of salivary glands in response to the
thought of food​, to odors, or to hunger
● Sympathetic stimulation​ increases the m ​ ucous content​ of
saliva (ex. When a person becomes frightened -> dry mouth with
thick mucus)
MASTICATION
● Food is chewed by teeth
● Incisors and canines​ primarily ​cut and tear food,​ while
premolars and molars ​crush and grind
● Breaks large food particles into many small ones with a much
larger total surface area than a few large particles
● Mastication ​increases efficiency of digestion​ ~ digestive
enzymes act on molecules only at the surface of the food
particles
PHARYNX
● Throat; connect mouth with the esophagus
● 3 parts
○ Nasopharynx, oropharynx, laryngopharynx
● Only ​oropharynx and laryngopharynx​ carry food to the
esophagus
● Posterior walls of the oropharynx and laryngopharynx are
formed by the superior, middle, and inferior ​pharyngeal
constrictor muscles
ESOPHAGUS
● Muscular tube lined with ​moist stratified squamous
epithelium​, that extends from the pharynx to the stomach
● 25 cm long and lies anterior to the vertebrae and posterior to the
trachea within the mediastinum
Larraine Castillo, 1NUR2
● Upper 2/3 of esophagus​ has ​skeletal muscle​ in its wall, while
the ​lower 1/3​ has ​smooth muscle
● Passes through the diaphragm and ends at the stomach
● Transports​ food from the pharynx to the stomach.
● Upper and lower ​esophageal sphincters​, located at the upper
and lower ends of the esophagus, regulate the movement of food
into and out of the esophagus
● Lower esophageal sphincter is sometimes called the ​cardiac
sphincter
● Thick, lubricating mucus that coats the inner surface of the
esophagus
SWALLOWING
● Deglutition
● 3 phases
○ Voluntary phase
○ Pharyngeal phase
○ Esophageal phase
● Voluntary phase​, a ​bolus​, or mass of food, is​ formed in the
mouth
○ Tongue pushes the bolus against the hard palate
○ Forces the bolus toward the posterior part of the mouth
and​ into the oropharynx
● Pharyngeal phase - ​controlled by a ​reflex​.
○ Initiated when a bolus of food stimulates receptors in the
oropharynx to ​elevate the soft palate, ​closing off the
nasopharynx
○ Pharynx elevates to receive bolus from mouth; The three
pharyngeal constrictor muscles​ contract in succession,
forcing food through the pharynx
○ At the same time, the ​upper esophageal sphincter
relaxes​ -> food is pushed into the esophagus
 ○ As food passes through the pharynx, the ​vestibular and
vocal folds​ close, and the ​epiglottis​ is tipped posteriorly,
so that the opening into the larynx is covered; this
prevents food from passing into the larynx
● Esophageal phase - ​responsible for ​moving food from
pharynx to the stomach
○ Muscular contractions of the esophagus occur in
peristaltic waves
○ Wave of relaxation of the esophageal muscles
precedes the bolus of food down the esophagus, and a
wave of strong contraction of the circular muscles
follows and propels the bolus through the esophagus
○ Gravity assists movement of material through esophagus;
however, the peristaltic contractions that move material
are sufficiently forceful
■ These peristaltic contractions cause ​relaxation
of the lower esophageal sphincter in the
esophagus​ as the peristaltic waves approach the
stomach.

Larraine Castillo, 1NUR2

16.4 STOMACH
ANATOMY OF THE STOMACH
● Stomach​ primarily houses food for mixing with HCl and other
secretions
○ Enlarged segment of the digestive tract in the ​left
superior part of the abdomen
○ Gastroesophageal opening - ​opening from the
esophagus into the stomach
● Cardiac region - ​stomach region ​around the gastroesophageal
opening​ near the heart
● Fundus - ​most ​superior​ part of the stomach
● Body - ​largest part of the stomach; turns to the right, forming a
greater curvature​ and a ​lesser curvature
● Pyloric opening - ​opening into the​ small intestine
● Pyloric sphincter - ​pyloric opening is surrounded by a relatively
thick ring of smooth muscle
● Pyloric region - ​region of the stomach near the pyloric opening
● Muscularis layer of the stomach consists of three layers: ​an
outer longitudinal layer, a middle circular layer, and an
inner oblique layer (LCO)
○ These muscular layers produce a ​churning​ action in the
stomach
○ Submucosa and mucosa of stomach are thrown into ​large
folds​ called ​rugae​ when the stomach is empty; allow
mucosa and submucosa to stretch, and the folds
disappear as the stomach is filled
● Stomach is lined with simple columnar epithelium
● Gastric pits - ​openings for ​gastric glands, f​ ormed by mucosal
surface
● Epithelial cells of the stomach​ can be divided into 5:
○ Surface mucous cells - ​on the ​inner surface of the
stomach​ and lining the gastric pits, which produce
mucus
○ Mucus coats and protects the stomach lining.
Larraine Castillo, 1NUR2
○ Remaining​ 4 groups of epithelial cells​ are located in the
gastric glands. Cells of the gastric glands include:
■ Mucous neck cells - ​produce mucus
■ Parietal cells - ​produce HCl and intrinsic factor
■ Endocrine cells - ​produce regulatory chemicals
■ Chief cells - ​produce ​pepsinogen​, a precursor of
the protein-digesting enzyme ​pepsin
SECRETIONS OF THE STOMACH
● As food enters the stomach, the food is mixed with stomach
secretions to become a semifluid mixture called ​chyme
● Stomach secretions:
○ HCl - produces 2.0 pH in stomach,​ which kills
microorganisms and activates the enzyme, pepsin
○ Pepsin - ​converted to pepsinogen. Pepsin breaks
covalent bonds of proteins to form smaller peptide
chains. Pepsin exhibits optimum enzymatic activity at a
pH of about​ 2.0
○ Mucus - ​forms a thick layer, which lubricates the
epithelial cells of the stomach wall and protects them
from acidic chyme and pepsin. Irritation of the stomach
mucosa -> secretion of a greater volume of mucus
○ Intrinsic factor - ​binds with ​vitamin B12​, which is
important in DNA synthesis and in RBC production
● Heartburn or gastritis​ - painful burning sensation in chest
usually associated with an increase in gastric acid secretion
and/or a backflush of acidic chyme into the esophagus
REGULATION OF STOMACH SECRETIONS
● Approximately ​2 L of gastric secretions​ are produced every
day; both nervous and hormonal mechanisms regulate these
● Neural mechanisms​ involve CNS reflexes within medulla
oblongata, can be influenced by higher brain centers
● Local reflexes are integrated within the enteric plexus and do not
involve the CNS.
 ● Regulation of stomach secretions can be divided into 3:
FUNCTIONS OF THE MAJOR DIGESTIVE SYSTEM HORMONES
Cephalic Phase
● Sensation of food​ stimulate medulla oblongata
● Vagus nerves carry ​parasympathetic action potentials​ ->
stomach, where enteric plexus neurons are activated
● Postganglionic neurons stimulate secretion by parietal and chief
cells and stimulate gastrin and histamine secretion by endocrine
cells
● Gastrin is carried -> blood -> stomach, where, along with
histamine, it stimulates secretion

Gastric phase
● Distention of stomach​ stimulates mechanoreceptors + activates
a parasympathetic reflex. Action potentials are carried by the
vagus nerves -> medulla oblongata
● Medulla oblongata increases action potentials in the vagus MOVEMENT IN THE STOMACH
nerves that stimulate secretions by parietal and chief cells + ● Two types of stomach movement aid digestion and help move
stimulate gastric and histamine secretion by endocrine cells
chyme through the digestive tract: ​mixing waves and
● Distention of stomach​ activates local reflexes that ​increase peristaltic waves
stomach secretions ○ Both result from ​smooth muscle contractions​ in the
● Gastrin is carried -> blood -> stomach stomach wall; occur about every 20 seconds and proceed
from body -> pyloric sphincter
Intestinal phase
● Relatively weak contractions -> ​mixing waves​, which ​mix
● Chyme​ in duodenum with pH < 2 or containing lipids​ inhibits ingested food with stomach secretions​ -> chyme
gastric secretions​ by 3 mechanisms
● The ​more fluid part of chyme​ -> ​pyloric sphincter​, whereas
○ Chemoreceptors​ in duodenum are ​stimulated by H+
more solid center​ -> b ​ ody
(low pH) or lipids​. Action potentials generated by the
● Stronger contractions -> ​peristaltic waves, ​which ​force chyme
chemoreceptors are carried by the vagus nerves -> -> pyloric sphincter​, which usually remains closed because of
medulla oblongata, ​inhibiting parasympathetic action
mild tonic contraction
potentials + decreasing gastric secretions
○ Each one is strong to cause partial relaxation of the
○ Local reflexes activated by H+ or lipids​ also inhibit
pyloric sphincter + pump a few mL of chyme -> pyloric
gastric secretions
opening + duodenum
○ Secretin and cholecystokinin produced by duodenum ● Increased motility -> increased emptying
decrease gastric secretions
Larraine Castillo, 1NUR2
 ● Peristaltic waves ​also occur when the ​stomach is empty
● Hunger pangs - ​peristaltic waves are increased by low blood
glucose levels and can create these
○ Occur for about 2-3 minutes and can build in strength to
a prolonged contraction
○ Begin 12 to 24 hours after the previous meals
○ Reach maximum intensity within 3 or 4 days and
progressively weaker
● If stomach empties too fast -> efficiency of digestion and
absorption in small intestine is reduced
● If rate of emptying is too slow -> highly acidic contents of
stomach may damage stomach wall
○ Stomach emptying should be regulated
● Hormonal and neural mechanisms increase stomach motility
● Major stimulus of gastric motility and emptying = ​distension
of the stomach wall
● Inhibition of gastric motility and empty is accomplished by
the
● Cholecystokinin - ​major ​inhibitor of motility and emptying​;
hence, stomach emptying is slower after a fatty meal due to the
release of cholecystokinin
● Vomiting - ​protective mechanism against ingestion of toxic or
harmful substances; also irritation anywhere along digestive
tract
○ Neural stimuli travel along vagus nerve to vomiting
center in medulla oblongata
16.5 SMALL INTESTINE
ANATOMY OF THE SMALL INTESTINE
● Small intestine​ is about 6 m long and has 3 parts: ​duodenum,
jejunum, ileum
Larraine Castillo, 1NUR2
● Duodenum ​is about 25 cm long; nearly completes a 180-degree
arc as it curves within the abdominal cavity
○ Common bile duct​ from liver and ​pancreatic duct​ from
the pancreas join and empty into the duodenum
● Jejunum ​is about 2.5 m long and makes up 2/5 of total length
● Ileum ​is about 3.5 m long and makes up 3/5 of the small
intestine
● The major site of digestion and absorption of food; large surface
area
○ Circular folds, villi, and microvilli
● Mucosa + submucosa = ​circular folds​ that run perpendicular to
long axis of digestive tract
● Villi - ​formed by mucosa; covered by simple columnar
epithelium; within each loose connective tissue core are a blood
capillary network and a lymphatic capillary called a ​lacteal
● Most cells composing surface of villi have numerous cytoplasmic
extensions called ​microvilli
● Mucosa ​of the small intestine is ​simple columnar epithelium
with 4 major cell types: (AGGE)
○ Absorptive​ - microvilli, produce digestive enzymes, and
absorb digested food
○ Goblet cells, ​which produce a protective ​mucus
○ Granular cells​, which may help protect the intestinal
epithelium from bacteria
○ Endocrine cells​, which produce regulatory hormones
● Epithelial cells are located within tubular glands of the mucosa,
called ​intestinal glands or crypts of Lierberkuhn​, at the base
of the villi
● Submucosa of the duodenum contains mucous glands, called
duodenal glands, ​which open into the base of the intestinal
glands
 ● Progressing from the duodenum through the ileum, there are
gradual decreases in the diameter of the small intestine +
thickness of the intestinal wall + in the number of circular folds +
number of villi
● Lymphatic nodules are common along the length of the digestive
tract, and clusters of lymphatic nodules, called ​Peyer patches​,
are numerous in the ileum
● Ileocecal junction - ​the site where the ileum connects to the
large intestine
● Ileocecal sphincter - ​ring of smooth muscle
● Ileocecal valve​ - allows intestinal contents to move from ileum
-> large intestine
SECRETIONS OF THE SMALL INTESTINE
● Secretions from mucosa contain: mucus, ions, and water
○ These secretions protect intestinal wall from acidic
chyme and action of digestive enzymes
○ Keep chyme in small intestine in a liquid form to facilitate
digestion
● Most secretions are produced by the intestinal mucosa
● Peptidases ​digest proteins
● Disaccharidases ​digest small sugars, specifically disaccharides
● Mucus is produced by ​duodenal glands​ and by​ goblet cells
● Hormones released from intestinal mucosa stimulate liver and
pancreatic secretions
● Vagus nerve, secretin release, and chemical or tactile irritation of
the duodenal mucosa all stimulate secretion by duodenal glands
MOVEMENT IN THE SMALL INTESTINE
● Peristaltic contractions​ - proceed along length of intestine for
variable distances and cause chyme to move along small
intestine
Larraine Castillo, 1NUR2
● Segmental contractions ​are propagated for only ​short
distances​ and mix intestinal contents
● Ileocecal sphincter and large intestine remains mildly contracted
most of the time, but peristaltic contractions cause sphincter to
relax and allow chyme to move from small intestine -> cecum
● Ileocecal valve prevents movement from the large intestine ->
ileum
ABSORPTION IN THE SMALL INTESTINE
● Most absorption occurs in the duodenum and jejunum, but some
occurs in the ileum
16.6 LIVER AND PANCREAS
ANATOMY OF THE LIVER
● Liver​ processes nutrients and detoxifies harmful substances
from the blood
● Produced ​bile
● Largest internal organ of the body and weighs about 1.36 kg (3
pounds)
● Located in the right upper quadrant of the abdomen, tucked
against inferior surface of diaphragm
● Posterior surface of liver is in contact with right ribs 5-12
● Two major lobes: ​right and left lobe
○ Two lobes are separated by a connective tissue septum
called the ​falciform ligament
○ Two smaller liver lobes, ​caudate lobe and quadrate
lobe​ can be seen from an inferior view
○ Porta​ is seen from an inferior view; gate through which
blood vessels, ducts, and nerves enter or exit the liver
● Liver receives blood from two sources:
○ Hepatic artery​ delivers ​oxygenated blood​ to the liver,
which supplies liver cells with oxygen.
○ Hepatic portal vein​ carries ​nutrient-rich blood​ from
digestive tract to liver
 ○ Blood exits the liver through ​hepatic veins​, which empty
into the inferior vena cava 1.
● Many delicate connective tissue septa divide the liver into 2.
lobules​ with portal triads at their corners
● Portal triads​ contain three structures: ​hepatic artery, hepatic 3.
portal vein, hepatic duct 4.
● Hepatic cords - ​formed by platelike groups of liver cells called
hepatocytes​, located between center and margins of each lobule. 5.
○ Separated from one another by blood channels called
hepatic sinusoids
● Sinusoid epithelium contains phagocytic cells that help remove
foreign particles from the blood Functions of the liver
● Blood from the hepatic portal vein and the hepatic artery flows
into sinusoids and mixes together
● Mixed blood flows toward the center of each lobule into a
central vein​, which unite to form hepatic veins, which carry
blood out of the liver to inferior vena cava
○ Sphincter regulates the opening into the duodenum
The hepatic ducts from the liver lobes combine to form the
common hepatic duct
The common hepatic duct combines with the cystic duct from the
gallbladder to form the common bile duct
The common bile duct joins the pancreatic duct
The combined duct empties into the duodenum at the duodenal
papilla
Pancreatic secretions may also enter the duodenum through an
accessory pancreatic duct, which also empties into the
duodenum

● Liver contains a system of ducts to deliver bile and other

secretions
● Bile canaliculus - ​cleftlike lumen between cells of each hepatic
cord
○ Bile flows through here -> hepatic ducts in the portal
triads
○ Hepatic ducts converge and empty into the right and left
hepatic ducts​ to transport bile out of the liver
○ Right and left hepatic ducts unite to form a single
common hepatic duct
○ Gallbladder - ​small sac on the inferior surface of the
liver that stores concentrated bile
○ Common hepatic duct is joined by ​cystic duct​ from ● Liver produces and secretes about 600-1000 mL of bile each day
gallbladder to form the ​common bile duct​, which joins ● Bile​ dilutes and neutralizes stomach acid; increases efficiency of
the pancreatic duct; together, they open into the fat digestion and absorption
duodenum at the ​duodenal papilla
Larraine Castillo, 1NUR2
 ● Bile salts​ emulsify fats, breaking the fat globules into smaller
droplets
● Bile also contains excretory products like cholesterol, fats, and
bile pigments
● Bilirubin ​is a bile pigment that results from the breakdown of
hemoglobin
● Gallstones​ may form if the amount of cholesterol secreted by the
liver becomes excessive and is not able to be dissolved by bile
salts
● Parasympathetic stimulation through vagus nerve stimulates bile
secretion by the liver
● Secretin ​from the duodenum also stimulates bile secretion and
release.
● Cholecystokinin ​stimulates gallbladder to contract and release
bile into the duodenum.
● Most bile salts are reabsorbed in the ileum.
● Blood carries the bile salts -> liver, where they stimulate
additional bile salt secretion and are once again secreted -> bile
● Loss of bile salts in the feces is reduced by this recycling process
Control of Bile Secretion and Release
1. Vagus nerve stimulation -> gallbladder contraction -> releasing
bile into duodenum
2. Secretin produced by duodenum and carried through the blood
to the liver stimulates bile secretion by liver
3. Cholecystokinin produced by duodenum and carried through the
blood -> gallbladder, stimulates gallbladder contraction and
sphincter relaxation -> releasing bile into duodenum
4. Bile salts stimulate bile secretion. Over 90% of bile salts are
reabsorbed in the ileum and returned -> liver, where they
stimulate additional secretion of bile salts
Larraine Castillo, 1NUR2
● Liver can remove sugar from the blood and store it in the form of
glycogen; can also store lipids, vitamins, copper and iron
(short-term)
● Transforms some nutrients into more readily usable substances
● An important line of defense against harmful substances;
detoxifies them by altering structure, making excretion easier
● Can also produce unique new compounds (blood proteins like
albumins, fibrinogen, etc,) are synthesized in the liver and
released into the blood
ANATOMY OF THE PANCREAS
● Pancreas​ is located retroperitoneal, posterior to the stomach in
the inferior part of the left upper quadrant
● Head​ near the midline of the body and ​tail ​that extends to the
left, where it touches the spleen
● Complex organ composed of both endocrine and exocrine tissues
● Endocrine​ part consists of ​pancreatic islets​ or ​islets of
Langerhans​, which produce hormones insulin and glucagon that
enter the blood, important in controlling blood levels of nutrients
(glucose and amino acids)
● Exocrine​ - compound acinar gland
○ Acini - ​produces digestive enzymes
○ Clusters of acini are connected by small ducts, which join
to form larger ducts, and the larger ducts join to form the
pancreatic duct​, which joins the common bile duct and
empties into the duodenum
FUNCTIONS OF THE PANCREAS
● Exocrine secretions​ include ​HCO3- and pancreatic enzymes
○ Bicarbonate ions neutralize the acidic chyme that enters
the small intestine from the stomach
○ Increased pH resulting from secretion of HCO3- stops
pepsin digestion but provides the proper environment
for the function of pancreatic enzymes, which are
important in digesting all major classes of food
 ● Major protein-digesting enzymes are: ​trypsin, chymotrypsin,
and carboxypeptidase​. These continue the protein digestion
that started in the stomach
● Pancreatic amylase ​continues the polysaccharide digestion that
began in the oral cavity
● Pancreatic enzymes also include ​lipase​ and ​nucleases​, which
are enzymes that degrade DNA and RNA to their component
nucleotides
● Both hormonal and neural mechanisms control the exocrine
secretory activity of the pancreas
Control of Pancreatic Secretion
- Parasympathetic stimulation from vagus nerve -> pancreas
releases a secretion rich in digestive enzymes
- Secretin, released from duodenum, stimulates pancreas to
release a watery secretion rich in ​HCO3 ions
- Cholecystokinin, released from duodenum, causes pancreas to
release a secretion rich in​ digestive enzymes
16.7 LARGE INTESTINE
ANATOMY OF THE LARGE INTESTINE
● Large intestine​: ​cecum, colon, rectum, anal canal
Cecum
● Proximal end of large intestine where it joins with the small
intestine at the ileocecal junction
● Located in the right lower quadrant of abdomen near iliac fossa
● Sac that extends inferiorly about 6 cm past ileocecal junction.
● Attached to it is the ​appendix
● Symptoms of ​appendicitis​ is abdominal pain in the ​mcBurney
point​, which is midway between umbilicus and the right
superior iliac spine of the coxal bone
Colon
Larraine Castillo, 1NUR2
● About 1.5-1.8 m long and consists of 4 parts: ​ascending colon,
transverse colon, descending colon, sigmoid colon
● Ascending colon - ​extends superiorly from the cecum to the
right colic flexure, near the liver, where it turns to the left.
● Transverse colon - ​extends from the right colic flexure to the
left colic flexure near the spleen, where the colon turns inferiorly
● Descending colon ​extends from left colic flexure to the pelvis,
where it becomes the ​sigmoid colon​, which is an S-shaped tube
that extends medially and inferiorly into the pelvic cavity and
ends at the rectum
● Crypts - ​straight, tubular glands contained by mucosal lining of
colon, which contain goblet cells
● Longitudinal smooth muscle layer of colon forms 3 bands called
teniae coli
Rectum
● Straight, muscular tube that begins at the termination of sigmoid
colon and ends at the anal canal
● Muscular tunic is composed of smooth muscle and is thicker in
rectum > rest of digestive tract
Anal Canal
● The last 2-3 cm of the digestive tract
● Begins at the inferior end of the rectum and ends at the ​anus
● Smooth muscle layer is thicker here > rectum and forms the
internal anal sphincter​ at its superior end. The ​external anal
sphincter​ at the inferior end of the anal canal is formed by
skeletal muscle
● Hemorrhoids​ are enlarged or inflamed rectal, or hemorrhoidal,
veins that supply the anal canal
○ May cause pain, itching, and/or bleeding around the anus
FUNCTIONS OF THE LARGE INTESTINE
● 18-24 hours​ are required for material to pass through the large
intestine
● Chyme​ -> ​feces in colon​, which is eliminated by ​defecation​ ~
absorption of water and salts, secretion of mucus, and action of
microorganisms
● Microorganisms reproduce rapidly and constitute about 30% of
dry weight
● Every 8-12 hours, large parts of colon undergo ​mass
movements​ that propel colon contents a considerable distance
toward the anus
○ Extends over 20 or more cm of large intestine
● Defecation reflex - ​occurs when feces distend the rectal wall
○ Local (weak) and parasympathetic reflexes (strong)
○ Action potentials travel along sensory nerve fibers to
defecation reflex center in sacral region of the spinal cord
○ Motor action potentials reinforce peristaltic contractions
in lower colon and rectum + cause internal anal sphincter
Absorption - ​begins in the stomach,​ where some small,
to relax
lipid-soluble molecules, such as alcohol and aspirin, can diffuse
○ External anal sphincter ​prevents feces from moving out
through the stomach epithelium into the blood
of rectum​ and through the anal opening; if this sphincter
● Occurs mostly in the duodenum and jejunum, some in the ileum
is relaxed voluntarily, feces are expelled
Transport - ​requires carrier molecules and includes facilitated diffusion,
○ Persists only for a few minutes and quickly subsides
cotransport, and active transport (latter two require energy to move
molecules across intestinal wall)
● Can be initiated by ​voluntary actions​ that stimulate a defecation
reflex
CARBOHYDRATES
○ Large inspiration of air -> closure of larynx -> contraction
● Consist primarily of starches, cellulose, sucrose, and small
of abdominal muscles -> pressure in abdominal cavity
amounts of fructose and lactose; all derived from plants, while
increases and forces feces into rectum -> stretching of
lactose is derived from animals
rectum -> defecation reflex
● Polysaccharides - ​large carbohydrates, such as starches,
cellulose, and glycogen, that consist of many chemically bonded
16.8 DIGESTION, ABSORPTION, AND TRANSPORT
sugars
Digestion - ​breakdown of food to molecules that are small enough
● Starch - ​energy-storage molecule in plants; ​cellulose f​ orms the
to be absorbed into the blood
walls of plant cells; ​glycogen​ is an energy-storage molecule in
Mechanical digestion - ​breaks large food particles into smaller
animals and is contained in muscle and liver
ones
Chemical digestion - ​uses ​enzymes​ to break covalent chemical
● Salivary amylase ​begins the digestion of carbohydrates in the
bonds in organic molecules to be smaller molecules
mouth
Larraine Castillo, 1NUR2

DIGESTION OF CARBOHYDRATES, LIPIDS, AND PROTEINS
Monosaccharides​ glucose, galactose, and fructose are absorbed by
intestinal epithelial cells.
Transport of glucose across the intestinal epithelium
1. Glucose is absorbed by cotransport with Na+ into intestinal
epithelial cells
2. Cotransport is driven by a sodium gradient established by a Na+
K+ pump
3. Glucose moves out of intestinal epithelial cells by facilitated
diffusion
4. Glucose enters the capillaries of the intestinal villi and is carried
through the hepatic portal vein to the liver
LIPIDS
Larraine Castillo, 1NUR2
● Insoluble or slightly soluble in water
● Triglycerides (most common; three fatty acids bound to
glycerol)), phospholipids, steroids, and fat-soluble vitamins
● Saturated fats are solid at room temperature, whereas
polyunsaturated fats are liquid at room temperature; found in
meat, dairy products, eggs, nuts, and certain oils
● Unsaturated fats are found in fish and most plant-based oils
● Lipase​, secreted by the pancreas, ​digests lipid molecules​;
products are fatty acids and monoglycerides
● Key step is ​emulsification​, by which bile salts transform l​arge
lipid droplets into much smaller lipid droplets
● Bile salts mix with lipids and act as detergents to disrupt lipid
droplets
○ By decreasing droplet size and increasing the droplet
number, the emulsification increases surface area of lipid
droplets exposed to the digestive enzymes
Lipid transport
1. Bile salts surround fatty acids and monoglycerides to form
micelles
2. Micelles attach to the plasma membranes of intestinal epithelial
cells, and the fatty acids and monoglycerides pass by simple
diffusion into the intestinal epithelial cells
3. Within the intestinal epithelial cell, the fatty acids and
monoglycerides are converted to triglycerides; proteins coat the
triglycerides to form chylomicrons, which move out of the
intestinal epithelial cells by exocytosis
4. The chylomicrons enter the lacteals of the intestinal villi and are
carried through the lymphatic system to the blood
PROTEINS
● Chains of amino acids; found in most of the plant and animal
products we eat
 ● Pepsin ​is a protein-digesting enzyme secreted by the stomach,
breaks down large proteins into smaller polypeptides
● Pepsin digests only about 10-20% of the total ingested protein
● In the small intestine, ​trypsin, chymotrypsin, and
carboxypeptidase​ continue protein digestion; these are
synthesized by the pancreas in an inactive state
● Other enzymes called ​peptidases​ further break down small
peptides intro tripeptides, dipeptides, or single amino acids.

Amino acid transport

1. Acidic and most neutral amino acids are absorbed by cotransport
into intestinal epithelial cells
2. Cotransport is driven by a sodium gradient established by a Na+
K+ pump
3. Amino acids move out of intestinal epithelial cells
4. Amino acids enter the capillaries of the intestinal villi and are
carried through the hepatic portal vein to the liver

Amino acids are actively transported into the various cells of the body;
stimulated by growth hormone and insulin
● Partially broken down and used to synthesize glycogen or lipids,
which can be stored
● Most of the excess amino acids are converted to lipids

WATER AND MINERALS

● Approximately 9 L of water enter the digestive tract each day.
● 92%​ of that water is ​absorbed in the small intestine​, about ​7%​ is
absorbed in the ​large intestine,​ about 1
​ %​ leaves the body in the
feces
● Water moves by osmosis across the wall of the digestive tract
● If the chyme is dilute, ​water moves from intestine -> blood; ​if
chyme is concentrated, ​water moves from blood -> small
intestine

Larraine Castillo, 1NUR2

 16.9 EFFECTS OF AGING ON THE DIGESTIVE SYSTEM
● Connective tissue layers of digestive tract (submucosa and
serosa) tend to ​thin
● Blood supply to the digestive tract decreases
● Decrease in number of smooth muscle cells in the muscularis ->
decreased motility
● Goblet cells secrete less mucus
● Glands tend to secrete less, ​but do not appreciable decrease
function of digestive system
● Digestive tract of elderly people becomes less and less protected
from these outside influences
● Mucosa heals more slowly
● Liver's ability to detoxify certain chemicals declines
● Ability of the hepatic phagocytic cells to remove particulate
contaminants and liver's ability to store glycogen decreases
● More susceptible to infections (ulcerations and cancers)
● Gastroesophageal reflux disorder (GERD) increases (people take
antacids and inhibitors of HCl secretion)
● Hiatal hernia and irregular esophageal motility may be worsened
● Enamel on teeth becomes thinner and may expose the
underlying dentin
● Gingiva covering the tooth root recedes, exposing additional
dentin which can become painful
● Lose teeth
● Muscles of mastication are weaker

Larraine Castillo, 1NUR2