CPT 4: PHYSIOLOGY - DOC V – DIGESTIVE SYSTEM

Functions of Digestive System Salivary glands

1. Ingestion - taking foods into mouth ➔ Assists in swallowing & digestion
2. Secretion - release of water, acid, buffers, and enzymes into Liver, Gallbladder, and Pancreas
lumen of GIT ➔ produce/store secretions that flow into the GI tract through
3. Mixing & propulsion - Churning & movement of food through ducts; the secretions aid in the chemical breakdown of food
GIT Neural Innervation of the GI Tract
4. Digestion - mechanical & chemical breakdown of food ➔ The gastrointestinal tract is regulated by:
5. Absorption - passage of digested products from GIT into blood a. Intrinsic set of nerves known as the enteric nervous
& lymph system
6. Defecation - elimination of feces from GIT b. Extrinsic set of nerves
Two Groups of Organs Compose The Digestive System ➔ that are part of the autonomic nervous system
a. Gastrointestinal (GI) tract Enteric Nervous System
b. Accessory digestive organ ➔ neurons that extend from the esophagus to the anus
Gastrointestinal Tract ➔ two plexuses
● alimentary canal ◆ the myenteric plexus
● continuous tube that extends from the mouth to the anus ◆ submucosal plexus
through the thoracic & abdominopelvic cavities ➔ plexuses of the ENS consist of:
● organs of the gastrointestinal tract: ◆ Motor neurons
○ Mouth ◆ Interneurons
○ Pharynx ◆ Sensory neurons
○ Esophagus TWO PLEXUSES
○ Stomach The myenteric plexus
○ Small intestine ➔ Plexus of Auerbach
○ Large intestine ➔ Located between the longitudinal & circular smooth muscle
Accessory Digestive Organs layers of the muscularis
Teeth ➔ motor neurons of the myenteric plexus supply the longitudinal
➔ physical breakdown of food & circular smooth muscle layers of the muscularis
Tongue ➔ mostly controls GI tract motility movement
➔ assists in chewing & swallowing ➔ Frequency of the strength of contraction of the muscularis

Inventor, Joanna Marie P. 1

CPT 4: PHYSIOLOGY - DOC V – DIGESTIVE SYSTEM
The submucosal plexus Mechanical & Chemical Digestion in the Mouth
➔ plexus of Meissner ➔ Chewing/mastication
➔ found w/in the submucosa ➔ Food is manipulated by the tongue, ground by the teeth, &
➔ supply the secretory cells of the mucosal epithelium mixed w/ saliva
➔ control the secretions of the organs of the GI tract ➔ Final product – Bolus ➔ Soft, flexible, mass
The wall of the GI tract contains two major types of sensory receptors ➔ Salivary Enzyme aids in the digestion
1. Chemoreceptors
Summary of Digestive Activities in the Mouth
➔ respond to chemicals in the food in the lumen
2. Mechanoreceptors STRUCTURE ACTIVITY RESULT
➔ stretch receptors
Cheeks & lips Keep food between Food uniformly chewed
➔ activated when food distends (stretches) the wall of a
teeth during mastication
GI organ
Autonomic Nervous System Salivary glands Secrete saliva Lining of mouth and pharynx
Parasympathetic Division moistened & lubricated.
Saliva softens, moistens, &
1. Vagus (X) nerves
dissolves food & cleanses
➔ mstst parts of the GI tract
mouth & teeth. Salivary
2. Sacral spinal cord amylase splits starch into
➔ last half of the large intestine smaller fragments (maltose,
Sympathetic Division maltotriose, & dextrins)
➔ Thoracic
Extrinsic tongue Move tongue from side Food maneuvered for
➔ Upper lumbar regions of the spinal cord
muscles to side and in & out mastication, shaped into
Nervous System of the GI Tract bolus, maneuvered for
Parasympathetic Nervous System swallowing
➔ form neural connections with the ENS
➔ increase in GI secretion & motility by increasing the activity of Intrinsic tongue Alter shape of tongue Swallowing and speech
muscles
ENS neurons
Sympathetic Nervous System Taste buds Serve as receptors for Secretion of saliva stimulated
➔ Causes a decrease in GI secretion & motility by inhibiting the gustation (taste) by nerve impulses from taste
neurons of ENS buds to salivatory nuclei in
brain stem to salivary glands

Inventor, Joanna Marie P. 2

 CPT 4: PHYSIOLOGY - DOC V – DIGESTIVE SYSTEM

Lingual glands Secrete lingual lipase Triglycerides broken down Summary of Digestive Activities in the Pharynx and Esophagus
into fatty acids & diglycerides
STRUCTURE ACTIVITY RESULT
Teeth Cut, tear, & pulverize Solid foods reduced to
food smaller particles Pharynx Pharyngeal stage of Moves bolus from oropharynx
deglutition to laryngopharynx & into
Salivary Enzymes esophagus; closes air
Salivary amylase passageways
➔ salivary glands
Esophagus Relaxation of upper -Permits entry of bolus from
➔ initiates the breakdown of starch
esophageal sphincter laryngopharynx into
➔ breaking down starch into smaller molecules esophagus
Lingual lipase
➔ secreted by lingual glands in the tongue Esophageal stage of -Pushes bolus down
➔ becomes activated in the acidic environment of the stomach deglutition esophagus
& thus starts to work after food is swallowed
Relaxation of lower -Permits entry of bolus into
➔ It breaks down dietary triglycerides (fats & oils) into fatty acids
esophageal sphincter stomach
& diglycerides
Deglutition Secretion of mucus -Lubricates esophagus for
➔ The movement of food from the mouth into the stomach is smooth passage of bolus
achieved by the act of swallowing
Functions of the Stomach
➔ facilitated by the secretion of saliva & mucus & involves the
1. Mixes saliva, food, & gastric juice to form chyme
mouth, pharynx, & esophagus
2. Serves as reservoir for food before release into small intestine
➔ 3 stages of swallowing:
3. Secretes gastric juice, which contains HCI (kills bacteria &
1. voluntary stage - in which the bolus is passed into the
denatures proteins), pepsin (begins the digestion of proteins).
oropharynx
Intrinsic factor (aids absorption of vitamin B12), & gastric lipase
2. pharyngeal stage - the involuntary passage of the
(aids digestion of triglycerides)
bolus through the pharynx into the esophagus
4. Secretes gastrin into blood
3. esophageal stage - the involuntary passage of the
bolus through the esophagus into the stomach

Inventor, Joanna Marie P. 3

CPT 4: PHYSIOLOGY - DOC V – DIGESTIVE SYSTEM
Summary of Digestive Activities in the Pharynx and Esophagus
STRUCTURE ACTIVITY RESULT
Surface mucous cells Secrete mucus -Forms protective barrier
& mucous neck cells that digestion of stomach
wall
Absorption -small quantity of water, ions,
short-chain fatty acids, &
some drugs enter
bloodstream
Parietal cells Secrete intrinsic -Needed for absorption of
factor vitamin B12 (used in red
blood cell
formation/erythropoiesis)
Secrete -Kills microbes in food;
hydrochloric acid denatures proteins; converts
pepsinogen into pepsin
Chief Cells Secrete -Pepsin breaks down protein
pepsinogen into peptides
Secrete gastric -Splits triglycerides into fatty
lipase acids & monoglycerides
G cells Secrete gastrin Stimulates parietal cells to
secrete HCI and chief cells
to secrete pepsinogen:
contracts lower esophageal
sphincter, increases motility
of stomach, & relaxes pyloric
sphincter
Inventor, Joanna Marie P.
Muscularis Mixing waves Chums and physically
(gentle peristaltic breaks down food & mixes it
movements with gastric juice, forming
chyme. Forces chyme
through pyloric sphincter
Pyloric sphincter Opens to permit Regulate passage of chyme
passage of chyme from stomach to duodenum;
into duodenum prevents backflow of chyme
from duodenum to stomach
Stomach
➔ J-shaped enlargement of the GI tract directly inferior to the
diaphragm in the abdomen
➔ serve as a mixing chamber & holding reservoir
➔ Digestion in the stomach
➔ digestion of starch & triglycerides continues
➔ digestion of proteins begin
➔ Final product – Chyme (acidic & liquid)
Mechanical & Chemical Digestion in the Stomach
➔ peristalsis passover the stomach every 15- 25 secs
➔ Propulsion
◆ process by which peristaltic wave moves gastric
contents from the body of the stomach down into the
antrum
➔ Retropulsion
◆ Food is forced back into the body of the stomach
◆ Chyme ( Product of stomach digestion which is acidic
& soupy liquid)
➔ Gastric emptying
◆ When food (chyme passes through the pyloric
sphincter to the duodenum
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CPT 4: PHYSIOLOGY - DOC V – DIGESTIVE SYSTEM
Effects of the Stomach
➔ kills many microbes in food
➔ HCl partially denatures proteins in food & stimulates the
secretion of hormones that promote the flow of bile &
pancreatic juice
➔ Acts on Pepsinogen to be converted to Pepsin
Pepsin
➔ secreted by chief cells as pepsinogen
➔ Pepsinogen is not converted into active pepsin until it comes in
contact with hydrochloric acid secreted by parietal cells -- to
become Pepsin
➔ digestion of proteins
➔ most effective in the very acidic environment
Mucous Cells & Mucous Neck Cells
➔ Secretes alkaline mucus that protects the stomach epithelial
cells are protected from gastric juices
Gastric Lipase
➔ splits triglycerides into fatty acids & monoglycerides
➔ has a limited role in the adult stomach, operates best at a pH
of 5–6
Absorption in the Stomach
➔ Only a small amount of nutrients are absorbed in the stomach
because its epithelial cells are impermeable to most materials
➔ Mucous cells of the stomach:
◆ absorb some water, Ions, short-chain fatty acids, &
Alcohol
Gastric Emptying Time
➔ 2-4 hours
➔ Rate of gastric emptying based in the chemical content of
food
◆ Carbohydrate – fastest to be emptied
◆ High protein foods
◆ Fat-laden food – slowest time
Pancreas
➔ Composition & Functions of Pancreatic Juice
◆ a clear, colorless liquid consisting mostly of water, some
salts, sodium bicarbonate, & several enzyme
◆ Sodium bicarbonate
● slightly alkaline pH (7.1–8.2)
● buffers acidic gastric juice in chyme
● stops the action of pepsin from the stomach
● creates the proper pH for the action of
digestive enzymes in the small intestine
Pancreatic Enzymes
Enzymes that digest proteins into peptides
● Trypsin ➔ (trypsinogen)
● Chymotrypsin ➔ (chymotrypsinogen)
● Carboxypeptidase ➔ Procarboxypeptidase
● Elastase ➔ Proelastase
● Pancreatic amylase ➔ Digest starch
● Pancreatic lipase ➔ principal triglyceride– digesting enzyme in
adults
● Ribonuclease & deoxyribonuclease ➔ Digest DNA & RNA
Role of Bile in Digestion
Bile
➔ Secreted by the hepatocytes of the liver
➔ yellow, brownish, or olive-green liquid
➔ has a pH of 7.6 – 8.6
➔ consists mostly of water, bile salts, cholesterol, a phospholipid
called lecithin, bile pigments, & several ions

Inventor, Joanna Marie P. 5

CPT 4: PHYSIOLOGY - DOC V – DIGESTIVE SYSTEM
Bile salts
➔ Emulsify Fats
◆ he breakdown of large lipid globules into a suspension
of small lipid globules
◆ The small lipid globules present a very large surface
area that allows pancreatic lipase to more rapidly
accomplish digestion of triglycerides. Bile salts also aid
in the absorption of lipids following their digestion
Functions of the Small Intestine
1. Segmentations mix chyme with digestive juices & bring food
into contact w/ mucosa for absorption; peristalsis propels
chyme through small intestine
2. Completes digestion of carbohydrates, proteins, & lipids;
begins & completes digestion of nucleic acids
3. Absorbs about 90% of nutrients & water that pass through
digestive system
Note:
● Most digestion & absorption of nutrients occur in the SMALL
INTESTINE.
● Its length alone provides a large surface area for digestion &
absorption, & that area is further increased by circular folds,
villi, & microvilli.
● small intestine begins at the pyloric sphincter of the stomach
Region of the Small Intestines
Duodenum
➔ 1st part of the Small intestine
➔ shortest region, & is retroperitoneal
➔ starts at the pyloric sphincter of the stomach
Jejunum
➔ small intestine between the duodenum & ileum
Ileum
➔ longest region of the small intestine
➔ Joins the large intestine at the ileocecal sphincter
Histology of the Small Intestine
➔ Cell types in the Epithelial layer of the small intestinal mucosa
➔ Absorptive cells of the epithelium
◆ release enzymes that digest food and contain microvilli
that absorb nutrients
➔ Goblet cells
◆ secrete mucus
➔ Paneth cells
◆ secrete lysozyme, a bactericidal enzyme, and are
capable of phagocytosis
➔ Three types of enteroendocrine cells are found in the intestinal
glands of the small intestine:
◆ S cells ➔ Secretes hormones secretin
◆ CCK cells ➔ Secretes cholecystokinin (CCK)
◆ K cells ➔ glucose-dependent insulinotropic peptide
(GIP)
➔ Brunner’s glands
◆ duodenal glands
◆ secrete an alkaline mucus that helps neutralize gastric
acid in the chyme
Special Structural Feature of the Small Intestine Facilitate the Process of
Digestion & Absorption
Circular folds or plicae circulares
➔ are folds of the mucosa and submucosa
➔ enhance absorption by increasing surface area
◆ causing the chyme to spiral, rather than move in a
straight line, as it passes through the small intestine

Inventor, Joanna Marie P. 6

CPT 4: PHYSIOLOGY - DOC V – DIGESTIVE SYSTEM
Villi
➔ fingerlike projections of the mucosa that are 0.5–1 mm long
➔ increases the surface area of the epithelium available for
absorption & digestion
Microvilli
➔ projections of the apical (free) membrane of the absorptive
cells
➔ brush border → extending into the lumen of the small intestine
➔ Increased surface area of the absorptive cells
➔ Contains digestive gland
Role of Intestinal Juice & Crush-Border Enzymes
Intestinal juice
➔ contains water & mucus & is slightly alkaline (pH 7.6)
➔ High concentration of bicarbonate ions
➔ Together pancreatic juice – aids in the absorption
Brush-Border Enzymes
➔ carbohydrate-digesting enzymes
◆ dextrinase, maltase, sucrase, & lactase
➔ protein-digesting enzymes
◆ called peptidases (aminopeptidase & dipeptidase)
➔ nucleotide-digesting enzymes
◆ nucleosidases & phosphatase
Mechanical Digestion in the Small Intestine
Movements of the small intestine
➔ governed mainly by the myenteric plexus
Two Types
➔ Segmentations
◆ Are mixing contractions that occur in portions of
intestine distended by a large volume of chyme
Inventor, Joanna Marie P.
◆ mix chyme with the digestive juices & bring the
particles of food into contact with the mucosa for
absorption
➔ Migrating motility complexes
◆ Peristaltic movement
◆ slowly migrates down the small intestine, reaching the
end of the ileum in 90–120 minutes
◆ begins in the lower portion of the stomach & pushes
chyme forward
Chemical Digestion in the Small Intestine
➔ Chyme entering the small intestine
◆ contains partially digested carbohydrates, proteins,
and lipids
➔ Completion of the digestion of carbohydrates, proteins, and
lipids is a collective effort of pancreatic juice, bile, and
intestinal juice in the small intestine
Absorption in the Small Intestine
➔ Mechanical and Chemical Digestion of food will break down
food into forms that can pass through the absorptive epithelial
cells lining the mucosa and into the underlying blood and
lymphatic vessels\
➔ breakdown products of food
◆ Carbohydrates →monosaccharides (glucose, fructose,
& galactose)
◆ Proteins → single amino acids, dipeptides, & tripeptides
from proteins
◆ Fats → fatty acids, glycerol, & monoglycerides
➔ Absorption
◆ Passage of these digested nutrients from the
gastrointestinal tract into the blood or lymph
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CPT 4: PHYSIOLOGY - DOC V – DIGESTIVE SYSTEM
◆ occurs via diffusion, facilitated diffusion, osmosis, &
active transport
◆ About 90% of all absorption of nutrients occurs in the
small intestine; the other 10% occurs in the stomach &
large intestine
◆ 90% of all water absorption occurs in the small intestine
Large Intestine
➔ terminal portion of the GI tract
➔ overall functions of the large intestine are the completion of
absorption, production of certain vitamins, formation of feces,
& the expulsion of feces from the body
Functions of the Large Intestine
1. Haustral churning, peristalsis, & mass peristalsis drive contents of
colon into rectum
2. Bacteria in large intestine convert proteins to amino acids,
breakdown amino acids, & produce some vitaminB & vitaminK
3. Absorption of some water, ions, & vitamins
4. Formation of feces
5. Defecation (emptying rectum)
Mechanical Digestion in the Large Intestine
Ileocecal sphincter
➔ Regulates the passage of chyme from the ileum into the
cecum
➔ Normally, the valve remains partially closed
➔ Factors that affects the opening or closing of the ileocecal
sphincter
➔ Gastroileal reflex
◆ Distension of the stomach after a meal intensifies
peristalsis in the ileum and forces any chyme into the
cecum
Inventor, Joanna Marie P.
◆ Hormone gastrin also relaxes the sphincter
◆ Distension of the cecum intensifies the degree of
contraction of the ileocecal sphincter
Movements of the Large Intestine
Haustral churning
➔ The haustra remains relaxed and becomes distended while
they fill up. When the distension reaches a certain point, the
walls contract and squeeze the contents into the next
haustrum
Peristalsis
➔ a slower rate (3–12 contractions per minute)
Mass peristalsis
➔ a strong peristaltic wave that begins at about the middle of
the transverse colon and quickly drives the contents of the
colon into the rectum
Gastrocolic reflex
➔ Food in the stomach initiates mass peristalsis in the colon
Chemical Digestion in the Large Intestine
➔ Final stage of digestion occurs in the colon through the activity
of bacteria that inhabit the lumen of the colon
➔ Mucus is secreted by the glands of the large intestine, but no
enzymes are secreted
➔ Action of bacteria on breakdown products
◆ Fermentation of remaining carbohydrates → release
hydrogen, carbon dioxide, & methane gasses. These
gasses contribute to flatus (gas) in the colon
◆ convert any remaining proteins to amino acids & break
down the amino acids into simpler substances
◆ decompose bilirubin to simpler pigments, including
stercobilin
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CPT 4: PHYSIOLOGY - DOC V – DIGESTIVE SYSTEM
ABSORPTION AND FECES FORMATION IN THE LARGE INTESTINE
➔ Once chyme has remained in the large intestine 3–10 hours
◆ Feces → solid or semisolid because of water absorption
➔ Of the 0.5–1.0 liter of water that enters the large intestine, all
but about 100–200 mL is normally absorbed via osmosis
➔ Absorbs ions - Sodium & chloride
➔ Absorbs vitamins - Vitamin K & B
THE DEFECATION REFLEX
➔ defecation reflex occurs as follows:
1. In response to distension of the rectal wall, the
receptors send sensory nerve impulses to the sacral
spinal cord
2. Motor impulses from the cord travel along
parasympathetic nerves back to the descending
colon, sigmoid colon, rectum, & anus
3. The resulting contraction of the longitudinal rectal
muscles shortens the rectum, thereby increasing the
pressure within it
4. This pressure, along with voluntary contractions of the
diaphragm & abdominal muscles, plus
parasympathetic stimulation, opens the internal anal
sphincter
PHASES OF DIGESTION
Cephalic Phase
➔ smell, sight, thought, or initial taste of food activates neural
centers in the cerebral cortex, hypothalamus, & brain stem
➔ brain stem then activates the facial (VII), glossopharyngeal
(IX), & vagus (X) nerves
Inventor, Joanna Marie P.
➔ facial & glossopharyngeal nerves stimulate the salivary glands
to secrete saliva, while the vagus nerves stimulate the gastric
glands to secrete gastric juice
➔ purpose of the cephalic phase of digestion is to prepare the
mouth & stomach for food that is about to be eaten
Gastric Phase
➔ Once food reaches the stomach, the gastric phase of
digestion begins
➔ Neural & hormonal mechanisms regulate the gastric phase of
digestion to promote gastric secretion & gastric motility
Neural regulation
➔ Food of any kind distends the stomach & stimulates stretch
receptors in its walls
➔ Chemoreceptors in the stomach monitor the pH of the
stomach chyme
➔ When the stomach walls are distended or pH increases
because proteins have entered the stomach & buffered some
of the stomach acid, the stretch receptors & chemoreceptors
are activated, & a neural negative feedback loop is set in
motion
➔ From the stretch receptors & chemoreceptors, nerve impulses
propagate to
➔ It also strengthens the contraction of the lower esophageal
sphincter to prevent reflux of acid chyme into the esophagus,
increases motility of the stomach, & relaxes the pyloric
sphincter, which promotes gastric emptying
➔ Gastrin secretion is inhibited when the pH of gastric juice drops
below 2.0 & is stimulated when the pH rises. This negative
feedback mechanism helps provide an optimal low pH for the
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CPT 4: PHYSIOLOGY - DOC V – DIGESTIVE SYSTEM
functioning of pepsin, the killing of microbes, & the denaturing amino acids from partially digested proteins & fatty acids from
of proteins in the stomach partially digested triglycerides
Intestinal Phase ➔ CCK stimulates secretion of pancreatic juice that is rich in
➔ Digestion begins once food enters the small intestine digestive enzymes
➔ In contrast to reflexes initiated during the cephalic & gastric ➔ It also causes contraction of the wall of the gallbladder, which
phases, which stimulate stomach secretory activity & motility, squeezes stored bile out of the gallbladder into the cystic duct
those occurring during the intestinal phase have inhibitory & through the common bile duct
effects that slow the exit of chyme from the stomach ➔ CCK causes relaxation of the sphincter of the
➔ prevents the duodenum from being overloaded with more hepatopancreatic ampulla (sphincter of Oddi), which allows
chyme than it can handle pancreatic juice & bile to flow into the duodenum
➔ responses occurring during the intestinal phase promote the ➔ CCK also slows gastric emptying by promoting contraction of
continued digestion of foods that have reached the small the pyloric sphincter, produces satiety (a feeling of fullness) by
intestine acting on the hypothalamus in the brain, promotes normal
➔ These activities of the intestinal phase of digestion are growth & maintenance of the pancreas, & enhances the
regulated by neural & hormonal mechanisms effects of secretin
Neural regulation ➔ Acidic chyme entering the duodenum stimulates the release of
➔ Distension of the duodenum by the presence of chyme causes secretin from the S cells of the intestinal glands in the small
the enterogastric reflex (en-ter-oˉ-GAS-trik) intestine
➔ Stretch receptors in the duodenal wall send nerve impulses to
the medulla oblongata, where they inhibit parasympathetic
stimulation & stimulate the sympathetic nerves to the stomach
➔ As a result, gastric motility is inhibited & there is an increase in
the contraction of the pyloric sphincter, which decreases
gastric emptying
Hormonal regulation
➔ intestinal phase of digestion is mediated by two major
hormones secreted by the small intestine: cholecystokinin &
secretin
➔ Cholecystokinin (CCK) is secreted by the CCK cells of intestinal
glands in the small intestine in response to chyme containing

Inventor, Joanna Marie P. 10