HUMAN DIGESTIVE SYSTEM 2nd Part

A. Anatomy of the Digestive System………...

1. Alimentary Canal…………………………...
2. Digestive Glands
- Both the liver and the pancreas are located
in the region of the duodenum. Secretions
from these two glands are emptied into the
duodenum where final digestion occurs.
a. Liver
- Largest gland in the body, exhibits both
exocrine and endocrine functions. Exocrine
liver secretes bile that aids in digestion.
Endocrine liver secretes somatomedin,
angiotensinogen, thrombopoietin, and
hepcidin, all are released directly into the
bloodstream.
- Wedge-shaped organ in the upper right
portion of the abdominal cavity, divided into
two lobes by falciform ligament, surrounded
by a thick capsule called Glisson’s capsule
that sends invaginations dividing the liver or
hepatic tissue into lobes and lobules.
 Gallbladder
- A small, pear-shaped sac for bile storage.
Consists of a round, blind-ended head, a
cylindrical main body, and a tapering neck.
Cystic duct arises from the neck which
connects the gallbladder to the liver.
Gallbladder stores and concentrates bile. At
least 90% of the water in the bile is absorbed
by the gallbladder.
Gall Stones
- Formed if the bile contains a lot of cholesterol
or bilirubin. Supersaturated bile with
cholesterol hardens into a cholesterol stone,
the most common type of gall stone which
can block the cystic duct and lead to
inflammations. Bilirubin can form complexes
with calcium to form pigment stone.

 Classical Hepatic Lobule

- Formed by polygonal mass of cells,
separated by very thin, almost
indistinguishable connective tissue from the
Glisson’s capsule. A central vein serves as the
central axis of the classical lobule. Hepatic
cells are polyhedral cells that radiate from
the central vein in the form of hepatic cords.
Hepatic sinusoids arising from branches of
the hepatic artery and hepatic portal vein  Biliary Ducts
occupy the spaces between hepatic cords. - Bile secreted by hepatocytes is brought to
Bile canaliculi are the small spaces in two- the gallbladder via several ducts, then from
celled thick hepatic cords and converge to the gallbladder to the duodenum via
form the bile ductules at the periphery of the another set of ducts. Bile is initially secreted
lobule. A portal triad is located at the corners into the bile canaliculi, which then flows to
of the lobule, each consisting of an the terminal bile ductules located at the
interlobular bile duct, interlobular hepatic periphery of the hepatic lobule. From there,
artery, and interlobular portal vein. bile is transported to the interlobular bile

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 ducts at the portal areas then to the right and
left hepatic ducts located outside the liver.
Each of these two ducts transports the bile to
the common hepatic duct, then to the cystic
duct going to the gallbladder for storage.
When bile is required during digestion, it is
transported from the gallbladder to the
common bile duct via the cystic duct. The
common bile duct joins with the pancreatic
duct to form an expanded ampulla of Vater
that empties into the duodenum.
- Bile canaliculi  bile ductules  interlobular
bile duct  left and right hepatic duct 
common bile duct  cystic duct  gall
bladder  common bile duct  ampulla of
Vater  duodenum.
b. Pancreas
- A compound acinus gland, both exocrine
and endocrine in function. Exocrine
pancreas is made up of pancreatic cell
clusters called pancreatic acinus. Each
acinus secretes pancreatic juice which
contains various digestive enzymes.
Endocrine pancreas is made up of cell
clusters that form pancreatic islets. Each islets
secretes insulin and glucagon. The
elongated pancreas lies in the upper
abdominal cavity behind the stomach. Its
regions include an enlarged head
(developed from ventral pancreatic bud)
pressed against the duodenum, an
elongated body, and a tapering tail
(developed from dorsal pancreatic bud).
- Connective tissue capsule invaginates to
divide the pancreatic or acinar tissue into
lobes and lobules. Each lobule is made up of
several pancreatic acini, a cluster of
pyramidal acinar cells, which contain
granules that form the pancreatic enzymes.
 Pancreatic Duct System
- Acinar cell secretions called pancreatic juice
empty into a series of ducts before it finally
reaches the duodenum. Each acinus
empties its secretion into intercalated ducts
that converge to form the intralobular ducts.
The pancreatic juice is then transported to
interlobular ducts that empty into a single
pancreatic duct or duct of Wirsung. At the
head region, interlobular ducts empty into an
accessory duct called the duct of Santorini
that empties into the duct of Wirsung, which
joins the common bile duct to form the
ampulla of Vater.
- Intercalated duct  intralobular ducts 
duct of Wirsung  duct of Santorini 
common bile duct  ampulla of Vater.
B. Physiology of the Digestive System
- Mechanical digestion processes include all
movements of the digestive tract responsible
for changing the physical state of large solid
particles into smaller particles, propelling
food along the entire digestive tract, and
mixing food particles with digestive enzymes.
- Chemical digestion processes include the
breakdown of foodstuff using various
digestive enzymes and related secretions.
1. Mastication/Chewing
- Involves the initial mechanical and chemical
digestion in the mouth. Food physical
breakdown is done by the cutting and
grinding functions of the teeth, aided by
tongue and the hard palate.
- Chemical digestion is carried out by the
salivary amylase or ptyalin that breaks down
the 1-4 glycosidic bonds of amylose (starch)
and amylopectin producing disaccharide
maltose, trisaccharide maltotriose, and
alpha-limit dextrin.
- The lips and cheeks keep the food in place,
digested and mixed with the saliva forming a
bolus. Lingual lipase is also secreted but is not
used during mastication. Instead, swallowed
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 together with the bolus and will be used in
later stages of digestion. Salivary secretion
may be enhanced by two types of reflexes:
a. Simple or Unconditioned Reflex
- Mouth chemoreceptors and baroreceptors
detect the presence of food and sends a
signal to sensory nerve fibers that carry
information to the salivary center in the
medulla, which in turn, sends impulses over
the extrinsic autonomic nerves (efferent
nerve fibers) to the salivary glands to
promote increased salivation.
b. Acquired or Condition Reflex
- Occurs without oral stimulation. Thinking,
seeing, smelling, or hearing food preparation
initiates salivary secretions. Since this reflex is
a learned response based on previous
experiences, the message is sent to the
pleasure center of the cerebral cortex, which
in turn, stimulates the salivary center in the
medullar and promotes salivation.
2. Deglutition/Swallowing
- Involves only bolus transport from the mouth
to the stomach. No food breakdown in the
esophagus. Occurs in three stages:
a. Oral Stage
- The first stage, masticated food or bolus is
squeezed or rolled posteriorly from the mouth
into the oropharynx by the pressure of the
tongue upward and backward. This process
can be stopped voluntarily.
c. Esophageal Stage
b. Pharyngeal Stage
- The second stage, bolus entry into the
oropharynx stimulates swallowing receptor
areas at the oropharynx opening and
tonsillar pillars. The sensory information is
brought to the deglutition center at the
medulla which in turn initiates pharyngeal
muscular contractions that allows food to be
transported into the esophagus.
 Soft Palate
- A muscular organ, together with the uvula, is
pulled upwards to close nasopharynx and
prevent food from entering the nasal cavity.
 Palatopharyngeal Folds
- The folds on each side of the pharynx are
pulled medially to approximate each other
forming a sagittal slit. This performs selective
action by allowing fully masticated food to
pass through with ease while impeding larger
ones. Since the stage lasts only for one
second, any large food is impeded too much
initiates forceful swallowing.
 Larynx
- Pulled upwards by the neck muscles. This
upward movement enlarges the esophageal
opening and lifts the glottis out of the
mainstream of food flow. Simultaneously, it
swings the epiglottis backward over the
glottis to prevent food entry into the trachea.
 Vocal Cords
- As the larynx is pulled upwards, the vocal
cords approximate each other. In any event
that a piece of food manages to enter
through the glottis, the vocal cords act as
secondary barriers, which initiates the
coughing reflex.
Inhibition of respiration during deglutition is also
controlled by the deglutition center in the
medulla, which in turn signals the respiratory
center (medullar) to halt respiration.
- The third stage, food is conducted from the
esophagus to the stomach by peristaltic
waves (primary and secondary). Peristalsis is
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 a progressive wave-like contraction of
muscular layers of hollow organs. In the
digestive tract, the presence of food distends
the wall causing a reflex contraction of
circular muscles behind the food location,
thus, pushing the food forward. This reflex
contraction occurs in succession and
continues as long as the food is present to
distend the wall.
3. Gastric Digestion
- Initial protein digestion occurs in the
stomach. Inactive pepsinogen is converted
to active pepsin once stomach pH has been
lowered to at least 1.5 by hydrochloric acid.
Pepsin breaks down the peptide bonds of
the long polypeptide to produce shorter
polypeptides called oligopeptides. Not all
the polypeptides are digested in the
stomach. So, when food is transported into
the duodenum, polypeptides and
oligopeptides will be digested further. Gastric
lipase is also secreted by the stomach chief
cells but can only break a few ester bonds in
the lipid content of the bolus. This enzymes,
together with the lingual lipase, will be
transported to the small intestine where they
participate in lipid digestion. Control of
gastric secretion involves three phases:
4. Intestinal Digestion
a. Cephalic Phase (stimuli in head)
- Initiated by factors arising before the food is
ever in the stomach. Thinking about, smelling,
tasting, chewing, and swallowing activate
the cortex, which in turn, activates the
digestive center in the medulla. Motor
impulses are then sent to the stomach for
increased gastric juice secretion.
b. Gastric Phase (stimuli in stomach)
- Initiated by factors arising from the presence
of food in the stomach. Increased secretions
by means of overlapping nervous pathways.
 Short Local Reflexes
- Stomach distention due to the presence of
food, especially protein, directly initiates the
intrinsic nerve plexuses to stimulate secretory
cells to release HCl and pepsinogen.
 Long Parasympathetic Reflexes
- Distension sends signals to the digestive
center of the medulla. Motor impulses are
sent back to the stomach for increased
gastric secretions.
c. Intestinal Phase (stimuli in duodenum)
- Initiated by factors arising after food has left
the stomach. Two components:
 Excitatory Component
- Initial presence of digested protein in the
duodenum will stimulate the secretion of
intestinal gastrin which is brought to the
stomach to “help” in protein digestion. But,
this component lasts only for a short period.
 Inhibitory Component
- Gastric secretion is gradually decreased by
gastric inhibitory peptides, secretin, and
cholecystokinin. Secretin release is triggered
by chyme acidity and partly by the presence
of fats. Secretin signals the liver to release bile
and signals pancreas to secrete alkaline for
acidic chyme. Cholecystokinin and gastric
inhibitory peptide release are triggered by
the presence of fatty acids and amino acids.
Cholecystokinin signals the pancreas to
secrete its digestive enzymes. Gastric
inhibitory peptidase slows down gastric
contractions. All these hormones are
transported by the blood to the stomach
where they inhibit gastric secretions.
- Final digestion occurs in the duodenum.
Proteins, carbohydrates, and fats in the
chyme will be broken down into absorbable
nutrients by various enzymes. Bile and
pancreatic enzymes are secreted into the
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 duodenum to help in the final digestion.
Hormones are also released to trigger bile
and pancreatic enzymes secretion.
a. Digestion of Protein
 Pancreatic Enzymes
- Trypsinogen is an inactive pancreatic
enzyme for polypeptides and oligopeptides
digestion in the chyme. Once secreted in the
duodenum, it is activated by the brush-
border enzyme enterokinase, and becomes
the active enzyme trypsin that digests
polypeptides and oligopeptides to
tripeptides and dipeptides. Other pancreatic
enzymes are chymotrypsinogen,
procarboxypeptidase, and proelastase,
which are activated by trypsin to
chymotrypsin, carboxypeptidase, and
elastase that also breaks down polypeptides
and oligopeptides.
 Brush-border Enzymes
- Two types for protein digestion: Dipeptidase
breaks down dipeptides into amino acids.
Aminopeptidase breaks down tripeptides to
release amino acids, now ready for
absorption. Undigested dipeptides and
tripeptides by these enzymes will be
reabsorbed by enterocytes for further
digestion.
 Intracellular Peptidase
- Breaks down the dipeptides and tripeptides
that were transported into the cell to release
the amino acids.
b. Digestion of Carbohydrates
 Pancreatic Enzymes
- Similar to salivary amylase, pancreatic
amylase also breaks down the1-4 glycosidic
bonds of amylose and amylopectin, giving
rise to maltose, maltotriose, and alpha-limit
dextrin.
 Brush-border Enzymes
- Three enzymes for carbohydrate digestion:
Lactase breaks down lactose (from milk) to
glucose and galactose. Maltase-
glucoamylase has two binding sites: maltase
breaks down maltose and glucoamylase
breaks down maltotriose. Both processes
release glucose. Sucrose-isomaltase has two
binding sites: sucrase breaks down sucrose to
release glucose and fructose, and
isomaltase breaks down the 1-6 glycosidic
bonds of alpha-limit dextrin to release
monosaccharides and/or disaccharides. The
disaccharides may be broken down further
by maltase or sucrase.
- Glucose, galactose, and fructose are the
final products of carbohydrate digestion,
ready for absorption.
c. Digestion of Fats
- Before fats can be chemically digested, they
must be broken down physically into smaller
pieces done by the bile through
emulsification. The smaller fat molecules can
now be digested by lingual lipase, gastric
lipase, and pancreatic enzymes.
 Pancreatic Enzymes
- Three types for fat digestion: Pancreatic
lipase breaks down ester bonds between
glycerol and fatty acids in triglycerides to
release free fatty acids and
monoacylglycerol (glycerol and one fatty
acid). Phospholipase A2 cleaves the ester
bond in phospholipids to release the free
fatty acids and glycerol. Cholesterol ester
hydrolase cleaves the ester bond in
cholesterol ester to release free fatty acids
and cholesterol. After fat digestion, free fatty
acids, monoacylglycerol, and cholesterol
are now ready for absorption.
d. Segmentation
- The alternating intestinal muscular
contractions that move the food forward
and backward. Contractions chop and mix
the ingesta with digestive enzymes.
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 e. Control of Secretion
 Pancreatic Secretion
- Pancreatic enzyme secretion regulated by
secretin and cholecystokinin are brought by
the blood to the pancreas. Secretin
stimulates pancreatic duct cells to release
sodium bicarbonate (NaHCO3), an alkaline
fluid to neutralize the acidic chyme.
Cholecystokinin stimulates pancreatic acinar
cells to release digestive enzymes.
 Secretion of Bile
- Bile is continuously synthesized and secreted
by the liver and stored in the gallbladder.
When needed in digestion, secretin
stimulates bile ejection from the gallbladder.
5. Intestinal Absorption
a. Small Intestine
- All carbohydrate, protein, and fat digestion
products, as well as most ingested
electrolytes, vitamins, and water are normally
absorbed by the small intestine
indiscriminately. Usually, only the calcium
and iron absorption is adjusted to the body’s
needs. Most absorption occurs in the
duodenum and jejunum. Only minimal
absorption occurs in the ileum because most
of the material have already been absorbed
before the intestinal contents reach the
ileum. However, vitamin B12 and bile salts are
only absorbed in the ileum.
 Carbohydrate Absorption
- Fructose is absorbed by means of facilitated
transport. Carrier proteins facilitate the
passive diffusion of fructose into the cell.
Glucose and galactose are absorbed by
means of secondary active transport.
 Protein Absorption
- Amino acids are absorbed in the same
manner as monosaccharides through the
use of sodium co-transport carriers and
secondary active transport.
 Fat Absorption
- Absorbable fat products are lipid-soluble
and thus can simply diffuse through the
phospholipid layer of the plasma membrane
of enterocytes. Once inside the cells,
monoglycerides and fatty acids are
synthesized into triglycerides and then
coated with a layer of lipoprotein forming
new molecules called chylomicrons, which
are extruded by endocytosis in the basal
region of the enterocytes and enter the
central lacteals for transport.
b. Large Intestine
 Salt and Water Absorption
- Contents delivered to the colon consists of
indigestible food residues (cellulose),
unabsorbed biliary components, and the
remaining fluid. As the undigested materials
are transported along the colon via slow
peristaltic movements, sodium is actively
reabsorbed, chloride ions follow passively
down the electrical gradient, and water
flows osmotically. What remains to be
eliminated is called feces.
 Vitamin Absorption
- Some food like beans, contain
carbohydrates for which humans lack
digestive enzymes. The gut microbiota
ferments these carbohydrates and produces
vitamin K and B vitamins including biotin,
which will be absorbed by intestinal epithelial
cells. Bacterial fermentation releases gas in
the process, that’s why we feel bloated when
we eat fiber-rich diet like legumes. Thus gas
(flatus) is then expelled through flatulence.
Constipation
- Normally, defecation should be done at least
3 times a week. If the frequency decrease,
the bowel remains in the colon for a longer
period. Thus, more water is removed via
epithelial absorption, making the bowel
harder and more difficult to pass.
Diarrhea
- Infectious diarrhea is the most common type
of diarrhea, caused by bacterial infection.
The large intestine’s response is to secrete a
lot of mucus to protect the wall of the colon.
Unfortunately, coating the intestinal wall with
a thick layer of mucus prevents it from
absorbing water from the bowel.