Human Physiology: Digestion & Absorption

Glycogenesis : Production of glycogen

Glycogenolysis : Breakdown of glycogen
Gluconeogenesis : The production of glucose from sources other than Carbohydrate (like Amino Acid,
Pyruvic Acid etc.)
Lipogenesis : The process by which lipid is created from glucose is called lipogenesis
Emulsification : The process by which the bile salts (Sodium glycation late and sodium taurocholate) in
bile, breaks down fatty foods into small granules like soap foam is known as
emulsification.
Micelli : High fatty acid molecules, monoglycerides, cholesterol and diglycerides bind with bile
salts to form fat particle which is known as.
Bariatrics : The branch of medical science in which the causes, prevention, treatment and surgery of
obesity is done is called bariatrics.
Peristalsis : The periodic contraction relaxation by which food after being swallowed moves through
the digestive tract into stomach is called peristalsis.
Hyperglycemia : Increased glucose level in blood
Hypoglycemia : Decreased glucose level in blood
Deamination : Removal of amino group from Amino Acid
Transamination : Production of new amino acid by exchanging amino group.
Chylomicron : Lipid molecules that are covered by protein forms a great molecule called chylomicron.
Lacteal : Lymphatic duct in the villi of intestine
Reflex : Reciprocal action
Intrinsic plexus : The intrinsic component is the enteric nervous system.
Extrinsic plexus : Extrinsic component is the sympathetic and parasympathetic innervation which come from
the central nervous system.
Apnea : cessation of breathing
Stretch receptor : Stretch receptors are mechanoreceptors responsive to distention of various organs and
muscles
Chole : Bile related (such as cholesterol, cholecystokinin)
Intestinal juice : There are many unicellular glands in the wall of intestine, which secrete many food
digestive enzymes, called intestinal juice.
 Human Anatomy

 Classification of human:
Kingdom : Animalia
Phylum : Chordata (notochord present in embryonic stage)
Sub-phylum : Vertebrata (the notochord is replaced by vertebral column)
Class : Mammalia (the female has active mammary glands)
Order : Primates (hands capable of grasping)
Suborder : Hominidae (tailess: thorax wide and Ventral surface is flattened)
Family : Hominidae (big brain)
Genus : Homo (Communicates through speech and facial expression)
Species : Homo sapiens

 Origin of man:
 Humans are mammals belonging to the Genus Primates.
 Besides human there are 279/235 more species in this Genus.
Example: monkey, gorilla, chimpanzee, Oran-utan, Hanuman, Gibbon etc.
 Scientists have divided the evolved groups into 2 suborders:
1. Suborder: Strepsirhini and 2. Sub-order: Haplorhini
 The suborder Haplorhini has been created with 6 families. The family in which human is included is called
Hominidae. The members of the family Hominidae are called Homonids.
 The closely related animals of human beings are: chimpanzee, orangutan, gorilla.

 The Mammalian characteristics of human beings:

1. Hair: The human body is covered with light fur; the sole of feet, palm of hands and face are without hair.
2. Mammary gland: In the thoracic region there is a pair of mammary glands (both in male and female)
which remains active in female and inactive in male.
3. Diaphragm: Between the chest and the abdomen there is a muscular diaphragm which helps in external
respiration.
4. Ear: In external ear there is pinna, three small bones in the middle ear, and in the inner ear there is spiral
cochlea.
5. Blood circulatory system: It is developed and closed circulatory system, the heart is completely four
chambered and fully developed red blood cell is anucleated.
6. Dentition: Heterodont type that means there are four types of teeth in the jaw.
7. Brain: Brain is well developed and the largest (con an average 1300 to 1450 c.c.), the cerebral hemisphere
is well formed. [Ref: Azmal]
 Other characteristics of human:
 Bipedal locomotion: Humans are the only mammal that can stand and walk on two legs with an upright spine
 Clenched fist: The thumb of the hand is placed opposite to the other four fingers (opposable grip), due to
which humans can clench their fist.
 Helpless and weak children: As human children are weak and helpless the rearing period lasts for a long time.
 Diverse food habit: Humans are omnivorous.
 Language, culture and religion: Humans have different language, culture and religion.
 Smell and vision: Since humans are diurnal, their vision it well developed, the dependence on the sense of
smell has decreased. Humans have the ability to see through 3-dimensional reflection (stereoscopic vision)
 Increase of average life span: The average life span of humans beings have increased along with
evolutionary is crease of body size.
 Childhood and adolescent growth
 Use of fire: Except for human, no other animals have learnt the use of fire.
 Expansion of social life: A well developed social life is one of the key forces behind evolutionary success
and dominance of man on earth.
Organ Systems of Human Body
Name of system Elements Main function
1.Integumentary Skin,hair,nail,sweat Immunity, sensation, regulation of temperature, water
system gland,mammary balance, and production of vitamin D
gland,sebaceous gland
2. Skeletal system Bone,cartilage, bone joint, Protection, formation of body structure, maintenance
nail, hair of physical balance, locomotion, production of blood
corpuscle and storage of minerals
3. Muscular system Voluntary, involuntary and Locomotion, production of heat, regulation of physical
cardiac muscle shape and posture
4. Alimentary system Alimentary/ digestive tract Digestion and absorption of food and elimination of
and digestive gland waste products.
5. Blood circulatory Blood, blood vessel and Transport of nutrition, gas, hormone and waste
system heart products, prevention of disease and regulation of body
temperature.
6. Lymphatic system Lymph, lymphatic duct and Elimination of foreign particles from blood, prevention
gland of disease, Tissue fluid balance and absorption of fat.
7. Respiratory System Lung and trachea Gaseous exchange between air and blood and
maintenance of blood pH.
8. Excretory system Kidney, ureter and urinary Excretion of nitrogenous waste products, regulation of
bladder blood pH and osmosis.
9. Nervous system Brain, Spinal cord and nerve Reception of impulse, control of locomotion,
regulation of physiological and intellectual activity.
10. Sensory system Eye, ear, nose, tongue and Vision, hearing, smelling, tasting, understanding of
skin changes in the surroundings.
11. Endocrine system Endocrine gland, reproductive Metabolism, reproduction and regulation of other
organ and placenta physiological activity
12. Reproductive Testes, ovary, sexual duct Production of gamete and offspring, takes part in
system and uterus growth and metabolism of body by secreting hormones
[Ref: Alim]
 Alimentary System

Human Digestive System

A. Alimentary canal (Gastrointestinal tract) B. Digestive glands

 
1. Mouth 1. Salivary glands
2. Buccal cavity 2. Liver
3. Pharynx (12.5 cm) 3. Pancreas
i. Naso-pharynx 4. Gastric glands
ii. Oro-pharynx 5. Intestinal glands
iii. Laryngo-pharynx
4. Oesophagus (23-25 cm or 25 cm)
5. Stomach: (30 cm)
a) Cardia
b) Fundus
c) Body
d) Pylorus
6. Small intestine (6-7 meters) (longest)
a) Duodenum
b) Jejunum
c) Ileum
7. Large intestine (1.5 meters) (wide: 4-7cm)
a) Caecum and appendix
b) Colon
i. Ascending colon
ii. Transverse colon
iii. Descending colon
iv. Sigmoid colon
c) Rectum (12/13 cm)
8. Anal canal (3.8 cm) [Ref: Majeda, Azmal]
 Digestion:
The biochemical process by which complex food substances are broken down under the influence of hormones
and with the help of enzymes into soluble simple and liquid molecules that can be absorbed by body cell is called
digestion. The body system through which the absorption and digestion of food is completed is called digestive
system.
 Digestion is completed in 2 steps. They are
1. Mechanical digestion
2. Chemical digestion
[Ref: Azmal]
 In human alimentary tract, digestion of different complex food occurs by following 6 steps:

1. Ingestion of food and water.

2. Movement (Peristalsis) of food along the alimentary tract.
3. Mechanical digestion of food.
4. Chemical digestion of food.
5. Absorption of digested food and water / production of vitamin K and Biotin (B7) by symbiotic bacteria.
6. Elimination of waste products.

 Time needed for digestion of food

● Buccal cavity: 5-30 sec
● Stomach: 2-24 hrs/ 2-6 hrs
● Small intestine: 3-5 hrs
● Large intestine: 1.5-2 days
● Human are omnivorous animal.
● Carbohydrate, protein and lipid are complex food. They are not directly absorbed by the cell. Since
they are complex food they need to be digested.
● Vitamin, mineral salts and water are simple food. They enter the cells regularly and there is no need
for digestion.
● Time needed for complete digestion of food: 24-72 hrs
● High calorie fat rich food needs 6 hours to be digested.
● Carbohydrate needs 2 hours to be digested [Ref. Alim, Azmal]

 Daily food requirement in an adult man:

Food Amount Function
1.Carbohydrate 415-600 gm Produces energy and increases efficiency of work
2. Protein 100-150 gm Growth of body, cell formation, synthesis of enzymes and hormones.
3. Lipid 50-55 gm Production of heat and regulation of body temperature
4. Vitamins 5500-5600 mg Helps in growth and nutrition and increases immunity
5. Minerals 8-10 gm Helps in normal growth and nutrition
6. Water 2-3 L (maximum) Keeps the protoplasm moist and alive
[Ref. Azmal, Alim]

 Name of food ingredients, digestive enzymes and products:

Food ingredients Digestive enzymes Products
Carbohydrate
Amylolytic enzymes
(Rice, Bread, Sugar, Glucose
(Ptyaline, Amylase, Maltase, Sucrase)
Vegetables)
Proteolytic enzymes
Protein
(Pepsin, Trypsin, Chymotrypsin, Aminopeptidase) Amino Acid
(Fish, Meat, Egg, Pulse)
Lipid Lipolytic enzyme
Fatty acid and
(Edible oil, Ghee, Butter, (Gastric and intestinal lipase, phospholipase, Cholesterol and
Glycerol
Animal Fat) Glycerol esterase, Lecithinase)
 Alimentary Tract
 Length of whole alimentary tract is 8-10 m or 29 feet through which about 11.5 L digested chyme
and digestive juice is propelled.

Mouth and buccal cavity

 Food enters through the mouth. The part of mouth which is bounded by lip is called vestibule.
 Buccal cavity lies just behind the mouth. It is protected by upper and lower jaw.
 Element: Teeth, Gingiva, palate and tongue.

 Palate
 There are two palates in buccal cavity- Hard palate and soft palate.
 Anterior 2/3rd of palate is hard and formed by palatine bone.
 posterior ⅓rd of palate is soft and formed by muscle.
 From the posterior margin of soft palate, a muscular uvula is hung down in the buccal cavity.
 Due to the presence of soft palate, food bolus cannot enter into nasal tract.

 Tooth:
The teeth remain firmly attached to the alveoli situated in the upper and lower jaw of human buccal cavity. The
number of teeth in adult human is 32 and 20 in infants (Deciduous teeth).
● Characteristics of human teeth :
a) Diphyodont: Two sets of teeth develop in a person's lifetime. First set of teeth (20) is deciduous or milk
teeth. They are erupted in infancy. In second time, deciduous teeth are dropped and substituted by
permanent teeth within 8-10 years. Within 18-24 years, total 32 permanent teeth are observed in human.
b) Thecodont: Teeth of human are embedded within the socket of bone of jaw.
c) Heterodont: In both jaw of human, there are different types of teeth (4 types). These are:
1. Incisors: 8 in number
2. Canine: 4 in number
3. Premolar: 8 in number. In deciduous teeth of infant there are no premolar.
4. Molar: 12 in number. The 3rd molar teeth erupt later. These teeth are called wisdom teeth. In milk
teeth of children the 3rd molar teeth remains absent.

● A standard tooth has 3 main parts:

1. Crown 2. Neck 3. Root.

● Following parts are seen in structure of a teeth-

from outside inwards-
i. Enamel: The outermost covering of the crown of teeth that is developed from ectoderm, white and
glossy, The hardest and rigid part of human body. Chemically it is hydroxyapatite.
ii. Dentine: Developed from embryonic mesoderm and bony yellowish layer.
iii. Cementum or periodontal membrane: It is the covering over the root of the teeth.
iv. Pulp cavity: It contains blood vessels, nerve fibers and loose connective tissue. From the pulp tooth
gets nutrition
 Dental Formula
 Dental formula of deciduous teeth / dental formula of child of 2-6 years:
I2C1P0M2 5  2
= = 10 + 10 = 20
I2C1P0M2 5  2
I2C1P2M3 8  2
 Dental formula of permanent teeth: = = 16 + 16 = 32 Digestive system: 1
I2C1P2M3 8  2

 Tongue:
Tongue is attached with bone of lower jaw (Mandible).
 There are flask shaped taste buds and papillae on dorsal surface of tongue.
 After every 5-10 days, taste buds are destructed and replaced by new taste buds
 Taste buds of different regions of tongue receive different tastes:
 Anterior part- Sweetness
 Two sides of the anterior part (anterior-lateral part)- Saltiness
 Two sides of the posterior part (posterior-lateral part)- Sourness/ Acidity
 Posterior part- Bitterness.
 In human tongue, there is no taste bud for spicy food.
Bitterness

 There are 3 types of gland in tongue: Acidity

a) Mucous gland
b) Serous gland Salinity
c) Lymph gland: They are collectively called lingual tonsil. Sweetness
Function: Taste, speech, mastication, deglutition and secretion of fluid. Fig: Different types of taste buds
[Source. Gazi Azmol]

Digestion of food in buccal cavity:

 Mechanical digestion: When food enters the buccal cavity, food is masticated by teeth and converted into
many small parts. in buccal cavity, food particles are crushed by teeth, tongue and palate and mixed with
saliva. This saliva mixed food mass is called Bolus, which is propelled to the oesophagus through pharynx
by the help of tongue and palate.

 Chemical digestion: ★ Ptyalin

 Carbohydrate digestion:  Others name- Salivary -alpha-
Ptyalin/Salivary––amylase amylase.
Complex Carbohydrate  Maltose.  Acts only on boiled starch
maltase  It’s action is started in buccal cavity
Maltose  Glucose.
 Protein & lipid are not digested in mouth cavity. but digestive
 Ptyalin process
is activated el– ion. occurs in

Pharynx
 It is funnel shaped and situated between buccal cavity and oesophagus which acts as common pathway for
movement of food and air. It has 3 parts-
1. Naso-pharynx
2. Oro-pharynx
3. Laryngo-pharynx
 Function: Forms common pathway for movement of food and air.
 Due to the presence of epiglottis, food enters into digestive tract and does not enter into the
respiratory tract.
 Food enters into oesophagus without entering to the respiratory tract due to the presence of epiglottis
 They are two tuber moving through pharynx. There are: Oesophagus and Trachea.

Oesophagus
 It extends from pharynx to stomach which is the most muscular parts of alimentary tract.
Function: By rhythmic contraction of oesophagus, food enters the stomach.

Stomach
 Stomach is situated below the diaphragm and upper part of the abdomen. It's parts are-
i. Cardia: The part of stomach where Oesophagus enters is cardia.
ii. Fundus: Dome shaped part left to cardia is called Fundus. It is filled with air.
iii. Body of Stomach: Below the fundus, middle part of stomach is body
iv. Pylorus: The part of stomach which enters the duodenum is pylorus. The part of pylorus which is attached
to duodenum is called pyloric canal and the part attached to middle part of stomach is called pyloric antrum.
v. Curvature:
 Greater curvature: The large convex curved part of left side of stomach is called greater curvature
 Lesser Curvature: The small concave curved part of right side is lesser curvature.
vi. Sphincter: Sphincter is formed by thick circular muscle. There are two sphincters in stomach-
 Cardiac sphincter: situated between Oesophagus and cardia which controls entrance of food from
oesophagus to stomach.
 Pyloric sphincter: situated between pylorus and duodenum which controls entrance of food from the
stomach into duodenum.

★ Containing capacity of stomach

 In Neonate - 30 ml (1 OZ)
 Puberty - 1 L
 In Adults- 1.5-2L

 Histological structure of stomach

 The wall of stomach has 5 layers. From outside inwards -
Serosa  Muscle layer  Submucosa  Muscularis Mucosa.  Mucosa
 Muscle layer is composed of Outer longitudinal, middle circular and inner oblique muscle.
 Submucosa contains connective tissue, blood vessels and nerves.
 Mucosa contains projections called rugae and gastric glands
 Digestion of food in stomach:
Mechanical digestion:
 Food enters stomach from Oesophagus (remains here for 2-6 hrs.)
 After that, a peristaltic movement pass along the wall of stomach after every 15-20 second.
 This movement mixes the food with gastric juice secreted from gastric glands. And soft, lubricous and
reduced food mass is converted into chyme.
 HCl consists in gastric juice secreted from parietal cell, makes the chyme acidic and detoxifies the chyme
by killing the bacteria.
 Chemical digestion:
 Carbohydrates are not digested in stomach. (No amylolytic enzyme is secreted from stomach)
 Protein digestion:
HCl
Pepsinogen (inactive)  Pepsin (active)
pepsin
Protein + water  Proteases + Peptones.
renin
Milk casein + water  Paracasein.
pepsin
Paracasein  Peptones.
Gelatinase
Gelatine  peptone + polypeptide.

 Lipid digestion:
Gastric Lipase
Butter fat  fatty Acid + Glycerol.

 Why is stomach not digested itself by it’s proteolytic enzyme?

1. Thick mucus layer of mucosa acts as physical barrier for HCl.
2. Basic HCO3 secreted by mucosal gland neutralizes HCl.
3. Pepsin remains as inactive pepsinogen initially.
4. Concentrated and tight inner lining epithelium prevents HCl entry.
 Gastric Ulcer: Breech of continuity of lining epithelium of stomach mucosa. It is caused by a notorious
bacterium (Helicobacter pylori) NSAID (Non-Steroidal Anti Inflammatory Drug) which is a pain-relieving
drug.
Small Intestine
 It extends from pyloric sphincter of stomach to ileocolic sphincter at the starting of
large intestine. It is divided into 3 parts:
i. Duodenum: First part of small intestine which is U shaped. It’s length is 25-30 cm.
ii. Jejunum: middle part which is 2.5 or 2-3 m.

iii. Ileum: Last part which is 3/5th of total length of small intestine. It's length is 3.5 or
3-4m. Fig: small intestine
 Histological structure of small intestine:
 The wall of Small intestine has 5 layers. From outside inwards -
Serosa  Muscle layer  Submucosa  Muscularis mucosa  Mucosa.
 Muscle layer is composed of outer longitudinal and inner circular muscle
 Submucosa contains connective tissue, blood vessels and nerves.
 Mucosa contains finger like projections called villi, goblet cells, absorptive cells and intestinal glands.
 Glands of different part of stomach lies in the mucosa except Brunner's gland of duodenum. It is the only
digestive gland which lies in the submucosa.
 Digestion of food in small intestine:
 Mechanical Digestion: The process of mechanical digestion in small intestine is-
1. Neutralizes acidity of food: The bicarbonate of bile juice reduces the acidity of the food coming from the
stomach and creates an environment suitable for the activities of other enzymes of small intestine.
2. Making food substances slippery: Due to the action of Nucin present in the intestinal juice, the food situated
in the small intestine becomes slippery and moves from one place to another.
3. Protection of wall of small intestine: Mucous is created from Brunners gland and goblet cell, which
protects the wall of small intestine from the function of enzymes.
4. pH balance: Bile juice and pancreatic juice maintains the pH of intestine.
5. Segmentation: Food is moved forward and backward within particular fragment of small intestine. As a
result, food is mixed with succus entericus (intestinal juice) and mucous.
6. Peristalsis: Due to peristaltic movement (periodic contraction and relaxation) chyme is moved slowly.
7. Emulsification: Breakdown of large fat particles into many small particles. Bile salt causes emulsification.
 Chemical Digestion: Final digestion of all types of food occurs in small intestine. Here 3 types of juice
act on food: Bile, intestinal juice and pancreatic juice.
 Carbohydrate digestion:
 By Pancreatic juice:
amylase
Starch  Disaccharides (maltose)
amylase
Glycogens  Disaccharides (maltose)
Maltase
Maltose  Glucose + Glucose
 By Intestinal juice:
amylase
Starch, Dextrin  Maltose + Maltotriose + small dextrin
Maltase
Maltose  Glucose + Glucose
Isomaltase
Isomaltose  Maltose + Glucose
sucrase
Sucrose  Glucose
invertase
Invertase  Glucose + Fructose
lactase
Lactose  Glucose + Galactose

★ Characteristics of pancreatic amylase:

1. It acts on both boiled and unboiled starch.
2. Up to 6 months, it is absent in pancreatic juice of children.
3. pH is 6.7-7
4. Normally acts in 45°C.
★ Intestinal amylase acts on both boiled and unboiled starch.
 Protein Digestion:
 By Pancreatic juice:
Enterokinase
Trypsinogen  Trypsin (inactive enzyme is activated)
Trypsin
Chymotrypsinogen  Chymotrypsin (inactive enzyme is activated)
Chymotrypsin
Proteose & Peptone  Polypeptide
Carboxypeptidase
Polypeptide  Dipeptide + Amino Acid.
Amino peptidase
Polypeptide  Amino Acid.
Tripeptidase
Tripeptide  Amino Acid.
Dipeptiase
Dipeptide  Amino Acid.
Collaginase
Collagen  Peptide
Elastase
Elastin  Peptide.

 By Intestinal juice:
Amino peptidase
Polypeptide  Amino Acid.
Erepsin
Dipeptide  Amino Acid.
Erepsin: is a mixture of enzyme present in intestinal juice.
Enterokinase: come from duodenal mucosa.

 Lipid digestion:
 By Pancreatic juice:
lipase
Fat  Fatty acid + Glycerol.
phosphoipase
Phospholipid  Fatty acid + Glycerol + Phosphoric acid.
chlesterolesterase
Cholesterol ester  Fatty acid + Glycerol.
 By Intestinal juice:
lipase
Triglycerides  Fatty acid + Glycerol.
lecithinase
Lecithin  Fatty acid + Glycerol + Phosphoric acid + Choline.
Monoglycer idase
Monoglyceride  Fatty acid + Glycerol.
 Nucleidase, nucleotidase and nucleosidase enzymes of intestinal glands break down nucleic acids and
their components into phosphate groups, pentose sugars and nitrogenous bases.
 01. In which layer of small intestine, is goblet cell present? [ M:21-22]
A. Serosa B. Mucosa C. Muscularis Mucosa D. Submucosa Ans: B
02. Which enzyme is found in salivary gland? [M:21-22]
A. Trypsin B. Amylase C. Pepsin D. Ptyalin Ans: D
03. Which enzyme helps in protein digestion?
A. Lactase B. Trypsin C. Amylase D. Lipase Ans: B
04. How many tooth sockets are there in the lower jaw? [D:17-18]
A. 32 B. 12 C. 16 D. 8 Ans: C
05. Which is the dental formula (ICPM) of a 6 years old girl? [M:16-17]
A. I2C1P2M3 B. I2C1P0M2 C. I2C2P1M0 D. I2C0P1M2 Ans: B
06. Which is not the part of small intestine? [M:16-17]
A. Duodenum B. Ileum C. Appendix D. Jejunum Ans: C
07. The part of which is appendix? [M:09-10]
A. Rectum B. Caecum C. Duodenum D. Sigmoid colon Ans: B
08. Which type of taste bud is present in anterior part of tongue? [M:06-07]
A. Sweetness B. Salinity C. Bitterness. D. Sourness. Ans: A

Digestive gland
Secreted juices Amount pH Water
Saliva 1200-1500 ml 6.2-7.4 95.5-99.5%
Gastric juice 2L 0.9-1.5 99.45%
Bile juice 400-800 ml 8-8.6 97-98%
Intestinal juice 1-2L 6.3-9.0 98.5%
Pancreatic juice 600-800 ML 8-8.3 98%

Salivary Gland
In two sides of buccal cavity, there are 3 pairs of salivary gland.
Gland Location Name of duct Opening Secretion
Parotid Below the ear Stenson duct In vestibule, opposite upper 2nd molar Serous
teeth.
Submandibular Below the mandible Wharton duct Two sides of frenulum of tongue Mixed
Sublingual Below the tongue Rivirus duct Two sides of frenulum of tongue Mucous

 There are 2 types of cell in salivary gland: 1. Serous cell 2. Mucous cell.
★ Serous cell secretes enzymes
★ Mucous cell secretes mucous.
★ Saliva is slightly acidic. pH: 6.2-7.4
★A healthy adult man secretes 1200-1500 mL saliva daily.
 Components of saliva:
1. Water: 99.5% (95.5-99.5%)
2. Inorganic substance: 0.2% (NaCl, KCl, CaCO3, HCO3-, PO43-)
3. Organic substance: 0.3% enzyme, (ptyalin, maltase, lysozyme) mucin, immunoglobulin A, Urea etc.
4. Cellular components: bacteria, leukocyte, epithelial cell etc.
5. Gas: O2, NH3, CO2 etc. are dissolved in saliva.
 Function of Saliva:
1. Mechanical function: Saliva helps to talk keeping buccal cavity wet. Mucin of saliva acts as lubricant
during mastication.
2. Digestion of food: Saliva contains amylolytic enzymes : Ptyalin , maltase.
3. Excretion: Some waste products such as : Lactic acid, Urea, Uric acid, heavy metal (Hg, Pb, As) etc. are
excreted through saliva.
4. Buffer action: Bicarbonate phosphate & mucin in small amount act as buffer in saliva.
5. Regulation of water balance
6. Anti bacterial action: IgA, Thiocyanate and lysozyme in saliva destroy bacteria and other microorganisms
that come with food.
7. Sensation of taste: It helps to taste.
8. Salivary amylase or ptyalin enzyme: Breaks the polysaccharide of cooked starch into maltose and dextrin
(disaccharides)
9. Chloride ion: It activates salivary amylase/ptyalin.
10. Bicarbonate ion: Helps to maintain the acidity of saliva within pH: 6.2-7.4. Helps to prevent enamel decay
by reducing the pH of the acid created inside mouth.
Note:
★ Mumps: Inflammation in parotid gland due to viral infection.
★ Xerostomia: During fear, excitement-or tension or during illness the secretion of saliva decreases. Then it
becomes harder to speak. This condition is called xerostomia.
★ Dysgeusia: People secreting less saliva suffer from this disease.

01. Which is not secreted from salivary gland? [M: 13-14]

A. Mucin B. Ptyalin C. Leucin D. Maltase Ans : C
02. Which of the following enzyme is present in saliva? [M: 07-08]
A. Protease B. Lipase C. Ptyalin D. Pepsin Ans : C
03. In which juice, are ptyalin and maltase found? [M: 06-07]
A. Intestinal B. Gastric C. Salivary D. Pancreatic Ans : C

Liver
 Structure of Liver:
 It is the largest and most important gland of human body.
 Liver is composed of 4 incomplete lobes: Right, Left, Quadrate & Caudate.
 Right lobe is 6 times larger than left lobe.
 Liver is divided into right and left lobes by mesentery Weight of Liver : 3-5% of body weight
called falciform ligament. In adult male: 1.4-1.8 kg
 Gall bladder lies below the right lobe of liver. In adult female: 1.2-1.4 kg
 Liver is covered by a covering called Glisson's capsule.
 Scientists have proved that about 500 biochemical reactions occur in liver.
 Liver is called as Organic Laboratory of the body.
 The liver is called the graveyard of dead cells and the active shelter of the life.
 Gall bladder remains attached to the lower side of the liver.
 The left and right hepatic ducts coming from liver joins together to form common hepatic duct. It joins
with bile duct-to form common bile duct, which opens into duodenum by a duct called Ampulla of
water.
 Histological structure of Liver:
 Each lobe of liver is composed of numerous lobules/Acinus.
 The lobules are polygons with 5 or 6 arms having a diameter of 1mm.
 Each lobule is composed of numerous hepatic cells (hepatocyte).
 Between lobules, there are empty space called sinusoid.
 Central vein is present at the centre of lobule.
 Wall of sinusoid contains liver macrophage called Kupffer cell.

 Storage function of Liver:

1. Storage of glycogen: Excess glucose of blood is converted into glycogen by Glycogenesis and stored in
liver.
2. Storage of blood: After leaving spleen and intestine, blood vessels unite to form hepatic portal vein and
enters the liver. Liver can store blood upto 1500 CC, and the liver functions as a storehouse of blood.
3. Storage of vitamin:
 Vitamins stored in liver are fat soluble vitamins (A, D, E, K) and water soluble vitamins (B,C).
 Vitamin K plays an important role in blood coagulation.
 Vitamin B12 (Cyanocobalamin) and B9 (Folic acid) are taken by bone marrow and produce RBC.
4. Storage of minerals:
 Liver primarily stores metal and potassium
 Due to the breakdown of Red blood corpuscles, the hemoglobin breaks in the Kupffer cell into Heme and
globin.
 Cu, Zn, Co, Mo, Fe, K etc are stored in liver.
 Fe of heme are stored as ferritin in liver.
5. Storage of bile: Bile is secreted from liver and stored in the gall bladder situated below the right lobe.
6. Storage of lipid and amino acid: Excess lipid or fat of blood is stored in liver as glycolipid and the glucose
which can't be stored as glycogen is converted to lipid by liver and stored in liver.
 Metabolic Function of liver:
1. Carbohydrate metabolism: To keep the blood glucose level normal, liver performs following metabolic
function:
Insulin
☞ Glycogenesis: Glucose  Glycogen
glycogenesis

 By this process, liver converts excess blood glucose into glycogen and maintains blood glucose level as 90
mg/100 cm3.
 Thus glycogen up to 100 gm is stored here. Muscle stores more than this (400 gm).
 Normal blood glucose level <7.8 mmol/L.
 Hepatic portal vein is the only vessel that carries sugar in various amount.

☞ Glycogenolysis: When blood glucose level is decreased, by glycogenolysis process the glycogen stored in
lilver is broken down into glucose and mixes with blood.
Glucogon Epinephrine
Glycogen  Glucose
glycogenesis
☞ Gluconeogenesis: When glycogen is insufficient than their need, glucose is produced from noncarbohydrate
fat/protein (glycerol/Amino acid).
glucagon
Non-carbohydrate  Glucose
glucogenesis
☞ Lipogenesis:
When blood glucose level exceeds glycogen storing capacity of liver, glucose is converted to triglyceride.
Hence, when carbohydrate rich food is eaten, blood triglyceride level is increased which is the major
cause of heart disease and stroke.
insulin
Glucose  triglyceride
lipogenesis
2. Protein metabolism: Liver performs following functions for protein metabolism :
 Deamination:
- Human body cannot store excess amino acid.
- So, liver breaks down excess amino acid by Deamination process and produce keto acid and amino group.
 Ornithine cycle: By this process, liver unites very toxic NH3 with CO2 produced from carbohydrate metabolism
and produce Urea which is excreted from body through urine. NH3 + CO2  Urea
 Production of plasma protein: Liver produces all plasma protein except gamma globulin/immuno globulin
/antibody such as albumin, globulin, transferrin, ceruloplasmin and blood clotting factor I, II, V,VII, IX, X, XI,
XII etc. The plasma protein thrombin and fibrinogen produced from liver helps in blood coagulation. The
provide protection to the immure system.
 Synthesis of hormone and enzyme: Liver synthesizes angiotensinogen hormone and catalase enzyme.
3. Fat metabolism: Liver performs following functions for fat metabolism:
-Converts glycerol into glucose by gluconeogenesis process.
-Synthesizes lipoprotein.
4. Production of Red Blood Cells (RBC): In childhood liver produces RBC. Later, it breaks down RBC.
5. Production of Cholesterol: Liver cell (hepatocyte) produces cholesterol. Cholesterol is responsible for heart
attack (coronary thrombosis) and stroke (Cerebral thrombosis).
6. Breakdown of hormone: Break down of almost all hormones occurs in liver. But breakdown of testosterone
and aldosterone are faster.
7. Breakdown of Hemoglobin:
-breakdown occurs in liver, spleen and bone marrow by the action of macrophage.
-Macrophage of liver is called Kupffer cell.
-Fe is not eliminated, it is reused for hemoglobin production.
8. Enzyme production: The liver produces an important enzyme called catalase. It helps to breakdown the
hydrogen peroxide stored in blood into water and oxygen. Catalase enzyme also destroys many harmful
Catalase
substance of human body. 2H2O2  2H2O + O2
9. Vitamin metabolism: Liver produces vitamin A from beta carotene Also, Liver produces prothrombin with the
help of vitamin K.
10. Nucleic acid metabolism: The purine and pyrimidine nucleotides are synthesized in liver with the help of amino
acid, glutamine etc. Again, in liver, due to metabolism of purine uric acid is created and due to the metabolism
of pyrimidine urea is produced. In liver, from glycine and Tyrin glycophorin acid and tercholic acid are
synthesized respectively.
11. Functions related to excretion: In the embryonic stage the liver produces R.B.C. In adult stage, it destroys red
blood cell. The mast cell situated in liver secrete heparin which prevents blood coagulation. Liver breaks down
heamoglobin of R.B.C to produce bilirubin and biliverdin.
12. Production of bile: Liver cell(hepatocyte) secretes bile continuously.
13. Production of heat
14. Keeping blood bacteria free.
 Breakdown process of Red blood cell

Red blood cell

After 120 days
Breakdown in (Liver, Spleen, Bone marrow)

Haemoglobin

Heme Globin It breaks down into

it’s own Amino acid
Acid
Iron (Fe)2+ Biliverdin (Green pigment) Eliminated from body
Reduction

[Re-used in bone Bilirubin (Yellow pigment)

Transferrin in blood, Eliminated from body by stool

ferittin in liver

 Disease of liver:
★ Hepatitis: Inflammation of liver is called Hepatitis. It occurs due to viral infection. It is named
as Hepatitis (A, B, C, D, E).
★ Hepatic Encephalopathy: When liver fails to eliminate toxic substances of blood, it remains
in blood and creates hepatic encephalopathy which leads the patient to coma or death.
★ Budd-Chiarri syndrome: When hepatic portal vein that supplies blood to liver is blocked, it
is called budd-chiarri syndrome.
★ Primary Biliary Cirrhosis: It is an auto immune disease of liver.
★ Hepatomegaly: When liver is enlarged abnormally, it is called hepatomegaly.
★ Symptoms of liver disease: yellowish faeces, Dark coloured urine, jaundice, swelling of
Thigh, leg and abdomen, Excessive tiredness etc.

Gall Bladder
 Gall bladder is a pear shaped gland which is situated below the right (Azmal)/quadrate(Majeda) lobe of
liver. It is absent in body of horse, dog, deer and rat.
★ Secretion of it is called Bile.
 Bile
★ Bile is yellowish green, adhesive, bitter and alkaline fluid secreted from hepatocyte.
★ 400-800ml bile is produced everyday from liver.
★ Bile contains no enzyme.

 Components of bile:
 Water: 97-98%/89%
 Inorganic salts: 0.5% (salts of sodium, potassium and
calcium).
 Bile salt: 0.8% (Sodium taurocholate and Sodium
glycocholate).
 Bile pigments: 0.2% Bilirubin and Biliverdin.
 Cholesterol: 0.38%
 Fat: 0.8%
 Bile acid: Cholic acid, lithocholic acid.

 Canal system of liver/Pathway of bile transmission:

Liver Gall bladder

Right & Left hepatic duct Cystic duct

Pancreas
Common hepatic duct
Duct of Wirsung

Common bile duct

Ampulla of Vater/Hepato-pancreatic ampulla

Opens into duodenum

 Function of bile:
1. Digestion: Bile creates alkaline environment in intestine which is compulsory for food digestion. Bile salt
breaks down large fat particles into many small particles by emulsification.
2. Absorption: Bile salt helps in absorption of fat, iron, calcium and fat soluble vitamins (A, D, E & K) etc.
3. Excretion: Cu, Zn, Pb, Hg, bile pigments, etc. are eliminated from body through bile.
4. pH regulation: Bile helps in action of various enzymes by maintaining pH of duodenum.
5. Buffer &Lubricant: Mucin of bile acts as buffer and lubricant.
6. Choleretic action: Bile itself acts as stimulator of It's own secretion. Bile salt is the strongest gall bladder
stimulant. Secreted bile salt is reabsorbed in intestine and returning back to liver through blood, it stimulates
secretion of bile. It is called choleretic action of liver or Collogue action.
7. Laxative action: Bile salt also helps in rhythmic contraction (peristalsis) of small intestine and large
intestine. It acts as natural laxative, increases rhythmic contraction of colon. As a result, Defecation
becomes easy. It is called laxative action.
8. Bile dissolves insoluble fatty acid, cholesterol etc. by neurotrophic process making them suitable to be
absorbed by intestine.

01. Which lobe of liver is attached to gall bladder? [M:20-21]

A. Right lobe B. Quadrate lobe C. Left lobe D. Caudate lobe. Ans. A
02. Which organ of human body produces fibrinogen? [M:19-20]
A. Pancreas B. Lung C. Liver D. Small intestine Ans. C
03. In which organ of human body, is highest number of goblet cell found? [M:19-20]
A. Large intestine B. Liver C. Lung D. Small intestine Ans. A
04. What is the name of macrophage consists in liver? [D: 17-18]
A. Monocyte. B. Kupffer cell C. Histocyte D. Neutrophil Ans. B
05. Which of the following information is correct about human bile? [D:17-18]
A. It is acidic fluid B. enzyme rich
C. Helps in digestion in stomach D. Produced in liver Ans. D
06. Largest lobe of human liver is- [M:16-17]
A. Left B. Right C. Quadrate D. Caudate Ans. B
07. Where kupffer cell is present? [D:16-17]
A. Spleen B. Brain C. Liver D. Pancreas Ans: C
08. Which vitamin is water soluble? [M:15-16]
A. Vitamin B complex B. Vitamin D C. Vitamin A D. Vitamin K Ans: A
09. From excess glucose of blood stream, stored polysaccharide in liver is- [M:14-15]
A. Starch B. Cellulose C. Glycogen D. Sucrose Ans: C
10. Bile is produced in human body from- [M:12-13]
A. Pancreas B. Liver C. Larynx D. Gall bladder Ans. B
 Pancreas

Position Pancreas is a chilly shaped mixed gland which is situated below the stomach transversely which
extends from U shaped loop of duodenum to spleen.

Structure ★ It’s weight is 60 gm.

★ It is 12-15 cm long and 5cm wide
★ It has 3 parts: head, body and tail
★ From glands of pancreas, many small ductules come out and unite to form pancreatic duct
(Wirsung duct) which unites with common bile duct near duodenum and as Ampulla of vater
it enters duodenum.
★ Pancreas is a chilli shaped mixed gland.

Endocrine Endocrine part of pancreas is composed of a cluster of 10 lac cells known as Islets of
part (10%) Langerhans.
Cells Alpha (15%) Glucagon (increases blood glucose level)
(V.V.I)
Beta (65%) Insulin (decreases blood glucose level)

Gamma/PP (15%) Pancreatic polypeptide (inhibits pancreatic juice secretion)

Delta (5%) Somatostatin (controls secretion of alpha and beta cells)

Exocrine Composed of numerous lobules /acinus. Cells of lobules secrete pancreatic juice.
part (90%)
Pancreatic juice Enzymes
(pH = 8-8.3)
Alkaline juice (HCO3- rich)

Others:
● Water: 98%
● Organic substance: 1.8%. enzymes such as: trypsin, amylase, lipase,
chymotrypsin etc.
● Inorganic substance: 0.2%. Bicarbonate salts of sodium, potassium,
calcium, magnesium and zinc.

Function ★ Since, it is alkaline, it neutralizes same amount of acidic juice of stomach.

★Amylase, trypsin, lipase enzymes digest carbohydrate, protein and fat respectively
★ Regulates acid-base balance, water balance and body temperature.
[Ref. Azmal, Ashraf]
[Note: Mixed gland: 1. Pancreas 2. Testes 3. Ovaries]
 01. Which enzyme is not present in pancreas? [D:19-20]
A. Ptyalin B. Maltase C. Trypsin D. Amylase Ans: A
02. Which enzyme is present in pancreatic juice? [D:19-20]
A. Pepsin B. Maltase C. Lactase D. Trypsin Ans: D
03. Which is a mixed gland? [M:15-16]
A. Parotid gland B. Pancreas C. Sweat gland D. Lacrimal Ans: B
04. Alpha cell of pancreas secrets -[M:14-15]
A. Insulin B. Pancreatic polypeptide C. Glucagon D. Lipase Ans: C
05. Where is Wirsung duct situated? [D:10-11]
A. Pancreas B. Salivary gland C. Liver D. Intestinal gland Ans: A
Gastric gland
 Gastric gland is a tubular gland. It’s secretion is called gastric juice.
 Gastrin hormone controls secretion of this juice.
 Mucosa of wall of stomach contains 3.5 million gastric pits.
 Gastric pits collectively contain about 40 million or 4 crore gastric glands.
 Gastric glands secrete about 2L gastric juice
 pH of gastric juice: 0.9-1.5
 Specific density: 1.002-1.004
 Freezing point: 0.59C

 Cells of gastric glands are as follow:

Cell Secreted substance
1. Oxyntic/parietal cell Hydrochloric acid
2. Mucous cell Mucous
3. Argentaffin cell Gastric intrinsic factor / Intrinsic factor of Castle
4. Zymogenic cell/peptic cell/chief cell Pepsinogen, Renin, Gelatinase, lipase
5. Gastrin/ G cell Gastrin hormone
 Components of gastric juice:
1. Water: 99.45%
2. Inorganic substance: 0.15% (HCl, NaCl etc.)
3. Organic substance: 0.40% (Mucin, enzyme, Intrinsic factor)
 Function of Gastric juice:
1. HCl consists in gastric juice creates acidic environment in stomach, destroy bacteria, and activates inactive
enzymes.
2. Renin of gastric juice converts casein into paracasein.
3. Gastric juice gives protection to the wall of stomach.
4. Some toxic materials, heavy metal, alkaloid etc. are eliminated from body through gastric juice.
5. Enzymes of gastric juice helps in protein and lipid digestion.
[Ref: Azmal, Alim, Majeda]
Intestinal gland
 Intestinal glands are Brush cell, Goblet cell, Paneth cell, Argentafine cell, Liberkhun's gland, Brunner's
glands etc.
 Juice secreted from intestinal glands is called intestinal juice or Succus entericus.
 Amount of daily secretion: 1-2 L
 it's pH is 6.3-9, average : 8.3
 Relative density: 1.010
 Components of succus entericus:
1. Water : 98.5%
2. Solid substance : 1.5%
★ Inorganic substance : 0.8%, salts of Na, K, Ca, Mg
★ Organic substance : 0.8%
a) Activator: Enteropeptidase or enterokinase .
 Function of succus entericus :
1. Mucous of succus intericus protects intestinal wall from action of different enzymes.
2. It’s activator enterokinase converts inactive trypsinogen into trypsin.
3. Enzymes of it digests carbohydrate, protein and fat. [Ref. Azmal, Alim]

Inactive enzymes Activator

1. Pepsinogen HCl
2. Prorenin HCl
3. Trypsinogen Enterokinase
4. Chymptrypsinogen Trypsin

Membrane enzyme:
 Plasma membrane of cell of microvilli of intestine contains some enzymes involved in digestion.
 These enzymes present in plasma membrane of cell of microvilli are called membrane enzyme.
 Major membrane enzymes are-
1. Aminopeptidase 2. Maltase 3. Sucrase 4. Lactase 5. Alkaline phosphatase 6. Nucleotidase.

Role of Nervous System in The enteric nervous system is

Digestion called the second brain of the
human body

Intrinsic plexus
or Enteric nervous system Extrinsic plexus
(Sympathetic and para-sympathetic)

Myenteric plexus Submucosal plexus

(Located in muscle layer) Acetylcholine Adrenaline
(Located in submucosa)

The enteric Relaxes muscle of

Peristalsis Controls secretion
nervous system is stomach and intestine
called the second and controls blood
flow to these organ
 Role of Nervous System in Digestion
 Introduction of Nervous System in Digestion
 Saliva secretion
☞ 2 types of reflex control saliva secretion in buccal cavity:
 Unconditioned reflex:
 Unconditioned reflex starts with entering of food into buccal cavity. Receptors of
taste bud of tongue are stimulated with taste of food and sensory neuron
transmits this nerve impulse to brain. Digestive system-2
 Since this reflex passes through the brain, it is called cranial reflex.
 Conditioned reflex:
 Taking decision after seeing food, smelling food and thinking about food is included to this type of reflex.
 Gastric juice secretion :
 Secretion of gastric juice occurs in 3 phases: 1. Nervous or Cephalic 2. Gastric 3. Intestinal
 Nervous or Cephalic phase:
 Impulse goes to stomach from brain by vagus nerve.
 It occurs before food enters the stomach
 Nervous phase lasts for 1 hour.
 Gastric phase:
 It occurs in stomach
 when stomach becomes enlarged to contain food, stretch receptor are stimulated and this impulse is
transmitted to nerve plexus of submucosa.
 Gastric juice secretion lasts for about 4 hours.
 Intestinal phase:
 This phase occurs in small intestine
 In this phase, mucosa of duodenum secrets 2 types of hormones: Cholecystokinin (CCK) and Secretin
 Secretin inhibits gastric juice secretion in stomach.
 Cholecystokinin contracts muscle of pyloric sphincter and thus inhibits gastric emptying.
 Pancreatic and bile juice secretion
Both secretin and cholecystokinin hormone controls secretion of pancreatic and bile juice. Secretion provides
stimuli to liver and pancreas to form hydrogen carbonate ion. As a result, Pancreatic and bile juice are alkaline
which neutralizes acidity. Cholecystokinerin produces stimuli to pancreas to form enzyme and to gall bladder
to release it. The secretion of both juices are controlled by nervous system. The vagus nerve stimulates them to
release juices.
[Ref. Azmal]

Name, source and function of hormones involved in digestion

Name Source Function (regulation)
Gastrin G cell of stomach Controls gastric juice secretion and HCl secretion.
Secretin S cell of Duodenum 1. Pancreatic juice secretion.
(First discovered 2. It stimulates liver to secrete bile.
Hormone) 3. It helps wall of stomach to secrete pepsin enzyme.
4. Inhibits gastric juice secretion in stomach.
Cholecystokinin I cell of duodenum 1.Controls secretion of bile
/Pancreozymin 2.Stimulates growth and development of pancreas.
3.It stimulates pancreatic juice secretion.
Somatostatin D cell (stomach and 1. Inhibits gastrin secretion and decreases gastric juice secretion.
intestine) 2. Decreases pancreatic juice secretion.
Enterokinin Wall of ileum 1.Helps intestinal glands to secrete maltase, sucrase,
invertase and lactase
Peptide YY Wall of ileum 1.It plays role in slowing down movement of food in intestine
Enterogastrone/ K cell of duodenum 1.It inhibits gastric motility and gastric juice secretion
Gastric inhibitory 2. For decreasing gastric contraction, it is called gastric
peptide -GIP inhibitory peptide.
Enterocrinin Wall of duodenum 1.It stimulates Lieberkühn’s gland to secrete enzyme and
mucous in intestinal juice.
Deocrinin Wall of duodenum 1.Stimulates Brunner's glands to secrete enzyme and
mucous in intestinal juice.
Pancreatic Islets of Langerhans 1.Inhibits pancreatic juice secretion.
polypeptide
Villi kinin Wall of small intestine 1.It increases activity of villi.
Vasoactive Intestinal Wall of small intestine 1.Dilates enteric blood vessel and stops gastric acid
Peptide (VIP) secretion.
Motilin Enterochromaffin cell of 1.Increases gastric and intestinal motility
duodenum / EC cell or M cell.
[Ref: Azmal, Alim]
 Difference between digestion and absorption:
Subject Digestion Absorption
Mechanism Large, complex food substance is Simple food particles enters blood from
broken down into simple and alimentary tract.
absorbable food particles.
Site Buccal cavity, Stomach and Villi of ileum and jejunum.
intestinal lumen.
Enzyme Needed Not needed
Activeness Always an active process It can be active, passive or diffusion
process.
Mechanical and chemical Occurs Doesn’t occur
digestion of food
Involvement of blood Absent Present
 Difference between enzyme and bile:
Subject Enzyme Bile
Source Any exocrine gland Liver
Chemical nature Biochemical substance Mixed (organic and inorganic)
Storage It is not stored It is stored in gall bladder
Effect on reaction It stimulates rate of reaction. It has no effect on reaction, it creates alkaline
environment.
Condition after action It remains unchanged Excreted from body as waste products.
 Digestive Enzyme at a Glance
Digestive organ Digestive gland & Juice Digestive enzyme
Oral Ptyalin (Salivary amylase)
Amylolytic
cavity/Buccal Salivary gland (Saliva) Maltase
Cavity Proteolytic & Lipolytic Absent
Amylolytic Absent
Pepsin
Gastric Gland (Gastric
Stomach Proteolytic Renin
Juice)
Gelatinase
Lipolytic Gastric Lipase
Pancreatic amylase
Amylolytic
Maltase
Trypsin
Chymotrypsin
Collagenase
Pancreas (Pancreatic Proteolytic Carboxypeptidase
juice) Aminopeptidase
Tripeptidase
Dipeptidase
Pancreatic Lipase
Lipolytic Phospholipase
Small Intestine Cholesterol esterase
Intestinal amylase
Maltase
Amylolytic
Sucrase
Lactase
Proteolytic Aminopeptidase
Intestinal gland (Succus
Intestinal lipase
Entericus)
Lipolytic Lecithinase
Monoglyceridase
Nuclease
Nucleic Acid Digestion Nucleotidase
Nucleosidase
 Absorption of food
 Vitamin, water, minerals are taken by cell directly. So, these need not be digested. These are absorbed
directly.
 90% of food absorption occurs in small intestine, 10% occurs in large intestine.
 Mucosa of jejunum and ileum of small intestine contains finger like projection called Villi. Total number
of villi is 50 lac which forms absorptive area of about 10 m2. Jejunum and ileum is specialized for
absorption, duodenum is mainly involved in secretion.
 Villi helps in absorption increasing absorptive surface area.
 Food absorption is mainly completed in 2 processes:
1. Inactive absorption: No need of metabolic energy (Like ATP)
2. Active absorption: Metabolic energy is needed.
Absorption of several food particles :
Food substance Active Diffusion Hormone Site of Absorption
absorption
Carbohydrate   Glucagon and Jejunum
glucocorticoid
Protein   Thyroxine Duodenum and jejunum
Fats  Glycerol and Fatty Thyroxine Duodenum and ileum
acid
Water   Small intestine is the main
site of water absorption.
Vitamin B, C B, C Ileum
Minerals   Wall of villi of small
intestine
Carbohydrates are mainly absorbed as monosaccharides. Carbohydrates in foods that are produced after
digestion are Glucose, fructose, galactose, mannose, levulose etc. Glucose and other simple sugars are absorbed
and enter the portal circulation through the blood stream in the process of active absorption or diffusion in the
epithelial cells of the villous wall of the jejunum part of the small intestine.
 Carbohydrate absorption
Active absorption
Glucose and Galactose  Columnar epithelium
Kinase enzyme
Diffussion of intestinal villi
Fructose, Sucrose, Lactose 

Hepatic portal vein

 Energy Production
 Accessory part is stored in Hepatic Vein
 Cell  Heart  Liver
liver and muscle as
Glycogen

 Insulin and glucocorticoid (cortisol) controls carbohydrate absorption.

 Protein absorption:
Under normal physiological conditions, meat is absorbed only as amino acids. Amino acids are absorbed
by the epithelial cells of the wall of the villi of the duodenum and jejunum of the small intestine in the process
of active absorption or diffusion and enter the portal circulation through the blood stream.
 Inactive absorption
D- Amino Acid  Columnar epithelium
Active absorption
L-Amino Acid  of intestinal villi

Hepatic portal vein

 Compensation and Growth 

of the body. Hepatic Vein
 Cell  Heart  Liver
 Excess amino acid is
released as urea.
★ Protein absorption is controlled by thyroxin hormone.
 Lipid absorption:
 The lipid type foods substances after digestion converts to fatty acid, glycerol, phospholipid and
cholesterol. In the duodenum and ileum of small intestine lipid is absorbed, Since glycerol is water soluble
it directly enters through the wall of villi into portal vein. But Absorption of fatty acid is a complex process.
At first they are converted into active fatty acid by the action of thyokinase enzyme. This active fatty
acid joins with cholesterol, phospholipid and protein to form chylomicron.
 These leave the epithelial cell by exocytosis process and passes the cell membrane of villi and enters lymph.
When the lymph appears whitish then it is called lacteal. Chylomicron goes to the plasma of the blood of
vein near to heart through the lymphatic system.
Active absorption Columnar epithelium
Fatty acid (Short Chain) and Glycerol 
of intestinal villi

Hepatic portal vein

Hepatic Vein
Cell  Heart  Liver
Active absorption
Fatty acid (long chain), Cholesterol  Columnar epithelium of intestinal villi.
● Energy Production ● Long chain fatty acid is converted to tri-glyceride and cholesterol
● Excess Lipid is stored in liver, is converted to cholesterol ester and unite with cellular protein of
mesentery and under skin. intestine to form lipoprotein called chylomicron.


Cell  Heart  Vein  Thoracic Lymphatic duct  Lacteal
 Lipid absorption is controlled by thyroxin.
 Vitamin Absorption:
In Small intestine
 A, D, E, K  with help of bile salts
In Leum
B and C  Diffusion and active absorption
 Water absorption
Small intestine are the main site of water absorption. In the small intestine, water is absorbed by the process
of osmosis in the cells lining the villi-wall. Normally 200-400 ml of water is absorbed per hour. After
absorption, the remaining water enters the large intestine.
In Small intestine
Water absorption  Diffusion and active absorption
 Mineral Absorption: Mineral salts are absorbed in an active process by the epithelial cells of the villi wall of
the small intestine.
In Small intestine
Minerals  Active absorption

Fate of absorbed nutrients

 Amino acid: Amino acid after being absorbed by the cell forms protein with the helps of enzyme. The
unnecessary and excess amino acid converts in the liver to form urea on one hand and other hand converts into
fatty acid and carbohydrate. Urea is a waste production, Carbohydrate and fatty acid are used in energy
production.
 Glucose: Energy is produced from glucose. But glucose combines with other substances to form the metallic
substances of protoplasm and some glucose is stored in the liver and muscles as glycogen.
 Fatty acid and glycerol: Animals make fats in their body by the rearrangement of fatty acids. Fatty acids form
the plasma membrane and nuclear membrane. The energy producing capacity of fats is double of glucose.

01. Where highest amount of food is absorbed? [M:19-20]

A. Stomach B. Duodenum C. Jejunum D. Caecum Ans: C
02. Which is the proteolytic enzyme? [D:17-18]
A. Maltase B. Sucrase C. Trypsin D. Lipase Ans: C
03. Which is not proteolytic enzyme? [D:16-17]
A. Trypsin B. Aminopeptidase C. Chymotrypsin D. Amylase Ans: D
04. Which is formed in upper part of small intestine by microvilli combinedly? [M:14-15]
A. Lumen B. Brush border C. Pyloric sphincter D. Quadrate lobe Ans: B
05. Which of the following is a protein in nature but not enzyme? [M:11-12]
A. Ptyalin B. Gamma globulin C. Troponin D. Lipase Ans: B
06. Which of the following is not enzyme that helps in starch digestion? [M:09-10]
A. Maltase B. Ptyalin C. Amylase D. Lysozyme Ans: D

Large intestine
Transverse colon

Ascending Descending
colon colon
 It extends from ileum to anal canal.
 Because of having no digestive juice, here no digestion occurs.
 It consists of 3 parts:
Appendix Sigmoid colon
1. Caecum and appendix:
 It is the only part of alimentary tract, the width of which(7.5cm) is greater than the length (6 cm)
 Ileum of small intestine is exposed to caecum through ileocecal sphincter.
 From caecum a finger like projection called appendix is created.
 Appendix is called storage of useful microbes.
 Due to infection of bacteria, inflammation of appendix is called appendicitis.
 2. Colon: it is the largest part of large intestine and U shaped. It has 4 parts-
a. Ascending colon
b. Descending colon
c. Transverse colon
d. Sigmoid Colon/ pelvic colon: it enters the rectum.
3. Rectum: The length of it is 12 or 13 cm. Lower part of rectum is enlarged to form rectal ampulla.
 Function of large intestine:
1. Bacterial action : There are about 500 species of symbiotic bacteria in caecum and rectum. They break
down undigested food particles into short chain fatty acid (Acetic acid, propanoic acid and butyric acid) by
fermentation and produces CO2 & H2, CH4 and H2S gases.
2. Absorption: Some undigested substances come from small intestine is absorbed in large intestine. Such
as- 70- 80% water, inorganic salt, glucose, amino acid, folic acid (B9), vitamin B &K.
3. Secretion: Goblet cells of mucosa secret mucous which acts as lubricant and keeps the interior of the
large intestine lubricous.
4. Production of faeces: About 350 gm chyle enter the large intestine daily. After absorption from chyle
about 135 gm liquid faeces is produced and faeces are stored here for a few time.
5. Storage of unnecessary portion of food : After digestion and absorption in small intestine, the remaining
part of food and digestive juice are stored in caecum and colon for a long time.
6. Through the large intestine, stool is released out of the body through the anal canal
 Defecation.
 The process in which undigested food is passed out of the body in the form of feces is called defecation or
ingestion. The undigested, unabsorbed and non-nutritive matter of food is called roughage. This
roughage is converted into stool in a special process. Mucus secreted from the wall of the large intestine
acts as a lubricant, thereby facilitating the passage of stool. Faeces remain in the colon for several hours.
Bacterial infection during this period produces various sulphur-containing gases (such as hydrogen
sulphide) and the faeces become foul-smelling.
 Defecation is a reflex reaction to the pressure exerted on the rectal wall when stool enters the rectum.
(defecation reflex) occurs. This causes peristalsis in the colon and pushes the stool down. Voluntary
contraction of the abdominal muscles and diaphragm relaxes the sphincter muscles inside the anal canal
and allows stool to pass out of the body through the anus.

Anal Canal
 It is controlled by 2 types of sphincter.
1. Internal sphincter : It is made up of smooth muscle and controlled involuntarily.
2. External sphincter : It is made up of non smooth or skeletal muscle and controlled voluntarily.
 Function: Defecation /Egestion occurs through the anal canal which is one type of reflex. Faeces becomes
malodorous due to production of H2S gas.
 Obesity

 If accumulation of fat in body is 20% or more of standard body weight, it is called Obesity.
 The branch of medical science where cause of obesity, prevention, treatment and surgery are discussed is
known as Bariatrics.
 Diseases that occur due to obesity:
Coronary heart disease Type-2 Diabetes Cancer
Hypertension Stroke Disease of Liver and gall bladder
Sleep apnea Osteoarthritis Sterility

 If weight of body is divide by the square of height, then the result is called Body Mass Index or BMI.
 Unit of BMI is Kg/m2
 People whose BMI is more than 30 Kg/m2, they are called obese.
 If the value of BMI is 50-100 Kg/m2, it is called morbid obesity.
 WHO has published following values of BMI:
Serial BMI Kg/m2 Classification
1. <18.5 Underweight
2. 18.5-24.9 Standard/ normal weight
3 25-29.9 Overweight
4 30-34.9 Class 1 obesity
5 35-39.9 Class 2 Obesity
6 >40 Class 3 Obesity

 Causes of obesity
According to Medical scientists, the causes responsible for obesity are:
1. Genetic : Polygene plays role in obesity. Offspring of obese parents become obese in 80% case.
2. Disease : Due to Polycystic ovary syndrome, obesity is seen in female. Besides this obesity can also occur
due to Cushing syndrome, hypothyroidism, Prader Willi syndrome.
3. Drug: Some drugs can also cause obesity. such as: Corticosteroids, hypothyroidism, contraceptive pills, Anti
depressants, Diabetes controlling drug: insulin.
4. Sex difference : If male and female eats same amount of food, female has more chance of fat accumulation.
5. Pregnancy : In every pregnancy , 4-6 pound weight is increased in female most of the time.

Besides this, some important causes of obesity are:

 Excessive fat and calorie rich food intake
 Laziness and easygoing lifestyle
 Not doing regular physical exercise
 Doing job without physical work (desk job)
 Emotion/Mental trauma
 Lack of education
 Lack of sleep [Ref: Azmal, Alim]
 Prevention of obesity :
 Regular exercise : walking fast or swimming for 150-250 min in every weak.
 Taking hygienic food : Excluding excess salt and fat rich food, fibred food should be taken.
 Dose: To reduce obesity, Orlistat (Xenical), Lorcaserine (Belviq), Phentermine (Suprenza) etc. drug are
used.
 Usage of GI hormone : To prevent obesity, some GI hormones act as magic bullet.
 Bariatric surgery : To control obesity, most effective treatment is Bariatric surgery by which accumulated
fat in body is eliminated. In case of people whose BMI is 40 Kg/m2 or more, Bariatric surgery is
suggested.
 Usage of gastric balloon.
 Regular observation of body weight.
 Ketogenic diet: A diet low in carbohydrates and fat is called a ketogenic diet. Currently doctors recommend
diet like this in controlling obesity.
[Ref. Azmal, A. Alim.]

01. Which of the following BMI indicates overweight?

A. 18.5-24.9 Kg/m2 B. 25-29.9 Kg/m2 C. 30-34.9 Kg/m2 D. 35.5-39.9 Kg/m2 Ans: B.
02. Which of the following disease is related to obesity?
A. Coronary heart disease B. Anemia C. Renal failure D. Asthma Ans: A.

 Hunger and satiety regulating hormone:

 Some GI hormones such as: Ghrelin, pancreatic polypeptide(PP), Peptide (PYYY) acts as food intake
controller for a brief time.
 Before food intake, the level of ghrelin is increased, that creates Appetite.
 On the other hand, while taking food, the level of PP and PYY is increases which causes feeling of satiety.

 Every 9.3 calorie food intake in addition to requirement, causes 1 gm fat accumulation in body.
 After every 2 weeks, Mucous layer of human stomach wall is newly created. If it Doesn't occur, stomach
itself will be digested.
 400 /500 species of bacteria helping in digestion that consists in human digestive system is absent in
digestive system of fetus in intrauterine life. But during birth or after birth, body of child gains these bacteria
from body of mother and nature.
[Ref. Alim]
01. Which of the following vitamin is water soluble? 15. Which hormone of human body stimulates
A. Vit-d B. Vit-c pancreas to secrete pancreatic juice?
C. Vit-e D. Vit-a A. Enterokinin B. Secretin
02. Which is not the simple digested element of C. Deocrinin D. Pancreatic polypeptide
lecithin? 16. Which immunoglobulin is found in saliva?
A. Phosphate group B. Fatty acid A. Igg B. Iga C. Igm D. Ige
C. Glycerol D. Choline 17. What is amount of saliva in ml that a healthy
03. Which is the largest gland of human body? person secretes daily?
A. Liver B. Pituitary A.1250-1600 ml B. 1100-1400 ml
C. Pineal gland D. Thymus C. 1200-1500 ml D. 1200-1400 ml
04. Which is not monosaccharide? 18. Which of the following is not proteolytic
A. Mannose B. Levolose enzyme?
C. Galactose D. Sucrose A. Elastase B. Lecithinase
05. Which acts on paracasein? C. Collagenase D. Gelatinase
A. Hcl B. Pepsin 19. Secretion of which digestive gland contains
C. Renin D. Gelatinase enterokinase enzyme?
06. Which acts on proteose and peptone? A. Bile B. Succus intericus
A. Trypsin B. Caboxypeptidase C. Pancreatic juice D. Gastric juice
C. Pepsin D. Gelatinase 20. Where is parotid duct exposed in buccal cavity?
07. Where urea has been created? A. Opposite 2nd upper molar teeth
A. Stomach B. Liver B. Opposite 2nd lower molar teeth
C. Ureter D. Muscle C. At root of 2nd upper molar teeth
08. Which of the following enzymes has been D. Opposite 1st molar teeth
activated by HCl? 21. Which hormone is secreted from alpha cells of
A. Trypsinogen B. Chymotrypsinogen pancreas?
C. Prorenin D. Pro ilastase A. Somatostatin B. Polypeptide
09. From which of the following is bile salt C. Glucagon D. Insulin
synthesized? 22. Which of the following helps in emulsification
A. Cholesterol B. Glycerol process?
C. Protein D. Fatty acid A. Bile salt B. Pancreatic juice
10. Which cell of the liver destroys bacteria, fungus C. Bile pigments D. Succus intericus
and protozoa? 23. What is the value of BMI in case of morbid
A. Kupffer cell B. Interstitial cell obesity?
C. hepatic cell D. Langerhans cell. A. < 40 B. > 30 C. 50-100 D. > = 40
11. Which of the following causes gastric ulcer? 24. Back part of the tongue tastes-
A. helicobacter pylori B. helicobacter jejuni A. Sour B. Salined C. Bitter D. Sweet
C. Clostridium botulinum D. Campylobacter jejuni. 25. Ampulla of vater is formed by-
12. Which process is not stimulated by insulin? A. Common hepatic duct + cystic duct
A. Glycogenesis B. Lipogenesis B. Wirsung duct + common hepatic duct
C. Gluconeogenesis D. Glycolysis C. Pancreatic duct + common bile duct
13. Which converts inactive chymotrypsinogen into D. Cystic duct + common hepatic duct
active chymotrypsin? Answer
A. HCl B. Enterokinase 1. B 2. A 3. A 4. D 5. B 6. B 7. B
C. Chloride ion D. Trypsin 8. C 9. A 10. A 11. A 12. C 13. D 14. B
14. Which of the following is called mixed gland? 15. B 16. B 17. C 18. B 19. B 20. A 21. C
A. Adrenal gland B. Pancreas 22. A 23. C 24. C 25. C
C. Salivary gland D. Intestinal gland
26. Where is RBC not destroyed? 39. Which of the following acts on complex
A. Bone marrow B. Spleen carbohydrate?
C. Kidney D. Liver A. Lactase B. Maltase
27. Which nerve controls cephalic phase of gastric C. Ptyalin D. Sucrase
juice secretion. 40. Which is not cell of gastric gland?
A. Meissner's plexus A. Mucous cell B. Goblet cell
B. Pathetic nerve C. Argentaffin cell D. Oxyntic cell.
C. Vestibulo cochlear nerve 41. Which acts as magic bullet to prevent obesity?
D. Pneumogastric nerve.
A. Gastric surgery B. Ketogenic diet
28. From which cell, is HCl produced?
C. Argentaffin cell D. Oxyntic cell
A. Goblet cell B. Hepatic cell
C. Oxyntic cell D. Mucous cell 42. Which is not part of large intestine?
29. Which is not directly taken by cell? A. Sigmoid colon B. Rectum
A. Lipid B. Minerals C. Descending colon D. Ileum
C. Amino acid D. Glucose 43. Which vitamin is absorbed by forming micelle?
30. Where is highest amount of water absorbed? A. Folic acid B. Ascorbic acid
A. Large intestine B. Stomach C. Cyanocobalamin D. Vitamin k
C. Small intestine D. Lacteal 44. Which is not function of liver?
31. Which controls production of heat and A. Lipid metabolism B. Toxin production
regulates body temperature? C. Bile salt synthesis D. Ceruplasmin synthesis
A. Fat B. Protein 45. Which prevents chyme from entering nostrils?
C. Vitamin D. Carbohydrates A. Soft palate B. Hard palate
32. What is the name of covering of liver? C. Epiglottis D. Tongue
A. Meninges B. Perimetrium 46. Which prevents food to move backward from
C. Periosteum D. Glisson's capsule buccal cavity?
33. Which of the following is present in succus
A. Uvula B. Epiglottis
entericus?
C. Soft palate D. Hard palate.
A. Gelatinase B. trypsin
47. Which part of alimentary tract doesn’t contain
C. Lactase. D. Aminopeptidase
34. Which prevents corrosion of enamel of teeth? any amylolytic enzyme?
A. Chloride ion B. Bicarbonate ion A. Buccal cavity B. Stomach
C. Antibody D. Lysozyme C. Duodenum D. Ileum
35. In which layer of stomach, is Meissner’s plexus 48. Which is storage form of iron in liver?
found? A. heme B. Globin
A. Mucosa B. Muscularis mucosa C. Ferritin D. Biliverdin
C. Serosa D. Submucosa 49. Which cell secretes bile?
36. Which layer of intestine contains blood vessels? A. Hepatocyte B. Kupffer cell
A. Muscularis mucosa B. Submucosa C. Beta cell D. Goblet cell
C. Mucosa D. Serosa 50. Chylomicron helps in absorption of -
37. What is the total number of canine teeth in A. Carbohydrate B. Lipid/ fat
human adults? C. Protein D. All of above
A.16 B. 4 Answer
C. 8 D. 12 26. C 27. D 28. C 29. A 30. C 31. A 32. D
38. Which of the following disease is not related to 33.A 34. B 35. D 36. B 37. B 38. B 39. C
obesity?
40. B 41. D 42. D 43. D 44. B 45. A 46. D
A. Stroke B. Asthma
47. B 48. C 49. A 50. B
C. Colon cancer D. Type-2 diabetes.
 Pelvis : Broad funnel-shaped place of origin of ureter.
Podocyte : Highly specialized cells of the kidney glomerulus that have foot processes
Peritubular capillary : Capillary that surround any tubule.
Gluconeogenesis : The process of generation of glucose from non-carbohydrate (Protein &
lipid) source.
Ureotelism : The excretion of excess nitrogen as urea.
Hydrostatic pressure : The pressure exerted by blood against the wall of a capillary.
Active process : The biological process in which ATP is used.
Deamination : The removal of an amino group from an amino acid or other compound.
Diuresis : Excretion of excess volume of water through urine.
Antidiuresis : Excretion of scanty volume of water through urine.
Osmoregulation : A process that regulates the osmotic pressure of fluid and electrolyte
balance in body.
Intracellular fluid : Fluid inside the cell.
Dialysis : Separation of small solute particles from colloid particles by means of a
semi-permeable membrane.
Collecting duct : A duct that receives urine from the distal convoluted tubule.
Azotemia : Azotemia is an elevation of blood urea, nitrogen and serum creatinine
levels.
Uraemia : Physical illness due to elevation in blood urea, nitrogen and other
nitrogenous waste compounds.
Juxtaglomerular complex : A structure in the kidney that regulates the function of each nephron and
secretes renin.
Nephrology : Branch of medical science that deals with diseases of the kidneys.

Scientist
Sir William Bowman
Arthur Robertson Cushney
Claude Bernard
Friedrich Gustav Jakob Henle
Hans Krebs + Kurt Henseliete
 Water intake and output in the body:
Daily water intake: 2600 ml
1. Drinking water  1450 ml
2. Food  800 ml
3. Cellular respiration  350 ml
Function
Described the fine structure of kidney
Described 3 basic mechanism of urine formation.
Described the mechanism of balance of internal environment in the body
Discovered Loop of Henle
Described the formation of urea.
[Ref. Azmal, Majeda, Alim]
Daily water output: 2600 ml
1. Tear (Scanty)
2. Water vapor from lung  400 ml
3. Sweat  1500 ml
4. Urine  1500 ml
5. Faeces  100 ml
 Different Types of Waste Products of Animals
 Excretory Substances:
 As a result of catabolic metabolism, the nitrogenous wastes produced in the body are called excretory
substances.
 The main excretory waste of human is Urine.
 Excretion of excess urea is called ureotelism
 The main nitrogenous waste products of man are-
 Urea  Ammonia  Creatinine
 Uric acid  Amino acid  Urochrome
Animal Main excretory substance Example
Ureotelic Urea Some terrestrial and marine animals including humans
Uricotelic Uric acid Insects, snakes, lizards, birds etc.
Ammonotelic Ammonia Hydra, earthworm, some fish (Rohu), Shrimp

 Other excretory substances:

 Bile pigment: These are the breakdown product of hemoglobin, Bilirubin and biliverdin.
 Sweat: Here excessive water, NaCl and Urea are present.
 CO2: Produced by respiration
 Salts of iron and calcium: Produced in the intestine.

Excretory system

Excretory organ Accessory excretory organ

(Excretes 80% of waste products) (Excretes 20% of waste products)
A pair of kidneys (Main excretory organ)
A pair of ureters Skin, lung, alimentary canal and
One urinary bladder liver etc.
One urethra
 Parts of excretory system:
Parts Features Functions
 It is about 25 – 30 cm (A. Alim), 25 cm (Azmal) long.  Transports urine from kidney to
Ureter  The base or point of origin of each ureter is urinary bladder.
swollen and is known as pelvis.
 It is a triangular, has the ability of contraction  Acts as a temporary storage site for
and expansion. urine.
 It can hold 700 – 750 ml of urine.  Contraction of detrusor muscle and
 Urge for urination occurs when 280 – 320 ml relaxation of sphincter muscle cause
Urinary excretion of urine from the body.
bladder urine is stored.
 It contains detrusor (involuntary) muscle in
its wall.
 The volume of human urinary bladder is equal
to the volume of brain.
 The length of the urethra is 18 – 20 cm in male  Urethra facilitates the urination
and 3.5 – 4 cm in female. process from bladder to outside of
Urethra the body.
 Facilitates semen ejaculation in
male.
[Ref: Azmal, Alim]
Kidney
Number 2 (Right and left kidney)
Length: 10 – 12 (Azmal)/ 11 – 12 (A.Alim)/ 11 – 13 (Majeda) cm
Width: 5-6 cm, Depth: 3 cm
Measurements
weight: 150 – 170 gm (Azmal)/125 – 170 gm (Alim) [Male]
130 – 150 gm (Azmal)/115 – 155 gm (Alim) [Female]
 Normally left kidney is slightly greater than
the right kidney.
 Extension: (12th thoracic vertebra- 3rd
lumber vertebrae)
 Upper part of the kidney is protected by 11th
Position & 12th rib.
 Normally the left kidney is slightly above
the right one due to presence of liver over
right kidney.
 Attached to the body wall through the
mesentery
Shape  Bean shaped / like bangla ‘5’
 The outer side Structures entering hilum: Structures that exit hilum:
of kidney is  Renal artery  Renal vein (Largest vein in the
convex  Nerves body)
 The inner  Ureter
side is concave
External
 Median
features
indentation of the
concave side of
the kidney is
called hilum /
hilus
Covering  Kidney is covered by renal capsule/tunica fibrosa
 Each kidney is surrounded by peritoneum membrane.
 It has renal fascia which is a layer of connective tissue encapsulating the kidney. Renal
fascia protects kidney from abrasion.
  Renal corpuscles, proximal & distal convoluted tubules lie here.
1. Cortex
 It lies in the outer side.
(Outer
 Outer 2/3 is called superficial cortex.
portion)
 Inner 1/3 is called juxtamedullary cortex.
 It consists of loop of Henle, collecting tubule, blood vessel
 Triangular (8 – 18 in number) renal pyramid is present.
Internal
2. Medulla  The apex of each pyramid is called papilla. papilla has 10 – 25 pores.
structure:
(Inner  Papilla gradually becomes a tubular structure called calyx minor (8 – 14)
3 parts
portion)  Several calyx minors united to form calyx major (2 – 3)
 All the pyramids project into pelvis which leads into ureter.
 The elongated portion of cortex that lies between the pyramids is
called renal columns of Bertini.
 Enlarged upper end of the ureter, the tube through which urine flows
3. Pelvis:
from the kidney to the urinary bladder.
[Ref. Azmal, Alim, Majeda]

8 - 18 10 - 25 8 - 14 2–3
Renal pyramid  Renal papilla  Minor calyx  Major calyx  pelvis

Nephron

 Nephron is the structural and functional unit of kidney.

 Developed from embryonic mesoderm.
 Number: Each kidney contains about 10 – 12 lac nephrons.
 Each nephron is 3 – 5 cm (Azmal)/3 cm (Majeda) in length.
 In human kidneys, 50% of nephrons are always active and the
remaining 50% of nephrons are in a resting state.
 Blood flow through each kidney is 1200 ml/min or, 1200 cm3/min
 Urine production: 125 cm3 blood is filtrated by both kidney
per minute, from which 124 cm3 (99%) is reabsorbed.
 Bowman 1st described the ultra-structure of kidney correctly. According to his description, each nephron
can be divided into 2 components-
 Bowl or cup shaped
1. Renal  Parietal layer (outer layer) consists of squamous
corpuscle a) Renal capsule / epithelium.
Bowman capsule  Visceral layer (inner layer) consists of podocyte cell.
/ Malpighian  A narrow space between these two layers is called
body / capsular spaces.
Malpighian  Composed of 50 – 60 (All book)/ 30 – 35 (Parvin)
corpuscle b) Glomerulus capillaries, which are originated from afferent arterioles
and together they form efferent arterioles.
2. Renal tubule: a) Proximal  Situated in cortex.
Length: 3 cm. convoluted tubule  Attached to the Bowman’s capsule.
 Length: 14 mm
 Lined by single layer of cuboidal epithelial cells.
 Numerous microvilli are present which is known as
brush border.
  In PCT Selective reabsorption takes place.
b) Loop of Henle  Situated in medulla. Length 20mm, U shaped.
 Lined by thick cuboidal and thin squamous epithelium.
c) Distal  Situated in cortex Length: 5 mm
convoluted tubule  Lined by single layer of cuboidal epithelium.
 It is situated partly in cortex and partly in medulla.
Length: 20 mm
Collecting duct  It is lined by single layer of cuboidal epithelium.
 Several collecting ducts join together to form the
Duct of Bellini.
[Ref: Azmal, Alim, Majeda]

Nephron

Renal corpuscle/ Malphigian body/ Malphigian corpuscle Renal tubule

Glomerulus Renal capsule Proximal Loop of Henle Distal convoluted Collecting duct
convoluted tubule tubule

Thin descending limb Thin ascending limb Thick ascending limb

[Ref: Azmal]

Diameter of afferent arteriole > Diameter of efferent arteriole, so high pressure is maintained in the
glomerulus all the time.
Function of Nephron : 1. Ultrafiltration 2. Reabsorption 3. Tubular Secretion 4. Manufacture of new substances
5. Regulation of pH.

 Different types of nephron:

Trait Superficial cortical Mid cortical nephron Juxtamedullary
nephron nephron
Percentage 85% 5% 10%
Situation of corpuscle Outer cortex Mid cortex Junction of cortex and
medulla
Loop of Henle Short Short or long Long
Urine production In normal condition – In an emergency
[Ref: Azmal, Alim]
 Function of different parts of nephron:
Parts of Nephron Function Name of the secretory substance
Visceral layer- ultrafiltration Ultra-filtrated materials of blood
1. Bowman’s capsule
Sends filtrated material to renal tubule
Acts as an ultrafiltrate. All components of plasma except
2. Glomerulus
colloid.
Active absorption Glucose, Amino acid, PO43, Na+, k+
Passive absorption Cl, HCO3, NaHCO3, Water, Small
A.Proximal
amount of Urea, Uric, Uric acid
convoluted
Secretion Creatinine, Hippuric acid, Pigment,
tubule
3. Renal Drugs including Penicillin, H+, NH4+
tubule Active absorption Na+, K+, Cl, Ca++, Mg++, Urea
B. Loop of
Passive absorption H2O
Henle
Secretion Urea
C. Distal reabsorption Na+, H2O
convoluted Secretion H+, NH4+, K+, Cl
tubule
reabsorption Na+, Cl-, H2O, K+, Urea
Secretion H+, NH4+, K+, HCO3-
Collecting Duct After reabsorption, the ultra-filtrated
fluid is stored in the collecting duct -
as urine and then sent to the bladder.
[Ref: Azmal, Alim]

 Function of Kidney:
1. Excretes waste materials from the blood. (Urea, Uric acid, Creatinine). Purification of blood.
2. Maintains pH and acid-base balance of the blood. Maintains blood pressure.
3. Maintains water balance. Osmoregulation regulates osmosis.
4. Regulates the level of various ions (Na+, K+, Ca2+, PO43, Cl)/ Salts in the body.
5. Secretion of hormones: Kidney secretes erythropoietin, prostaglandin, angiotensin, calcitriol.
Erythropoietin stimulates RBC synthesis.
6. Release of enzyme: Kidney releases renin enzyme which regulates aldosterone level in the blood.
Note : Rennin is an enzyme present in the stomach that helps to digest milk. [Azmal, Alim]
7. Gluconeogenesis: Kidney can supply 20% of glucose through this process.
8. Removes toxin, herbs, pigments, hormone, excess vitamin, excess medicine from the body.
9. Homeostasis: Kidney maintains homeostasis by removing various unnecessary substances from the blood.
10. Formation of strong bone and teeth: Kidney plays a major role in formation of vitamin D. Vitamin D
makes bone and teeth strong.
11. Regulates osmosis.
12. To keep blood components constant.
13. Reabsorption.
 1. Which organ synthesize erythropoietin? [M: 19 – 20]
A. Heart B. Kidney C. Lung D. Brain Ans. B
2. Which one is the structural and functional unit of kidney? [M: 19 – 20]
A. Neuron B. Alveolus C. Lacuna D. Nephron Ans. D
3. Where loop of Henle is located? [M: 17 – 18]
A. Renal tubule B. Renal corpuscle
C. Afferent arteriole D. Efferent arteriole Ans. A
4. Which one is not a part of human excretory system? [D: 17 – 18]
A. Kidney B. Urethra C. Adrenal gland D. Ureter Ans. C
5. Which one is not the function of kidney? [D: 16 – 17]
A. Regulation of blood pressure B. Maintenance of acid base balance
C. Regulation of temperature D. Regulation of blood ion Ans. C
6. Loop of Henle is the part of- [M: 13 – 14]
A. Liver B. Kidney C. Spleen D. Heart Ans. B
Physiology of excretion
 As human is ureotelic, physiology of excretion can be described in 2 headlines.
a) Formation of nitrogenous waste product
b) Formation of urine.
Formation of nitrogenous waste product

 Hans Krebs & Kurt Henseleit described the formation of urea.

De-aminase
 Amino acid  keto acid + NH2
ornithine/urea
 2NH3 + CO2  Urea [CO (NH2)2] + H2O
Cycle
 Ammonia is more toxic than urea. So, liver converts NH3 into urea by addition of
Urea CO2 which is derived from carbohydrate metabolism. This process is called urea
cycle/ornithine cycle. Produced urea remains in the blood plasma which
subsequently goes to the kidney through circulatory system and is excreted from
the body as urine.
 Small amount of urea is produced in kidney and brain.
Uric acid  Formula: C5H4O3N4 Less toxic than urea.
 Uric acid is produced from metabolism of purine base.
 Uric acid is formed from the metabolism of purine. Presence of excessive amount
of uric acid in urine is called hyper-uricosuria. This uric acid accumulate as
needle-shaped crystals in kidney, ureter or bladder which is known as kidney
stone/renal calculi.
 Renal stone mainly consists of calcium oxalate, calcium phosphate and uric acid.
Creatinine  Approximately 2% of the body’s creatinine is used in the muscle for formation of
energy through metabolism.
 In muscle, creatinine is produced from the metabolism of amino acid creatine.
 Blood creatine level is used as diagnostic index for kidney function.
 Normal level of creatinine in blood: Male: 0.6 – 1.2 mg/dl; Female: 0.5 – 1.1 mg/dl
 Kidney
Liver

2NH3 Ultrafiltration
Reabsorption
Ornithine Glomerular filtrate Urine
Urea Renal artery
cycle Secretion
Bowman’s capsule Collecting duct
CO2

Urinary
Discharged outside Urethral meatus Urethra Ureter
bladder

Formation of urine

 According to Cushy, Urine formation takes place by the following 3 basic mechanism-
 Occurs in renal corpuscle. Renal corpuscle acts as an ultrafiltration.
 About 1200 ml of blood flows every minute through two kidneys.
 All blood of the body passes through kidney in every 4 – 5 min for the purpose
of filtration.
 Everyday two kidneys purify about 170 liters of blood, which is 40 percent
a) Ultrafiltration of total volume of blood in the body.
 The effective filtration pressure is 25 mm Hg.
 Due to net filtration pressure, except larger protein and blood corpuscles, almost
entire water, salt, carbohydrates, Urea, Uric acid etc. are squeezed out of the capillary
into Bowman’s capsule as glomerular filtrate.
 The amount of glomerular filtrate is about 125 ml.
 80% (Azmal) / 60% (Parvin) of the glomerular filtrate is reabsorbed back into
blood.
 In PCT, 60% of the glomerular filtrate is reabsorbed. Reabsorption- Glucose, amino
b) Selective acid, water, Na+, K+, Cl, PO43CSome urea (10%), vitamin, lactate, uric acid
reabsorption and hormone.
 In loop of Henle, 70% water is reabsorbed by osmosis.
 In DCT, Na+, K+, H+, Cl, Vitamin, water etc are reabsorbed.
 In collecting duct, mainly water & little Na+, Cl, Urea are reabsorbed.
 In PCT, creatine, hippuric acid, pigment, penicillin and small amount of urea are
actively secreted.
c) Active  In loop of Henle, Some amount of urea is secreted.
secretion  In DCT, H+, K+, NH4+, Serotonin, creatinine, histamine, choline, steroid are
secreted.
 In collecting duct, H+, K+, NH4+, HCO3 are secreted.
*** 40 – 45% urea of the glomerular filtrate is reabsorbed back into the blood from renal tubules, rest of the urea is
excreted through urine.
[Ref: Azmal, Alim]
  Fresh hold substance: The components of the glomerular filtrate which are completely reabsorbed in
the renal tubular wall are called fresh hold substances or completely reabsorbed substance. Like-
glucose, potassium ion.
 Non-fresh hold substance: The components of the glomerular filtrate which are not reabsorbed in the
renal tubule at all are called non-fresh hold substances or fully excreted substances. Like-sulphate,
creatinine etc.
 For ultra-filtration the wall of glomerular capillary and Bowman’s capsule unitedly form a filter of 3 layers.
The layers are:
 Glomerular capillary endothelium.
 Glomerular capillary basement membrane.
 Bowman’s capsule endothelium.
 Cells of tubular wall are specifically designed for reabsorption. Like-
 Absorption surface of these cells are more due to having microvilli & basal channel.
 Cytoplasm contains more number of mitochondria.
 Cells are strictly adherent to the capillaries.

[Ref: Azmal]
Pressures of filtration
Glomerular Hydrostatic Pressure/ G. HP  75 mm Hg / 70 mm Hg
Glomerular Osmotic Pressure/ G. OP)  30 mmHg
Bowman’s capsule Hydrostatic Pressure/ B. HP)  20 mmHg
Bowman’s capsule Osmotic Pressure/ B. OP)  0 mmHg

Azmal Sir Parvin Mam

Net filtration pressure Net filtration pressure
= (G. HP + B. OP)  (G. OP + B. HP) = (G. HP + B. OP)  (G. OP + B. HP)
= (75 + 0)  (30 + 20) = (70 + 0)  (25 + 15)
= 75 – 50 = 70 – 40
= +25 mm Hg = +30 mm Hg
 Characteristics of urine:
 0.6 – 2.5L/day (healthy adult)/Avg: 1.5 L
 Oliguria: amount of urine < 400 ml
Amount  Polyuria: amount of urine > 2.5 L
 Anuria: amount of urine < 100 ml
 On average, 1500 ml urine / 6 – 8 times urine is excreted per day.
 Straw (pale yellow) in color due to presence of ‘Urochrome’ pigment
Color  Cloudy (If blood, pus or bacteria are present)
 Dark yellow (due to dehydration)
Smell  Strong acidic due to presence of Urinode (C6H8O)
pH  5 – 6.5 / 4.5 – 8
Specific gravity  1.008 – 1.030
[Ref: Azmal, Majeda]
Components of urine: (95-97)% water and (3-5)% solids in which organic and inorganic components are
included.
Organic components Percentage Inorganic components Percentage
(60%) (40%)
Nitrogenous:
Sodium 0.35
Urea 2
Uric acid 0.5 Potassium 0.15
Hippuric acid 0.05 Ammonium 0.04
Creatinine 0.07 Magnesium 0.01
Ketone bodies 0.02 Chloride 0.60
Sulphate 0.18
Phosphate 0.27
Calcium 0.03
[Ref: Azmal]
 Unusual elements of urine:
Unusual elements Related disease Name of the situation
1. Glucose Diabetes mellitus (DM) Glycosuria
2. Protein Renal inflammation, Leukemia, Proteinuria
Lymphosarcoma etc.
3. Lipid Renal disease, Alcoholism Lipuria
4. Bilirubin Jaundice Bilirubinuria
5. Blood Inflammation of kidney, prostate, Haematuria.
kidney injury
[Ref: Azmal]

 Diuretics are those which causes more urination.

 Diuretic substances: Tea, coffee, water, salted water, alcohol.
 Kidney cleansing food: Apple, cider, vinegar, beet, dark green spinach, black grape, garlic, nut and
pulses, dandelion spinach, turmeric, carrots etc.
 High sodium containing food: Cheese, salt, pickles, chutney, potato chips, soy sauce and banana,
date, mango, orange.
 Some disease like diabetes, nephritis influences the rate of urine formation.
[Ref: Azmal, Alim, Majeda]
1. By which cycle urea is produced in the liver? [M: 15 – 16; D: 19 – 20]
A. Carbon cycle B. Ornithine cycle C. Krebs cycle D. Nitrogen cycle Ans. B
2. For which pigment urine becomes normal straw color? [M: 14 – 15; D: 16 – 17]
A. Uric acid B. Urochrome C. Creatinine D. Ammonia Ans. B
3. Which one is not the element of urine? [M: 12 – 13]
A. Creatinine B. Uric acid C. Bilirubin D. Urochrome Ans. C
4. What is the percentage of ammonium in human urine? [D: 10 – 1a]
A. 0.04 B. 0.01 C. 0.35 D. 0.15 Ans. A
5. How much (%) of urine filtrated in glomerulus is reabsorbed in the proximal convoluted tubules
without ADH activity? [M: 10 – 11]
A. 40% B. 60% C. 80% D. 20% Ans. B
6. Which one is actively secreted in proximal convoluted tubule? [D: 10 – 11]
A. Vitamin B. Creatinine C. Amino acid D. Cl Ans. B
7. Which one is not correct about kidney? [D: 09 – 10]
A. kidney is the main organ of osmoregulation B. In kidney, urea is produced from ammonia
C. Water reabsorption is increased due to ADH D. Glucose is reabsorbed through active process Ans. B
8. What percent of excretion of our body occurs by the kidney? [M: 06-07]
A) 60% B) 75% C) 80% D) 90% Ans: C
9. Which one is not a step of urine formation? [D: 05 – 06]
A. Active secretion B. Selective reabsorption C. Absorption D. Ultrafiltration Ans. C

Acute Renal Failure: Symptoms and Measures

 50% nephrons of human kidneys are always active and 50% are in rest or inactive.
 In 70 years old man, kidney can perform only 50% of its function.
 Symptoms are revealed when kidney loses 75% / 70 – 75 % of its function.
 Renal failure are of two types-
I. Chronic renal failure: If the functional lose of kidney persists for 3 or more than 3 month.
II. Acute renal failure: Sudden stoppage or decrease of kidney function of a healthy man within 48 hours.
 Causes of acute renal failure:
 Approximately 70% of renal failure is caused by diabetes and high blood pressure.
 These are many causes of acute renal failure. These are classified into 3 categories i.e. pre-renal, renal and
post – renal cause. [Ref: Azmal, Meghnad]
1. Pre-renal cause 2. Post-renal cause 3. Renal cause:
 Excessive bleeding  Renal stone  Excessive inflammation
 Severe diarrhoea, vomiting  Ureteric stone  Multiple myeloma
 Severe burn  Prostate enlargement  Nephritis
 Heart attack  Pelvis & abdominal cancer  Snake bite
 Heart failure  Stone in urethra & bladder  High BP
 Liver failure  Tumor in urethra & bladder  Drug- Antibiotic, pain killer
 Dehydration, allergy  Blood clotting in the ureter  Arsenic, lead, mercury, CCl4 etc.
 Operation, abortion, shock  Colon cancer, cervix cancer  Acute tubular necrosis, scleroderma
 Acute pancreatitis
 Mismatched blood transfusion
[Ref: Azmal, Alim, Majeda]
 Symptoms:
 Scanty and concentrated urine or absence of  Flank Pain
urination.  Hiccups for a long period of time.
 Generalized swelling.  Anorexia, nausea and vomiting
 Frequent breathing.  Metallic taste in the mouth.
 Excess nitrogenous waste products in blood.
[Ref: Azmal]
 Diagnosis of acute renal failure:
 When renal failure occurs, there is-
 Increase of urea and creatinine in the blood.
 Abnormal increase or decrease of ion in blood.
 The amount of RBC in the blood decreases. This condition is called anemia.
 Formation of small amount of urine (< 0.5 ml/ kg/h for 6 hours)
[Ref: Alim]
 Measures:
 High blood pressure and diabetes must be controlled.
 Additional 500 ml of water should be given along with the amount of water he urinates
 Low protein intake (urea formation will be low)
 Food with low amount of salt and potassium should be ingested. Like: orange, chocolate, mushroom
(High level of K+ in the blood can cause heart attack)
 Use and consumption of nephrotoxic drugs should be avoided completely if renal failure occurs.
 The level of erythropoietin and calcitriol which are released from kidney must be kept in required
level. Hemoglobin level in the blood must be kept in desired or normal level.
 Must refrain from smoking. After 50 years of age, kidney must be checked regularly. If there are any
diabetic or hyper-tensive patient in the family, their kidney must be checked regularly.
 Whether albumin is present in urine or not, to know the status of diabetes, patient must be checked
regularly and necessary steps must be taken.
 For this ultrasonography, IVU, renogram should be done.
[Ref: Azmal]
Dialysis
 Dialysis is a procedure to remove waste products and excess fluid from the blood when the kidneys stop
working properly.
 Azotemia: Azotemia is an elevation of blood urea nitrogen and serum creatinine levels.
 Uremia: Physical illness due to elevation in blood urea nitrogen and other nitrogenous waste compounds.
 When dialysis is needed?
 Normally, condition of kidney is diagnosed by creatinine clearance test.
 Amount of creatinine cleared by the human kidney in every minute is called creatinine clearance.
 Creatinine clearance in healthy adult is 125 cc/min.
 Dialysis is required when creatinine clearance is 10-12 cc/min.
 Types of dialysis: a) Hemodialysis b) Peritoneal dialysis [Ref: Alim]
 Hemodialysis:
 In this method, special type of filter or dialysis membrane is used in the dialysis machine to excrete the excess
waste products and fluid from the blood. Blood cells, platelet, protein can’t pass through this membrane.
 In this method, blood is brought out from artery by a pump and is driven to the vein, Heparin is mixed
with blood to prevent clot formation.
 In this method, Gortex graft is placed between a vein and an artery of patient’s hand or leg. This method
is called Cimino fistula.
 Blood and dialysate glucose do not have a diffuse effect.
 Patient is to be encountered hemodialysis at least 2 times in week.
 4 – 5 hours are needed to complete this procedure.
 Composition of dialysate:
1. Constant body temperature. 3. Excess nutrition. Ex- Glucose.
2. Proper ionic balance: Na+, K+, Cl, Ca2+, Mg2+, 4. Excess pH and buffering capacity.
HCO3 (as acetate)
 Peritoneal dialysis:
 In this process, natural peritoneal membrane is used as dialysis membrane instead of artificial membrane.
 During peritoneal dialysis, patient can move freely and lead a normal life.
 It’s another name is Continuous Ambulatory Peritoneal Dialysis (CAPD)
 Dialysate is replaced 3 – 4 times in a day. Renal Transplantation

Renal Transplantation
 Renal transplantation can be done in two ways.
(i) Among close relatives (Ex- Father- Mother, brother, sister, maternal uncle, maternal aunt)
(ii) Taking the kidney of a dead person
Points must be kept in mind regarding renal transplantation are-
 Kidney must be transplanted in the patient’s body within 48 hours of collection from any
donor (relative or not). If the donor is dead, kidney must be collected immediately after
death of the donor.
 Collected kidney must be healthy (HIV or other inflammation free)
 Blood group of kidney donor and receiver must be same.
 Type of tissue of kidney donor and receiver must be same.
 Antibody system of the receiver must be suppressed by medicine. To prevent inflammation and
serious illness the receiver must take antibiotics.
[Ref: Azmal]
 Life span of transplanted  Control of urinary pH:
kidney:
A. Control chemical substance or buffer system.
1 year  about 95% B. Phosphate system: H+ ions are excreted through
5 year  about 85-90% urine as NaH2PO4
C. Ammonia system: Excreted in urine as NH3, NH4Cl
10 year  about 75%

Hormonal action

 French physiologist Claude Bernard first stated the maintenance of constant internal environment of the
body
 Four major hormones help to regulate the concentration of urine and sodium level in blood.
i. Antidiuretic hormone (ADH) ii. Aldosterone
iii. Angiotensin II iv. Atrial natriuretic peptide (ANP)
 H2O and salt secretory hormone: ANP: A hormone produced by the heart (atrial wall)
 H2O and salt reabsorbing hormone: ADH, Aldosterone, Angiotensin II [Ref. Alim]
Aldosterone:
 Aldosterone produced in Cortex of adrenal gland
 Aldosterone perform function in  Distal convoluted tubule of kidney
ADH:
 ADH produced in Hypothalamus
 ADH stored in posterior pituitary
 ADH perform function in  Distal convoluted tubule and collecting duct
 Osmoregulation:

Body H2O () Body H2O ()

Blood concentration ()

Blood concentration ()

blood flow ()

Blood flow()

Hypothalamus (–)
Hypothalamus (+)
Posterior pituitary

Posterior pituitary
ADH secretion stopped

ADH secretion
Decreased H2O reabsorption in nephron

Increased H2O reabsorption It can increase from 1

in nephron H2O content in urine is high ml/min upto 16
ml/min.

H2O content in urine is low Decreased concentration of urine

Increased concentration of urine

 Regulation of water balance:

 Body water is distributed as- Extra-cellular fluid- 45%; Intra-Cellular-fluid- 55%
 Amount of water in the body- Male- 60%; Female- 50% ; Child- 70%
 If much water is drunk at a time, more than normal amount of urine is produced within 3 – 4 hours.
 Daily 1500 gm salt is filtrated and only 15 gm of salt is excreted and rest of the salt is reabsorbed by
nephron. Sweat is another pathway of salt excretion.
 Regulation of sodium balance:
 Na+ ion is an important element of body fluid & it maintains the extra-cellular fluid volume.
 Na+ level- Extracellular fluid- 142 mmol/L; Intracellular fluid- 10 mmol/L
 Regulation of K+ balance:
 K+ level in Extracellular fluid  4 mmol/L; Intracellular fluid  160 mmol/L
 K+ deficiency leads to diarrhea and muscle weakness.
 Excess or less K+, both can cause heart disease.
  Atrial Natriuretic Peptide (ANP): A hormone produced by the atrial wall of the heart. ANP increases
sodium excretion and decreases blood pressure and blood volume.
 ADH ∝ Reabsorption of water.
[Ref: Alim]
Role of hormone in regulation of sodium balance in blood
Blood volume 

JG cell of nephron (+)

Secretion of renin

Angiotensinogen (Inactive) Angiotensin I (active)

Angiotensin converting
enzyme (ACE)

Angiotensin II

Contraction of blood vessel Increased H2O & Adrenal gland (+)

salt reabsorption in
nephron
Secretion of aldosterone

Na+ reabsorption in
nephron

‘+’ means excited

‘’ means increased
Blood volume  ‘’ means decreased

 Angiotensinogen is produced in the liver and ACE is produced in the lung.

 Aldosterone is called lifesaving hormone.
 Aldosterone works by Na+– K+ pump.
 1. Which of the following hormone controls sodium level in blood? [M: 18 – 19]
A. Renin B. Angiotensin C. Aldosterone D. ADH Ans. C
2. The kidney should be transplanted within how much time period after collecting from donor? [M: 16 – 17]
A. 72 hours B. 48 hours C. 100 hours D. 2 hours Ans. B

1. Which one is the covering of kidney? 14. Which hormone stimulates sodium-potassium pump?
A. Pleura B. Epidermis A. Renin B. Angiotensin
C. Pericardium D. Capsule C. ADH D. Aldosterone
2. Which one is the value of neutral pH? 15. Where osmoreceptor is located?
A. 7.4 B. 0 C. 7 D. 1 A. Kidney B. Liver
C. Hypothalamus D. Lung
3. Which one is present in the visceral layer of 16. Who described the mechanism of balance of the
Bowman’s capsule? internal environment of the body?
A. Podocyte B. Squamous epithelial cell A. Bateson B. Claude Bernard
C. Squamous cell D. Cuboidal C. Thompson D. John Kerry
4. Which one forms duct of Bellini? 17. Deficiency of which hormone causes diabetes
A. Loop of Henle insipidus?
B. Proximal convoluted tubule A. Aldosterone B. Insulin
C. Collecting duct C. ADH D. Angiotensin
D. Distal convoluted tubule 18. Which one regulates sodium level in plasma?
5. Urea is produced by mainly in- A. ADH B. Aldosterone
A. Kidney B. Intestine C. Liver D. Stomach C. FSH D. TSH
19. Which one helps in aldosterone secretion?
6. Urea is produced by which enzyme?
A. Glucagon B. TSH
A. Lipase B. Amylase C. Angiotensin D. Vasopressin
C. De-aminase D. Carboxylase 20. The kidney should be transplanted within how
7. Which one is not a step of urine formation? much time period after collecting from donor?
A. Ultrafiltration B. Tubular reabsorption A. 72 hours B. 24 hours
C. Active secretion D. Selective absorption C. 48 hours D. 96 hours
8. ______ % water is reabsorbed in proximal 21. All blood passes through kidney to be filtrated in every-
convoluted tubule? A. 2 – 3 min B. 3 – 5 min
A. 55% B. 45% C. 80% D. 60% C. 4 – 5 min D. 4 – 6 min
9. Which one occurs when the concentration of 22. Kidney produces how much urine per day?
A. 1.5 – 2.5 L B. 0.5 – 2.5 L
Hydrogen ion increases? C. 1.5 – 3 L D. 1.5 – 2.5 L
A. Acidosis B. Alkalosis 23. In male, which one is the normal level of
C. Hypernatremia D. Hyperglycemia creatinine in blood?
10. Which one is the normal pH of blood plasma? A. 0.5 – 1.1 mg/dl B. 0.3 – 1.6 mg/dl
A. 7.1 – 7.2 B. 7.35 – 7.45 C. 0.6 – 1.2 mg/dl D. 0.8 – 2.6 mg/dl
C. 7.25 – 7.35 D. 7.45 – 7.55 24. Amount of body water is highest in-
A. Adult male B. Adult female
11. Which one releases atrial natriuretic hormone?
C. Child D. Old male
A. Kidney B. Liver C. Brain D. Heart 25. Which one causes strong acidic smell of urine?
12. In 70 years old man, kidney can perform A. Urochrome B. Urinode
only______ % of its function? C. Uric acid D. Urea
A. 10% B. 25% C. 45% D. 50% Answer
13. In which process water is reabsorbed in the loop 01.D 02.C 03.A 04.C 05.C 06.C 07.D
of Henle? 08.D 09.A 10.B 11.D 12.D 13.C 14.D
A. Diffusion B. Active absorption 15.C 16.B 17.C 18.B 19.C 20.C 21.C
C. Osmosis D. Phagocytosis 22.B 23.C 24.C 25.B
26. In urine, amount of which substance is the most? 41. Which one is not a part of Malpighian body?
A. Urea B. Uric acid A. Glomerulus
C. Creatinine D. Water B. Podocyte
27. Which process is related to excretion of large C. Squamous epithelium
volume of urine? D. Loop of Henle
A. Antidiuresis B. Anuria 42. Microvilli are present in which part of renal
C. Oliguria D. Diuresis tubule?
28. Which one stays as acetate in dialysate?
A. PCT B. DCT
A. Sodium ion B. Potassium ion
C. Loop of Henle D. Collecting duct
C. Calcium ion D. Bicarbonate ion
29. Which one prevents intravascular clotting? 43. In which region of nephron reabsorption occurs
A. Prothrombin B. Heparin the most?
C. Fibrinogen D. Thromboplastin A. Proximal convoluted tubule
30. It takes_____ hours to complete hemodialysis. B. Distal convoluted tubule
A. 5 – 6 hours B. 4 - 5 hours C. Loop of Henle
C. 3 – 4 hours D. 5 – 10 hours D. Collecting duct
31. Which one is ammoniotelic animal? 44. Which hormone is released from kidney?
A. Lizard B. Human A. Adrenaline B. Aldosterone
C. Hydra D. Marine animals C. Vasopressin D. Erythropoietin
32. Which one is the main waste products in human? 45. Deamination occur in which of the following
A. Urine B. Bile C. Feces D. Sweat organs?
33. Which one is not an accessory excretory organ in A. Liver B. Kidney
human? C. Stomach D. Heart
A. skin B. Lung
46. Which substance causes formation of renal
C. Intestine D. Kidney
stone?
34. Which one transports urine from kidney to
urinary bladder? A. Urea B. Uric acid
A. Ureter B. Urethra C. Ammonia D. Creatinine
C. Renal pelvis D. Renal medulla 47. Which one is the vital diagnostic index for kidney
35. Which one temporarily stores urine? function?
A. Urethra B. Urinary bladder A. Urea B. Uric acid
C. Kidney D. Ureter C. Ammonia D. Creatinine
36. The left kidney is slightly above the right kidney 48. Which one is not absent in glomerular filtrate?
due to presence of which organ? A. Glucose B. Protein
A. Stomach B. Liver C. RBC D. Platelet
C. Spleen D. Pancreas 49. In human, blood flow through two kidneys per
37. Which structure exits through hilum of kidney? minute is?
A. Ureter B. Renal artery A. 1000 cc B. 1200 cc
C. Nerves D. Renal calyx
C. 2000 cc D. 1500 cc
38. Which gland is attached to kidney?
50. How much filtrate is reabsorbed by kidney per
A. Pancreas B. Thyroid
C. Ovary D. Adrenal minute?
39. The apex of renal pyramid is called- A. 125 cm3 B. 1 cm3
3
A. Renal column B. Renal apex C. 124 cm D. 99 cm3
C. Renal papilla D. Renal cortex Answer
40. Which one is the structural and functional unit 26.D 27.D 28.D 29.B 30.B 31.C 32.A
of kidney? 33.D 34.A 35.B 36.B 37.A 38.D 39.C
A. Neuron B. Neurite 40.C 41.D 42.A 43.A 44.D 45.A 46.B
C. Nephron D. Sinusoid 47.D 48.A 49.B 50.C