DIGESTIVE SYSTEM

I. Organs of the DS are either part of the - Actions include chewing, churning of food in
GI tract (alimentary canal) or accessory stomach, and mixing food with digestive
digestive organs. The GI tract includes juices.
the mouth, esophagus, stomach, and
intestines, it is considered to be part of 4. Chemical digestion
the outside of the body because the - Chemical change of the food particles,
mouth and anus both pen to the outer bonds are broken to change a large
environment. The accessory organs molecule into a smaller one so absorption
include the teeth, tongue, salivary can happen more effectively.
glands, pancreas, and liver. These - This involves the use of enzymes,
organs assist in the digestive of food. hydrochloric acid, and other digestive
juices.
5. Absorption
- Transport of digested food molecules from
the GI into the blood and lymphatic vessels
6. Defecation
- Elimination of feces (indigestible
substance/digestive waste)

A. Digestive Processes
- There are six food processing activities:

1. Ingestion
- Brining food into the mouth (eating)
2. Propulsion
- Moving food through the GI tract, peristalsis
(contractions of smooth muscle in GI tract)
helps to move the food along. B. Abdominal Regions and Quadrants
3. Mechanical digestion - Digestive organs are located in the
- Physical change of the food particles from abdominal cavity. Be familiar with the
large to small, this helps to increase the approximate location of the intestinal
surface area to make chemical digestion organs within the nine regions and four
more effective. quadrants as shown.

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 DIGESTIVE SYSTEM
A. The Peritoneal Cavity and Peritoneum
- The peritoneum is an extensive serous
membrane in the abdominal cavity, the
visceral peritoneum covers the surfaces of
digestive organs.
- A cavity is found in between the visceral
and parietal peritoneum.
- The parietal peritoneum lines the wall of
the abdominal cavity.
- The peritoneal cavity is a slit like space
filled with serous fluid. A double layer of
serous membranes that hold digestive
organs in place is called the mesentery.
- Organs surrounded by mesentery and
suspended in the cavity are called
intraperitoneal or peritoneal organs.
- Some are not surrounded by mesentery;
they are called retroperitoneal

II. Anatomy of the DS

- This section focuses in the gross anatomical
and microscopic anatomical characteristics
of the DS

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 DIGESTIVE SYSTEM
major blood and lymphatic vessels, and
some gland tissue
3. The Muscularis Externa
- Two layers of smooth muscle: the circular
and longitudinal layers that help to contract
the tube so food passes by (peristalsis)
4. The Serosa
- Outermost layer, actually the visceral
peritoneum, organs that don't have a serosa
have a layer of fibrous connective tissue
called the adventitia, such as the esophagus.
Some organs have both a serosa and
adventitia.
5. Nerve plexuses
- the GI tract and accessory organs are
innervated by the autonomic nervous
system (sympathetic and parasympathetic).
- There are two plexuses: the myenteric
nerve plexuses that innervates the smooth
muscle in tunica muscularis externa and
controls contraction. The submucosa
nerve plexus innervates the submucosa
and controls glandular secretion.

B. Histology of the Alimentary Canal Wall

- The ff are the layers found in all organs of
the GI tract. The thickness of each layers
varies with location or organs.
1. The Mucosa
- inner most layer, closest to the lumen, it is
called a mucous membrane and has three
layers; 1) lining epithelium that secretes
C. The Mouth and Associated Organs
mucus and absorbs nutrients, it contains
- The mouth is primarily used for mechanical
intrinsic glands; 2) a lamina propria that
digestion
has loose connective tissue rich in
1. Mouth
capillaries and lymphoid tissue; 3) a
- Also known as the oral cavity, its opening is
muscularis mucosa made up of smooth
the oral orifice, and it is the site of ingestion.
muscle.
The lips are also known as vestibule and the
2. The Submucosa
oral cavity proper is the space inside the
- Contains connective tissue that helps to
mouth (internal to teeth)
reshape the organs once food passes by,

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 DIGESTIVE SYSTEM
a. Mouth Tissue 2. Tongue
- The mouth is lined by stratified squamous - Composed of skeletal muscle, it repositions
epithelium and this is also called a mucous food during chewing and shapes it into a
membrane. The mouth also has layer called bolus.
internal mucosa, submucosa, and external - The tongue contains taste buds and also
later of muscle and bone instead or a serosa. helps to shape sounds when one is
The tongue, lips, gums, and palate are lined speaking.
with cells that are slightly keratinized for - The tongue is attached to the floor of the
extra protection. mouth by the lingual frenulum. The tongue
b. Cheeks also contains lingual tonsils.
- Made up primarily by the buccinator
muscle, they help to keep food within oral
cavity.
c. Lips
- Muscular flaps that have a translucent area
called the red region. This is the area that
can become dried or chapped because there
are no lubricating glands. The labial
frenulum connects the lips to the gums.

3. Salivary Glands
- Compound tubular glands that produce a
liquid containing water, mucus, proteins, a
buffer, and enzymes.
- The purpose of saliva is to moisten, begin
the digestion of starch, neutralize acids,
stimulate growth of beneficial bacteria in
the mouth and dissolve food chemicals so
we can taste them (stimulate the
chemoreceptors of the mouth).
a. Salivary glands include the parotid,
submandibular, and sublingual.

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 DIGESTIVE SYSTEM
4. Teeth - Swallowing is a voluntary action that is
- The first set of teeth humans develop is the controlled by skeletal muscle.
deciduous (20 milk teeth) and then the E. Esophagus
permanent teeth (32 teeth). - Long muscular tube that moves food
- Teeth are specialized structures found through peristalsis. The lumen is typically
within sockets of the gum called alveoli and collapsed.
are held in place by the periodontal 1. Gross Anatomy
ligament. They form an immoveable joint. - It extends from the laryngopharynx,
- Teeth are composed of three layers called through the thorax, exits via the esophageal
enamel (hardest substance in the body), hiatus, and meets the stomach at the cardiac
dentin (bone like tissue that is harder than orifice.
bone), and the pulp cavity (hollow centered - The cardiac sphincter controls the entering
filled with blood vessels and nerves). and exiting of substances into/ out of the
- The teeth can also be divided into three stomach.
sections, the crown, the neck, and the root. 2. Microscopic Anatomy
Every tooth has its own blood and nervous - It has non-keratinized stratified epithelium,
supply (pulp). the mucosa and submucosa form folds
when esophagus is empty.
- The submucosa contains glands that
lubricate the food as it passes by.
- The upper part of the esophagus contains
skeletal muscle and the rest contains
smooth muscle.
- The esophagus contains an adventitia layer
not a serosa layer.
F. Stomach
- A pouch with sphincter muscles at both
ends: superiorly is the cardiac sphincter and
inferiorly is the pyloric sphincter.
- They contract to contain the food within the
stomach while it is liquefied, mixed with
stomach acid (hydrochloric acid) and
turned into chyme. This is the site where
proteins are first digested by pepsin
enzymes.
- Substances absorbed through the stomach
are: water, electrolytes and some drugs.
D. Pharynx
- Food is process in the stomach for about 4
- Once food leaves the mouth it passes into
hours.
the pharynx (the cavity behind the mouth)
1. Gross Anatomy
and moves from the oropharynx into the
- It is inferior to the diaphragm and anterior
laryngopharynx.
to spleen and pancreas, The stomach is
- There it is routed to enter the esophagus by
generally J shaped and has the following
contractions of the pharyngeal constrictor
features: cardiac sphincter, cardiac region,
muscles.
fundus, body, pyloric antrum, pyloric canal,
and pyloric sphincter.
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 DIGESTIVE SYSTEM
- The curves of the stomach are described as - The lining is composed of simple columnar
the greater and lesser curvature. Internally epithelial cells and many goblet cells that
large folds called rugae are visible. secrete bicarbonate buffered mucus.
- These folds allow the stomach to expand so - The mucus protects the stomach lining.
it can hold up to 4L of food at one time. - Gastric pits are also visible, these open into
- It has three layers of smooth muscle: gastric glands.
longitudinal layer, circular layer, and - There are some enteroendocrine cells that
oblique layer. release hormones related to digestion and
undifferentiated stem cells that divide to
replace the damaged lining
a. Mucous Neck Cells
- Secret a mucus different of that secreted by
goblet cells.
b. Parietal (Oxyntic) Cells
- Produce the hydrochloric acic
c. Chief (Zymogenic) Cells
- Secrete enzyme called pepsinogen that
becomes pepsin when activated by the
hydrochloric acid.

G. Small Intestine
- This is the longest section, an area where
chemical digestion is completed and most
nutrients are absorbed.
2. Microscopic Anatomy - Food remains here for about 3-6 hours.
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 DIGESTIVE SYSTEM
- The small intestine can be divided into - Microscopic folds on the apical side of the
three section: duodenum, ileum, jejunum. simple columnar epithelial cell in the
- It uses peristalsis to move chyme along and mucosa.
for segmentation movements. - The folds increase the surface area of the
1. Gross Anatomy cell's membrane allowing for greater
- The tube runs from the pyloric sphincter of interaction.
the stomach to the beginning of the large - This is also the area where chemical
intestine. digestion is completed.
- The first division is the duodenum (5%)
short area where the digestive chemicals Intestinal crypts contain cells that produce
from the pancreas and gall bladder are digestive juice in the small intestine and stem
received. cell replace the epithelium every 3-6 days.
- The second division is the jejunum (40%) a Duodenal glands also secrete a solution that
longer region where food is digested and neutralizes stomach acid.
nutrients are absorbed.
- The last section is the ileum (60%) it
connects to the large intestine.

2. Microscopic Anatomy
- The small intestine is designed for
absorption of nutrients; thus its
modifications increase its surface area by
200 square feet.
a. Circular folds
- Transverse ridges (1 cm tall) that force the
chyme to spiral as it slows it down to
increase absorption.
b. Villi
- These are finger-like projections (1mm tall)
made up of simple columnar epithelial cells
specialized for absorption (enterocytes). H. Large Intestine
- They are in close contact with capillaries - Area where food remains for 12-24
and lacteal (lymph vessels that absorb hours. Some absorption and digestion
fat) occur (by bacteria) it is primarily
c. Microvilli
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 DIGESTIVE SYSTEM
designed to reabsorb water and
electrolytes.
1. Gross anatomy
- It is wider than the small intestine but
shorter.
- It is divided into the cecum (opening of
ileum to large intestine, has ileocecal valve),
the vermiform appendix (opens to the
cecum, contains lymphoid tissue), the colon
(has at least four sections), the rectum (has
rectal valves that prevent feces from being
passed along with gas) and the anal canal
(external to abdominal pelvic cavity, has
external anal canal).
- The sections of the colon and bends are:
ascending colon, right colic (hepatic)
flexure, transverse colon, left colic (splenic)
flexure, descending colon, and sigmoid
colon and rectum.
- Some of the feature are: the teniae coli
(longitudincal strips that run along the
colon), the haustra (pockets or sacs) and the
epiploic appendages (hanging fat filled
pouches)

I. Liver
- Considered the largest gland, it performs
over 500 functions that influence several
systems beside the digestive system. In
regards to the digestive system it produces
bile.
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 DIGESTIVE SYSTEM
- A substance that emulsifies fat and makes it
accessible to fat digesting enzymes.
- The liver is involved in balancing blood
glucose levels, it responds to hormones, and
clears toxins or drugs from the blood and
makes blood proteins.
1. Gross anatomy
- It is protected by the rib cage. It has a
diaphragmatic surface and a visceral
surface; the bare area is fused to the
diaphragm.
- It has four lobes: right and left lobes that are
divided by the falciform ligament, the
caudate lobe, and the quadrate lobe.
- The posterior and inferior view also shows
the round ligament (ligamentum teres) and
the ligamentun venosum. The port heptis is
also on this side.
- Major blood vessels, nerves, and ducts enter
through the porta hepatis.
- Bile is carried from the liver by the right
and left hepatic ducts that merge into the
common hepatic duct that also connects to
the cystic duct of the gall bladder.
- Bile reaches the small intestine through the 2. Microscopic Anatomy
common hepatic duct. - Liver tissue shows multiple hexagonal
sections called liver lobules. Each lobule
contains a central vein, hepatocytes
arranged into “plates”, and is surrounded by
connective tissue.
- At the corners there are portal triads
containing a hepatic vein, artery, and bile
duct.
- Liver cells are called hepatocytes and aside
from the many functions they perform they
have the ability to regenerate the liver.
J. Gall Bladder
- Muscular sac that stores bile, it is attached
to the cystic duct and when the muscle
contract bile exits through this duct and
into the common hepatic duct.
K. Pancreas
- A gland that is both exocrine (has a duct)
and endocrine (releases hormones into the
blood stream).

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 DIGESTIVE SYSTEM
- It produces 22 different enzymes for
digestion by acinar cells and buffers to
neutralized stomach acid by epithelial cells.
It joins gall bladder secretions and both
enter the duodenum via the
hepatopancreatic ampulla at the major
duodenal papilla.
L. Mesenteries
- Double layer sheets of serosa membranes
that hold organs in place by connecting
them to the dorsal and ventral abdominal
walls. Sometimes they are referred to as
ligaments.
- Ventral Mesenteries
1. Falciform Ligament - Connects liver to
anterior wall
2. Lesser Omentum - Runs from the liver
to the lesser curvature
- Dorsal Mesenteries
1. Greater Omentum - From the greater
curvature to the posterior wall,
however it also connects to the
intestines. It also holds a lot of fat
2. Mesentery Proper - Support and hold
the jejunum and ileum.
3. Transverse Mesocolon - Attaches the
transverse colon, it fuses with the
greater omentum.
4. Sigmoid Mesocolon - Connects sigmoid
colon to posterior pelvic wall.

Mumps

- Although any of the salivary glands may be

the target of a nasopharyngeal infection, the
mumps virus (paramyxovirus) typically
attacks the parotid glands.

10
 DIGESTIVE SYSTEM
- Mumps is an inflammation and enlargement Jaundice
of the parotid glands accompanied by
moderate fever, malaise (general - A yellowish coloration of the sclerae (whites
discomfort), and extreme pain in the throat, of the eyes), skin, and mucous membranes
especially when swallowing sour foods or due to a buildup of a yellow compound
acidic juices. called bilirubin. After bilirubin is formed
from the breakdown of the heme pigment in
Root Canal Therapy aged red blood cells, it is transported to the
liver, where it is processed and eventually
- Root canal therapy is a multistep procedure excreted into bile.
in which all traces of pulp tissue are
removed from the pulp cavity and root Gallstones
canals of a badly diseased tooth. After a hole
is made in the tooth, the root canals are - If bile contains either insufficient bile salts
filed out and irrigated to remove bacteria. or lecithin or excessive cholesterol, the
Then, the canals are treated with cholesterol may crystallize to form
medication and sealed tightly. The damaged gallstones
crown is then repaired. Function of Liver and Gallbladder
Gastroesophageal Reflux Disease - Carbohydrate, Lipid, and Protein
- If the lower esophageal sphincter fails to Metabolism
close adequately aft er food has entered the - Processing of Drugs and Hormones
stomach, the stomach contents can reflux - Excretion of Bilirubin
(back up) into the inferior portion of the - Synthesis of Biles Salts
esophagus. - Storage
- Phagocytosis
Pylorospasm - Activation of Vitamin D

- The smooth muscle fibers of the sphincter Lactose Intolerance

fail to relax normally, so food does not pass
easily from the stomach to the small - Symptoms of lactose intolerance include
intestine, the stomach becomes overly full, diarrhea, gas, bloating, and abdominal
and the infant vomits often to relieve the cramps aft er consumption of milk and
pressure. other dairy products. The symptoms can be
- Pylorospasm is treated by drugs that relax relatively minor or serious enough to
the muscle fibers of the pyloric sphincter. require medical attention.

Pyloric Stenosis Appendicitis

- Is a narrowing of the pyloric sphincter that - Inflammation of the appendix, termed

must be corrected surgically. The hallmark appendicitis, is preceded by obstruction of
symptom is projectile vomiting—the the lumen of the appendix by chyme,
spraying of liquid vomitus some distance inflammation, a foreign body, a carcinoma
from the infant. of the cecum, stenosis, or kinking of the
organ.
- Begins with referred pain in the umbilical
region of the abdomen, followed by
anorexia (loss of appetite for food), nausea,
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 DIGESTIVE SYSTEM
and vomiting. Aft er several hours the pain Hepatitis B
localizes in the right lower quadrant (RLQ)
and is continuous, dull or severe, and - is caused by the hepatitis B virus (HBV) and
intensified by coughing, sneezing, or body is spread primarily by sexual contact and
movements. contaminated syringes and transfusion
equipment.
Colorectal Cancer - It can also be spread via saliva and tears.
- Hepatitis B virus can be present for years or
- is among the deadliest of malignancies, even a lifetime, and it can produce cirrhosis
ranking second to lung cancer in males and and possibly cancer of the liver.
third aft er lung cancer and breast cancer in - Individuals who harbor the active hepatitis
females. B virus also become carriers. A vaccine is
- Intake of alcohol and diets high in animal fat available.
and protein are associated with increased
risk of colorectal cancer; dietary fiber, Hepatitis C
retinoids, calcium, and selenium may be
protective. Signs and symptoms of - caused by the hepatitis C virus (HCV), is
colorectal cancer include diarrhea, clinically similar to hepatitis B. Hepatitis C
constipation, cramping, abdominal pain, can cause cirrhosis and possibly liver
and rectal bleeding, either visible or occult cancer.
(hidden in feces). - In developed nations, donated blood is
screened for the presence of hepatitis B and
Hepatitis C.

- Is an inflammation of the liver that can be Hepatitis D

caused by viruses, drugs, and chemicals,
including alcohol. Clinically, several types of - is caused by the hepatitis D virus (HDV). It
viral hepatitis are recognized. is transmitted like hepatitis B, and in fact a
person must have been co-infected with
Hepatitis A (infectious hepatitis) hepatitis B before contracting hepatitis D.
- Hepatitis D results in severe liver damage
- is caused by the hepatitis A virus (HAV) and and has a higher fatality rate than infection
is spread via fecal contamination of objects with hepatitis B virus alone.
such as food, clothing, toys, and eating - HBV vaccine is protective.
utensils (fecal–oral route).
- It is generally a mild disease of children and Hepatitis E
young adults characterized by loss of
appetite, malaise, nausea, diarrhea, fever, - is caused by the hepatitis E virus and is
and chills. spread like hepatitis A. Although it does not
- Eventually, jaundice appears. cause chronic liver disease, hepatitis E virus
- This type of hepatitis does not cause lasting has a very high mortality rate among
liver damage. pregnant women.
- Most people recover in 4 to 6 weeks. A
Achalasia (ak′-a-LA-zē-a; a- = without; -chalasis
vaccine is available.
= relaxation)

- A condition caused by malfunction of the

myenteric plexus in which the lower
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 DIGESTIVE SYSTEM
esophageal sphincter fails to relax normally Borborygmus
as food approaches. A whole meal may
become lodged in the esophagus and enter - A rumbling noise caused by the propulsion
the stomach very slowly. Distension of the of gas through the intestines.
esophagus results in chest pain that is often Bulimia (bū-LEM-ē-a; bu- = ox; limia = hunger or
confused with pain originating from the binge–purge syndrome)
heart.
- A disorder that typically affects young,
Bariatric surgery (bar′-ē-AT-rik; baros- = single, middle-class white females,
weight; -iatreia = medical treatment) characterized by overeating at least twice a
week followed by purging by self -induced
- A surgical procedure that limits the amount vomiting, strict dieting or fasting, vigorous
of food that can be ingested and absorbed in exercise, or use of laxatives or diuretics; it
order to bring about a significant weight occurs in response to fears of being
loss in obese individuals. overweight or to stress, depression, and
- The most commonly performed type of physiological disorders such as
bariatric surgery is called gastric bypass hypothalamic tumors.
surgery. In one variation of this procedure,
the stomach is reduced in size by making a Canker sore (KANG-ker)
small pouch at the top of the stomach about
- Painful ulcer on the mucous membrane of
the size of a walnut.
the mouth that affects females more often
- The pouch, which is only 5–10% of the
than males, usually between ages 10 and
stomach, is sealed off from the rest of the
40; may be an autoimmune reaction or a
stomach using surgical staples or a plastic
food allergy.
band.
- The pouch is connected to the jejunum of Cirrhosis (si-RŌ-sis)
the small intestine, thus bypassing the rest
of the stomach and the duodenum. - Distorted or scarred liver as a result of
- The result is that smaller amounts of food chronic inflammation due to hepatitis,
are ingested and fewer nutrients are chemicals that destroy hepatocytes,
absorbed in the small intestine. This leads parasites that infect the liver, or alcoholism;
to weight loss. the hepatocytes are replaced by fibrous or
adipose connective tissue.
Barrett’s esophagus - Symptoms include jaundice, edema in the
legs, uncontrolled bleeding, and increased
- A pathological change in the epithelium of
sensitivity to drugs.
the esophagus from nonkeratinized
stratified squamous epithelium to columnar Colitis (kō-LĪ-tis)
epithelium so that the lining resembles that
of the stomach or small intestine due to - Inflammation of the mucosa of the colon
long-term exposure of the esophagus to and rectum in which absorption of water
stomach acid; increases the risk of and salts is reduced, producing watery,
developing cancer of the esophagus. bloody feces and, in severe cases,
dehydration and salt depletion.
- Spasms of the irritated muscularis produce
cramps. It is thought to be an autoimmune
condition.
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 DIGESTIVE SYSTEM
Colonoscopy (kō-lon-OS-kō-pē; -skopes = to - Most types of food poisoning cause diarrhea
view) and/or vomiting, often associated with
abdominal pain.
- The visual examination of the lining of the
colon using an elongated, flexible, fiber- Gastroenteritis (gas′-trō-en-ter-Ī-tis; gastro- =
optic endoscope called a colonoscope.
stomach; -enteron- = intestine; -itis =
- It is used to detect disorders such as polyps,
inflammation)
cancer, and diverticulosis; to take tissue
samples; and to remove small polyps. Most - Inflammation of the lining of the stomach
tumors of the large intestine occur in the and intestine (especially the small
rectum. intestine).
- It is usually caused by a viral or bacterial
Colostomy (kō-LOS-tō-mē; -stomy = provide an
infection that may be acquired by
opening)
contaminated food or water or by people in
- The diversion of feces through an opening close contact.
in the colon, creating a surgical “stoma” - Symptoms include diarrhea, vomiting, fever,
(artificial opening) that is made in the loss of appetite, cramps, and abdominal
exterior of the abdominal wall. discomfort.
- This opening serves as a substitute anus
Gastroscopy (gas-TROS-kō-pē; -scopy = to view
through which feces are eliminated into a
with a lighted instrument)
bag worn on the abdomen.
- Endoscopic examination of the stomach in
Dysphagia (dis-FA-jē-a; dys- = abnormal; -
which the examiner can view the interior of
phagia = to eat)
the stomach directly to evaluate an ulcer,
- Difficulty in swallowing that may be caused tumor, inflammation, or source of bleeding.
by inflammation, paralysis, obstruction, or
trauma. Halitosis (hal′-i-TŌ-sis; halitus- = breath; -osis =
condition)
Flatus
- A foul odor from the mouth; also called bad
- Air (gas) in the stomach or intestine, usually breath. Heartburn A burning sensation in a
expelled through the anus. If the gas is region near the heart due to irritation of the
expelled through the mouth, it is called mucosa of the esophagus from hydrochloric
eructation or belching (burping). acid in stomach contents.
- Flatus may result from gas released during - It is caused by failure of the lower
the breakdown of foods in the stomach or esophageal sphincter to close properly, so
from swallowing air or gas containing that the stomach contents enter the inferior
substances such as carbonated drinks. esophagus. It is not related to any cardiac
- Food poisoning A sudden illness caused by problem.
ingesting food or drink contaminated by an
infectious microbe (bacterium, virus, or Hemorrhoids (HEM-ō-royds; hemo- = blood; -
protozoan) or a toxin (poison). rhoia = flow)
- The most common cause of food poisoning
is the toxin produced by the bacterium - Varicosed (enlarged and inflamed) superior
rectal veins.
Staphylococcus aureus.

14
 DIGESTIVE SYSTEM
- Hemorrhoids develop when the veins are which the inflammation extends from the
put under pressure and become engorged mucosa through the submucosa, muscularis,
with blood. and serosa.
- If the pressure continues, the wall of the - (2) Ulcerative colitis is an inflammation of
vein stretches. the mucosa of the colon and rectum, usually
- Such a distended vessel oozes blood; accompanied by rectal bleeding.
bleeding or itching is usually the first sign - Curiously, cigarette smoking increases the
that a hemorrhoid has developed. risk of Crohn’s disease but decreases the
- Stretching of a vein also favors clot risk of ulcerative colitis.
formation, further aggravating swelling and
pain. Irritable bowel syndrome (IBS)
- Hemorrhoids may be caused by - Disease of the entire gastrointestinal tract
constipation, which may be brought on by in which a person reacts to stress by
low-fiber diets. developing symptoms (such as cramping
- Also, repeated straining during defecation and abdominal pain) associated with
forces blood down into the rectal veins, alternating patterns of diarrhea and
increasing pressure in those veins and constipation.
possibly causing hemorrhoids. Also called - Excessive amounts of mucus may appear in
piles. feces; other symptoms include flatulence,
Hernia nausea, and loss of appetite.
- The condition is also known as irritable
- Protrusion of all or part of an organ through colon or spastic colitis.
a membrane or cavity wall, usually the
abdominal cavity. Malabsorption (mal-ab-SORP-shun; mal- = bad)

Hiatus (diaphragmatic) Hernia - A number of disorders in which nutrients

from food are not absorbed properly.
- is the protrusion of a part of the stomach - It may be due to disorders that result in the
into the thoracic cavity through the inadequate breakdown of food during
esophageal hiatus of the diaphragm. digestion (due to inadequate digestive
enzymes or juices), damage to the lining of
Inguinal Hernia the small intestine (from surgery, infections,
- is the protrusion of the hernial sac into the and drugs like neomycin and alcohol), and
inguinal opening; it may contain a portion impairment of motility.
of the bowel in an advanced stage and may - Symptoms may include diarrhea, weight
extend into the scrotal compartment in loss, weakness, vitamin deficiencies, and
males, causing strangulation of the bone demineralization.
herniated part.
Malocclusion (mal′-ō-KLOO-zhun; mal- = bad; -
Inflammatory bowel disease (in-FLAM-a-tō′-rē occlusion = to fit together)
BOW-el) - Condition in which the surfaces of the
- Inflammation of the gastrointestinal tract maxillary (upper) and mandibular (lower)
that exists in two forms. teeth fit together poorly.
- (1) Crohn’s disease is an inflammation of
any part of the gastrointestinal tract in
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 DIGESTIVE SYSTEM
Nausea (NAW-sē-a; nausia = seasickness) Layers of the GI Tract

- Discomfort characterized by a loss of - The basic arrangement of layers in most of

appetite and the sensation of impending the gastrointestinal tract, from deep to
vomiting. superficial, is the mucosa, submucosa,
- Its causes include local irritation of the muscularis, and serosa.
gastrointestinal tract, a systemic disease, - Associated with the lamina propria of the
brain disease or injury, overexertion, or the mucosa are extensive patches of lymphatic
effects of medication or drug overdosage. tissue called mucosa-associated lymphoid
- Traveler’s diarrhea Infectious disease of the tissue (MALT).
gastrointestinal tract that results in loose,
urgent bowel movements, cramping, Neural Innervation of the GI Tract
abdominal pain, malaise, nausea, and - The gastrointestinal tract is regulated by an
occasionally fever and dehydration. intrinsic set of nerves known as the enteric
- It is acquired through ingestion of food or nervous system (ENS) and by an extrinsic
water contaminated with fecal material set of nerves that are part of the autonomic
typically containing bacteria (especially nervous system (ANS).
Escherichia coli); viruses or protozoan - The ENS consists of neurons arranged into
parasites are fewer common causes. two plexuses: the myenteric plexus and the
Overview of the Digestive System submucosal plexus.
- The myenteric plexus, which is located
- The digestive system is composed of two between the longitudinal and circular
main groups of organs: the gastrointestinal smooth muscle layers of the muscularis,
(GI) tract and accessory digestive organs regulates GI tract motility.
- The GI tract is a continuous tube extending - The submucosal plexus, which is located in
from the mouth to the anus. the submucosa, regulates GI secretion.
- The accessory digestive organs include the - Although the neurons of the ENS can
teeth, tongue, salivary glands, liver, function independently, they are subject to
gallbladder, and pancreas. regulation by the neurons of the ANS.
- Digestion includes six basic processes: - Parasympathetic fibers of the vagus (X)
ingestion, secretion, mixing and propulsion, nerves and pelvic splanchnic nerves
mechanical and chemical digestion, increase GI tract secretion and motility by
absorption, and defecation. increasing the activity of ENS neurons.
- Mechanical digestion consists of - Sympathetic fibers from the thoracic and
mastication and movements of the upper lumbar regions of the spinal cord
gastrointestinal tract that aid chemical decrease GI tract secretion and motility by
digestion. inhibiting ENS neurons.
- Chemical digestion is a series of hydrolysis
reactions that break down large Peritoneum
carbohydrates, lipids, proteins, and nucleic - The peritoneum is the largest serous
acids in foods into smaller molecules that membrane of the body; it lines the wall of
are usable by body cells. the abdominal cavity and covers some
abdominal organs.

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 DIGESTIVE SYSTEM
- Folds of the peritoneum include the - Salivary amylase then begins the digestion
mesentery, mesocolon, falciform ligament, of starches, and lingual lipase acts on
lesser omentum, and greater omentum. triglycerides.

Mouth Pharynx

- The mouth is formed by the cheeks, hard - The pharynx is a funnel-shaped tube that
and soft palates, lips, and tongue. extends from the internal nares to the
- The vestibule is the space bounded esophagus posteriorly and to the larynx
externally by the cheeks and lips and anteriorly.
internally by the teeth and gums. - The pharynx has both respiratory and
- The oral cavity proper extends from the digestive functions.
vestibule to the fauces.
- The tongue, together with its associated Esophagus
muscles, forms the floor of the oral cavity. It - The esophagus is a collapsible, muscular
is composed of skeletal muscle covered with tube that connects the pharynx to the
mucous membrane. The upper surface and stomach.
sides of the tongue are covered with - It contains an upper and a lower esophageal
papillae, some of which contain taste buds. sphincter.
Glands in the tongue secrete lingual lipase,
which digests triglycerides into fatty acids Deglutition
and diglycerides once in the acid
environment of the stomach. - Deglutition, or swallowing, moves a bolus
- The major portion of saliva is secreted by from the mouth to the stomach.
the major salivary glands, which lie outside - Swallowing consists of voluntary,
the mouth and pour their contents into pharyngeal (involuntary), and esophageal
ducts that empty into the oral cavity. There (involuntary) stages.
are three pairs of major salivary glands: Stomach
parotid, submandibular, and sublingual
glands. - The stomach connects the esophagus to the
- Saliva lubricates food and starts the duodenum.
chemical digestion of carbohydrates. - The principal anatomical regions of the
Salivation is controlled by the nervous stomach are the cardia, fundus, body, and
system. pylorus.
- The teeth (dentes) project into the mouth - Adaptations of the stomach for digestion
and are adapted for mechanical digestion. include rugae; glands that produce mucus,
- A typical tooth consists of three principal hydrochloric acid, pepsin, gastric lipase, and
regions: crown, root, and neck. Teeth are intrinsic factor; and a three-layered
composed primarily of dentin and are muscularis.
covered by enamel, the hardest substance in - Mechanical digestion consists of propulsion
the body. There are two dentitions: and retropulsion.
deciduous and permanent. - Chemical digestion consists mostly of the
- Through mastication, food is mixed with conversion of proteins into peptides by
saliva and shaped into a soft, flexible mass pepsin.
called a bolus. - The stomach wall is impermeable to most
substances.

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 DIGESTIVE SYSTEM
- Among the substances the stomach can - Its glands secrete fluid and mucus, and the
absorb are water, certain ions, drugs, and circular folds, villi, and microvilli of its wall
alcohol. provide a large surface area for digestion
and absorption.
Pancreas - Brush-border enzymes digest α-dextrins,
- The pancreas consists of a head, a body, and maltose, sucrose, lactose, peptides, and
a tail and is connected to the duodenum via nucleotides at the surface of mucosal
the pancreatic duct and accessory duct. epithelial cells.
- Endocrine pancreatic islets secrete - Pancreatic and intestinal brush-border
hormones, and exocrine acini secrete enzymes break down starches into maltose,
pancreatic juice. maltotriose, and α-dextrins (pancreatic
- Pancreatic juice contains enzymes that amylase), α-dextrins into glucose (α-
digest starch (pancreatic amylase), proteins dextrinase), maltose to glucose (maltase),
(trypsin, chymotrypsin, carboxypeptidase, sucrose to glucose and fructose (sucrase),
and elastase), triglycerides (pancreatic lactose to glucose and galactose (lactase),
lipase), and nucleic acids (ribonuclease and and proteins into peptides (trypsin,
deoxyribonuclease). chymotrypsin, and elastase). Also, enzymes
break off amino acids at the carboxyl ends
Liver and Gallbladder of peptides (carboxypeptidases) and break
off amino acids at the amino ends of
- The liver has left and right lobes; the left peptides (aminopeptidases). Finally,
lobe includes a quadrate lobe and a caudate enzymes split dipeptides into amino acids
lobe. The gallbladder is a sac located in a (dipeptidases), triglycerides to fatty acids
depression on the posterior surface of the and monoglycerides (lipases), and
liver that stores and concentrates bile. nucleotides to pentoses and nitrogenous
- The lobes of the liver are made up of lobules bases (nucleosidases and phosphatases).
that contain hepatocytes (liver cells), - Mechanical digestion in the small intestine
sinusoids, stellate reticuloendothelial (Kupff involves segmentation and migrating
er) cells, and a central vein. motility complexes.
- Hepatocytes produce bile that is carried by - Absorption occurs via diffusion, facilitated
a duct system to the gallbladder for diffusion, osmosis, and active transport;
concentration and temporary storage. most absorption occurs in the small
- Bile’s contribution to digestion is the intestine.
emulsification of dietary lipids. - Monosaccharides, amino acids, and short-
- The liver also functions in carbohydrate, chain fatty acids pass into the blood
lipid, and protein metabolism; processing of capillaries.
drugs and hormones; excretion of bilirubin; - Long-chain fatty acids and monoglycerides
synthesis of bile salts; storage of vitamins are absorbed from micelles, resynthesized
and minerals; phagocytosis; and activation to triglycerides, and formed into
of vitamin D. chylomicrons.
Small Intestine - Chylomicrons move into lymph in the
lacteal of a villus.
- The small intestine extends from the pyloric - The small intestine also absorbs
sphincter to the ileocecal sphincter. It is electrolytes, vitamins, and water.
divided into duodenum, jejunum, and ileum.

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 DIGESTIVE SYSTEM
Large Intestine exit of chyme from the stomach, which
prevents the small intestine from being
- The large intestine extends from the overloaded with more chyme than it can
ileocecal sphincter to the anus. handle.
- Its regions include the cecum, colon, rectum, 5. The activities that occur during the
and anal canal. various phases of digestion are
- The mucosa contains many goblet cells, and coordinated by neural pathways and by
the muscularis consists of teniae coli and hormones.
haustra.
- Mechanical movements of the large Development of the Digestive System
intestine include haustral churning,
peristalsis, and mass peristalsis. 1. The endoderm of the primitive gut
- The last stages of chemical digestion occur forms the epithelium and glands of most
in the large intestine through bacterial of the GI tract.
action. Substances are further broken down, 2. The mesoderm of the primitive gut
and some vitamins are synthesized. forms the smooth muscle and
- The large intestine absorbs water, ions, and connective tissue of the GI tract.
vitamins. Aging and the Digestive System
- Feces consist of water, inorganic salts,
epithelial cells, bacteria, and undigested - General changes include decreased
foods. secretory mechanisms, decreased motility,
- The elimination of feces from the rectum is and loss of tone.
called defecation. - Specific changes may include loss of taste,
- Defecation is a reflex action aided by pyorrhea, hernias, peptic ulcer disease,
voluntary contractions of the diaphragm constipation, hemorrhoids, and diverticular
and abdominal muscles and relaxation of diseases.
the external anal sphincter.
✓ Digestive enzymes are produced by the
Phases of Digestion salivary glands, tongue, stomach, pancreas,
1. Digestive activities occur in three and small intestine.
overlapping phases: cephalic, gastric, ✓ In the context of the digestive system,
and intestinal. absorption is the movement of the products
2. During the cephalic phase of digestion, of digestion from the lumen of the GI tract
salivary glands secrete saliva and into blood or lymph.
gastric glands secrete gastric juice in ✓ The lamina propria has the following
order to prepare the mouth and functions: (1) It contains blood vessels and
stomach for food that is about to be lymphatic vessels, which are the routes by
eaten. which nutrients are absorbed from the GI
3. The presence of food in the stomach tract; (2) it supports the mucosal epithelium
causes the gastric phase of digestion, and binds it to the muscularis mucosae; and
which promotes gastric juice secretion (3) it contains mucosa-associated lymphatic
and gastric motility. tissue (MALT), which helps protect against
4. During the intestinal phase of digestion, disease.
food is digested in the small intestine. In ✓ The neurons of the myenteric plexus
addition, gastric motility and gastric regulate GI tract motility, and the neurons
secretion decrease in order to slow the
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 DIGESTIVE SYSTEM
of the submucosal plexus regulate GI ✓ Nutrients being absorbed in the small
secretion. intestine enter the blood via capillaries or
✓ Mesentery binds the small intestine to the the lymph via lacteals.
posterior abdominal wall. ✓ The fluid secreted by duodenal (Brunner’s)
✓ The uvula helps prevent foods and liquids glands—alkaline mucus— neutralizes
from entering the nasal cavity during gastric acid and protects the mucosal lining
swallowing. of the duodenum.
✓ Chloride ions in saliva activate salivary ✓ Because monoglycerides are hydrophobic
amylase. (nonpolar) molecules, they can dissolve in
✓ The main component of teeth is connective and diff use through the lipid bilayer of the
tissue, specifically dentin. plasma membrane.
✓ The first, second, and third molars do not ✓ The stomach and pancreas are the two
replace any deciduous teeth. digestive system organs that secrete the
✓ The esophageal mucosa and submucosa largest volumes of fluid.
contain mucus-secreting glands. ✓ The ascending and descending portions of
✓ Both. Initiation of swallowing is voluntary the colon are retroperitoneal.
and the action is carried out by skeletal ✓ Goblet cells in the large intestine secrete
muscles. Completion of swallowing— mucus to lubricate colonic contents.
moving a bolus along the esophagus and ✓ The pH of gastric juice rises due to the
into the stomach—is involuntary and buffering action of some amino acids in food
involves peristalsis by smooth muscle. proteins.
✓ After a large meal, the rugae stretch and
disappear as the stomach fills.
✓ Parietal cells in gastric glands secrete HCl,
which is a component of gastric juice. HCl
kills microbes in food, denatures proteins,
and converts pepsinogen into pepsin.
✓ Hydrogen ions secreted into gastric juice
are derived from carbonic acid (H2CO3).
✓ Histamine is a paracrine agent released by
mast cells in the lamina propria.
✓ The pancreatic duct contains pancreatic
juice (fluid and digestive enzymes); the
common bile duct contains bile; the
hepatopancreatic ampulla contains
pancreatic juice and bile.
✓ The phagocytic cell in the liver is the stellate
reticuloendothelial (Kupffer) cell.
✓ While a meal is being absorbed, nutrients,
O2, and certain toxic substances are
removed by hepatocytes from blood flowing
through liver sinusoids.
✓ The ileum is the longest part of the small
intestine.

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