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KHOA NGUYEN

Hong Bang International University


Physiology Department
03/14/2022

THE DIGESTIVE SYSTEM


CONTENTS
• Structure and general function of the digestive system
• Layers of the wall of the gut tube
• The four activities of the digestive tract
• Digestive tract perfusion
• Regulation of digestion functions
• Liver and biliary tract physiology
Anatomy of the Digestive System
• The gastrointestinal tract
(gut tube)
• Accessory organs of digestion
• Teeth
• Tongue
• Salivary glands
• Liver
• Biliary tract (including GB)
• Pancreas
General function of the Digestive System

Food GI TRACT Wastes

Nutrients
CONTENTS
• Structure and general function of the digestive system
• Layers of the wall of the gut tube
• The four activities of the digestive tract
• Digestive tract perfusion
• Regulation of digestion functions
• Liver and biliary tract physiology
Layers of the wall of the gut tube
• Serosa: protects underlying organs, secretion of a
serous fluid that helps with reducing friction. Suspend
the gut tube from the posterior abdominal wall
• Muscularis: in charge of motility
• Submucosa: provide a means of nourishment for the
mucosa and for the blood & lymph to move absorbed
nutrients
• Mucosa: secretion and absorption of nutrients
Small intestinal mucosa
The brush border
• Microvilli

• Increase surface
area for absorption
How much is the increase in surface area?
CONTENTS
• Structure and general function of the digestive system
• Layers of the wall of the gut tube
• The four activities of the digestive tract
• Digestive tract perfusion
• Regulation of digestion functions
• Liver and biliary tract physiology
Activities of the digestive system
Motility
• Peristalsis
• Segmentation
(https://www.youtube.com/watch?v=hKQ8eFpUKLs)

• Rhythm of gut tube motility:


provided by the interstitial
cells of Cajal.
Secretion Enzyme
(pepsin)

• Digestive juices Electrolytes


• Modes
• Baseline
• Activated
• Components
• Enzymes
• Electrolytes Mucus
• Mucus
Digestive enzymes
• NOTE:
• All of the necessary
enzymes for complete
digestion of food (*) will all
be secreted into the GI tract
after the stomach
• Salivary lipase and
amylase, as well as gastric
pepsin are NOT necessary
for complete digestion of
food
Digestion
• Cut the food into small molecules that can be absorbed
• Includes
• Mechanical digestion
• Chewing
• Contraction/ grinding movements of the stomach and small intestine
• Chemical digestion
• HCl: partly digest protein
• Digestive enzymes: catalyzes the hydrolysis of food
Digestion of carbohydrates (sugar)
• Begins at the mouth
(salivary amylase)
• Complete at the duodenum
due to the actions of:
• Pancreatic amylase
• Brush border enzymes
• Maltase
• Sucrase
• Lactase (CC: lactose
intolerance)
• Peptidase
Digestion of carbohydrates (sugar)

• NOTE:
• To be transported
from the lumen of
the gut tube into the
intestinal epithelium,
all sugar molecules
will have to be
broken down into
monosaccharides
first!
Digestion of protein

• Begins at the stomach


(pepsin + HCl)
• Complete at the
duodenum due to the
actions of
• Pancreatic peptidases
• Trypsin
• Chymotrypsin
• Elastase
• Carboxypeptidase
• Brush border enzymes
• Dipeptidases
• Aminopeptidase
Digestion of protein

• NOTE:
• The final products of
protein digestion are 40%
amino acids, 60% di and
tripeptides.
• Amino acids, along with di
and tripeptides, can all be
absorbed into the intestinal
epithelium
• However, will have to be
amino acids to be absorbed
into the blood
Digestion of lipids

• Startsat the mouth (salivary


lipase) but very little!
• Complete at the duodenum
• Requires bile, lipase, and
colipase for complete
digestion
• Productsof fat digestion will
be absorbed into the lacteals
(lymphatics), NOT blood.
Digestion of lipids
Digestion of lipids
Digestion of lipids
Absorption
• Mechanisms
• Secondary active transport
• Facilitated diffusion
• Simple diffusion

• Products of digestion will be absorbed into


• Capillaries– Portal venous system – liver – heart (which
types of macronutrient?)
• Lymphatic vessels – thoracic duct – heart (which type?)
Portal venous system
Lymphatic system
CONTENTS
• Structure and general function of the digestive system
• Layers of the wall of the gut tube
• The four activities of the digestive tract
• Digestive tract perfusion
• Regulation of digestion functions
• Liver and biliary tract physiology
Blood supply for the
digestive system
• Increased after meal
• Regulated by:
• Thenervous system
• Endocrine/ Paracrine factors
Arterial system of the digestive system
CONTENTS
• Structure and general function of the digestive system
• Layers of the wall of the gut tube
• The four activities of the digestive tract
• Digestive tract perfusion
• Regulation of digestion functions
• Liver and biliary tract physiology
Regulation of digestive functions
Endocrine system
Enteric nervous system
• Myenteric (Auerbach) plexus
• Controls motility
• Submucosal (Meissner)
plexus
• Receptive of chemicals and
mechanical (stretching) stimuli
using chemo and
mechanoreceptors
• Controls perfusion, secretion,
and absorption
Autonomic nervous system

• Parasympathetic NS
• Vagus nerve (X)
• S2 – S4 from sacral
plexus
• Sympathetic NS
• Sympatheticbranches
from T5 – L2 spinal levels
Parasympathetic NS
• Vagus nerve (CN
X)
• S2 – S4 sacral
nerves
• Increased
muscularis
contraction
• But decrease
sphincter
constriction
• Increase secretion
• Vasodilation
Sympathetic NS
• Branches from T5 –
L2 spinal levels
• Relax muscularis
• Butcontract
sphincters
• Vasoconstriction
Secretory phases
• Cephalic: Food hasn’t reached the stomach
• Gastric: Digesta arrives at the stomach
• Intestinal: Digesta entering the small intestine
Secretory phases
Stages Stimulus Description Function

1. Cephalic Thinking about, seeing, Increased PANS activity Prepare for when bolus
smelling, or tasting -> increased saliva and enters the stomach
food gastric juice secretion

2. Gastric Food entering the Bolus entering the Mixing and churning of
stomach stomach causing stomach contents and
distension of the gastric mix it with gastric
wall and increased juices, turning the
gastric juice secretion digesta into chyme
3. Intestinal Chyme entering the Enterogastric reflex Inhibition of gastric
small intestine (SANS) slows gastric juice secretion
motility and decreases Control the rate of
gastric juices movement of chyme
from the stomach to
the duodenum
Regulation of feeding and satiety
• Hypothalamus
• Hunger center
• Satiety center

• Satiety
• Mechanoreceptors –
chemoreceptors from the
stomach/ intestine
• Concentration of nutrients in
the blood
Digestion at the mouth and stomach
Activity Regulation
Mechanical:
- Chewing
- Swallowing
Secretion: Saliva Autonomic Nervous
System
Digestion of starch
(sugar)
Absorption
Chewing
• Grind and break up food by actions of teeth
• Increase surface area of food in contact with enzymes
• Decrease friction with digestive mucosa
• Easy – to – swallow

• Controlled by chewing reflex center in the brainstem


Swallow
• 3 stages: mouth, pharynx, esophagus (controlled by medullary swallowing center)
• 1/3 upper esophagus: under voluntary control -> upper esophageal sphincter (UES)
• 2/3 lower esophagus: not voluntary -> lower esophageal sphincter (LES)
Swallowing
Salivary secretion
• Contents:
• Few in Na+ and Cl-
• Adundance of K+ and
HCO3-
• Hypotonic
• Amylase & Lipase
• Mucus, glycoproteins
• Immunoglobulin A and
lysozyme: immune function
Control of salivary secretion
Digestion at the stomach
Activity Regulation
Mechanical: Nervous system
- Storing food Endocrine system
- Turning food into chyme
- Moving chyme into SI
- Vomitting
Secretion: gastric juices Autonomic Nervous System
Endocrine System
Digestion: protein, lipase

Absorption: medication (aspirin),


alcohol
Functional areas
of the stomach
• Storing the food
• Fundus
• Receptive relaxation
• Assist with receiving bolus
without increasing intra-
abdominal pressure

• Mixing and churning motion


• Peristaltic waves: 3/min
• Body
• Pyloric portion
• Formation of chyme
Regulation of stomach motility & emptying

• Wall distension
• Acid

• Fat

• Hyperosmolarity
Vomitting
• Vomitting center
• Peripheral stimulus
(digestive,
vestibular, palatal)
• Central stimulus
(on the CTZ –
chemoreceptor
trigger zone), or
higher nervous
centers)
Gastric secretory activity
Gastric secretory activity
Secreting cells Substance secreted Effect(s)
Mucous cells Mucus Lubrication
Protection
Parietal cells HCl Activates pepsinogen
Intrinsic factor Absorption of Vit B12
Chief cells Pepsinogen Protein digestion
ECL cells Histamine Increase HCl secretion
G cells Gastrin Increase HCl secretion
D cells Somatostatin Decrease HCl secretion
Gastric secretory activity
Gastric secretory activity

Proton pump
Gastric secretory activity

Omeprazole
Pantoprazole

Regulation of HCl secretion
Peptic ulcer
CONTENTS
• Structure and general function of the digestive system
• Layers of the wall of the gut tube
• The four activities of the digestive tract
• Digestive tract perfusion
• Regulation of digestion functions
• Liver and biliary tract physiology
General functions of the liver
• Metabolism
• Bile production
• Storage
• Detoxification
• Endocrine
Functions of the liver
• Detoxification
Functions of the liver
• Bile secretion H20 (Osmosis)

• Bile contents
• Bile salts (produced from
cholesterol
• Lecithin (phospholipid)
• HCO3-
• Cholesterol (left overs from
bile salt production)
• Bile pigments (Ex: Bilirubin)
• Water and other ions
Bilirubin
• Origin of bilirubin:
from metabolism
of old RBCs
• Interstitial
accumulation of
bilirubin
jaundice
Bile production
Enterohepatic circulation
Biliary tree
• Intrahepatic
• Extrahepatic
Biliary tree
• Intrahepatic
• Extrahepatic
Gallstones
• Cholesterol
gallstones
• Pigment gallstones
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