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SLIDE 1 ANATOMY AND PHYSIOLOGY OF THE GASTROINTESTINAL SYSTEM Introduction to the gastrointestinal system The gastrointestinal tract (GIT

) consists of a hollow muscular tube starting from the oral cavity, where food enters the mouth, continuing through the pharynx, esophagus, stomach and intestines to the rectum and anus, where food is expelled. There are various accessory organs that assist the tract by secreting enzymes to help break down food into its component nutrients. Thus the salivary glands, liver, pancreas and gall bladder have important functions in the digestive system. Food is propelled along the length of the GIT by peristaltic movements of the muscular walls.

SLIDE 2

The primary purpose of the gastrointestinal tract is to break food down into nutrients, which can be absorbed into the body to provide energy. First food must be ingested into the mouth to be mechanically processed and moistened. Secondly, digestion occurs mainly in the stomach and small intestine where proteins, fats and carbohydrates are chemically broken down into their basic building blocks. Smaller molecules are then absorbed across the epithelium of the small intestine and subsequently enter the circulation. The large intestine plays a key role in reabsorbing excess water. Finally, undigested material and secreted waste products are excreted from the body via defecation (passing of feces).

Although each section of the tract has specialized functions. The contents of the tube are considered external to the body and are in continuity with the outside world at the mouth and the anus. the entire tract has a similar basic structure with regional variations. . called epithelium.SLIDE 3 Basic structure The gastrointestinal tract is a muscular tube lined by a special layer of cells.

Muscularis externa This smooth muscle layer has inner circular and outer longitudinal layers of muscle fibers separated by the myenteric plexus or Auerbach plexus. lymphoid tissue and glands that support the mucosa. the epithelium may be simple (a single layer) or stratified (multiple layers). This comprises layers of smooth muscle which can contract to change the shape of the lumen. fibrous connective tissue and larger vessels and nerves. . Serosa/Mesentery The outer layer of the GIT is formed by fat and another layer of epithelial cells called mesothelium. Depending on its function. nerves. Areas such as the mouth and esophagus are covered by a stratified squamous (flat) epithelium so they can survive the wear and tear of passing food.SLIDE 4 The wall is divided into four layers as follows: Mucosa The innermost layer of the digestive tract has specialized epithelial cells supported by an underlying connective tissue layer called the lamina propria. The inner lining is constantly shed and replaced. making it one of the most rapidly dividing areas of the body. At its outer margin there is a specialized nerve plexus called the submucosal plexus or Meissner plexus. Beneath the lamina propria is the muscularis mucosa. Neural innervations control the contraction of these muscles and hence the mechanical breakdown and peristalsis of the food within the lumen. This supplies the mucosa and submucosa. Submucosa The submucosa surrounds the muscularis mucosa and consists of fat. The lamina propria contains blood vessels. Simple columnar (tall) or glandular epithelium lines the stomach and intestines to aid secretion and absorption.

food passes through the pharynx and esophagus via the action of swallowing. Mastication refers to the mechanical breakdown of food by chewing and chopping actions of the teeth. such as the tongue. The tongue. starts the process of digestion of complex carbohydrates. It is lined by a stratified squamous oral mucosa with keratin covering those areas subject to significant abrasion. smell or even appearance of food. temperature and taste using its specialized sensors known as papillae. a strong muscular organ.SLIDE 5 Individual components of the gastrointestinal system Oral cavity The oral cavity or mouth is responsible for the intake of food. It is also the sensing organ of the mouth for touch. Each gland is divided into smaller segments called lobes. The mucin (a glycoprotein) in saliva acts as a lubricant. manipulates the food bolus to come in contact with the teeth. The oral cavity also plays a limited role in the digestion of carbohydrates. This occurs due to nerve signals that tell the salivary glands to secrete saliva to prepare and moisten the mouth. Each pair of salivary glands secretes saliva with slightly different compositions. across the mucosa. Salivary glands Three pairs of salivary glands communicate with the oral cavity. The final function of the oral cavity is absorption of small molecules such as glucose and water. Salivation occurs in response to the taste. The enzyme serum amylase. . From the mouth. hard palate and roof of the mouth. Each is a complex gland with numerous acini lined by secretory epithelium. In salivation refers to the mixing of the oral cavity contents with salivary gland secretions. The acini secrete their contents into specialized ducts. a component of saliva.

Immunoglobins are secreted help to fight microorganisms and a-amylase proteins start to break down complex carbohydrates. rich in mucin and with a smaller amount of protein. Submandibular The submandibular glands secrete 70% of the saliva in the mouth. Mucin is a glycoprotein that acts as a lubricant. They secrete 25% of saliva. irregular shaped glands located under the skin on the side of the face. The main functions are to provide buffers and lubrication.SLIDE 6 Parotids The parotid glands are large. An enlarged parotid gland can be easier felt when one clenches their teeth. in a groove along the inner surface of the mandible. Sublingual The sublinguals are the smallest salivary glands. They are found in the floor of the mouth. The parotids produce a watery secretion which is also rich in proteins. They produce approximately 5% of the saliva and their secretions are very sticky due to the large concentration of mucin. These glands produce a more viscid (thick) secretion. covered by a thin layer of tissue at the floor of the mouth. . They are situated below the zygomatic arch (cheekbone) and cover part of the mandible (lower jaw bone).

the submucosa (SM) secretes mucus from mucous glands (MG) which aid the passage of food down the esophagus.and food is propelled into the stomach by waves of peristalsis. The esophagus functions primarily as a transport medium between compartments. . The wall of the esophagus is made up of inner circular and outer longitudinal layers of muscle that are supplied by the esophageal nerve plexus. This nerve plexus surrounds the lower portion of the esophagus. It extends from the pharynx to the stomach after passing through an opening in the diaphragm. it is swallowed and passes down the esophagus. The esophagus has a stratified squamous epithelial lining (SE) which protects the esophagus from trauma. The lumen of the esophagus is surrounded by layers of muscle (M)-voluntary in the top third.SLIDE 7 Esophagus The esophagus is a muscular tube of approximately 25cm in length and 2cm in diameter. Once food has been chewed and mixed with saliva in the mouth. progressing to involuntary in the bottom third.

fundus. These allow the stomach to stretch and expand when food enters. located just left of the midline between the esophagus and small intestine.5 liters of material. The stomach has five major functions:      Temporary food storage Control the rate at which food enters the duodenum Acid secretion and antibacterial action Fluidization of stomach contents Preliminary digestion with pepsin. dilated portion of the stomach that has contact with the left dome of the diaphragm. body and pylorus. It is divided into four main regions and has two borders called the greater and lesser curvatures.SLIDE 8 Stomach The stomach is a J shaped expanded bag. . The first section is the cardia which surrounds the cardial orifice where the esophagus enters the stomach. gastrin and pepsinogen secretion. The inner surface of the stomach is contracted into numerous longitudinal folds called rugae. lipases etc. This is where most gastric glands are located and where most mixing of the food occurs.the cardia.the esophageal and the duodenal. With two openings. Gastric contents are expelled into the proximal duodenum via the pyloric sphincter. The body is the largest section between the fundus and the curved portion of the J. The fundus is the superior.and four regions. Each region performs different functions. The stomach can hold up to 1. the fundus collects digestive gases. Finally the pylorus is the curved base of the stomach. the body secretes pepsinogen and hydrochloric acid. and the pylorus is responsible for mucus.

MM.SLIDE 9 THE STOMACH-HISTOLOGY Key:    G.mucosa containing glandular tissue. different areas of the stomach contain different types of cells which secrete compounds to aid digestion. The main types involved are: o parietal cells which secrete hydrochloric acid o chief cells which secrete pepsin o enteroendocrine cells which secrete regulatory hormones.circular muscle LM.inner oblique muscle CM.outer longditudional muscle .submucosa The stomach contains three layers of involuntary smooth muscle which aid digestion by physically breaking up the food particles: o o o OM.muscularis mucosae SM.

. The jejunum The ileum. Brunner's glands in the submucosa secrete alkaline mucus which neutralizes the chyme and protects the surface of the duodenum. The mucosa of these sections is highly folded (the folds are called plicae). and together are about 4-6 meters long. increasing the surface area available for absorption dramatically. The whole of the small intestine is lined with an absorptive mucosal type. The intestine also has a smooth muscle wall with two layers of muscle.SLIDE 10 The Small Intestine The small intestine is the site where most of the chemical and mechanical digestion is carried out. rhythmical contractions force products of digestion through the intestine (peristalsis). There are three main sections to the small intestine:    The duodenum forms a 'C' shape around the head of the pancreas. Its main function is to neutralize the acidic gastric contents (called 'chyme') and to initiate further digestion. with certain modifications for each section. The jejunum and the ileum are the greatly coiled parts of the small intestine. and where virtually all of the absorption of useful materials is carried out. the junction between the two sections is not well-defined.

the area available for absorption is vast.and blood containing digestive products from the small intestine is taken to the liver via the hepatic portal system. . The epithelial surface of the plicae (P) is further folded to form villi(V).the vessels can be seen in the submucosa (SM). and the surface of each villus is covered in small microvilli to maximize surface area. The double muscle layer (M) moves food through the intestine by peristalsis. Each villus has its own blood supply.SLIDE 11 The micrograph above shows a section of the jejunum. These increase the surface area of the small intestine still further. and clearly shows the highly folded structure of the mucosa of the small intestine.

SLIDE 12 Large intestine The large intestine is horse-shoe shaped and extends around the small intestine like a frame. It has a length of approximately 1. The functions of the large intestine can be summarized as: 1. 2. The mucosa of the large intestine lacks villi seen in the small intestine. . The wall of the colon is made up of several pouches (haustra) that are held under tension by three thick bands of muscle (taenia coli). It expands to hold fecal matter before it passes through the anorectal canal to the anus. Thick bands of muscle. It consists of the appendix. 3. cecum. known as sphincters. The accumulation of unabsorbed material to form feces. Reabsorption of water. ascending. The rectum is the final 15cm of the large intestine. salts. Some digestion by bacteria. The mucosal surface is flat with several deep intestinal glands. Food then travels along the colon. sugar and vitamins. and the rectum.5m and a width of 7. The bacteria are responsible for the formation of intestinal gas. control the passage of feces. transverse. The cecum is the expanded pouch that receives material from the ileum and starts to compress food products into fecal material. Numerous goblet cells line the glands that secrete mucous to lubricate fecal matter as it solidifies. descending and sigmoid colon.5cm.

passing semi-solid feces into the rectum to be expelled from the body through the anus. almost all of the nutritionally useful products have been removed. The large intestine removes water from the remainder.SLIDE 13 By the time digestive products reach the large intestine. The large intestine also contains areas of lymphoid tissue (L). . The mucosa (M) is arranged into tightlypacked straight tubular glands (G) which consist of cells specialized for water absorption and mucus secreting goblet cells to aid the passage of feces. these can be found in the ileum too (called Peyer's patches) and they provide local immunological protection of potential weak-spots in the body's defenses.

It is surrounded by a strong capsule and divided into four lobes namely the right. peptidases and amylases for fats. All nutrients absorbed by the intestines pass through the liver and are processed before traveling to the rest of the body. caudate and quadrate lobes. glucagon and other substances and these are the areas damaged in diabetes mellitus. body and tail. The exocrine (secretory) portion makes up 80-85% of the pancreas and is the area relevant to the gastrointestinal tract. The bile produced by cells of the liver. Here. neck. Endocrine refers to production of hormones which occurs in the Islets of Langerhans.SLIDE 14 Accessory Glands The Pancreas The pancreas consists mainly of exocrine glands that secrete enzymes to aid in the digestion of food in the small intestine. its main roles in digestion are in the production of bile and metabolism of nutrients. It acts as a mechanical filter by filtering blood that travels from the intestinal system. However. . body and neck. The main functions of the gall bladder are storage and concentration of bile. Bile is produced by the liver but stored in the gallbladder until it is needed. It empties via the cystic duct into the biliary duct system. Liver The liver is a large. It detoxifies several metabolites including the breakdown of bilirubin and estrogen. the same place that bile from the liver drains into. The organ is approximately 15cm in length with a long. The pancreas is a lobular. The Islets produce insulin. proteins and carbohydrates respectively. pinkish-grey organ that lies behind the stomach. enters the intestines at the duodenum. These are released into the duodenum via the duodenal ampulla. The main enzymes produced are lipases. The liver has several important functions. Pancreatic exocrine secretion is hormonally regulated. Structurally. Bile is released from the gall bladder by contraction of its muscular walls in response to hormone signals from the duodenum in the presence of food. head. slender body connecting the head and tail segments. the tail stretches back to just in front of the spleen. it makes fats water soluble and gives the pancreatic enzymes lots of surface area to work on. As bile is essentially an emulsifying agent. pear shaped organ that sits in a depression on the posterior surface of the liver's right lobe. bile salts break down lipids into smaller particles so there is a greater surface area for digestive enzymes to act. the pancreas has four sections. left. the liver has synthetic functions. It consists of a fundus. In addition. producing albumin and blood clotting factors. Gall bladder The gallbladder is a hollow. Bile is a thick fluid that contains enzymes to help dissolve fat in the intestines. Its head communicates with the duodenum and its tail extends to the spleen. and the same hormone that encourages secretion (cholesystokinin) also encourages discharge of the gall bladder's store of bile. reddish-brown organ situated in the right upper quadrant of the abdomen. The pancreas has both exocrine and endocrine functions.

b. the appendix starts making endocrine cells for the developing fetus. The spleen is the soft. A second important function of the spleen is to filter worn-out . make white blood cells and antibodies. During and after digestion. a. c. Features A finger size. The spleen is shaped like a loose fist and is tucked under the left side of the diaphragm. The spleen is also a blood reservoir. Appendix function warrants further research. If the increase in size is significant. SLIDE 16 Spleen The human spleen is an organ that creates lymphocytes for the destruction and recycling of old redblood cells. the size of the spleen increases.44 lbs. As quickly as 11 weeks after conception. the spleen can rupture. meaning an organ previously more fully developed in the human species that currently serves no function. and the appendix endocrine cells secrete amines and peptide hormones that help with biological checks and balances as the fetus grow. purplish-red organ tucked just under the rib cage on the left side of the abdomen. The wall of the appendix is composed of all layers typical of the intestine. such as hormones. the body signals the spleen to contract. Acting as a lymphoid organ after birth. viruses and bacteria that cells learn how to fight. The appendix. The average weight of an adult spleen is 0. It is about the size of the heart and is made up of a spongy material that can hold up to three gallons of blood. The appendix is longest in childhood and gradually shrinks throughout adult life. slimy. forcing replacement blood into the circulation. Endocrine cells secrete useful chemicals. Fetal Development The appendix assists in fetal development. the appendix measures between 2 and 8 inches long and a half-inch wide. Immune Function The appendix helps create and train white blood cells. When a child experiences a sudden blood loss. is part of a complicated chain that makes B lymphocytes (one variety of white blood cells) and a class of antibodies known as immunoglobulin A antibodies.SLIDE 15 Appendix Scientists considered the appendix a leftover vestigial organ. by virtue of its lymphoid tissue. but it is thickened and contains a concentration of lymphoid tissue. dead-end sac. Lymphoid organs. the appendix wards against disease. The location of the appendix exposes white blood cells to a bounty of drugs. Studies prove otherwise. but strong evidence substantiates this body part and its role in health and development. with their lymphoid tissue. Chemicals also originate in the appendix that dispatches white cells to needed locations throughout the body.

Inside the stomach. and gallbladder further breakdown chyme into elements that can be easily absorbed and used by the body. The bolus passes through the esophageal sphincter before it enters the stomach. making it easier to be swallowed and slide down the back of the throat and esophagus. Very little digestion occurs in the large intestine. hydrochloric acid is released. Saliva initiates digestion and changes the chewed food into a soft mass. Finally. or the chewing of food in the mouth. liver. Transcript Digestion is the process by which the gastrointestinal system retrieves important nutrients for the body and chemically changes the unused food into waste. and platelets from the blood. or the chewing of food in the mouth. where all nutrients and vitamins are absorbed. in the small intestine. SLIDE 17 The liquefied bolus. Mastication.red and white blood cells. The large intestine plays a key role in reabsorbing excess water. or bolus. It is here that enzymes released from the pancreas. Digestion Digestion is the process by which the gastrointestinal system retrieves important nutrients for the body and chemically changes the unused food into waste. Chyme can travel through up to 20 feet of small intestine before it passes through the ileocecal valve to enter the large intestine. now called chyme. the first section of the small intestine. The villi enable digested food to enter the bloodstream. A third job of the spleen is to store platelets and a large percentage of the body's platelets normally found there. is the first step of digestion. Undigested chyme that enters the large intestine is considered waste. is the first step of digestion. It is here. breaking down large food molecules into smaller ones and liquefying the bolus. . or end of the large intestine. Saliva makes the bolus slippery. then passes through the pyloric sphincter and enters the duodenum. The small intestine is lined with a heavily folded inner mucosa and small fingerlike projections called villi. undigested material and secreted waste products are excreted from the body via defecation (passing of feces). The waste becomes more and more solid as it passes through the large intestine because water is continuously being reabsorbed from the waste. Proteins. Waste collects in the rectum. Mastication. until the brain signals for it to be expelled from the body. ready to be sent where needed. fats and carbohydrates are chemically broken down into their basic building blocks in the stomach and absorbed in the small intestine.

The Stomach: After food has left the esophagus it enters the stomach. stomach. esophagus. bile duct. The esophagus is the tube that connects the mouth to the stomach. gall bladder. When this happens. The muscles around the stomach squeeze the stomach and food in the stomach like mixing pancake batter in a plastic bag. They are acids that dissolve food down into smaller pieces so it can be absorbed into the blood stream. jejunum and ileum. It also moves the nutrients and waste through our body. Sometimes. the salivary glands produce saliva containing an enzyme which starts off the digestive process. which is a wave of muscle contractions that pushes the food down the tube. At the end of the esophagus is the lower esophageal sphincter (LES). Then the teeth and jaws chew the apple to break the bite sized pieces into smaller pieces. The stomach provides four basic functions that assist in the early stages of digestion and prepare the food for further processing in the small intestine: The stomach is a temporary storage container which can hold a large meal for a long time. the stomach . the stomach muscles contract and force anything that is in your stomach up through the lower esophageal sphincter. There are natural chemicals in your stomach that we call digestive juices. The LES is trying to stay closed but the contractions create more pressure than your LES can hold. tongue and salivary glands. This is to make the pieces small enough to fit through the esophagus and to make less work for the stomach. Food moves through the esophagus by peristalsis. large intestine. jaws. pancreatic duct. Just like you need to put water in the bag to get a smooth mix. pancreas. The Esophagus: The food is then swallowed which takes the food from the mouth to the esophagus. which closes to prevent food from re-entering the esophagus. when something gets in the stomach that the stomach doesn’t like.This is where chemical and enzymatic digestion starts. While the food is still in the mouth. the stomach contents go back up through the esophagus and come out through the mouth.Introduction: Our digestive system is made up of the body parts that change raw food into nutrients that the body can use and waste. We call this "throwing up". It is made up of the mouth including the teeth. rectum and anus. small intestine including the duodenum. liver. digestion starts when the jaws use the teeth to bite into the apple. This begins to break down the food by dividing it into bite sized pieces. The Mouth: When a person eats any food such as an apple.

in a C-shaped formation. The Small Intestine: The small intestine is approximately 20 feet long and is divided into 3 segments . the duodenum mixes the chyme with these enzymes within its lumen. Fats are broken down in the duodenum by "lipase" . The Pancreas: The pancreas makes and delivers digestive juices through a tube called the pancreatic duct to the upper part of the small intestine. At the spot where the stomach and duodenum meet. The Gall Bladder: The gall bladder is a pouch-shaped organ which lies near the liver. Another important function of the liver is that it produces sugars from proteins and fatty substances. The carbohydrates are broken down in the duodenum by enzymes from the pancreas and liver into sugars. further aiding digestion. and by moving the chyme in a shaking kind of motion. and it has a lining which is specialized in the absorption of carbohydrates and proteins. as well as the absorption of fatty products. The proteins have been broken down in the stomach by enzymes called pepsin and acid into amino acids. The duodenum begins just beyond the stomach and curves around the head of the pancreas and the entrance of the common bile duct. The liver also converts poisons in the blood into materials which can be safely excreted from the body. Bile and pancreatic juice also enter the duodenum around its midpoint.the duodenum. It also secretes bile which is a substance containing fatty materials. This allows us to go to the bathroom without pain or body damage. These help in the digestion. it is slowly released into the small intestine for further processing. the gallbladder releases bile into the small intestine where it is able to help dissolve fats. by secreting enzymes which aid indigestion. The liver uses calcium to reduce the amount of acid in the body waste. jejunum.makes juices to mix with the food to liquefy it which is a requirement for the food to go to the small intestine. One of its main functions is to process fat and other nutrient-rich liquefied food that drains from the small intestine so it can be used. and ileum. and stores it. is a muscle called the pyloric sphincter which prevents the regurgitation of material back into the stomach. When food is digested. and it secretes albumin which helps to keep fluid within the blood vessels. It accepts bile from the liver. As food is liquefied in the stomach. The duodenum is responsible for further processing the material from the stomach (called chyme). The jejunum is the next portion of the small intestine. The Liver: The liver has hundreds of functions.

The material first passes through the ascending colon and then through the transverse colon. sugar. electrolytes and water are small enough to soak into the villi of the jejunum and drop into the blood stream. By the time material reaches this point. bile salts and water to soak through the walls and into the blood stream. Where the ileum joins the large intestine is a valve. Its function is to move the waste from the small intestine on to the rectum. it has a rather pasty consistency. It is about 5 feet long. which prevents the back flow of materials into the small intestine. and bile salts which are a component of bile. Throughout this process. It has a specialized muscle. called the anal sphincter. called the ileocecal valve. it is quite firm. By the time the waste reaches the segment called the sigmoid. electrolytes. The pores in the ileum are slightly bigger than those in the jejunum and allow vitamin B12. The blood takes all these nutrients to all the other parts of the body to provide fuel to do their jobs. The Large Intestine: The parts of the food that can’t be digested get pushed into the large intestine. and it is responsible for absorption of fats. fatty acid particles. minerals. vitamins. The ileum is the last portion of the small intestine. also called the colon. The sigmoid colon is designed to slow down this movement of the waste until it is ready to be eliminated. which prevents the body waste from escaping until the appropriate time. It stores the firm waste until you are ready to get rid of it by "going to the bathroom". vitamins dissolved in fatty liquids.from the pancreas into fatty acids. it absorbs more water. The lowermost segment of the large intestine is called the rectum. . Amino acid.