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Secretary function of GIT

Primary secretary products of GIT are: Digestive enzymes GI-hormones Mucous Electrolytes, HCl, NaHCO3 GIT secretary glands 1. Goblet cells: mucous producing glands 2. Brunners gland: mucous glands 3. Crypts of Lieberkuhn: water and electrolytes 4. Gastric glands: Oxyntic, pyloric and mucous glands 5. Complex glands: salivary, pancreatic glands and liver 6. Enteroendocrine cells: produce hormones 7. Others: Panet cells, APUD cells, chromaffine cells

Factors stimulating GIT secretions

Local mechanical factors: distension, irritation, pH Nervous stimulation: ANS, ENS Sympathetic stimulation inhibits GIT-secretions Parasympathetic stimulation increases GIT-secretions Meissners plexus increases GIT-secretion Hormonal mechanisms: Gastrin increase HCl secretion Secretin increases NaHCO3 secretion from pancreas Mucous Function Composition Lubrication - Water Protection - Electrolytes - Glycoproteins - Polysaccharides

Salivary secretion
Produced by 3 pairs of salivary glands Average salivary out put is 800 1500 ml/day Salivry pH = 6.0 -7.4 Ionic composition: K+, HCO3, Na, Cl The primary secretion contains ptyalin, mucous and ECF Active secretion of K & HCO3 in the duct Active reabsorption of Na & Cl in the salivary duct

Function of saliva
Moistening the mouth and aids speech Keeps oral hygien, contains bacteriocidal substances: thyocyanide, lysozymes Lubricates food and assissts swallowing Buffers suden change of oral pH Xerostomia Dry mouth due to insufficient salivary production

Regulation of salivary secretion

Totally controlled by the PNS Integrated at the salivatory centre in the MO The salivatory nuclei controls salivary glands The salivatory nuclei are stimulated by impulses from Sensory impulses from the tongue (taste, touch) Sensory impulses from the esophaguse, stomach, SI Impulses from the cerebral cortex (sight, smell) Impulses from the feeding centre in the hypothalamus

Regulation of salivary secretion

Regulation of salivary secretion

Appetite Centre (HT)

Sight Cortex Smell Sound

Superior salivatory nucleus Inferior salivatory nucleus

Medulla Ob.



Taste Touch Temperature FN




Lower esophagus Stomach Upper SI


Microscopic Anatomy of the Stomach

Regulation of Gastric Secretion

Neural and hormonal mechanisms regulate the release of gastric juice Stimulatory and inhibitory events occur in three phases 1. Cephalic (reflex) phase: prior to food entry 2. Gastric phase: once food enters the stomach 3. Intestinal phase: as partially digested food enters the duodenum

Cephalic Phase
Excitatory events include: Sight or thought of food Stimulation of taste or smell receptors Inhibitory events include: Loss of appetite or depression Decrease in stimulation of the parasympathetic division


Gastric Phase
Excitatory events include: Stomach distension Activation of stretch receptors (neural activation) Activation of chemoreceptors by peptides, caffeine, and rising pH Release of gastrin to the blood Inhibitory events include: A pH lower than 2 Emotional upset that overrides the parasympathetic division


Intestinal phase
Excitation low pH partially digested food enters the duodenum and encourages gastric gland activity Inhibition distension of duodenum presence of fatty, acidic, or hypertonic chyme, and/or irritants in the duodenum Initiates inhibition of local reflexes and vagal nuclei Closes the pyloric sphincter Inhibit gastric secretion

Regulation of Gastric Secretion


Release of Gastric Juice


Mechanism of HCl Secretion

Steps in HCl secretion
1. Cl- is actively pumped into the lumen It enters the parietal cells from ECF in exchange for HCO32. H+ is actively pumped into the lumen in exchange for K+ by H+K+ ATP ase
H2O + CO2 CA H2CO3CA + +HCO3 H

3. K+ is diffused into the lumen and Na+ enters the parietal cells and H2O moves into the lumen by osmosis Parietal cells secrete 160 mmol/L of HCl, pH = 0.8, 3 million x that of blood pH Carbonic anhydrase (CA) inhibitor = acetazalamide




Factors stimulating HCl secretion

1. 2. 3. 4. Histamine HR ACh MR Gastrin GR ClOther factors = HCl H+ Distension K+ Tactile stimulation Parietal cells Type of food Irritation Drugs inhibiting HCl secretion Drugs Nexium Alcohol Omeprazole Excessive HCl secretion Cemetidin, Ranitidin Results in PUD Zollinger-Ellisons syndrome 16
2 2

Secretion of the small intestine

Mucosa of the SI secrets: Digestive enzymes Mucous: protective and lubricant Electrolytes Intestinal secretary out put = 2-3 L/d, pH,7.0 Hormones Intestinal secretary glands: 1. Brunners gland: mucous glands, duodenal in ditribution 2. Crypts of Lieberkun: mucous and electrolytes. Distribute in the SI below the duodenum and in the LI. 3. Goblet cells: mucous glands 4. Enterocytes: digestive enzymes 5. Enteroendocrine cells: produce hormones 6. Enterochromaffin cells: serotonin producing cells 17 7. APUD cells: amine precursor uptake and decarboxilating cells

Digestive enzymes secreted in the SI

1. 2. Peptidase: splits peptides into amino acids Four enzymes hydrolyzing diasaccharides into monosaccharides: sucrase, maltase isomaltase and lactase 3. Intestinal lipase: splits neutral fats into glycerol and fatty acids. Regulation of SI secretion 1. Local factors: tactile, distension, irritation, pH. 2. Hormonal: secretin, CCK, VIP, glucagon, GIP 3. Nervous: vagal stimulation increases intestinal secretion sympathetic stimulation decreases intestinal secretion

Enteroendocrine cells
G-cells = secret gastrin S-cells = secret secretin I-cells = produce CCK EG-cells = enteroglucagon and GLP Gland-cells = GIP and VIP D-cells = Somatostatin Other cells = motilin, substance-P


Regulation of Secretion & Motility of SI

Enteric reflexes that respond to presence of chyme increase intestinal motility VIP (vasoactive intestinal polypeptide) stimulates the production of intestinal juice segmentation depends on distension which sends impulses to the enteric plexus & CNS Distension produces more vigorous peristalsis 10 cm per second Sympathetic impulses decrease motility


Secretion of the large intestine

Glands Cryps of Lieberkuhn Goblet cells

Secret H2O, electrolytes and mucous

Regulated by local (tactile) factors


The Pancreas
Pancreas Location: Lies deep to the greater curvature of the stomach The head is encircled by the duodenum and the tail abuts the spleen Divided into: Head, body and tail Connected to the duodenum via the main pancreatic duct (duct of Wirsung) and accessory duct (duct of Santorini). Pancreas contains two types of secretary glands: 1. Endocrine cells (islets of Langerhans) secrete hormones and 2. Exocrine cells (acinar cells): secrete a mixture of fluid rich in NaHCO3 and digestive enzymes called pancreatic juice.

Fig. Acinus of the Pancreas


Composition of Pancreatic Juice

Out put: 1-2 L/day, pH of 7.1 to 8.2 Contains water, enzymes & sodium bicarbonate Digestive enzymes 1. Proteolytic enzymes: trypsin: activated by enterokinase chymotrypsin: activated by trypsin Carboxypolypeptidase: activated by trypsin Elastase: activated by trypsin Trypsin inhibitor: combines with trypsin produced inside pancreas Ribonuclease: to digest nucleic acids 2. Pancreatic enzymes involved in CHO digestion: pancreatic amylase 3. Pancreatic enzymes involved in fat digestion: pancreatic lipase, cholesterol esterase, phospholipase

Pancreatic Activation


Regulation of Pancreatic Secretions

Secretin acidity in intestine causes increased sodium bicarbonate release GIP fatty acids & sugar causes increased insulin release CCK fats and proteins cause increased digestive enzyme release

Liver and Gallbladder

The liver is the heaviest gland in the body and the second largest organ in the body after the skin. The liver is divisible into left and right lobes, separated by the falciform ligament. Associated with the right lobe are the caudate and quadrate lobes. The gallbladder is a sac located in a depression on the posterior surface of the liver.

Liver and gallbladder

Liver Weighs 3 lbs. Located below diaphragm in the abd Right lobe larger Gallbladder on right lobe Size causes right kidney to be lower than left Gallbladder has fundus, body, neck


Liver: Associated Structures


Liver: Associated Structures

Bile leaves the liver via: Bile ducts, which fuse into the common hepatic duct The common hepatic duct, which fuses with the cystic duct These two ducts form the common bile duct

Liver: Microscopic Anatomy

Hexagonal-shaped liver lobules are the structural and functional units of the liver Composed of hepatocyte (liver cell) plates radiating outward from a central vein Portal triads are found at each of the six corners of each liver lobule Portal triads consist of: 1. Bile duct 2. Hepatic artery supplies oxygen-rich blood to the liver 3. Hepatic portal vein carries venous blood with nutrients from digestive viscera

Liver: Microscopic Anatomy


Functions of the liver

1. On Carbohydrate Metabolism: It is the site of glycogenesis, gluconeogenesis and glycogenolysis Turn proteins into glucose Turn triglycerides into glucose Turn excess glucose into glycogen & store in the liver Turn glycogen back into glucose as needed 2. On Lipid Metabolism It is the site of -oxidation, formation of phospholipids, lipoproteins, synthesis of cholesterol, and conversion of CHO into fat 32

Functions of Liver
3. Protein Metabolism Deamination of amino acids = removes NH2 (amine group) from amino acids so can use what is left as energy source Converts resulting toxic ammonia (NH3) into urea for excretion by the kidney Synthesizes plasma proteins utilized in the clotting mechanism and immune system Convert one amino acid into another

Other Functions of the liver

4. Inactivation of drugs & hormones (Sulfonamide, penicillin, thyroid, steroids) 5. Removes the waste product; bilirubin 6. Releases bile salts that help digestion of fat by emulsification 7. Stores fat soluble vitamins: A, B12, D, E, K 8. Stores iron and copper 9. Filtration of blood: phagocytizes worn out blood cells & bacteria. Removes blood clots and toxins from portal circulation 10. Activates vitamin D 11. Storage of blood: a major blood reservoir 12. Synthesis of blood clotting factors (F-I, II, VII, IX, X)

Secretion of bile
Bile is secreted by hepatocytes in the liver for two purposes 1. It facilitates fat digestion and absorption in the SI 2. Serves as a means of excretion of waste products (bilirubin and cholesterol) Bile secretion has two stages: 1. Primary secretion: contains bile salt, cholesterol, lecithin, electrolytes (Na, Ca, K ions) 2. Secondary secretions: contains primary secretions plus water, NaHCO3, K, Cl. Average biliary out put: 600 -1200 ml/day is secreted by the liver yellow-green in colour b/c of bilirubin & pH = 7.6 - 8.6 Components water & cholesterol bile salts: Na & K salts of bile acids bile pigments (bilirubin) from hemoglobin molecule heme: broken down into iron and bilirubin globin: a reusable protein

Storage of bile
Stored in the GB GB can accommodate 20 to 60 ml of bile GB mucousa can absorb water, Na, Cl, K but not Ca, cholesterol bile salts and fats.


Bile secretion


Regulation of Bile Secretion