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Small Intestine

Dr Raghuveer Choudhary

Overview - Nearly all chemical digestion and nutrient absorption occur in the small intestines.

Gross anatomy
• • • • Three regions: Duodenum - first 25 cm Jejunum – next 2.5 m Ileum – last 3.6 m ; ends at ileocecal junction – joins cecum of large intestine

Three Parts of Small Intestine

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The Small Intestine plays key role in digestion and absorption of nutrient, 90% of nutrient absorption occurs in the small intestine
• The Duodenum • The segment of small intestine closest to stomach • 25 cm (10 in.) long • “Mixing bowl” that receives:
– chyme from stomach – digestive secretions from pancreas and liver

The Jejunum
• Is the middle segment of small intestine • 2.5 meters (8.2 ft) long • Is the location of most:
– chemical digestion – nutrient absorption

The Ileum
• The final segment of small intestine • 3.5 meters (11.48 ft) long

Wall of Small Intestine

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Small Intestine
• Nearly all chemical digestion & nutrient absorption occurs here • Longest part of digestive tract • Circular folds of mucosa , villi, and microvilli – enhance surface area for absorption of nutrients

Digestive System
Less in distal small int; inc Absorptive area another 10x

Or folds Kerckring – well developed in duodenum and jejunum; inc absorptive area 3x

Structure of the Villi in the Small Intestine

On each epithelial cell on each villus; inc absorptive capacity for another 20x

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Microvilli (brush border)

brush border enzymes

- The surface area inside the small intestine is greatly increased by circular folds, villi, and microvilli.

villi

Intestinal Villus

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Epithelial cells cover the mucosa

Small Intestine
• Each villus is a fold in the mucosa. • Covered with columnar epithelial cells interspersed with goblet cells. • Epithelial cells at the tips of villi are exfoliated and replaced by mitosis in crypt of Lieberkuhn. • Lamina propria contain lymphocytes, capillaries, and central lacteal. Insert fig. 18.12

Digestive Anatomy: Histological Overview

Figure 21-2e: ANATOMY SUMMARY: The Digestive System

Intestinal Villi
• A series of fingerlike projections:
– in mucosa of small intestine

• Covered by simple columnar epithelium:covered with microvilli Intestinal glands have goblet cells between columnar epithelial cells • Eject mucins onto intestinal surfaces Brush Border Enzymes are integral membrane proteins ,on surfaces of intestinal microvilli

Small Intestine
• Absorbs
– – – – – 80% ingested water Electrolytes Vitamins Minerals Carbonates
• Active/facilitated transport • Monosaccharides

– Lipids
• • • • Monoglycerides Fatty acids Micelles Chylomicrons

– Proteins
• Di-/tripeptides • Amino acids

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Intestinal Secretions
• • • • • Watery intestinal juice 1.8 liters per day enter intestinal lumen Moistens chyme Assists in buffering acids Keeps digestive enzymes and products of digestion in solution

Intestinal Movements
• Chyme arrives in duodenum • Weak peristaltic contractions move it slowly toward jejunum

Digestive Secretions:
(7 L / Day From Tissues into Lumen

)

• • • • • • • •

Salivary glands Pancreas Water Enzymes Mucus Ions: H+, K+, Na+ HCO3-, ClMass Balance (H2O)
Figure 21-5: Daily mass balance in the digestive system

Intestinal Enzymes
• Microvilli contain brush border enzymes that are not secreted into the lumen.
– Brush border enzymes remain attached to the cell membrane with their active sites exposed to the chyme.

• Absorption requires both brush border enzymes and pancreatic enzymes.

Absorption in Small Intestine
• Duodenum and jejunum:
– Carbohydrates, amino acids, lipids, iron, and Ca2+.

• Ileum:
– Bile salts, vitamin B12, electrolytes, and H20.

Small Intestine
• Secretes digestive enzymes
– Peptidases
• Amino• Di• Tri-

– – – –

Sucrases Maltase Lactase Saccharidases
• Di• Tri-

– Lipase – Nucleases
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brush border enzymes

- activates zymogens - complete digestion of carbohydrates and proteins

Chemical Digestion and Absorption of Nutrients

Chemical Digestion and Absorption of Nutrients
Carbohydrates
Proteins Lipids

Nucleic Acids
Vitamins Minerals Water

Digestion and Absorption of Carbohydrate
- Most digestible dietary carbohydrate is

starch.
- The

starch digestion begins in the mouth by salivary amylase. - But fully digestion of starch occurs in the small intestines.

CHEMICAL DIGESTION OF CARBOHYDRATES
STARCH
mouth
salivary amylase

SUCROSE

LACTOSE

stomach

small intestine

pancreatic amylase

MALTOSE
brush border maltase

SUCROSE
brush border sucrase

LACTOSE
brush border lactase

glucose + glucose
(absorbed into blood of villus)

glucose + fructose
(absorbed into blood of villus)

glucose + galactose
(absorbed into blood of villus)

Digestion and Absorption of Carbohydrates
• Salivary amylase:
– Begins starch digestion.
Insert fig. 18.32

• Pancreatic amylase:
– Digests starch to oligosaccharides. – Oligosaccharides hydrolyzed by brush border enzymes.

• Glucose is transported by secondary active transport with Na+ into the capillaries.

- Starch is digested to oligosaccharides (3-8 glucose residues), disaccharide maltose, and glucose.

pancreatic amylase

Brush border enzymes

oligosaccharides starch Intestinal lumen

glucose

glucose

glucose

Intestinal epithelial cells

blood

Glucose is absorbed by: - sodium-dependent glucose transporter (SGLT). - solvent drag

Digestion and Absorption of Proteins

CHEMICAL DIGESTION OF PROTEINS
PROTEINS
mouth

stomach
pepsin

HCl

pepsinogen from intestinal glands

SMALLER PROTEINS, POLYPEPTIDES
small intestine
trypsin enterokinase trypsinogen

trypsin
chymotrypsin carboxypeptidase trypsin chymotrypsinogen procarboxypeptidase

from pancreas

peptides
brush border peptidases

amino acids

(absorbed into blood of villus)

Digestion and Absorption of Protein
• Digestion begins in the stomach when pepsin digests proteins to form polypeptides. • In the duodenum and jejunum:
– Endopeptidases cleave peptide bonds in the interior of the polypeptide: • Trypsin. • Chymotrypsin. • Elastase. – Exopeptidases cleave peptide bonds from the ends of the polypeptide: • Carboxypeptidase. • Aminopeptidase.

- Proteins are digested by proteases and peptidases. - Protein digestion starts in the stomach.

Protein digestion continues in the small intestine by pancreatic enzymes trypsin and chymotrypsin.

Protein digestion is completed in the small intestine by brush border enzymes carboxypeptidase, aminopeptidase, and dipeptidase.

Amino acid absorption is similar to that of monosaccharides, via several sodiumdependent amino acid cotransporters.

Digestion and Absorption of Protein
• Free amino acids absorbed by cotransport with Na+. • Dipeptides and tripeptides transported by secondary active transport using a H+ gradient to transport them into the cytoplasm. • Hydrolyzed into free amino acids and then secreted into the blood.

(continued)

Insert fig. 18.33

Digestion and Absorption of Lipids

- Lipids are digested by enzymes called lipases. - Most fat digestion occurs in the small intestine via several steps.

CHEMICAL DIGESTION OF FATS
FATS
mouth
lingual lipase minimal effects

stomach

gastric lipase

minimal effects

small intestine

bile

from gallbladder/liver

EMULSIFIED FATS
pancreatic lipase + cholesterol esterase from pancreas

FATTY ACIDS, GLYCEROLS, GLYCERIDES
reassembled into

CHYLOMICRONS

(absorbed into lymph of villus)

Digestion and Absorption of Lipids
• Arrival of lipids in the duodenum serves as a stimulus for secretion of bile. • Emulsification:
– Bile salt micelles are secreted into duodenum to break up fat droplets.

• Pancreatic lipase and colipase hydrolyze triglycerides to free fatty acids and monglycerides.
– Colipase coats the emulsification droplets and anchors the lipase enzyme to them. – Form micelles and move to brush border.

Digestion and Absorption of Lipids

(continued)

• Free fatty acids, monoglycerides, and lysolecithin leave micelles and enter into epithelial cells.
– Resynthesize triglycerides and phospholipids within cell.
• Combine with a protein to form chylomicrons.

• Secreted into central lacteals.