Large intestine

Large Intestine
• Extends from ileocecal valve to anus • Regions
– Cecum – Appendix – Colon
• Ascending • Transverse • Descending

– Rectum – Anal canal


Also called large bowel Is about 1.5 meters long and 7.5 cm wide 3 Parts of the Large Intestine:

1. Cecum: the pouchlike first portion -Stores materials and begins compaction 2. Colon: the largest portion, Has a larger diameter and thinner wall than small intestine The wall of the colon: forms a series of pouches (haustra) which permit expansion and elongation of colon 3. Rectum: the last 15 cm of digestive tract

The areas of the colon are:
• • • • • • Ascending Transverse Descending Sigmoid Rectum Anal canal

Large Intestine
• The large intestine is wider than the small intestine and begins beyond the ileocecal sphincter and ends at the anus. • The large intestine consists of the cecum; the ascending colon, • transverse colon, descending colon, and sigmoid colon; the • rectum; and the anal canal.

• The longitudinal layer of smooth muscle is arranged in three discrete strips called teniae coli. • Contractions of this discontinuous muscle layer cause the wall • of the large intestine to form bulges known as haustra.

• colon is lined with transporting epithelial cells called colonocytes, • which absorb fluid and transport electrolytes but do not • express digestive enzymes.

Large Intestine
• Histology
– No villi – No permanent circular folds – Smooth muscle
• Taeniae coli • Haustra

– Epiploic appendages – Otherwise like rest of Gl tract

Microscopic Anatomy
• Mucosa of large intestine = simple columnar epithelium except anal canal = nonkeratinized stratified squamous epithelium • No circular folds • No villi

Histology of the large intestine
• Absence of villi • Presence of goblet cells • Deep intestinal glands

Mucosa and Glands of the Colon
Colon has a Lack of villi Abundance of goblet cells Presence distinctive intestinal glands

Figure 24–24

Glands of the Large Intestine
• • • • Are deeper than glands of small intestine Are dominated by goblet cells Mucosa does not produce enzymes Provides lubrication for fecal material Physiology of the Large Intestine• Less than 10% of nutrient absorption occurs in large intestine • Prepares fecal material for ejection from the body

Functions of the large intestine
• Reabsorb water and compact material into feces • Absorb vitamins produced by bacteria • Store fecal matter prior to defecation

Colonic Phase
• Function
– Final reabsorption of water and ions (proximal colon)
• 2 L enters 200 ml leaves

– Propulsion – Elimination of remaining waste products (rectum)

• The main functions of the large intestine are • completion of fluid absorption • and the storage and elimination of fecal waste.

• • Reabsorption of bile salts:

Absorption in the Large Intestine Reabsorption of water
– in the cecum – transported in blood to liver

• Absorption of vitamins produced by bacteriaorganic molecules • Important as cofactors or coenzymes in metabolism • Normal bacteria in colon make 3 vitamins that supplement diet • Absorption of organic wastes

Physiology of the large intestine
• Reabsorption in the large intestine includes: – Water – Vitamins – K, biotin, and B5 – Organic wastes – urobilinogens and sterobilinogens – Bile salts – Toxins

3 Vitamins Produced in the Large Intestine
1. Vitamin K:
– – a fat-soluble vitamin required by liver for synthesizing 4 clotting factors, including prothrombin
a water-soluble vitamin important in glucose metabolism a water-soluble vitamin required in manufacture of steroid hormones and some neurotransmitters

2. Biotin:
– – – –

3. Pantothenic acid:

Organic Wastes
• Bacteria convert bilirubin to urobilinogens and stercobilinogens:
– urobilinogens absorbed into bloodstream are excreted in urine – urobilinogens and stercobilinogens in colon convert to urobilins and stercobilins by exposure to oxygen

• Bacteria break down peptides in feces and generate:
– ammonia:
• as soluble ammonium ions

– indole and skatole:
• nitrogen compounds responsible for odor of feces

– hydrogen sulfide:
• gas that produces “rotten egg” odor

Bacterial flora & Intestinal Gas
• Bacterial flora • Ferment cellulose • Synthesize vitamin B & K

• Flatus – 500 ml / day = gas • N, CO2, H, methane, H2S, two amines – indole & skatole

• Gastroileal and gastroenteric reflexes:
– move materials into cecum while you eat

Movements of the Large Intestine

• Movement from cecum to transverse colon is very slow: allowing hours for water absorption • Peristaltic waves move material along length of colon • Segmentation movements (haustral churning) mix contents of adjacent haustra

Movements of the Large Intestine
• Movement from transverse colon through rest of large intestine results from powerful peristaltic contractions (mass movements) • Stimulus is distension of stomach and duodenum; relayed over intestinal nerve plexuses • Distension of the rectal wall triggers defecation reflex:
– 2 positive feedback loops – both loops triggered by stretch receptors in rectum

Elimination of Feces
• Requires relaxation of internal and external anal sphincters • Reflexes open internal sphincter, close external sphincter • Opening external sphincter requires conscious effort

Sensory innervation and continence
• Mechanoreceptors in the rectum detect distention and supply the ENS • The anal canal in the region of the skin is innervated by somatosensory nerves that transmit signals to CNS • This region has sensory receptors of pain, temperature and touch • Contraction of internal anal sphincter and puborectalis muscle blocks the passage of feces and maintains continence

• Stretching of rectum stimulates defecation reflexes • Intrinsic defecation reflex – stretch signals • Transmit impulses to spinal cord • Spinal reflex causes contraction of rectum and relaxation of internal anal sphincter • Relaxation of external anal sphincter is under voluntary control & can be suppressed • With relaxation of the external anal sphincter, fecal material can pass to the outside

Neural Control of Defecation
1. Filling of the rectum 2. Reflex contraction of rectum & relaxation of internal anal sphincter

3. Voluntary relaxation of external sphincter

Feces Formation and Defecation
• Chyme dehydrated to form feces • Feces composition
– – – – – Water Inorganic salts Epithelial cells Bacteria Byproducts of digestion

• Control
– Parasympathetic – Voluntary

• Defecation
– Peristalsis pushes feces into rectum – Rectal walls stretch

Diarrhea too little water absorbed Constipation

too much water absorbed, causing difficulty in defecation

• is defined as an increase in stool fluid • volume of more than 200 mL within 24 hours • In general terms, diarrhea may result from the delivery of more fluid to the colon than the colon can absorb, or • it may result if feces move too rapidly through the colon to allow the colon to adequately • absorb fluid. • The general causes of diarrhea are:

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