UNIT-III

DIGESTIVE SYSTEM

INTRODUCTION
 The digestive system is a group of organs.
 That work together to break down food into simpler substances so that the body can absorb
nutrients, produce energy, and eliminate waste.
 It includes oral cavity (mouth), pharynx, esophagus, stomach, small intestine, large
intestine.
 Accessory organs of the digestive system: salivary glands, pancreas, liver and gall bladder.

 FUNCTIONS OF THE ORGANS OF DIGESTIVE TRACT

 Oral cavity
 The oral cavity is responsible for taking food into the body.
 It helps in recognizing the taste of food.
 It carries out mechanical digestion with the help of salivary enzymes.
 It moistens and lubricates food with saliva.

 It also serves as a route for administering certain medicines.

 It plays an important role in speech.
 Teeth
 Incisors
 These teeth are used to cut and bite food into pieces.
 Cuspids/Canines
 These pointed teeth help in holding and tearing food.
 Bicuspids/Premolars
 These teeth assist in crushing and grinding food and appear after about nine years of age.
 Molars
 These are the largest teeth, located at the back of the mouth, and are mainly involved in
grinding food.
 Tongue
 Taste sensation
 Tongue helps detect different tastes like sweet, sour, salty, bitter, and umami.
 Chewing (Mastication)
 It moves and positions food between teeth for proper chewing.
 Swallowing (Deglutition)
 Tongue pushes food towards the pharynx to help in swallowing.
 Speech and Articulation
 Tongue helps in forming and pronouncing words clearly.
 Mixing food with saliva
 It mixes food with saliva to form a soft mass called bolus.
 Sucking
 Essential for sucking in infants during feeding.
 Oral cleaning
 Tongue helps remove food particles from the teeth and oral cavity.
 Sensation
 Detects touch, temperature, and pain inside the mouth.
 Pharynx
 Common passage for air and food
 Pharynx allows both air (to lungs) and food (to esophagus) to pass.
 Swallowing (Deglutition)
 Moves food from the mouth to the esophagus during swallowing.
 Respiration
 Acts as a pathway for air to reach the larynx and lungs.
 Speech and Voice Resonance
 Helps in producing sound and voice modulation.
 Defense against infection
 Tonsils in the pharynx trap and fight germs entering the body.
 Equalizing ear pressure
 Eustachian tubes in the pharynx help balance air pressure in the middle ear.

 Esophagus
 Food passage
 Esophagus carries food and liquids from the pharynx to the stomach.
 Swallowing (Deglutition)
 Muscular contractions (peristalsis) push the food downward.
 Prevention of backflow
 Lower esophageal sphincter prevents stomach acid and food from coming back into the
esophagus.
 Lubrication
 Mucus secreted by esophagus walls helps smooth passage of food.
 Protection
 Mucus lining protects the esophagus from mechanical injury and acid damage.

 Stomach
 Storage of food
 Stomach temporarily stores ingested food before digestion
 Mechanical digestion
 Muscular contractions mix and churn food into a semi-liquid form called chyme.
 Chemical digestion
 Gastric juices containing enzymes and acid break down proteins and fats.
 Secretion of gastric juices
 Stomach secretes hydrochloric acid and digestive enzymes for digestion.
 Absorption
 Minimal absorption occurs, mainly water, alcohol, and certain drugs.
 Protection
 Mucus lining protects the stomach wall from acid and digestive enzymes.
 Defense against pathogens
 Acidic environment kills many ingested microbes.

 Small intestine
 Digestion of food
 Enzymes from the pancreas and intestinal lining break down proteins, carbohydrates, and
fats.
 Absorption of nutrients
 Nutrients like amino acids, glucose, and fatty acids are absorbed into the bloodstream.
 Secretion of digestive juices
 Intestinal glands secrete enzymes and mucus to aid digestion and smooth passage of food.
 Mixing and propulsion
 Muscular movements mix food with digestive juices and move it along the intestine.
 Immune defense
 Contains lymphoid tissue (Peyer’s patches) that helps protect against pathogens.

 Large intestine
 Absorption of water and electrolytes
 Removes water and salts from undigested food, forming solid feces.
 Formation and storage of feces
 Converts waste into feces and stores it until defecation.
 Bacterial fermentation
 Houses beneficial bacteria that break down certain undigested substances and produce
vitamins.
 Secretion of mucus
 Mucus lubricates the intestine, aiding smooth passage of feces.
 Defecation
 Expels waste from the body through the rectum and anus.
 Vitamin absorption
 Absorbs some vitamins like vitamin K and certain B vitamins produced by gut bacteria.

 Pancreas
 Secretion of digestive enzymes
 Produces enzymes (amylase, lipase, proteases) for digestion in the small intestine.
 Production of hormones
 Produces insulin and glucagon to regulate blood sugar levels.
 Neutralization of stomach acid
 Secretes bicarbonate-rich fluid to neutralize acidic chyme entering the small intestine.

 Liver
 Detoxification
 Removes toxins, drugs, and harmful substances from the blood.
 Bile production
 Produces bile to help digest fats and absorb fat-soluble vitamins.
 Metabolism of carbohydrates
 Maintains blood glucose levels by storing glycogen and releasing glucose when needed.
 Metabolism of proteins
 Converts amino acids, removes ammonia, and synthesizes plasma proteins like albumin and
clotting factors.
 Metabolism of fats
 Breaks down fats to produce energy and forms cholesterol and lipoproteins.
 Storage
 Stores vitamins (A, D, E, K, B12) and minerals (iron, copper).
 Immune function
 Contains Kupffer cells that help fight infections.
 Hormone regulation
 Helps inactivate hormones like insulin, estrogen, and thyroid hormones.
 Blood clotting
 Produces clotting factors essential for coagulation.
 Conversion of substances
 Converts excess carbohydrates and proteins into fats and other usable forms.
 Gall bladder
 Bile storage
Stores bile produced by the liver until it’s needed for digestion.
 Bile release
Releases bile into the small intestine (duodenum) to help digest fats.
 Bile concentration
Removes water and electrolytes from bile to make it more concentrated and effective.
 Fat digestion support
Aids in the emulsification of fats, breaking them into smaller droplets for easier digestion.
 Regulation
Works with hormones like cholecystokinin (CCK) to release bile when fatty food is
consumed.

 Salivary gland
 Saliva secretion
 Produces saliva to keep the mouth moist.
 Digestion of carbohydrates
 Saliva contains amylase, which starts breaking down starch into simpler sugars.
 Lubrication
 Helps in chewing, swallowing, and speaking by moistening food and the oral cavity.
 Protection
 Saliva has antimicrobial substances that help prevent infections in the mouth.
 Taste facilitation
 Dissolves food particles, allowing taste buds to detect flavors.
 Buffering
 Maintains the pH of the mouth to protect teeth and oral tissues.

 SALIVA
 Introduction
 Saliva is a vital digestive fluid secreted by the salivary glands in the mouth.
 It aids in the initial digestion of food, lubricates and softens food for easy swallowing,
protects teeth and oral tissues from infection.
 It also contains important enzymes like amylase that begin carbohydrate digestion.
 Composition
 Saliva is mainly water (about 99%), and the remaining 1% consists of:
 Electrolytes / inorganic substances
 Sodium (Na⁺)
 Potassium (K⁺)
 Calcium (Ca²⁺)
 Magnesium (Mg²⁺)
 Chloride (Cl⁻)
 Bicarbonate (HCO₃⁻) – helps maintain pH
 Organic components
 Enzymes
 Amylase (ptyalin) – starts carbohydrate digestion
 Lipase – minor role in fat digestion
 Mucus (mucin)
 lubricates food for easy swallowing
 Proteins & glycoproteins
 help in oral defense
 Immunoglobulins (IgA)
 protect against microbes
 Urea & uric acid
 minor waste products
 Other components
 Antibacterial compounds (lysozyme, lactoferrin, peroxidase)
 Hormones and growth factors (trace amounts)
 Regulation of secretion
 Saliva secretion is mainly controlled by the autonomic nervous system (ANS)
 Parasympathetic stimulation (main controller)
 Increases watery saliva secretion
 Stimulated by the sight, smell, taste, or thought of food.
 Works via cranial nerves VII (facial) and IX (glossopharyngeal).
 Sympathetic stimulation
 Produces thick, mucous-rich saliva.
 Occurs during stress or fear.
 Reflex control
 Taste receptors on the tongue and pressure receptors in the oral cavity trigger reflex
secretion.
 Hormonal influence
 Minor role; e.g., aldosterone can slightly modify electrolyte content.
 Function of secretion
 Digestive function
 Contains amylase, which begins the digestion of carbohydrates.
 Helps in the breakdown of food into smaller particles.
 Lubrication and swallowing
 Mucus (mucin) in saliva moistens and softens food, making it easier to chew and swallow.
 Oral hygiene and protection
 Washes away food particles and bacteria.
 Contains lysozyme, immunoglobulins (IgA), and antibacterial compounds to prevent
infections.
 pH and mineral balance
 Maintains oral pH and protects teeth from demineralization.
 Provides calcium and phosphate ions for enamel repair.
 Taste facilitation
 Dissolves food substances, helping taste buds perceive flavors.
 Wound healing
 Contains growth factors and proteins that help in healing minor injuries in the oral mucosa.
 Antiviral and antifungal defense
 Saliva has compounds like lactoferrin and peroxidase that help inhibit viruses and fungi.
 Foam and buffer formation
 Helps in forming a protective film on teeth and oral tissues, reducing acid attack from
bacteria.
 Speech and oral comfort
 Keeps the mouth moist, facilitating clear speech and comfortable oral movement.
 GASTRIC JUICE
 Introduction
 Gastric juice is a digestive fluid secreted by the gastric glands of the stomach.
 It contains hydrochloric acid, enzymes, and mucus.
 which together help in the digestion of proteins, destruction of harmful microorganisms,
and conversion of food into chyme for further digestion in the intestine.
 Composition
 Water (≈ 99%)
 Acts as a solvent and helps in mixing food.
 Hydrochloric Acid (HCl)
 Creates an acidic medium (pH 1–3).
 Activates pepsinogen to pepsin and kills microorganisms.
 Enzymes
 Pepsin: digests proteins into peptides.
 Rennin (in infants): curdles milk protein (casein).
 Gastric lipase: digests fats (minor role).
 Mucus (with bicarbonate)
 Protects the stomach lining from acid and enzymes.
 Intrinsic Factor
 Essential for vitamin B₁₂ absorption in the intestine.
 Electrolytes
 Sodium, potassium, chloride, phosphate ions.
 Function of gastric juice
 Protein digestion
 Pepsin breaks proteins into peptides.
 Activation of enzymes
 Hydrochloric acid (HCl) converts pepsinogen into pepsin.
 Provides acidic medium
 HCl maintains a low pH (1–3) required for enzyme action.
 Antibacterial action
 Destroys harmful microorganisms present in food.
 Digestion of milk (in infants)
 Rennin curdles milk protein (casein).
 Fat digestion (minor role)
 Gastric lipase helps in limited fat digestion.
 Protection of stomach lining
 Mucus and bicarbonate protect the gastric mucosa from acid and enzymes.
 Absorption of vitamin B₁₂
 Intrinsic factor is necessary for vitamin B₁₂ absorption in the intestine.
 Regulation of gastric secretion
 Gastric secretion is regulated in three phases:
 Cephalic Phase (≈30%)
 Stimulated by sight, smell, taste, and thought of food.
 Controlled by the vagus nerve.
 Increases secretion of HCl and enzymes.
 Gastric Phase (≈60%)
 Begins when food enters the stomach.
 Stomach distension and presence of proteins stimulate secretion.
 Gastrin hormone increases HCl and pepsin secretion.
 Intestinal Phase (≈10%)
 Triggered when chyme enters the intestine.
 Initially causes slight stimulation, then inhibition.
 Hormones like secretin and CCK reduce gastric secretion.
 Mechanism of Gastric Secretion
 Secretion of hydrochloric acid (HCl)
 Parietal cells of gastric glands secrete HCl.
 Carbon dioxide (CO₂) combines with water to form carbonic acid (H₂CO₃).
 H₂CO₃ breaks into H⁺ and HCO₃⁻.
 H⁺ ions are secreted into the stomach lumen in exchange for K⁺.
 Cl⁻ ions move into the lumen and combine with H⁺ to form HCl.
 Secretion of enzymes
 Chief cells secrete pepsinogen (inactive form).
 HCl converts pepsinogen into active pepsin, which digests proteins.
 Secretion of mucus
 Mucous cells secrete mucus and bicarbonate.
 This protects the stomach lining from acid and enzymes.

 PANCREATIC JUICE
 Introduction
 Pancreatic juice is an alkaline digestive fluid.
 Secreted by the exocrine part of the pancreas into the duodenum.
 It contains powerful digestive enzymes and bicarbonate ions, which help in the digestion of
carbohydrates, proteins, and fats and in neutralizing the acidic chyme coming from the
stomach.
 Composition of pancreatic juice
 Water (≈ 98–99%)
 Acts as a solvent and helps transport enzymes.
 Bicarbonate ions (HCO₃⁻)
 Neutralize acidic chyme from the stomach.
 Provide an alkaline pH (≈ 7.8–8.4) for enzyme activity.
 Digestive enzymes
a. Proteolytic enzymes (protein digestion)
 Trypsinogen → trypsin
 Chymotrypsinogen → chymotrypsin
 PR carboxypeptidase
b. Carbohydrate-digesting enzyme
 Pancreatic amylase
c. Fat-digesting enzymes
 Pancreatic lipase
 Phospholipase
 Cholesterol esterase
d. Nucleic acid–digesting enzymes
 Ribonuclease (RNase)
 Deoxyribonuclease (DNase)
 Electrolytes
 Sodium, potassium, chloride, calcium ions
 Function of pancreatic juice
 Digestion of carbohydrates
 Pancreatic amylase converts starch into maltose and dextrin’s.
 Digestion of proteins
 Trypsin, chymotrypsin, and carboxypeptidase break proteins into peptides and amino acids.
 Digestion of fats
 Pancreatic lipase breaks fats into fatty acids and monoglycerides.
 Other enzymes help in fat digestion.
 Digestion of nucleic acids
 RNase and DNase digest nucleic acids into nucleotides.
 Neutralization of gastric acid
 Bicarbonate ions neutralize acidic chyme from the stomach.
 Provides optimal pH
 Creates an alkaline environment for intestinal enzyme activity.
 Facilitates absorption
 Proper digestion helps in the absorption of nutrients in the intestine.
 Regulation of pancreatic secretion
 Pancreatic secretion is regulated by neural and hormonal mechanisms and occurs in three
phases:
 Cephalic phase
 Stimulated by sight, smell, taste, and thought of food.
 Controlled by the vagus nerve.
 Causes mild secretion of enzyme-rich pancreatic juice.
 Gastric phase
 Begins when food enters the stomach.
 Stomach distension and proteins stimulate secretion via vagal reflexes.
 Produces a small amount of enzyme secretion.
 Intestinal phase
 Starts when chyme enters the duodenum.
 Controlled by intestinal hormones:
a. Secretin
 Released in response to acidic chyme.
 Stimulates secretion of bicarbonate-rich pancreatic juice.
b. Cholecystokinin (CCK)
 Released in response to fats and proteins.
 Stimulates secretion of enzyme-rich pancreatic juice.
 Neural regulation
 Parasympathetic stimulation increases pancreatic secretion.
 Sympathetic stimulation slightly inhibits secretion.
 BILE
 Introduction
 Bile is a yellowish-green digestive fluid.
 Which is produced by the liver and stored in the gallbladder.
 It contains bile salts, bile pigments, cholesterol, and electrolytes and plays an essential role
in the digestion and absorption of fats.
 Composition of bile
 Water (≈ 97%)
 Acts as a solvent and helps in digestion.
 Bile salts
 Sodium salts of bile acids (cholic acid, chenodeoxycholic acid).
 Essential for emulsification and absorption of fats.
 Bile pigments
 Bilirubin and biliverdin (from hemoglobin breakdown).
 Give bile its yellow-green color.
 Cholesterol
 Excretory product of bile.
 Phospholipids
 Mainly lecithin, helps in fat digestion.
 Electrolytes
 Sodium, potassium, calcium, chloride, bicarbonate ions.
 Mucus
 Secreted by gallbladder, helps in lubrication.
 Function of bile
 Emulsification of fats
 Bile salts break large fat globules into small droplets, increasing surface area for lipase
action.
 Digestion of fats
 Facilitates the action of pancreatic lipase on fats.
 Absorption of fats and fat-soluble vitamins
 Helps in absorption of vitamins A, D, E, and K.
 Neutralization of gastric acid
 Bile is alkaline, helping to neutralize acidic chyme from the stomach.
 Excretory function
 Eliminates bilirubin, excess cholesterol, and drugs from the body.
 Prevention of gallstones
 Keeps cholesterol in solution, preventing stone formation.
 Stimulation of intestinal motility
 Promotes peristalsis in the intestine.
 Antibacterial action
 Helps inhibit growth of certain intestinal bacteria.

 INTESTINAL SECRETION
 Introduction
 Intestinal secretion refers to the digestive fluids released by the glands of the small
intestine, intestinal glands (crypts of Lieberkühn) and Brunner’s glands.
 These secretions contain water, mucus, enzymes, and electrolytes.
 Which help in the final digestion of nutrients, protection of the intestinal mucosa, and
maintenance of an alkaline environment for proper absorption.
 Secretion of small intestine
 The small intestine secretes fluid mainly from the intestinal glands (Crypts of Lieberkühn)
and Brunner’s glands.
 Intestinal Juice (Succus Entericus)
 Secreted by the crypts of Lieberkühn.
 Clear, watery, and alkaline in nature.
 Contains water, mucus, electrolytes, and digestive enzymes.
 Provides an ideal medium for final digestion and absorption of nutrients.
 Enzymes of Intestinal Juice
 Disaccharidases (maltase, sucrase, lactase) – digest sugars.
 Peptidases (erepsin) – convert peptides into amino acids.
 Enterokinase (enter peptidase) – activates trypsinogen to trypsin.
 Lipase – helps in fat digestion (minor role).
 Mucus Secretion
 Protects the intestinal lining from digestive enzymes.
 Lubricates intestinal contents for smooth movement.
 Brunner’s Glands Secretion
 Located in the duodenum.
 Secrete alkaline mucus rich in bicarbonate.
 Neutralizes acidic chyme from the stomach.
 Secretion of large intestine
 The large intestine mainly secretes mucus and does not produce digestive enzymes:
 Mucus secretion
 Secreted by goblet cells in the intestinal lining.
 Lubricates fecal matter and facilitates smooth passage.
 Protection of mucosa
 Mucus protects the intestinal wall from mechanical injury and bacterial irritation.
 Bicarbonate secretion
 Helps neutralize acids produced by bacterial fermentation.
 Maintains a suitable pH in the colon.
 Electrolyte secretion
 Secretes potassium and bicarbonate ions into the lumen.
 Response to irritation
 Secretion increases during inflammation or irritation to protect the mucosa.

 MOVEMENTS OF ALIMENTARY TRACT

 Introduction
 Movements of the alimentary tract are the coordinated muscular contractions and
relaxations of the gastrointestinal wall.
 That help in the mixing, grinding, and propulsion of food along the digestive tract.
 These movements ensure proper digestion, absorption, and elimination of food residues.
 Types of movements
 There are two main types of movements:
 Propulsion movements (Peristalsis)
 Wave-like muscular contractions that push food forward through the digestive tract.
 Mixing movements
 Continuous movements that mix chyme with digestive enzymes and help in absorption of
nutrients.
 Swallowing or deglutition
 Swallowing (deglutition) is the process by which food passes from the mouth to the
stomach.
 It involves the coordinated action of the mouth, pharynx, and esophagus and is helped by
secretions like saliva and mucus.
 Swallowing occurs in three phases:
 Voluntary phase
 Food is formed into a bolus and pushed by the tongue into the oropharynx.
 Pharyngeal phase
 This is an involuntary phase where the bolus moves from the pharynx to the esophagus.
 The soft palate closes the nasal passage, pharyngeal muscles contract, and the epiglottis
covers the larynx to prevent food from entering the airway.
 This phase lasts 1–2 seconds.
 Esophageal phase
 In this involuntary phase, the bolus is pushed from the esophagus to the stomach by
peristaltic movements.
 The lower esophageal sphincter relaxes to allow food to enter the stomach.
 This phase lasts 5–8 seconds.

 Movement of stomach
 Stomach filling
 When food enters the stomach, the rugae flatten and the stomach expands, increasing its
volume.
 During this expansion, the internal pressure remains almost constant until the stomach
reaches its maximum capacity.
 Mixing of stomach contents
 Food mixes with gastric secretions to form chyme.
 Peristaltic mixing waves push the liquid part toward the pylorus, while the solid part is
pushed back to the stomach body for further mixing.
 A small amount of chyme enters the duodenum, and the rest returns for continued mixing.
 Stomach emptying
 The stomach usually empties in 3–4 hours depending on the food.
 The pyloric sphincter stays partly closed, allowing small amounts of chyme to enter the
duodenum with each contraction, a process called the pyloric pump.

 Movement of small intestine

 The small intestine shows mixing (segmentation) and propulsion (peristalsis).
 These movements mix and slowly push chyme forward at about 1 cm/min, taking 3–5 hours
to reach the ileocecal junction.
 Movement of large intestine
 The colon shows segmental movements for mixing and peristaltic mass movements that
occur a few times daily to move contents toward the rectum.
 Reflexes in the colon and rectum
 When food enters the stomach and chyme reaches the duodenum, it stimulates mass
movements in the colon.
 These strong peristaltic movements push the fecal matter toward the rectum.
a. Defecation reflex
 The defecation reflex begins when the rectum is stretched by the presence of feces.
 Local reflexes cause weak contraction of the rectum and relaxation of the internal anal
sphincter.
 Parasympathetic reflexes produce strong rectal contractions and are mainly responsible for
defecation.
 Relaxation of the internal anal sphincter allows feces to move toward the anus
b. External anal sphincter
 The external anal sphincter, made of skeletal muscle and under voluntary control, normally
prevents defecation and is consciously relaxed to expel feces.

 DIGESTION
 Introduction
 Digestion is the process by which food is broken down into simple, absorbable substances
that the body can use for energy, growth, and repair.
 It involves mechanical actions like chewing and mixing, and chemical actions using digestive
enzymes and juices.
 This process starts in the mouth, continues through the stomach and intestines, and ends
with absorption of nutrients and elimination of waste.
 Mouth
 Intake of food
 The mouth is the entry point of food into the digestive system, and digestion begins here.
 Mastication (chewing)
 Teeth chew the food and break it into small pieces, making it easier to digest.
 Mixing with saliva
 Chewed food mixes with saliva, which softens and lubricates the food.
 Secretion of saliva
 Saliva is secreted by the salivary glands and helps in moistening the food.
 Carbohydrate digestion
 Saliva contains the enzyme salivary amylase, which starts the digestion of carbohydrates.
 Role of the tongue
 The tongue helps in moving food, mixing it with saliva, and forming a bolus.
 Formation of bolus
 Food is converted into a soft mass called a bolus, which is easy to swallow.
 Swallowing (deglutition)
 The tongue pushes the bolus toward the pharynx, allowing it to pass into the esophagus.
 Stomach
 Storage of food
 The stomach temporarily stores food and releases it slowly into the small intestine.
 Mechanical digestion
 The stomach muscles churn and mix food, breaking it into a semi-liquid form.
 Secretion of gastric juice
 Gastric glands secrete gastric juice containing hydrochloric acid and enzymes
 Action of hydrochloric acid (HCl)
 HCl kills harmful bacteria and provides an acidic medium for enzyme action
 Protein digestion
 The enzyme pepsin starts the digestion of proteins into simpler substances.
 Formation of chyme
 Food is converted into a semi-liquid substance called chyme.
 Limited absorption
 The stomach absorbs small amounts of water, alcohol, and some drugs.
 Regulation of food movement
 The pyloric sphincter controls the slow passage of chyme into the small intestine.
 Small intestine
 Completion of digestion
 The small intestine is the main site where digestion of carbohydrates, proteins, and fats is
completed.
 Secretion of intestinal juice
 Intestinal glands secrete intestinal juice that contains enzymes to digest food.
 Action of pancreatic juice
 Pancreatic enzymes help in the digestion of carbohydrates, proteins, and fats.
 Action of bile
 Bile from the liver emulsifies fats, making them easier to digest.
 Absorption of nutrients
 Digested nutrients are absorbed into the blood and lymph through villi.
 Presence of villi
 Villi increase the surface area for maximum absorption of nutrients.
 Movement of food
 Peristalsis moves food slowly through the small intestine.
 Absorption of water and minerals
 Water, vitamins, and minerals are also absorbed in the small intestine.
 Large intestine
 Absorption of water
 The large intestine absorbs water from undigested food and helps in maintaining fluid
balance.
 Absorption of electrolytes
 Salts and electrolytes are absorbed, which are essential for body functions.
 Formation of feces
 Undigested material is converted into semi-solid feces.
 Bacterial action
 Beneficial bacteria act on waste material and synthesize vitamins like vitamin K and some B
vitamins.
 Storage of feces
 The rectum stores feces temporarily before elimination.
 Elimination of waste
 Feces are expelled from the body through the process of defecation.
 Lubrication by mucus
 Mucus secreted by the large intestine helps in smooth passage of feces.
 No digestion of food
 The large intestine does not secrete digestive enzymes for food digestion.
 Absorption of food
 Absorption of food is the process by which the digested nutrients pass from the digestive
tract into the blood and lymph.
 It mainly occurs in the small intestine through finger-like structures called villi.
 Absorption allows nutrients such as carbohydrates, proteins, fats, vitamins, minerals, and
water to reach body cells for energy, growth, and repair.
 Carbohydrates
 Carbohydrates are finally digested into simple sugars such as glucose, fructose, and
galactose before absorption.
 The absorption of carbohydrates mainly takes place in the small intestine, especially in the
jejunum.
 Only monosaccharides can be absorbed through the intestinal mucosa.
 Glucose and galactose are absorbed by active transport with the help of sodium ions.
 Fructose is absorbed by facilitated diffusion without the use of energy.
 Intestinal villi increase the surface area and help in efficient absorption of carbohydrates.
 Absorbed sugars enter the blood capillaries present in the villi.
 These sugars are transported to the liver through the portal circulation for further
metabolism.
 Lipids
 Lipids are digested into fatty acids, monoglycerides, glycerol, and cholesterol before
absorption.
 Bile salts emulsify fats into small droplets, which increases the surface area for digestion.
 Fatty acids and monoglycerides combine with bile salts to form micelles.
 Absorption of lipids mainly occurs in the small intestine, especially in the jejunum.
 Fatty acids and monoglycerides diffuse into the intestinal epithelial cells.
 Inside the intestinal cells, fatty acids and monoglycerides are re-formed into triglycerides.
 Triglycerides combine with proteins to form chylomicrons.
 Chylomicrons enter the lacteals of the villi and pass into the lymphatic system.
 Chylomicrons finally enter the bloodstream through the thoracic duct for distribution to
tissues.
 Proteins
 Proteins are digested into amino acids, dipeptides, and tripeptides before absorption.
 Absorption of proteins mainly takes place in the small intestine, especially in the jejunum.
 Amino acids are absorbed through the intestinal mucosa by active transport.
 Dipeptides and tripeptides are absorbed by peptide transport mechanisms.
 Inside the intestinal cells, dipeptides and tripeptides are broken down into amino acids.
 Intestinal villi increase the surface area for efficient protein absorption.
 Absorbed amino acids enter the blood capillaries of the villi.
 Amino acids are transported to the liver through the portal circulation for metabolism and
use.
 Water
 Most water is absorbed in the small intestine, especially in the jejunum and ileum, following
the osmotic gradient created by nutrient absorption.
 Water moves into intestinal cells by osmosis without requiring energy.
 Electrolytes like sodium and potassium help create an osmotic gradient that aids water
absorption.
 Some water is absorbed in the large intestine, which helps concentrate feces.
 Villi and microvilli increase the surface area for efficient water absorption.
 Absorbed water enters blood capillaries and is transported throughout the body to
maintain hydration and support metabolism.
 Iron
 Iron is mainly absorbed in the duodenum and the upper part of the jejunum of the small
intestine.
 Dietary iron exists in two forms: heme iron from animal sources and non-heme iron from
plant sources.
 Heme iron is absorbed directly into the intestinal cells through specific heme transporters.
 Non-heme iron must first be converted from ferric (Fe³⁺) to ferrous (Fe²⁺) form by stomach
acid and enzymes before absorption.
 Iron enters the intestinal cells via divalent metal transporter 1 (DMT1) on the apical
membrane.
 Inside the cells, iron is stored as ferritin or transported into the blood via ferroprotein.
 In the blood, iron binds to transferrin, which carries it to the liver, bone marrow, and other
tissues for storage and use.
 Proper iron absorption is essential for hemoglobin synthesis and overall oxygen transport
in the body.

 APPLICATION AND IMPLICATIONS IN NURSING

 Nutritional assessment
 Nurses assess patients’ ability to digest and absorb nutrients to prevent malnutrition and
deficiency-related complications.
 Diet planning
 Understanding digestion helps nurses plan appropriate diets (e.g., high-protein, low-fat, or
soft diets) for patients with gastrointestinal disorders.
 Monitoring digestive disorders
 Knowledge of absorption helps in identifying signs of malabsorption, such as diarrhea,
bloating, or weight loss.
 Medication administration
 Some medications are absorbed better with certain nutrients; nurses must know when to
give medicines in relation to meals.
 Fluid and electrolyte balance
 By understanding water and electrolyte absorption, nurses can manage dehydration and
maintain proper fluid balance.
 Patient education
 Nurses educate patients about dietary modifications, healthy eating habits, and nutrient
absorption for overall wellness.
 Supporting recovery
 In post-surgical or illness care, nurses ensure patients receive nutrients that are easy to
digest and absorb for faster recovery.
 Preventing complications
 Knowledge of nutrient absorption helps prevent complications like anemia, osteoporosis,
and protein-energy malnutrition.
 Monitoring special populations
 In infants, elderly, or critically ill patients, nurses monitor digestion and absorption closely
to meet their special nutritional needs.
 Enhancing quality of care
 Applying knowledge of digestion and absorption allows nurses to provide individualized
care that supports growth, repair, and overall health.

MULTIPLE CHOICE QUESTIONS

1. What is the semi-liquid mixture of food formed in the stomach called

(a) Chyme
(b) Bolus
(c) Bile
(d) Feces

2. Which part of the digestive system absorbs most water and electrolytes
(a) Stomach
(b) Large intestine
(c) Small intestine
(d) Mouth

3. Which organ is mainly responsible for the digestion of proteins

(a) Stomach
(b) Small intestine
(c) Liver
(d) Mouth

4. Which organ stores bile and releases it into the small intestine
(a) Pancreas
(b) Liver
(c) Gallbladder
(d) Stomach

5. Which organ absorbs most water and forms feces

(a) Stomach
(b) Small intestine
(c) Large intestine
 (d) Mouth

6. Which enzyme present in saliva starts the digestion of starch

(a) Pepsin
(b) Salivary amylase
(c) Lipase
(d) Trypsin

7. Which of the following is NOT a component of saliva

(a) Water
(b) Electrolytes
(c) Mucus
(d) Bile

8. Which acid is present in gastric juice and helps in protein digestion and killing
bacteria
(a) Hydrochloric acid (HCl)
(b) Citric acid
(c) Acetic acid
(d) Lactic acid

9. Which component of gastric juice helps in fat digestion

(a) Pepsin
(b) Gastric lipase
(c) Hydrochloric acid
(d) Mucus

10. Pancreatic juice contains which substance to neutralize acidic chyme from the
stomach
(a) Hydrochloric acid
(b) Sodium bicarbonate
(c) Bile salts
(d) Pepsin

11. The secretion of pancreatic juice is regulated by which hormones

(a) Gastrin and secretin
(b) Insulin and glucagon
(c) Adrenaline and cortisol
(d) Thyroxine and calcitonin

12. The gallbladder mainly functions to

(a) Produce pancreatic juice
(b) Store and concentrate bile
(c) Absorb nutrients
(d) Digest proteins

13. Which organ secretes both digestive enzymes and hormones

(a) Liver
 (b) Gallbladder
(c) Pancreas
(d) Stomach

14. Bilirubin present in bile is primarily a product of

(a) Fat metabolism
(b) Protein metabolism
(c) Breakdown of red blood cells (hemoglobin)
(d) Carbohydrate metabolism

15. Which secretion is produced by the small intestine to aid digestion

(a) Gastric juice
(b) Intestinal juice (succus entericus)
(c) Bile
(d) Saliva

16. Which cells in the small intestine secrete mucus to protect the intestinal lining
(a) Goblet cells
(b) Parietal cells
(c) Chief cells
(d) Beta cells

17. Which movement propels food forward along the digestive tract
(a) Segmentation
(b) Peristalsis
(c) Mixing
(d) Churning

18. Which enzyme in the mouth starts the digestion of carbohydrates

(a) Pepsin
(b) Salivary amylase
(c) Lipase
(d) Trypsin

19. What is the main digestive function of the stomach

(a) Carbohydrate digestion
(b) Protein digestion and formation of chyme
(c) Fat emulsification
(d) Absorption of water

20. Fat digestion mainly occurs in which part of the digestive system
(a) Mouth
(b) Stomach
(c) Small intestine
(d) Large intestine

ANSWERS KEY
 1-a 2-b 3-a 4-c 5-c 6-b 7-d 8-a 9-b 10-b
11-a 12-b 13-c 14-c 15-b 16-a 17-b 18-b 19-b 20-c

THEORETICAL QUESTIONS
Short Answer Questions (each question carries 4 marks)
1. Write short notes on saliva.
2. Function of mouth.
3. Write shorts notes on carbohydrates.
4. Write application and implications in nursing.
5. Write notes on secretion of small and long intestine.

Long Answer Questions (each question carries 8 marks)

1. What is bile? Write their functions with composition.
2. What do you mean by bile? Discuss about composition, regulation of secretion and functions
of saliva.
3. Briefly explain about gastric juice.
4. Explain pancreatic secretion with their composition, function, regulation of pancreatic
secretion.
5. What is digestion? Briefly explain Digestion in mouth, stomach, small intestine, large
intestine, absorption of food.