Digestive System

(Anatomy & Physiology)

Notes by: Mr Hashim Majnoon
Asst. Professor (Psy. Nsg.)

Introduction

The digestive system is a complex, continuous muscular tube also called as the gastrointestinal (GI)
tract—extending from the mouth to the anus, assisted by organs like the liver, pancreas, and
gallbladder. It breaks down food into essential nutrients (proteins, fats, carbs) for energy, growth,
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and repair, absorbs them into the bloodstream, and eliminates waste.

Functions of the Digestive System

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The functions of the digestive system are:
. Ingestion. Food must be placed into the mouth before it can be acted on; this is an active,
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voluntary process called ingestion.
. Propulsion. If foods are to be processed by more than one digestive organ, they must be
propelled from one organ to the next; swallowing is one example of food movement that
depends largely on the propulsive process called peristalsis(involuntary, alternating waves of
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contraction and relaxation of the muscles in the organ wall).
. Mechanical [Link] digestion prepares food for further degradation by
enzymes by physically fragmenting the foods into smaller pieces, and examples of
mechanical digestion are the mixing of food in the mouth by the tongue, churning of food in
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the stomach, and segmentation in the small intestine.
. Chemical [Link] sequence of steps in which large food molecules are broken down
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into their building blocks by enzymes is called chemical digestion.
. . Transport of digested end products from the lumen of the GI tract to the blood or lymph is
absorption, and for absorption to happen, the digested foods must first enter the mucosal
cells by active or passive transport processes.
. Defecation. Defecation is the elimination of indigestible residues from the GI tract via the
anus in the form of feces.

Anatomy of the Digestive System

The organs of the digestive system can be separated into two main groups: those forming the
alimentary canal and the accessory digestive organs.
Organs of the Alimentary Canal
The alimentary canal, also called the gastrointestinal tract, is a continuous, hollow muscular tube
that winds through the ventral body cavity and is open at both ends. Its organs include the
following:
1. Mouth

Food enters the digestive tract through the mouth, or oral cavity, a mucous membrane-lined cavity.
Mouth has;
● Lips. The lips (labia) protect its anterior opening.
● Cheeks. The cheeks form its lateral walls.
● Palate. The hard palate forms its anterior roof, and the soft palate forms its posterior roof.
● Uvula. The uvula is a fleshy finger-like projection of the soft palate, which extends inferiorly
from the posterior edge of the soft palate.
● Vestibule. The space between the lips and the cheeks externally and the teeth and gums
internally is the vestibule.
 ● Oral cavity proper. The area contained by the teeth is the oral cavity proper.
● Tongue. The muscular tongue occupies the floor of the mouth and has several bony
attachments- two of these are to the hyoid bone and the styloid processes of the skull.
● Lingual frenulum. The lingual frenulum, a fold of mucous membrane, secures the tongue to
the floor of the mouth and limits its posterior movements.
● Tonsils. At the posterior end of the oral cavity are paired masses of lymphatic tissue, the
palatine tonsils.
Teeth
Teeth are hard, calcified structures anchored in the jawbone designed for breaking down food
(mastication), aiding speech, and providing facial structure. They consist of protective enamel,
underlying dentin, and inner pulp containing nerves and blood vessels. Teeth include incisors for
cutting, canines for tearing, and premolars/molars for grinding.
Structure of a Tooth
Each tooth is divided into the crown (visible above the gumline) and the root (embedded in the jaw).
● Enamel: The hardest, white outer layer of the crown that protects against decay and wear.
● Dentin: A bone-like, softer layer beneath the enamel that makes up the bulk of the tooth.
● Pulp: The innermost part containing nerves, blood vessels, and connective tissue, providing
nourishment and sensation.
● Cementum: A layer covering the root, anchoring it into the jawbone.
● Periodontal Ligament: Tissue that connects the cementum to the jawbone, acting as a shock
absorber.

Types of Teeth and Functions

Humans have 32 permanent (or 20 primary) teeth, classified by shape and purpose:
● Incisors (8 total): Chisel-shaped, front teeth used for cutting and biting food.
● Canines (4 total): Pointed teeth designed for tearing and grasping food.
● Premolars (8 total): Also called bicuspids, they feature two points to crush and break food.
● Molars (12 total): Large, flat surfaces for grinding and chewing food thoroughly.

Salivary glands
Salivary glands are exocrine organs in the mouth that produce saliva, a vital fluid for digestion, oral
hygiene, and tissue protection. Humans have three pairs of major salivary glands and hundreds of
tiny minor glands scattered throughout the oral
Major Salivary Glands
These large, paired glands produce the majority of your daily saliva (about 0.5 to 1.5 litres).
● Parotid Glands: The largest pair, located in front of and just below each ear. They secrete a
watery (serous) saliva rich in the enzyme amylase through Stensen's duct.
● Submandibular Glands: Located beneath the lower jaw, these are roughly the size of a
walnut. They produce about 70% of total saliva, which is a mix of watery and thicker
 ●

(mucous) fluid released via Wharton’s duct.

● Sublingual Glands: The smallest of the major glands, situated under the floor of the mouth
on either side of the tongue. They primarily secrete thick, mucous saliva through several
small ducts (Rivinus ducts).

Minor Salivary Glands

There are between 600 and 1,000 minor glands located in the lips, cheeks, tongue, and palate.
Unlike major glands, they are microscopic and provide continuous lubrication to keep the mouth
moist even at night when major glands rest.

Saliva is an incredibly complex fluid, composed of about 99.5% water and 0.5% solutes. Despite
that tiny percentage of solids, those electrolytes and proteins are what make saliva essential for
your health.
Here is a breakdown of what’s inside:

1. Water (99.5%)
The primary medium that keeps the mouth moist, dissolves food for tasting, and allows for the
mechanical movement of the tongue and cheeks.

2. Solutes
● Sodium and Potassium: Regulate osmotic pressure.
● Calcium and Phosphate: Essential for remineralization, helping to "repair" tooth enamel that
has been weakened by acids.
● Bicarbonate: Acts as a buffer to neutralize acids produced by bacteria, preventing tooth
decay.
● Chloride: Activates the digestive enzymes.
● Amylase (Ptyalin): The star of digestion; it starts breaking down complex carbohydrates
(starches) into simple sugars while you’re still chewing.
● Mucin: A glycoprotein that gives saliva its "slippery" texture. It coats food to help it slide
down the esophagus and protects the lining of the mouth.
● Lingual Lipase: Begins the very early stages of fat (lipid) digestion.
● Lysozyme and Lactoferrin: Antimicrobial agents that kill or inhibit the growth of bacteria and
fungi.
● Immunoglobulin A (IgA): An antibody that provides the first line of immune defense against
oral pathogens.

Functions of Saliva
● Digestion: Salivary amylase begins the chemical breakdown of starches into simpler sugars
like maltose.
 ● Lubrication: It moistens food to form a bolus (soft ball), making it easier to swallow, and
prevents the mouth's soft tissues from sticking together.
● Oral Protection: It contains lysozymes and antibodies (IgA) that fight bacteria, and
bicarbonates that buffer acids to protect tooth enamel from decay.
● Taste: Saliva acts as a solvent, dissolving food particles so they can be detected by taste
buds.
● Tissue Repair: Growth factors in saliva (like EGF) help speed up the healing of small cuts or
sores in the mouth.

[Link]
From the mouth, food passes posteriorly into the nasopharynx, oropharynx and laryngopharynx.

● Oropharynx. The oropharynx is posterior to the oral cavity.

● Nasopharynx. Posterior to nasal cavity
● Laryngopharynx. The laryngopharynx is continuous with the esophagus below; both of which
are common passageways for food, fluids, and air.
[Link]

The esophagus or gullet, runs from the pharynx through the diaphragm to the stomach.
 ● Size and function. About 25 cm (10 inches) long, it is essentially a passageway that
conducts food by peristalsis to the stomach.
● Structure. The walls of the alimentary canal organs from the esophagus to the large intestine
are made up of the same four basic tissue layers or tunics.
● Mucosa. The mucosa is the innermostlayer, a moist membrane that lines the cavity, or
lumen, of the organ; it consists primarily of surface epithelium, plus a small amount of
connective tissue (lamina propria) and a scanty smooth musclelayer.
● Submucosa. The submucosa is found just beneath the mucosa; it is a soft connective tissue
layer containing blood vessels, nerveendings, lymph nodules, and lymphatic vessels.
● Muscularis externa. The muscularis externa is a muscle layer typically made up of an inner
circular layer and an outer longitudinal layer of smooth muscle cells.

[Link]
The stomach is a muscular, J-shaped, hollow organ in the upper left abdomen that serves as a vital
part of the digestive system, storing and breaking down food through mechanical (churning) and
chemical (acid/enzymes) processes. It transforms food into a semi-liquid mixture called chyme,
which is slowly released into the small intestine.
Location: Situated between the esophagus and the small intestine (duodenum), located in the left
upper quadrant of the abdomen, specifically within the epigastric and left hypochondriac regions.

Capacity: Typically holds about \(1.5\) liters in adults but can stretch to hold up to 4 liters,
according to and.

Structure: It has four main parts: the cardia, fundus, body, and pyloric part. Its thick wall consists of
three muscular layers (inner oblique, middle circular, outer longitudinal) allowing for intense
churning.

Size. The stomach varies from 15 to 25 cm in length, but its diameter and volume depend on how
much food it contains; when it is full, it can hold about 4 liters (1 gallon) of food, but when it is
empty it collapses inward on itself.
Parts

● Cardiac region. The cardiac region surrounds the cardioesophageal sphincter, through
which food enters the stomach from the esophagus.
● Fundus. The fundus is the expanded part of the stomach lateral to the cardiac region.
● Body. The body is the midportion, and as it narrows inferiorly, it becomes the pyloric antrum,
and then the funnel-shaped pylorus.
● Pylorus. The pylorus is the terminal part of the stomach and it is continuous with the small
intestine through the pyloric sphincter or valve.
● Rugae. The mucosa of the stomach is thrown into large folds called rugae when it is empty.
● Greater curvature. The convex lateral surface of the stomach is the greater curvature.
● Lesser curvature. The concave medial surface is the lesser curvature.

Secretions of Stomach
The smooth lining of stomach is dotted with millions of deep gastric pits in sub mucosal layer,
which lead into gastric glands that secrete the solution called gastric juice.
● Chief cells. The chief cells produce protein-digesting enzymes, mostly pepsinogens.
● Parietal cells. The parietal cells produce corrosive hydrochloric acid, which makes the
stomach contents acidic and activates the enzymes.
● Enteroendocrine cells. The enteroendocrine cells produce local hormones such as gastrin,
that are important to the digestive activities of the stomach.

Functions:
● Storage: Acts as a holding tank, allowing meals to be consumed quickly but digested slowly.
● Digestion: Produces hydrochloric acid and pepsin to break down proteins and kill bacteria.
● Production of Intrinsic Factor: Produces a substance necessary for Vitamin \(B_{12}\)
absorption in the small intestine.

[Link] intestines

The small intestine is a 3-5 meter (20–22 foot)

long, narrow tube (approx. 2 cm diameter) extending from the stomach to the large intestine. Its
primary function is the chemical digestion of chyme and the absorption of nutrients. It is divided
into three sections—the duodenum, jejunum, and ileum—which maximize absorption through a
massive surface area created by folds, villi, and microvilli.
Anatomy of the Small Intestine
The small intestine is structured for maximum absorption and transport:
● Segments:
○ Duodenum (approx. 10 inches): C-shaped, shortest, and most fixed part. It receives
chyme from the stomach, bile from the liver/gallbladder, and digestive enzymes from
the pancreas.
○ Jejunum (approx. 8 feet): Middle section, primary site for nutrient absorption. It has
thick walls with rich blood supply and large, tall plicae circulares (folds).
○ Ileum (approx. 12 feet): Longest part, ends at the ileocecal valve, which controls flow
into the large intestine and prevents bacterial reflux.
● Microscopic Anatomy:
 ○ Surface Area Enhancement: Villi (finger-like projections) and microvilli (on
enterocytes) increase surface area up to 200 square meters.
○ Layers: Mucosa (inner, absorptive), Submucosa (connective tissue, blood vessels),
Muscularis (smooth muscle for movement)
● Cell Types: Contains enterocytes (absorption), Goblet cells (mucus), Paneth cells (defense),
and Enteroendocrine cells (hormone secretion).

Physiology of the Small Intestine

The small intestine performs three main tasks: digestion, absorption, and motility. [1, 2, 3, 4]
● Digestion: The duodenum neutralizes acidic chyme using Brunner's glands and receives bile
to emulsify fats, while pancreatic enzymes break down carbohydrates, proteins, and fats.
● Absorption:
○ Jejunum: Major site for absorbing amino acids, sugars, and fatty acids.
○ Ileum: Absorbs vitamin \(B_{12}\), bile salts, and any remaining nutrients.
○ Nutrients enter the blood via capillaries or fats through the lymphatic system (lacteals).
● Motility:
○ Segmentation: Mixes chyme with digestive enzymes by contracting circular muscles.
○ Peristalsis: Propels food forward through rhythmic contraction of longitudinal muscles.
● Immune System: Peyer's patches in the ileum act as a barrier, protecting the body from
pathogens in food.

[Link] Intestines
The large intestine (large bowel) is the final, ~5-foot-long segment of the gastrointestinal tract,
comprising the cecum, colon, rectum, and anal canal. It converts liquid waste (chyme) into feces by
absorbing water, electrolytes, and vitamins produced by bacterial flora, while storing and propelling
waste for excretion. Its key structural features include haustra (pouches), teniae coli (muscle
bands), and omental appendices.
Anatomy of the Large Intestine
● Parts:
○ Cecum: The start of the large intestine, connected to the small intestine (ileum) and
the appendix.
○ Colon: Divided into four parts: Ascending (right side), Transverse (top), Descending
(left side), and Sigmoid (bottom).
○ Rectum: Stores feces until defecation.
○ Anal Canal: The final exit with internal and external sphincters.
● Unique Structural Features:
○ Teniae Coli: Three bands of longitudinal smooth muscle.
○ Haustra: Pouches created by muscle tension that allow for expansion.
○ Omental Appendices: Small, fat-filled sacs of peritoneum.
● Microscopic Anatomy: The mucosa contains intestinal glands (crypts) with many goblet cells
for mucus secretion to lubricate feces, but lacks villi.
 ● Blood Supply & Innervation: Supplied by the superior and inferior mesenteric arteries.
Innervation is provided by the sympathetic (lumbar trunks) and parasympathetic (vagus and
pelvic nerves) systems

Physiology of the Large Intestine

● Water and Electrolyte Absorption: Absorbs remaining water (up to 90% is already absorbed
in the small intestine), sodium, chloride, and potassium.
● Bacterial Fermentation & Vitamin Production: Harbors bacteria that break down remaining
carbohydrates, producing vitamin K, biotin, and short-chain fatty acids.
● Feces Formation & Storage: Converts liquid waste into solid stool, stored primarily in the
descending and sigmoid colon.
● Defecation: Peristaltic waves move feces into the rectum, initiating the reflex to expel stool

Accessory organs of digestion

[Link]

The liver is a reddish-brown, wedge-shaped organ and the largest gland in the human body,
weighing approximately 1.5 kg (3.3 lbs). It is located in the right upper quadrant of the abdominal
cavity, protected by the rib cage and sitting just beneath the diaphragm
Gross Anatomical Structure
Externally, the liver is divided into 2 unequal lobes, while functionally it is categorized into 8
segments
● Anatomical Lobes:
○ Right Lobe: The largest lobe, making up the bulk of the organ.
○ Left Lobe: A smaller, flattened lobe that extends into the epigastrium.
● Ligaments:
 ○ Falciform Ligament: A sickle-shaped fold that attaches the liver to the anterior
abdominal wall and separates the right and left lobes.
○ Ligamentum Teres: The fibrous remnant of the umbilical vein, found in the free edge of
the falciform ligament

Functions of Liver
The liver is often called the body's "chemical factory" because it performs over 500 vital functions.
While the anatomy you mentioned—the lobes and ligaments—provides the framework, the
hepatocytes (liver cells) within those structures do the heavy lifting.
Its functions are generally grouped into three main categories: Metabolism, Detoxification, and
Storage.

1. Metabolic & Digestive Functions

● Bile Production: The liver produces bile, which is stored in the gallbladder and released into
the small intestine to emulsify fats, making them easier to digest and absorb.
● Carbohydrate Metabolism: It maintains blood glucose levels. When sugar is high, it stores
glucose as glycogen; when sugar is low, it breaks glycogen back down into glucose.
● Protein Synthesis: It creates most of the proteins found in your blood plasma, including
albumin(which keeps fluid in your vessels) and clotting factors (which help your blood clot
after an injury).
● Lipid Metabolism: It synthesizes cholesterol and produces lipoproteins to transport fats
throughout the body.

2. Detoxification and Filtration

● Blood Filtration: Using Kupffer cells, the liver acts as a sieve, removing bacteria, parasites,
and old red blood cells from the bloodstream.
● Neutralizing Toxins: It breaks down alcohol, medications, and drugs into harmless
substances that can be excreted in urine or bile.
● Ammonia Conversion: It converts highly toxic ammonia (a byproduct of protein digestion)
into urea, which the kidneys then filter out.

3. Storage and Regulation

● Vitamin & Mineral Storage: The liver keeps a "reserve tank" of vitamins A, D, E, K, and B12,
as well as minerals like iron (stored as ferritin) and copper.
● Hormone Regulation: It breaks down and removes excess hormones from the circulation,
such as estrogen and aldosterone, to maintain hormonal balance.

4. Immune Support
● The liver is a major part of the mononuclear phagocyte system. It produces immune factors
and removes antigens from the blood that enters from the gut.
Blood supply
Hepatic Portal Vein (approx. 75%): Carries
Hepatic Artery (approx. 25%):

Venous Drainage: Hepatic Vein

[Link]
The gallbladder is a small, pear-shaped organ in the upper right abdomen, located under the liver,
which stores and concentrates bile produced by the liver to aid in digesting fats. It releases bile into
the small intestine after meals, specifically prompted by fat intake. Common issues include
gallstones (cholelithiasis), inflammation (cholecystitis), or removal (cholecystectomy).
Functions and Usage
● Storage & Concentration: It stores \(30\) to \(80\) milliliters of bile between meals,
concentrating it to make it more effective.
● Digestion Aids: When food, especially fatty food, enters the small intestine, the gallbladder
contracts and releases bile to break down fats.
● Digestive Efficiency: Bile salts in the bile help break down large fat globules into smaller
droplets to help enzymes
[Link]

The pancreas is a 15-25 cm long, tadpole-shaped gland located behind the stomach in the upper
abdomen that acts as both an exocrine and endocrine organ. It is crucial for digestion by releasing
enzymes (amylase, lipase, protease) into the small intestine, and for regulating blood sugar by
secreting hormones (insulin, glucagon) into the bloodstream.

Anatomy and Location:

● Location: Situated retroperitoneally, spanning the posterior abdominal wall behind the
stomach.
● Parts: Comprised of the head (right side, nested in the duodenum), neck, body, and tail (left
side, extending toward the spleen).
● Structure: It is considered a gland, specifically a compound tubuloacinar gland.
Functions
● Digestion (Exocrine): Produces pancreatic juices (up to 8 oz daily) containing lipase to break
down fat, protease for proteins, and amylase for starches.
● Blood Sugar Regulation (Endocrine): Produces insulin (lowers blood sugar) and glucagon
(raises blood sugar) via the islets of Langerhans.
● Digestive Support: Secretes sodium bicarbonate to neutralize stomach acid in the
duodenum.

Physiology of digestion and absorption

Digestion and absorption involve breaking down food mechanically and chemically into small
nutrients (monosaccharides, amino acids, fatty acids) for uptake into the blood or lymph, primarily
in the small intestine. Enzymes like amylase, pepsin, and lipase break down food, while villi and
microvilli maximize absorption area.

Physiology of Digestion
● Mechanical Digestion: Physical breakdown starts with chewing in the mouth, followed by
churning in the stomach and segmentation in the small intestine.
● Chemical Digestion:
○ Mouth: Salivary amylase breaks down starch.
○ Stomach: Hydrochloric acid and pepsin begin protein digestion.
○ Small Intestine: Pancreatic enzymes (trypsin, amylase, lipase) and bile from the liver
break down proteins, carbohydrates, and emulsify fats.
● Regulation: Neural (vagus nerve) and hormonal (gastrin, CCK) signals control secretion and
motility.
●
Physiology of Absorption
● Small Intestine: Primary site for nutrient absorption. Large surface area (villi/microvilli)
enhances efficiency.
○ Carbohydrates: Monosaccharides (glucose, galactose) are absorbed via active
transport; fructose via facilitated transport.
○ Proteins: Amino acids are absorbed via active transport.
○ Lipids: Fatty acids and glycerol enter epithelial cells, form chylomicrons, and enter the
lymphatic system.
● Large Intestine: Reabsorbs water, electrolytes, and some vitamins.
● Transport: Nutrients enter the blood to be transported to the liver via the hepatic portal
system, or via the lymph (fats).
Key Processes Summary
● Carbohydrates: Starch —>Maltose —> Monosaccharides (Glucose, Fructose).
● Proteins: Polypeptides —> Peptides —> Amino acids.
● Lipids: Triglycerides —> Monoglycerides + Fatty acids.
● Water: Absorbed passively via osmosis.