Digestive System

The human digestive system is a complex network of structures and organs responsible for the
process of digestion, which involves processing food and liquids into forms that can be absorbed
into the bloodstream for the body's use. It also handles the elimination of wastes. This system
primarily consists of the digestive tract, also known as the alimentary canal or gastrointestinal
tract, which is a series of organs through which food passes. Additionally, it includes organs that
contribute necessary juices for digestion.

I. Major Structures of the Digestive Tract (Alimentary Canal)

The digestive tract begins at the lips and ends at the anus.
●​ Mouth (Oral Cavity)​

○​ Function: Prepares food for transport through the upper digestive tract. Little
actual digestion occurs here, but food is prepared through mastication (chewing).
Chewing reduces food to small particles and mixes it with saliva, which lubricates
and moistens dry food. The tongue helps form a rounded mass of food called a
bolus.
○​ Structures:
■​ Teeth: Hard, white structures primarily used for mastication. Humans
typically have two sets: deciduous (milk) teeth (20 total) and permanent
teeth (32 total). They are supported by the gums, which are rich in blood
vessels.
■​ Tongue: A muscular, mobile organ on the floor of the mouth, accessory to
speech, chewing, and swallowing. It guides food between teeth and
contains taste buds. The tongue's glands also produce saliva.
■​ Lips and Cheeks: Fleshy folds composed of skin and mucous membrane,
rich in mucus-secreting glands for lubrication during speech and
mastication.
■​ Palate (Roof of the Mouth): Concave, formed by the hard palate (bone)
and soft palate (fibrous sheet and muscles). A small projection called the
uvula hangs from the soft palate.
■​ Floor of the Mouth: Visible when the tongue is raised, featuring folds of
mucous membrane and openings for salivary gland ducts.

●​ Pharynx (Throat)​
 ○​ Function: A passageway for swallowed solids and liquids into the esophagus, and
for air to and from the trachea during respiration. It also connects to the middle
ear via the Eustachian tube, equalizing air pressure.
○​ Divisions: Oral pharynx (shared by respiratory and digestive tracts), nasal
pharynx (airway), and laryngeal pharynx (airway).
○​ Swallowing (Deglutition): The first stage is voluntary, forcing the bolus from the
mouth into the pharynx. The soft palate elevates to prevent entry into the nasal
pharynx, and the larynx moves up. Pharyngeal peristaltic (squeezing)
contractions propel the bolus downward. The epiglottis diverts the bolus away
from the larynx.

●​ Esophagus​

○​ Function: A muscular tube that passes food from the pharynx to the stomach.
○​ Structure: About 25 cm long, composed of four layers: mucosa, submucosa,
muscularis (inner circular, outer longitudinal), and tunica adventitia. The upper
third has voluntary striated muscle, the middle third a mixture, and the lower third
involuntary smooth muscle.
○​ Sphincters: Has an upper esophageal sphincter (cricopharyngeus muscle) and a
lower esophageal sphincter, both normally closed except during swallowing.
The lower esophageal sphincter protects the esophagus from gastric reflux.
○​ Transport: Accomplished by primary esophageal peristaltic contractions
originating in the pharynx, moving the bolus in approximately 10 seconds. If the
bolus is too large or contractions too weak, secondary peristaltic contractions
may occur. Liquids may fall by gravity to the lower esophagus when upright,
awaiting sphincter opening.
●​ Stomach​

○​ Function: Receives food from the esophagus, retains it for grinding and mixing
with gastric juice, and converts it into chyme (a semiliquid mass). It begins the
digestion of carbohydrates and proteins and discharges chyme periodically into
the small intestine.
○​ Anatomy: Located in the upper left abdomen. It has a concave lesser curvature
and a convex greater curvature. When empty, its mucosal lining forms
longitudinal folds called rugae.
○​ Parts:
■​ Cardia: Opening from the esophagus.
■​ Fundus: Uppermost part, frequently containing a gas bubble, adapts to
volume changes.
■​ Body: Largest part, serves as a reservoir.
■​ Antrum: Lowermost, funnel-shaped part.
■​ Pyloric Canal: Connects antrum to duodenum.
 ■​ Pylorus: Narrowest portion, the outlet into the duodenum, surrounded by
the pyloric sphincter.
○​ Muscle Layers: Three layers: outer longitudinal, middle circular (strongest,
forming the pyloric sphincter), and inner oblique (strongest in the fundus).
○​ Contractions: Three types of motor activity: small contraction waves with
mixing/crushing effect, peristaltic waves (propelling contents through the pyloric
sphincter), and tonic (sustained) contractions that decrease lumen size for
accommodation. Peristaltic contractions occur at a constant rate of three per
minute from the gastric antrum.
○​ Gastric Mucosa: Lines the inner surface, covered by a thick mucus layer that
lubricates food and protects the stomach from its own digestive enzymes. It
contains gastric pits into which gastric glands secrete.
○​ Gastric Glands Cells:
■​ Mucoid cells: Secrete gastric mucus.
■​ Zymogenic (chief) cells: Secrete pepsinogen, which forms the
protein-digesting enzyme pepsin in the presence of acid.
■​ Gastrin (G) cells: Secrete the acid-stimulating hormone gastrin in
response to lowered acidity and stomach distension.
■​ Parietal (oxyntic) cells: Secrete hydrochloric acid (HCl) and intrinsic
factor (essential for vitamin B12 absorption).
■​ Enterochromaffin-like cells: Secrete substances like serotonin.
○​ Gastric Secretion: 1.2 to 1.5 litres of highly acidic, enzyme-rich gastric juice
daily. Divided into three phases:
■​ Cephalic phase: Reflex response to sensory stimuli (taste, smell, sight,
sound), mediated by the vagus nerve.
■​ Gastric phase: Mediated by vagus nerve and gastrin release, stimulated
by distension, peptides, and amino acids from protein digestion.
■​ Intestinal phase: Complex, involves both stimulatory and inhibitory
processes, with hormones like glucagon and secretin suppressing acid
secretion.
○​ Absorption and Emptying: The stomach absorbs few digestion products but can
absorb substances like glucose, simple sugars, amino acids, some fat-soluble
substances, water, and alcohol. The rate of emptying depends on the meal's
composition (fluids faster than solids, carbohydrates faster than proteins, proteins
faster than fats).
●​ Small Intestine​

○​ Function: The principal organ of the digestive tract where most digestion and
absorption of nutrients occur. It mixes and transports contents, produces enzymes,
and absorbs nutrients.
○​ Anatomy: Longest part of the digestive tract (670-760 cm), divided into three
functional segments.
○​ Segments:
■​ Duodenum: First part (23-28 cm), C-shaped, encircles the pancreas.
Receives pancreatic juice and bile through the duodenal papilla. Important
for neutralizing gastric acid and optimal pH for enzymes.
■​ Jejunum: Upper two-fifths of the remaining small intestine. Primary site
for absorption.
■​ Ileum: Remaining three-fifths, ends at the ileocecal valve with the large
intestine.
○​ Surface Area: Its total absorptive surface area is enormous (approx. 4,500 sq
meters) due to unique mucosal structures:
■​ Plicae Circulares (Valves of Kerckring): Concentric folds increasing
surface area 5-8 times.
■​ Villi: Tiny, finger-like projections (0.5-1 mm high) covering the folds,
increasing surface area. Contain a rich network of blood vessels and a
central lacteal (lymph channel).
 ■​ Microvilli (Brush Border): Ultrafine projections on the surface of
epithelial cells covering villi, further enlarging absorbing surface ~25
times. They also secrete enzymes like disaccharidase and peptidase.
○​ Cells: Goblet cells (secrete mucin/mucus) are scattered among surface epithelial
cells. Intestinal glands (Lieberkühn’s glands) at the base of villi contain
undifferentiated cells (for renewal), goblet cells, and endocrine cells. Paneth cells
(in glands) may contain lysozyme.
○​ Contractions and Motility: Regulated by electrical impulses, mainly
segmenting contractions (localized, circumferential contractions that mix and
churn chyme) and peristaltic contractions (advancing waves that transport
contents downward).
○​ Secretions: The succus entericus (mixture of secretions into the small intestine)
contains water, inorganic salts, mucus, cellular debris, and enzymes such as
amylase, lipase, peptidases, sucrase, maltase, and enterokinase. Secretions are
controlled by nerves (e.g., vagus) and hormones.
○​ Absorption of Specific Nutrients:
■​ Carbohydrates: Absorbed as monosaccharides (glucose, fructose,
galactose). Starch is digested by pancreatic amylase, then disaccharidases
in the brush border break disaccharides into monosaccharides. Glucose
and galactose are actively transported, fructose by simple diffusion.
■​ Proteins: Digested first into peptides, then individual amino acids. Pepsin
in the stomach begins digestion, but the majority occurs in the duodenum
and jejunum by pancreatic proteases (trypsin, chymotrypsin, elastase).
Peptidase activity occurs outside and inside enterocytes. Small peptides
are absorbed more rapidly than amino acids.
■​ Fats: Stored as triglycerides. Pancreatic lipase breaks long-chain
triglycerides into monoglycerides and fatty acids, which combine with bile
salts to form micelles (making fats water-soluble). Micelles pass through
the unstirred layer and fuzzy coat to the brush border, where fatty acids
and monoglycerides enter cells, are re-synthesized into triglycerides,
packaged into chylomicrons, and enter the lymphatic system (lacteals).
Medium-chain fatty acids pass directly into the portal vein.
■​ Water, Salts, Minerals: Most are absorbed in the small intestine, chiefly
the jejunum. Sodium is absorbed actively, chloride passively, and
potassium passively or by facilitated diffusion. Water absorption is
secondary to electrolyte absorption and helps maintain intestinal contents
in an isotonic state.
■​ Fat-soluble vitamins (A, D, E, K): Pass with chylomicrons into the
lymphatic system. Bile salts are essential for their absorption.
 ■​ Calcium: Absorbed primarily in the duodenum by an energy-requiring
process essential to vitamin D, parathyroid hormone, and growth hormone.
Lactose aids absorption, while excess fatty acid and high
magnesium/oxalates interfere.
■​ Magnesium: Two-thirds of dietary magnesium is absorbed, influenced
inversely by calcium levels.
■​ Hematinics (Folic acid, Vitamin B12, Iron):
■​ Folic acid: Necessary for nucleic acid synthesis and cell
replication, absorbed in the jejunum.
■​ Vitamin B12 (Cobalamin): Essential for blood cell formation. It
binds with intrinsic factor (from parietal cells) to be absorbed in
the terminal ileum.
■​ Iron: Necessary for hemoglobin synthesis. Almost wholly
absorbed in the duodenum by an energy-requiring process. Alcohol
can increase absorption.

●​ Large Intestine (Colon)​

○​ Function: Serves as a reservoir for liquids from the small intestine, absorbs water
and electrolytes (sodium, chloride), and stores fecal material for defecation. It also
secretes mucus for lubrication. Bacteria in the colon synthesize essential vitamins
like niacin, thiamin, and vitamin K.
○​ Anatomy: Larger in diameter but shorter (150 cm) than the small intestine.
 ○​ Divisions: Cecum (first part, sac with closed end), ascending colon, transverse
colon, descending colon, and sigmoid colon. The ileocecal valve guards the
opening from the ileum into the cecum.
○​ Distinguishing Features:
■​ Taeniae: Three long bands of longitudinal muscle fibers.
■​ Haustra (Sacculations): Circular furrows formed by the taeniae being
shorter than the intestine, constricting the wall.
■​ Appendices Epiploicae: Collections of fatty tissue.
○​ Inner Surface: Many crypts lined with mucous glands and goblet cells, but lacks
villi and plicae circulares.
○​ Motility: Local contractions and retrograde propulsions ensure mixing. Motility
is stimulated by mastication, fat, bile salts, and hormones like gastrin and
cholecystokinin. Secretin, glucagon, and vasoactive intestinal peptide suppress
motility.
○​ Intestinal Gas: Gas in the GI tract (nitrogen, oxygen, hydrogen, methane, carbon
dioxide) varies in composition. High levels of hydrogen and methane reflect
bacterial activity in the colon, especially from fermentable dietary residues (e.g.,
vegetable saccharides from beans).

●​ Rectum and Anus​

 ○​ Rectum: Continuation of the sigmoid colon, ending in the rectal ampulla. The
colonic taeniae spread out to form a wide external longitudinal muscle coat.
○​ Anal Sphincters: The internal circular muscle coat forms the thick internal anal
sphincter (smooth muscle, autonomic innervation), and the external anal
sphincter is composed of striated (voluntary) muscle with somatic innervation.
These sphincters control defecation.

○​ Defecation: The rectum is normally empty, but when filled, it triggers the impulse
to defecate. Voluntary effort and visceral reflexes (originating from rectal
distension) lead to the relaxation of the internal anal sphincter.

II. Accessory Organs and Glands

These organs contribute juices and other substances essential for the digestive process but are not
part of the direct passage of food.

●​ Salivary Glands​

○​ Function: Secrete saliva to dissolve food, act as a lubricant, initiate enzymatic

hydrolysis of starch (via amylase), and stimulate taste buds. Saliva also keeps the
oral cavity moist, inhibits bacterial growth (due to lysozyme), and helps excrete
certain substances.
○​ Major Pairs: Parotid (largest, below/in front of each ear, secretes watery fluid
with amylase), submandibular (near lower jawbone, secretes both serous and
mucous fluid), and sublingual (under the tongue, primarily secretes mucus).
○​ Control: Regulated by the sympathetic and parasympathetic divisions of the
autonomic nervous system. Secretion is normally constant (1-1.5 litres/day) but
increases with stimulation (unconditioned salivary reflex) or learned associations
(conditioned salivary reflex).
○​ Composition: Water, inorganic ions (bicarbonate, phosphates, chloride,
potassium, sodium) acting as buffers, and organic constituents (proteins, amino
acids, lysozyme, amylase).
●​ Liver​

○​ Function: The largest gland and most complex organ in function. It participates
in metabolism of protein, carbohydrates, and fat; synthesizes cholesterol and bile
acids; initiates bile formation; transports bilirubin; metabolizes drugs; and
controls carbohydrate transport and storage.
○​ Gross Anatomy: Located under the lower right rib cage. Divided into a large
right lobe and a smaller left lobe. Receives blood from two sources: oxygenated
blood from the hepatic artery and partially oxygenated blood from the portal
vein (which collects blood from the spleen, pancreas, gallbladder, and
gastrointestinal tract). The porta hepatis is the entry/exit point for blood vessels
and hepatic ducts.
○​ Microscopic Anatomy: Composed of lobules, which contain cords of
hepatocytes (liver cells) radiating from central veins. Hepatocytes perform
metabolic functions and produce bile. Sinusoids (capillaries) allow direct access
 of hepatocytes to the bloodstream. Kupffer cells line sinusoids and function as
phagocytes.
○​ Hepatocyte Functions: Contain mitochondria (energy), endoplasmic reticulum
(drug/hormone metabolism, cholesterol synthesis, protein formation), Golgi
apparatus (protein transport), and lysosomes (storage/digestion). They convert
ammonia to urea, conjugate bilirubin (making it water-soluble for excretion in
bile), and convert other monosaccharides and metabolites into glucose. The liver
also metabolizes fat, forms storage fats (triglycerides), and synthesizes cell
membrane components and lipoproteins. It stores folic acid, vitamin B12, and
vitamin E.

●​ Gallbladder​

○​ Function: A saccular structure (capacity ~50 ml) that stores and concentrates
bile. Bile is concentrated by reabsorption of water, chloride, and bicarbonate.
○​ Biliary Tract: Begins with right and left hepatic ducts, which join to form the
hepatic duct. This is joined by the cystic duct (from the gallbladder) to form the
common bile duct, which usually joins the main pancreatic duct at the
hepatopancreatic ampulla (ampulla of Vater) before emptying into the
duodenum at the duodenal papilla.
○​ Bile: Formed in hepatocytes, aids in the dispersion and digestion of fat in the
small intestine. Contains inorganic ions, protein, bilirubin (golden/dark amber
color), bile acids (from cholesterol), phospholipids, and cholesterol. Distension of
the duodenum, especially by fat, triggers cholecystokinin (CCK) secretion,
causing gallbladder contractions.
●​ Pancreas​

○​ Function: A long gland behind the stomach and spleen, acting as both an
exocrine (ductal) and endocrine (ductless) gland.
○​ Exocrine Function: Acinar tissue (more than 95% of cells) produces important
digestive enzyme precursors. These enzymes digest proteins (proteases), fats
(lipases), and carbohydrates (amylases). They are secreted into ducts that join the
pancreatic duct, which empties into the duodenum, often via the
hepatopancreatic ampulla.
■​ Enzyme secretion is mediated by stimulants like secretin (from gastric
acid), cholecystokinin (CCK) (from dietary fat, amino acids, HCl), and
acetylcholine (from sensory aspects of feeding).
■​ Pancreatic juice secretes bicarbonate to neutralize stomach acid, bringing
intestinal contents to an optimal pH for enzyme activity.
 ○​ Endocrine Function: Islets of Langerhans produce hormones directly into the
bloodstream.
■​ Alpha (A) cells: Produce glucagon, which elevates blood glucose by
stimulating glycogen breakdown in the liver.
■​ Beta (B) cells: Produce insulin, which lowers blood glucose by
stimulating glucose absorption into muscle and fat tissue.
■​ Delta (D) cells: Produce somatostatin, which inhibits the release of
glucagon and insulin, as well as acid, pepsin, and other intestinal
hormones, and motility.

■​ Other hormones: Vasoactive intestinal polypeptide (VIP) and

somatostatin regulate intestinal secretion and motility. Pancreatic
polypeptide is secreted in response to protein meals.

III. Other Key Concepts

●​ Digestion Chemistry: All digestive enzymes are hydrolyzing enzymes, meaning they
catalyze reactions that insert a water molecule to split large molecules into smaller units
(e.g., starch to glucose, proteins to amino acids, fats to glycerol and fatty acids).
●​ Absorption Mechanisms: Digestive products are absorbed by active transport (requires
energy and a carrier), passive diffusion (no energy/carrier, moves down concentration
gradient), facilitated diffusion (no energy, but requires a carrier), and endocytosis
(engulfing material into the cell).
●​ Hormones of the Gastrointestinal Tract: Peptide messenger molecules (hormones)
regulate motor and secretory functions. They can act paracrine (locally) or endocrine
(via bloodstream). Examples include gastrin (stimulates acid), somatostatin (inhibits
many functions), CCK (gallbladder contraction, pancreatic enzymes), gastric inhibitory
 peptide (enhances insulin, inhibits water absorption), intestinal glucagon (modulates
motility), motilin (stimulates gastric emptying), neurotensin (modulates motility, relaxes
sphincter), secretin (stimulates bicarbonate), and vasoactive intestinal peptide (VIP)
(inhibits gastrin/acid, stimulates water/electrolyte secretion, relaxes sphincters).
Prostaglandins influence smooth muscle and protect mucosa.
●​ Gastrointestinal Tract as an Organ of Immunity: Contains significant lymphoid
tissue, including pharyngeal tonsils, appendix, Peyer patches (in small intestine), and
lymphocytes/plasma cells in the lamina propria and between epithelial cells. This
immune system (B and T lymphocytes, immunoglobulins like IgA, IgM, IgG, IgD, IgE)
defends against viruses, bacteria, parasites, toxins, and foreign proteins. Secretory IgA in
the intestinal lumen protects against pathogens.

●​ Blood and Nerve Supply: The gastrointestinal tract receives arterial blood from
branches of the celiac trunk, superior mesenteric artery, inferior mesenteric artery, and
hypogastric artery. Venous blood is returned to the portal vein, which carries it to the
liver. Nerve supply is provided by both the parasympathetic (vagus nerve) and
sympathetic divisions of the autonomic nervous system, forming networks like the celiac
plexus, Auerbach plexus, and Meissner plexus.