DIGESTIVE
SYSTEM
Nutrition and Metabolism
Dr. Johanne Baluyut
Fellow in Internal Medicine and Philippine College of Physicians
FUNCTIONS OF THE DIGESTIVE SYSTEM
1. Ingestion: eating
FUNCTIONS OF THE DIGESTIVE SYSTEM
1. Ingestion
- eating
2. Secretion: release of water, enzymes, bu ers
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FUNCTIONS OF THE DIGESTIVE SYSTEM
1. Ingestion: eating
2. Secretion: release of water, enzymes, bu ers
3. Mixing and propulsion : movement along GI tract
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FUNCTIONS OF THE DIGESTIVE SYSTEM
1. Ingestion: eating
2. Secretion: release of water, enzymes, bu ers
3. Mixing and propulsion : movement along GI tract
4. Digestion: breakdown of
foods
Mechanical digestion
Chewing mixes food with saliva
Rounds up food into a soft bolus for
swallowing
Chemical digestion
Salivary amylase (enzyme) breaks down
polysaccharides (starch) maltose and
larger fragments
Continues in the stomach for about an
hour until acid inactivates amylase
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FUNCTIONS OF THE DIGESTIVE SYSTEM
1. Ingestion: eating
2. Secretion: release of water, enzymes, bu ers
3. Mixing and propulsion : movement along GI tract
4. Digestion: breakdown of foods
a. Mechanically: by movements of digestive
organs
b. Chemically: by enzymes
5. Absorption: moving
products of digestion into
the body ff
FUNCTIONS OF THE DIGESTIVE SYSTEM
1. Ingestion: eating
2. Secretion: release of water, enzymes, bu ers
3. Mixing and propulsion : movement along GI tract
4. Digestion: breakdown of foods
a. Mechanically: by movements of digestive
organs
b. Chemically: by enzymes
5. Absorption: moving products of digestion into the
body
6. Defecation: dumping
waste products
ff
FUNCTIONS OF THE DIGESTIVE SYSTEM
1. Ingestion : eating
2. Secretion: release of water, enzymes, bu ers
3. Mixing and propulsion : movement along GI tract
4. Digestion: breakdown of foods
a. Mechanically: by movements of digestive organs
b. Chemically: by enzymes
5. Absorption: moving products of digestion into the body
6. Defecation: dumping waste products
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DIVISION OF
THE
DIGESTIVE
SYSTEM
1. Digestive Tract
2. Accessory digestive organs
DIVISION OF THE DIGESTIVE SYSTEM
Digestive Tract Accessory Digestive Organs
• Oral cavity • Teeth
• Pharynx • Tongue
• Esophagus • Gallbladder
• Stomach • Salivary glands
• Small Intestine • Liver
• Large Intestine • Pancreas
• Anus
TUNICS
1. Mucosa
2. Submucosa
3. Muscularis
4. Serosa
TUNICS
THREE MAJOR FUNCTIONS
1. Secretion of mucus
• Protect digestive organs from digesting themselves
• Ease food along the tract
2. Absorption of end product of digestion
3. Protection against infectious disease
TUNICS
Four Tunics
1. Mucosa :
epithelium in
direct content
with food;
made of
connective
tissue, glands,
and thin
muscularis
mucosae
TUNICS
Four Tunics
2. Submucosa
: connective
tissue, blood
vessels,
lymphatic
vessels, and
enteric
nervous
system (ENS)
TUNICS
Four Tunics
3. Muscularis :
inner circular
layer, outer
longitudinal
layer; Smooth
muscle in most
of GI tract;
Except skeletal
(voluntary
muscle) in
mouth,
pharynx, upper
esophagus,
and external
anal sphincter
TUNICS
Four Tunics
4. Serosa :
visceral layer of
peritoneum;
Also forms
extensions:
greater
omentum and
mesentery
ENTERIC
NERVOUS
SYSTEM
1. Sensory neurons
2. Motor neurons
3. Interneurons
ENTERIC NERVOUS SYSTEM
THREE MAJOR TYPES OF ENTERIC NEURONS
1. Sensory neurons - detect changes in the chemical composition
of the digestive tract
2. Motor neurons - stimulate or inhibit smooth muscle
contraction and glandular secretion
3. Interneurons - connect sensory to motor neurons
ASSIGNMENT:
1. Di erentiate submucosal and myenteric plexus
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PERITONEUM
• The peritoneum is a serous
membrane that lines the
abdominopelvic cavity and organs
• Mesenteries are peritoneum
that extend from the body wall
to many of the abdominopelvic
organs
• Retroperitoneal organs are
located behind the peritoneum
ASSIGNMENT:
2. Enumerate all retroperitoneal organs
DIVISION OF THE DIGESTIVE SYSTEM
Digestive Tract Accessory Digestive Organs
• Oral cavity • Teeth
• Pharynx • Tongue
• Esophagus • Gallbladder
• Stomach • Salivary glands
• Small Intestine • Liver
• Large Intestine • Pancreas
• Anus
1. Mouth (Oral Cavity)
• Cheeks
• Tongue
• Hard palate
• Soft palate
• Uvula
• Lingual tonsils
2. Salivary Glands
• Parotid
• Submandibular
• Sublingual
2. Salivary Glands
Control of Salivation
- Primarily by the
parasympathetic division of the
autonomic nervous system
- Salivary glands secrete serous,
enzyme-rich saliva in response to:
• Ingested food which
stimulates chemoreceptors
and pressoreceptors
•The thought of food
- Strong sympathetic
stimulation inhibits salivation
and results in dry mouth
3. Teeth
Four types of teeth
1. Incisors (8): used to cut
food
2. Cuspids (canines) (4):
used to tear food
3. Premolars (8): for
crushing and grinding
food
4. Molars (12): used for
crushing and grinding
food
3. Teeth
4. Pharynx and
Esophagus
4. Pharynx and
Esophagus
Food passage from mouth ->
Stomach
Swallowing: 3 stages
1. Voluntary stage: bolus of food ->
oropharynx
2. Pharyngeal stage: oropharynx ->
esophagus
• Soft palate moves up and
epiglottis moves down; prevent
food from entering nasopharynx and
larynx
3. Esophageal: food -> stomach by
peristalsis
4. Pharynx and
Esophagus
Food passage from
mouth -> Stomach
Esophageal sphincters:
1. Upper: controls entry ->
esophagus
2. Lower: controls entry ->
stomach; GERD
5. Stomach
Four Regions
1. Cardia
2. Fundus
3. Body
4. Pylorus
5. Stomach
Histology
1. Mucous neck cells -
secretes acid and mucus
2. Parietal cells - secretes HCl
and intrinsic factor (IF)
3. Chief cells - produces
pepsinogen
4. Endocrine cells - G cells
produces regulatory
hormones (Gastrin, histamine,
endorphins, serotonin, cholecystokinin
(CCK), and somatostatin into the lamina
propria)
5. Stomach
Secretions of the
Stomach
• Mucus protects the stomach
lining
• Pepsinogen is converted to
pepsin, which digests proteins
• Hydrochloric acid promotes
pepsin activity and kills
microorganisms
• Intrinsic factor is necessary for
vitamin B12 absorption
• Gastrin and histamine regulate
stomach secretions
5. Stomach
REGULATION: Secretions of the
Stomach
1. Cephalic phase
• Initiated by the sight, smell, taste, or thought
of food
• Nerve impulses from the medulla
stimulate hydrochloric acid, pepsinogen,
gastrin, and histamine secretion.
2. Gastric phase
• Initiated by distention of the stomach, which
stimulates gastrin secretion and activates
CNS and local re exes that promote
secretion
3. Gastrointestinal phase
• Acidic chyme, which enters the
duodenum and stimulates neuronal
re exes and the secretion of hormones
(secretin, cholecystokinin) that inhibit gastric
secretions
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5. Stomach
REGULATION: Secretions of the
Stomach
1. Cephalic phase
• Initiated by the sight, smell, taste, or thought
of food
• Nerve impulses from the medulla
stimulate hydrochloric acid, pepsinogen,
gastrin, and histamine secretion.
2. Gastric phase
• Initiated by distention of the stomach, which
stimulates gastrin secretion and activates
CNS and local re exes that promote
secretion
3. Gastrointestinal phase
• Acidic chyme, which enters the
duodenum and stimulates neuronal
re exes and the secretion of hormones
(secretin, cholecystokinin) that inhibit gastric
secretions
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5. Stomach
REGULATION: Secretions of the
Stomach
1. Cephalic phase
• Initiated by the sight, smell, taste, or thought
of food
• Nerve impulses from the medulla
stimulate hydrochloric acid, pepsinogen,
gastrin, and histamine secretion.
2. Gastric phase
• Initiated by distention of the stomach, which
stimulates gastrin secretion and activates
CNS and local re exes that promote
secretion
3. Gastrointestinal phase
• Acidic chyme, which enters the
duodenum and stimulates neuronal
re exes and the secretion of hormones
(secretin, cholecystokinin) that inhibit gastric
secretions
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5. Stomach
Movements of the
Stomach
• Waves mix the stomach
contents with stomach
secretions to form chyme
• Peristaltic waves move the
chyme into the duodenum
• Hunger contractions
• Vomiting
• Reverse peristalsis
Movements of the Stomach
6. Small Intestine
• The body’s major digestive organ
• Digestion is completed and
absorption occurs
• Runs from pyloric sphincter to
the ileocecal valve
Has three subdivisions:
1. Duodenum: ~ 10” long. The
bile and pancreatic ducts empty
here
2. Jejunum: ~ 8’ long
3. Ileum: ~ 12’ long
ASSIGNMENT:
3. Di erentiate jejunum and ileum anatomically.
(Write answer in table form)
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6. Small Intestine
Movements of the Small
Intestine
• Segmental contractions mix
intestinal contents
• Peristaltic contractions move
materials distally
• Distension of the intestinal wall,
local re exes, and the
parasympathetic nervous system
stimulate contractions
• Distension of the cecum initiates a
re ex that stimulates contraction
of the ileocecal sphincter
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7. Pancreas
Location
• Lies deep to the greater curvature
of the stomach
• The head is encircled by the
duodenum and the tail sits against
the spleen
• Produces pancreatic juice in acinar
cells
• Passes into duodenum via
pancreatic duct
Secretions that help digestion
• Sodium bicarbonate (NaHCO ): pH
7.1-8.2)
• Digestive enzymes: many
• Pancreatic lipase: fat-digesting
• Pancreatic amylase: starch-digesting
• Proteases: made in inactivated form
Activated by enterokinase from
small intestine
Chymotrypsinogen,
trypsinogen, carboxypeptidase
RNAase and DNAase
7. Pancreas
8. Liver
• Weighs 1.4 kg (3 lb)
• 2nd largest organ in the
body
• Located in the right upper
quadrant, below
diaphragm
• The liver has four external
lobes: right lobe, left lobe,
caudate, and quadrate
8. Liver
• Internally, the liver is
divided into eight
segments
8. Liver
• Functional unit is lobule
• Consists of hepatocytes in rows that
radiate around central vein
• Sinusoids (permeable capillaries with
phagocytic [Kuppfer] cells) are between
cells
• Blood reaches liver lobules from
• Hepatic artery (branch of celiac):
blood high in O2
• Hepatic portal vein (formed by veins
from digestive organs and spleen):
blood low in O2 but rich in nutrients
from digestive organs
• Liver segments are divided into lobules
• Hexagonal-shaped liver lobules are
the structural and functional units of
the liver
• Composed of hepatocyte (liver cell)
plates radiating outward from a
central vein
• Portal triads are found at each of the six
corners of each liver lobule
8. Liver
Functions of the Liver:
1. Produces bile, which contains bile salts
that emulsify fats
Functions of bile
• Emulsi cation: breaking apart clusters of
fats so they are more digestible
• Absorption of fats
Formation and recycling of bile
• Bilirubin from heme when RBCs broken
down
• Bile is digested and excreted (5%)
stercobilin: gives feces brown color
• Bile salts reabsorbed (95%) into blood in
small intestine (ileum) portal
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Gallstones may form from bile
Obstruct bile ducts from gallbladder pain
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8. Liver
Functions of the Liver: 7. Protein metabolism
- Remove NH2 from amino acids
ammonia (NH3) urea to
2. Stores and processes nutrients, kidneys (urine)
produces new molecules, and detoxi es - Synthesize most plasma proteins:
molecules albumin
3. Hepatic phagocytic cells phagocytize 8. Removes many harmful substances
red blood cells, bacteria, and other from blood
debris Detoxi es alcohol
Inactivates steroid and thyroid
4. Produces blood components hormones
Eliminates some drugs (like penicillin)
5. Carbohydrate metabolism into bile
- Polysaccharide stored in liver as
glycogen 8. Excretion of bilirubin
- Converts glycogen, fructose, From heme (in RBCs) to bilefeces
galactose, lactic acid, amino acids
glucose to increase blood glucose 9. Stores fat-soluble vitamins (ADEK) and
minerals (Fe, Cu)
6. Lipid metabolism
- Produces cholesterol, triglycerides; 10. Activates vitamin D
makes bile
- Makes lipoproteins for lipid transport
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9. Gallbladder
- A small sac on the inferior
surface of the liver
- Stores and concentrates
bile
9. Gallbladder
Bile
• A yellow-green, alkaline solution containing
bile salts, bile pigments, cholesterol, neutral
fats, phospholipids, and electrolytes
• Bile salts are cholesterol derivatives that:
• Emulsify fat
• Facilitate fat and cholesterol absorption
• Helps make cholesterol soluble
• Enterohepatic circulation recycles bile salts
therefore they are
never voided in the feces
• The chief bile pigment is bilirubin, a waste
product of heme.
• Bilirubin is metabolized by bacteria
in the small intestines and
urobilogen is produced, which
gives feces its dark color
9. Gallbladder
9. Gallbladder
Regulation of Bile
Secretion
• Acidic, fatty chyme causes the duodenum to
release:Cholecystokinin (CCK) and secretin
into the bloodstream
• Cholecystokinin causes:
• The gallbladder to contract and
releases bile
• Relaxation of the sphincters of the
bile
duct and hepatopancreatic ampulla
• Secretin increases bile secretion (water and
bicarbonate ions)
• As a result, bile enters the duodenum
• Bile salts and secretin transported in blood
stimulate the liver to produce bile
• Vagal stimulation causes weak contractions
of the gallbladder
9. Large Intestines
➡Extends from the ileocecal
valve to the anus
➡Absorbs water and
eliminate the waste via
feces
➡Is subdivided into the
cecum, appendix, colon,
rectum, and anal canal
9. Large Intestines
Three unique features:
1. Teniae coli: three bands of
longitudinal smooth muscle in
its muscularis
2. Haustra: pocketlike sacs
caused by the tone of the teniae
coli
3. Epiploic appendages : fat- lled
pouches of visceral peritoneum
➡The mucosal lining of the large
intestine is simple columnar
epithelium with mucus-producing
crypts
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9. Large Intestines
Secretions of the Large
Intestines:
• Mucus protects the intestinal lining
• The bacterial ora of the large intestine
consist of:
– Bacteria surviving the small intestine
that enter the cecum
– Those entering via the anus
• These bacteria:
1. Colonize the colon
2. Ferment indigestible carbohydrates
3. Release irritating acids and gases
( atus)
4. Synthesize B complex vitamins and
vitamin K
5. Constitute about 30% of the dry
weight of the feces
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Movement in the Large Intestines:
ASSIGNMENT:
4. Di erentiate enterogastric, gastro-ileal and
gastrocolic re ex.
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CHEMICAL
DIGESTION
Carbohydrate
Lipid
Protein
Carbohydrates
• Begins in mouth with salivary amylase
digesting starches
• Pancreatic amylase nishes the
process in the small intestine. Simple
sugars are also broken down here
• Include starches, glycogen, sucrose,
lactose, glucose, and fructose
• Polysaccharides are broken down into
monosaccharides by a number of
di erent enzymes
• Insulin in uences the rate of glucose
transport
•
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Carbohydrates
Monosaccharides
1. Taken up by intestinal epithelial cells by 3. Glucose is transported to the cells that
symport that is powered by a Na gradient require energy
or by facilitated di usion
4. Glucose enters the cells through
2. Carried to the liver, where the non-glucose facilitated di usion
sugars are converted to glucose
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Proteins
• Broken down into amino
acids
• Begins in the stomach with
pepsin
• Trypsin and chymotrypsin
are also important protein
digesting
enzymes.
Lipids
Include triglycerides, phospholipids, steroids, and fat-
soluble vitamins
Emulsi cation is the transformation of large lipid
droplets into smaller droplets and is
accomplished by bile salts
Lipase digests lipid molecules to form fatty acids and
a monoglyceride
Micelles form around lipid digestion products and
move to epithelial cells of the small
intestine, where the products pass into the cells by
simple di usion
Within the epithelial cells, free fatty acids are
combined with monoglycerides to form
triglycerides
Proteins coat triglycerides, phospholipids, and
cholesterol to form chylomicrons
Chylomicrons enter lacteals within intestinal villi and
are carried through the lymphatic
system to the bloodstream
Triglycerides are stored in adipose tissue, converted
into other molecules, or used as
energy
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