INTERIOR OF STOMACH
Mucosa of stomach is thrown into folds called gastric rugae,
which disappear when the stomach distends.
There are two longitudinal folds along the lesser curvature
which form a canal called gastric canal; the swallowed liquids
go along this passage to the lower end of stomach. Thus, the
lesser curvature has a high risk of development of ulcers.
GASTRIC JUICE
The cells of gastric glands secrete about 2500 mL of gastric
juice daily. It has a pH of 1-2 at the luminal surface; i.e. it is
strongly acidic. It contains 99% water and 1% solids. The
important constituents of gastric juice are
pepsinogen,hydrochloric acid, mucus, intrinsic factor, HCO3
etc.
Hydrochloric Acid (HCI)
HCl is secreted by the parietal (oxyntic) cells of the fundic
[Link] glands
Functions of HCI
Activation of pepsinogen to pepsin
Provides a medium necessary for the action of pepsin on
proteins
Has antiseptic and antibacterial actions
Helps in absorption of iron and calcium by making them
soluble
Stimulates the secretion of pancreatic juice and bile.
Pepsinogen
The chief cells secrete pepsinogen. This is an inactive
precursor of pepsin, Hydrochloric acid converts inactive
pepsinogen into active pepsin by cleaving a peptide from the
molecule. Actions of pepsin to digest proteins found in
ingested food.
Splits the milk proteins caseinogin into casein
Splits proteins into proteases, peptones and polypeptides
Ability to digest collagen.
Mucus is secreted by the neck mucus cells of fundic gland,
cells of pyloric gland and cardiac gland. Mucus forms a gel-like
coat over the mucosa. It is alkaline in nature and forms an
extremely important protective layer, saving the stomach
from the destructive action of HCl. Substances like alcohol,
vinegar, aspirin, etc. can destroy this barrier and produce
gastritis.
PHASES OF GASTRIC SECRETION
There are 3 phases of gastric secrection:
Cephalic, gastric And intestinal phase
Cephalic Phase
It is the psychic secretion that occurs even before food enters
the [Link] of food in the mouth, sight, smell or
thought of food, etc. may stimulate gastric acid secretion,
which is mediated via vagus nerve.
This secretion is called appetite juice.
Gastric Phase
The presence of food in the stomach initiates this phase
and Stimulate HCL production. When the pH of gastric
contents becomes less than 2, there is a feedback inhibition of
gastrin hormone and HCL. This protects the gastric mucosa
from damage due to increased acidity.
When stimulated by the presence af food, the
entcroendocrine cells in the pylorus and duodenum secrete
the hormone gastrin directly into the circulating blood.
Gastrin, circulating in the blood , stimulates the gastric glands
to produce more gastric juice.
In this way, secretion of digestive juice is continued after
completion of a meal and the end of the cephalic phase.
intestinal phase
When the partially digested contents of the stomach reach
the small intestine, two hormones, secretin and
cholecystokinin (CCK), are produced by endocrine cells in the
intestinal mucosa. They slow down the secretion of gastric
juice and reduce gastric motility. By slowing the emptying
rate of the stomach, the chyme in the duodenum becomes
more thoroughly mixed with bile and pancreatic juice.
The rate at which the stomach empties depends largely on
the type of food eaten. A carbohydrate meal leaves the
stomach in 2-3 hours, a protein meal remains for longer and a
fatty meal remains in the stomach for longest.
SMALL INTESTINE
The small intestine is contnuous with the stomach at the
pyloric sphincter. It extends from the pylorus to the ileocecal
junction and it leads into the large intestine at the ileocaecal
valve. It is about 6 meters long and 2.5cm in diameter. Its
structure is adapted for digestion and absorption. It lies in the
abdominal cavity, surrounded by the large intestine. In the
small intestine the chemical digestion of food is completed
and absorption of most nutrients takes [Link] small
intestine is comprised of three continuous parts.
Deudenum
Jeujenum
Ileum
DUODENUM
The duodenum is the shortest, widest and most fixed part of
small intestine It is 10 inches long (25 cm).
It extends from the pylorus to the duodenojejunal flexure,
It is closely related to the head of the pancreas, in the form of
letter “C”
POSITION The duodenum is lies above the level of umbilicus,
opposite to the vertebrae L1, L2 and L3.
PARTS
Duodenum has four parts:
Superior or first part (5 cm)
Descending or second part (7.5 cm)
Horizontal or third part (10 cm); and
Ascending or fourth part (2.5 cm)