DIGESTIVE SYSTEM

[Link] Zia
 Alimentary Tract Overview
• A continuous muscular tube from mouth to
anus
• Functions: ingestion, digestion, absorption,
excretion
• Structurally similar throughout, but
functionally specialized

Main Components of the Alimentary

Tract
• Mouth
• Pharynx
• Oesophagus
• Stomach
• Small intestine
• Large intestine
• Rectum & Anal canal
 Accessory Organs of Digestion
• 3 pairs of salivary glands – start digestion in the mouth
• Pancreas – secretes enzymes into the small intestine
• Liver & biliary tract – produce and transport bile
BASIC STRUCTURE OF THE GI
TRACT:
• The walls of the alimentary tract are formed by four layers of tissue(Esphagus onwards)
1. • adventitia or outer covering
2. • muscle layer
3. • submucosal layer
4. • mucosa — lining.

• Adventitia (outer covering)

• In the thorax loose fibrous tissue
• abdomen: the organs are covered by a serous membrane called peritoneum
Regarded as a balloon against
which organs are pressed from
outside.
• The parietal peritoneum lines
the walls of the abdominal and
pelvic cavities.
• the visceral peritoneum covers
the organs.
• The potential space between
peritoneal cavity.
 HOW STRUCTURES ARE COVERED IN
PERITONEUM:
•Pelvic organs
→ Covered only on their superior surface
•Stomach & intestines
→ Deeply invaginated from behind
→ Almost completely surrounded by peritoneum
→ Attached to posterior abdominal wall by mesentery
→ Greater omentum: Fat-storing apron-like fold from stomach
•Retroperitoneal organs
→ Pancreas, kidneys, spleen, adrenal glands
→ Covered only on anterior surface
•Liver
→ Invaginated from above
→ Almost fully covered by peritoneum
→ Connected to diaphragm by peritoneal folds
Muscular Layer of GI Tract
(Muscularis Externa)
• Typically composed of two smooth muscle
layers:
1. Inner circular layer
2. Outer longitudinal layer

• Function:
• peristalsis and mixing movements of the gut
• Between the two muscle layers:
1. Blood vessels
2. Lymph vessels
3. Myenteric (Auerbach’s) plexus

• Myenteric Plexus:
• A network of sympathetic and
parasympathetic nerves
• Regulates motility by controlling smooth
muscle activity
• Also influences local blood flow
 Submucosa – GI Tract

• Made of loose connective

tissue with elastic fibres
• Contains:
1. Blood vessels
2. Lymph vessels
3. Lymphoid tissue
4. Submucosal (Meissner's)
plexus:
→ Sympathetic +
parasympathetic nerves
→ Supplies the mucosal lining
• Supplied by both divisions of the autonomic
nervous system:
• Parasympathetic
• Sympathetic
• Their effects are usually antagonistic
Parasympathetic Supply
• Mainly via the vagus nerves (cranial nerves X)
• Distal part of the tract supplied by sacral
nerves
• Functions:
• Stimulates smooth muscle contraction
• Increases secretion of digestive juices
Sympathetic Supply
• Originates from the thoracic and lumbar
spinal cord
• Functions:
• Inhibits smooth muscle contraction
• Reduces glandular secretion
Intrinsic Plexuses (within the gut wall)
[Link] (Auerbach’s) Plexus
1. Located between circular and longitudinal
muscle layers
2. Controls motility and peristalsis
[Link] (Meissner’s) Plexus
1. Located in the submucosa
2. Regulates mucosal glands and secretions
ARTERIAL SUPPLY
•Thorax:

•Oesophagus → Oesophageal arteries (thoracic aorta)

•Abdomen/Pelvis:

•Coeliac artery → Stomach, liver, spleen, pancreas, gall bladder

Branches: Left gastric, Splenic, Hepatic

•Superior mesenteric artery → Small intestine, caecum, ascending + most of transverse colon

•Inferior mesenteric artery → Distal transverse colon, descending, sigmoid colon, upper rectum

•Middle + inferior rectal arteries → Distal rectum & anus (from internal iliac)
MOUTH:
• Anteriorly —by the lips
• Posteriorly —it is continuous with the oropharynx
• Laterally —by the muscles of the cheeks
• Superiorly —by the bony hard palate and muscular soft palate
• Inferiorly —by the muscular tongue and the soft tissues of the floor of the mouth

•Entire oral cavity is lined by stratified squamous epithelium

•Contains mucus-secreting glands throughout
• Hard Palate
• Soft Palate
• Uvula

•Four mucosal folds arise from the upper

uvula:
•Palatoglossal arches (anterior)
•Palatopharyngeal arches (posterior)
•Palatine tonsils lie between the two
arches on each side
 Oesophagus :
• Length: ~25 cm Diameter: ~2 cm
• Lies anterior to vertebral column,
posterior to trachea & heart
• Extends from pharynx to stomach,
passing diaphragm at T10
Sphincters
• Upper (cricopharyngeal): Prevents
air entry + aspiration
• Lower (cardiac): Physiological
sphincter, prevents acid reflux
• Tone increases with intra-abdominal
pressure
• Aided by diaphragm contraction
• Arterial:
• Thorax → Oesophageal arteries (from aorta)
• Abdomen → Inferior phrenic + left gastric
artery
• Venous:
• Thorax → Azygos & hemiazygos veins
• Abdomen → Left gastric vein → Porto-
systemic anastomosis
STOMACH
 RELATIONS:
• Anteriorly —left lobe of liver and anterior abdominal wall
• Posteriorly —abdominal aorta, pancreas, spleen, left kidney and
adrenal gland
• Superiorly — diaphragm, oesophagus and left lobe of liver
• Inferiorly — transverse colon and small intestine
• To the left — diaphragm and spleen
• To the right—liver and duodenum
Structure of the Stomach
• Continuity:
• Begins at the cardiac sphincter (joins
oesophagus)
• Ends at the pyloric sphincter (joins
duodenum)
• Curvatures:
• Lesser curvature: Short, on posterior
surface
• Greater curvature: Long, curves along
anterior/lateral surface
• Regions:
1. Fundus
2. Body
3. Pyloric antrum → ends at pyloric
sphincter
• Pyloric Sphincter:
• Opens when stomach is empty
• Closes when stomach is full (prevents early
emptying)
Wall of the Stomach (4 Layers)
[Link]
[Link]
[Link] externa
(modified):
1. Outer longitudinal
2. Middle circular
3. Inner oblique (unique to
stomach)
[Link] (outer covering)
Small Intestine – Overview

• Begins at the pyloric sphincter, ends at the

ileocaecal valve
• Lies within the abdominal cavity, surrounded by the
large intestine
• Length: ~5 meters
• Main site for:
• Chemical digestion
• Nutrient absorption
•Duodenum (~25 cm)
Curves around the head of the pancreas

•Jejunum (~2 meters)

•Middle portion, Suspended by the
mesentery

•Ileum (~3 meters)

•Ends at ileocaecal valve
Blood Supply

• Arterial:
• Supplied by superior mesenteric artery
• Venous:
• Drains into superior mesenteric vein → portal vein
LARGE INTESTINE:
• Length: 1.5m
• Cecum Right Iliac Fossa

• Caecum
• Dilated blind pouch,Opens to ileum via
ileocaecal valve,Appendix (~13 cm) – rich in
lymphoid tissue
• Ascending Colon
• Ends at hepatic flexure (right upper
quadrant)
• Transverse Colon
• Crosses abdomen
• Ends at splenic flexure (left upper quadrant)
• Descending Colon
• Runs down the left side of the abdomen
• Continues into sigmoid colon
PARTS OF THE LARGE INTESTINE
• Sigmoid Colon
• S-shaped segment
• Leads into rectum
• Rectum (~13 cm)
• Slightly dilated final section of colon
• Leads into anal canal
• Anal Canal (~3.8 cm)
• Final passage to the exterior
• Controlled by:
• Internal sphincter – smooth muscle
(involuntary)
• External sphincter – skeletal muscle
(voluntary)
Wall Structure & Features

• 4 layers of GI wall present

• Longitudinal muscle → forms taeniae coli (3 bands)
• Ends at recto-sigmoid junction
• Forms Haustrations
• Mucosa:
• Goblet cells → mucus secretion
• Form simple tubular glands
• Disappear beyond rectum-anal junction
• Anal canal lining:
• Stratified squamous epithelium
• Merges with skin externally
• Anal columns (6–10 vertical folds)
• Each contains terminal branches of superior rectal vessels
 Blood Supply
• Arterial:
• Superior mesenteric
artery → Caecum,
ascending, 2/3 transverse
colon
• Inferior mesenteric artery
→ Remaining colon, upper
rectum
• Internal iliac branches →
Lower rectum & anus
• Venous:
• Superior & inferior
mesenteric veins → Portal
vein
• Distal rectum & anus →
Internal iliac veins
ACCESSORY
ORGANS
 Pancreas – Overview
• Color & Weight: Pale grey, ~60 grams
• Length: 12–15 cm
• Location: Epigastric & left
hypochondriac regions
Anatomical Position
• Head: Lies in the curve of the
duodenum
• Body: Lies behind the stomach
• Tail: In front of left kidney, near spleen
• Posterior relations: Abdominal aorta &
inferior vena cava
Exocrine Pancreas
• Composed of lobules with secretory alveoli
• Drained by small ducts → form the pancreatic duct
• Pancreatic duct joins common bile duct → forms hepatopancreatic
ampulla
• Opens into duodenum via sphincter of Oddi
• Secretes pancreatic juice → contains enzymes for:
• Carbohydrates
• Proteins
• Fats
Endocrine Pancreas
• Contains islets of Langerhans
(ductless clusters)
• Hormones secreted directly
into blood
• Examples: Insulin, glucagon,
somatostatin
• Blood supply
• The splenic and mesenteric arteries supply arterial
blood to the pancreas and the venous drainage is by
the veins of the same names
 Liver – Overview
• Largest gland in the body
• Weight: 1–2.3 kg
• Location:
• Right hypochondriac region (mostly)
• Epigastric region
• Extends into left hypochondriac region
• Surfaces:
• Upper/anterior – smooth, curved (fits diaphragm)
• Posterior – irregular, houses key structures
 RELATIONS:
•Superior & Anterior:
Diaphragm, anterior
abdominal wall

•Inferior: Stomach, bile ducts,

duodenum, hepatic flexure,
right kidney, adrenal gland

•Posterior: Oesophagus, IVC,

aorta, gall bladder, vertebral
column

•Lateral: Lower ribs,

diaphragm
Liver Structure & Support
• Enclosed in a thin capsule, partly covered by
peritoneum
• Held by:
• Peritoneal ligaments
• Intra-abdominal pressure
• Lobes:
• Right (large)
• Left (wedge-shaped)
• Caudate and Quadrate (posterior surface)
Portal Fissure (Hilum of Liver)

Structures entering:
• Portal vein – nutrient-rich blood from GI organs
• Hepatic artery – oxygenated blood
• Nerve fibres – sympathetic & parasympathetic
Structures leaving:
• Right & left hepatic ducts – bile drainage
• Lymph vessels – drain to abdominal/thoracic nodes
Liver Microanatomy
• Composed of lobules (hexagonal units)
• Made of hepatocytes in radiating columns
• Sinusoids between columns carry mixed blood from portal
vein & hepatic artery
• Kupffer cells (macrophages) line sinusoids for immune
defense
• Blood drains into central veins → hepatic veins → IVC
Bile Secretion
• Bile canaliculi lie between hepatocyte columns
• Drain into larger bile ducts
• Form right & left hepatic ducts → carry bile out of liver
Bile Ducts – Overview
• Right & left hepatic ducts → join to form common
hepatic duct
• Cystic duct (from gall bladder) joins hepatic duct
→ forms common bile duct (~7.5 cm long, ~6 mm
wide)
• Common bile duct joins main pancreatic duct
→ together form hepatopancreatic ampulla
→ opens into duodenum via sphincter of Oddi
Gall Bladder – Overview
• Shape: Pear-shaped sac
• Location: Attached to posterior surface of right liver
lobe
• Parts:
• Fundus (expanded end)
• Body
• Neck → joins cystic duct
Gall Bladder Structure
• Layers: Same as GI tract, with modifications
• Peritoneum: Covers only the inferior surface
• Muscle layer: Includes oblique fibres
• Mucosa: Has rugae when empty (flatten when full)
Blood & Nerve Supply
• Arterial: Cystic artery (branch of hepatic artery)
• Venous: Cystic vein → drains into portal vein
• Nerve supply:
• Sympathetic + parasympathetic fibres