Anatomy of the Digestive system

Intracellular digestion
Part of metabolism: involves oxidation of glucose and fatty acids for energy.
Extracellular digestion
Food is not pure glucose and fatty acids. These must be extracted from food.
Process by which nutrients are gained from food occurs within lumen of alimentary
canal.
Extracellular as it is outside the cell border.
Alimentary includes mouth to anus and is divided off into sphincters (smooth
muscles that can contract to segment into parts of different function.
Human digestion tract
Two functions: Digestion and Absorption
Digestion: breakdown of food into constituent organic molecules (i.e. Starch in to
carbs and monosaccharides or lipids in to FFA and glycerol.
Mechanical digestion: physical breakdown of large food particles into
smaller food particles. (NO breakage of chemical bonds)
Chemical Digestion: enzymatic cleavage of chemical bonds such as
peptide bonds in proteins or glyosidic bonds of starches.
Absorption: transport of products of digestion from digestive tract into
circulatory system to distribute to tissue and cells.
Starts with Oral cavity (mouth) and then proceeds to pharynx (pathway for air and food).
From pharynx food enters esophagus which transports food into the stomach.
Food from stomach enters the small intestine and then to large intestine.
Waste products enters rectum where feces are stored until release.
Salivary glands, pancreas, liver and gallbladder provide enzymes/lubrication needed for
digestion of good.
Enteric system
Neurons that control the function of the gastrointestinal system.
Present in the walls of the digestive tract and trigger peristalsis or rhythmic
contract of gut to move food through.
Functions independently of brain and spinal cord.

Regulated by autonomic nervous system.

Parasympathetic division involved in simulation digestive activities increase
secretions from exocrine glands promoting peristalsis. (Sleepy after meal)
Sympathetic system inhibits these activities. Blood flow is decreased to
digestive tract during intensive activity and gut motility slow down.
Ingestion and digestion
Ingest food to obtain nutrients.
Feeding behaviour controlled by ADH (fluid), Aldosterone (fluid consumption),
glucagon, ghrelin, leptin and cholecystokinin.
Glucagon (pancreas) and Ghrelin (stomach and pancreas) stimulate hunger feelings.
Leptin and cholecystokinin stimulate feelings of fullness.
Digestion occurs in oral cavity, stomach, and the duodenum (first part of small intestine).
Oral Cavity
Mechanical and chemical digestion.
Mechanical through chewing (Mastication). Break down large food particles into
small particles (Mouth, lips and teeth).
Increase surface area to volume ratio of food allowing for greater surface
area for enzymatic digestion.
Controls the size of food particles entering the lumen of alimentary
lumen (too big can be a problem).
Chemical digestion-breakage of chemical bonds in macromolecules. (Minimal)
Relies on enzymes from saliva produced by three pairs of salivary
glands.
Saliva helps moisten and lubricate food making mechanical digestion
easier.
Salivary glands are innervated by parasympathetic nervous system.
Food in oral cavity trigger neural circuit to trigger these glands.
Saliva can be triggered by smell or sight.
Contains salivary amylase (AKA ptyalin) - hydrolyzes starch into
smaller sugars (Maltose and dextrin)
Contains lipase: catalyzes the hydrolysis of lipids.

Tongue forces the food into a bolus which is forced into the back of the pharynx and swallowed.
Pharynx
Cavity that leads from mouth and nasal cavity to esophagus. Connected to larynx as well.
Three parts
Nasopharynx (behind nasal cavity), oropharynx (at back of mouth) and
laryngopharynx (above vocal cords)
Epiglottis (cartilaginous) prevents food from entering the larynx (air passage)

Esophagus
Connects pharynx to the stomach.
Top third of esophagus is skeletal muscle. Bottom third is composed of smooth muscle.
Middle is a mix of both.
Top of esophagus is under somatic (voluntary control). Rest is under autonomic
(involuntary) nervous control.
Rhythmic contraction of smooth muscle moves food towards stomach (Peristalsis)
Certain pathologies such as exposure of chemicals, infectious agents, physical
stimulation in posterior pharynx and cognitive stimulation can lead to reversal of
peristalsis (Emesis-vomiting).
Swallowing is initiated in muscle of oropharynx which makeup upper esophageal
sphincter.
Peristalsis pushes and propels bolus towards stomach.
When it enters stomach, muscular ring lower esophageal sphincter (cardiac sphincter)
relaxes and opens to allow passage of food.
Stomach (2L capacity, upper left abdominal cavity)
Three main sources of energy: Carbs, Fats and Proteins
Chemical digestion of carbs and fats is initiated in mouth by saliva.
No digestion occurs in the esophagus. (exception: Enzymatic activity from the mouth)
Uses HCL to digest food. Has mucosa that is thick enough to prevent auto digestion.
Four main parts: fundus and body (contain gastric glands) as well as antrum and pylorus
(contain Pyloric glands).
Internal curfacture of stomach is lesser curvature and external curvature is greater curvature.

Lining of the stomach has folds called rugae.

Mucosa of stomach has gastric glands and pyloric glands.
Gastric glands respond to signals from vagus nerve of parasympathetic nervous
system that is triggered in response to sight, taste and smell of food.
Has three cell types: mucous cells, chief cells and parietal cells.
Mucous: produce bicarbonate rich mucus that protects muscular wall
from acidic and proteolytic environment of stomach.
*Gastric juice is a combination of secretion from other two cell types in
gastric glands.
Chief cell: secretes pepsinogen, the inactive zymogen form of pepsin the
proteolytic enzyme.
Parietal cells: secrete HCL which releases hydrogen ions in the stomach.
The hydrogen ions cleave pepsinogen to pepsin.
Also secreted intrinsic factor-a glycoprotein involved in
absorption of vitamin B12.
Pepsin digests proteins by cleaving peptide bonds near aromatic amino
acids resulting in short peptide fragments. Most active at low pH.
Stomach acid kills harmful bacteria except helicobacter pylori, which is asymptomatic but can
cause ulcers.
The acid also breaks intramolecular bonds in food as well as denature proteins.
Pyloric glands- have G-cells that secrete gastrin (peptide hormone)
Gastrin-stimulates parietal cells to secrete HCL and signals stomach to contract and
mix.
Digestion of solid food in stomach makes an acidic semifluid mixture: Chyme
Combined mechanical and chemical digestion increases surface area of food particles so
in the small intestine, absorption of nutrients is maximized.
Alcohol is absorbed directly in stomach.
Duodenum
Small intestine has three part: dudeonum, jejunum and ileum.
Duodenum responsible for majority of digestion and has low involvement in
absorption.
Absorption occurs mostly in jejunum and ileum.

Food leaves stomach through pyloric sphincter and enters duodenum.

Presence of chyme in duodenum causes releases of brush-border enzymes like
disaccharides (maltase, isomaltase, lactase and surcrase) and peptidases.
Brush border enzymes present on luminal surface of cells lining duodenum
break down dimers and trimers of biomolecules into absorbable monomers.
Dudodenum secretes enteropeptidase involved in activation of digestion
enzyme released from accessory organs.
Dudodenum also secretes secretin and cholecystokinin (CCK) into the
bloodstream.
Lack of a particular disaccharidase causes inability to breakdown that sugar.
Instead, it is hydrolyzed by bacteria produce methane gas as byproduct.
Undigested bacteria are osmotic pulling in water into the stool causing
diarrhea.
Peptidases-break down proteins/peptides.
Aminopeptidase secreted by glands into the duodenum that removes N-terminal
amino acid from peptide.
Dipeptides-cleaves peptide bonds of dipeptides to release free amino acids.
Dipeptides and tripeptides can be absorbed across intestinal wall unlike
carbs.
Enteropeptidase- enzyme that activates trypsinogen (pancreatic protease) into
trypsin.
Can also activate procarboxypeptidase A and B to their active forms.
Secretin: Peptide hormone that causes pancreatic enzymes to release into duodenum.
Regulates pH of digestive tract by reducing HCL secretion from parietal cells and
increasing bicarbonate secretion from pancreas.
Type of Enterogastrone-slows motility through digestive tract. Increased
time for digestive enzymes to act on chyme.
Cholecystokinin (CCK)
Secreted in response to chyme (amino acids and fat in chyme) appearance in
duodenum.
Stimulates release of bile and pancreatic juice. Also signals satiety in brain.
Bile contains: bile salts, pigments and cholesterol. Bile salts are derives from
cholesterol.

Do not perform chemical digestion. (bile salts arent enzymes)

Bile salts aid in mechanical digestion and facilitate chemical digestion of
lipids.
Have hydrophobic and hydrophilic regions and act as a detergent.
In small intestine, bile salts emulsify (mechanical) fats and
cholesterol into micelles.
Without bile fats separate out of aqueous mixture in dudodenum
and cannot be accessed by pancreatic lipase which is water
soluble. (Keeps fats in aqueous portion*)
Micelles increase surface area of fats allowing for increase rate
of lipase activity.
*Bile gets fats into solution and increases surface area by placing
them in micelles allowing for mechanical digestion. Then lipase
comes in and hydrolyzes the ester bonds in lipids (chemical
digestion)
CCK also promotes pancreatic juice secretion.
Pancreatic juices contains enzymes in a bicarbonate rich alkaline
solution.
Neutralizes acidic chime and provides an environment for
digestive enzymes at pH 8.5.
Pancreatic juice digest all three types of macromolecules.
Accessory Organs of Digestion
Includes: Pancreas, liver and gallbladder.
Pancreas (Endocrine/Exocrine)
Endocrine-releases insulin, glucagon and somatostatin. (Sugar level in blood
regulation)
Hormonal regulations are controlled by islets of Langerhans.
Exocrine- acinar cells that produce pancreatic juice.
Bicarbonate-rich alkaline secretions containing digestive enzymes that work on
all macromolecules.
Pancreatic amylase-breaks down polysaccharides into small disaccharides.
Pancreatic peptidase (trypsinogen, chymotrypsinogen and carboxypeptidase
A/B) are released in zymogen form but once activated aid in protein digestion.

Pancreatic lipase-breaks down fats into FFA and glycerol.

Pancreatic juices are transferred to duodenum through duct system that runs
along middle of pancreas. Acinar cells secrete products into ducts. The ducts
empty into duodenum through major and minor papillae.
Enteropeptidase-produced by duodenum. Activates trypsin and carboxypeptidases.
Liver
Two structures which communicated with the digestive system.
Bile ducts-connected liver with both gallbladder and small intestine.
Bile is produced in liver and travels down bile ducts where it is stored in gallbladder or
secreted into duodenum.
Liver receives blood from the digestive tract through hepatic portal vein.
Nutrient rich blood is processed by liver before draining into inferior vena cava
before returning to the right side of heart.
Blood entering the liver through hepatic portal vein: excess sugar can be used to
create glycogen and fats can be stored as triacylglycerols.
Liver can produce glucose for the body through glycogenolysis and
gluconeogenesis.
Liver can detoxify endogenous compounds and exogenous compounds.
Detoxifies ammonia a waste product of amino acid metabolism to Urea
which is excreted by kidney (endogenous)
Detoxifies and metabolizes alcohol and medications.
Liver can modify drugs. Thus, some drugs are activated by enzymes in liver while
others are inactivated and cannot be consumed orally.
Bile composed of bile salts, pigments and cholesterol. Bile salts are amphipathic
and can emulsify fat.
Pigment in bile is bilirubin, a by-product of hemoglobin breakdown.
Bilirubin travels to liver where it conjugated to a protein and
secreted into bile for excretion.
If liver cannot process or excrete bilirubin-Jaundice results.
Liver damage, XS. RBC destruction, blockage of bile duct.
Liver synthesizes albumin-maintains plasma oncotic pressure and carrier molecule for
drugs. Also synthesizes clotting factors for used in blood coagulation.

Gallbladder (beneath liver)

Stores and concentrates bile.
With CCK release, gallbladder contracts and pushes bile into biliary tree.
Bile duct merges with pancreatic duct before empting into duodenum.
Site of cholesterol or bilirubin stone formation.
Stone travels into bile duct and cause blockage. It may get stuck in duodenum
resulting in blockage of pancreatic duct causing pancreatitis.
Absorption and Defecation:
Absorption in small intestine (jejunum and ileum). Large intestine absorbs water.
Duodenum-digestion whereas the jejunum and ileum are used for absorption of nutrients.
Small intestine is lined with villi in the epithelial lining.
Each villus has microvilli increasing surface area for absorption.
Middle of each villus has a capillary bed for absorption of water soluble nutrients and a
lacteal (lymphatic channel) that takes up fats for transports into lymphatic system.
Simple sugars(glucose, fructose, galactose) and amino acids are absorbed by active transport
and facilitated diffusion into epithelial cells lining small intestine.
Nutrients move across epithelial cell into intestinal capillaries.
Blood passing through the capillaries carry the nutrients away from epithelial cells.
Concentration gradient in which there is a low concentration of nutrients in the blood
causes nutrients to diffuse across the epithelial cells into the intestinal capillaries.
Absorbed molecules go to liver via hepatic portal circulation.
Fatty acids follow same process and diffuse into intestinal capillaries. They do not need a
transporter as they are non-polar and can pass through cell membrane.
Large fats, glycerol and cholesterol move separately into intestinal cells but reform into
triglycerides.
Triglycerides and esterified cholesterol are packages into chylomicrons.
Chylomicrons enter lymphatic circulation through lacteals not bloodstream. The
lacteals converge and enter venous circulation through thoracic duct in base of
neck before empting into left subclavian vein.

Vitamins are absorbed in small intestine.

Fat soluble (ADEK) or Water soluble (B and C)

Fat soluble dissolve into chylomicrons to enter the body.
Inability to digest and absorb fat properly (liver, gallbladder, pancreas or small
intestine pathologies) result in low fat soluble vitamins.
Water soluble absorbed with water, amino acids, and carbs across endothelial
cells of plasma intestine and directly into plasma.
Small intestine also absorbs water. Most of the water in chime is from secretion. A person can
consume 2L but secretions add 7L of fluid.
To maintain fluid balance, water is reabsorbed by osmosis. As solutes absorbed into
bloodstream, water is drawn with it and eventually reaches capillaries.
Water passes tracellularly (across cell membrane) or paracellularly(squeezing
between cells) to get to blood.
Large intestine
Involved in water absorption. Larger diameter but shorter than small intestine.
Three parts: cecum, colon and rectum.
Cecum: pocketing that accepts fluid exiting small intestine through the ileocecal valve.
It is the site where the appendix is attached to.
Appendix is thought to be vestigial. May play a role in warding off bacterial
population or repopulating large intestine with normal bacteria after diarrhea.
Inflammation of appendix (appendicitis).
Colon: divided into ascending, descending and sigmoid.
Absorbs water and salts from undigested material left over from small intestine.
Small intestine absorbs more water than colon.
Has a concentration effect and forms feces.
*too much water absorption=constipation, too little diarrhea.
Rectum: Site for feces (contains indigestible material, water, bacteria (E.coli) and
digestive secretions not reabsorbed (enzymes/bile).
Anus: opening through which wastes are eliminated.
Two sphincters: internal and external anal sphincters.
External: under voluntary control (somatic).
Internal: Involuntary control (autonomic)

Small and large intestine as well as stool have bacteria. Mostly anaerobes.
Cecum has aerobic bacteria.
Symbiotic relationship: bacteria have a steady source of food and by-products are beneficial
to humans (i.e. Vitamin K for clotting factors, and biotin (vitamin B7), a coenzyme for
metabolize enzymes)