DIGESTIVE SYSTEM

A. OVERVIEW
1. BASIC FUNCTION
a. Breakdown of food molecules i. Proteins amino acids ii. Carbohydrates monosaccharides iii. Lipids glycerol + fatty acids iv. Nucleic acids nucleotides b. Absorb amino acids, monosaccharides, nucleotides, glycerol + fatty acids

2. BASIC ANATOMY
a. Gastrointestinal tract (GI) tube b. Accessory organs- attach to GI tract

B. FOUR LAYERS OF GI TRACT

1. INNER MUCOSA
a. Surround lumen (space) b. Lined w/epithelial tissue i. Mouth, pharynx, upper esophagus = stratified squamous epithelia ii. Stomach, small + large intestines = simple squamous epithelia c. Contain MALTs d. Secrete mucus e. Secrete enzymes (stomach, small intestines) f. Absorption of food molecules (small intestines)

2. SUB MUCOSA
a. Made up of areolar tissue b. Contain large blood vessels- carry away the absorbed material c. Contain submucosal plexus- part of enteric nervous system

3. MUSCULARIS
a. Mouth, pharynx, upper esophagus = skeletal muscle b. Stomach, small+large intestines = smooth muscle (ANS) c. Inner layer circular layer d. Outer layer - longitudinal

4. OUTER SEROSA
a. Coordinated constriction of 2 smooth muscle layers = PERISTALSIS b. myenteric plexus part of enteric nervous system

C. MOUTH oral/buccal cavity

1. FAUCES- OPENING INTO PHARYNX FROM ORAL CAVITY 2. ROOF
a. Anterior hard palate (maxilla, palatine bone) b. Posterior soft palate (GI tract begins)

3. UVULA ATTACHED TO SOFT PALATE- CLOSE OFF NASOPHARYNX

4. CONTAIN TEETH (32) 5. SALIVARY GLANDS

a. Parotid gland- largest / in cheek /duct of gland empty in upper jaw b. Submandibular- under tongue/ posterior /most inferior c. Sublingual under tongue/ above submandibular /anterior d. Saliva i. 99% water ii. Mucus iii. Amylase enzyme that breaks down starch iv. Lingual lipase enzyme that digests lipids

6. CHEWING FOOD- mastication

a. Mechanically breakdown food b. Mix food w/saliva form bolus c. Begin chemical digestion of carbohydrates, lipids

D. SWALLOWING- deglutition
1. VOLUNTARY STAGE TONGUE PUSH BOLUS BACK INTO OROPHARYNX 2. PHARYNGEAL STAGE- BOLUS MOVES INTO ESOPHAGUS (reflex) 3. ESOPHAGEAL STAGES WAVES OF PERISTALSIS MOVE THE BOLUS DOWN THE ESOPHAGUS

E. ESOPHAGUS
1. TUBE THAT IS ABOUT 10 INCHES LONG 2. RUNS POSTERIOR TO TRACHEA 3. PASS THROUGH DIAPHRAGM VIA THE ESOPHAGEAL HIATUS 4. TWO VALVES
a. Upper valve- upper esophageal sphincter = between pharynx + esophagus b. Lower esophageal sphincter (cardiac valve) stomach= esophagus

F. STOMACH
1. BASIC ANATOMY
a. Cardiac valve b. CARDIAC- region just below cardiac valve c. FUNDUS superior round portion / expands to store food d. BODY- midsection e. PYLORUS inferior portion (digestive area) f. Pyloric sphincter/valve between stomach + small int. g. Inner wall w/folds = RUGAE h. 3 layers of smooth muscle i. Outer longitudinal ii. Middle circular layer iii. Inner oblique

2. HISTOLOGY
a. Mucosal lining w/multiple gastric pits b. Bottom of gastric pit- gastric glands c. Gastric glands are composed of different cell types i. Mucus cells- secrete mucus ii. Parietal cells- secrete
Hydrochloric acid (Hcl) Intrinsic factor (help absorb vit. B12)

iii. Chief cells- secrete

Pepsinogen Gastric lipase (digest lipids)

iv. G cells secrete gastrin (hormone)

3. SECRETIONS = GASTRIC JUICE (2-3 liters/day) 4. DIGESTION IN STOMACH

a. Gastric lipase will digest lipids (triglycerides) b. Pepsinogen will digest proteins multiple polypeptide chains

c. Peristalsis will mix the gastric juice w/bolus = form CHYME

5. REGULATION OF GASTRIC SECRETION + MOTILITY (3 phases)

CEPHALIC PHASE
SENSORY STIMULI DETECTED BY EYES + NOSE

BRAIN
ACTION POTENTIALS DOWN VAGUS NERVE TO STOMACH
Parasympathetic Stimuli

STIMULATE SUBMUCOSAL PLEXUS

STIMULATE SMOOTH MUSCLE CONTRACTION STIMULATE GASTRIC JUICE TO INCREASE SECRETIONS

GASTRIC PHASE
CHEMORECEPTORS + STRETCH RECEPTORS
Located In Mucosa

STIMULATED WHEN BOLUS ENTERS STOMACH

Stretching, UPh RECEPTORS SEND ACTION POTENTIALS TO SUBMUCOSAL PLEXUS
INCREASED MOTILITY

INCREASE GASTRIC GLAND SECRETION

INCREASE GASTRIN LEVELS

INCREASE CONTRACTION OF CARDIAC + RELAX PYLORIC VALVE

INCREASE CONTRACTIONS IN MUSCULARIS LAYER

CHYME ENTERS SMALL INTESTINES DECREASE STRETCH IN STOMACH STOMACH RELAXES

INTESTINAL PHASE
CHYME
Filled w/fatty acids + glucose

STIMULATE CHEMORECEPTORS
Line Intestinal Mucosa

RELEASE 2 HORMONES SECRETIN CCK

Decrease gastric gland secretion Decrease stomach motility

G. PANCREAS
1. ANATOMY
a. Behind stomach, in upper L abdomen b. Consists of head- body- tail (medial to lateral) c. Exocrine gland w/ducts i. Pancreatic duct (runs length of pancreas) splits into: ii. Accesory duct- delivers secretions directly into sm. Int. iii. Hepatopancreatic ampulla will join 1st with duct from liver+ then empties into sm. Int.

2. HISTOLOGY
EXOCRINE

a. 99% of cells (ACINAR) form multiple small clusters = ACINI (connect to small ducts) 1% of cells form pancreatic islets (islets of Langerhans)

ENDOCRINE b.

3. ACINI SECRETIONS = PANCREATIC JUICE

a. 1200-1500 ml/day b. Contain water, sodium bicarbonate (help neutralize stomach acid) c. Various enzymes i. Pancreatic amylase- digest starch ii. Pancreatic lipase- digest lipids iii. Nucleases- digest nucleic acids iv. Proteases- digest proteins
Trypsin Chymotrypsin Elastase

v. Peptidases digest small polypeptide chains d. Proteases secreted in inactive form= ZYMOGEN

H. LIVER / GALLBLADDER
1. ANATOMY
a. Heaviest organ, 2nd largest b. Broken into 2 lobes, large right lobe + small left lobe by falciform ligament c. Located in R upper quad. Under diaphragm d. Connected to gall bladder = pear shaped sac under right lobe of liver e. DUCTS

LIVER PORTAL SYSTEM

R + L HEPATIC DUCTS COMMON HEPATIC DUCT CYSTIC DUCT COMMON BILE DUCT PANCREATIC DUCT HEPATO-PANCREATIC AMPULLA
2. HISTOLOGY a. Broken down into multiple lobules b. Lobule: i. Built around central vein ii. Multiple hepatocytes that radiate out from central vein iii. Spaces between hepatocytes= SINUSOIDS (filled w/blood) iv. Sinusoids connect to portal veins outside c. Flow of blood

FLOW OF PORTAL BLOOD

DIGESTIVE ORGAN HEPATIC PORTAL VEIN LIVER VENULES SINUSOIDS CENTRAL VEINS HEPATIC VEIN INFERIOR VENA CAVA
d. Kupffer cells among hepatocytes = phagocytic cells (filter the blood as it passes through sinusoids) e. Some hepatocytes form bile secrete into bile canaliculi (small bile ducts) outside of lobule f. Bile sent to gall bladder i. Stored ii. Concentrated

3. BILE
a. Make 800- 1000ml/day b. Composition i. Water ii. Salts iii. Cholesterol iv. Bile pigments v. Lecithin c. Function- emulsify lipids (breaks up lipids into globules) d. Bile is reabsorbed in the small int. return to liver via the portal vein

4. FUNCTIONS
Chemical factory

a. Carbohydrate metabolism b. Lipid metabolism c. Protein metabolism d. Detoxification e. SYNTHESIZE BILE main digestive function f. Filter blood g. Make blood proteins

I. SMALL INTESTINES
1. LENGTH
a. 21 feet - dead b. 10 feet - alive

2. 3 SECTIONS
a. DUODENUM- 1st foot b. JEJUNUM next 3 ft. c. ILEUM- last 6ft

3. HISTOLOGY
a. Mucosa form fingerlike projections= VILLI b. VILLUSi. Lamina propria core (conn. tissue) ii. Lacteal carry lipids iii. Arteriole, capill. , venule carry amino acids , monosaccharides c. Epithelia i. Simple columnar cells w/ micro villi form brush border absorptive cell ii. Goblet cells- secrete mucus iii. Paneth cells - phagocytosis iv. Enteroendrocrine cell produce CCK, secretin d. Base of villi = Brunners glands secrete alkaline mucus

4. MECHANICAL DIGESTION
a. Segmentations localized mixing contraction (growling noise) b. Migrating motility complex waves of peristalsis that will empty the small int.

5. INTESTINAL JUICE ENZYMES

a. Digest sugars i. Sucrose broken down by SUCRASE ii. Lactose broken down by LACTASE iii. Maltose broken down by MALTASE b. Digest peptide i. Amino peptidase ii. Dipeptidase

6. ABSORPTION (mostly in ileum)

a. Monosaccharides- absorbed by facilitated diffusion or active transport 100% efficient b. Amino acids- absorbed by active transport 95-98% efficient c. Lipids- enter cell by simple diffusion, packaged into chylomicrons, then dumped into lacteals d. Absorb H2O
Everyday ~ 9.3 liters (7 liters digestive juice) of water enter small int. + 8.3 reabsorbed by osmosis

J. LARGE INTESTINES
1. ANATOMY
a. 5 feet long b. Connect to ileum via the ileoceccal valve c. Begin as pouch = CECUM (lower rt. Quad.) i. Attached to appendix (MALT) d. Cecum empties into colon e.

LARGE INTESTINE
ASCENDING COLON TRANSVERSE COLON DESCENDING COLON SIGMOID COLON RECTUM ANUS
2. HISTOLOGY
a. No villi b. Epithelial folds form intestinal glands i. Absorptive cells- absorb H2O ii. Goblet cells produce mucus

3. FUNCTIONS
a. Reabsorbed H2O 80% 800ml b. Contain bacteria produce vit. K, B vitamins