16.

1 FUNCTIONS OF THE DIGESTIVE SYSTEM The functions of the digestive system include the
following:
1. Ingestion and mastication. Ingestion is the
consumption of food or liquids through the
mouth. Mastication is chewing.
2. Propulsion and mixing: Propulsion moves food
through the digestive tract, while mixing moves
food back and forth to combine it with
secretions.
3. Digestion and secretion: Digestion breaks down
large molecules into smaller ones through
mechanical and chemical means. Secretion adds
liquids, enzymes, and mucus to the food.
4. Absorption: Absorption moves nutrients (amino
acids, monosaccharides, fatty acids, vitamins,
minerals, and water) from the digestive tract into
the blood or lymph.
5. Elimination: Elimination removes undigested
material and waste from the body as feces.
16.2 ANATOMY AND HISTOLOGY OF THE DIGESTIVE
SYSTEM
The digestive system includes the digestive tract
(gastrointestinal tract) and associated organs.
1. Digestive tract portions:
• Oral cavity (mouth)
• Pharynx (throat)
• Esophagus
• Stomach
• Small and large intestines
• Anus
2. Associated organs:
• Salivary glands (empty into the oral cavity)
• Liver (empties into the small intestine)
• Pancreas (empties into the small intestine)
The digestive tract consists of four major tunics, or layers:
The four tunics are:
1. Mucosa (innermost layer):
• Inner mucous epithelium: Protective layer.
• Lamina propria: Loose connective tissue.
• Muscularis mucosae: Thin smooth muscle
layer.
2. Submucosa:
• Thick loose connective tissue containing
nerves, blood vessels, and small glands.
• Contains a nerve plexus innervated by
autonomic nerves.
3. Muscularis:
• Inner layer: Circular smooth muscle.
• Outer layer: Longitudinal smooth muscle.
• Nerve plexus (part of the enteric nervous
system) lies between muscle layers.
 4. Serosa or Adventitia (outermost layer): Symptoms:
• Serosa: Smooth epithelial layer • Acute abdominal pain and tenderness
(peritoneum) with connective tissue. worsened by movement.
• Adventitia: Connective tissue in regions not Mesenteries:
covered by peritoneum, continuous with Function:
surrounding connective tissue. • Hold abdominal organs in place.
• Provide a route for blood vessels and nerves
to the organs.
Structure:
• Two layers of serous membranes with loose
connective tissue in between.
Types of Mesenteries:
1. Mesentery proper: Associated with the small
intestine.
2. Lesser omentum: Connects the lesser curvature
of the stomach to the liver and diaphragm.
3. Greater omentum:
o Connects the greater curvature of the
stomach to the transverse colon and
posterior body wall.
o A long, double fold of mesentery that
creates the omental bursa (a pocket).
o Contains adipose tissue, giving it the
Peritoneum appearance of a fat-filled apron covering
The peritoneum is a serous membrane. the anterior abdominal viscera.
• Visceral peritoneum (serosa): Covers the organs. Retroperitoneal
• Parietal peritoneum: Lines the wall of the • Organs without mesenteries, located along the
abdominal cavity. abdominal wall.
Examples:
• Duodenum
• Pancreas
• Ascending colon
• Descending colon
• Rectum
• Kidneys
• Adrenal glands
• Urinary bladder

16.3 ORAL CAVITY, PHARYNX, AND ESOPHAGUS

Anatomy of the Oral Cavity
The oral cavity or mouth, is divided into two regions:
(1) the space between the lips or cheeks and the teeth,
and
(2) the oral cavity proper, which lies inside the teeth and
houses the tongue.

Peritonitis:
Definition: Life-threatening inflammation of the
peritoneal membranes.
Causes:
• Chemical irritation (e.g., bile leakage from the
digestive tract).
• Infection (e.g., ruptured appendix).
 Teeth Classification:
1. Permanent teeth (secondary teeth): 32 teeth in
adults.
2. Primary teeth (deciduous, milk, or baby teeth):
20 teeth lost during childhood and replaced by
permanent teeth.

Lips, Cheeks, and Tongue

Lips
• Muscular, primarily formed by the orbicularis
Each tooth has three regions:
oris muscle.
1. Crown: The visible portion of the tooth with one
• Outer surface: Covered by skin with keratinized or more cusps (points).
stratified epithelium. 2. Neck: The small region between the crown and
Cheeks the root.
• Form the lateral walls of the oral cavity. 3. Root: The largest region, anchoring the tooth in
• Contain buccinator muscles, which flatten the bone of the maxillae and mandible.
cheeks against teeth.
• Aid in mastication by moving food, holding it in
place, and assisting with chewing.
• Important in forming words during speech.
Tongue
• Large, muscular organ occupying most of the oral
cavity.
Attachment:
• Posterior: Main attachment in the oral cavity.
• Anterior: Connected to the mouth floor by the
frenulum.
Teeth
• Number: 32 permanent teeth in adults, located
in the mandible and maxillae.
• Quadrants:
o Right upper, left upper, right lower, left
lower.
• In adults, each quadrant contains
1. One central incisor.
2. One lateral incisor.
3. One canine.
4. First and second premolars.
5. First, second, and third molars (wisdom
teeth).
Tooth Structure:
• Dentin: Bulk of the tooth; living, cellular, calcified
tissue.
• Enamel: Hard, acellular substance covering
dentin in the crown, protects against abrasion
and bacterial acids.
• Cementum: Covers dentin in the root and helps
anchor the tooth in the jaw.
• Pulp cavity: Hollow center of the tooth filled with
pulp (blood vessels, nerves, and connective
tissue), surrounded by dentin.
Tooth Support:
• Alveoli: Pockets in the mandible and maxillae
where teeth are held.
• Gingiva (gums): Dense fibrous connective tissue Parotid Glands:
and moist stratified squamous epithelium • Size and Location: Largest salivary glands,
covering the alveolar processes. located just anterior to each ear.
• Periodontal ligaments: Secure teeth in the
• Ducts: Enter the oral cavity adjacent to the
alveoli by embedding into the cementum.
second upper molars.
Dental Issues:
• Mumps: A viral infection causing inflammation of
• Dental caries (tooth decay): the parotid glands, leading to swollen cheeks.
o Caused by acid from bacteria breaking The virus can also affect other structures, such as
down enamel. the testes in adult males, possibly resulting in
o Enamel cannot repair itself, requiring a
sterility.
dental filling to prevent further damage. Submandibular Glands:
• Periodontal disease: • Function: Produce more serous than mucous
o Inflammation and degeneration of
secretions.
periodontal ligaments, gingiva, and
• Location: Felt as a soft lump along the inferior
alveolar bone
border of the mandible.
o Most common cause of tooth loss in
• Ducts: Open into the oral cavity on each side of
adults.
the frenulum of the tongue.
Palate and Tonsils
Sublingual Glands:
• Function: Separates the oral cavity from the
• Size and Function: Smallest of the three paired
nasal cavity, preventing food from entering the
salivary glands, primarily producing mucous
nasal cavity during chewing and swallowing.
secretions.
• Parts:
• Location: Below the mucous membrane in the
1. Hard palate: Anterior part containing bone.
floor of the oral cavity.
2. Soft palate: Posterior part made of skeletal
• Ducts: Each gland has 10–12 small ducts opening
muscle and connective tissue.
onto the floor of the oral cavity.
• Uvula: Posterior extension of the soft palate.
Saliva
Tonsils:
• Saliva is composed of fluid and proteins and has
Location:
three main functions
• Lateral posterior walls of the oral cavity.
1. it helps keep the oral cavity moist, which
• Nasopharynx.
is needed for normal speech and for
• Posterior surface of the tongue.
dissolving food particles so they can be
Salivary Glands tasted,
• Major pairs: 2. it has protective functions, and
1. Parotid glands 3. it begins the process of digestion.
2. Submandibular glands
3. Sublingual glands
• Function: Produce saliva, a mixture of serous
(watery) and mucous fluids.
Salivary Amylase:
• A digestive enzyme in saliva that breaks down
starch by breaking the covalent bonds between
glucose molecules. This produces disaccharides
like maltose and isomaltose.
Saliva has several protective functions:
1. It prevents bacterial infections in the mouth by
washing the oral cavity with a mildly antibacterial
enzyme, called lysozyme
2. Saliva also neutralizes the pH in the mouth,
which reduces the harmful effects of bacterial
acids on tooth enamel.
3. The neutralization effect of saliva prevents the
ulceration and infection of the oral mucosa and
caries (cavities) formation in the teeth.
Swallowing (deglutition)
The three phases of swallowing are:
1. the voluntary phase
2. the pharyngeal phase
3. the esophageal phase

1. Voluntary Phase:
• A bolus (mass of food) is formed in the mouth.
• The tongue pushes the bolus against the hard
palate, moving it toward the posterior mouth
and into the oropharynx.
2. Pharyngeal Phase:
• Controlled by a reflex.
• The bolus stimulates receptors in the
oropharynx, elevating the soft palate to close off
the nasopharynx.
• The pharynx elevates to receive the bolus.
• Pharyngeal constrictor muscles contract,
pushing food through the pharynx.
 • The upper esophageal sphincter relaxes, and
food enters the esophagus.
• The vocal folds close, and the epiglottis tips
posteriorly to cover the larynx, preventing food
from entering.
3. Esophageal Phase:
• Moves food from the pharynx to the stomach.
• Muscular contractions of the esophagus occur in
peristaltic waves.

Peristalsis
Waves of smooth muscle contraction push digesting food Stomach Muscularis Layer:
and waste through the digestive tract. Consists of three layers:
1. Outer longitudinal layer
16.4 STOMACH 2. Middle circular layer
3. Inner oblique layer
Anatomy of the Stomach These layers produce a churning action
The stomach is divided into four regions: important for digestion.
1. Cardiac Part: Where the esophagus opens into
the stomach at the gastro-esophageal opening. Stomach Mucosa and Submucosa:
2. Fundus: Located to the left of the cardiac part, • The rugae (folds) allow stretching when the
superior to the cardiac opening. stomach is empty. The folds disappear as the
3. Body: The largest part of the stomach, which stomach fills.
creates the greater and lesser curvatures • The stomach is lined with simple columnar
4. Pyloric Part: Funnel-shaped and opens into the epithelium.
small intestine. • Gastric pits: Tubelike openings for the gastric
• Surrounded by the pyloric sphincter, which glands.
regulates the movement of gastric contents
into the small intestine. The epithelial cells of the stomach can be divided into
five groups:
1. Surface mucous cells, which are found on the
inner surface of the stomach and lining the
gastric pits. These cells produce mucus that coats
and protects the stomach lining.
2. mucous neck cells, which produce mucus;
3. parietal cells, which produce hydrochloric acid
and intrinsic factor;
4. endocrine cells, which produce regulatory
hormones and paracrine signal molecules; and
5. chief cells, which produce pepsinogen, a
precursor of the protein-digesting enzyme
pepsin
Secretions of the Stomach
• Food is mixed with stomach secretions to
become chyme (semifluid mixture).

Stomach Secretions:
1. Hydrochloric acid:
• Produces a pH of about 2.0.
• Kills microorganisms and activates pepsin.
2. Pepsin:
• Converted from pepsinogen (inactive form).
• Breaks down proteins into smaller peptides.
• Works best at a pH of about 2.0.
3. Mucus:
• Forms a thick layer that lubricates the stomach
wall.
• Protects the wall from the acidic chyme and
pepsin.
• More mucus is secreted when the stomach
mucosa is irritated.
4. Intrinsic factor:
• Binds with vitamin B12 to help with absorption
in the small intestine.
• Vitamin B12 is important for DNA synthesis and
red blood cell production.

Heartburn (Gastritis):
• Heartburn is a painful or burning sensation in the
chest.
• It is usually caused by an increase in gastric acid
secretion and/or acidic chyme backflushing into
the esophagus.
Regulation of Stomach Secretions
• Approximate secretion: 2 L of gastric juice
produced each day.
• Both nervous and hormonal mechanisms
regulate gastric secretions.
Three Phases of Regulation:
1. Cephalic Phase: The “get started” phase, where
stomach secretions increase in anticipation of
food.
2. Gastric Phase: The “go for it” phase, where most
secretion stimulation occurs.
3. Intestinal Phase: The “slow down” phase, where
stomach secretion decreases.
Movement in the Stomach 16.5 SMALL INTESTINE
• Two types of movements aid digestion and help
move chyme through the digestive tract: Anatomy of the Small Intestine
1. Mixing waves • Major function of the small intestine:
2. Peristaltic waves Absorption of nutrients.
• Both types of movement result from smooth • Most absorption occurs in the first and
muscle contractions in the stomach wall. second portions (duodenum and jejunum),
• The contractions occur about every 20 seconds though some absorption occurs in the third
and proceed from the body of the stomach portion (ileum).
toward the pyloric sphincter. • Length of the small intestine: About 6
meters.
Parts of the small intestine:
1. Duodenum: About 25 cm long.
2. Jejunum: About 2.5 m long, making up two-
fifths of the total length.
3. Ileum: About 3.5 m long, making up three-fifths
of the total length.

• Small intestine: Major site for digestion and

absorption of food, with a large surface area for
efficiency.
Three modifications increase surface area:
1. Circular folds: Mucosa and submucosa form
folds perpendicular to the digestive tract.
2. Villi: Tiny, fingerlike projections of the mucosa,
0.5–1.5 mm long, covered by simple columnar
• Peristaltic waves occur when the stomach is epithelium. Each villus has a blood capillary
empty. network and a lymphatic capillary (lacteal) for
• These waves are increased by low blood nutrient transport.
glucose levels and can cause hunger pangs, 3. Microvilli: Cytoplasmic extensions on most cells
which last 2–3 minutes and may become of the villi.
stronger over time. Hunger pangs usually start
12–24 hours after the last meal.
• Hunger pangs are sometimes referred to as the
stomach "growling."
 16.6 LIVER AND PANCREAS

Anatomy of the Liver

• Liver: The largest internal organ, weighing about
The mucosa of the small intestine is simple columnar 1.36 kg (3 pounds).
epithelium with four major cell types: • Location: In the right upper quadrant of the
1. absorptive cells, which have microvilli, produce abdomen, beneath the diaphragm, and in
digestive enzymes, and absorb digested food; contact with right ribs 5–12.
2. goblet cells, which produce a protective mucus; • Lobes:
3. granular cells, which may help protect the 1. Right lobe
intestinal epithelium from bacteria; and 2. Left lobe
4. endocrine cells, which produce regulatory 3. Caudate lobe
hormones. 4. Quadrate lobe
Secretions of the Small Intestine • Lobes' separation: The right and left lobes are
• Secretions in the small intestine: Primarily separated by the falciform ligament.
mucus, ions, and water, which lubricate and • Porta: A visible area where blood vessels, ducts,
protect the intestinal wall, keep chyme in a liquid and nerves enter or exit the liver.
form, and aid digestion.
• Enzymes in epithelial cells:
o Peptidases: Digest proteins by breaking
peptide bonds into amino acids.
o Disaccharidases: Digest disaccharides
(like maltose) into monosaccharides (like
glucose).
Movement in the Small Intestine
• Peristaltic contractions: Move chyme along the
length of the intestine.
• Segmental contractions: Occur over short
distances and mix intestinal contents.
Process of mixing:
1. A secretion or food is introduced into the
digestive tract.
2. Segments of the digestive tract alternate
between contraction and relaxation.
3. Material spreads out in both directions from the
site of introduction.
4. The secretion or food becomes more diffuse over
time.
 Functions of the Liver

The liver receives blood from two sources:

1. Hepatic artery: Delivers oxygenated blood to the
liver.
2. Hepatic portal vein: Carries nutrient-rich blood
from the digestive tract to the liver.
• Blood exits the liver through hepatic veins into
the inferior vena cava.
Liver Structure: • The liver produces and secretes 600–1000 mL of
• Divided into hepatic lobules. bile daily.
• Hepatic lobules are hexagon-shaped regions • Components of Bile:
surrounded by connective tissue septa. Bile salts, Bile pigments, Cholesterol,
• Portal triad: Located at each corner of the lobule, Lipids, Lipid-soluble hormones, Lecithin
containing: (a mixture of phospholipids)
1. Hepatic portal vein • Bile salts emulsify lipids, which is necessary for
2. Hepatic artery subsequent digestion by lipase.
3. Hepatic duct • Bile pigments (e.g., bilirubin) are greenish-
Hepatic Cords: Strings of hepatocytes (functional liver yellow to brown and result from the breakdown
cells) radiating out from the central vein. of hemoglobin by hepatocytes.
Hepatocytes: Take up nutrients from portal blood, store, • Bile pigments give feces their characteristic color.
detoxify, or synthesize compounds before releasing them • Gallstones: Form when excessive cholesterol
into hepatic sinusoids or bile canaliculi. secreted by the liver cannot be dissolved by bile
Hepatic Sinusoids: Blood channels between hepatic salts.
cords lined with endothelial cells and hepatic phagocytic
cells.
Bile Canaliculi: Small clefts between hepatocytes where
bile is produced and flows toward the hepatic triad to exit
via hepatic ducts.
 • Pancreatic islets (islets of Langerhans): Produce
hormones crucial for nutrient regulation.
• Acinar cells: Produce digestive enzymes.
• Acini clusters form lobules, separated by thin
septa.
Functions of the Pancreas
Pancreatic Enzymes: Digest all major food classes:
Proteolytic enzymes (digest proteins):
1. Trypsin
2. Chymotrypsin
3. Carboxypeptidase
• Pancreatic amylase: Continues polysaccharide
digestion.
• Lipase: Digests lipids.

PROCESS Figure 16.19 Control of Bile Secretion and

Release Parasympathetic impulses, cholecystokinin, and
secretin all stimulate bile secretion and gallbladder
contractions.

Anatomy of the Pancreas

• Pancreas Structure:
o Composed of endocrine and exocrine
tissues with multiple functions.
o Located behind the stomach and is
retroperitoneal.
• Position:
o Head: Situated within the curvature of
the duodenum. 16.7 LARGE INTESTINE
o Body and Tail: Extend toward the spleen. Anatomy of the Large Intestine
o • Large Intestine: Extends from the ileocecal
junction to the anus.
• It consists of four parts: (1) cecum, (2) colon, (3)
rectum, and (4) anal canal.
• Material takes 18–24 hours to pass through the
large intestine, compared to 3–5 hours in the
small intestine.
• Movements are slower than in the small
intestine.
Functions:
• Converts chyme into feces.
• Stores feces until elimination by defecation.
• About 1500 mL of chyme enters the cecum daily.
• Over 90% of chyme volume is reabsorbed,
leaving only 80–150 mL of feces for elimination.
Cecum 16.8 DIGESTION, ABSORPTION, AND TRANSPORT
• Proximal end of the large intestine, located at the Types of Digestion:
ileocecal junction. 1. Mechanical Digestion: Breaks large food
• Found in the right lower quadrant of the particles into smaller ones.
abdomen near the iliac fossa. 2. Chemical Digestion:
• Sac extends 6 cm below the ileocecal junction. o Uses enzymes to break covalent
Colon chemical bonds in organic molecules.
• Colon Length: Approximately 1.5–1.8 m. o Breakdown Products:
Parts of the Colon: ▪ Carbohydrates→Monosacchari
1. Ascending Colon: des.
o Extends superiorly from the cecum to ▪ Lipids → Fatty acids and
the right colic flexure (near the liver). monoglycerides.
2. Transverse Colon: ▪ Proteins → Amino acids.
o Extends from the right colic flexure to
the left colic flexure (near the spleen).
3. Descending Colon:
o Extends inferiorly from the left colic
flexure to the pelvis.
4. Sigmoid Colon:
o S-shaped tube extending medially and
inferiorly into the pelvic cavity, ending at
the rectum.

• The mucosal lining of the colon contains

numerous straight, tubular glands called crypts,
which contain many mucus-producing goblet
cells.
Rectum: 1. Glucose is absorbed by cotransport with Na +
• A straight, muscular tube starting at the into intestinal epithelial cells.
termination of the sigmoid colon and ending at 2. Cotransport is driven by a sodium gradient
the anal canal. established by a Na +–K + pump.
Anal Canal: 3. Glucose moves out of the intestinal epithelial
• Last 2–3 cm of the digestive tract. cells by facilitated diffusion.
• Starts at the inferior end of the rectum, ends at 4. Glucose enters the capillaries of the intestinal
the anus (external opening). villi and is carried through the hepatic portal vein
Muscle Layers: to the liver.
• Internal Anal Sphincter: Smooth muscle, located
at the superior end of the anal canal.
• External Anal Sphincter: Skeletal muscle, located
at the inferior end of the anal canal.
Hemorrhoids:
• Enlarged or inflamed rectal veins (hemorrhoidal
veins).
 Proteins
• Chains of amino acids found in plant and animal
foods.
• Pepsin: A stomach enzyme that breaks large
proteins into smaller polypeptides, digesting 10–
20% of ingested protein.
• Small Intestine Enzymes:
o Trypsin, chymotrypsin, and
carboxypeptidase (from the pancreas)
continue protein digestion.
1. Micelle Formation: Bile salts form micelles • Peptidases:
around lipid droplets. The hydrophobic ends face o Enzymes in the small intestine break
the lipids, and the hydrophilic ends face the peptides into tripeptides, dipeptides, or
water. single amino acids.
2. Lipid Absorption: Lipids, fatty acids, and o Peptidases are bound to the microvilli.
monoglycerides diffuse from micelles into
intestinal epithelial cells.
3. Triglyceride Formation: Inside epithelial cells,
fatty acids and monoglycerides form
triglycerides, which are packaged into
chylomicrons.
4. Transport to Bloodstream: Chylomicrons exit
cells via exocytosis, enter lymphatic capillaries
(lacteals), and travel in chyle to the bloodstream.
Liver and Lipid Fate:
• Lipids can be stored.
• Lipids can be converted into other molecules.
• Lipids can be used for energy. 1. Absorption: Tripeptides, dipeptides, and amino
Cholesterol Transport: acids are absorbed by intestinal epithelial cells
• low-density lipoproteins (LDLs) carry cholesterol using various cotransport mechanisms.
to tissues. 2. Na⁺ Gradient: Many amino acids are absorbed by
• high-density lipoproteins (HDLs), transport cotransport with a Na⁺ gradient, similar to
cholesterol to the liver. glucose transport. Inside the cells, tripeptides
and dipeptides are broken down into amino
acids.
3. Amino Acid Movement: Amino acids leave the
intestinal epithelial cells and enter blood
capillaries in the villi.
4. Transport to Liver: Amino acids are carried by
the hepatic portal vein to the liver, where they
may be modified or released into the blood to be
distributed throughout the body.
1. Active Transport: Sodium, potassium, calcium,
magnesium, and phosphate ions are actively
transported from the small intestine.
2. Vitamin D: Required for the transport of calcium
(Ca²⁺).
3. Chloride (Cl⁻) Movement:
o Passively moves through the duodenum
and jejunum with sodium (Na⁺).
o Actively transported from the ileum.