Chapter 13-Digestive system; Nutrition (PDF).pptx

1
ANATOMY AND
PHYSIOLOGY
CHAPTER 13: DIGESTIVE SYSTEM/NUTRITION
BIO 343
2 OUTLINE
1) GENERAL ANATOMY AND FUNCTION
• Digestive function; relationship with the peritoneum; anatomy of the gastrointestinal tract
2) THE LIVER, GALLBALDDER, AND PANCREAS
• Liver; Gallbladder and bile; Pancreas
3) THE SMALL INTESTINE
• Gross anatomy; Circulation; Microscopic Anatomy; Intestinal Motility
4) CHEMICAL DIGESTION AND ABSORPTION
• Carbohydrates; Proteins; Lipids; Nucleic acids; Vitamins; Minerals; Water
5) THE LARGE INTESTINE
• Gross anatomy; Circulation; Microscopic Anatomy; Intestinal Microbes and Gas; Absorption and
Motility; Some Digestive System Diseases
DIGESTIVE FUNCTION
 The digestive system is a collection of organs that process food, extract nutrients
from it, and eliminate the residue
 The digestion stage has two facets: mechanical and chemical
• Mechanical digestion is the physical breakdown of food into smaller particles. It
is achieved by the cutting and grinding action of the teeth and the churning
contractions of the stomach. It exposes more food surface to the action of
digestive enzymes.
• Chemical digestion is a series of hydrolysis reactions that break dietary
macromolecules into their monomers. It is carried out by digestive enzymes
produced by the salivary glands, stomach, pancreas, and small intestine.
3
DIGESTIVE FUNCTION
 The digestive system performs its function into 5 stages:
1. Ingestion, the selective intake of food
2. Digestion, the mechanical and chemical breakdown of food into a form usable
by the body
3. Absorption, the uptake of nutrient molecules into the epithelial cells of the
digestive tract and then into the blood or lymph
4. Compaction, absorbing water and consolidating the indigestible residue into
feces
5. Defecation, the elimination of feces
4
GENERAL ANATOMY
 The digestive system has two anatomical subdivisions:
the digestive tract and the accessory organs
 The digestive tract (or alimentary canal)
• Muscular tube extending from mouth to anus that
measures about 5 m long
• It includes the mouth, pharynx, esophagus, stomach,
small intestine, and large intestine
• The stomach and intestines constitute the
gastrointestinal (GI) tract
 The accessory organs
• Include the teeth, tongue, salivary glands, liver,
gallbladder, and pancreas
5
© McGraw-Hill Education
GENERAL ANATOMY
 Most of the digestive tract have a wall composed of the following tissue layers
(from inner to outer surface):
• Mucosa
• Epithelium
• Lamina propria (connective tissue)
• Muscularis mucosae (smooth muscle)
• Submucosa (contains blood and
lymphatic vessels)
• Muscularis externa
• Inner circular layer
• Outer longitudinal layer
• Serosa
• Thin layer of areolar tissue topped
by a simple squamous mesothelium
6
RELATIONSHIP TO PERITONEUM
 The parietal peritoneum is the serous membrane © McGraw-Hill Education
that lines the wall of the abdominal cavity

 The stomach and intestines are loosely suspended
from the abdominal wall by connective tissue sheets
called mesenteries
 Mesenteries have important functions:
• They hold the abdominal viscera in their proper
relationship to each other
• They provide passage for the blood vessels and nerves
that supply the digestive tract
• They contain many lymph nodes and lymphatic vessels
 Mesocolon is the extension of the mesentery that
Greater omentum and small intestine retracted to show the
anchors the colon to the posterior abdominal wall mesocolon and mesentery.
7
RELATIONSHIP TO PERITONEUM
 Lesser omentum—a ventral mesentery that © McGraw-Hill Education
extends from the liver to the right superior
margin (lesser curvature) of the stomach
 Greater omentum—hangs from the left inferior
margin (greater curvature) of the stomach and
loosely covers the small intestine
 When an organ is enclosed by mesentery on all
sides, it is considered to be within the peritoneal
cavity or intraperitoneal (Ex: Stomach, liver, and
other parts of small and large intestine)
 An organ outside the peritoneal cavity is said to
be retroperitoneal (Ex: duodenum, pancreas, The lesser omentum attaches the stomach to the liver,
while the greater omentum covers the small intestine
parts of large intestine)
8
THE MOUTH
 The mouth is also known as the oral (or buccal) cavity
 Its functions include:
• Ingestion (food intake)
• Taste and other sensory responses to food
• Mastication (chewing) and chemical digestion
• Swallowing, speech, and respiration
 The mouth is enclosed by the cheeks, lips, palate and
tongue
• Its anterior opening between the lips is the oral fissure
• Its posterior opening into the throat is the fauces The Oral Cavity
9
MASTICATION
 Mastication (chewing) breaks food into pieces small enough to be swallowed and
exposes more surface to the action of digestive enzymes
• It is the first step in mechanical digestion
 During mastication, the cheek and tongue position the food between the teeth for
grinding, and the muscles of mastication move the jaws to bring the teeth into
intermittent contact
• The food is made softer and warmer, and the enzymes in the saliva begin to break
down carbohydrates in the food
• After chewing, the food (now called a bolus) is swallowed
 Mastication requires little thought because food stimulates oral receptors that
trigger an automatic chewing reflex
10
SALIVA AND THE SALIVARY GLANDS
 Saliva plays several important roles:
• It moistens and cleanses the mouth
• It inhibits bacterial growth
• It dissolves molecules so they can stimulate the taste buds
• It digests a little starch and fat
• It makes swallowing easier by binding the food particles into a soft mass (bolus)
and lubricating it with mucus
 Saliva is a hypotonic solution of 97% to 99.5% water, a pH of 6.8 to 7.0, and

contains mucus, electrolytes, and enzymes
11
THE SALIVARY GLANDS
 There are two kinds of salivary glands, intrinsic and extrinsic
 The intrinsic (minor) salivary glands are an indefinite number of small glands
dispersed amid the other oral tissues
• They secrete saliva at a fairly constant rate but in relatively small
amounts
 The extrinsic (major) salivary glands are three
pairs of larger, more discrete organs located
outside of the oral mucosa
1. The parotid glands just beneath the skin anterior to the
earlobes
2. The submandibular glands located halfway along the
body of the mandible
3. The sublingual glands located in the floor of the mouth
12
THE PHARYNX
 Pharynx—a muscular funnel that connects the oral cavity to
the esophagus and the nasal cavity to the larynx
• It is the point where the digestive and respiratory tracts
intersect
 It has a superficial layer of circular skeletal muscle divided
into superior, middle, and inferior pharyngeal constrictors,
which force food downward during swallowing
• When food is not being swallowed, the inferior constrictor
remains contracted to exclude air from the esophagus
• This constriction is regarded as the upper esophageal sphincter
(it is regarded as a physiological sphincter rather than a constant © 2021 Rapid Vocal Results
anatomical structure since it disappears at the time of death)
13
THE ESOPHAGUS
 The esophagus is a straight muscular tube of 25 to 30 cm long
• It begins at a level inferior to the larynx and posterior to the
trachea
• After passing downward through the mediastinum, it penetrates
the diaphragm at an opening called the esophageal hiatus, and
continues another 3 to 4 cm to meet the stomach
• Its opening into the stomach is called the cardial orifice
• Food pauses briefly at this point before entering the stomach
because of a constriction called the lower esophageal sphincter
(LES)
• The LES prevents stomach contents from regurgitating into the
esophagus, thus protecting the esophageal mucosa from the
erosive effect of stomach acid
• “Heartburn” is the burning sensation produced by acid reflux into © 2009 WebMD, LLC.
the esophagus
14
FUNCTION AND INNERVATION OF THE STOMACH
 The stomach is a muscular sac that functions primarily as a food storage organ,
with an internal volume of about 50 mL when empty, and 1.0 to 1.5 L after a
typical meal
 When extremely full, it may hold up to 4 L and extend nearly as far as the pelvis
 The stomach mechanically breaks up food particles, liquifies the food, and begins
the chemical digestion of proteins and fat
• This produces an acidic, soupy semidigested food called chyme
 The stomach receives parasympathetic nerve fibers from the vagus nerve and
sympathetic fibers from the celiac ganglia (in the upper abdomen)
15
GROSS ANATOMY
 The stomach is located in the upper left abdominal cavity © McGraw-Hill Education
and immediately inferior to the diaphragm

 It is divided into four regions:
• The cardial part (cardia) is a small area within about 3
cm of the cardial orifice
• The fundic region (fundus) is the dome superior to the
esophageal attachment
• The body is the greatest part distal to the cardial
orifice
• The pyloric part is a slightly narrower pouch at the
inferior end
• It has a funnel-like antrum and a narrower pyloric
canal which terminates at the pylorus
• The pylorus is surrounded by a thick ring of
Gross anatomy of the stomach
smooth muscle called the pyloric sphincter that
regulates entry into the duodenum
16
MICROSCOPIC ANATOMY
 The stomach wall has more or less the same tissue layers as in the esophagus; it
has a mucosa and a submucosa
 The mucosa is covered with a simple columnar glandular epithelium
• The apical regions of its cells are filled with mucin
• After it is secreted, mucin swells with water and becomes mucus
 Layers of the mucosa have depressions called gastric pits which are lined with
the same columnar epithelium as in the surface
• Two or three tubular glands open into the bottom of each gastric pit
• In the cardial and pyloric regions, they are called cardial glands and pyloric
glands, respectively
• In the rest of the stomach, they are called gastric glands
17
MICROSCOPIC ANATOMY
 Mucous cells
• Secrete mucus
• Predominate in cardiac and pyloric glands
 Parietal cells
• Are found mostly in the upper half of the gland
• Secrete hydrochloric acid, intrinsic factor, and an
appetite-stimulating hormone called ghrelin
 Chief cells
• Are the most numerous
• Secrete gastric lipase and pepsinogen
Mucosa of stomach wall
18
GASTRIC SECRETION
 The gastric glands produce 2 to 3 L of gastric juice per day, composed mainly of:
• Water
• Hydrochloric acid (contributes to stomach acidity)
• Pepsin (first secreted as pepsinogen, it digests dietary proteins and has an
autocatalytic effect; converts pepsinogen into more pepsin)
• Gastric lipase (digest 10-15% of the dietary fat in the stomach)
• Intrinsic factors (released by parietal cells; essential for the absorption of
vitamin B12 by the small intestine)
• Chemical messengers (hormones and paracrine signals)
19
20 OUTLINE
THE LIVER
 The liver is a reddish brown gland located immediately inferior to the diaphragm
• It is the body’s largest gland, weighing about 1.4 Kg
 One of the major function of the liver is the secretion of bile, which contributes
to digestion
 The liver also processes and stores nutrients
 It serves as a filter and functions in the removal of old red blood cells
 It is also responsible for the synthesis of plasma proteins
21
GROSS ANATOMY
22
GROSS ANATOMY
 The liver has four lobes: the right, left, quadrate, and caudate lobes
• From an anterior view, we see only a large right lobe and a smaller left lobe
• They are separated from each other by a sheet of mesentery called the falciform ligament
• From the inferior view, we also see a squarish quadrate lobe and a tail-like caudate lobe
posterior to that
 Between these lobes there is an irregular opening called the porta hepatis, which
is a point of entry for the hepatic vein and artery, and a point of exit for the bile
passages, all of which travel in the lesser omemtum
 The gallbladder adheres to a depression on the inferior surface of the liver
between the right and quadrate lobes
 The diaphragm is attached to the liver in the bare area at its superior surface
23
MICROSCOPIC ANATOMY
The hepatic lobules and their relationship to the blood vessels

A hepatic sinusoid
24
MICROSCOPIC ANATOMY
 The interior of the liver is filled with innumerable cylinders called hepatic lobules
separated by a sparse connective tissue called stroma
 A lobule consists of a central vein passing down its core, surrounded by radiating
plates of cuboidal cells called hepatocytes
 Each plate of hepatocytes is an epithelium one or two cells thick
 The spaces between the plates are blood-filled channels called hepatic sinusoids
• They are lined by a fenestrated endothelium that separates the hepatocytes from the blood
cells, allowing only blood plasma into the space between the hepatocytes and endothelium
• The sinusoids also contain phagocytic cells called stellate macrophages (or Kupffer cells), which
remove bacteria and debris from the blood
 The liver secretes bile into narrow channels, the bile canaliculi
25
MICROSCOPIC ANATOMY
© McGraw-Hill Education Gallbladder, pancreas, and bile passages 26

MICROSCOPIC ANATOMY
 Bile passes from the bile canaliculi into small bile ductules between the lobules,
and then converge to form the right and left hepatic ducts
 The right and left hepatic ducts then converge on the inferior side of the liver to
form the common hepatic duct, which is joined by the cystic duct to form the bile
duct
 The bile duct descends through the lesser omentum toward the duodenum
 Near the duodenum, the bile duct joins the duct of the pancreas and forms an
expanded chamber called the hepatopancreatic ampulla
 The ampulla terminates at a fold of tissue, the major duodenal papilla, and
contains a muscular hepatopancreatic sphincter, which regulates the passage of
bile and pancreatic juice into the duodenum
27
THE GALLBLADDER AND BILE
 The gallbladder is a pear-shaped sac on
the underside of the liver that serves to
store and concentrate bile
 It is about 10 cm long and internally lined
by a highly folded mucosa with a simple
columnar epithelium
 Its central part is called body

 Its head, also called fundus, usually projects slightly beyond the inferior margin of the liver
 Its neck, also called cervix, leads into the cystic duct, which in turn leads to the bile duct
 The gallbladder doesn’t secrete anything of its own except for a little mucus
• It receives, stores, and concentrates the bile produced by the liver
28
THE GALLBLADDER AND BILE
 Bile has a light yellow-green color when secreted by the liver, but becomes deep,
intense green when concentrated in the gallbladder
 The principal bile pigment, bilirubin, is derived from the decomposition of
hemoglobin
 Bile gets into the gallbladder by first filling the bile duct, then overflowing the
gallbladder
 About 80% of the bile acids are reabsorbed in the ileum (last portion of the small
intestine), and returned to the liver where the hepatocytes absorb and resecrete
them (this route is called the enterohepatic circulation)
 The remaining 20% of the bile is excreted in the feces. This is the body’s only way
of eliminating excess cholesterol
29
THE PANCREAS
 The pancreas is a flattened, spongy, retroperitoneal gland posterior to the greater
curvature of the stomach
 It measures 12-15 cm long and about 2.5 cm thick
 It has a head encircled by the duodenum, a midportion called the body, and a
blunt tail on the left
 The pancreas acts both as an endocrine and exocrine gland
• Its endocrine part is the pancreatic islets, which secrete insulin and glucagon
• 99% of the pancreas is exocrine tissue that secretes pancreatic juice, which is
made up of alkaline mixture of water, enzymes, zymogens (inactive precursor
of an enzyme), sodium bicarbonate, and other electrolytes
30
THE PANCREAS
 The pancreatic zymogens are trypsinogens,

chymotrypsinogen, and procarboxypeptidase
 When trypsinogen is secreted into the
intestinal lumen, it is converted to trypsin by
enteropeptidase
 Trypsin is autocatalytic; it converts trypsinogen
into still more trypsin.
 Trypsin also converts the other two zymogens
into chymotrypsin and carboxypeptidase, in
addition to its primary role of digesting dietary The activation of pancreatic enzymes in the small intestine
protein
31
32 OUTLINE
GROSS ANATOMY OF THE SMALL INTESTINE
 The small intestine is a coiled tube filling most of
the abdominal cavity inferior to the stomach and
liver
 It is divided into three regions: the duodenum,
jejunum, and ileum
 The duodenum constitutes the first 25 cm of the
small intestine
 Along with the pancreas, most of the duodenum is
retroperitoneal
 It receives the stomach contents, pancreatic juice, and bile
 Stomach acid gets neutralized there, fats are physically
broken up by the bile acids, pepsin is inactivated by the
high pH, and pancreatic enzymes take over the job of © McGraw-Hill Education
chemical digestion
33
GROSS ANATOMY OF THE SMALL INTESTINE
 The jejunumꟷthe first 40% of the small intestine beyond the duodenum (about 1
to 1.7 m in a living person)
• It has a thick and muscular wall
• Its rich blood supply gives it a relatively red color
• Most digestion and nutrient absorption occur in this site
 The ileumꟷlast 60% of the postduodenal small intestine (about 1.6 to 2.7 m)
• Compared with the jejunum, its wall is thinner, less muscular, less vascular, and has a paler pink
color
 The end of the small intestine is the ileocecal junction and is surrounded by a
sphincter muscle valve called ileal papilla, which regulates passage of food
residue into the large intestine
34
MICROSCOPIC ANATOMY
 The lumen of the small intestine is lined with simple columnar epithelium
 The muscularis externa is notable for a thick inner circular layer and a thinner
outer longitudinal layer
 The small intestine has a large internal surface area
• This is provided by its relatively great length and by 3 kinds of
internal folds of projections: the circular folds, villi, and microvilli
• This is essential for effective digestion and absorption
 The circular folds (or plicae circulares) are the largest of
these internal folds (up to 1 cm high)
• They slow the progress of the chyme and make it flow on a
spiral path, increasing its contact with the mucosa and
promoting more absorption Circular folds (or plicae circulares)
35
MICROSCOPIC ANATOMY
 Villi are 0.5 to 1.0 mm high finger-like projections

• They are largest in the duodenum and become progressively
smaller in more distal regions of the intestine
• They are covered with columnar enterocytes (absorptive cells)
and mucus-secreting goblet cells
• The core of a villus is filled with areolar tissue of the lamina
propria and contains blood capillaries that absorb most
nutrients, and a lymphatic capillary called lacteal that absorbs
most lipids
Intestinal villi
36
MICROSCOPIC ANATOMY
 Microvilli are much smaller plasma membrane
extensions (about 1 µm high) © McGraw-Hill Education
• They form a brush border on the surface of each

enterocyte
• In addition to increasing surface area, they contain
brush border enzymes in the plasma membrane that
carry out some of the final stage of chemical
digestion
37
INTESTINAL MOTILITY © McGraw-Hill Education
 Segmentation is a movement in which stationary ringlike

constrictions appear at several places along the intestine
and then relax as new constrictions form elsewhere
• Pacemaker cells of the muscularis externa set the rhythm of
segmentation
• The intensity of contraction can be modified by nervous and Segmentation, showing progressive stages
from top to bottom
hormonal influences
 When most nutrients have been absorbed and little remains

but undigested residue, segmentation declines and
peristalsis begins
• The wave travels 10-70 cm and dies out, only to be followed by another
wave that begins a little farther down the tract
• Waves are triggered by motilin, a hormone secreted in the duodenum
• Each wave travels partway down the intestine and milks the contents The migrating motor complex of peristalsis, in which
successive waves of peristalsis overlap each other
toward the colon
38
39 OUTLINE
CARBOHYDRATES
 Most carbohydrates in the diet are consumed as disaccharides or polysaccharides
(Ex: sucrose, lactose, maltose, glycogen, cellulose)
 The most digestible dietary carbohydrate is starch
• Starch is digested first to oligosaccharides, then into the disaccharide maltose,
and finally to glucose, which is absorbed by the small intestine
• This process begins in the mouth, where salivary amylase breaks starch down
into shorter segments
• Salivary amylase functions best at pH 6.8-7.0, typical of the oral cavity, and
stops working in the stomach at a pH any lower than 4.5
• About 50% of the dietary starch is digested before it reaches the small
intestine
40
CARBOHYDRATES
 When reaching the small intestine, pancreatic

amylase converts starch to oligosaccharides
and maltose within 10 min
 Its digestion is completed as the chyme
contacts the brush border of the enterocytes
 Two brush border enzymes, dextrinase and
glucoamylase, hydrolyze oligosaccharides that
are three or more residues long, while
maltase hydrolyzes maltose
 The end product is glucose, which is then
reabsorbed by the epithelial cells Starch Digestion in the Small Intestine
41
PROTEINS
 The amino acids absorbed by the small intestine come from
three sources: (1) dietary proteins, (2) digestive enzymes
digested by each other, and (3) sloughed epithelial cells
digested by these enzymes
 Enzymes that digest proteins are called proteases (peptidases)
• They are absent from the saliva but first encountered in the
stomach
• Pepsin hydrolyzes any peptide bond between tyrosine and
phenylalanine, thereby digesting 10%-15% of the dietary
protein in the stomach
• Pepsin has an optimal pH of 1.5-3.5, so it is inactivated when
it passes into the duodenum and mixes with the alkaline
pancreatic juice (of pH 8)
42
PROTEINS
 In the small intestine, the pancreatic enzymes
trypsin and chymotrypsin take over digestion by
hydrolyzing polypeptides into even shorter
oligopeptides
 Finally, these are taken apart one amino acid at a
time by three more enzymes:
1) Carboxypeptidase, which removes amino acids
from the ꟷCOOH end of the chain
2) Aminopeptidase, which removes them from the
ꟷNH2 end
3) Dipeptidase, which splits dipeptides in the
middle and releases the last two free amino
acids
43
LIPIDS
 Fats are digested by enzymes called lipases
• Lingual lipase, secreted by the intrinsic salivary glands of the
tongue, digests a small amount of fat while food is still in the
mouth
• It is joined by gastric lipase in the stomach
• About 10% to 15% of dietary fat is digested before the chyme
passes on to the duodenum
 Most fat digestion occurs in the small intestine through the
action of pancreatic lipase
 In the small intestine, absorption of lipids depends on minute droplets in the bile called
micelles
• Micelles are made in the liver, and consist of 20 to 40 bile acid molecules
• Micelles in the bile pass to the small intestine and pick up several types of dietary and semidigested
lipids
• Without micelles, the small intestine absorbs only about 40% to 50% of the dietary fat and almost no
cholesterol 44
NUCLEIC ACIDS AND VITAMINS
 The nucleic acids, DNA and RNA, are present in much smaller quantities in the
small intestine
• The nucleases (ribonuclease and deoxyribonuclease) of pancreatic juice hydrolyze them to their
constituent nucleotides
• Nucleosidases and phosphatases of the brush border then decompose their nucleotides into
phosphate ions, nitrogenous bases, and simple sugars
• These products are transported across the intestinal epithelium by membrane carriers and
enter the capillary blood of the villus
 Vitamins
• Fat-soluble vitamins (A, D, E, and K) are absorbed in the small intestine like other lipids
• Water-soluble vitamins are absorbed by diffusion or mediated transport, except for vitamin B12,
which is taken up by receptor-mediated endocytosis
45
WATER AND MINERALS
 Water and minerals are absorbed by diffusion primarily within the small
intestines
 The absorption of Na+, Cl-, and K+ as well as Ca2+ and iron are important to
maintain physiological processes
• Na+ is cotransported with sugars and amino acids, Cl- is actively transported by a pump, K+ is
absorbed by simple diffusion, Ca2+ is absorbed through the transcellular route, while iron is
taken up by active transport as a protein complex
 Water is absorbed by osmosis following the absorption of salts and organic
nutrients
• Diarrhea—occurs when the large intestine absorbs too little water
• Constipation—occurs when fecal movement is slow, too much water gets reabsorbed, and
feces become hardened
46
47 OUTLINE
GROSS ANATOMY OF THE LARGE INTESTINE
 The large intestine measures about 1.5 m long and 6.5 cm in diameter
 It consists of four regions: the cecum, colon, rectum, and anal canal
 The cecum
• It is a blind pouch in the lower right abdominal quadrant
• Attached to its lower end is the appendix, which is populated with lymphocytes
and is a significant source of immune cells
 The colon
• It is divided into the ascending, transverse, descending, and sigmoid regions
• The ascending, transverse, and descending colons form a squarish, three-sided
frame around the small intestine
• The sigmoid colon forms the S-shaped portion of the tract turning downward at
the pelvic cavity
48
GROSS ANATOMY OF THE LARGE INTESTINE
 The rectum
• Is the portion ending at the anal
canal
• It has three infoldings called
transverse rectal folds (rectal valves),
which enable it to retain feces while
passing gas
 The anal canal
• The final 3 cm of the large intestine
• The mucosa forms longitudinal ridges
called anal columns with depressions
between them called anal sinuses
© McGraw-Hill Education 49
MICROSCOPIC ANATOMY
 The mucosa of the large intestine has a simple

squamous columnar epithelium in most regions
 There are no circular folds or villi in the large
intestine, but there are intestinal crypts
(invagination of epithelium)
• They have a great density of goblet cells that
secrete mucus
 The lamina propria and submucosa of the large
intestine have an abundance of lymphatic tissue,
providing protection from the bacteria that densely
populate the large intestine
Microscopic anatomy of the colon
50
INTESTINAL MICROBES AND GAS
 The large intestine harbors about 800 species of bacteria collectively called the
gut microbiome
• They digest cellulose, pectin, and other plant polysaccharides for which we
have no digestive enzymes, and the body absorbs the resulting sugars
• Some bacteria also synthesize vitamin B and vitamin K, which are absorbed by
the colon
 A less desirable product of these bacteria is intestinal gas (flatus)
• The large intestine contains about 7 to 10 L of gas, expelling about 500 mL/day
as flatus and reabsorbing the rest
• Much of this is swallowed air that has worked its way through the digestive
tract, but the gut microbes add to it
51
SOME DIGESTIVE SYSTEM DISEASES
 Ulcers
• Characterized by erosion of the lining of the GI wall due to pepsin and acid
• They are common in the lower part of the stomach and the initial part of the small
intestine
• Can be caused by stress, chronic use of aspirin and other non-steroidal anti-
inflammatory medications, and chronic alcohol use
 Gallstones
• Are hard masses in the gallbladder or bile ducts, usually
composed of cholesterol, calcium carbonate, and bilirubin
• Cholelithiasis, the formation or presence of gallstones, is
most common in obese women over the age of 40
52
SOME DIGESTIVE SYSTEM DISEASES
 Lactose intolerance
• Lactose becomes indigestible after the age of 4 in most individuals due to a decline in
lactase production
• Lactose passes undigested into the large intestine
• This increases osmolarity of intestinal contents, causes water retention in the colon,
and induces gas production by bacterial fermentation of the lactose
 Ulcerative colitis
• Chronic inflammation resulting in ulceration of the large intestine, especially the
sigmoid colon and rectum
• Tends to be hereditary but the exact causes are not well known
• Signs and symptoms may include diarrhea, abdominal pain and cramping, rectal pain
and bleeding
53
The End
54

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1

that lines the wall of the abdominal cavity

 Saliva is a hypotonic solution of 97% to 99.5% water, a pH of 6.8 to 7.0, and

anatomical structure since it disappears at the time of death)

and immediately inferior to the diaphragm

Mucosa of stomach wall

The hepatic lobules and their relationship to the blood vessels

© McGraw-Hill Education Gallbladder, pancreas, and bile passages 26

 Its central part is called body

 The pancreatic zymogens are trypsinogens,

 Villi are 0.5 to 1.0 mm high finger-like projections

• They form a brush border on the surface of each

 Segmentation is a movement in which stationary ringlike

 When most nutrients have been absorbed and little remains

 When reaching the small intestine, pancreatic

 The mucosa of the large intestine has a simple

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