Gastrointestinal System

Objectives

1. Describe the components of the gastrointestinal

tract and discuss their functions.
2. Describe digestive processes along the GI tract
3. Identify the types of gastrointestinal motility and
describe their control
 Organs of the GI System

• Gastrointestinal tract (alimentary

canal) = the tube

-oral cavity, pharynx, esophagus,

stomach, small intestine and large
intestine

• Accessory organs = Secretes

into the tube

- Salivary glands, liver, gallbladder,

pancreas
Functions of GI Components
 Histology of GI Tract
• Serosa (outermost – contacts the peritoneal cavity)
• Muscularis (mostly smooth muscle – some skeletal
for voluntary movement)
– longitudinal and circular
– Controlled by Enteric Nervous System
• submucosa
– Connective tissue layer containing blood vessels, glands,
and the nerves (ENS)
• Mucosa: epithelium, connective tissue, and
smooth muscle
– Mucosal epithelium = innermost layer that’s in contact with
the food & has lymphatic nodules
– Connective tissue (Lamina propria)
– smooth muscle layer: helps with controlling surface area and
changes in volume within the tract
Histology of GI Tract
Serosa
 Reflex arc of the ENS

SENSORY MOTOR MESSAGES

MESSAGES • short reflexes are
1. mechanoreceptors independent of
 CNS
• detect distension – regulate localized
due to the entry of activities affecting
food small segments
2. chemoreceptors of the GI tract
 • e.g. release of
• detect osmolarity, secretions in
changes in pH, response to the
products of arrival of food
digestion
 LONG REFLEX: Autonomic Nervous
System (CNS) REGULATION

• Motor neurons come from the

parasympathetic and sympathetic
nervous systems to act on
– ENS motor neurons
– directly on smooth muscle or
secretory cells
• Parasympathetic = rest & digest
– Promotes digestive & absorptive
activities
• Sympathetic = fight or flight
– Shuts down digestive activities
 Mouth

• Also called the oral

(buccal) cavity
– Walls of mouth lined
with stratified
squamous epithelium
– Its function is both
mechanical and
chemical digestion
 Salivary Glands
• Major salivary glands
include:
– Parotid: anterior to
ear
– Submandibular:
medial to body of
mandible
– Sublingual: anterior
to submandibular
gland under tongue
 Salivation

• Total of 1 to 1.5 L of saliva per day from the

parotid, submandibular and sublingual glands.
• Cells of salivary glands filter water from blood
& add amylase, mucin and lysozyme
• Ducts slightly modify electrolyte
• Sight, smell & thought of food stimulate
salivation
 Key Components of Saliva
• Salivary amylase = begins starch digestion
• Lingual lipase = digests fat after it reaches the
stomach
• Mucus = aids in swallowing
• Lysozyme = enzyme that kills bacteria
• Immunoglobulin A = inhibits bacterial growth
 The Pharynx
• Food passes from mouth
into oropharynx and then
into laryngopharynx
– Stratified squamous
epithelium lining with
mucus-producing glands
– External muscle layers
consists of two skeletal
muscle layers
 The Esophagus
• Flat muscular tube that runs from
laryngopharynx to stomach
– Is collapsed when not involved in food
propulsion
• Joins stomach at cardial orifice
• Gastroesophageal (cardiac) sphincter
surrounds cardial orifice
– Keeps orifice closed when food is not
being swallowed
– Mucus cells on both sides of sphincter
help protect esophagus from acid
reflux
 The Esophagus
• Esophagus has all four
alimentary canal layers
– Esophageal mucosa
contains stratified
squamous epithelium
– Muscularis: skeletal
muscle superiorly;
mixed in middle;
smooth muscle
inferiorly
– Serosa is called
adventitia (not located
in the peritoneum)
 Swallowing
• Coordinated by swallowing center in brain stem
(medulla & pons)
• Occurs in two phases:
– Buccal phase
• tongue collects food & pushes it back into oropharynx
– Pharyngeal-esophageal phase
• pharyngeal muscles push food bolus down the esophagus
• lower esophageal sphincter relaxes to allow passage of food
into the stomach
Swallowing
 Purpose of muscularis = Peristalsis

• Once you swallow food, that food is

continually moving along the GI tract
through involuntary waves of smooth
muscle contractions of the muscularis
layer = peristalsis
• At the muscularis layer, the Circular
muscles block off backward movement
while longitudinal muscles and
coordinated circular contractions propel
food in one direction
 Gross Anatomy of the Stomach
• Major regions of the stomach
– Cardial part (cardia): surrounds
cardial orifice
– Fundus: dome-shaped region
beneath diaphragm
– Body: midportion
– Pyloric part: wider and more
superior portion of pyloric
region, antrum, narrows into
pyloric canal that terminates in
pylorus
• Pylorus is continuous with
duodenum through pyloric
valve (sphincter controlling
stomach emptying)
 Histological Features of the Stomach
• Stomach wall contains regular
four tunics; however,
muscularis and mucosa are
modified
• Muscularis externa has circular
and longitudinal smooth muscle
layers, as well as extra third
layer, the oblique (diagonal)
layer
– For mixing food with stomach
secretions as well as mechanical
breakdown (churning)
• Mucosa layer is also modified
– Consists of simple columnar
epithelium entirely composed of
mucous cells
Microscopic Anatomy of the Stomach
• Types of gland cells
– Glands in fundus and
body produce most
gastric juice
– Glands include
secretory cells
• Mucous cells
(goblet cells)
• Parietal cells
• Chief cells
• Enteroendocrine
cells (G cells)
 Secretions in the Stomach
• Surface epithelia and mucous cells
– HCO3– and mucus
• Parietal cells
– HCl
– Intrinsic factor
• Chief cells
– Pepsinogen
• Enteroendocrine (G) cells
– Gastrin
Gastric Acid Secretion
 Gastric Acid Secretion

• 2 to 3 L of gastric juice/day (H2O, HCl & pepsin)

• Parietal cells contain carbonic anhydrase (CAH)
CAH
– CO + H O  H CO  HCO - + H+
2 2 2 3 3
– H+ is pumped into stomach lumen by H+K+ATPase
• antiporter uses ATP to pump H+ out & K+in
– HCO3- exchanged for Cl- (chloride shift)
• Cl- pumped out to join H+ forming HCl
•  HCO3- in blood causes alkaline tide (blood pH )
Functions of Hydrochloric Acid

• Activates enzymes pepsin & lingual lipase

• Converts ingested ferric ions (Fe+3) to ferrous
ions (Fe+2) that can be absorbed & utilized for
hemoglobin synthesis
• Destroys ingested bacteria & pathogens
Production & Action of Pepsin
Regulation of Gastric Secretion

• Gastric secretions are broken

down into three phases
1. Cephalic (reflex) phase
2. Gastric phase
3. Intestinal phase
Cephalic (reflex) phase

Secretory activity
of stomach
Gastric phase

Secretory activity
of stomach
Intestinal phase
 Digestive Function in Small
Intestines
• Involves:
– Secretion
• Occurs primarily in the
duodenum
– Chemical digestion
• Duodenum
– Nutrient absorption
• Along ileum and jejunum
 Special Histology of the small intestine

• Mucosa has lots of folds to accommodate sudden

increase in volume and to increase surface area for
absorption

• Finger like extensions (villi) to increase the surface area

for absorption

• Microvilli on the surface of villi for additional expansion of

surface area
Special Histology of the small intestine
 Secretions into the Small
Intestines
• Secretions from pancreas
– Water, HCO3–, proteases, lipases, amylases
• Enzymes are delivered in their inactive form (zymogens)
– Exocrine pancreas secretes 1500 mL pancreatic juice
into duodenum
• Secretions from the liver
– Bile (bile acids and pigments)
• Secretions from intestinal epithelia
– Brush border enzymes
 Activation of Zymogens

• Trypsinogen converted to trypsin by intestinal

epithelium
• Trypsin converts other 2 as well as digests dietary
protein
Carbohydrate Digestion in Small
Intestine

• Salivary amylase stops working in acidic stomach (if < 4.5)

– 50% of dietary starch digested before it reaches small intestine
• Pancreatic amylase completes first step in 10 minutes
• Brush border enzymes act upon oligosaccharides, maltose,
sucrose, lactose & fructose
– lactose indigestible after age 4 in most humans (lack of lactase)
 Carbohydrate Absorption

• Sodium-glucose transport proteins (SGLT) in membrane

help absorb glucose & galactose
• Fructose absorbed by facilitated diffusion then converted to
glucose inside the cell
Sodium-Dependent Glucose
Absorption
 Protein Digestion & Absorption

• Pepsin has optimal pH of 1.5 to 3.5 -- inactivated

when passes into duodenum & mixes with
alkaline pancreatic juice (pH 8)
 Protein Digestion & Absorption

• Pancreatic enzymes take over protein digestion

by hydrolyzing polypeptides into shorter
oligopeptides
 Protein Digestion & Absorption

• Brush border enzymes finish the task producing amino acids

that are absorbed into the intestinal epithelial cells
– amino acid cotransporters move into epithelial cells & facilitated
diffusion moves amino acids out into the blood stream
Fat Digestion & Absorption
Fat Digestion & Absorption
Fat Digestion & Absorption
 Which Is the Best Choice to
Reduce Fat Digestion?
• Suppress duodenal hormone secretion
• Suppress the activity of chief cells in the
stomach
• Decrease intrinsic factor secretion
• Block gall bladder contraction
• Inactivate pancreatic lipase
 Bowel Motility
Overall Functions
• Mixes chyme with intestinal juice, bile &
pancreatic juice
• Churns chyme to increase contact with mucosa
for absorption & digestion
• Moves residue towards large intestine
 Types of Intestinal Movements
• Segmentation
– random ringlike constrictions mix & churn contents
– 12 times per minute in duodenum
• Peristalsis
– waves begin in duodenum but each one moves
further down
– push chyme along for 2 hours
– suppressed by refilling of stomach
• Purpose of
segmentation is
to mix & churn -
not to move
material along as
in peristalsis
LARGE INTESTINE (aka colon)
• extends from the ileocecal sphincter to the anus
• Lies inferior to stomach and liver
• Frames the small intestine
• Includes:
– Cecum & appendix
– ascending colon
– transverse colon
– descending colon
– sigmoid colon
– rectum
– anal canal
 Large Intestinal Function
• Compaction and expulsion of feces
– Various movements are involved
• Electrolyte and water reabsorption
– Digestive tract receives about 9 L of water/day
– 0.7 L in food, 1.6 L in drink, 6.7 L in secretions
– 8 L is absorbed by the small intestine
– Only 0.8 L is absorbed by the large intestine
• Bacterial digestion
• Synthesis of vitamin K and some B vitamins by
bacteria
• Some reabsorption of bile salts
 Bowel Motility in Small and Large
Intestines
• Small intestine
– 2-4 hours to traverse
– Segmental contractions to mix
– Peristaltic waves to move forward
• Large intestine
– Slow progression at 5-10 cm per hour
– Segmental contractions produce haustra
– 1-3 mass movements per day
 Defecation
• Stretching of the rectum triggers the intrinsic
defecation reflex, a spinal reflex mediated by
parasympathetic nerves
– muscularis contracts & internal sphincter relaxes
• Voluntary inputs from the cerebral cortex override
the spinal reflex
• defecation occurs only if external anal sphincter is
voluntarily relaxed
• Abdominal contractions (Valsalva maneuver)
increase abdominal pressure
Neural Control of Defecation
1. Filling of the
rectum
2. Reflex contraction
of rectum &
relaxation of
internal anal
sphincter
3. Voluntary
relaxation of
external sphincter