Physiology of Gastrointestinal Tract

2nd year

Dr. Osama A. Shaikh Omar

www.uqu.sa/oashaikhomar

Lectures 1 & 2

References:
Human Physiology - Rhoades & Pflanzer Textbook of Medical Physiology - Guyton & Hall Physiology, a regulatory systems approach - Strand

Anatomic considerations

GIT is also referred to as an Alimentary Canal, the GIT is just like a tube extending from the mouth down to the anal opening. It can be divided in two parts: 1- Component parts of segments of the GIT.
2-The accessory organs located inside the GIT.

Anatomic Considerations
1- The component parts of segments of the GIT:
Mouth, oropharynx, oesophagus, stomach, small intestine (duodenum, jejunum & ileum) large intestine ( cecum, ascending, transverse, descending & sigmoid colon) rectum & anal canal.

2- The accessory located inside the GIT:

organs

Teeth, Tongue, Salivary glands (Parotid, sublingual & submandibular). Pancreas, liver & gall bladder & the appendix.

Basic Structure of the GIT

GI tract is about 30 feet long from mouth to anus. The Histological organization of the 4 major digestive layers: Mucosa Submucosa Muscularis (2 layers) - Inner Circular - Outer Longitudinal Serosa (fibrous).

Histology of the GIT Wall

Mucosa
The mucosa is the inner most layer of the gastrointestinal tract that is surrounding the lumen. This layer comes in direct contact with the food and is responsible for absorption and secretion.

Submucosa
The submucosa consists of a dense irregular layer of connective tissue with large blood vessels, lymphatics and nerves branching into the mucosa and muscularis.

Muscularis (2 layers)
- Inner Circular - Outer Longitudinal
The circular muscle layer prevents the food from going backwards and the longitudinal layer shortens the tract (peristalsis). Between the two muscle layers are the myenteric plexus.

Serosa or adventitia
consists of several layers of connective tissue .

Functions of the GIT

1-Port of entrance = Ingestion of food (nutrients, i.e. protein, carbohydrate & fat. water, vitamins, & minerals). It is an active process that includes decision making, mastication & swallowing. 2- Digestion of food, which starts in the mouth & continues in the stomach & in the small intestine. This is aided by enzymes in the saliva, stomach, small intestine but mainly the pancreatic enzymes are involved in digestion. Digestion of fat also requires bile from the liver.

Functions of the GIT

3- Absorption of digested food products of food in form of monosaccharide , amino acids , fatty acids ,etc.
Absorption is partial in the stomach but mainly in the

small intestine. 4- Formation of feces and excreted via the rectum. 5- Formation of RBCs through secretion of intrinsic factor hydrochloric acid - in the gastric juice some vitamins by the colonic bacterial flora.

Functions of the GIT

6- Endocrine functions e.g. secretion of GIT hormones . 7- Regulation of: water balance. blood glucose level. blood reactions.

Functions of the GIT

To achieve these different functions the following mechanisms are involved:
section of digestive juices such as saliva, gastric HCl , enzymes & bile. GIT motility for mixing with digestive juices & passage through the GIT. Secretion of GIT hormones.

Control of the GIT functions

Control of the GIT functions: GIT secretion & motility are both generally control by: 1. Neural control. 2. hormonal control.

Control of the GIT functions

1) Neural control This is mainly by the autonomic nervous system (ANS). In addition to the sympathetic (noradrenergic) & parasympathetic divisions ( Cholinergic), in the gut the enteric nervous system (ENS) is considered to be the third division of the ANS.
The sympathetic stimulation inhibits motility , constricts sphincters & causes vasoconstriction (secretion is not necessarily inhibited) The parasympathetic stimulation increases motility , relaxes the sphincters & vasodilatation & stimulates secretions.

Control of the GIT functions

The enteric nervous system: Consists of two nerve plexuses:
Myenteric plexus which is mainly concerned with regulation of motility e.g. peristalsis.
lies between Longitudinal & circular muscles layers.

Meissners or submucous plexus which is mainly concerned with regulation of sensory functions e.g. increased blood flow, exocrine & endocrine secretions in response to stimulation of mechano & chemo-receptors of the gut.
lies in the Submucosa.

Control of the GIT functions

2) Hormonal control is mainly via GIT hormones such as secretin, Cholecystokinin (CCK), somatostatin, Gastrin, Gastric Inhibitory Peptide (GIP), Vasoactive Intestinal Peptide (VIP), . .etc. These GIT hormones may acting in one of the following fashions:
The GIT hormones are divided into two families according to structural & functional similarities: Gastrin Family including Gastrin & CCK. Secretin Family including secretin, glucagons, VIP & GIP.

Control of the GIT functions

3) Motility - the progression of food, fluids and waste

through the digestive tract.

4) The digestive Juices

These are of five types : Saliva, Gastric Juice, Pancreatic Juice, Bile , & Intestinal Juice (Succus Intericus).

Functions of Saliva
- Initiates digestion of carbohydrates. - Lubricates food to facilitates swallowing. - Neutralizes any gastric acid that refluxes from stomach. - Keeps mouth moist . - Keeps mouth & teeth clean. - Antibacterial action (Enzyme role).

Salivary glands
Salivary Glands are the main source of the secretion in the mouth. Saliva is form from: 1) Parotid glands - secrete serous saliva (watery fluid) such as Digestive enzymeAmylase (breaking down starch and glycogen (polysaccharides) to disaccharides). 2) Submandibular glands - secrete mucous saliva. 3) Sublingual glands secrete mixed type of saliva. 4) Minor Salivary Glands - They are 1-2mm in diameter and unlike the other glands. Their secretion is mainly mucous. 5) Von Ebner's Glands - found in on the tongue and they secrete a serous fluid that begin lipid hydrolysis. They are an essential component of taste.

The Tongue

Tongue: the tongue is covered with papillae (small projections ). - Many of the papillae have Mechanical processing that help the tongue grip food.

- Many of the papillae have sensory analysis by touch, temperature, and taste receptors (Large taste buds & Small taste buds).

The Mouth
Salivary glands Teeth Tongue
Teeth:
according to the location and function, they are divided into: Incisors Canine Premolars Molars.

Digestion in Mouth Chewing and swallowing

1. Voluntary stage 2. Pharyngeal stage 3. Esophageal stage Voluntary stage
The presence of food in the mouth initiates reflex inhibition lead to drop the lower jaw which stimulates muscle to contract. Mastication (Chewing) - form ball of food called bolus. Pushing the bolus to the pharynx (swallowing) - It is controlled by the swallowing centers located in the medulla oblongata.

Digestion in Mouth
Pharyngeal stage:
The epiglottis lowers to cover the airway so that the bolus does not enter the larynx. The bolus is passed into the pharynx. Contract pharyngeal muscles swallowing.

Esophageal stage:
Open the upper esophagus sphincter (ES). Start peristalsis close the upper (ES) and open the lower (ES).

The Esophagus
Structure of the Esophagus:
The

esophagus is a flexible tube which leads from the pharynx in the upper throat to the stomach.

It is about 10 inches long.

Its walls are made of muscle fibers which contract in waves (called peristalsis) to push the bolus down to the stomach. Innervation is by the Vagus nerve. It has two sphincters: - upper esophageal sphincters. - lower esophageal sphincters.

The Esophagus
Functions of the esophagus:
1- Conduit to move food from the pharynx to the stomach. 2- Prevention of air from entering the stomach via the upper esophageal sphincter. 3- Prevention of reflux of gastric contents to the esophagus via the lower the esophageal sphincter stomach movement.

The Esophagus
Esophageal Secretion: Mucous cells secrete entirely mucoid secretion to: - Lubricate esophageal walls peristalsis. - Protect esophageal walls from digestion by gastric juice reflux.