THE DIGESTIVE SYSTEM

The digestive system contributes to

homeostasis by breaking down food into
forms that can be absorbed and used by
body cells. It also absorbs water, vitamins,
and minerals and eliminates wastes from
body.
Foods are broken down into molecules that
are small enough to enter body cells, this is a
process called DIGESTION.

The organs involved in the breakdown of
food are collectively known as THE
DIGESTIVE SYSTEM.

Overall, the digestive system performs six
basic processes:
1. ingestion
2. secretion
3. mixing and propulsion
4. digestion
5. absorption
6. defecation
Layers of the gastro intestinal tract:
1. mucosa
2. submucosa
3. muscularis
4. serosa

NEURAL INNERVATION OF THE GI TRACT
Enteric Nervous System
o It is the the brain of the gut. It consists of about 100 million neurons that
extend from the esophagus to the anus.

Autonomic Nervous System
o The vagus (X) nerves supply parasympathetic fibers to most parts of the GI
tract, with the exception of large intestine which is supplied with
parasympathetic fibers from the sacral spinal cord.

Gastrointestinal Reflex Pathways
o The neurons of the ENS are components of GI reflex pathways that regulate GI
secretion in response to stimuli present in the lumen of the GI tract. The initial
components of a typical GI reflex pathway are sensory receptors that are
associated with the sensory neurons of the ENS.

PERITONEUM
The largest serous membrane of the body. It consists of simple squamous epithelium
(mesothelium) with a supporting layer of areolar connective tissue.

It is divided into the parietal peritoneum lines the wall of the abdominopelvic cavity
and the visceral peritoneum covers some of the organs in the cavity and is their
serosa.

Peritoneal cavity is the slim space containing lubricating serous fluid that is between
the parietal and visceral peritoneum.

MOUTH
Also referred to as the oral or buccal cavity. It is formed by the cheeks, hard and soft
palates and tongue.



















SUMMARY OF DIGESTIVE ACTIVITIES IN THE MOUTH

STRUCTURE ACTIVITY RESULT
Cheek and lips Keep the food
between the
teeth
Foods are uniformly chewed during mastication
Salivary glands Secrete saliva Lining of the mouth and pharynx moistened and
lubricated. Saliva softens, moistens, and dissolves food
and cleanses the mouth and teeth.

TONGUE
STRUCTURE ACTIVITY RESULT
Extrinsic tongue
muscle
move tongue from
side to side, in and
out
Food maneuvered for mastication, shaped into
bolus and maneuvered for swallowing
Intrinsic tongue
muscle
Alter shape of tongue For swallowing and speech
Taste buds Serve as receptor for
gustation
Secretion of saliva stimulated by nerve impulses
from taste buds to salivary nuclei in the brain stem
to salivary glands
Lingual glands Secretes lingual lipase triglycerides broken down into fatty acids and
diglycerides
Teeth cut , tear and
pulverize food
Solid foods reduced to smaller particles for
swallowing.

PHARYNX
It is a funnel-shaped tube that extends from the internal nares to the esophagus
posteriorly and to the larynx anteriorly.

Composed of skeletal muscle and lined by mucous membrane and divided into three
parts:
o nasopharynx for respiration only
o oropharynx
o laryngopharynx

ESOPHAGUS
is a collapsible muscular tube, about 25 cm (10 in.) long, that lies posterior to the
trachea

it pierces the diaphragm through an opening called the esophageal hiatus
both for respiration and digestion

The mucosa of the esophagus consists of nonkeratinized stratified squamous
epithelium, lamina propria (areolar connective tissue), and a muscularis mucosae
(smooth muscle).

The submucosa contains areolar connective tissue, blood vessels, and mucous glands.

The muscularis of the superior third of the esophagus is skeletal muscle, the
intermediate third is skeletal and smooth muscle, and the inferior third is smooth
muscle.

At each end of the esophagus, the muscularis becomes slightly more prominent and
forms two sphinctersthe upper esophageal sphincter (UES) or valve,which
consists of skeletal muscle, and the lower esophageal sphincter (LES) or valve,
which consists of smooth muscle.

The upper esophageal sphincter regulates the movement of food from the pharynx
into the esophagus; the lower esophageal sphincter regulates the movement of food
from the esophagus into the stomach.

The superficial layer of the esophagus is known as the adventitia, rather than the
serosa as in the stomach and intestines, because the areolar connective tissue of this
layer is not covered by mesothelium and because the connective tissue merges with the
connective tissue of surrounding structures of the mediastinum through which it passes.

DEGLUTITION
The movement of food from the mouth into the stomach is achieved by the act
of swallowing or deglutition.

Deglutition is facilitated by the secretion of saliva and mucus and involves the mouth,
pharynx, and esophagus.

Swallowing occurs in three stages: (1) the voluntary stage, in which the bolus is
passed into the oropharynx; (2) the pharyngeal stage, the involuntary passage of the
bolus through the pharynx into the esophagus; and (3) the esophageal stage, the
involuntary passage of the bolus through the esophagus into the stomach




Swallowing starts when the bolus is
forced to the back of the oral cavity and into
the oropharynx by the movement of the
tongue upward and backward against the
palate. This is the voluntary stage.

With the passage of the bolus into
the oropharynx, the involuntary pharyngeal
stage of swallowing begins.

The bolus stimulates receptors in
the oropharynx, which send impulses to the
deglutition centerin the medulla oblongata
and lower pons of the brain stem.

The returning impulses cause the soft palate and uvula to move upward to close off the
nasopharynx, which prevents swallowed foods and liquids from entering the nasal
cavity.

In addition, the epiglottis closes off the opening to the larynx, which prevents the bolus
from entering the rest of the respiratory tract.

The bolus moves through the oropharynx and the laryngopharynx. Once the upper
esophageal sphincter relaxes, the bolus moves into the esophagus.

The esophageal stage of swallowing begins once the bolus enters the esophagus.

During this phase, peristalsis, a progression of coordinated contractions and
relaxations of the circular and longitudinal layers of the muscularis, pushes the bolus
onward . Peristalsis occurs in other tubular structures, including other parts of the GI
tract and the ureters, bile ducts, and uterine tubes; in the esophagus it is controlled by
the medulla oblongata.

STOMACH
The stomach is a J-shaped enlargement of the GI tract directly inferior to the diaphragm
in the abdomen.

The stomach connects the esophagus to the duodenum, the first part of the small
intestine

One of the functions of the stomach is to serve as a mixing chamber and holding
reservoir.

The position and size of the stomach vary continually; the diaphragm pushes it inferiorly
with each inhalation and pulls it superiorly with each exhalation. Empty, it is about the
size of a large sausage, but it is the most distensible part of the GI tract and can
accommodate a large quantity of food.

Digestion of starch and triglycerides continues, digestion of proteins begins, the
semisolid bolus is converted to a liquid, and certain substances are absorbed.

ANATOMYOF THE STOMACH
The stomach has four main regions: the cardia, fundus, body, and pyloric part

The cardia surrounds the superior opening of the stomach.

The rounded portion superior to and to the left of the cardia is the fundus.

Inferior to the fundus is the large central portion of the stomach, the body.

The pyloric part is divisible into three regions.

The first region,
the pyloric antrum, connects to the
body of the stomach.

The second region,
the pyloric canal, leads to the third
region, the pylorus, which in turn
connects to the duodenun.

When the stomach is empty, the
mucosa lies in large folds, or rugae,
that can be seen with the unaided eye.

The pylorus communicates with
the duodenum of the small intestine via
a smooth muscle sphincter called
the pyloric sphincter.

The concave medial border of the stomach is called the lesser curvature; the convex
lateral border is called the greater curvature.

HISTOLOGY OF THE STOMACH
The mucosa contains a lamina
propria (areolar connective tissue) and
muscularis mucosae (smooth muscle).

Epithelial cells extends down into the
lamina propria, where they form columns of
secretory cells called gastric glands.

Several gastric glands open into the
bottom of narrow channels called gastric
pits. Secretions from several gastric glands
flow into each gastric pit and then into the
lumen of the stomach.

The gastric glands contain three
types of exocrine gland cells that secrete
their products into the stomach lumen:
mucous neck cells, chief cells, and parietal
cells.

Both surface mucous cells and mucous neck cells secrete mucus.

Parietal cells produce intrinsic factor (needed for absorption of vitamin B12) and
hydrochloric acid.

The chief cells secrete pepsinogen and gastric lipase.

The secretions of the mucous, parietal, and chief cells form gastric juice, which totals
20003000 mL (roughly 23 qt.) per day.

In addition, gastric glands include a type of enteroendocrine cell, the G cell, which is
located mainly in the pyloric antrum and secretes the hormone gastrin into the
bloodstream.

Three additional layers lie deep to the mucosa.

The submucosa of the stomach is composed of areolar connective tissue.

The muscularis has three layers of smooth muscle (rather than the two found in the
esophagus and small and large intestines): an outer longitudinal layer, a middle circular
layer, and an inner oblique layer. The oblique layer is limited primarily to the body of the
stomach.

The serosa is composed of simple squamous epithelium (mesothelium) and areolar
connective tissue; the portion of the serosa covering the stomach is part of the visceral
peritoneum.

At the lesser curvature of the stomach, the visceral peritoneum extends upward to the
liver as the lesser omentum. At the greater curvature of the stomach, the visceral
peritoneum continues downward as the greater omentum and drapes over the
intestines.
MECHANICAL AND CHEMICAL DIGESTION IN THE STOMACH
The peristaltic movements called mixing waves macerate food and mix it with chyme.

As the food reaches the pylorus, each mixing wave periodically forces about 3 mL of
chyme into duodenum through the pyloric sphincter, a phenomenon known as gastric
emptying.

The forward and backward movements of the gastric contents are responsible for most
mixing in the stomach.
The hydrochloric acid secreted
increases the acidity of the stomach contents
to a pH of 2 or lower. At this pH, pepsinogen
is converted to pepsin - an active enzyme
which begins the chemical digestion of
proteins into peptides.

Salivary amylase functions best at pH
6 or 7. Therefore, it becomes inactive when it
reaches the stomach, and consequently,
digestion of starch does not take place there.

The mucous coats the cells lining the
stomach and protects them from the digestive
action of the enzyme pepsin.

Within 2 to 4 hours after eating a
meal, the stomach has emptied its contents
into the duodenum.

PANCREAS
The pancreas is an
elongated gland that
is below the
stomach. It produces
pancreatic juice that
contains digestive
enzymes. The
pancreas also
secretes insulin into
the blood. Insulin is
needed to allow
glucose or sugar
from food to get into
the bloodstream.
People who cannot
produce insulin are
diabetics.
LIVER
The largest gland in the
body is the liver. It is on the right
side of the body underneath the
ribs. It weighs about three pounds
and is eight inches long. The liver
stores a form of glucose called
glycogen. Vitamin A is
manufactured in the liver. Bile
which is needed to breakdown fat
is made in the liver. This organ is
also where alcohol, drugs, bacteria
and old blood cells are broken
down and removed from the body.
Damage to the liver can be serious
because this organ is extremely
necessary to life.

GALL BLADDER
The gallbladder is a small sac on the underside of the
right lobe of the liver. It stores bile that is made by
the liver. Bile travels from the liver through the
hepatic ducts to the gallbladder. It holds about two
ounces of bile. Bile is needed to breakdown the fat
that is in food.

SMALL INTESTINE
a long tube where most digestion
and absorption of nutrients occur
averages 2.5 cm (1 in.) in diameter
and length is about 3 m (10 ft)

Three Parts:
1. Duodenum
2. Jejunum
3. Ileum



1. DUODENUM
the shortest region
starts at the pyloric
sphincter of the stomach to the
jejunum
In the form of a C-shaped
tube that extends about 25 cm (10
in.)
duodenum means 12
because it is about as long as the
width of 12 fingers

2. JEJUNUM
is about 1 m (3 ft) long
and extends to the ileum
Jejunum means empty,
which is how it is found at death

3. ILEUM
measures about 2 m (6 ft)
joins the large intestine at
a smooth muscle sphincter called the
ileocecal sphincter (valve)


FUNCTIONS OF THE SMALL INTESTINE
1. Segmentations mix chyme with digestive juices and bring food into contact with mucosa
for absorption; peristalsis propels chyme through small intestine.

2. Completes digestion of carbohydrates, proteins, and lipids; begins and completes
digestion of nucleic acids.

3. Absorbs about 90% of nutrients and water that pass through digestive system.

HISTOLOGY
FOUR LAYERS
1. Serosa
visceral peritoneum

2. Muscularis propria
with thin outer longitudinal layer
with thicker inner circular layer
Auerbach (mysenteric) plexus in
between

3. Submucosa
fibroelastic tissue with blood vessels and nerves
STRONGEST component of intestinal wall
contains Meissner plexus

4. Mucosa
a. Muscularis mucosa: thin, separate from submucosa
b. Lamina propria: connective tissue, immune function
c. Epithelial layer: covers vili and crypts
contains:
Goblet cells: secrete mucus
Paneth cells: mucosal defense system; secrete lysosyme, TNF, cryptidins
Enterocytes: absorption; with microvilli, covered by the glycocalyx
Enteroendocrine cells

LARGE INTESTINE
is a hollow tube that makes up the last 6 feet of the digestive tract
large intestine consists of the cecum (a pouch-like structure at beginning of the large
intestine), colon, rectum and anus


FOUR PARTS OF THE COLON
1. ascending colon
begins at the cecum, where
it joins the end of the small
intestine, and travels
upward along the right side
of the body to the
transverse colon

2. transverse colon
connects the ascending
colon to the descending
colon and lies across the
upper abdomen

3. descending colon
connects the transverse
colon and the sigmoid colon
and lies along the left side
of the body

4. sigmoid colon
connects the descending
colon and the rectum
HISTOLOGY
The colon and rectum are made up of a number
of different tissues organized into layers:
1. Mucosa
inner lining (epithelium), lamina
propria (connective tissue) and thin layer of
muscle (muscularis mucosa)

2. Submucosa
Connective tissue, glands, blood
vessels, lymphatic vessels and nerves

3. Muscularis propria (muscular layer)

4. Serosa (serous layer)
outer lining of the colon but not the
rectum


FUNCTIONS OF THE LARGE INTESTINE
1. Haustral churning, peristalsis, and mass peristalsis drive contents of colon into rectum.
2. Bacteria in large intestine convert proteins to amino acids, break down amino acids, and
produce some B vitamins and vitamin K.
3. Absorbing some water, ions, and vitamins.
4. Forming feces.
5. Defecating (emptying rectum).


PHASES OF DIGESTION

1. Cephalic Phase
During the cephalic phase of digestion, the smell, sight, thought, or initial taste of food
activates neural centers in the cerebral cor- tex, hypothalamus, and brain stem. The purpose of
the cephalic phase of digestion is to prepare the mouth and stomach for food that is about to
be eaten.

2. Gastric Phase
During the gastric phase of digestion, the muscles of your stomach wall flex to help mix
together food particles, gastric juice and pepsin before the food moves on to your small
intestine.

3. Intestinal Phase
The intestinal phase of digestion begins once food enters the small intestine. In contrast
to reexes initiated during the cephalic and gastric phases, which stimulate stomach secretory
activity and motility, those occurring during the intestinal phase have in- hibitory effects that
slow the exit of chyme from the stomach. This prevents the duodenum from being overloaded
with more chyme than it can handle. In addition, responses occurring during the in- testinal
phase promote the continued digestion of foods that have reached the small intestine. These
activities of the intestinal phase of digestion are regulated by neural and hormonal mechanisms.

DISORDER: HOMEOSTATIC IMBALANCES
Dental Carries (tooth decay)
Is an infection, bacterial in origin, that causes
demineralization and destruction of the hard tissues
(enamel, dentin and cementum), usually by
production of acid by bacterial fermentation of the
food debris accumulated on the tooth surface. Saliva
cannot reach the tooth surface to buffer the acid
because the plaque covers the teeth. Brushing the
teeth after eating removes the plaque from flat
surfaces before the bacteria can produce acids.
Dentist also recommends that the plaque between
the teeth be removed every 24 hours with dental
floss.

Periodontal Disease
It is an inflammation and degeneration of the gingivae, alveolar
bone, periodontal ligament, and cementum. In one such called
pyorrhea. Initial symptoms include enlargement and inflammation of
the soft tissue and bleeding and alveolar bone may be resorbed,
causing loosening of the teeth and recession of the gums. Periodontal
diseases are often caused by poor oral hygiene, local irritant, impacted
food, and cigarette smoke or by poor bite.
Peptic Ulcer Disease
Ulcers that develop in areas of the GI tract
exposed to acidic gastric juices. The most
common complication of this disease is bleeding,
which can lead to anemia if enough blood is lost.
It also leads to shock and death. Bacterium
helicobacter pylori, nonsteroidal anti
inflammatory drug such as aspirin and
hypersecretion of HCl are the three distinct cause of peptic ulcer disease.


Diverticular Disease
Characterized by pain, either constipation or
increased frequency of defecation, nausea, vomiting, and
low-grade fever. Because diets low in fiber contributes to
development of diverticulitis. Patients who change to hish-
fiber diets show marked relief of symptoms. In severe
cases, affected portion of the colon may require surgical
removal. If diverticular rupture, the release of bacteria into
the abdominal cavity can cause peritonitis.


Colorectal Cancer (colon cancer/bowel cancer)
It is a cancer from uncontrolled cell growth in the
colon or rectum (parts of the large intestine), or in
the appendix. Genetic analysis shows that
essentially colon and rectal tumors are genetically
the same cancer. Symptoms of colorectal cancer
typically include rectal bleeding and anemia which
are sometimes associated with weight loss and
changes in bowel habits. Screening is effective at
decreasing the chance of dying from colorectal
cancer and is recommended starting at the age of
50 and continuing until a person is 75 years old.
Localized bowel cancer is usually diagnosed
through sigmoidoscopy or colonoscopy.



Hepatitis
It is an inflammation of the liver that can be caused by viruses, drugs, and chemicals,
including alcohols. Inflammation of the liver and characterized by the presence
of inflammatory cells in the tissue of the organ.

Hepatitis A (infectious hepatitis)
Caused by the hepatitis A virus and is spread via fecal
contamination of objects such as food, clothing, toys, and eating utensils
(fecal-oral route). It characterized by loss of appetite, malaise, nausea,
diarrhea, fever, and chills. This type of hepatitis does not cause lasting
liver damage.
Hepatitis B
It is spread by sexual contacts and contaminated syringes and
transfusion equipment. Also can spread via saliva and tears.
Hepatitis C
It is clinically similar to hepatitis B. it cause cirrhosis and possibly
liver cancer.
Hepatitis D
It is transmitted like hepatitis B and in fact a person must have
been co-infected with B before contracting D. it result to severe liver
damage and has higher fatality rate than .
Hepatitis E
It is spread like A. although it does not cause
chronic liver disease. It has very high mortality rate
among women.
Anorexia Nervosa
It is a chronic disorder characterized by self-induced weight loss,
negative perception o body image, and physiological changes that
result from nutritional depletion. Patient with this disease have a
fixation on weight control and often insist on having a bowel
movement everyday despite inadequate food intake. They often
abuse laxatives, which worsen the fluid and electrolyte imbalances
and nutrition deficiencies. It is found predominantly in young, single females, and it may
be inherited. Abnormal patterns of menstruation, amenorrhea, and a lowered basal
metabolic rate reflect the depressant effect of starvation.