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Chapter 64: Secretory Functions of

the Alimentary Tract

Guyton and Hall, Textbook of Medical Physiology, 12th edition


General Principles of GI Tract Secretion

Anatomical Types of Glands

a. Mucous glands (Goblet cells)

b. Crypts of Lieberkuhn

c. Tubular glands

d. Salivary glands, pancreas, and liver


General Principles of GI Tract Secretion

Fig. 64.1 Typical function of a glandular cell for formation and secretion
of enzymes and other secretory substances
General Principles of GI Tract Secretion

Basic Mechanism of Stimulation of the Alimentary


Tract Glands

1. Contact of food with the epithelium stimulates


secretionfunction of enteric nervous stimuli

2. Local epithelial stimulation also activates the ENS


and include tactile stimulation, chemical irritation,
and distension of the gut wall
General Principles of GI Tract Secretion

Autonomic Stimulation of Secretion

1. Parasympathetic stimulation increases alimentary


tract glandular secretion; especially true in the
upper portion of the tract.

2. Sympathetic stimulation has a dual effect; alone it


slightly increases secretion, and if parasympathetic
or hormonal stimulation is already causing copius
secretion, the superimposed sympathetic will
reduce the secretion
General Principles of GI Tract Secretion

Autonomic Stimulation of Secretion

3. In the stomach and intestine, several GI hormones


regulate the volume and character of the secretions.

4. The hormones are produced in response to food in


the lumen of the gut
General Principles of GI Tract Secretion

Basic Mechanism of Secretion by Glandular Cells

1. Secretion of organic substances (Fig. 64.1)

2. Water and electrolyte secretion

3. Lubricating and protecting properties of mucous


Secretion of Saliva

Saliva Contains a Serous Secretion and a Mucus


Secretion

1. Principle glands are the parotid, submandibular,


and sublingual (also the tiny buccal glands)

2. Serous secretion contains ptyalin (amylase) and the


mucus contains mucin for lubrication and surface
protective properties
Secretion of Saliva

Secretion of Ions in Saliva

1. Saliva contains large quantities of potassium and


bicarbonate ions

2. Acini secrete a primary secretion containing


ptyalin or mucin in a solution of ions

3. Ductal epithelium secretes the bicarbonate ion


into the lumen
Secretion of Saliva

Nervous Regulation of Salivary Secretion

Fig. 64.3 Parasympathetic nervous regulation of salivary secretion


Secretion of Saliva

Nervous Regulation of Salivary Secretion

1. Controlled mainly by parasympathetic pathways


2. Salivation can be stimulated or inhibited by signals
coming from higher brain centers
3. Salivation can occur in response to reflexes in the
stomach and upper small intestines
4. Sympathetic stimulation can increase salivation a
small amount
5. Secretion always requires adequate nutrients from
the blood
Secretion of Saliva

Esophageal Secretion

1. Entirely mucus and provide lubrication for


swallowing

2. Contains both simple and compound mucus


glands
Gastric Secretion

Characteristics of the Gastric Secretions

1. Secretions from the gastric glands (oxyntic)

a) Mucus neck cells-secrete mucus


b) Chief or peptic cells-secrete pepsinogen
c) Parietal cells- secrete HCl and intrinsic factor
Gastric Secretion

Fig. 64.4 Oxyntic gland from the body of the stomach


Gastric Secretion

Basic Mechanism of HCl Secretion

Fig. 64.5 Schematic anatomy of the canaliculi in a parietao


(oxyntic) cell
Gastric Secretion

Fig. 64.6 Postulated mechanism for secretion of HCl. P indicate active pumps
and the dashed lines epresent free diffusion and osmosis
Gastric Secretion

Basic Factors That Stimulate Gastric Secretion


are AcH, Gastrin, and Histamine

a. AcH (from parasympathetic stimulation) excites


secretion of pepsinogen, HCl, and mucus

b. Both gastrin and histamine stimulate secretion of


acid by parietal cells but not the other cells
Gastric Secretion

Secretion of Intrinsic Factor by Parietal Cells

a. Essential for the absorption of vitamin B-12 in the


ileum

Pyloric GlandsSecretion of Mucus and Gastrin

Surface Mucus Cells- secrete large quantities of


viscous mucus that coat the stomach mucosa
Gastric Secretion

Stimulation of Gastric Acid Secretions

a. Parietal cells are the only cells that secrete HCl

b. Paritetal cells operate in close association with


enterochromaffin like cells (ECL) whose primary
function is to release histamine

c. Stimulation of acid secretion by gastrin-causes the


release of histamine from the ECL cells; release of
gastrin is in response to proteins in stomach
Gastric Secretion

Stimulation of Gastric Acid Secretions

d. Regulation of pepsinogen secretion occurs in


response to two signals:

1) Stimulation of the peptic cells by AcH from the


vagus nerve or nerves of the enteric nervous
system
2) Stimulation of peptic cell secretion in response
to acid in the stomach
Gastric Secretion

Phases of Gastric Secretion

a. Cephalic phase

b. Gastric phase

c. Intestinal phase
Gastric Secretion
Phases of Gastric Secretion

Fig. 64.7 Phases of gastric secretion and their regulation


Gastric Secretion

Inhibition of Gastric Secretion by Other Post-


Stomach Intestinal Factors

a. Function is to slow passage of chyme from the stomach


when the small intestine is already filled or overactive

b. Presence of food initiates a reverse enterogastric reflex

c. Presence of acid, fat, protein breakdown products, etc.


causes the release of several intestinal hormones;
especially secretin which inhibits stomach secretion
Gastric Secretion

Chemical Composition of Gastrin and Other GI


Hormones

a. Gastrin, CCK, and secretin are all large polypeptides

b. Activity of all of these lie in the last amino acids of


the chain
Pancreatic Secretions

Fig. 64.10 Regulation of pancreatic secretion


Pancreatic Secretions

Pancreas

a. Large compound gland


b. Enzymes secreted by the acini cells
c. Bicarbonate secreted by small ductules
d. Pancreatic juice produced in response to the
presence of chyme
Pancreatic Secretions

Pancreatic Digestive Enzymes

a. For proteins: trypsin, chymotrypsin, and


carboxypeptidase
b. For cbh: pancreatic amylase
c. For fats: pancreatic lipase, cholesterol esterase,
and phopholipase

Secretion of trypsin inhibitor prevents the digestion


of the pancreas itself
Pancreatic Secretions

Secretion of Bicarbonate Ions

a. Bicarbonate provides alkali in the pancreatic


juice to neutralize the HCl coming into the
duodenum from the stomach
Pancreatic Secretions

Fig. 64.8 Secretion of isoosmotic sodium bicarbonate solution by the pancreatic ductules and ducts
Pancreatic Secretions

Regulation of Pancreatic Secretion-Basic


Stimulation That Causes Secretion

a. Acetylcholine-released from the parasympathetic


vagus nerve endings and other cholinergic nerves
associated with the enteric nervous system
b. Cholecystokinin-secreted by the duodenal and
upper jejunal mucosa when food enters the small
intestine
c. Secretin-secreted as in cholecystokinin when
highly acidic food enters the intestine
d. Multiplicative effects of a, b, and c
Pancreatic Secretions

Phases of Pancreatic Secretion

a. Cephalic and Gastric Phases


b. Intestinal Phase
c. Secretin stimulates secretion of bicarbonate ions
d. Cholecystokinin production which stimulates
more digestive enzymes by the acini (similar to
vagal stimulation)
Secretion of Bile by the Liver

Functions of Bile

a. Bile salts help to emulsify the large fat molecules


of food and aid in the absorption of the digested
fat

b. Means of secretion of several important waste


products from the blood (especially bilirubin
and excesses of cholesterol)
Secretion of Bile by the Liver

Physiologic Anatomy of Biliary Secretion

a. Bile is secreted in two stages by the liver

1) Initial secretion by the hepatocytes;


contains bile salts, cholesterol, and other
organic compounds; into the bile
canaliculi
2) Bile empties into termnal bile ducts, then
the hepatic duct, and finally the common
bile duct into the duodenum or diverted
through the cystic duct into the gallbladder
Secretion of Bile by the Liver

Physiologic Anatomy of Biliary Secretion

b. Bile is stored and concentrated in the gallbladder


Secretion of Bile by the Liver

Table 64.2 Composition of Bile

Liver Bile Gallbladder Bile


Water 97.5 g/dl 92 g/dl

Bile salts 1.1 g/dl 6 g/dl

Bilirubin 0.04 g/dl 0.3 g/dl

Cholesterol 0.1 g/dl 0.3-0.9 g/dl

Fatty Acids 0.12 g/dl 0.3-1.2 g/dl

Lecithin 0.04 g/dl 0.3 g/dl

Sodium Ions 145 mEq/L 130 mEq/L

Potassium Ions 5 mEq/L 12 mEq/L

Calcium Ions 5 mEq/L 23 mEq/L

Chloride Ions 100 mEq/L 25 mEq/L

Bicarbonate Ions 28 mEq/L 10 mEq/L


Secretion of Bile by the Liver

Fig. 64.11 Liver secretion and gallbladder emptying


Secretion of Bile by the Liver

Emptying of the Gallbladder-Role of CCK

a. Most potent stimulus for the gallbladder to


undergo rhythmic contractions when food enter
the small intestine

b. Main stimulus for CCK is fatty foods

Bile Salts Function in Digestion and Absorption

a. Have a detergent action on fat particles


which causes the emulsification of the fat

b. Help in the absorption by forming micelles


Secretion of Bile by the Liver

Fig. 64.12 Formation of gallstones


Secretion of the Small Intestine

Secretion of Mucus by Brunners Glands in the


Duodenum

a. Secrete large amounts of mucus in response to:


tactile or irritating stimuli on the mucosa, vagal
stimulation, or secretin

b. Mucus protects the duodenal wall from the acidic


chyme coming from the stomach

c. Can be inhibited by sympathetic stimulation


Secretion of the Small Intestine

Secretion of Intestinal Digestive Juices by the


Crypts of Lieberkuhn

a. Surface covered by goblet cells (mucus) and


enterocytes (secrete water and electrolytes)

b. Mechanism of secretion of the watery fluid is


unclear but involves the active secretion of chloride
ions and bicarbonate ions
Secretion of the Small Intestine

Secretion of Intestinal Digestive Juices by the


Crypts of Lieberkuhn

c. Digestive enzymes in the small intestine secretion:


several peptidases; sucrase, maltase, isomaltase,
and lactase for splitting disaccharides into
monosaccharides; and small amounts of intestinal
lipase

d. Regulation is entirely local by the enteric nervous


system
Secretion of the Small Intestine

Secretion of Mucus by the Large Intestine

a. Many crypts but no villi in the large intestine

b. Epithelial cells secrete almost no enzymes but


contain many mucus cells

c. Rate of mucus formation is regulated by the direct


tactile stimulation of the epithelial cells