Mouth

• Digestion begins in the mouth and ends in the small

intestine.
• The mouth mechanically and chemically breaks down
nutrients into a
usable size and form.
• The teeth masticate food, breaking it down into a size
suitable for swallowing.
• Saliva, produced by the salivary glands in the mouth,
dilutes and softens the food in the mouth for easier
swallowing.
Esophagus
• As food enters the upper esophagus, it passes
through the upper esophageal sphincter, a
circular muscle that prevents air from entering
the esophagus and food from refluxing into the
throat.
• The bolus of food travels down the esophagus
and is pushed along by peristalsis, which propels
it through the length of the GI tract.
• As food moves down the esophagus, it reaches
the cardiac or lower esophageal sphincter, which
lies between the esophagus and the upper end of
the stomach.
• The sphincter prevents reflux of stomach
contents back into the esophagus.
Organs of
gastrointestinal
tract
Stomach
• The stomach performs three tasks: storing swallowed food and
liquid; mixing food, liquid, and digestive juices; and emptying its
contents into the small intestine.
• It produces and secretes hydrochloric acid (HCl), mucus, the enzyme
pepsin, and the intrinsic factor.
• Pepsin and HCl facilitate the digestion of protein.
• Mucus protects the stomach mucosa from acidity and enzyme activity.
• The intrinsic factor is essential for the absorption of vitamin B12.
Small Intestine
• Segmentation and peristaltic movement
in the small intestine
facilitate both digestion and absorption
(Fig. 46-2).
• Chyme mixes with digestive juices (e.g.,
bile and amylase).
• Resorption in the small intestine is so
efficient that, by the time the chyme
reaches the end of the small intestine,
it is pastelike in consistency.
Small Intestine (#2)
• The small intestine has three sections: the
duodenum, the jejunum, and the ileum.
• The duodenum is approximately 20 to 28 cm (8 to 11
inches) long and continues to process the chyme from
the stomach.
• The jejunum is approximately 2.5 m (8 feet) long and
absorbs carbohydrates and proteins.
• The ileum is approximately 3.7 m (12 feet) long and
absorbs water, fats,
certain vitamins, iron, and bile salts.
• The duodenum and jejunum absorb most of the
nutrients and electrolytes.
• The intestinal wall also absorbs nutrients across
the mucosa and into lymph fluids or blood vessels.
Small Intestine (#3)
• Substances, such as plant fiber, that the small
intestine cannot digest empty into the cecum
at the lower right side of the abdomen.
• The large intestine begins at the cecum.
• Impairment of the small intestine alters the
digestive process.
• For example, conditions such as inflammation,
surgical resection, or obstruction disrupt
peristalsis, reduce the area of absorption, or
block the passage of chyme.
• Electrolyte and nutrient deficiencies then
develop.
Large Intestine
• The lower GI tract is called the large intestine
(colon) because it is larger in diameter than
the small intestine.
• The large intestine is shorter (1.5 to 1.8 m)
but much wider than the small intestine.
• The large intestine is divided into the cecum,
colon, and rectum.
• The large intestine is the primary organ of
bowel elimination.
• It is positioned like a question mark, partially
encircling the small intestine.
Large Intestine (#2)
• Chyme enters the large intestine by waves of peristalsis through the
ileocecal valve, a circular muscular layer that prevents regurgitation.
• The colon is divided into the ascending, transverse, descending, and
sigmoid colons.
• The muscular tissue of the colon allows it to accommodate and
eliminate large quantities of waste and gas (flatus).
• It has three functions: absorption, secretion, and elimination.
• The large intestine absorbs water, sodium, and chloride from the
digested food that has passed from the small intestine.
Large Intestine (#3)
• Healthy adults absorb more than a gallon of water and an ounce of
salt from the colon every 4 hours.
• The amount of water absorbed from chyme depends on the speed at
which colonic contents move.
• Chyme is normally a soft, formed mass.
• If peristalsis is abnormally fast, there is less time for water to be
absorbed, and the stool is watery.
• If peristaltic contractions slow, water continues to be absorbed; and a
hard mass of stool forms, resulting in constipation
Large Intestine (#4)
• The secretory function of the colon aids in electrolyte balance.
• The colon secretes bicarbonate in exchange for chloride.
• The colon also excretes about 4 to 9 mEq of potassium daily.
• Therefore serious alterations in colon function (e.g., diarrhea) cause severe
electrolyte disturbances.

• Slow peristaltic contractions move contents through the colon.

Intestinal content is the main stimulus for contraction.
• Mass peristalsis pushes undigested food toward the rectum.
• These mass movements occur only three or four times daily, with the strongest
during the hour after mealtime.
Large Intestine (#5)
• The rectum is the final portion of the large intestine. Here bacteria
convert fecal matter into its final form.
• Normally the rectum is empty of waste products (feces) until just
before defecation.
• It contains vertical and transverse folds of tissue that help to
temporarily hold fecal contents during defecation.
• Each fold contains an artery and vein that can become distended from
pressure during straining.
• This distention often results in hemorrhoid formation.
Anus
• The body expels feces and flatus from the rectum through the
anal canal and anus.
• Contraction and relaxation of the internal and external sphincters,
innervated by sympathetic and parasympathetic stimuli, aid in the
control of defecation.
• The anal canal is richly supplied with sensory nerves that help to
control continence
Defecation
• The physiological factors critical to bowel function and defecation
include normal GI tract function, sensory awareness of rectal
distention and rectal contents, voluntary sphincter control, and
adequate rectal capacity and compliance.
• Normal defecation begins with movement in the left colon, moving
stool toward the anus.
• When stool reaches the rectum, the distention causes relaxation of
the internal sphincter and an awareness of the need to defecate.
• At the time of defecation, the external sphincter relaxes, and abdominal
muscles contract, increasing intrarectal pressure and forcing
the stool out.
Defecation (cont.)
• Sometimes people use the Valsalva maneuver to assist in stool passage.
• The Valsalva maneuver exerts pressure to expel feces through a voluntary
contraction of the abdominal muscles while maintaining forced
expiration against a closed airway.
• Patients with cardiovascular disease, glaucoma, increased intracranial
pressure, or a new surgical wound are at greater risk for cardiac
dysrhythmias and elevated blood pressure with the Valsalva maneuver and
need to avoid straining to pass the stool.
• Normal defecation is painless, resulting in passage of soft, formed stool.