The alimentary tract provides the body
Water,
Electrolytes,
Vitamins and
Nutrients.
How?
movement of food through the alimentary tract
secretion of digestive juices and digestion of the food
absorption of water, various electrolytes, vitamins, and digestive products
circulation of blood through the gastrointestinal organs to carry away the
absorbed substances and
control of all these functions by local, nervous, and hormonal systems.
NEURAL CONTROL OF GASTROINTESTINAL FUNCTION—ENTERIC NERVOUS
SYSTEM
Differences between the myenteric and submucosal plexuses
MYENTERIC PLEXUSES
increased tonic contraction, or “tone,” of the gut wall;
increased intensity of the rhythmical contractions;
slightly increased rate of the rhythm of contraction; and
increased velocity of conduction of excitatory waves
along the gut wall to cause peristaltic waves.
SUBMUCOSAL PLEXUSES
inhibitory
local intestinal secretion,
local absorption, and
local contraction of the submucosal muscle
TYPES OF NEUROTRANSMITTERS SECRETED BY ENTERIC NEURONS
acetylcholine
Norepinephrine
adenosine triphosphate
Serotonin
Dopamine
Cholecystokinin
substance P
vasoactive intestinal polypeptide,
somatostatin
leu-enkephalin,
met-enkephalin, and
bombesin
HORMONAL CONTROL OF GASTROINTESTINAL MOTILITY
Gastrin
secreted by the “G” cells of the antrum of the stomach in
response to stimuli associated with ingestion of a meal
The primary actions of gastrin are
(1) stimulation of gastric acid secretion and
(2) stimulation of growth of the gastric mucosa.
Cholecystokinin (CCK)
secreted by “I” cells in the mucosa of the duodenum and jejunum mainly
in response to digestive products of fat, fatty acids, and monoglycerides in
the intestinal contents
contracts the gallbladder, expelling bile into the small intestine
slows the emptying of food from the stomach to give adequate time for
digestion of the fats in the upper intestinal tract.
CCK also inhibits appetite to prevent overeating
Secretin
secreted by the “S” cells in the mucosa of the duodenum in
response to acidic gastric juice emptying into the duodenum from
the pylorus of the stomach.
promote pancreatic secretion of bicarbonate to neutralize the acid
in the small intestine
Bicarbonate secretion
Lumen Blood
H2O CO2 CO2
H2CO3
HCO3- HCO3-
H + H+
Cl- ATP
Cl -
Na+ Na+ Na+
H2O H2O
11
Gastric inhibitory peptide [GIP])
secreted by the mucosa of the upper small intestine,
mainly in response to fatty acids and amino acids but
to a lesser extent in response to carbohydrate.
It has a mild effect in decreasing motor activity of
the stomach and therefore slows emptying of gastric
contents into the duodenum when the upper small
intestine is already overloaded with food products.
also stimulates insulin secretion.
Motilin
secreted by the stomach and upper duodenum during fasting
increases gastrointestinal motility
Ingestion
MASTICATION (CHEWING)
Incisors, molars and jaw muscle.
Much of the chewing process is caused by a chewing reflex.
Motor branch of the fifth cranial nerve.
SWALLOWING (DEGLUTITION)
Swallowing can be divided into:
Voluntary stage: initiates the swallowing process;
Pharyngeal stage: is involuntary and constitutes passage of food through the
pharynx into the esophagus; and
Esophageal stage: involuntary phase that transports food from the pharynx to the
stomach.
The function of oral cavity and esophagus
The function of oral cavity and esophagus
Functional Anatomy of Stomach
Oesophagus
Fundu Lower Oesophageal
Sphincter
Fundus
s • Storage
Body
• Storage Duodenum
• Mucus Pylorus
• HCl Body
• Pepsinogen Antrum
• Intrinsic factor
Antrum
• Mixing/Grinding
• Gastrin 21
Gastric secretions
1. HCl
converts pepsinogen to pepsin for chemical digestion
provides optimal pH environment for pepsin
destroys some bacteria
stimulates the small intestinal mucosa to release
secretinand CCK
promotes the absorption of Ca and Fe in small intestine
24
Gastric secretions
2. Pepsinogen (precursor of pepsin)
digestion of proteins
3. Mucus
forms a protective barrier: Mucus-bicarbonate barrier
4. Intrinsic factor
combines with vitamin B12 to make it absorbable
26
Intrinsic Factor
Only gastric secretion that is Essential for health
Secreted from parietal cells in humans, chif cells in
other species
Forms a complex with vitamin B12 in the gut
The complex is resistant to digestion and therefore
enables absorption of vitamin B12
Lack of intrinsic factor causes Vit B12 deficiency
(pernicious anaemia) – as all the Vit B12 is digested
and therefore can not be absorbed
27
Secretion of the pancreas
Endocrine - insulin & glucagon
Exocrine - enzymes and bicarbonate
essential for digestion
almost under separate hormonal control
28
Gall bladder
Sphincter of Oddi
29
Activation of pancreatic proteases
Enterokinase
Trypsinogen Trypsin
Trypsinogen Trypsin
Chymotrypsinogen Chymotrypsin
Proelastase Elastase
Procarboxypeptidase Carboxypeptidase
30
Bicarbonate secretion
Lumen Blood
H2O CO2 CO2
H2CO3
HCO3- HCO3-
H + H+
Cl- ATP
Cl -
Na+ Na+ Na+
H2O H2O
31
Bicarbonate function
Function
1. Neutralize gastric
acid emptied into the
duodenum
2. Provide a favorable
alkaline environment
for optimal activity of
pancreatic enzymes
32
Control of Pancreatic
Function
• Bicarbonate secretion stimulated by
secretin
• Secretin released in response to acid in
duodenum
• Zymogen secretion stimulated by
cholecystokinin (CCK)
• CCK released in response to fat/amino
acids in duodenum
• Also under neural control (vagal/local
reflexes) - triggered by arrival of organic
nutrients in duodenum
33
Small Intestine secretion
34
Biliary secretion Structure Liver
Liver lobule
Central
vein Central
vein
Bile
Blood
Bile
canaliculus
Portal
triad
Hepatic
artery
Hepatic
portal vein
Portal triad 50
51
54
Functions of bile
Emulsification of fats
Increased absorption of lipids into
enterocytes (include vitamin A, D, E, K)
Increased synthesis and secretion of bile
Cholesterol excretion (only route)
Excretion of breakdown products of
haemoglobin (bilirubin)
56
Regulation of Bile Release
• Acidic, fatty chyme causes the duodenum to release:
• Cholecystokinin (CCK) and secretin into the bloodstream
• Bile salts and secretin transported in blood stimulate the liver to
produce bile
• Vagal stimulation causes weak contractions of the gallbladder
• Cholecystokinin causes:
• The gallbladder to contract
• The sphincter of Oddi to relax
• As a result, bile enters the duodenum
57
