Digestive system

1
 Function of the digestive system
 ingestion: taking food and liquid into
mouth
 Secretion: total about 7 liter into lumen
 Mixing and propulsion: through GI
muscle and peristalsis and motility
 Digestion: Breakdown of ingested food
(mechanical and chemical)
 Absorption: Passage of nutrients into the
blood
 Metabolism: Production of cellular
energy (ATP)
 Defecation: waste substance leave the
GI tract through anus

2
Organs of the Digestive System

 Two main groups

 Alimentary canal or gastrointestinal tract –
continuous coiled hollow tube from mouth to
anus(5-7 meter)
 Accessory digestive organs:
teeth ,tongue ,salivary
gland ,liver ,gallbladder ,and pancreas

3
Organs of the Digestive System

4
 Four-quadrant pattern
• For the simple four-
quadrant topographical
pattern a horizontal
transumbilical plane
passes through the
umbilicus and the
intervertebral disc
between vertebrae LIII
and LIV and intersects
with the vertical median
plane

5
 Nine-region organizational pattern
• The nine-region organizational description is based on two
horizontal and two vertical planes
• the superior horizontal plane (the subcostal plane) is
immediately inferior to the costal margins, which places it
at the lower border of the costal cartilage of rib X.
• the inferior horizontal plane (the intertubercular plane)
connects the tubercles of the iliac crests, which are palpable
structures 5 cm posterior to the anterior superior iliac
spines.
• the vertical planes pass from the midpoint of the clavicles
inferiorly to a point midway between the anterior superior
iliac spine and pubic symphysis.
6
7
 Assignment
• Describe the planes for the four quadrant
regions and the Nine-region organizational
pattern of the abdomen.
• For each region of the Nine-region
organizational pattern state four organs
located.

8
 Organs of the Alimentary Canal
 Mouth
 Pharynx
 Esophagus
 Stomach
 Small intestine
 Large intestine
 Anus
9
 Mouth (Oral Cavity) Anatomy
 Lips (labia) – protect
the anterior opening
 Cheeks – form the
lateral walls
 Hard palate – forms
the anterior roof
 Soft palate – forms
the posterior roof
 Uvula – fleshy
projection of the
soft palate 10
 Mouth (Oral Cavity) Anatomy
 Vestibule – space
between lips
externally and teeth
and gums internally
 Oral cavity – area
contained by the
teeth
 Tongue – attached
at hyoid bone and
styloid processes of
the skull, and by the
lingual frenulum
11
 Tongue

 Dorsum (upper part of

tongue covered with papillae
taste receptor and buds)
 filiform papillae

 fungiform papillae

 circumvallate papillae

 Paltine tonsil and

lingual tonsil 12
13
14
 Salivary glands
-Parotid gland: In the parotid fossa, three main
structures transverse this gland – facial nerve,
external carotid artery, and retromandibular
vein. The parotid duct opens near the upper 2nd
molar tooth. The gland is completely serous.
- Submandibular gland: Sitting most
posteriorly in the submandibular triangle, it is
supplied by the facial artery and vein.
Submandibular ducts, which cross the lingual
nerves, open on both sides of the tongue
frenulum. It is mostly serous but partially
mucus,.
- Sublingual gland: The smallest salivary
gland sits beneath the oral mucosa in the floor
of the mouth. It has multiple small openings.
This gland is almost completely mucus-
secreting.
15
Teeth
• Teeth
(mechanical breakdown)
– Incisors used for cutting
– Canines used for stabbing
and holding
– Molars large surface area
used for grinding
• Primary or deciduous teeth
20
• Secondary or permanent
teeth 32

16
 Structure of Teeth

Crown - exposed surface of tooth

Neck - boundary between root and crown

Enamel - outer surface (the hardest substance in the

body 95% calcium salts)
Dentin – bone-like, but noncellular(70% calcium
salts)
Pulp cavity - hollow with blood vessels and nerves
Root canal - canal length of root
gingival sulcus - where gum and tooth meet
17
 Processes of the Mouth

 Mastication (chewing) of food

 Mixing masticated food with saliva to
produce easy food called bolus
 Saliva contain 2 enzyme,salivary
amylase and lingual lipase
 Initiation of swallowing by the tongue
 Allowing for the sense of taste

18
Layers of Alimentary Canal Organs
 Mucosa
 Innermost layer
 Moist membrane
1. Surface epithelium : secretion and
absorption,renew every 5-7 days also
contain enteroendocrine cells
2. Small amount of connective tissue
(lamina propria): contain blood and
lymphatic vessels also contain MALT
3. Small smooth muscle layer 19
Layers of Alimentary Canal Organs

 Submucosa
 Just beneath the mucosa
 Soft connective tissue with blood vessels,
nerve endings, and lymphatics also contain
submucosal plexus

20
Layers of Alimentary Canal Organs
 Muscularis externa – smooth muscle
1. Inner circular layer
2. Outer longitudinal layer
Between them is myenteric plexus
 Serosa
 Outermost layer – visceral peritoneum
 Layer of serous fluid-producing cells
(mesothelium) 21
Layers of Alimentary Canal Organs

22
Digestive Anatomy: Histological

23
 Pharynx Anatomy
 Nasopharynx –
not part of the
digestive system
 Oropharynx –
posterior to oral
cavity
 Laryngopharynx –
below the oropharynx
and connected to
the esophagus
24
 Pharynx Function
 Serves as a passageway for air and
food
 Food is propelled to the esophagus by
two muscle layers
 Longitudinal inner layer
 Circular(constrictor muscles) outer layer
 Food movement is by alternating
contractions of the muscle layers
(peristalsis)
25
• Constrictor muscles
• The three constrictor muscles on each side
are major contributors to the structure of
the pharyngeal wall and their names
indicate their position-superior, middle,
and inferior constrictor muscles.
• overlap each other in a fashion resembling
the walls of three flower pots stacked one
on the other.
• These muscles constrict or narrow the
pharyngeal cavity.
• All of the constrictors are innervated by the
pharyngeal branch of the vagus nerve [X].

26
27
Longitudinal muscles
• The three longitudinal muscles of the
pharyngeal wall are named according to
their origins-stylopharyngeus from the
styloid process of the temporal bone,
salpingopharyngeus from the cartilaginous
part of the pharyngotympanic tube (salpinx
is Greek for tube), and palatopharyngeus
from the soft palate.
• The longitudinal muscles elevate the
pharyngeal wall, or during swallowing, pull
the pharyngeal wall up and over a bolus of
food being moved through the pharynx and
into the esophagus. 28
29
 Esophagus
 Runs from pharynx to stomach through
the diaphragm( 25 cm)
 Conducts food by peristalsis
(slow rhythmic squeezing): contraction
of circular layer above the food and
contraction of longitudinal below the
food
 Passageway for food only (respiratory
system branches off after the pharynx)
30
Esophagus
The esophagus is posterior to the larynx
and trachea in the neck region and upper
thorax. It travels on the right side of the
descending aorta, passes through the
diaphragm, and connects with the
stomach.
There are also inner circular and outer
longitudinal muscle layers.
The upper third is skeletal muscle
(voluntary), middle third is mixed, and
lower third is smooth muscle
(involuntary).
esophagogastric junction is located
approximately at the level of the
diaphragm. Contractions of the diaphragm
create sphincter-like effects, preventing
reflux of stomach acids and content.
31
The esophagogastric junction is a
 Peristalsis in Esophagus
Muscles contract

Muscles
contract, Muscles relax
Bolus of constricting
food passageway
and pushing
bolus down
Muscles relax,
allowing Muscles contract
passageway
to open

Muscles
Stomach relax

32
• The esophagus is a flexible, muscular tube that can be
compressed or narrowed by surrounding structures at four
locations:
1. the junction of the esophagus with the pharynx in the neck;
2. in the superior mediastinum where the esophagus is crossed by
the arch of aorta;
3. in the posterior mediastinum where the esophagus is compressed
by the left main bronchus;
4. in the posterior mediastinum at the esophageal hiatus in the
diaphragm.
• These constrictions have important clinical consequences. For
example, a swallowed object is most likely to lodge at a
constricted area. An ingested corrosive substance would move
more slowly through a narrowed region, causing more damage at
this site than elsewhere along the esophagus. Also, constrictions
33
present problems during the passage of instruments.
34
Arterial supply and venous and lymphatic drainage
•Esophageal arteries arise from the thoracic aorta,
bronchial arteries, and ascending branches of the left
gastric artery in the abdomen.
•Venous drainage involves small vessels returning to
the azygos vein, hemiazygos vein, and esophageal
branches to the left gastric vein in the abdomen.
•Innervation
•Esophageal branches arise from the vagus nerves
and sympathetic trunks.

35
 Histology of the esophagus
• the esophagus is covered by nonkeratinized stratified squamous
epithelium.
• In general, it has the same layers as the rest of the digestive tract.
• In the submucosa are groups of small mucus-secreting glands,
the esophageal glands, whose secretion facilitates the transport of
foodstuffs and protects the mucosa.
• In the lamina propria of the region near the stomach are groups
of glands, the esophageal cardiac glands, that also secrete mucus.
• At the distal end of the esophagus, the muscular layer consists of
only smooth muscle cells that, close to the stomach, form the
lower esophageal sphincter; in the mid portion, a mixture of
striated and smooth muscle cells; and at the proximal end, only
striated muscle cells.
36
 Stomach Anatomy

 Located on the left side of the

abdominal cavity
 Food enters at the
cardioesophageal sphincter
Site where food is churned into chyme
Protein digestion begins

37
 Stomach Anatomy

 Regions of the stomach

 Cardiac region – near the heart
 Fundus
 Body
 Pylorus – funnel-shaped terminal end
 Food empties into the small intestine at
the pyloric sphincter
38
Stomach

39
 Stomach Anatomy
 Rugae – internal folds of the mucosa
 External regions
 Lesser curvature
 Greater curvature

40
Stomach

41
 Stomach Anatomy

 Layers of peritoneum attached to the

stomach
 Lesser omentum – attaches the liver to the
lesser curvature
 Greater omentum – attaches the greater
curvature to the transverse colon which
Contains fat to insulate, cushion, and
protect abdominal organs

42
Stomach Anatomy

43
44
Lymphatic drainage

45
• The stomach is innervated
by sympathetic and
parasympathetic fibres.
• The sympathetic supply
originates from the fifth to
twelfth thoracic spinal
segments and is mainly
distributed to the stomach
via the greater and lesser
splanchnic nerves and the
coeliac plexus.
• The parasympathetic
supply is from the vagus
nerves
46
 Stomach Functions

 Acts as a storage tank for food

 Site of food breakdown and mixing
 Chemical breakdown of protein begins
 Delivers chyme (processed food) to the
small intestine

47
Structure of the Stomach Mucosa

 Gastric pits
formed by
folded mucosa
 Glands and
specialized
cells are in the
gastric gland
region
48
 Specialized Mucosa of the
Stomach
 Simple columnar epithelium
 Mucous neck cells – produce a sticky
alkaline mucus
 Gastric glands – secrete gastric juice
 Chief cells – produce protein-digesting
enzymes (pepsinogens)
 Parietal cells – produce hydrochloric acid
and Intrinsic factor(B12 absorption)
 Endocrine cells (G cell) – produce gastrin49
which stimulates both parietal and chief cells)
 Cells of the gastric glands
• Surface mucous cells have short surface microvilli and secrete protective
bicarbonate ions directly into the deeper layers of the surface mucous coat.
• Neck mucous cells are squeezed between the parietal cells in the neck and
base of the gastric glands.
• Parietal or oxyntic cells are distributed along the length of the glands but
tend to be most numerous in the isthmus of the glands. Parietal cells secrete
gastric acid as well as intrinsic factor, a glycoprotein necessary for the
absorption of vitamin B12 in the terminal ileum.
• Chief, peptic or zymogenic cells are located towards the bases of the gastric
glands. These are the pepsin-secreting cells.
• Stem cells are found mainly in the neck of the gastric glands. These
undifferentiated cells divide continuously to replace all other types of cell in
the glands.

50
Structure of the Stomach Mucosa

51
 Peritoneum
• The peritoneum is a continuous, glistening, and slippery
transparent serous membrane.
• It lines the abdominopelvic cavity and invests the viscera
• Divide into
• The peritoneum consists of two continuous layers: the parietal
peritoneum, which lines the internal surface of the
abdominopelvic wall, and the visceral peritoneum, which
invests viscera such as the stomach and intestines.
• Both layers of peritoneum consist of mesothelium, a layer of
simple squamous epithelial cells.
• The space between them contain fluid and called peritoneal
cavity this cavity may be accumulated by several liters of fluid
state called ascites 52
53
 Membranes
Mesenteries - double sheets of peritoneum, surrounding and
suspending portions of the digestive organs
Peritoneal folds
1. falciform ligament:- attach the liver to anterior abdominal wall
and diaphragm
2. Greater omentum - "fatty apron", hangs anteriorly from
stomach, double layer encloses fat
3. Lesser omentum - between stomach and liver
4. Mesentery proper - suspends and wraps the small intestine
5. Mesocolon - suspends and wraps the colon, parts are
i. transverse mesocolon
ii. sigmoid mesocolon
• Ascending and descending ,pancreas, first 2 parts of the
duodenum and kidneys are Retroperitoneal structure
54
Greater and lesser sacs of the peritoneal cavity

A. Intraperitoneal.
B. Retroperitoneal

55
 Mesenteries

• Greater omentum
and transverse colon
reflected

56
 Mesenteries

• Superficial view
of the abdominal
organs

57
 Small Intestine

 The body’s major digestive organ

 Site of nutrient absorption into the blood
 Muscular tube extending from the
pyloric sphincter to the ileocecal valve
 Suspended from the posterior
abdominal wall by the mesentery

58
Subdivisions of the Small Intestine

 Duodenum(25cm)
 Attached to the stomach
 Curves around the head of the pancreas
 Fixed retroperitoneal structure
 Jejunum (2.5m)
 Attaches anteriorly to the duodenum
 Ileum (3.5m)
 Extends from jejunum to large intestine 59
 Duodenum
• The first part of the SI.
• This C-shaped structure
• its lumen is the widest of the small intestine.
• The duodenum is divided into four parts:
I. the superior part (first part)
II.the descending part (second part)
III.the inferior part (third part)
IV.the ascending part (fourth part), terminates at
the duodenojejunal flexure
60
 Duodenum and Related Organs
Liver
Bile

Gall-
bladder
Stomach

Bile
Pancreas
Acid chyme

Intestinal enzymes

Pancreatic
Duodenum of juice
small intestine

61
 Jejunum
• The jejunum and ileum make up the last two
sections of the small intestine.
• The jejunum represents the proximal two-fifths.
• It is mostly in the left upper quadrant of the
abdomen and is larger in diameter and has a
thicker wall than the ileum.
• The less prominent arterial arcades and longer
vasa recta (straight arteries) compared to those of
the ileum are a unique characteristic of the
jejunum.
62
Ileum
• The ileum makes up the distal three-fifths
of the small intestine and is mostly in the
right lower quadrant.
• Compared to the jejunum, the ileum has
thinner walls, shorter vasa recta, more
mesenteric fat, and more arterial arcades

63
A. Jejunum. B. Ileum

64
Regions of Small Intestine

65
Small intestine

66
 Villi of the Small Intestine

 Fingerlike
structures formed
by the mucosa
 Give the small
intestine more
surface area

Figure 14.7a

67
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 14.24
Microvilli of the Small Intestine

 Small projections of the

plasma membrane
 Found on absorptive cells

Figure 14.7c

68
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 14.25
 Structures Involved in Absorption
of Nutrients

 Absorptive cells
 Blood capillaries
 Lacteals (specialized
lymphatic capillaries)

Figure 14.7b
69
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 14.26
 Folds of the Small Intestine

 Called circular folds or plicae circulares

 Deep folds of the mucosa and
submucosa
 Do not disappear when filled with food
 The submucosa has Peyer’s patches
(collections of lymphatic tissue)

70
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 14.27
 Digestion in the Small Intestine
 Enzymes from the brush border
 Break double sugars into simple sugars
 Complete some protein digestion
 Pancreatic enzymes play the major
digestive function
 Help complete digestion of starch
(pancreatic amylase)
 Carry out about half of all protein digestion
(trypsin, etc.)
71
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 14.57a
 Chemical Digestion in the Small
Intestine

Figure 14.6

72
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 14.23b
 Digestion in the Small Intestine

 Pancreatic enzymes play the major

digestive function (continued)
 Responsible for fat digestion (lipase)
 Digest nucleic acids (nucleases)
 Alkaline content neutralizes acidic chyme

73
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 14.57b
 Absorption in the Small Intestine
 Water is absorbed along the length of
the small intestine
 End products of digestion
 Most substances are absorbed by active
transport through cell membranes
 Lipids are absorbed by diffusion
 Substances are transported to the liver
by the hepatic portal vein or lymph
74
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 14.59
 Propulsion in the Small Intestine

 Peristalsis is the major means of moving

food
 Segmental movements
 Mix chyme with digestive juices
 Aid in propelling food

75
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 14.60
Large Intestine

 Larger in diameter, but shorter than the

small intestine
 Frames the internal abdomen

76
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 14.28
Large Intestine

Figure 14.8
77
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 14.28
Regions of Large Intestine
Cecum – pocket at proximal end with
Appendix
Colon
Ascending colon - on right, between
cecum and right colic flexure
Transverse colon - horizontal portion
Descending colon - left side, between
left colic flexure and
Sigmoid colon - S bend near terminal
end
Rectum – terminal end is anal canal - ending at the anus -
which has internal involuntary sphincter and external voluntary
sphincter 78
 Histology of Large Intestine

1. Mucosa - abundant goblet cells, stratified

squamous epithelium near anal canal
2. No villi
3. Longitudinal muscle layer incomplete, forms
three bands or taenia coli
4. Circular muscle - forms pockets or haustra
between bands

79
 Functions of the Large Intestine

 Absorption of water
 Eliminates indigestible food from the
body as feces
 Does not participate in digestion of food
 Goblet cells produce mucus to act as a
lubricant

80
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 14.29
 Structures of the Large Intestine

 Cecum – saclike first part of the large

intestine
 Appendix
 Accumulation of lymphatic tissue that
sometimes becomes inflamed
(appendicitis)
 Hangs from the cecum
81
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 14.30a
 Structures of the Large Intestine

 Colon
 Ascending
 Transverse
 Descending
 S-shaped sigmoidal
 Rectum
 Anus – external body opening

82
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 14.30b
Divisions of the gastrointestinal tract into foregut, midgut, and
83
hindgut, summarizing the primary arterial supply to each segment.
Venous drainage
• Venous drainage of the spleen, pancreas,
gallbladder, and the abdominal part of the
gastrointestinal tract, except for the inferior part
of the rectum, is through the portal system of
veins, which deliver blood from these structures
to the liver.
• Once blood passes through the hepatic sinusoids,
it passes through progressively larger veins until it
enters the hepatic veins, which return the venous
blood to the inferior vena cava just inferior to the
diaphragm.
84
85
86
 Portosystemic anastomosis
• The hepatic portal system drains blood from the
visceral organs of the abdomen to the liver.
• In normal individuals, 100% of the portal venous blood
flow can be recovered from the hepatic veins, whereas
in patients with elevated portal vein pressure (e.g. due
to cirrhosis), there is significantly less blood flow to
the liver.
• The rest of the blood enters collateral channels, which
drain into the systemic circulation at specific points

87
The largest of these collaterals occur at:
•the gastroesophageal junction around the cardia of the
stomach-where the left gastric vein and its tributaries form
a portosystemic anastomosis with tributaries to the azygos
system of veins of the caval system;
•the anus-the superior rectal vein of the portal system
anastomoses with the middle and inferior rectal veins of the
systemic venous system;
•the anterior abdominal wall around the umbilicus-the
para-umbilical veins anastomose with veins on the anterior
abdominal wall(superficial epigastric veins).

88
 89
Portosystemic anastomoses
• When the pressure in the portal vein is elevated, venous
enlargement (varices) tend to occur at and around the
sites of portosystemic anastomoses and these enlarged
veins are called:
• hemorrhoids at the anorectal junction;
• esophageal varices at the gastroesophageal junction;
• caput medusae at the umbilicus.

90
 Food Breakdown and Absorption in
the Large Intestine
 No digestive enzymes are produced
 Resident bacteria digest remaining
nutrients
 Produce some vitamin K and B
 Release gases
 Water and vitamins K and B are absorbed
 Remaining materials are eliminated via
feces 91
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 14.61
 Propulsion in the Large Intestine
 Sluggish peristalsis
 Mass movements
 Slow, powerful movements
 Occur three to four times per day
 Presence of feces in the rectum causes
a defecation reflex
 Internal anal sphincter is relaxed
 Defecation occurs with relaxation of the
voluntary (external) anal sphincter
92
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 14.62
 Pancreas

• Retroperitoneal :compose
of head, body and tail

• Endocrine and exocrine

gland

• Common bile duct and

major pancreatic duct lead
to ampulla of vater then to
second part of duodenum
through sphincter of oddi 93
 Pancreas
 Produces a wide spectrum of digestive
enzymes that break down all categories of food
 Enzymes are secreted into the duodenum
 Alkaline fluid introduced with enzymes
neutralizes acidic chyme
 Endocrine products of pancreas (langerhans
island)
 Insulin
 Glucagons
 Somatostatin 94
Slide 14.38
Exocrine Pancreas: Histology

95
 Liver
 Largest gland in the body
 Located on the right side of the body
under the diaphragm
 Consists of four lobes suspended from
the diaphragm and abdominal wall by
the falciform ligament
 Connected to the gall bladder via the
common hepatic duct
96
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 14.39
 Liver
On right under diaphragm,
largest organ made up of 4
lobes (left and right, caudate,
and quadrate)

Hilus (porta hepatis) –

underside "entry" point

Gall bladder

Microscopic anatomy: Liver lobules and triads 97

Microscopic Anatomy of
Liver

98
Visceral Surface of the Liver

99
 Role of the Liver in Metabolism

 Several roles in digestion

 Detoxifies drugs and alcohol
 Degrades hormones
 Produce cholesterol, blood proteins
(albumin and clotting proteins)
 Plays a central role in metabolism

100
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 14.77
Bile
 Produced by cells in the liver
 Composition
 Bile salts
 Bile pigment (mostly bilirubin from the
breakdown of hemoglobin)
 Cholesterol
 Phospholipids
 Electrolytes
101
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 14.40
Gall Bladder

 Sac found in hollow fossa of liver

 Stores bile from the liver by way of the
cystic duct
 Bile is introduced into the duodenum in
the presence of fatty food
 Gallstones can cause blockages

102
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 14.41
 Chemical Digestion in the Small
Intestine

Figure 14.6

103
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 14.23b
 Gallbladder
• Stores and concentrates bile to ten folds
• Expels bile into duodenum
– Bile emulsifies fats

104
105