THE DIGESTIVE SYSTEM 2
-Nerve Supply to the GIT
-The Peritoneum
NERVE SUPPLY TO THE GIT
• The GIT is regulated by an intrinsic set of
nerves known as the enteric nervous system
(ENS) and by an extrinsic set of nerves that
are part of the autonomic nervous system
(ANS).
a) The Enteric Nervous System (ENS)–
• The “brain of the gut”!
• Consists of about 100 million neurons that
extend from the esophagus to the anus.
• The neurons of the ENS are arranged into 2
plexuses:
i) Myenteric plexus (plexus of Auerbach),
-Located between the longitudinal and circular
smooth muscle layers of the muscularis
externa
ii) Submucosal plexus (plexus of Meissner)
-Found within the submucosa
• The plexuses of the ENS consist of motor
neurons, interneurons, and sensory neurons
• Motor neurons of myenteric plexus controls
GIT motility, especially the frequency and
strength of contraction of muscularis externa
• Motor neurons of the submucosal plexus
control the secretions of the organs of the
GIT.
• The interneurons of the ENS interconnect the
neurons of the myenteric and submucosal
plexuses.
• The sensory neurons of the ENS supply the
mucosal epithelium. Some of these sensory
neurons function as:
-Chemoreceptors - activated by the presence
of certain chemicals in food
-Stretch receptors – activated when food
distends the wall of a GI organ
b) Autonomic Nervous system (ANS)–
•The neurons of the ENS can function
independently
•However, they are subject to regulation by the
neurons of the ANS
•Parasympathetic nerve fibers to most parts of
the GIT are supplied by the vagus (X) nerves.
-These parasympathetic nerves form neural
connections with the ENS
-In general, stimulation of the parasympathetic
nerves that innervate the GIT causes an increase
in GI secretion and motility by increasing the
activity of ENS neurons
•Sympathetic nerves that supply the GIT arise
from the thoracic and upper lumbar regions of
the spinal cord.
-These sympathetic nerves also form neural
connections with the ENS
-In general, the sympathetic nerves that supply
the GIT cause a decrease in GI secretion and
motility by inhibiting the neurons of the ENS.
NB: Emotions such as anger, fear, and anxiety
may slow digestion because they stimulate the
sympathetic nerves that supply the GI tract.
Nervous Control of GIT
PERITONEUM
• The largest serous membrane of the body
• Consists of a layer of simple squamous
epithelium (mesothelium) with an underlying
supporting layer of areolar connective tissue
• The peritoneum is divided into:
-The parietal peritoneum, which lines the
wall of the abdominopelvic cavity
-The visceral peritoneum, which covers some
of the organs in the cavity and is their serosa
• Peritoneal cavity –
-Slim space containing lubricating serous fluid
that is between the parietal and visceral
portions of the peritoneum.
-Retroperitoneal (behind) organs
- These organs lie on the posterior abdominal
wall and are covered by peritoneum only on
their anterior surfaces; they are not in the
peritoneal cavity
- The kidneys, ascending and descending
colons, duodenum, and pancreas, are said to
be retroperitoneal
• The peritoneum contains large folds that
weave between the viscera (this is unlike the
pericardium and pleurae, which smoothly
cover the heart and lungs)
• The folds bind the organs to one another and
to the walls of the abdominal cavity
• They also contain blood vessels, lymphatic
vessels, and nerves that supply the abdominal
organs
• There are 5 major peritoneal folds: the
greater omentum, falciform ligament, lesser
omentum, mesentery, and mesocolon
• The greater omentum –
-Omentum (“fat skin”)
-Largest peritoneal fold, drapes over the
transverse colon and coils on the small
intestine like a “fatty apron”
-Double sheet that folds back on itself, giving
it a total of 4 layers
-Attached along the stomach and duodenum,
and extends downward anterior to the small
intestine, then turns and extends upward and
attaches to the transverse colon
• The adipose tissue content of the greater
omentum can greatly expand with weight
gain, giving rise to the characteristic “beer
belly” seen in some overweight individuals
• The many lymph nodes of the greater
omentum contribute macrophages and
antibody-producing plasma cells that help
combat and contain infections of the GI tract
• The falciform ligament –
-Falciform - (sickle-shaped)
-Attaches the liver to the anterior abdominal
wall and diaphragm
-The liver is the only digestive organ that is
attached to the anterior abdominal wall
• The lesser omentum –
-Arises as an anterior fold in the serosa of the
stomach and duodenum
-Suspends the stomach and duodenum from
the liver
• The lesser omentum is the pathway for blood
vessels entering the liver and contains the
hepatic portal vein, common hepatic artery,
and common bile duct, along with some
lymph nodes
• The mesentery –
-Mesentery – middle
-Fan-shaped fold of the peritoneum
-It binds the jejunum and ileum of the small
intestine to the posterior abdominal wall
• The mesentery extends from the posterior
abdominal wall to wrap around the small
intestine and then returns to its origin,
forming a double-layered structure
• Between the 2 layers are blood and lymphatic
vessels and lymph nodes
• The mesocolon –
-Two separate folds of peritoneum that bind
the transverse colon (by transverse
mesocolon) and sigmoid colon (by sigmoid
mesocolon) of the large intestine to the
posterior abdominal wall
• The mesocolon also carries blood and
lymphatic vessels to the intestines
• Together, the mesentery and mesocolon hold
the intestines loosely in place, allowing
movement as muscular contractions mix and
move the luminal contents along the GI tract
Clinical Examples
• Ascites - In certain diseases, the peritoneal
cavity may become distended by the
accumulation of several liters of fluid, a
condition called ascites.
• Peritonitis –
-An acute inflammation of the peritoneum
-A common cause of peritonitis is
contamination of the peritoneum by
infectious microbes, which can result from
accidental or surgical wounds in the
abdominal wall, or from perforation or
rupture of abdominal organs
• Example - if bacteria gain access to the
peritoneal cavity through an intestinal
perforation or rupture of the appendix, they
can produce an acute, life-threatening form of
peritonitis.
• A less serious form of peritonitis can result
from the rubbing together of inflamed
peritoneal surfaces.
• Peritonitis is of particularly grave concern to
patients on peritoneal dialysis, a procedure in
which the peritoneum is used to filter the
blood when the kidneys fail.
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