ANATOMY AND PHYSIOLOGY DIGESTIVE SYSTEM The digestive system is the series of tube like organs that convert

our meals into body fuel. In all there's about 30 feet (9 meters) of these convoluted pipeworks, starting with the mouth and ending with the anus. Along the way, food is broken down, sorted, and reprocessed before being circulated around the body to nourish and replace cells and supply energy to our muscles.

Digestion is the mechanical and chemical breakdown of food into smaller components that are more easily absorbed into the bloodstream, for instance. Digestion

is a form of catabolism: a breakdown of large food molecules to smaller ones. The functions of the digestive system are digestion, absorption and elimination . DIGESTIVE PROCESS When food enters the mouth, digestion starts by the action of mastication, a form of mechanical digestion, and the contact of saliva. Saliva, which is secreted by the salivary glands, contains salivary amylase, an enzyme which starts the digestion of starch in the food. After undergoing mastication and starch digestion, the food will be in the form of a small, round slurry mass called a bolus, It will then travel down the esophagus and into the stomach by the action of peristalsis. Gastric juice in the stomach starts protein digestion. Gastric juice mainly contains hydrochloric acid and pepsin. As these two chemicals may damage the stomach wall, mucus is secreted by the stomach, providing a slimy layer that acts as a shield against the damaging effects of the chemicals. At the same time protein digestion is occurring, mechanical mixing occurs by peristalsis which is waves of muscular contractions that move along the stomach wall. This allows the mass of food to further mix with the digestive enzymes. After some time (typically an hour or two in humans), the resulting thick liquid is called chyme. When the pyloric sphincter valve opens, chyme enters the duodenum where it mixes with digestive enzymes from the pancreas, and then passes through the small intestine, in which digestion continues. When the chyme is fully digested, it is absorbed into the blood. 95% of absorption of nutrients occurs in the small intestine. Water and minerals are reabsorbed back into the blood in the colon (large intestine) where the pH is slightly acidic about 5.6 - 6.9. Some vitamins, such as biotin and vitamin K (K2MK7) produced by bacteria in the colon are also absorbed into the blood in the colon. Waste material is eliminated from the rectum during defecation.

PARTS OF THE DIGESTIVE SYSTEM Mouth The mouth is the first part of the digestive tract. The tongue and the teeth are found in the mouth. The inside of the mouth is lubricated with saliva that comes from the salivary glands. The strongest muscles are found in each side of the mouth. They help move the lower jaw and give it a biting force. There are four types of teeth in the mouth. The incisors are used in cutting food. The canines are used for grasping, piercing and tearing. The premolars and molars are used for crushing and grinding. Aside from tasting food, the tongue is used for moving the food as the saliva softens it. We have three pairs of salivary glands. Saliva from these glands lubricates the food and makes it soft. Saliva also contains an enzyme that breaks down starch. Throat Also called the pharynx, the throat is the next destination for food you've eaten. From here, food travels to the esophagus or swallowing tube. Esophagus From the mouth, food goes down the esophagus through the pharynx or throat. The esophagus is a muscular tube that can open and close at the pharynx. It can also open and close to the stomach. The walls of the esophagus consist of smooth muscles. The wavelike movement of these muscles, called peristalsis, pushes the food down to the stomach.

Stomach The stomach is a hollow muscular organ shaped like a bag. Its upper end is connected to the esophagus while the lower end is connected to the small intestine. The upper and lower end of the stomach has smooth circular muscles called sphincter muscles. When the upper end muscle relaxes, the stomach opens and food gets in. When the lower end muscles relaxes, partially digested food moves out of the stomach. The sphincter muscles keep the food in the stomach. The stomach is flexible and can expand when you eat. It can hold from 1 to 3 liters of food. The stomach acts as a storage bag of food. If the stomach could not store food, you would have to eat every twenty minutes or so instead of just three times a day. The stomach contains three layers of smooth muscles which also produce peristaltic movements to continue breaking down the food. Small intestine Made up of three segments the duodenum, jejunum, and ileum the small intestine is a 22foot long muscular tube that breaks down food using enzymes released by the pancreas and bile from the liver. Peristalsis also is at work in this organ, moving food through and mixing it with digestive secretions from the pancreas and liver. The duodenum is largely responsible for the continuous breaking-down process, with the jejunum and ileum mainly responsible for absorption of nutrients into the bloodstream.

Contents of the small intestine start out semi-solid, and end in a liquid form after passing through the organ. Water, bile, enzymes, and mucous contribute to the change in consistency. Once the nutrients have been absorbed and the leftover-food residue liquid has passed through the small intestine, it then moves on to the large intestine, or colon Colon (Large Intestine) The colon is a 6-foot long muscular tube that connects the small intestine to the rectum. The large intestine is made up of the cecum, the ascending (right) colon, the transverse (across) colon, the descending (left) colon, and the sigmoid colon, which connects to the rectum. The appendix is a small tube attached to the cecum. The large intestine is a highly specialized organ that is responsible for processing waste so that emptying the bowels is easy and convenient. Stool, or waste left over from the digestive process, is passed through the colon by means of peristalsis, first in a liquid state and ultimately in a solid form. As stool passes through the colon, water is removed. Stool is stored in the sigmoid (S-shaped) colon until a "mass movement" empties it into the rectum once or twice a day. It normally takes about 36 hours for stool to get through the colon. The stool itself is mostly food debris and bacteria. These bacteria perform several useful functions, such as synthesizing various vitamins, processing waste products and food particles, and protecting against harmful bacteria. When the descending colon becomes full of stool, or feces, it empties its contents into the rectum to begin the process of elimination.

Rectum The rectum (Latin for "straight") is an 8-inch chamber that connects the colon to the anus. It is the rectum's job to receive stool from the colon, to let the person know that there is stool to be evacuated, and to hold the stool until evacuation happens. When anything (gas or stool) comes into the rectum, sensors send a message to the brain. The brain then decides if the rectal contents can be released or not. If they can, the sphincters relax and the rectum contracts, disposing its contents. If the contents cannot be disposed, the sphincter contracts and the rectum accommodates so that the sensation temporarily goes away. Anus The anus is the last part of the digestive tract. It is a 2-inch long canal consisting of the pelvic floor muscles and the two anal sphincters (internal and external). The lining of the upper anus is specialized to detect rectal contents. It lets you know whether the contents are liquid, gas, or solid. The anus is surrounded by sphincter muscles that are important in allowing control of stool. The pelvic floor muscle creates an angle between the rectum and the anus that stops stool from coming out when it is not supposed to. The internal sphincter is always tight, except when stool enters the rectum. It keeps us continent when we are asleep or otherwise unaware of the presence of stool. When we get an urge to go to the bathroom, we rely on our external sphincter to hold the stool until reaching a toilet, where it then relaxes to release the contents.

ACCESSORY ORGANS Pancreas The pancreas secretes digestive enzymes into the duodenum, the first segment of the small intestine. These enzymes break down protein, fats, and carbohydrates. The pancreas also makes insulin, secreting it directly into the bloodstream. Insulin is the chief hormone for metabolizing sugar. Gallbladder The gallbladder stores and concentrates bile, and then releases it into the duodenum to help absorb and digest fats.

Liver The liver has multiple functions, but its main function within the digestive system is to process the nutrients absorbed from the small intestine. Bile from the liver secreted into the small intestine also plays an important role in digesting fat. In addition, the liver is the bodys chemical "factory." It takes the raw materials absorbed by the intestine and makes all the various chemicals the body needs to function. The liver also detoxifies potentially harmful chemicals. It breaks down and secretes many drugs. Macroscopic structure

The liver is the largest gland of the body, weighing 1200 -1600 g, it is wedgeshaped, and covered by a network of connective tissue (Glisson's capsule). liver - left lobe liver - right lobe falciform ligament gall bladder kidneys inferior vena cava abdominal aorta

Situated in the upper right portion of the abdominal cavity, the liver is divided by fissures (fossae) into four lobes: the right (the largest lobe), left, quadrate and caudate lobes. It is connected to the diaphragm and abdomainal walls by five ligaments: the membranous falciform (also separates the right and left lobes), coronary, right and left triangular ligaments, and the fibrous round ligament (which is derived from the embryonic umbilical vein). The liver is the only human organ that has the remarkable property of selfregeneration. If a part of the liver is removed, the remaining parts can grow back to its original size and shape. Blood flow Venous blood from the entire gastrointestinal tract (containing nutrients from the intestines) is brought to the liver by the hepatic portal vein. Branches of this vein pass in between the lobules and terminate in the sinusoids. Oxygenated blood is supplied in the hepatic artery. The blood leaves the liver via a central vein in each lobule, which drains in the hepatic vein.

Hepatic vein - one of several short veins originating within the lobes of the liver as small branches, which unite to form the hepatic veins. These lead directly to the inferior vena cava, draining blood from the liver.

Inferior vena cava - formed by the union of the right and left common iliac veins, collects blood from parts of the body below the diaphragm and conveys it to the right atrium of the heart.

Hepatic artery - a blood vessel which supplies the liver with oxygenated blood. It supplies 20% of the liver's blood.

Hepatic portal vein - a blood vessel which drains venous blood into the liver from the entire gastrointestinal tract. It supplies the remaining 80% of the liver's blood.

Microscopic structure

Lobules - hexagonally shaped functional units of the liver, made up of liver cells arranged in one-cell-thick platelike layers that radiate from the central vein to the edge of the lobule. branch of hepatic portal vein

bile duct

sinusoids

central vein

liver cells
portal area branch or hepatic artery

Hepatocytes - the liver cells. Sinusoids - small blood vessels between the radiating rows of hepatocytes. They receive oxygen-rich blood from the hepatic artery and nutrients from the intestines via the portal vein. Oxygen and nutrients diffuse through the capillary walls into the liver cells.

Portal area - situated at the corner of each lobule, it is a complex composed of branches of the hepatic portal vein, hepatic artery, bile duct, and nerve. Bile ducts - any of the ducts that convey bile from the liver. Bile is drained from the liver cells by many small ducts that unite to form the main bile duct of the liver, the hepatic duct. This joins the cystic duct, which leads from the gallblader, to form the common bile duct, which drains into the duodenum.

Central vein - a blood vessel in the middle of each lobule which receives blood from the hepatic portal vein and hepatic artery via the sinusoids and drains the blood into the hepatic vein.

Gastric Cancer