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Alimentary Canal
Accessory Digestive Organs
Mouth
Pharynx
Esophagus
Stomach
Small intestine
Large intestine
Anus
Ingestion
Propulsion
Mechanical Digestion
Chemical Digestion
Absorption
Defecation
Chewing
Mixing of food with saliva by the tongue
Churning food in the stomach
Segmentation or local constriction in the intestine
Segmentation kinda like peristalsis but peristalsis moves in one
direction, while segmentation goes back and forth
Series of catabolic steps which breakdown complex food into its chemical building
blocks
Starts in the mouth and ends in the small intestine
Nothing much happens in the esophagus
Passage of digested end products from the lumen of the GI tract into the blood or lymph
The small intestine is the major absorptive site
There is a very rich blood supply to carry the nutrients to the liver
Proteins, fats, and carbs each have their own set of enzymes.
More bile will be produced if you have a high fat diet
Initiated by stimuli arising inside or outside the digestive tract involving CNS center and
extrinsic autonomic nerves
o Mesentery
Abdominal cavity no line to tell where abdominal and pelvic begins
Serous membrane because its enclosed
Mesentery important. This is where the blood vessels run through. If
the mesentery gets twisted and the blood supply gets pinched off then
the organ will die
Peritoneal cavity the slitlike space between the visceral and parietal peritoneum
o Intraperitoneal or peritoneal organs
o Retroperitoneal
Surrounded by the peritoneal?
Between the parietal peritoneum and body wall retroperitoneal. Like
kidneys and ureters
It is a potential space. Even though the serous is one the body wall
theres the possibility of it forming a cavity and something abscess
forming
Peritonitis it is extremely painful when there is movement of the
organs inside and when you push on the abdomen the muscles are
rigid. If you really ant to see if they have it, then you check for
rebound tenderness.
Organs that lay between the parietal peritoneum and the body wall
o Pancreas
o Some of the large intestine
Double layer of peritoneum that extends to the digestive organs from the body wall
Can use this to your advantage, stuff mesentery can also be absorbed
and filter out of the mesentery.
Important for dialysis (intraperitoneal dialysis), you fill abdomen with
fluid and it absorbs all the waste and toxins.
Also used to give medications, meds can be absorbed through the
mesentery.
Splanchnic Circulation
Hepatic Portal Circulation
Collects nutrient rich venous blood from the intestine and transports it to the liver
Liver absorbs and collects nutrients
Mouth
Pharynx
Esophagus
Stomach
Small intestine
Large intestine
Accessory organs
Mouth
Lips and Cheeks
Palate
Tongue
Salivary glands
Teeth
Mouth Histology:
Mouth Palate:
Mouth Tongue:
Internal
o Intrinsic muscle
o Extrinsic muscle
External
o Lingual frenulum
o Papillae
o Sulcus terminalis
Lingual frenulum secures the bottom of the tongue to the floor of the mouth
o Lingual = tongue
o If it is too long and attaches to far then they can have speech
problems tongue tied. and because it runs down the middle,
instead of seeing a rounded tongue you will se a forked tongue
3 different types of pili:
Sulcus terminales groove down the center of the tongue goes down the center
Function
Structure
Components
Composition of Saliva
Control of Salivation
Extrinsic glands
- Parotid gland
- Submandibular gland
- Sublingual gland
Intrinsic glands scattered throughout the buccal mucosa
Extrinsic WILL have the ducts!
The Intrinsic do NOT!
97+% water
Slightly acidic
Electrolytes
Amylase
Mucin
Lysozyme
IgA secretory immunoglobin and lysozyme are there for protection
(to kill off bacteria)
Under parasympathetic
Motor impulses come from the facial and glossopharyngeal nerves
Important to have continuous saliva to help prevent tooth decay
(caries) d/t the lysozymes and IGA.
Mouth Teeth:
Oropharynx and laryngeal pharynx both are food passageways (food and air
passageway)
Surrounded by pharyngeal constrictor muscles that help propel food (involved in
peristalsis)
Mouth
Pharyngeal-Esophageal Phase
Ingests
Mechanical digestion (mastication)
Initiate propulsion by swallowing (deglutition)
Chemical digestion by amylase
Gross Anatomy
Microscopic Anatomy
Fundus dome-shaped part directly under the diaphragm fundus = top of any
dome shaped organ
Body mid portion of the stomach
Pyloric region distal portion of the stomach the other term used is the
terminal portion of the stomach
Pyloric antrum superior part of the pyloric region
Pyloric canal formed by a narrowing of the pyloric antrum
Pyloric terminal portion of the pyloric region
Pyloric sphincter muscle that controls emptying of the stomach
o Very substantial, it works well
o And it has to work well because if too much food leaves the
stomach then the small intestine cant absorb it all
o When food is in the stomach and from there on it is known as
chyme
Greater curvature convex lateral portion of the stomach
o Greater omentum attaches
o Greater omentum does not attach to anything else acts as an
apron that sits over the in intestine
Lining is dotted with millions of gastric pits that lead to gastric glands that produce
gastric juice
Cell walls of gastric pit are primarily goblet cells
Goblet cells produce mucus
o Serotonin
o Somatostatin
o Histamine causes the release of acid
Protects the mucosa from damage by the acid and digestive enzymes in the stomach
H. Pylori and NSAIDs are bad for the stomach/mucosal barrier
Big concern with gastric ulcer? They can extend all the way through
the stomach (perforation)
Undifferentiated stem cells in the gastric pits replace shed or damaged cells rapidly
There is a rapid turnover of cells
Small intestine replaces cells every 2-3 days
Cephalic head
Gastric gastric secretions, production of acid and pepsin
Intestinal
Local neural and hormonal mechanisms initiated when food hits the stomach
Stimuli are distension, peptides, and low acidity
Phase lasts 3 to 4 hours
Intrinsic controlled
pH comes up acidity goes down and vice versa
Acid is produced by a proton pump which pumps hydrogen ions into the stomach lumen
against a large gradient
Potassium is pumped into the cells
Exchanging H and K to try to keep charge the same
Gastrin plays the major role in acid production and release is stimulated
by:
o Rising pH
o Partially digested protein
o Caffeine
The higher the protein in the meal the more gastrin is secreted
o Goes back to the fact hat the stomach monitors solutes (what is
being digested). Monitors for protein and fats
o Fats are mostly ingested in the small intestine
Two phases
o Excitatory Cephalic and gastric stage are both excitatory
(extrinsic control)
o Inhibitory
Partially digested food caused the intestinal mucosa to release intestinal (enteric) gastrin
which has the same effect as gastrin
Distention of the intestine causes the enterogastric reflex:
o Inhibits the vagal nerve
o Inhibits local reflexes
o Activates the sympathetic system
With the first phase just trying to gear up (small intestine telling
stomach to produce more acid), once the intestine starts to distend it
tells it to slow down via the enterogastric reflex
Receptive relaxation from the brain stem in response to food moving through the
esophagus
Adaptive relaxation from stretch of the stomach
A lot of what goes on is die to stretch
Intrinsic ability of visceral smooth muscle to exhibit the stress-relaxation response (to be
stretched without increasing its tension)
This is surrounded by smooth muscle when you expand it it contracts,
but not so much in the stomach
Peristalsis begins weakly at the cardia and gains strength as it reaches the pylorus
Each peristaltic wave pushes about 3ml of chyme into the small intestine!!
The rate of gastric peristalsis is controlled by pacemaker cells called
interstitial cells of Cajal
Creates its basic electrical rhythm (BER) of three waves per minute
Rate remains constant
o The BER does NOT very, it will always be 3 per
minute regardless of how empty or full the
stomach is
The larger the meal and more liquid it contains the faster the stomach empties
Liquids empty first, solids last
Rate is dependent on the duodenum talking about how much goes into
the intestine
As the duodenum is stretched, gastric activity is inhibited
Carbohydrates in the intestine move fast digestion starts in mouth
Fats move slowly
Remember peristalsis waves are still every 3
Bottom line looking at the inhibitory phase of gastric secretions
Proteins chemical digestion in stomach
Fats chemical digestion in small intestine
Gross Anatomy
Microscopic Anatomy
Digestive Process
Innervation
Blood supply
Fan shaped membrane that tethers the small intestine (and part of the large intestine) to
the posterior abdominal wall
Carries blood vessels
Cancer in the small intestine is rare
Mesentery extension of parietal peritoneum, carries blood vessels
Plicae circulares or circular folds can be up to 1 cm tall force the chyme to spiral and
slow down
Lacteals lymph vessels that absorb nutrients
Have spiral folds in small intestine that slows down the chyme
One of the reason there is a distinction of the 3 the Plicae circulares
are in the jejunum
Nutrients from blood supply to liver hepatic portal system; thats
blood vessels (veins) and lymph also take nutrients to liver
Lacteal means milk because the lymph is a creamy color going through
here
Microvilli tiny projections called the brush border with brush border
enzymes
Mucosa
Submucosa
Muscularis
Epithelium of the mucosa is simple columnar absorptive cells with goblet cells and
enteroendocrine cells
Intraepithelial lymphocytes which kill without being primed
o B cell and T cell have to come together to produce antibodies,
but not the case of the mucosa in small intestine.
o Will produce antigens with an adequate fit, i.e. immune system
elsewhere is tailor made while this is off the rack this is not
acquired immunity it is a one time shot.
Intestinal crypts or crypts of Lieberkuhn pits that pierce the mucosa
Epithelial cells in the crypts secrete intestinal juice that is a carrier fluid for nutrients
intestinal juice is enzyme POOR
o Carrier fluid there is NOT anything in that fluid that helps it
digest
Stem cells at the base of the crypt divide to replace epithelial cells
Is bilayered
Has an adventitia
Covered by the peritoneum (except the portion of small intestine that is retroperitoneal )
Layer here is important for peristalsis & segmentation
Intestinal Juice
Optimal Activity
Motility
Moves chyme, intestinal juice, bile and pancreatic enzymes from the duodenum to the
ileocecal valve
Peristalsis is used to move food out
Segmentation just moves it back and forth
Segmentation takes place intestinal content is moved back and forth
Alternating contractions of rings of smooth muscle
Mixes chyme
Segmentation is considered mechanical digestion its mixing
chemicals in with the food but by itself it is considered mechanical
Pacemaker sets the pace at 12 14 contractions per minute in the duodenum and 8 9
contractions per minute in the ileum
o You monitor the nutrients in the chyme, thats how you know
absorbiton is complete nd persitalsis can start
Migrating mobility complex each successive wave starts a little more distal to the last
Gastroileal reflex enhanced activity of the stomach enhances the force of segmentation
Prefix in reflex origin (where stimulus is taking place)
Suffix target of stimulus know this so you can get answers right!
When stomach is fill it makes the ilium work faster want the intestine
to work slowly, but for some reason this reflex happens
Gross Anatomy
Microscopic Anatomy
Bacterial Flora
Digestive Process
Cecum
Appendix
Colon
Rectum
Anal Canal
External Features
Ascending colon
Right colic or hepatic flexure
Transverse colon
Left colic or splenic flexure
Descending colon
Sigmoid colon
Except the transverse and sigmoid (they are retroperitoneal), the colon is attached
to the posterior abdominal wall by the mesentery
Will have to be able to identify this! Can be hard in the pig, dont see
where it bends
Sigmoid colon is the S shaped part
Colon cancer: Rare to see cancer in small intestine. Will be colon
cancer if it is in the GI tract.
Sigmoidoscopy pt is awake
Colostomy under twilight sedation
Occult blood cant see it, bleeding going on very slowly. Not changing
the color of the stool. What youre measuring for is not blood, but iron.
Bottom line: most bleeding isnt caused by cancer, and most cancers
dont bleed
Colon is colonized by bacteria that survived the small intestine and those that gained
entrance from the anus
Synthesize B complex vitamins and vitamin K
Digestion does NOT take place in the colon, expect for the bacteria in
the colon that synthesizes B complex vitamins and Vitamin K.
Babies dont have bacteria in the GI tract and they dont produce a lot
of acid in their stomach
Ferment indigestible carbohydrates creating:
o Hydrogen
o Nitrogen
o Methane
o Carbon dioxide
o Dimethyl sulfide gas the one that has the odor
Digestion
Motility
Defecation
Valsalva maneuver closes the glottis and contract the diaphragm and abdominal wall
muscle to aid in the process
Function
Gross Anatomy
Microscopic Anatomy
Composition of Bile
Gall Bladder
Regulation of Bile Release
4 lobes
o Right lobe
o Left lobe
o Caudate lobe
o Quadrate lobe
Round ligament or ligament of teres remnant of the umbilical cord that stays attached
to the liver
Lesser omentum anchors the lesser curvature of the stomach to the liver
Ligament for the liver used to be the umbilical cord
Lesser omentum from stomach to liver so that both are tied down
Greater omentum comes of the greater curvature of the stomach not
attached to anything
The hepatic artery and the hepatic portal vein enter the liver at the porta hepatis
The gall bladder lies in the recess of the inferior right lobe
in shape
Hepatocytes or liver cells are arranged around a central vein (hepatocytes are
mature liver cell)
Hepatocytes have large amounts of rough and smooth endoplasmic reticulum, Golgi
apparatuses, peroxisomes, and mitochondria
The liver regenerates
At the six corners of the lobule is a portal triad (portal tract region)
o Hepatic artery oxygen travels through the hepatic artery (lots of mitochondra so
they need it)
o Hepatic portal vein
o Bile duct
Liver sinusoids enlarged leaky capillaries between hepatocyte plates
Hepatic macrophages (Kupffer cells) make up part of the wall of the sinusoids
Blood from the hepatic portal vein and hepatic artery percolate from the triad region to
the sinusoids to the central vein
Blood and oxygen travel to the center vein
While bile travels to the corners where it is transferred to the bile ducts
Secreted bile flows through bile canaliculi
urine, but it is not *normally* released there. Only released If the bile
cant make it into the small intestine
Bile release from liver cells is stimulated by secretin released by the intestine that is
exposed to fatty chyme
o Secretin is produced in the small intestine
o Fat is being measured In the stomach
With babies, the liver isnt prepared to breakdown bilirubin yet why
some get jaundice
And if a baby is breastfed they will be jaundice! But it is normal, the
bilirubin doesnt hurt anything. If they arent being breastfed and the
bilirubin gets too high the baby can have permanent brain damage
If an adult gets jaundice = something wrong with liver
Why wont it make to the intestine?
1) Gallstone blocking the bile duct
2) Or tumor pushing on bile duct
Can ask the pt?
1) Why color is your urine? The urine will be dark
2) What color is your stool? If not getting ther stercoblin the stool will
be pasty white
Risk factors for gallstones:
- Fat
- Female
- Forty
- Fertile
When no digestion is occurring the hepatopancreatic sphincter is closed and bile backs up
into the gall bladder via the cystic duct
Pancreas makes digestive enzymes
Hepatopancreatic sphincter if its closed the bile will back up
Cholecystokinin (CCK)
o Contraction of the gall bladder
o Secretion of pancreatic juice
o Relaxation of the hepatopancreatic sphincter
Any chemical In small intestine to digest food is either made from the
pancreas or bile from liver, the small intestine makes none
Anatomy
Composition of Pancreatic Juice
Regulation of Pancreatic Secretion
Pancreas Anatomy:
Retroperitoneal
Head is encircled in the C-shaped duodenum
Tail abuts the spleen
Lies deep to the greater curvature of the stomach
Favorite question on test is where it is found
When dissecting the pig, look for the duodenum to find the
pancreas
Produces pancreatic juice that drains via the main pancreatic duct that fuses with the
bile duct
Accessory pancreatic duct empties directly into the duodenum
o Accessory duct may or may not be present, the pancreas cannt
tolerate much of the enzymes it produces to the accessory duct
helps empty it
o Amylase - also in the mouth. And even though they do the same
thing (break down straches), but the difference is the amylaese
produced by the pancreas isnt going to survive acid like that
made in the mouth
o Lipase digests fat
o Nuclease destroys nuclei, 2-3 day turnover in small intestine,
there will be a lot of nuclei there.
Carboxypeptidase and chymotrypsin are released in inactive forms
Carboxypeptidase chews up peptides
The villi has microvilli produce brush border enzymes, its these
enzymes that finally break down (particularly peptides into amino acids
and glucose into glycogen) the food/chyme.
Trypsinogen is activated to trypsin in the duodenum
Trypsin activates the enzymes