Introduction

Digestive System consists of:

Objectives
After studying this chapter, The student should be able to:

Give

the general functions served by the digestive system. List the major components of saliva. Give their functions. How its secretion is controlled.

 Explain

how food is swallowed & transported to the stomach. Describe digestion in the stomach. How gastric secretion is regulated. i.e. stimulated & inhibited. List the factors that govern emptying of the stomach.

List

major components of pancreatic secretion. Give their functions. Explain how secretion is controlled.

Give

the functions of the

liver. Explain the role of bile in the digestive process & its control. Explain functions of gall bladder & control.

Intestinal

secretion &

motility. Regulation of intestinal wall. Factors affecting intestinal absorption.

List the functions of the colon. List the various types & functions of motility.

Explain how defecation occurs.

Digestive system

Gastro intestinal tract

Digestive glands 1.salivary glands 2.liver 3.Pancreas

General Structure of the Digestive System

Layers of Alimentary Canal Organs

Cross section of the gut.

Functions of GIT

Functions of digestive System:

It is the normal site for: Food & fluids enterance to body: so it supplys & provides' body with :

Nutritive subs. Vitamins. Minerals. Fluids

1.digestion of food: break down of complex: Protein, fat & carbohydrate 2.Secretion of digestive juice: various enzymes & hormones. 3. Motility: Propulsion + mixing' contents (mostly anal wards) 4.Absorption: mainly in small intestine: absorption of products of digest & vitamins & minerals: all pass from m.m to blood or lymphatics. 5.Excretion: of undigested & unabsorbed substances. 6.it has immune function.

1) Digestion
Breakdown of food materials small particles. (ready for absorption & utilization by body cells) Mostly in proximal part of SI.

Illustration of the average time food spends in each part of the digestive system along with the average pH.

2) Absorption

Transfer of the contents of the gut from lumen into the mucosa to blood.

3) Secretion:
Transport

of fluid, electrolytes, peptides, .etc from blood to GIT lumen. ( about 7500 ml/day) Usually isotonic with plasma (except saliva is hypotonic.)

4) RES (Immune System)

Humoral antibodies & cellular immune system (lymphocytes in Peyers patches in SI ). Protect the body against micro-organisms in lumen of gut.

5) Endocrine function

Release of somatostatin, intestinal glucagon, gastrin, secretin, CCK etc

Regulation of GIT functions

(1) Nervous: neural Regulation (2) Hormonal regulation

Innervation of the digestive tract

1.
2. 3.

Musculature of the digestive tract is composed of smooth muscle fibers. Except for the striated muscles of: Mouth. The upper part of the oesophagus. The external anal sphincter.

1) 2)

All smooth muscles are involuntary, controlled by: Autonomic nerves: a) Extrinsic: (symp & parasymp) b) Intrinsic: (enteric nerve plexus) The myenteric (Aurbach's plexus) The submucosal (Meissner's plexus)

a) Intrinsic innervation of the gut The enteric nerve plexus comprises:

1)

The myenteric (Aurbach's plexus): lies in the musculosa between the circular & longitudinal muscle layers. It is concerned with controlling the motor activity of the alimentary canal. It is mainly excitatory to the tonic & rhythmic contractions, but it also contains some inhibitory neurons.

2) The submucosal (Meissner's plexus):

lies in the submucous layer. It is concerned with controlling the local secretory function of the GIT by stimulating the local exocrine & endocrine secretory cells. It contains the neurons of the sensory afferent nerves which arise from the mucosal layer.

Innervation of the gut.

b) Extrinsic innervation of the gut

The intrinsic neural plexuses of the ENS are: connected together & modulated by extrinsic autonomic nerves (sympathetic & parasympathetic).

The parasympathetic supply is generally excitatory to the enteric nervous system: It stimulates the motility and secretion. However, it contains also some inhibitory vagal fibers to the stomach and the gastrointestinal sphincters.

The sympathetic nerve supply generally inhibits secretion and motility. However, it contains also some excitatory fibers.

Sensory fibers arise from the luminal epithelium and wall of the gut to the enteric plexuses and from there to the prevertebral ganglia, spinal cord and brain stem.

Gastrointestinal Reflexes
Local enteric reflexes: integrated in the ENS. e.g. reflex gastrin secretion & myenteric (peristaltic) reflex & gastrocolic reflex. 2) Ganglionic reflexes: integrated at the prevertebral symp ganglia (celiac, mesenteric & hypogastric). e.g. enterogastric reflex.
1)

3) Central nervous reflexes: integrated in the CNS (the brain and spinal cord). e.g. peristaltic reflex in the upper half of the oesophagus ( vagovagal reflex) & the spinal defecation reflexes.

Receptors in 'wall: (short reflexes)

Chemoreceptor
Stimulated by: Products of food digestion & acids & Osmotic changes

Mechanoreceptors
Stim. By stretch

Local n. plexus

Send impulses to
Or through afferent autonomic n. as vagus nerve

Receptors out side the gut

stimulation of: visual, alfactory or taste receptors can lead to GIT responses through : - long reflexes They affect the gut function through efferent autonomic nerves. Or leads to: - Hormonal release: Release of local hormones: act only on GIT, affect secretion and motility.

Release of GIT hormones is regulated by:

1- Nerve impulses :
- Local - Autonomic

2- Chemical factors:
- food digestion products. - pH changes. -osmolarity .. all can stimulate ' mucosal cells -

to produce : hormones..

Smooth m of GIT functions as a syncytium

*The longitudinal m.fs are arranged in bundles & extends down the Intestinal tract. *m.fs. are electrically connected through huge number of gap junctions with low resistance for ion movement, so electrical signals travel from one cell to the next very rapidly along the bundles. *The bundles fuse with one another at many points so they function as a syncytium that allow spread of action potential in all directions in the muscles. *N.B. (there are few connections between longitudinal & circular m layers.)

Electrical activity of GIT smooth muscles: it is of 2 types :

1-slow wave (BER): it is not action potential, just small changes in RMP. 2- Spike potential: they are true action potentials , they occur on peaks of slow waves

1) Basic electrical rhythm (BER)

The

smooth muscle of the GIT has spontaneous rhythmic fluctuations in membrane potential between about 65 & 45 mV. Except in the oesophagus & the proximal portion of the stomach.

BER
Initiated by the interstitial cells of Cajal, stellate mesenchymal pacemaker cells with smooth muscle-like features that send long branched processes into the intestinal smooth muscle. The BER itself rarely causes muscle contraction, but spike potentials superimposed on the most depolarizing portions of the BER waves do increase muscle tension.

BER of GIT smooth muscle & its relation to muscle contraction.

The rate of the BER is

about 4/min in the stomach. It is about 12/min in the duodenum about 8/min in the distal ileum. about 2/min at the cecum. about 6/min at the sigmoid. The function : to coordinate peristaltic and other motor activity. Contractions occur only during the depolarizing part of the waves.

2) The Spike
The

depolarizing portion(Ca2+ influx). The repolarizing portion (K+ efflux). Many polypeptides & neurotransmitters affect the BER: e.g. Ach increases the number of spikes & the tension of the smooth muscle epinephrine decreases the number of spikes and the tension

Stimulatory effect of acetylcholine and inhibitory effect of epinephrine.

The Peristaltic Movement (Peristalsis)

Propels

the food or chyme along the GIT & It has a mixing function. Peristalsis is a wave of constriction usually preceded by relaxation- of the gut which proceeds analwards . It is a local enteric reflex triggered by distension of the gut. (called the myenteric or peristaltic reflex).

Peristaltic reflex
Stimulus:

distension of the gut (e.g. by a bolus of food) Receptors: receptors in the gut mucosa. send impulses to neurons of the myenteric plexus.

Effect
Ring constriction proximal to the bolus: (contraction of the circular m fibers & relaxation of the longitudinal m fibers). Receptive relaxation distal to the bolus: (relaxation of the circular m fibers & contraction of the longitudinal m fibers). This pulls the gut wall over the bolus helping its propulsion analwards.

Peristalsis

The Law of the Gut:

A distension of the gut produces a peristaltic wave that starts at the site of distension & proceeds analwards.

Electrical activity of GIT smooth muscles: it is of 2 types :

1-slow wave (BER): it is not action potential,just small changes in RMP due to cyclic changes of electrcal pace maker cells whice r specialised cells,present among smooth muscles, it causes opening of ion channels with inward current that generate the slow wave activity. 2- Spike potential: they r true action potentials ,they occur on peaks of slow waves, they r due to much Ca++& little Na+ influx. Factors that make the membrane more excitable r: strech , acetylcholine,parasympathetic nerves & several GIT hormones. The sympathetic,nor adrenaline & certain hormones r inhibitory factors.