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HUMAN ANATOMY AND PHYSIOLOGY

DIGESTIVE SYSTEM

DIGESTIVE SYSTEM The digestive system consists of the digestive tract, a tube that extends from the mouth to the anus, plus the associated organs, which secrets fluids into the digestive tract. The inside of the digestive tract is continuous with the outside environment, where it opens at the mouth and anus. Nutrients cross the wall of the digestive tract to enter the circulation. It consists of the oral cavity, pharynx, esophagus, stomach, small intestine, large intestine and anus. Accessory glands are associated with the digestive tract. The salivary glands empty into the oral cavity, and the liver and pancreas are connected to the small intestine. Various parts of the digestive tract are specialized for different functions, but nearly all parts consist of four layers, or tunics: the mucosa, submucosa, muscularis or adventitia. The mucosa, consists of mucous epithelium, a loose connective tissue called the lamina propria, and a thin smooth muscle layer, the muscularis mucosa. The epithelium in the mouth, esophagus, and anus resists abrasion, and epithelium in the stomach and intestine absorbs and secretes. The submucosa lies just outside the mucosa. It is a thick layer of loose connective tissue containing nerves, blood vessels, and small glands. An extensive network of nerve cell process forms a plexus (network). The plexus is innervated by autonomic nerves. The muscularis, which is the most parts of the digestive tube, consist of an inner layer of circular smooth muscle and an outer layer of longitudinal smooth muscle. Another nerve plexus also innervates by autonomic nerves lies between the two muscle layers. Together the nerve plexuses of the submucosa and muscularis compose the enteric plexus. This plexus is extremely important in the control of movement and secretion within the tract. The fourth, or outermost, layer of the digestive tract is either a serosa or an adventitia. Some regions of the digestive tract are either a serosa or an adventitia. Some regions of the digestive are covered by the peritoneum, and others are not. The regions that are covered by the peritoneum is histologically known as the serosa and the areas that are not covered by the peritoneum is also known as the adventitia.

Mouth or oral cavity

Food begins its journey through the digestive system in the mouth, also known as the oral cavity. Inside the mouth are many accessory organs that aid in the digestion of foodthe tongue, teeth, and salivary glands. Teeth chop food into small pieces, which are moistened by saliva before the tongue and other muscles push the food into the pharynx. Mastication or chewing begins the process of mechanical digestion, in which large food particles are broken down into smaller ones.

Teeth. The teeth are 32 small, hard organs found along the anterior and lateral edges of the mouth. The teeth can be divided into quadrants right upper, left upper, right lower, and left lower. In adults, each quadrant contains, one central and one lateral incisor; one canine; first and second premolars; and first, second and third molars. The third molar is usually called as the wisdom tooth because they actually appear in a persons late teens or early twenties.

Each tooth is made of a bone-like substance called dentin and covered in a layer of enamelthe hardest substance in the body. The surface of the dentin in the root is covered with cementum, which helps anchor the tooth in the jaw. Teeth are living organs and contain blood vessels and nerves under the dentin in a soft region known as the pulp which is filled with blood vessels, nerves and connective tissues. The teeth are anchored within alveoli along he alveolar processes of the mandible and maxillae. The alveolar processes are covered with dense fibrous connective tissue and moist squamous epithelium which refer to us gingiva or gums. The teeth are held in place by periodontal ligaments, which are connective tissue fibers that extend from the alveolar walls and are embedded into the cementum. Food taken into the mouth is chewed or being masticated, by the teeth. The incisors and canines primarily cut and tear the food, whereas the premolars and molars primarily crush and grind it. Mastication breaks large food particles into many smaller ones, which have a much larger total surface area than a few large particles would have. Because the digestive enzyme only reacts at the surface of the food particles, mastication increases the efficiency of digestion.

Palate and Tonsils. The palate or roof of the oral cavity, consists of two parts. The anterior part contains bone and is called the hard palate, whereas the posterior portion consists of skeletal muscle and connective tissue and is called as the soft palate. The uvula is the posterior extension of the soft palate. The palate separates the oral cavity and prevents the food from passing through the nasal cavity during chewing or swallowing. Tongue. The tongue is located on the inferior portion of the mouth just posterior and medial to the teeth. It is a small organ made up of several pairs of muscles covered in a thin, bumpy, skin-like layer. The outside of the tongue contains many rough papillae for gripping food as it is moved by the tongues muscles. The taste buds on the surface of the tongue detect taste molecules in food and connect to nerves in the tongue to send taste information to the brain. The tongue also helps to push food toward the posterior part of the mouth for swallowing. This process is also known as deglutition. This could be divided into three separate phases: the voluntary phase, the pharyngeal phase, and the esophageal phase. During the voluntary phase, a bolus (mass of food) is formed in the mouth. The bolus is pushed by the tongue against the hard and soft palates and posteriorly towards the oropharynx. During the pharyngeal phase, the soft palate is elevated, closing off the nasopharynx. The pharynx and larynx are elevated. Successive constriction of the pharyngeal constrictors from superior and inferior forces the bolus through the pharynx and into the esophagus. As this occurs the epiglottis bends down over the opening of the larynx to prevent aspiration. During the esophageal phase, the bolus is moved by peristaltic contractions of the esophagus towards the stomach.

Salivary Glands. The salivary glands are accessory organs that produce a watery secretion known as saliva. Saliva helps to keep the oral cavity moist and begins the digestion of carbohydrates. The body also uses saliva to lubricate food as it passes through the mouth, pharynx, and esophagus. There are 3 sets of salivary glands found in the oral cavity. The parotid gland, are serous gland that are located at the anterior portion of each ear. Parotid ducts enter the oral cavity adjacent to the second upper molars. The submandibular glands can be felt as a soft lump along the inferior border of the mandible. These glands open to the oral cavity on each side of the frenulum of the tongue. The sublingual glands, the smallest of the three paired salivary glands. They lie immediately below the mucous membrane in the floor of the oral cavity. Each sublingual gland has 10 12 small ducts opening onto the floor of the oral cavity. Secretions of the Oral Cavity. Saliva is secreted at the rate of approximately 1 liter (L) per day. The serous part of the saliva, produced mainly by the parotid and submandibular glands, contains enzyme called salivary amylase which breaks the covalent bonds between glucose molecules in starch and other polysaccharide to produce the disaccharides maltose and isomaltose. Saliva prevents bacterial infection in the mouth by washing the oral cavity and it contains lysozyme, which has a weak antibacterial action. The serous part of the saliva dissolves molecules, which must be in solution to stimulate taste receptors. The mucous secretions of the submandibular and sublingual glands contains a large amount of mucin, a proteoglycan that gives a lubricating quality to the secretions of the salivary glands. Salivary gland secretion is regulated primarily by the autonomic nervous system.

Pharynx The pharynx, or throat, is a funnel-shaped tube connected to the posterior end of the mouth. The pharynx is responsible for the passing of masses of chewed food from the mouth to the esophagus. The pharynx also plays an important role in the respiratory system, as air from the nasal cavity passes through the pharynx on its way to the larynx and eventually the lungs. Because the pharynx serves two different functions, it contains a flap of tissue known as the epiglottis that acts as a switch to route food to the esophagus and air to the larynx. Esophagu

s The esophagus is a muscular tube connecting the pharynx to the stomach that is part of the upper gastrointestinal tract. It carries swallowed masses of chewed food along its length. At the inferior end of the esophagus is a muscular ring called the lower esophageal sphincter or cardiac sphincter. The function of this sphincter is to close of the end of the esophagus and trap food in the stomach. Stomach

The stomach is a muscular sac that is located on the left side of the abdominal cavity, just inferior to the diaphragm. The opening form the esophagus to the stomach is

called cardiac opening because it is near the heart. The region of the stomach around the cardiac opening is known as the cardiac region. The most superior part of the stomach is the fundus. The largest part of the stomach is the body, which turns to the right, forming a greater curvature on the left and a lesser curvature on the right. The opening of the stomach to the small intestine is known as the pyloric opening which is surrounded by a relatively thick ring of smooth muscle called the pyloric sphincter. The region of the stomach near the pyloric opening is known as the pyloric region. In an average person, the stomach is about the size of their two fists placed next to each other. This major organ acts as a storage tank for food so that the body has time to digest large meals properly. The stomach also contains hydrochloric acid and digestive enzymes that continue the digestion of food that began in the mouth which are produce by the gastric glands. There are five groups of cells that can be found in the stomach. The first group consists of surface mucous cells on the inner surface of the stomach and lining in the gastric pits. Those cells produce mucus, which coats and protects the stomach lining. The remaining four cell types are found in the gastric gland; the mucous neck cells, which produce mucus; parietal cells, which produce hydrochloric acid and intrinsic factor; endocrine cells, which produce regulatory hormones; and the chief cells, which produce pepsinogen, a precursor of the protein digesting enzyme pepsin. Regulation of Stomach Secretions Cephalic Phase 1. The taste, smell, or thought of food or tactile sensations of food in the mouth stimulate the mouth stimulate the medulla oblongata. 2. Parasympathetic action potentials are carried by the vagus nerves to the stomach. 3. Preganglionic parasympathetic vagus nerve fibers stimulate postganglionic neurons in the enteric plexus of the stomach. 4. Postganglionic neurons stimulate secretions by parietal and chief cells and stimulate gastrin secretion by endocrine cells. 5. Gastrin is carried through the circulation back to the stomach, where it stimulates secretion by parietal and chief cells. Gastric Phase 1. Distention of the stomach stimulates mechanoreceptors and activates a parasympathetic reflex. Action potentials generated by the mechanoreceptors are carried by the vagus nerves to the medulla oblongata. 2. The medulla oblongata increases action potentials in the vagus nerves that stimulate stomach secretions. 3. Distention of the stomach also activates local reflexes that increases stomach secretions.

Gastrointestinal Phase

1. Chime in duodenum with a pH less than 2 or containing fat digestion products inhibits gastric secretions by three mechanisms. 2. Chemoreceptor in the duodenum are stimulated by H+ or lipids. Action potentials generated by the chemoreceptors are carried by the vagus nerves to the medulla oblongata, where they inhibit parasympathetic action potentials. 3. Local reflexes activated by H+ or lipids also inhibit gastric secretion. 4. Secretin, gastric inhibitory polypeptide and cholecystokinin produced by the duodenum inhibit gastric secretions in the stomach.

Small Intestine

The small intestine is a long, thin tube about 1 inch in diameter and about 10 feet long that is part of the lower gastrointestinal tract. It is located just inferior to the stomach and takes up most of the space in the abdominal cavity. The entire small intestine is coiled like a hose and the inside surface is full of many ridges and folds. These folds are used to maximize the digestion of food and absorption of nutrients. By the time food leaves the small intestine, around 90% of all nutrients have been extracted from the food that entered it. The small intestine consists of 3 parts: the duodenum, the jejunum and ileum. The duodenum is about 25 cm long. The jejunum is about 2.5 m long and makes up 2/5 of the total length of the small intestine. The ileum is about 3.5 m. long and makes up the 3/5 of the small intestines length. The surface of the small intestine has 3 modifications that increase the surface area 600 fold: the circular folds, villi, and the microvilli. The mucosa and the submucosa from a series of circular folds that run perpendicular to the long axis of the digestive tract. Villi are tiny fingerlike projections of the mucosa that have numerous cytoplasmic projections, the microvilli. These projections help in the absorption of nutrients that are distributed to the body through blood circulation.

The duodenum, jejunum and the ileum are similar in structure except that there is a gradual decrease in diameter of the small intestine, in the thickness of the intestinal wall, in the number of the circular folds, and in the number of villi as one progresses through the small intestine. Peyers patches are cluster of lymph nodes found along the surface of the small intestine. This helps to protect the intestinal tract from harmful microorganisms. The junction between the ileum and the large intestine is the ileocecal junction. It has a ring of smooth muscle the ileocecal sphincter and the ileocecal valve, which allows material contained in the intestine to move from the ileum to the large intestine, but not in the opposite direction.

Liver and Gallbladder

The liver is a roughly triangular accessory organ of the digestive system located to the right of the stomach, just inferior to the diaphragm and superior to the small intestine. The liver weighs about 3 pounds and is the second largest organ in the body. The liver has many different functions in the body, but the main function of the liver in digestion is the production of bile and its secretion into the small intestine. It stores and processes nutrients, synthesize new molecules and detoxifies harmful chemicals. It secretes 700 mL of bile each day. Bile contains no digestive enzymes, but it plays an important role in digestion by diluting and neutralizing stomach acid and by dramatically increasing the efficiency of fat digestion and absorption. Bilirubin is a bile pigment that results from the breakdown of hemoglobin. The gallbladder is a small, pear-shaped organ located just posterior to the liver. The gallbladder is used to store and recycle excess bile from the small intestine so that it can be reused for the digestion of subsequent meals. Pancreas The pancreas is a large gland located just inferior and posterior to the stomach. It is about 6 inches long and shaped like short, lumpy snake with its head connected to the duodenum and its tail pointing to the left wall of the abdominal cavity. The

endocrine part of the pancreas consists of pancreatic islets (Islets of the Langerhans). These islets produce insulin and glucagon, which enters the blood. The major proteolytic enzymes are carbotrypsin, chymotrypsin, carboxypeptidase. These enzymes continue the protein digestion that takes place in the stomach while the pancreatic amylase continues the digestion of polysaccharide digestion that began in the oral cavity. Large Intestine

The large intestine is a long, thick tube about 2 inches in diameter and about 5 feet long. It is located just inferior to the stomach and wraps around the superior and lateral border of the small intestine. It consists of the cecum, colon, rectum and anal canal. The cecum is the proximal end of the large intestine and is where the large and small intestine meets at the ileocecal junction. Attached to the cecum is a tube about 9 cm long called appendix. The colon consists of 4 parts: the ascending colon, transverse colon, descending colon and the sigmoid colon. The rectum is a straight, muscular tube that begins at the termination of the sigmoid colon and ends at the anal canal. The last part of the large intestine is the anal canal it begins at the inferior of the rectum and ends at the anus. Normally 18 24 hours is required for material to pass through the large intestine in contrast to the 3 5 hours required for movement of chyme through the small intestine. While in the colon the chime is converted into feces. The large intestine absorbs water and contains many symbiotic bacteria that aid in the breaking down of wastes to extract some small amounts of nutrients. Feces in the large intestine exit the body through the anal canal which is known as the process of defecation. Digestive System Physiology The digestive system is responsible for taking whole foods and turning them into energy and nutrients to allow the body to function, grow, and repair it. The six primary processes of the digestive system include: 1. Ingestion of food 2. Secretion of fluids and digestive enzymes

3. 4. 5. 6.

Mixing and movement of food and wastes through the body Digestion of food into smaller pieces Absorption of nutrients Excretion of wastes Ingestion The first function of the digestive system is ingestion, or the intake of food. The mouth is responsible for this function, as it is the orifice through which all food enters the body. The mouth and stomach are also responsible for the storage of food as it is waiting to be digested. This storage capacity allows the body to eat only a few times each day and to ingest more food than it can process at one time. Secretion In the course of a day, the digestive system secretes around 7 liters of fluids. These fluids include saliva, mucus, hydrochloric acid, enzymes, and bile. Saliva moistens dry food and contains salivary amylase, a digestive enzyme that begins the digestion of carbohydrates. Mucus serves as a protective barrier and lubricant inside of the GI tract. Hydrochloric acid helps to digest food chemically and protects the body by killing bacteria present in our food. Enzymes are like tiny biochemical machines that disassemble large macromolecules like proteins, carbohydrates, and lipids into their smaller components. Finally, bile is used to emulsify large masses of lipids into tiny globules for easy digestion. Mixing and Movement The digestive system uses 3 main processes to move and mix food:

Swallowing. Swallowing is the process of using smooth and skeletal muscles in the mouth, tongue, and pharynx to push food out of the mouth, through the pharynx, and into the esophagus. Peristalsis. Peristalsis is a muscular wave that travels the length of the GI tract, moving partially digested food a short distance down the tract. It takes many waves of peristalsis for food to travel from the esophagus, through the stomach andintestines, and reach the end of the GI tract. Segmentation. Segmentation occurs only in the small intestine as short segments of intestine contract like hands squeezing a toothpaste tube. Segmentation helps to increase the absorption of nutrients by mixing food and increasing its contact with the walls of the intestine. Digestion. Digestion is the process of turning large pieces of food into its component chemicals. Mechanical digestion is the physical breakdown of large pieces of food into smaller pieces. This mode of digestion begins with the chewing of food by the teeth and is continued through the muscular mixing of food by the stomach and intestines. Bile produced by the liver is also used to mechanically break fats into smaller globules. While food is being mechanically digested it is also being chemically digested as larger

and more complex molecules are being broken down into smaller molecules that are easier to absorb. Chemical digestion begins in the mouth with salivary amylase in saliva splitting complex carbohydrates into simple carbohydrates. The enzymes and acid in the stomach continue chemical digestion, but the bulk of chemical digestion takes place in the small intestine thanks to the action of the pancreas. The pancreas secretes an incredibly strong digestive cocktail known as pancreatic juice, which is capable of digesting lipids, carbohydrates, proteins and nucleic acids. By the time food has left the duodenum, it has been reduced to its chemical building blocks fatty acids, amino acids, monosaccharides, and nucleotides.

Absorption. Once food has been reduced to its building blocks, it is ready for the body to absorb. Absorption begins in the stomach with simple molecules like water and alcohol being absorbed directly into the bloodstream. Most absorption takes place in the walls of the small intestine, which are densely folded to maximize the surface area in contact with digested food. Small blood and lymphatic vessels in the intestinal wall pick up the molecules and carry them to the rest of the body. The large intestine is also involved in the absorption of water and vitamins B and K before feces leave the body. Excretion. The final function of the digestive system is the excretion of waste in a process known as defecation. Defecation removes indigestible substances from the body so that they do not accumulate inside the gut. The timing of defecation is controlled voluntarily by the conscious part of the brain, but must be accomplished on a regular basis to prevent a backup of indigestible materials.

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