ACEIT: Anatomy & Physiology Notes – Digestive System

Structures of the Digestive System

A. Alimentary canal, digestive tract, or gastrointestinal (GI) tract
1. Extends from mouth to anus___9 meters (29 feet) in length
2. Involved in digestion, absorption, and metabolism of nutrients
B. Main organs and accessory organs
1. Main organs: mouth, pharynx, esophagus, stomach, small intestine, large intestine,
rectum, anal canal
2. Accessory organs: teeth and tongue, salivary glands, liver, gallbladder, pancreas,
vermiform appendix
Mouth
A. Also known as oral cavity___ hollow chamber with a roof, floor, and walls
1. Roof___ formed by hard palate (parts of maxillary and palatine bones) and soft palate
(an arch-shaped muscle separating mouth from pharynx)
2. Uvula___ a downward projection of the soft palate
a. Uvula and soft palate prevent food and liquid from entering nasal cavities
b. Assists in speech and swallowing (deglutition)
3. Floor___ formed by tongue and its muscles
a. Lingual frenulum___ fold of mucous membrane that helps anchor the tongue to the
floor of the mouth
b. Papillae___ small elevations on mucosa of tongue; taste buds, found in many
papillae
Teeth
A. Types of teeth___ incisors, cuspids, bicuspids, and tricuspids
1. Deciduous (also known as baby or primary) teeth___ full set equals 20 teeth
a. First tooth erupts at about 6 months
b. Complete set in place at about 2 years of age
2. Permanent teeth___ full set equals 32 in most; 28 teeth are a normal variation in others
a. First permanent tooth erupts at about 6 years of age
b. Set of complete usually between ages of 17 and 24 years
B. Structures of a typical tooth___ crown, neck, and root

Disorders of the Mouth and Teeth

A. Infections, cancer, congenital defects, and other disorders can cause serious
complications including malnutrition
B. Infections and cancer of the mouth may spread to other parts of the body
1. Leukoplakia___ precancerous condition of mouth tissue
a. Snuff dipper’s pouch___ caused by use of chewing tobacco
b. Squamous cell carcinoma___ most common form of mouth cancer
2. Dental caries
a. Tooth disease resulting in permanent defect called a “cavity”
b. Infection may spread to other adjacent tissues or to blood
c. Lost or diseased teeth may be replaced by dentures or implants
3. Gingivitis___ gum inflammation or infection
a. Most cases result from poor oral hygiene
b. Can be a complication of diabetes, vitamin deficiency, or pregnancy
 4. Thrush, or oral candidiasis___ caused by yeastlike fungal organism
a. Patches of “cheesy” – looking exudate form over an inflamed tongue and oral
mucosa, which itches and bleeds easily
b. Common in immunosuppressed individuals (with AIDS) or after antibiotic
therapy
5. Periodontitis___ inflammation of periodontal membrane
a. Often a complication of advanced or untreated gingivitis
6. Cleft lip and cleft palate___ most common congenital defects of the mouth
a. May occur alone or together
b. Caused by failure of mouth structures to fuse during embryonic development
Salivary Glands
A. Three pairs of salivary glands
1. Secrete about 1 liter of saliva/day
2. Located outside of GI tract
3. Convey secretions via ducts into tract lumen
B. Parotid glands___ largest of salivary glands
1. Located in front of ear at angle of jaw
2. Ducts open into mouth opposite second molars
3. Inflamed in mumps-Parotiditis
C. Submandibular glands___ ducts open on either side of lingual frenulum
D. Sublingual glands___ ducts open into floor of mouth
E. Saliva contains salivary amylase___ begins digestion of carbohydrates
Pharynx
A. Muscular tube (throat) lined with mucous membrane
B. Functions as part of both respiratory and digestive systems
C. Subdivided into three anatomical segments

Wall of the Digestive Tract

A. Lumen___ hollow space within the “tube” of the digestive tract
B. Tissue layers of the wall of the digestive tube from inside to outside
1. Mucosa___ mucous epithelium
2. Submucosa___ connective tissue
3. Muscularis___ two layers of smooth muscle that move food through the tube by
rhythmic muscular waves known as peristalsis
4. Serosa___ serous membrane that covers the outside of abdominal organs
a. Composed of visceral peritoneum in abdominal cavity
b. It attaches the digestive tract to the wall of the abdominopelvic cavity by forming
folds called mesenteries
Esophagus
A. Muscular, mucus-lined tube about 25 cm (10 inches) long
B. Connects pharynx to stomach
C. Muscular walls help push food toward stomach
D. Sphincters at each end of esophagus help keep ingested material moving in one direction
down the tube
1. Upper esophageal sphincter (UES)
2. Lower esophageal sphincter (LES)
 E. GERD___ gastroesophageal reflux disease
1. Backflow of acidic stomach contents into esophagus causes symptoms of heartburn
and indigestion
2. Mild symptoms treated by nonsurgical measures include dietary changes, weight loss,
acid blocking or buffering medications, and drugs that strengthen LES
3. Severe and frequent episodes of GERD can trigger asthma attacks, cause severe chest
pain, bleeding, or narrowing and chronic irritation of esophagus
4. Untreated GERD may result in a precancerous condition called Barrett esophagus
5. Common symptom of hiatal hernia
Stomach
A. Pouch for food that lies in upper part of abdominal cavity just under diaphragm
1. About the size of a large sausage when empty
2. Expands considerably after a large meal
B. Contraction of muscular walls of stomach mixes food with gastric juice and breaks it
down into chyme
C. Mucous membrane lines the stomach
1. Membrane lies in folds (rugae) when stomach is empty
2. Many microscopic glands secrete gastric juice and hydrochloric acid into stomach
D. Divisions of stomach___ fundus, body, and pylorus
E. Pyloric sphincter muscle closes opening of pylorus (lower part of stomach) to retain food
to facilitate partial digestion
F. Disorders of the stomach
1. Gastroenterology___ study of stomach and intestines and their diseases
a. Stomach is potential site of numerous diseases and conditions
b. Gastric diseases often exhibit these signs or symptoms: gastric (inflammation),
anorexia (appetite loss), nausea (upset stomach), and emesis (vomiting)
2. Pylorospasm___ abnormal spasms of the pyloric sphincter
a. Common condition in infants
b. Pyloric stenosis is similar abnormality___ obstructive narrowing of the pyloric
opening
3. Ulcer___ open wound caused by acid in gastric juice
a. Often occurs in duodenum or stomach
b. Associated with infection by the bacterium Helicobacter pylori and use of
NSAIDs
c. Current treatment involves triple therapy
4. Stomach cancer
a. Associated with consumption of alcohol or preserved food, use of chewing
tobacco, and infection by H. pylori
b. No practical way to screen for early stages
Small Intestine
A. Size___ about 7 meters (20 feet) long but only 2 cm or so in diameter
B. Divisions
1. Duodenum
2. Jejunum
3. Ileum
 C. Lining
1. Many microscopic glands (intestinal glands) secrete intestinal juice
2. Arranged into multiple circular folds___ plicae
3. Folds covered with villi (microscopic finger-shaped projections from surface of
mucosa into intestinal cavity) ___ contain blood and lymph capillaries
D. Disorders of the small intestine
1. Enteritis___ intestinal inflammation
2. Gastroenteritis___ inflammation of stomach and intestines
3. Malabsorption syndrome___ group of symptoms resulting from failure to absorb
nutrients properly (e.g. anorexia, weight loss, abdominal bloating, cramps, anemia,
and fatigue)

Liver and Gallbladder

A. Liver
1. Size and location
a. Liver is the largest gland
b. Fills upper right section of abdominal cavity and extends over into left side
2. Classified as exocrine gland
a. Secretes bile
b. Has a variety of metabolic functions
3. Ducts
a. Hepatic___ drains bile from liver
b. Cystic___ duct by which bile enters and leaves gallbladder
c. Common bile___ formed by union of hepatic and cystic ducts and drains bile from
hepatic or cystic ducts into duodenum
B. Gallbladder
1. Location___ undersurface of the liver
2. Function___ concentrates and stores bile produced in the liver
C. Disorders of the liver and gallbladder
1. Gallstones___ hard clumps made of cholesterol, crystallized bile pigments, and calcium
salts
a. Cholelithiasis___ condition of having gallstones
b. Cholecystitis___ inflammation of the gallbladder; may accompany cholelithiasis
c. Stones can obstruct bile canals___ a condition called choledocholithiasis___ causing
jaundice
2. Hepatitis___ liver inflammation
a. Characterized by liver enlargement, jaundice, anorexia, discomfort, gray-white
feces, and dark urine
b. Caused by a variety of factors: toxins, bacteria, viruses, hepatitis A, B, and C, and
parasites
3. Cirrhosis___ degeneration of liver tissue involving replacement of normal (but
damaged) tissue with fibrous and fatty tissue
4. Portal hypertension___ high blood pressure in the hepatic portal veins caused by
obstruction of blood flow in a diseased liver; may cause varicosities of surroundings
systemic veins
Pancreas
A. Location___ behind stomach
B. Functions
1. Pancreatic cells secrete pancreatic juice into pancreatic ducts; main duct empties into
duodenum
2. Pancreatic islets (of Langerhans) ___ cells not connected with pancreatic ducts; secrete
hormones glucagon and insulin into the blood
C. Pancreatic disorders
1. Pancreatitis___ inflammation of pancreas
a. Acute pancreatitis results from blocked ducts that force pancreatic juice to
backflow
2. Cystic fibrosis___ thick secretions block flow of pancreatic juice
3. Pancreatic cancer___ very serious; fatal in the majority of cases
Large Intestine
A. Size and location___ 1.5 meters long; forms lower, or terminal, portion of digestive tract
B. Divisions
1. Cecum
2. Colon___ ascending, transverse, descending, and sigmoid
3. Rectum
4. Anal canal
C. Opening to exterior___ anus
D. Disorders of the large intestine often relate to abnormal motility (rate of movement of
contents)
1. Diarrhea___ results from abnormally increased intestinal motility; may result in
dehydration or convulsions
2. Constipation___ results from decrease intestinal motility
3. Diverticulitis (inflammation of abnormal outpouchings called diverticula) ___ may
cause constipation
4. Colitis___ general name for any inflammatory condition of the large intestine
5. Colorectal cancer___ a common malignancy of the colon and rectum associated with
colonic polyps; advanced age; low-fiber, high -fat diets, and genetic predisposition
Appendix and Appendicitis
A. Vermiform appendix is blind tube attached directly to cecum; no important digestive
function in humans
B. Appendicitis___ inflammation or infection of appendix
1. If appendix ruptures, infectious material may spread to other organs
2. Most common acute abdominal condition requiring surgery
3. Affects 7% to 12% of population younger than 30 years

Peritoneum
A. Description___ large sheet of serous membrane
1. Parietal layer of peritoneum lines abdominal cavity
2. Visceral layer of peritoneum covers abdominal organs
3. Peritoneal space lies between parietal and visceral layers
 B. Extensions of peritoneum___ largest are the mesentery and greater omentum
1. Mesentery___ extension of parietal peritoneum, which attaches most of small intestine
to posterior abdominal wall
2. Greater omentum, or “lace apron” ___ hangs down from lower edge of stomach and
transverse colon over intestines
C. Peritonitis___ inflammation of peritoneum resulting from infection or other irritant;
often a complication of ruptured appendix
D. Ascites___ abnormal accumulation of fluid in peritoneal space; often causes bloating of
abdomen
Digestion
A. Definition___ process that changes food into a form that can be absorbed and used by cells
1. Mechanical digestion___ chewing, swallowing, and peristalsis break food into tiny
particles, well with digestive juices, and move them along the digestive tract
2. Chemical digestion___ breaks up large nutrient molecules into compounds having
smaller molecules; brought about by digestive enzymes
B. Enzymes and chemical digestion
1. Enzymes___ protein molecules to act as catalysts, speeding up chemical reactions
2. Chemical digestion___ specific enzymes speed up thebreakdown of specific molecules
3. Hydrolysis___ enzymes speed up reactions that add water to break large molecules into
smaller molecules
C. Carbohydrate digestion___ mainly in small intestine
1. Maltase___ changes maltose to glucose
2. Sucrase___ changes sucrose to glucose
3. Lactase___ changes lactose to glucose
D. Protein digestions___ starts in stomach; completed in small intestine
1. Gastric juice enzyme pepsin partially digests proteins
2. Pancreatic enzyme trypsin completes digestion of proteins to amino acids
3. Intestinal enzymes, peptidases, completed digestion of partially digested proteins to
amino acids
E. Fat digestion
1. Bile contains no enzymes but emulsifies fats (breaks fat droplets into very small
droplets)
2. Pancreatic lipase changes (emulsifies) fats to fatty acids and glycerol in small
intestine
Absorption
A. Definition___ digested nutrients moves from intestine into blood or lymph
B. Absorption site___ nutrients and most water are absorbed from small intestine; some water
also absorbed from large intestine
1. Minerals and other nutrients are actively transported through the intestinal mucosa;
water absorbed by osmosis
2. Fatty acids and glycerol diffuse into absorptive cells in GI tract
3. “Water-soluble vitamins” are dissolved in water and absorbed; “fat-soluble vitamins”
are absorbed with the end products of fat digestion
C. Surface area and absorption___ large surface area of GI tract composed of mucosal folds,
villi, and microvilli that increase efficiency and speed of absorption