Gastro intestinal

system
Royce Mathew
2
 Functions of digestive system
 Ingestion or consumption of food substances
 Breaking them into small particles
 Transport of small particle to different areas of
the digestive tract
 Secretionof necessary enzymes and other
substances for digestion
 Digestion of food particles
 Absorption of digestive products (nutrients)
 Removal of unwanted substances from the body
 Structure of the GI tract
 4 layers:
- 1- mucosa: epithelial cells (enterocytes)  role vary with
location
- lamina propria = layer of connective tissue under the
epithelial, containing blood vessels, nerves and lymphatic
vessels (Peyer’s patches)
- the muscularis mucosae: thin layer of smooth muscles
- 2- submucosa: layer of connective tissue rich containing the
submucosal plexus (Meissner’s plexus)
- 3- muscularis externa – radial and longitudinal smooth
muscles + Auerbach plexus(in contact with Meissner’s)
- 4- serosa:connective tissue continuying through the
mesenteries (a thin membranes rich in blood and lymphatic
capillaries) and the peritoneum (a double layer membrane
surrounding the abdominal organs)
 Deals with
 Transport
 Digestion-
 Absorption and
 Elimination of waste products
Digestionis a process by which
complex food material are broken
down into simpler and smaller
molecules so that it can be easily
absorbed and used by the body
 Food for body:

 Carbohydrates, proteins and lipids are absorbed in a form that can not be
taken up by the cells  food needs to be broken a small pieces
(mechanical digestion) and broken down chemically (chemical digestion)
Steps in food digestion

 Carbohydrates, proteins and lipids are absorbed in a

form that can not be taken up by the cells  food
needs to be broken a small pieces (mechanical
digestion) and broken down chemically (chemical
digestion)
 Chemical digestion refers to the degradation of:

1 2
 1- Carbohydrates ---> disaccharides --->
monosaccharides

 2- Proteins ---> peptides ---> amino acids

 3- Lipids ---> diglycerides --->

monoglycerides
and fatty acids
Function

of GI system
receiving food
 Digestion of food
 Absorption of digested food
 Elimination of undigested food materials
 Secretion of group of juices like saliva, gastric juice, pancreatic juice, bile
and intestinal juice
 Regulation of water balance
 Regulation of electrolyte balance
 Excretion of microbial toxins, food toxins
 GIT consist of
 Mouth
 Pharynx
 Esophagus
 Stomach
 small intestine
 Large intestine
 Anus
 Accessory digestive organs
 Teeth
 Tongue
 Salivary glands
 Exocrine part of Pancreas
 liver
 Gall bladder
 Functions of mouth

 Ingestion of food materials

 Chewing and mixing of food with saliva
 Appreciation of taste
 Transfer of food to esophagus by swallowing
 Role in speech
 Social functions like smiling and other expressions
 Mouth: mostly
mechanical digestion 
mastication  food is
broken down in small
particles so food
particles can be
chemically digested 
bolus

 Enzymes:
- lingual amylase
carb. (step 1)
- lingual lipase
lipid (step 1)
 Salivary glands
 Parotid gland- largest salivary gland. Secretions from this gland emptied into oral
cavity by stensen’s duct, nearly 35-40mm long
 Submaxillary or submandibular gland- saliva from this gland emptied by
whartson’s duct, about 40 mm long
 The duct opens at the side of frenulum of tongue, by means of small openings on the
summit of papilla called caruncula sublingualis
 Sublingual gland- smallest, saliva from these gland is
emptied into 5-15 small ducts called ducts of ravinus.
One of the duct is larger and called Bartholin’s duct
 Salivary gland classified based on secretion
 Serous glands- secrete thin and watery saliva ( parotid)
 Mucus glands- made up of mucus cells, these glands secrete thick,
viscous saliva with high mucin content- minor glands like buccal glands.
Lingual mucus glands and palatal glands belong to this type
 Mixed glands- secrete both serous and mucus cells
Saliva
 Salivary gland arranged in 3 groups
 Sub mandibular / sub maxillary
 Sun lingual
 Parotid gland
 Properties
 Vol. 1-1.5 liters per day
 pH – slightly acidic 6.35-6.85
 Specific gravity 1.002- 1.012
 Appearance- colorless, odorless and tasteless
 Saliva- Composition
Enzymes
 Salivary Amylase
(ptyalin)
 lysozyme
Mucins (glyco-proteins)
Fluid
 Hypotonic
 High [K+]
With increased salivary
flow, [HCO3-]and
osmolarity increase
Secretion is inhibited by
sleep
Saliva- functions
 Digestive function
 Digestion of CHO- Salivary amylase –act on boiled starch and convert it into
dextrin and maltose
 Non digestive functions
 Protective function
 Enzyme lysozyme kills micro organism
 Acidity of saliva kills micro organism
 saliva flushes down the micro organism to the stomach where it destroyed by HCl
 Other functions
- preparation of food for swallowing
 Saliva act as solvent for foods
 Solid food dissolves in saliva and stimulate taste buds
 Saliva keep the mouth moist and helps in speech
 minor role in regulation of water balance
 Minor role in electrolyte balance
 Major role in oral hygiene
 Appreciation of taste
 Regulation of secretion of
saliva
 Spontaneous secretion- 5%
 Periodic secretion – contolled by salivary reflex
 Unconditioned reflex
 Conditioned reflex
 salivary glands are under control of autonomic nervous system and efferent
nerve fibres from both para sympathetic and sympathetic divisions of
autonomic nervous system
 Applied physiology
 Hyposalivation

temporary- emotional conditions, feverand

dehydration
Permanent- Sialolithiasis
Bell’s palsy
 Hyper salivation
decay of tooth
Disease esophagus
cerebral sroke
Parkinsonism
 Other disorders
- Drooling
- Xerostomia
- Mumps
 Pharynx,esophagus:
passageway for food
(from mouth to
stomach)
Stomach
 widest part of GIT
 Shape empty- J shape and vertical
 External features
 2 curvatures
 Greater curvature- convex and separate esophagus by a notch called Cardiac Notch
 Lesser curvature- it is concave- also called Angularis incisura
 2 Orificies
 Cardiac orificies- it presents a physiological sphincter called cardiac sphincter
 Pyloric orifice- near the duodenal end presents anatomical sphincter
  2 surfaces
 Anterio surface-pointing infront and upwards
 Posterior surface- facing backward and down

Sub division
 Cardiac region- upper part of stomach, where esophagus opens
 Fundus- small dome shaped part filled with air
 Body or corpus- 75-80%of the stomach
 Pyloric part- has 2 parts Antrum and pyloric canal (Antrum-body of stomach end in
Antrum, Junction between body and antrum is marked by Incisura Angularis and pyloric
canal guarded by pyloric Sphincter and opens to duodenum)
Stomach glands

 Fundic glands- situated in body and fundus of the

stomach
 Pyloric glands- pyloric part of the stomach
 Cardiac glands- cardiac region of the stomach
 Functions of stomach
 It act as a reservoir of food
 Formation of chyme- peristaltic movement of the
stomach mix the bolus with the gastric juice and
convert it into semisolid material known as chyme
 Digestion of food
 Absorption of digested food
 Timely release of partly digested food
 secretion of gastric juice
 Hemopoietic function
 Protective function
 Gastric juice
 Daily secretion- about 2 liters per day
 pH- 0.9-1.2 ( Highly acidic)
 Specific gravity- 1.002-1.004
 Appearance- colorless. Odorless watery fluid
 Composition
 Water
 Solids
 Organic constituents
 Enzymes- pepsinogen, Rennin and gastric lipase, gelatinase and urase
 Mucin
 Intrinsic factor
 Gastrin(hormone)
 Gastric Juice

Water 99.5% Solids 0.5%

Enzymes Inorganic
Other organic substances
1. Pepsin Substances
1. Mucus
2. Renin( in animals only) 1. HCl
2. Intrinsic factor
3. Gastric lipase 2. Na

4. Gelatinase 3. Ca

5. Urease 4. K
 Functions of gastric juice
 Digestive functions-mainly act on proteins
 Digestion of proteins
HCl
Pepsinogen pepsin
Pepsin
Protein peptones+
polypeptides
Actions of other enzymes on
gastric juice
 Gelatinase- degrades type 1 and type V gelatin & type
IV and V collagen into peptides
 Urase- acts on urea and produces ammonia
 Gastric amylase- degrades starch
 Rennin – Curdles milk
 Rennin milk curdling enzyme
 It convert caseinogen to casein
 Gastric lipase- weak enzyme. No significant digestion of fat in stomach
 Functions of HCL
Activation pepsinogen to pepsin
It provides an optimum acidic pH for the action of pepsin
Antimicrobials action
Absorption of iron
it hydrolyses sucrose into glucose and fructose
 Functions of Mucin
It act as a lubricating agent for food
It gives a protective inner covering to the
stomach wall
prevent digestive action of pepsin on the wall
of stomach, particularly gastric mucosa
 Functions of intrinsic factor

Proper absorption of Vit B12 and folic acid

 Other functions

helps in excretion of heavy metal ion like

Hg, Pb, Bi
Helps in water regulation
 Regulation of gastric juice
 Cephalic phase- conditioned reflex. Sight of food, time of food
will stimulate higher centre in brain. This will increase
parasympathetic action of vagus
Vagus stimulate gastric glands and increase secretion of gastric
juice
This phase is regulated by nervous mechanism.
During this phase gastric secretion occurs even without food in the
stomach
Quantity of juice is less but rich in enzymes and HCl
- Unconditioned reflex- inborn reflex. When food placed in the
mouth salivary secretion is induced, at the same time gastric
secretion also occurs
- Conditioned reflex- reflex response accquired by previous
experience
 Gastric Phase
most important phase
Controlled by local hormone gastrin
when food enters stomach it will stimulate pyloric glands
These glands secrete gastrin
Gastrin absorbed by blood and carried to the body of stomach
This gastrin stimulate gastric juice production
 Nervous mechanism
Vagovagal reflex is the reflex in which entrance of
food in stomach causes the secretion of gastric juice
Intestinal phase
When small amount of food enters small
intestine it will stimulate wall of
intestine to secrete a hormone
enterogastrin. It absorbed by the blood
and carried to stomach. It stimulate
secretion of gastric juice
 It is the secretion of gastric juice when chyme enters the intestine. When
chyme enters intestine initially the gastric secretion increases but later it
stops. It is regulated by both nervous and hormonal control
 Applied physiology

 Gastritis
Nausea, Vomiting, Anorexia, indigestion,
 Peptic ulcer- ulcer in the wall of stomach or duodenum caused by digestive
action of the gastric juice
 Zollinger- ellison syndrome- secretion of excess of HCL in stomach
 Factors influencing gastric secretion
 Factors which cause increase in gastric secretion are
 Alcohol and
 Caffeine
 Collection of gastric juice
 In human beings gastric juice is collected by using Ryle’s
tube
 Gastric analysis
 Gastric juice analysed for
 Measurement of peptic activity
 Measurement of gastric activity- total acid, free acid and
combined acid
Pancreas
Figure 20.10
Properties of pancreatic juice

 Volume- 500-800 ml /day

 Reaction- highly alkaline pH of 8-8.3
 Specific gravity- 1.010- 1.018
 All the intralobular duct unite to form
the main duct of pancreas called
Wirsung’s duct
 Wirsung’s duct joins common bile duct
to form ampulla of Vater which opens
to duodenum
Pancreatic juice

 Pancreas is a mixed gland because it produce both

endocrine and exocrine hormones
 Exocrine- pancreatic juice
 It is carried through pancreatic duct and later by
common bile duct
 Pancreatic juice enters into small intestine
 Composition
Water (97.5%) Solids (2.5%)

Organic Constituents
1. Enzymes
Proteolytic enzymes
Trypsin Inorganic constituents
Chymotrypsin
Carboxy peptidase
Collagenase
Elastase
Nuclease
DNAse
RNA se
Pancreatic amalyse
Pancreatic lipase
Phospho lipase
2. Mucin
3. Trypsin Inhibitor
 Functions of pancreatic juice
 Digestive Functions
Protein digestion
Enterokinase
Trypsinogen Trypsin
Trypsin is a powerful endopeptidase. It acts on proteins and convert them to poly
peptides and proteoses
Collagenase digest collagen
Elastase digest elastin
 Trypsin inhibitor- trypsiniogen activated only when it
reaches small intestine. If it activated in the pancreas it
may hydrolyze the pancreatic tissue proteins resulting
in pancreatic damage
 Action of Trpsin
 Digestion proteins
 Curdling of milk
 Acceleration of blood clotting
 Activation of other enzymes of pancreatic juice
Trpsin converts
Chymotrypsinogen to chymotrypsin
Procarboxypeptidases to
carboxypeptidases
 CHO digestion- Converts starch into dextrin
 Pancreatic amlyase digests starch into maltose and iso maltose

 Lipid digestion
 Pancreatic lipase digest trigycerides to monoglycerides, free acids and glycerol
 Digestion of fat by P.Lipase requires bile salts and colipase ( a co-enzyme)
 Trypsin inhibitor prevents the activation of trypsinogen to trypsin till
pancreatic juice reaches the small intestine
 Functions Mucin
It acts as a lubricating agent for food
it gives protective inner covering to the wall of the
pancreatic duct
Other functions

 Takes part in the excretion of heavy metal ions like Pb,

Bi,
 Takes part in the water balance
 Regulation of electrolyte balance
 Bicarbonate ions helps in neutralizing the acidic chyme
entering the intestine
 Regulation of secretion
pancreatic juice
 Cephalic phase- Initiated by conditioned reflex(food placed in the mouth) and un
conditioned reflex (sight or smell of food)
 Gastric phase- when food enters stomach, stimulate the secretion of gastrin
 Intestinal phase
Food enters the small intestine, stimulate wall of intestine. Wall of small
intestine secrete two local hormones secretin and pancreozymin –
cholecystokinin(PZ-CCK)
 Secretin is absorbed by the blood from small intestine and carried to
pancreas. It stimulates the pancreas to secrete pancreatic juice rich in
electrolytes
 Pancreozymin is absorbed by the blood and carried to pancreas, it
stimulates the pancreas to secrete more pancreatic juice rich in enzymes
 Applied physiology
 Pancreatitis
Acute
Chronic
 Steatorrhoea – formation of bulky, foul smelling frothy and clay coloured stool
with large quantity of undigested fat
lack of pancreatic lipase
Liver disease affecting bile secretion
Celiac diseases
Liver
 Largest gland in the body
 Metabolic factory of the body
 Weighing about 1.5kg in man
 Located immediately below the diapharagm
Functions

 Synthetic functions
important substance like plasma proteins, blood
clotting factors, glycogen are synthesized in the liver
 Storage functions
CHO stored as glycogen
Minerals like iron as ferritin
storage of Vitamins
 Metabolic functions of liver
CHO metabolism
Liver is site of gluconeogenesis
Glucose is converted to glycogen and stored
Liver acts as a buffer organ in the regulation of
blood glucose level
When blood glucose level increases a portion of
glucose is converted to glycogen and stored in
the liver.
When blood glucose level decreases, glycogen is
broken down to glucose and released to the
blood
Role of liver in protein
metabolism
Important proteins like plasma proteins and blood clotting factors
synthesized in liver
 Liver is site of
Decarboxylation reaction
Transamination reaction
Synthesis of urea
Synthesis of non essential amino acids
Inter conversion of amino acids and CHO
Role of liver in lipid
metabolism
 Liver is the site of beta oxidation
 It is site of synthesis of lipids and lipo proteins
 Inter conversion of CHO and fats
 Detoxificaton function or action
 Haemopoietic function
During fetal life RBC produced in the liver
 Old RBC is destroyed in the liver
 Secretion of bile
Bile
 Bile is secreted by the liver hepatocytes
 Bile composition: water, mucus, bile salts (emulsify lipids),
bile pigments (biliverdin and bilirubin), cholesterol, fatty
acids, phospholipids like lecithin
 The bile salts are reabsorbed back to the liver for reuse by
the enterohepatic circulation
 From hepatocytes, bile is released into canaliculi
 From here it passes through small ducts and hepatic ducts
and reaches the common hepatic ducts.
 From common hepatic duct bile is diverted either directly
into the intestine or into gall bladder
 Storage of bile
 Most of the bile enters the gall bladder, where it is stored.
 It is released from gall bladder into intestine when ever required.
 When bile is stored in gall bladder it undergo many changes both in quality and
quantity
 Vol. is decreased because of absorption of large amount of water and electrolytes
 Concentration of bile salts, bile pigments, cholesterol, fatty acids and lecithin id increased
because of absorption of water
 pH is decreased slightly
 Specific gravity is increased
 Mucin is added to bile
 Properties
Daily secretion- 800-1200 ml/day
pH - 8-8.6
Specific gravity- 1.010 to 1.011
Appearance - greenish yellow, watery fluid of bitter
taste
 Bile salts
 These are sodium and potassium salts of bile acids, which
are conjugated with glycine or taurine
1. Functions of bile salts
Bile salts- derived from bile acids, important bile
acids are Cholic acid and Chenodeoxy acid this in
turn derived from cholestrol
1. Emulsification of fats
- Act as a detergent and helps in emulsification
( fat globules are broken down into minute
droplets and made in the form of milky fluid
called emulsion) of fats. So easy to digest
- Helps in the absorption of digested fatty acids-
bile salts combine with fats and make complexes
of fats called micelles. The fat in the form of
micelles can be absorbed easily
- Bile salts stimulate the liver to secrete more bile
- Bile salts stimulate the gall bladder and produces its contraction- This increase
the flow of the bile into the small intestine this action is called Cholagogue
action
- About 500mg of bile salts are secreted per day. Out of 95% of bile salts are
reabsorbed from the intestine and carried back to liver. Bile salts reabsorbed
and reused. This part or circulation is called entero hepatic circulation
- 5% of bile salts are excreted through faeces
 In short the functions of bile salts are
 Emulsification of fats
 Absorption of fats
 Choleretic action
 Cholagogue action
 Laxative action
 Prevention of gall stone formation
2. Mucin
- Act as a lubricating agent
- Protective covering to the wall of intestine and prevent destruction
Other Functions
- Bicarbonate ion helps in neutralizing acidic chyme entering the small intestine
- Bile helps in excretion of bile pigments and excess cholesterol
- Helps in excretion of heavy metal ion and toxins
Regulation of bile secretion

 Secretion of bile controlled by the hormone

Pancreozymin- Cholecystokinin( PZ-CCK)
 When partly digested food enters small intestine it
will stimulate the wall of intestine. This secrete a
hormone PZ-CCK, this absobed by blood and carried
to liver and gall bladder. This increase the
production of bile in liver and also cause contraction
of gall bladder. Bile flows from gall bladder and
relaxes the sphincter of oddi. Thus bile enters small
intestine
Bile pigments

 Excretory products in bile

 Bilirubin and biliverdin are two major bile pigments
 Bile pigments formed during breakdown of Hb
 Formation and excretion of
bile pigments
 Senile erytrocytes are destroyed in reticuloendithelial system and Hb is released
from them
 Hb is brohen into globin and heme
 Heme is spilt into iron and pigment biliverdin
 Iron goes into iron pool and reused
 The first formed pigment is reduced into bilirubin
 Bilirubin released into the blood from retoculoendothelial system
 In the blood bilirubin is transported by plasma protein, albumin. The bilirubin
circulating in the blood is called free bilirubin or unconjugated bilirubin
 Within few hours after entering into the circulation the free bilirubin taken up by
the liver cells
 In the liver it is conjugated with glucoronic acid to form conjugated bilirubin
 Conjugated bilirubin is excreted into intestine through bile
 Fate of conjugated bilirubin

 In the intestine 50% of conjugated bilirubin is

converted into urobilinogen by intestinal bacteria
 Remaining 50% of conjugated bilirubin from the
intestine is absorbed into blood and enters the liver
through portal vein( Entero-hepatic circulation)
 About 5% of urobilinogen is excreted by the kidney
through urine
 Some of the urobilinogen excreted in feces as
stercobilinogen
Gall Bladder
 Functions
 Storage of bile
 Concentration of bile
 Controls the flow of bile to the small intestine
 Reduce the alkalinity of stored bile
 Regulates equalization of pressure in the bilary
system
 Secretes mucin and make bile more thick
 Maintenance of pressure in biliary System
Filling and emptying of gall
bladder
 While taking food or when chyme enters the intestine
gall bladder contracts along with relaxation of sphincter
of oddi.
 Contraction of gall bladder is influenzed by neural
factor and Hormonal factor
Regulation of bile secretion

 Choleretics- substance which increase the secretion of bile from

liver. The effective agents are,
Acetylcholine
secretin
Cholecystokinin
Acid chyme in the intestine
Bile salts
 Cholagogues- an agent which increases the release of bile from gall bladder into
intestine. The common cholagogues are
Bile salts
Calcium
Fatty acids
Amino acids
Inorganic acids
 Hydrocholertic agents- which cause secretion of bile from liver with large
amount of water with less amount of solids. HCl is the hydrocholertic agent.
Applied physiology

 Jaundice
pre hepatic or hemolytic jaundice
hepatic jaundice
Post hepatic or extra hepatic jaundice
 Hepatitis
 Cirrhosis of liver
 Gall stones
 Gastro intestinal system
1. Deglutition 2nd phase
2. Deglutition
3. Small intestine movements
4. Small intestinal juice or succus entericus
5. Composition and functions of gastric juices
6. Hydrochloric acid secretion
7. Functions of gastric HCL
8. How the stomach protected from the HCl
9. Peptic ulcer
10. Functions of large intestine
11. Functions of bile
12. Functions of liver
1. Composition and functions of pancreatic juice
2. Functions of bile in the fat digestion
3. Peristalsis
4. Digestion and absorption of carbohydrate
5. Phases of gastric juice secretion and how it regulated
6. Saliva
7. Jaundice
8. Bile salts