Because learning changes everything.

Chapter 25

The Digestive System

ANATOMY & PHYSIOLOGY

The Unity of Form and Function
NINTH EDITION
KENNETH S. SALADIN

© 2021 McGraw Hill. All rights reserved. Authorized only for instructor use in the classroom.
No reproduction or further distribution permitted without the prior written consent of McGraw Hill.
 Digestive Function

Digestive system—organ system that processes food, extracts

nutrients, and eliminates residue
Five stages of digestion
• Ingestion: selective intake of food
• Digestion: mechanical and chemical breakdown of food into
a form usable by the body
• Absorption: uptake of nutrient molecules into the epithelial
cells of the digestive tract and then into the blood and lymph
• Compaction: absorbing water and consolidating the
indigestible residue into feces
• Defecation: elimination of feces

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 Digestive Function

Mechanical digestion—the physical breakdown of food into smaller particles

• Cutting and grinding action of the teeth

• Churning action of stomach and small intestines

• Exposes more food surface to digestive enzymes

Chemical digestion—a series of hydrolysis reactions that breaks dietary macromolecules into their
monomers (residues)
• Carried out by digestive enzymes produced by salivary glands, stomach, pancreas, and small intestine
• Polysaccharides into monosaccharides
• Proteins into amino acids
• Fats into monoglycerides and fatty acids
• Nucleic acids into nucleotides

Some nutrients are present in a usable form in ingested food and can be directly absorbed
• Vitamins, amino acids, minerals, cholesterol, and water
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 General Anatomy

Digestive system has two subdivisions: digestive

tract and accessory organs

Digestive tract (alimentary canal)

• 30 ft long muscular tube extending from

mouth to anus

• Mouth, pharynx, esophagus, stomach, small

intestine, and large intestine

• Gastrointestinal (GI) tract is the stomach

and intestines

Accessory organs

• Teeth, tongue, salivary glands, liver,

gallbladder, and pancreas

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 General Anatomy

Most of digestive tract follows a

basic structural plan with the
digestive tract wall consisting of
layers:

• Mucosa: epithelium, lamina

propria, muscularis mucosae

• Submucosa

• Muscularis externa: inner

circular layer, outer longitudinal
layer

• Serosa: areolar tissue,

mesothelium

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 General Anatomy

Mucosa (mucous membrane)—lines the lumen and consists of:

• Inner epithelium
• Simple columnar in most of digestive tract
• Stratified squamous from mouth through esophagus, and in
lower anal canal
• Lamina propria: loose connective tissue layer
• Muscularis mucosa: thin layer of smooth muscle
• Tenses mucosa creating grooves and ridges that enhance
surface area and contact with food
• Improves efficiency of digestion and nutrient absorption
• Mucosa-associated lymphatic tissue (MALT): the mucosa
exhibits an abundance of lymphocytes and lymphatic nodules

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 General Anatomy 5

Submucosa—thicker layer of loose connective tissue

• Contains blood vessels, lymphatic vessels, a nerve plexus,
and in some places mucus-secreting glands that dump
lubricating mucus into the lumen
• MALT extends into the submucosa in some parts of the GI
tract

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 General Anatomy 6

Muscularis externa—consists of usually

two layers of muscle near the outer
surface

• Inner circular layer

• In some places, this layer

thickens to form valves
(sphincters) that regulate the
passage of material through the
tract

• Outer longitudinal layer

• Responsible for the motility that

propels food and residue through the
tract

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 General Anatomy

Serosa—composed of a thin layer of areolar tissue topped by simple squamous mesothelium

• Begins in the lower 3 to 4 cm of the esophagus

• Ends just before the rectum

• Adventitia: fibrous connective tissue layer that binds and blends the pharynx, most of the
esophagus, and the rectum into adjacent connective tissue of other organs

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 General Anatomy

Enteric nervous system—nervous network in esophagus,

stomach, and intestines that regulates digestive tract motility,
secretion, and blood flow
• Thought to have over 100 million neurons
• Can function independently of central nervous system
• But CNS usually exerts influence on its action

• Often considered part of autonomic nervous system

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 General Anatomy

Enteric nervous system is composed of two networks of

neurons
• Submucosal plexus: in submucosa
• Controls glandular secretions of mucosa

• Controls movements of muscularis mucosae

• Myenteric plexus: parasympathetic ganglia and nerve

fibers between the two layers of the muscularis externa
• Controls peristalsis and other contractions of muscularis externa

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 Relationship to the Peritoneum

Mesenteries—connective tissue sheets that

suspend stomach and intestines from
abdominal wall
• Looseness allows stomach and intestines
to undergo strenuous contractions with
freedom of movement in the abdominal
cavity
• Hold abdominal viscera in proper
relationship to each other
• Prevent intestines from becoming twisted
and tangled by changes in body position
and by its own contractions
• Provide passage of blood vessels and
nerves that supply digestive tract
• Contain many lymph nodes and lymphatic
vessels

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 Relationship to the Peritoneum

Parietal peritoneum—a serous membrane that lines the wall

of the abdominal cavity
• Turns inward along posterior midline
• Forms posterior mesentery: a translucent two-layered
membrane extending to the digestive tract
• The two layers of the mesentery separate and pass
around opposite sides of the organ forming the serosa
• Come together on the far side of the organ and continue
as another sheet of tissue, called the anterior mesentery
• May hang freely in the abdominal cavity
• May attach to the anterior abdominal wall or other organs

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 Relationship to the Peritoneum

Lesser omentum—a ventral mesentery that

extends from the lesser curvature of the
stomach to the liver

Greater omentum—hangs from the greater

curvature of the stomach (its left inferior
margin)
• Covers small intestine like an apron
• The inferior margin turns back on itself and
passes upward
• Forming a deep pouch between its deep
and superficial layers
• Inner superior margin forms serous
membranes around the spleen and
transverse colon—mesocolon
• Part of the body’s first line of defense
against toxins and infections

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 Relationship to the Peritoneum

Intraperitoneal—when an organ is enclosed by mesentery on both

sides
• Considered within the peritoneal cavity
• Stomach, liver, and parts of small and large intestine

Retroperitoneal—when an organ lies against the posterior body

wall and is covered by peritoneum on its anterior side only
• Considered to be outside the peritoneal cavity
• Duodenum, pancreas, and parts of the large intestine

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 Regulation of the Digestive Tract

Motility and secretion of the digestive tract are controlled by

neural, hormonal, and paracrine mechanisms

Neural control
• Short (myenteric) reflexes: stretch or chemical stimulation
acts through myenteric plexus
• Stimulates peristaltic contractions of swallowing
• Long (vagovagal) reflexes: parasympathetic stimulation of
digestive motility and secretion

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 Regulation of the Digestive Tract

Hormones
• Chemical messengers secreted into bloodstream that
stimulate distant parts of the digestive tract
• Gastrin and secretin

Paracrine secretions
• Chemical messengers that diffuse through the tissue fluids
to stimulate nearby target cells

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 The Mouth

The mouth is known as the oral, or buccal cavity

Functions
• Ingestion (food intake)
• Taste and other sensory responses to food
• Chewing and chemical digestion
• Swallowing, speech, and respiration

Mouth enclosed by cheeks, lips, palate, and tongue

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 The Mouth

Oral fissure—anterior opening

between lips

Fauces—posterior opening to the

throat

Stratified squamous epithelium

lines mouth
• Keratinized in areas subject to
food abrasion: gums and hard
palate
• Nonkeratinized in other areas:
floor of mouth, soft palate, and
insides of cheeks and lips

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 The Cheeks and Lips

Cheeks and lips

• Retain food and push it between the teeth
• Essential for speech
• Essential for sucking and blowing actions, including
suckling by infants
• Fleshiness due to subcutaneous fat, buccinator muscle of
the cheek, and orbicularis oris of the lips
• Labial frenulum: median fold that attaches each lip to the
gum between the anterior incisors
• Vestibule: space between cheeks or lips and the teeth

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 The Tongue

Lingual glands: serous and mucous glands amid the extrinsic

muscles
• Secrete a portion of the saliva

Lingual tonsils: contained in the root

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 The Palate

Palate—separates oral cavity from nasal

cavity
• Makes it possible to breathe while chewing food

Hard (bony) palate—anterior portion that is

supported by the palatine processes of the
maxillae and the palatine bones
• Palatine rugae: transverse ridges that help the
tongue hold and manipulate food

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 The Palate

Soft palate—posterior to hard palate with

more spongy texture
• Composed of skeletal muscle and glandular tissue
• No bone
• Uvula: conical medial projection visible at the rear of the
mouth
• Helps retain food in the mouth until one is ready to
swallow
Pair of muscular arches on each side of the
oral cavity
• Palatoglossal arch: anterior arch
• Palatopharyngeal arch: posterior arch
• Palatine tonsils are located on the wall between the
arches

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 The Teeth

Masticate (chew) food into smaller pieces

• Makes food easier to swallow
• Exposes more surface area for action of digestive
enzymes, speeding chemical digestion
32 adult teeth

• 16 in mandible (lower jaw)

• 16 in maxilla (upper jaw)

• From midline to the rear of each jaw

• 2 incisors—chisel-like cutting teeth used to bite off a piece of food

• 1 canine—pointed and act to puncture and shred food

• 2 premolars—broad surface for crushing, shredding, and grinding

• 3 molars—even broader surface for crushing, shredding, and grinding

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 The Teeth
Alveolus—tooth socket in bone
• Gomphosis joint formed between tooth and bone

Periodontal ligament—modified periosteum whose collagen

fibers penetrate into the bone on one side and into the tooth
on the other
• Anchors tooth firmly in alveolus
• Allows slight movement under pressure of chewing

Gingiva (gum)—covers the alveolar bone

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 The Teeth

Regions of a tooth
• Crown: portion above the gum
• Root: the portion below the
gum, embedded in alveolar
bone
• Neck: the point where crown,
root, and gum meet
• Gingival sulcus: space between
the tooth and the gum
• Hygiene in the sulcus is important
to dental health

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 The Teeth

Dentin—hard yellowish tissue that makes up most of

the tooth

Enamel—covers crown and neck

• A noncellular secretion that cannot regenerate

Cement—covers root

Cementum and dentin are living tissue and can

regenerate

Root canal—space in a root leading to pulp cavity in

the crown
• Nerves and blood vessels
• Apical foramen: pore at the basal end of each root
canal

Occlusion—meeting of the teeth with the mouth closed

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 The Teeth

20 deciduous teeth (milk teeth or baby teeth)

Teeth develop beneath gums and erupt in a predictable order

• Erupt from 6 to 30 months
• Beginning with incisors
• Between 6 and 25 years of age, are replaced by 32
permanent teeth

Third molars (wisdom teeth) erupt from age 17 to 25 years

• May be impacted: crowded against neighboring teeth and
bone so they cannot erupt

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 Tooth and Gum Disease

The human mouth is home to more than 700 species of

microorganisms, especially bacteria

Plaque—sticky residue on the teeth made up of bacteria and

sugars
• Calculus: calcified plaque
• Bacteria metabolize sugars and release acids that dissolve
the minerals of enamel and dentin to form dental caries
(cavities)

Root canal therapy is necessary if cavity reaches pulp

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 Tooth and Gum Disease

Calculus in the gingival sulcus wedges the tooth and gum

apart
• Allows bacterial invasion of the sulcus
• Gingivitis: inflammation of the gums
• Periodontal disease: destruction of the supporting bone
around the teeth which may result in tooth loss

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 Saliva and the Salivary Glands

Saliva
• Moistens mouth
• Begins starch and fat digestion
• Cleanses teeth
• Inhibits bacterial growth
• Dissolves molecules so they can stimulate the taste buds
• Moistens food and binds it together into bolus to aid in
swallowing

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 Saliva and the Salivary Glands 1 to 1.5 L of saliva per day

Saliva is a hypotonic solution of 97.0% to 99.5% water and the

following solutes:
• Salivary amylase: enzyme that begins starch digestion in the
mouth
• Lingual lipase: enzyme that is activated by stomach acid and
digests fat after food is swallowed
• Mucus: binds and lubricates a mass of food and aids in
swallowing
• Lysozyme: enzyme that kills bacteria
• Immunoglobulin A (IgA): an antibody that inhibits bacterial
growth
• Electrolytes: , , , phosphate, and bicarbonate
• pH: 6.8 to 7.0

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 Histology of Salivary Glands

Compound tubuloacinar
glands
• Branched ducts ending in
acini

Mucous cells secrete mucus

Serous cells secrete thin

fluid rich in enzymes and
electrolytes

Mixed acinus has both

mucous and serous cells

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 The Pharynx

Pharynx—muscular funnel connecting oral cavity to

esophagus and nasal cavity to larynx
• Digestive and respiratory tracts intersect
• Has deep layer of longitudinal skeletal muscle
• Has superficial layer of circular skeletal muscles that form
pharyngeal constrictors (superior, middle, and inferior) that
force food downward during swallowing
• When not swallowing, the inferior constrictor (upper esophageal
sphincter) remains contracted to exclude air from the esophagus
• Disappears at the time of death when the muscles relax, so it is a
physiological sphincter, not an anatomical structure

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 The Esophagus

Esophagus—straight muscular tube 25–30 cm long

• Begins at level between C6 and the cricoid cartilage
• Extends from pharynx to cardial orifice of stomach passing
through esophageal hiatus in diaphragm
• Lower esophageal sphincter: food pauses here because of
constriction
• Prevents stomach contents from regurgitating into the esophagus
• Protects esophageal mucosa from erosive stomach acid
• Heartburn—burning sensation produced by acid reflux into the
esophagus

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 The Esophagus

Nonkeratinized stratified squamous epithelium

Esophageal glands in submucosa secrete mucus

Deeply folded into longitudinal ridges when empty

Skeletal muscle in upper one-third, mix of muscle types in

middle one-third, and only smooth muscle in bottom one-
third

Meets stomach at level of T7

Covered with adventitia

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 Swallowing

Swallowing (deglutition)—a complex action involving over 22

muscles in the mouth, pharynx, and esophagus
• Swallowing center: pair of nuclei in medulla oblongata that
coordinates swallowing
• Communicates with muscles of the pharynx and esophagus by way
of trigeminal, facial, glossopharyngeal, and hypoglossal nerves

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 Swallowing 3

Figure 25.11 Part 1

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 Swallowing 5

Figure 25.11 Part 2

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 Swallowing 7

Figure 25.11 Part 3

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 The Stomach

Stomach—a muscular sac in upper left abdominal cavity

immediately inferior to the diaphragm
• Primarily functions as a food storage organ
• volume of about 50 mL when empty
• 1.0 to 1.5 L after a typical meal
• Up to 4 L when extremely full—can extend nearly as far as the
pelvis

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 The Stomach

Mechanically breaks up food, liquefies it, and begins

chemical digestion of protein and fat
• Chyme: soupy or pasty mixture of semidigested food in
the stomach

Most digestion occurs after the chyme passes on to the small

intestine

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 Gross Anatomy of the Stomach

Stomach—J-shaped; relatively vertical in tall

people, horizontal in short people
• Divided into four regions
• Cardial part (cardia)—small area within
about 3 cm of the cardial orifice

• Fundus—dome-shaped portion superior to

esophageal attachment

• Body—makes up the greatest part of

stomach

• Pyloric part—narrower pouch at the

inferior end
• Subdivided into the funnel-like antrum
• Narrower pyloric canal that terminates
at pylorus
• Pylorus—narrow passage to
duodenum
• Pyloric sphincter—regulates the
passage of chyme into the duodenum

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 Microscopic Anatomy of the Stomach

Stomach has a simple columnar

epithelium covered by mucous

• Apical regions of its surface cells are

filled with mucin

• Mucin swells with water and becomes

mucus after it is secreted

Mucosa and submucosa are flat when

stomach is full but form longitudinal
wrinkles called gastric rugae when empty

Muscularis externa has three layers

(instead of the two seen elsewhere)

• Outer longitudinal, middle circular,

and inner oblique layers

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 Microscopic Anatomy of the Stomach

Gastric pits—depressions in gastric mucosa

• Lined with simple columnar epithelium

• Two or three tubular glands open into the

bottom of each gastric pit

• Cardiac glands in cardial part

• Pyloric glands in pyloric parts

• Gastric glands in the rest of the stomach

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 Microscopic Anatomy of the Stomach
Mucous cells—secrete mucus
• Predominate in cardiac and pyloric glands
• In gastric glands, called mucous neck cells
since they are concentrated at the neck of the
gland

Regenerative (stem) cells—found in base of pit

and in neck of gland
• Divide rapidly and produce continual supply of
new cells to replace cells that die

Parietal cells—found mostly in the upper half of

the gland
• Secrete hydrochloric acid (HCl), intrinsic
factor, and a hunger hormone called ghrelin

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 Hydrochloric Acid

HCl activates pepsin and lingual lipase

Breaks up connective tissues and plant cell walls

• Helps liquefy food to form chyme

Converts ingested ferric ions to ferrous ions

• absorbed and used for hemoglobin synthesis

Contributes to nonspecific disease resistance by destroying most ingested pathogens

Most ulcers are caused by acid-resistant bacteria Helicobacter pylori, which can be treated
with antibiotics and Pepto-Bismol

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 Microscopic Anatomy of the Stomach 4

Chief cells—most numerous

• Secrete gastric lipase and

pepsinogen

• Dominate lower half of gastric

glands

• Absent from pyloric and cardiac

glands

Enteroendocrine cells—concentrated
in lower end of gland

• Secrete hormones and paracrine

messengers that regulate
digestion

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 Pepsin
Zymogens—digestive enzymes secreted as inactive proteins

• Converted to active enzymes by removing some of their amino acids

Pepsinogen—zymogen secreted by chief cells

• Hydrochloric acid removes some of its amino acids and forms pepsin that digests proteins

• Autocatalytic effect—as some pepsin is formed, it converts more pepsinogen into more pepsin

Pepsin digests dietary proteins into shorter peptides

• Protein digestion is completed in the small intestine

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 Gastric Lipase

Gastric lipase—produced by chief cells

Gastric lipase and lingual lipase play a minor role in digesting

dietary fats
• Digests 10% to 15% of dietary fats in the stomach
• Rest digested in the small intestine

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 Intrinsic Factor

Intrinsic factor—a glycoprotein secreted by parietal cells

Essential to absorption of vitamin by the small intestine

• Binds vitamin and then intestinal cells absorb this complex by receptor-
mediated endocytosis

Vitamin is needed to synthesize hemoglobin

• Deficiency causes anemia

Secretion of intrinsic factor is the only indispensable function of the stomach

• Digestion can continue if stomach is removed (gastrectomy), but supplements

will be needed

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 Chemical Messengers

Gastric and pyloric glands have a variety of cells that

produce a variety of chemical messengers
• Most are hormones that enter blood and stimulate distant
cells
• Some are paracrine secretions that stimulate neighboring
cells
• Several are peptides produced in both the digestive tract
and the central nervous system: gut–brain peptides
• Substance P, vasoactive intestinal peptide (VIP), secretin, gastric
inhibitory peptide (GIP), cholecystokinin, and neuropeptide Y (NPY)

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 Gastric Motility

Swallowing center of medulla oblongata signals stomach to relax

Vagus nerve relays message from medulla and activates a receptive-relaxation response in
stomach

• Resists stretching briefly, but relaxes to hold more food

Soon stomach shows a rhythm of peristaltic contractions controlled by enteric pacemaker

cells in longitudinal layer of muscularis externa

• A ring of constriction every 20 seconds

• Becomes stronger contraction at pyloric part

• After 30 minutes or so these contractions become quite strong

• They churn the food, mix it with gastric juice, and promote its physical breakup and
chemical digestion

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 Gastric Motility

Thick muscularis of antrum acts as a strong pump that breaks up

semidigested food and prepares it for intestine

Antral contractions come in waves that churn and break up the chyme
into small particles

Only about 3 mL of chyme is squirted into the duodenum at a time; this

small amount allows duodenum to:
• Neutralize the stomach acid
• Digest nutrients little by little

If duodenum is overfilled, it inhibits gastric motility

Typical meal emptied from stomach in 4 hours

• Less time if the meal is more liquid
• As long as 6 hours for a high-fat meal

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 Vomiting

Vomiting—forceful ejection of stomach and intestinal contents (chyme) from the mouth

Emetic center in the medulla oblongata integrates multiple muscle actions

Vomiting induced by:

• Overstretching of the stomach or duodenum
• Chemical irritants such as alcohol and bacterial toxins
• Visceral trauma
• Intense pain or psychological and sensory stimuli

Chronic vomiting
• Results in dangerous fluid, electrolyte, and acid–base imbalances
• Bulimia: eating disorder; hydrochloric acid in vomit causes tooth
enamel to erode

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 Digestion and Absorption

Stomach does not absorb any significant amount of nutrients

• Does absorb aspirin and some lipid-soluble drugs

Alcohol is absorbed mainly by small intestine

• Intoxicating effects depend partly on how rapidly the
stomach is emptied

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 Regulation of Gastric Function

Figure 25.17
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 Regulation of Gastric Function 3

Cephalic phase

• Stomach responds to sight, smell, taste, or

thought of food

• Sensory and mental inputs converge on

hypothalamus

• Hypothalamus relays signals to medulla

oblongata

• Vagus nerve fibers from medulla stimulate the

enteric nervous system of stomach, stimulating
gastric secretion

• 40% of stomach’s acid secretion occurs in

cephalic phase

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 Regulation of Gastric Function 4

Gastric phase
• Period in which swallowed food and
semidigested protein activate gastric
activity
• Two-thirds of gastric secretion and one-
half of acid secretion occur in this
phase
• Ingested food stimulates gastric activity in
two ways
• By stretching the stomach
• Activates short reflex mediated
through myenteric plexus; activates
long reflex mediated through the
vagus nerves and the brainstem
• By increasing the pH of its contents

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 Regulation of Gastric Function 5

Gastric secretion is stimulated by three chemicals

• Acetylcholine (ACh)—secreted by parasympathetic nerve
fibers of both reflexes
• Histamine—a paracrine secretion from enteroendocrine
cells in the gastric glands
• Gastrin—a hormone produced by the enteroendocrine G
cells in pyloric glands

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 Regulation of Gastric Function 6

Intestinal phase
• Duodenum responds to arriving chyme and
moderates gastric activity through hormones and
nervous reflexes
• Duodenum initially enhances gastric secretion but
soon inhibits it
• Stretching of duodenum accentuates vagovagal
reflex that stimulates stomach
• Peptides and amino acids in chyme stimulate G
cells of duodenum to secrete more gastrin,
further stimulating stomach
• Soon acids and fats trigger enterogastric reflex
—duodenum sends inhibitory signals to stomach
by way of enteric nervous system
• Duodenum also signals medulla to inhibit vagal
nuclei (reducing vagal stimulation of stomach)
and stimulate sympathetic neurons (sending
inhibitory signals to the stomach)

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 Regulation of Gastric Function 7

Intestinal phase (continued)

• Chyme also stimulates duodenal enteroendocrine cells to release
secretin and cholecystokinin
• They stimulate the pancreas and gallbladder
• Also suppress gastric secretion
• Gastrin secretion declines and pyloric sphincter contracts tightly to
limit chyme entering duodenum
• Gives duodenum time to work on chyme
• Enteroendocrine cells also secrete glucose-dependent insulinotropic
peptide (GIP) originally called gastrin-inhibiting peptide
• Stimulates insulin secretion in preparation for processing nutrients about to
be absorbed by small intestine

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 The Liver, Gallbladder, and Pancreas

Small intestine receives chyme from stomach and secretions

from liver and pancreas
• These secretions enter digestive tract near the junction of
stomach and small intestine
• These secretions are important to the digestive process of
the small intestine

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 The Liver

Liver—reddish brown gland located immediately inferior to the diaphragm

The body’s largest gland

• Weighs about 1.4 kg (3 lbs)

Variety of functions

• Secretes bile which contributes to digestion

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 Gross Anatomy of Liver

Four lobes—right, left, quadrate, and caudate

• Falciform ligament separates left and right lobes

• Sheet of mesentery that suspends the liver from the diaphragm

• Round ligament (ligamentum teres)—fibrous remnant of umbilical vein

• Carries blood from umbilical cord to liver of the fetus

From inferior view, squarish quadrate lobe next to the gallbladder and a tail-like caudate
lobe posterior to that

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 Gross Anatomy of Liver 2

Hilum—irregular opening between quadrate and caudate lobes

• Point of entry for hepatic portal vein and proper hepatic artery

• Point of exit for the bile passages

• All travel in lesser omentum

Gallbladder—adheres to a depression on the inferior surface of the liver, between right and
quadrate lobes

Bare area on superior surface where it attaches to diaphragm

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 Microscopic Anatomy of the Liver
Hepatic lobules—tiny cylinders that fill the interior of the liver

• About 2 mm long and 1 mm in diameter

• Central vein: passes down the core

• Hepatocytes: cuboidal cells surrounding central vein in radiating sheets or

plates

• Each plate of hepatocytes is an epithelium one or two cells thick

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 Microscopic Anatomy of the Liver 3

Hepatic sinusoids: blood-filled channels that fill spaces between the plates
• Lined by a fenestrated endothelium that separates hepatocytes from blood cells
• Allows plasma into the space between the hepatocytes and endothelium
• Hepatocytes have brush border of microvilli that project into this space
• Blood filtered through the sinusoids comes directly from the stomach and intestines,
enters through hepatic portal vein and leaves to drain into vena cava

Stellate macrophages: phagocytic cells in the sinusoids that remove bacteria and debris
from the blood

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 Microscopic Anatomy of the Liver

Hepatocytes

• After a meal, hepatocytes absorb from

the blood: glucose, amino acids, iron,
vitamins, and other nutrients for
metabolism or storage

• Between meals, hepatocytes break

down stored glycogen and release
glucose into the blood

• Remove and degrade: hormones,

toxins, bile pigments, and drugs

• Secrete into the blood: albumin,

lipoproteins, clotting factors,
angiotensinogen, and other products

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 Microscopic Anatomy of the Liver

Bile canaliculi—narrow channels into which

the liver secretes bile

Bile passes into bile ductules of the triads

Ultimately into the right and left hepatic ducts

Common hepatic duct: formed from

convergence of right and left hepatic ducts on
inferior side of the liver

Cystic duct coming from gallbladder joins

common hepatic duct

Bile duct: formed from union of cystic and

common hepatic ducts

• Descends through lesser omentum

toward the duodenum

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 The Gallbladder and Bile

Gallbladder—a pear-shaped sac on underside of liver

• Serves to store and concentrate bile by absorbing water
and electrolytes
Bile—yellow-green fluid containing minerals, cholesterol, neutral fats, phospholipids, bile
pigments, and bile acids
Bilirubin: principal pigment derived from the decomposition of hemoglobin
Bacteria in large intestine metabolize bilirubin to urobilinogen
Stercobilin responsible for the brown color of feces
Urobilin responsible for yellow color of urine
Bile acids (bile salts): steroids synthesized from cholesterol
Bile acids and lecithin, a phospholipid, aid in fat digestion and absorption
Gallstones may form if bile becomes excessively concentrated with wastes

© McGraw Hill 71
 The Gallbladder and Bile

Gallstones (biliary calculi)—hard masses in either the

gallbladder or bile ducts
• Composed of cholesterol, calcium carbonate, and bilirubin

Cholelithiasis—presence of gallstones
• Most common in obese women over 40—excess cholesterol

Painful obstruction of ducts

• Result in jaundice (yellowing of skin), poor fat digestion, and
impaired absorption of fat-soluble vitamins

Lithotripsy—use of ultrasonic vibration to pulverize stones without

surgery
© McGraw Hill 72
 The Pancreas

Pancreas—spongy retroperitoneal gland posterior to greater

curvature of stomach
• Measures 12 to 15 cm long, and 2.5 cm thick
• Has a head encircled by duodenum, a body (midportion),
and a tail on the left
• Both an endocrine and exocrine gland
• Endocrine portion—pancreatic islets that secrete insulin and
glucagon; concentrated in the tail of the gland
• Exocrine portion—99% of pancreas that secretes 1,200 to 1,500
mL of pancreatic juice per day
• Secretory acini release their secretion into small ducts that converge on
the main pancreatic duct

© McGraw Hill 73
 The Pancreas 2

Pancreas (continued)
• Pancreatic duct runs lengthwise through middle of the
gland
• Joins the bile duct at the hepatopancreatic ampulla
• Hepatopancreatic sphincter controls release of both bile and
pancreatic juice into the duodenum
• Accessory pancreatic duct: smaller duct that branches
from the main pancreatic duct
• Opens independently into the duodenum
• Bypasses the sphincter and allows pancreatic juice (alkaline
mixture of water, enzymes, zymogens, sodium bicarbonate, and
other electrolytes ) to be released into duodenum even when bile is
not
© McGraw Hill 74
 The Pancreas 4
Pancreatic zymogens are:

• Trypsinogen

• Secreted into intestinal lumen

• Converted to trypsin by enteropeptidase that is secreted by mucosa of small
intestine
• Trypsin is autocatalytic—converts trypsinogen into still more trypsin

• Chymotrypsinogen: converted to trypsinogen by trypsin

• Procarboxypeptidase: converted to carboxypeptidase by trypsin

© McGraw Hill 75
 The Pancreas 5

Other pancreatic enzymes

• Pancreatic amylase: digests starch
• Pancreatic lipase: digests fat
• Ribonuclease and deoxyribonuclease: digest RNA and
DNA, respectively

© McGraw Hill 76
 Regulation of Secretion 1

Three stimuli are chiefly responsible for the release of

pancreatic juice and bile: acetylcholine, cholecystokinin, and
secretin
• Acetylcholine (ACh): from vagus and enteric nerves
• Stimulates acini to secrete enzymes during cephalic phase of
gastric control even before food is swallowed
• Enzymes remain in acini and ducts until chyme enters the duodenum

© McGraw Hill 77
 Regulation of Secretion 2

Cholecystokinin (CCK): secreted by mucosa of

duodenum in response to arrival of fats in small
intestine
• Stimulates pancreatic acini to secrete enzymes
• Strongly stimulates gallbladder
• Induces contractions of gallbladder and
relaxation of hepatopancreatic sphincter to
discharge bile into duodenum
Secretin: released from duodenum in response to
acidic chyme arriving from the stomach
• Stimulates ducts of both liver and pancreas to
secrete more sodium bicarbonate
• Raises pH to the level required for activity of
the pancreatic and intestinal digestive enzymes

© McGraw Hill 78
 The Small Intestine

Nearly all chemical digestion and

nutrient absorption occurs in the
small intestine

The longest part of the digestive

tract
• About 5 m long in a living
person
• Up to 8 m long in a cadaver—
no muscle tone

“Small” intestine refers to the

diameter—not length
• Diameter is about 2.5 cm (1
in.)

© McGraw Hill 79
 Gross Anatomy of the Small Intestine 2

Small intestine—coiled tube filling most of the abdominal

cavity inferior to stomach and liver

Divided into three regions:

• Duodenum: first 25 cm (10 in.)
• Begins at pyloric valve
• Major and minor duodenal papillae distal to pyloric valve
• Receives major and minor pancreatic ducts, respectively
• Arches around head of the pancreas
• Ends at a sharp bend called the duodenojejunal flexure

© McGraw Hill 80
 Gross Anatomy of the Small Intestine 3

Small intestine regions (continued):

Duodenum
• Most is retroperitoneal
• Receives stomach contents, pancreatic
juice, and bile
• Stomach acid is neutralized here
• Fats are physically broken up (emulsified)
by bile acids
• Pepsin is inactivated by increased pH
• Pancreatic enzymes perform chemical
digestion

© McGraw Hill 81
 Gross Anatomy of the Small Intestine 4

Small intestine regions (continued)

• Jejunum: first 40% of small
intestine beyond duodenum
• Roughly 1.0 to 1.7 m in a
living person
• Has large, tall, closely spaced
circular folds
• Its wall is relatively thick and
muscular
• Especially rich blood supply
which gives it a red color
• Most digestion and nutrient
absorption occurs here

© McGraw Hill 82
 Gross Anatomy of the Small Intestine 5

Small intestine regions (continued):

• Ileum: forms last 60% of the postduodenal small
intestine
• About 1.6 to 2.7 m, thinner, less muscular, less
vascular, and paler pink color
• Aggregated lymphoid nodules—prominent
lymphatic nodules in clusters on the side opposite
the mesenteric attachment; visible to naked eye;
become larger near large intestine
• Ileocecal junction—end of the small intestine;
where the ileum joins the cecum of the large
intestine
• Ileal papilla—formed by the thickened muscularis of
the ileum; protrudes into the cecum; regulates
passage of food residue into the large intestine
• Both jejunum and ileum are intraperitoneal and
covered with serosa

© McGraw Hill 83
 Circulation

The small intestine receives nearly all of its blood supply

from the superior mesenteric artery

Fans out through the mesentery to give rise to 12 to 15

jejunal and ileal arteries

Superior mesenteric vein

• This joins the splenic vein and then flows into the hepatic
portal system, headed for the liver with its load of nutrients

© McGraw Hill 84
 Microscopic Anatomy of the Small Intestine 1

Small intestine tissues designed for nutrient digestion and

absorption
• Lumen lined with simple columnar epithelium
• Muscularis externa is noted for a thick inner circular layer
and a thinner outer longitudinal layer
• Large internal surface area—great length and three types
of internal folds or projections
• Circular folds (plicae circulares)—increase surface area by a factor
of 2 to 3
• Villi—increase surface area by a factor of 10
• Microvilli—increase the surface area by a factor of 20

© McGraw Hill 85
 Microscopic Anatomy of the Small Intestine 2

Circular folds (plicae circulares)—largest folds of intestinal wall

• Up to 10 mm high
• Involve only mucosa and submucosa
• Occur from duodenum to middle of ileum
• Relatively small and sparse in ileum; not found in distal half, as most
nutrient absorption is completed by this point

• Cause chyme flow in spiral path causing more contact with

mucosa
• Promote more thorough mixing and nutrient absorption

© McGraw Hill 86
 Microscopic Anatomy of the Small Intestine 3

Villi—finger-like projections 0.5 to 1 mm

tall

• Make mucosa look fuzzy

• Villus covered with two types of

epithelial cells

• Absorptive cells (enterocytes)

• Goblet cells—secrete mucus

• Epithelia joined by tight junctions that

prevent digestive enzymes from
seeping between them

• Core of villus filled with areolar tissue

of lamina propria

• Contains arteriole, capillaries,

venule, and lymphatic capillary
called a lacteal

© McGraw Hill 87
 Microscopic Anatomy of the Small Intestine 4

Microvilli—form a fuzzy brush border on apical

surface of each absorptive cell
• About 1 μm high; increase absorptive surface area

Brush border enzymes—contained in plasma

membrane of microvilli
• Carry out some of the final stages of enzymatic digestion
• Not released into the lumen
• Contact digestion: chyme must contact the brush border for
digestion to occur
• Intestinal churning of chyme ensures contact with the
mucosa

© McGraw Hill 88
 Microscopic Anatomy of the Small Intestine 5

Intestinal crypts—numerous pores that open into

tubular glands on the floor of the small intestine
between bases of the villi
• Similar to gastric glands
• In upper half, have enterocytes and goblet cells like
the villi
• In lower half, dominated by dividing stem cells
• Life span of 3 to 6 days; new epithelial cells
migrate up the crypt to the tip of the villus where
they are sloughed off and digested
• A few Paneth cells are clustered at the base of
each crypt
• Secrete lysozyme, phospholipase, and
defensins—defensive proteins that resist
bacterial invasion of the mucosa

© McGraw Hill 89
 Microscopic Anatomy of the Small Intestine

Duodenal glands—in submucosa of duodenum

• Secrete an abundance of bicarbonate-rich mucus
• Neutralize stomach acid and shield the mucosa from its
erosive effects

Large population of lymphocytes throughout lamina propria

and submucosa of small intestine
• Intercept pathogens before they can invade bloodstream
• Aggregated into lymphatic nodules in ileum

© McGraw Hill 90
 Intestinal Motility 1

Contractions of small intestine serve three functions

• To mix chyme with intestinal juice, bile, and pancreatic
juice
• To neutralize acid
• Digest nutrients more effectively

• To churn chyme and bring it in contact with the mucosa for

contact digestion and nutrient absorption
• To move residue toward large intestine

© McGraw Hill 91
 Intestinal Motility
Segmentation—movement in which stationary ring-like constrictions appear in several
places along the intestine

• They relax and new constrictions form elsewhere

• Most common kind of intestinal contraction

• Enteric pacemaker cells in muscularis externa set rhythm of segmentation

• Contractions about 12 times per minute in the duodenum

• 8 to 9 times per minute in the ileum

• When most nutrients have been absorbed and little remains but undigested residue,
segmentation declines and peristalsis begins

© McGraw Hill 92
 Intestinal Motility 4

Ileal papilla usually closed

• Food in stomach triggers gastroileal reflex that enhances
segmentation in the ileum and relaxes the valve
• As cecum fills with residue, pressure pinches the valve
shut
• Prevents reflux of cecal contents into the ileum

© McGraw Hill 93
 Carbohydrate Digestion

Starch—most digestible dietary

carbohydrate
• Cellulose is indigestible
• Starch is first digested to
oligosaccharides (up to
eight glucose residues long)
• Oligosaccharides then
digested to the disaccharide
maltose
• Maltose finally digested to
glucose which is absorbed
by the small intestine

© McGraw Hill 94
 Carbohydrate Digestion

Process begins in the mouth

• Salivary amylase hydrolyzes
starch into oligosaccharides
• Amylase works best at pH of
6.8 to 7.0 of oral cavity
• Amylase quickly denatured on
contact with stomach acid and
digested by pepsin
• About 50% of dietary starch is
digested before it reaches
small intestine
• Pancreatic amylase resumes
starch digestion in intestine

© McGraw Hill 95
 Carbohydrate Digestion

When reaching small intestine, pancreatic amylase quickly

converts starch to oligosaccharides and maltose

Brush border enzymes continue carbohydrate digestion:

• Dextrinase and glucoamylase hydrolyze oligosaccharides
• Maltase hydrolyzes maltose (a disaccharide)
• Sucrase and lactase hydrolyze the disaccharides sucrose
and lactose
• In most people, lactase production stops in childhood

• Monosaccharides produced by disaccharide hydrolysis

(such as glucose) are immediately absorbed

© McGraw Hill 96
 Carbohydrate Digestion

Plasma membrane of absorptive cells has transport proteins that absorb

monosaccharides as soon as brush border enzymes release them

80% of absorbed sugar is glucose

• Taken up by sodium–glucose transport (SGLT) proteins
• Glucose is transported out the base of absorptive cell into ECF by
facilitated diffusion
• Sugar entering ECF increases its osmolarity
• Draws water osmotically from lumen of intestine, through leaky tight
junctions between epithelial cells
• Water carries more glucose and other nutrients with it by solvent drag

© McGraw Hill 97
 Carbohydrate Digestion

SGLT also absorbs galactose

Fructose is absorbed by facilitated

diffusion (by a different carrier
protein) and converted to glucose

Glucose, galactose, and any

remaining fructose are
transported out of the base of the
cell by facilitated diffusion

Absorbed by blood capillaries in

the villus

Hepatic portal system delivers

them to the liver

© McGraw Hill 98
 Lactose Intolerance

In people without lactase, lactose passes undigested into large

intestine
• Increases osmolarity of intestinal contents
• Causes water retention in the colon and diarrhea
• Gas production by bacterial fermentation of the lactose

Occurs in many people

• 15% of American Whites, 90% of American Blacks, 70% of
Mediterraneans; and nearly all of Asian descent

Can consume yogurt and cheese since bacteria have broken down
the lactose

© McGraw Hill 99
 Protein Digestion

Amino acids absorbed by the small intestine come from three

sources
• Dietary proteins
• Digestive enzymes digested by each other
• Sloughed epithelial cells digested by enzymes

Endogenous amino acids from last two sources total about

30 g/day

Exogenous amino acids from our diet total about 44 to 60

g/day

© McGraw Hill 100

 Protein Digestion 2

Proteases (peptidases)—enzymes that digest proteins

• Begin their work in stomach in optimum pH of 1.5 to 3.5
• Pepsin hydrolyzes any peptide bond between tyrosine and
phenylalanine
• Pepsin digests 10% to 15% of dietary protein into shorter peptides
and some free amino acids

© McGraw Hill 101

 Protein Digestion 3

Protein digestion continues in small intestine

• Pepsin inactivated when it passes into the duodenum and
mixes with alkaline pancreatic juice (pH 8)
• Pancreatic enzymes trypsin and chymotrypsin take over
the process
• Hydrolyze polypeptides into even shorter oligopeptides

© McGraw Hill 102

 Protein Digestion 4

Oligopeptides taken apart one

amino acid at a time by three more
enzymes
• Carboxypeptidase—removes
amino acids from –COOH end of
the chain
• Carboxypeptidase is a
pancreatic secretion
• Aminopeptidase—removes
amino acids from –NH2 end
• Dipeptidase—splits dipeptides in
the middle and release two free
amino acids
• Aminopeptidase and dipeptidase
are brush border enzymes

© McGraw Hill 103

 Protein Absorption 1
Brush border enzymes finish task, producing free amino
acids that are absorbed into intestinal epithelial cells
• Sodium-dependent amino acid cotransporters move amino
acids into epithelial cells
• Facilitated diffusion moves amino acids out into
bloodstream
Infants absorb proteins by pinocytosis (maternal IgA) and
release them into the blood by exocytosis

© McGraw Hill 104

 Lipids Absorption

Hydrophobicity of lipids makes their digestion and

absorption complicated
Lipases—fat-digesting enzymes
• Lingual lipase secreted by intrinsic salivary glands of the
tongue
• Active in mouth, but more active in stomach along with gastric
lipase
• 10% to 15% of lipids digested before reaching duodenum

• Before digestion in duodenum, vigorous pumping in

stomach’s antrum emulsifies the fat (breaks up globs)
• Emulsification droplets are passed to small intestine

© McGraw Hill 105

 Lipid Digestion

Emulsification droplets are broken down further by bile, lecithin, and agitation produced
by intestinal segmentation
• Exposes more fat surface to enzymatic action

There is enough pancreatic lipase in the small intestine after a meal to digest the
average daily fat intake in as little as 1 to 2 minutes

Lipase acts on triglycerides

• Removes first and third fatty acids from glycerol backbone, but leaves the middle
one
• The product of lipase action are two free fatty acids (FFAs) and a monoglyceride

© McGraw Hill 106

 Lipid Digestion

Absorption of free fatty acids, monoglycerides, and other lipids depends on minute droplets
in the bile called micelles

• Made in the liver

• Consist of 20 to 40 bile acid molecules aggregated with their hydrophilic side groups
facing outward and their hydrophobic steroid rings facing inward

• Bile phospholipids and cholesterol diffuse into the center of the micelle to form its core

© McGraw Hill 107

 Lipid Digestion 3

Micelles pass down the bile duct into the duodenum

• There they absorb fat-soluble vitamins, cholesterol, and
the FFAs and monoglycerides produced by fat digestion

They transport lipids to the surface of the intestinal

absorptive cells

Lipids leave the micelles and diffuse through the plasma

membrane into the cells

Micelles are reused, picking up another cargo of lipid,

transporting them to the absorptive cells

© McGraw Hill 108

 Lipid Digestion 4

Within the intestinal cell, free fatty acids and monoglycerides are
transported to the smooth ER

Resynthesized into triglycerides

Golgi complex coats these with phospholipids and protein to form

chylomicrons
• Packaged into secretory vesicles that migrate to basal surface
of cell
• Release their contents into core of villus
• Taken up by lacteal into lymph
• White, fatty intestinal lymph (chyle) flows into larger and larger
lymphatic vessels until it enters the bloodstream

© McGraw Hill 109

 Chylomicron Formation

Figure 25.31
© McGraw Hill 110
 Nucleic Acid Digestion

Nucleic acid
• Nucleases (deoxyribonuclease and ribonuclease) of
pancreatic juice hydrolyze DNA and RNA to nucleotides
• Nucleosidases and phosphatases of brush border split
them into phosphate ions, ribose or deoxyribose sugar,
and nitrogenous bases
• Membrane carriers allow absorption

© McGraw Hill 111

 Vitamins

Vitamins
• Absorbed unchanged
• Fat-soluble vitamins: A, D, E, and K absorbed with other
lipids
• If ingested without fat-containing food, they are not absorbed at all
but are passed in the feces and wasted
• Water-soluble vitamins, B complex and C, absorbed by
simple diffusion and if bound to intrinsic factor from the
stomach

© McGraw Hill 112

 Minerals

Minerals (electrolytes)
• Absorbed all along small intestine
• Na+ cotransported with sugars and amino acids
• Cl− exchanged for bicarbonate reversing chloride–
bicarbonate exchange that occurs in the stomach
• K+ absorbed by simple diffusion

© McGraw Hill 113

 Minerals

Iron and calcium absorbed as needed

• Iron absorption is inhibited by liver hormone hepcidin to
prevent overload
• Absorptive cells bind ferrous ions (Fe2+) and internalize
them by active transport
• Unable to absorb ferric ions (Fe3+) but stomach acid
reduces ferric ions to absorbable ferrous ions
• Transferrin (extracellular protein) transports iron in blood
to bone marrow, muscle, and liver

© McGraw Hill 114

 Minerals

Calcium is absorbed throughout the intestine by different

mechanisms
• Transcellular absorption in the duodenum
• Enters through calcium channels in apical cell membrane
• Binds to calbindin protein so concentration gradient will continue to
favor calcium influx
• Actively transported out of base of cell into bloodstream by
calcium–ATPase and Na+–Ca2+ antiport
• Diffusion between epithelial cells in jejunum and ileum
• Most absorbed calcium is from meat and dairy
• Dietary fat retards calcium absorption

© McGraw Hill 115

 Minerals

Parathyroid hormone—secreted in response to a drop in blood

calcium levels
• Stimulates kidney to synthesize vitamin D from precursors
made by epidermis and liver
• Vitamin D affects absorptive cells of the duodenum in three
ways
• Increases number of calcium channels in apical membrane
• Increases the amount of calbindin in cytoplasm
• Increases the number of calcium–ATPase pumps at basal membrane
• Parathyroid hormone increases the level of calcium in the
blood

© McGraw Hill 116

 Water

Digestive system is one of several systems involved in fluid

balance
Digestive tract receives about 9 L of water/day
• 0.7 L in food, 1.6 L in drink, 6.7 L in gastrointestinal
secretions
• 8 L is absorbed by small intestine and 0.8 L by large
intestine
• 0.2 L voided in daily fecal output

© McGraw Hill 117

 Water

Water is absorbed by osmosis following the absorption of

salts and organic nutrients

Diarrhea—occurs when large intestine absorbs too little

water
• Feces pass through too quickly if intestine is irritated
• Feces contain high concentrations of a solute (such as
lactose)

Constipation—occurs when fecal movement is slow, too

much water gets reabsorbed, and feces become hardened

© McGraw Hill 118

 Gross Anatomy of the Large Intestine 1

Large intestine
• Measures 1.5 m (5 ft.) long and 6.5
cm (2.5 in.) in diameter in cadaver
• Begins as cecum inferior to ileal
papilla
• Appendix attached to lower end of
cecum
• Densely populated with
lymphocytes—a significant
source of immune cells
• Ascending colon, right colic (hepatic)
flexure, transverse colon, left colic
(splenic) flexure, and descending
colon frame the small intestine
• Sigmoid colon is S-shaped portion
leading down into pelvic cavity

© McGraw Hill 119

 Gross Anatomy of the Large Intestine 2

Rectum: portion ending at anal canal

• Has three curves and three infoldings,
called the transverse rectal folds (rectal
valves)
Anal canal: final 3 cm of the large intestine
• Passes through levator ani muscle and
pelvic floor, terminates at the anus
• Anal columns and sinuses—exude
mucus and lubricant into anal canal
during defecation
• Large hemorrhoidal veins for superficial
plexus in anal columns and around
orifice
• Hemorrhoids—permanently distended
veins that protrude into anal canal or
bulge outside the anus

• Obesity and pregnancy

© McGraw Hill 120

 Gross Anatomy of the Large Intestine 3

Muscularis externa of colon is unusual

• Taenia coli—longitudinal fibers
concentrated in three thickened, ribbon-like
strips
• Haustra—pouches in the colon caused by
the muscle tone of the taeniae coli
• Internal anal sphincter—smooth muscle of
muscularis externa
• External anal sphincter—skeletal muscle of
pelvic diaphragm

Omental appendices—club-like, fatty pouches

of peritoneum adhering to the colon; unknown
function
Supplied by mesenteric arteries.
The superior and inferior mesenteric veins drain the same parts of
the large intestine as the correspondingly named arteries and drain
into the hepatic portal system
© McGraw Hill 121
 Microscopic Anatomy of the Large Intestine

Mucosa—simple columnar epithelium

• Anal canal has nonkeratinized stratified squamous epithelium in its lower half for abrasion
resistance

No circular folds or villi in large intestine

Intestinal crypts—glands sunken deep into lamina propria with a high density of mucus-secreting goblet
cells

Lamina propria and submucosal have a lot of lymphatic tissue

• Provides protection from large population of bacteria in large intestine

© McGraw Hill 122

 Intestinal Microbes and Gas

Gut microbiome—about 800 species of bacteria that populate

the large intestine
• Bacteria digest cellulose, pectin, and other carbohydrates for
which our cells lack enzymes
• Help in synthesis of vitamins B and K
Flatus—intestinal gas
• Average person produces 500 mL of flatus per day
• Most gas in large intestine is reabsorbed instead
• Much of flatus is swallowed air, but bacteria add to it
• Hydrogen sulfide, indole, and skatole produce odor
• Hydrogen gas may explode during electrical cauterization used in
surgery

© McGraw Hill 123

 Absorption and Motility 1

Large intestine takes about 36 to 48 hours to reduce residue

of a meal to feces
• Most time in transverse colon
• Does not chemically change the residue
• Reabsorbs water and electrolytes

Feces consist of about 75% water and 25% solids

• Solids: 30% bacteria, 30% undigested fiber, 10% to 20%
fat, small amount of mucus, proteins, salts, digestive
secretions, and sloughed epithelial cells

© McGraw Hill 124

 Absorption and Motility

Haustral contractions occur every 30 minutes

• Distension of a haustrum stimulates it to contract
• Churns and mixes residue promoting water and salt
absorption

Mass movements—stronger contractions that occur one to

three times a day
• Triggered by gastrocolic and duodenocolic reflexes
• Filling of the stomach and duodenum stimulates motility of the
colon
• Move residue several centimeters

© McGraw Hill 125

 Neural Control of Defecation

Figure 25.35
© McGraw Hill 126