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Chapter 24: The Digestive System BIO 211 Lecture Instructor: Dr. Gollwitzer 1 • Today in class we will: – Describe the general functions of the digestive system – Discuss how enzymes work – Discuss the movement of digestive materials through the digestive tract – Discuss the mechanisms that control digestive functions – Begin our discussion on the major functions of the organs, regions and anatomical structures of the digestive tract • Oral cavity – Tongue – Saliva – Mastication • Pharynx – Deglutition – Swallowing reflex • Esophagus • Stomach – Secretory structures and secretions 2 Components and Primary Functions Figure 24-1 3 Digestive System • Provides fuel that keeps body running – Glucose – ATP • Provides building blocks needed for cell growth and repair – Monosaccharides (carbohydrates, CHOs) – Amino acids (proteins) – Monoglycerides and fatty acids (lipids) 4 Functions of the Digestive System • • • • • • Ingestion Mechanical processing Digestion Secretion Absorption Excretion 5 Functions of the Digestive System • Ingestion – Entry of materials into digestive tract via mouth 6 Functions of the Digestive System • Mechanical processing – = Crushing/shearing of food – Makes materials easier to move along GI tract – Increases surface area of available to enzymes – May/may not be required before ingestion • Not for liquids • For solids – Teeth- tear, mash food (mastication) – Tongue – squashes, compacts food – Stomach and intestines – swirl, mix, churn 7 Functions of the Digestive System • Digestion – = Chemical breakdown of food into small organic fragments that can be absorbed by digestive epithelium – Simple molecules absorbed intact, e.g., glucose – Larger molecules must be broken down by digestive enzymes (e.g., polysaccharides, proteins, triglycerides) 8 Functions of the Digestive System • Secretion – = Release of water, acids, enzymes, buffers, salts into digestive tract – By: • Digestive tract epithelium • Glandular organs, e.g., pancreas – Into digestive tract 9 Functions of the Digestive System • Absorption – Movement of organic substrates, electrolytes (ions), vitamins, water – Across digestive epithelium and into interstitial fluid around digestive tract – Surface area greatly increased by folds in lining of digestive tract 10 Functions of the Digestive System • Excretion – Digestive tract and glandular organs waste products into lumen of tract – Waste mixes with indigestible residue of digestive process – Leaves body as feces eliminated through defecation 11 Lining of the Digestive Tract • Protects surrounding tissues against: – Corrosion from digestive acids and enzymes – Mechanical stresses, abrasion – Bacteria swallowed with food that are found naturally in digestive tract 12 Enzymes • Are catalysts: – Proteins that lower the activation energy of a chemical reaction – Not changed or used up in the reaction 13 How Enzymes Work Figure 2–21 14 Movement of Digestive Materials • By smooth muscle layers of digestive tract • Pacesetter cells – Smooth muscle cells in: • Muscularis mucosae • Muscularis externa – Contract spontaneously – Trigger rhythmic waves of contraction that spread through digestive tract 15 Figure 24-3 16 Movement of Digestive Materials • Muscularis externa – Involved in: • Peristalsis • Segmentation 17 Movement of Digestive Materials • Peristalsis – Waves of muscular contractions – Move bolus (small, oval mass of digestive contents) along GI tract – Process: • Circular muscles behind bolus contract, while circular muscles ahead of bolus relax • Longitudinal muscles ahead of bolus contract (shortens adjacent segments) • Bolus forced forward 18 Figure 24-4, 7th edition 19 Movement of Digestive Materials • Mass movements – Powerful peristaltic contractions – Move GI contents from transverse colon through rest of large intestine ( bowel movements) 20 Movement of Digestive Materials • Segmentation – Regional mechanical processing (e.g., haustral churning in large intestine) – Cycles of contractions • Churn and break up the bolus • Mix contents with intestinal secretions – Not a set pattern so does not push materials along tract 21 Control of Digestive Functions • Regulated by 3 types of mechanisms – Neural – Hormonal – Local 22 Figure 24-5, 7th edition 23 Neural Mechanisms • Control – Movement of materials along digestive tract • Local peristaltic movements – Control small segments (via short reflex to myenteric plexus) • Large-scale peristaltic waves – Control movement from one region of digestive tract to another (via long reflex to CNS) – Digestive gland secretions • Exocrine secretory cells buffers, acids, enzymes • Enteroendocrine cells hormones 24 Hormonal Mechanisms • Via hormones produced by digestive tract • Hormones – Are peptides (e.g., gastrin, secretin, cholecystokinin CCK, gastric inhibitory peptide GIP) – Produced by enteroendocrine cells in stomach (gastrin) or duodenum (secretin, CCK, GIP) – Target cells in stomach, small intestine, liver, pancreas – Reach targets via bloodstream – Affect every aspect of digestive function – Can stimulate or inhibit smooth muscle cells’ responses to neural commands 25 Local Mechanisms • Via local factors, e.g., – pH, chemical messengers, e.g., prostaglandins, histamine • Coordinate response to local conditions • Affect only that portion of tract, e.g., – Lamina propria of stomach releases histamine secretion of HCl by parietal cells 26 Oral Cavity • Tongue – Functions • Mechanical processing - compresses, abrades food • Manipulation – assists in chewing, preparing material for swallowing • Sensory analysis - by touch, temperature, taste receptors • Secretion – Mucins mucous layer – Lingual lipase breaks down lipids 27 Oral Cavity • Saliva – Produced by 3 pairs of salivary glands • Submandibulars 70 % • Parotids 25% • Sublinguals 5% – Components • Water 99.4% • Remaining 0.6%: – – – – Electrolytes (Na, Cl, HCO3) Buffers pH near 7.0 Glycoproteins (mucins) lubricating action Antibodies and digestive enzymes – help control oral bacteria 28 Oral Cavity • Saliva (continued) – Functions • Lubricates mouth and materials in it • Dissolves chemicals that stimulate taste buds • Initiates digestion – Of complex carbohydrates via salivary amylase – Of lipids via lingual lipase (from tongue glands) – Control of secretions • By ANS • Secretions increased by: – Chewing with empty mouth – Smell of/thinking about food – Irritating/unpleasant stimuli, nausea 29 Oral Cavity • Mastication (chewing) – Combination of mandibular movements by muscles of mastication (elevation/depression, protraction/ retraction, medial/lateral movement) – Forces food back and forth across oral cavity; also involves muscles of cheeks, lips, tongue – Ingested material shredded and moistened with salivary secretions – Tongue compacts food into bolus – Compact, moist bolus easy to swallow • No nutrients absorbed in oral cavity • But lipid-soluble drugs can dissolve, e.g., nitroglycerine 30 Pharynx • Shared passage for food and air • Connects nasal and oral passages to respiratory and digestive systems, respectively • Lymphoid tissue (tonsils) contributes to body’s defense system • Muscles cooperate with muscles of oral cavity and esophagus to initiate deglutition (swallowing) 31 Pharynx • Deglutition – Complex process – Control • Initiation voluntary but proceeds involuntarily • Also occurs unconsciously as result of saliva collecting at back of mouth – Occurs approximately every 40 seconds 32 Pharynx • Deglutition (continued) – Swallowing reflex • Begins when bolus stimulates tactile receptors on posterior palate • Info relayed to swallowing center in brain motor commands to: – Larynx epiglottis covers entrance to airway (glottis) – Uvula and soft palate block backward passage – Pharyngeal muscles propel bolus into esophagus 33 Figure 24-11 34 Esophagus • Primary function – Carries solid food and liquids to stomach from oral cavity and pharynx • Bolus pushed through esophagus/toward stomach by peristaltic wave (under CNS control) • Approach of bolus triggers esophageal sphincter and bolus enters stomach • Transit time through esophagus – Liquids = 2 sec – Bolus = 9 sec – Dry or poorly lubricated bolus much slower, may need second peristaltic wave to push into stomach 35 Stomach • Primarily a holding tank – Food saturated with gastric juices, exposed to stomach acids, and digestive effects of enzyme pepsin – Preliminary digestive steps occur here • Can distend a lot as it receives food because of rugae (temporary folds) 36 Stomach • 4 major functions – Storage of ingested food – Mechanical breakdown of ingested food – Disruption of chemical bonds in food through actions of acids/enzymes – Production of intrinsic factor • Glycoprotein required for vitamin B12 absorption in small intestine – Essential for hematopoiesis and synthesis of bone proteins • Only essential function of stomach 37 Stomach • Produces chyme – Viscous, acidic soupy mixture of partially digested food – Formed from ingested substances + stomach gland secretions • Has extra layers of muscle to assist in churning/mixing – Muscularis mucosae – outer, circular layer – Muscularis externa – inner, oblique layer 38 Stomach • Secretory sheet – Simple columnar epithelium that covers surface – Produces alkaline mucous layer • Protects epithelial cells against acids and enzymes in gastric lumen • Gastric pits – Openings to gastric glands – Open onto gastric surface 39 Figure 24-13 40 Gastric Glands • In stomach fundus and body • gastric juice with enzymes and acid • 2 types of secretory cells – Parietal cells – Chief cells 41 Parietal Cells • Produce – Intrinsic factor • Required for absorption of vitamin B12 – Required for synthesis of bone proteins and hematopoiesis – HCl • • • • • • Keeps stomach contents at pH 1.5 – 2 Does not digest chyme Kills most microorganisms in food Denatures protein and inactivates most enzymes in food Breaks down plant cell walls and CT in meat Low pH essential for production of pepsin – protein digesting enzyme 42 HCl • Very strong acid • H+ and Cl- transported separately into stomach lumen by different mechanisms – Otherwise would destroy cell • H2O + CO2 H2CO3 HCO3- + H+ • H+ actively transported into lumen of gastric gland in stomach • HCO3- moves into interstitial fluid in exchange for Cl- which diffuses across cell and exits into lumen of gastric gland in stomach • H+ and Cl- HCl in stomach lumen 43 Figure 24-14 44 Chief Cells • Produce – Enzymes important for digesting milk in newborns • Rennin – coagulates milk proteins • Gastric lipase – initiates digestion of milk fats – Pepsinogen • Inactive proenzyme • Converted to pepsin (active proteolytic/ protein-digesting enzyme) by HCl 45 Pyloric Glands • In stomach pylorus • 2 Types of glands – Mucus-secreting cells/glands mucous secretion – Enteroendocrine glands hormones e.g., G cells gastrin that stimulates: • Secretion by parietal and chief cells • Contractions of gastric wall that mix/stir gastric contents 46 Figure 24-13 47 Peptic Ulcers • Result from: – Excessive acid production – Inadequate production of alkaline mucus that protects epithelium from acid • Digestive acids and enzymes erode: – Lining of stomach (gastric ulcer) – Proximal small intestine (duodenal ulcer) • 80% caused by gastric bacterial infection by Heliobacter pylori (H. pylori) – Treat with antibiotic drugs that inhibit acid production 48 • Today in class we will: – Continue our discussion on the major functions of the organs, regions and anatomical structures of the digestive tract • Stomach – Regulation of gastric secretory activity » Cephalic, gastric and intestinal phases, associated events, mechanisms and hormones – Digestion and absorption • Small intestine – – – – – – – – Digestion, nutrient absorption and associated structures Surface characteristics Intestinal secretions and associated structures Intestinal movements Emesis Associated glandular organs (Pancreas, liver and gallbladder) Mechanisms that coordinate digestive glands Coordination of absorption 49 Regulation of Gastric Secretory Activity • Gastric secretions – HCl – Enzymes • Controlled via production of: – Hormones (e.g., G cells Gastrin) – HCl (by parietal cells) – Enzymes (e.g., chief cells pepsinogen) • Involves three overlapping phases – Cephalic phase – Gastric phase – Intestinal phase 50 Regulation of Gastric Activity Figure 24-15 51 Regulation of Gastric Secretory Activity • Phases named for location of control center • Cephalic phase – Controlled by CNS (brain and spinal cord) • Gastric phase – Regulated by short reflexes of ANS • i.e.,enteric nervous system (ENS) within parasympathetic sytem – Involves submucosal and myenteric plexuses – Coordinated in stomach wall • Intestinal phase – Regulated by intestinal hormones (e.g. CCK, GIP, secretin) from enteroendocrine cells 52 Cephalic Phase • Directed by CNS • Prepares stomach to receive food • Begins when you see, smell, think about food – Exaggerated by anger/hostility – Inhibited by anxiety, stress, fear • Short duration (minutes) 53 Cephalic Phase • Stimulates CNS ANS (parasympathetic) vagus nerve (CN X) submucosal plexus of stomach innervates mucous, parietal, chief, G cells of stomach • Increases production of gastric juice by stimulation of: – Mucous cells mucus – Chief cells pepsinogen ( pepsin) – Parietal cells HCl • Stimulates G cells gastrin 54 Regulation of Gastric Activity Figure 24-15 55 Gastric Phase • • • • Regulated by short reflexes of ENS Begins with arrival of food in stomach Long duration (3-4 hours) Purpose of this phase – Enhances secretions started in cephalic stage – Homogenizes and acidifies chyme – Initiates protein digestion by pepsin • 3 mechanisms – Neural – Hormonal – Local 56 Gastric Phase • Neural mechanism – Short reflexes triggered by: • Stomach distention that stimulates stretch receptors • Increased pH of gastric contents that stimulates chemoreceptors (also stimulated by proteins, alcohol, and caffeines) – Receptors stimulate ENS (submucosal and myenteric plexuses) which then stimulates: • • • • Mucous cells mucus Chief cells pepsinogen Parietal cells HCl Mixing waves in muscularis externa 57 Gastric Phase • Hormonal mechanism – G cells gastrin, stimulated by: • ENS (see previous) • Partially digested proteins in chyme – Gastrin (via system circulation) stimulates: • Chief cells pepsinogen • Parietal cells HCL • Mixing waves in muscularis externa of stomach and intestinal tract 58 Gastric Phase • Local mechanism – Filling stomach stimulates mast cells in CT of lamina propria histamine which stimulates parietal cells HCl 59 Regulation of Gastric Activity Figure 24-15 60 Intestinal Phase • Begins when chyme enters small intestine (after several hours of gastric mixing) • Long duration (hours) • Purpose of this phase – Controls rate of gastric emptying (entry of chyme into duodenum) • Pylorus contracts • Small quantity of chyme squirts through pyloric sphincter into small intestine – Ensures small intestine functions efficiently (secretion, digestion, absorption) – Triggers events that affect/coordinate activities of stomach (generally inhibits its activity), intestinal tract, pancreas, liver, gallbladder 61 Intestinal Phase • Neural mechanisms – Chyme distends duodenum, stimulates • Stretch receptors • Chemoreceptors – Receptors trigger • Enterogastric reflex (to myenteric plexus) – Inhibits gastrin production and gastric contractions – Contracts pyloric sphincter – Prevents further discharge of chyme into duodenum • Local reflexes increase mucous production protects duodenal lining from acids/enzymes 62 Intestinal Phase • Hormonal mechanisms – Presence of lipids and carbohydrates secretion of hormones by enteroendocrine cells in duodenum • Cholecystokinin (CCK) decreases gastric acid/enzyme secretion • Gastric inhibitory peptide (GIP) decreases gastric secretions, contraction – Partially digested proteins stimulate G cells in duodenum gastrin stomach increase acid and enzyme production (feedback mechanism) 63 Intestinal Phase • Hormonal mechanisms (continued) – pH < 4.5 stimulates enteroendocrine cells secretin • Inhibits chief cells • Inhibits parietal cells • Stimulates pancreas buffers that protect duodenum by neutralizing acid in chyme (inc pH) • Stimulates liver bile secretion 64 Regulation of Gastric Activity Figure 24-15 65 Digestion in Stomach • At pH > 4.5 (first 1-2 hours post meal) – Proteins – preliminary digestion by pepsin – Carbohydrates (by salivary amylase) and lipids (by lingual lipase) – digestion permitted until pH<4.5 • At pH < 2 – Pepsin increases protein digestion begun but not completed (limited time) – Complex proteins smaller peptides and polypeptide chains 66 Absorption in Stomach • No nutrients – Epithelial cells covered in mucous, so not directly exposed to chyme – Epithelial cells lack specialized transport mechanisms – Gastric lining impermeable to water – Digestion not completed • Alcohol – Lipid soluble; diffuses through mucous, enters lipid membranes of epithelial cells • Some drugs – Aspirin - lipid soluble • Prolonged use gastric bleeding 67 Small Intestine • Plays key role in: – Digestion – Nutrient absorption – Water absorption 68 Small Intestine • Digestion – Completed in SI (small intestine) • Starts in mouth (lipids and CHOs) and stomach (proteins) – Most enzymes for digestion come from accessory organs • Pancreas digestive enzymes and buffers • Liver bile = buffers and bile salts (emulsify lipids and facilitate digestion/absorption of lipids) stored in gallbladder SI 69 Small Intestine • Nutrient absorption – SI absorbs 90% of nutrients (remainder absorbed in LI) – Epithelial surface adapted for absorption • Surface area increased 600X by: – Plicae (transverse folds) – Villi with microvilli • Extensive capillary network in villi – Hepatic portal circulation liver » Adjusts nutrient concentrations of blood before it reaches systemic circulation 70 Intestinal Villi • Fingerlike projections of mucosa • Covered by simple columnar epithelium with microvilli (brush border) • Interior contains: – – – – Lamina propria Capillary network; originates in vascular network in submucosa Nerve endings Lacteals (lymphatic capillaries) • Transport materials that cannot enter blood capillaries (i.e., FAs) – Smooth muscle cells – Move back and forth • Exposed to liquefied intestinal contents by contractions of: – Smooth muscle cells in villi – Muscularis mucosae in mucosa • Movement also squeezes lacteals and helps move lymph out of villi 71 Figure 24-17 72 Small Intestine • Surface characteristics – Vary over length of SI and parallel absorptive activity – Duodenum • Receives chyme, neutralizes acids, primary site for digestion • Few plicae, small villi – Jejunum • Primary site for absorption • Prominent plicae and villi • Plicae and villi gradually decrease in size distally – Ileum • Little/no nutrient absorption • No plicae 73 Intestinal Secretions/Structures • Intestinal juice – Watery fluid – Source • Osmosis of water out of mucosa into concentrated chyme • Secreted by intestinal cells/glands – Functions • Moistens chyme • Assists in buffering acids • Liquefies digestive enzymes from pancreas and products of digestion 74 Intestinal Secretions/Structures • Goblet cells – Unicellular exocrine structures – Interspersed between columnar epithelial cells – Secrete mucins onto intestinal surfaces • Intestinal glands – At base of villi – Contain enteroendocrine cells hormones that coordinate digestive functions 75 Intestinal Secretions/Structures • Duodenal glands – Produce: • Mucus – Protects epithelium from enzymes and acidity of chyme – Contains buffers that elevate pH of chyme (over length of duodenum, pH goes from 1-2 to 7-8) • Urgastrone – Inhibits gastric acid production by stomach – Stimulates division of epithelial stem cells of digestive tract; epithelial cells replaced every 3-7 days 76 Intestinal Secretions/Structures • Brush border enzymes – Membrane proteins on surface of intestinal microvilli – Break down materials that come in contact with brush border – Released into lumen by disintegrated epithelial cells that shed at intestinal surface – e.g., enterokinase activates key pancreatic proenzyme, trypsinogen 77 Intestinal Movements • Stimulation of stretch receptors in stomach accelerates movement along/through SI • Chyme moved through duodenum by short, local reflexes • Gastroenteric reflex – Stimulates motility and secretion along entire SI • Gastroileal reflex – Triggers relaxation of ileocecal valve (at entrance to large intestine) • Digestive tract hormones enhance or suppress reflexes 78 Emesis (Vomiting) • Chemical or mechanical irritation (of pharynx, esophagus, stomach, proximal small intestine): – Increases digestive fluid secretion, including saliva (buffers stomach acid, protects teeth) – Triggers vomiting reflex (vomiting center in medulla oblongata) – Intestinal contents eliminated as quickly as possible • Pylorus relaxes • Contents of duodenum and proximal jejunum discharged into stomach by strong peristaltic waves toward the stomach (rather than toward the ileum) • Vomiting occurs as stomach regurgitates its contents through esophagus and pharynx 79 Glandular Organs Associated With Small Intestine • Pancreas • Liver • Gall bladder 80 Pancreas • Endocrine (1%) – Cells located in pancreatic islets • Alpha cells glucagon increase blood glucose • Beta cells insulin decrease blood glucose • Exocrine (99%) – Acinar cells pancreatic enzymes – Epithelial cells water and ions that assist in diluting and buffering acids in chyme – Enzymes + water + ions = pancreatic juice 81 Pancreas Exocrine Secretory Activity • Controlled by duodenal hormones triggered by chyme – Secretin pancreatic secretion of watery, buffer solution (pH 7.5 – 8.8) that helps raise pH – CCK production and secretion of pancreatic enzymes (also occurs during cephalic stage before food reaches stomach; head start important so enzymes can be synthesized before chyme reaches duodenum) 82 Pancreas Exocrine Secretory Activity • Pancreatic enzymes – Pancreatic amylase • Breaks down starches (similar to salivary amylase) – Pancreatic lipase • Breaks down complex lipids FAs that can be absorbed (similar to lingual lipase) – Nucleases • Break down nucleic acids (DNA, RNA) – Proteolytic enzymes • 70% of pancreatic enzymes • Digest proteins; attack peptide bonds – Proteases – break apart large protein complexes – Peptidases – break small peptide chains into individual amino acids 83 Pancreatic Proteolytic Enzymes • Secreted as inactive proenzymes – Proenzymes converted to active enzymes after they reach small intestine – Protects secretory cells from destruction by own enzyme products 84 Pancreatic Proteolytic Enzymes Proenzyme Enzyme Catalyst Active Enzyme Trypsinogen Enterokinase (brush border of duodenum) Trypsin Trypsin Chymotrypsinogen Chymotrypsin Procarboxypeptidase Trypsin Carboxypeptidase Proelastase Elastase Trypsin 85 Liver • Can’t live without your liver • >200 functions! • 3 General functions – Metabolic regulation – Hematological regulation – Bile production 86 Liver: Metabolic Regulation • Liver = primary organ involved in regulating composition of blood • All blood leaving absorptive surfaces of digestive tract hepatic portal system liver • Liver cells adjust blood composition before it reaches systemic circulation – Extract toxins – Extract/replenish nutrients (e.g., CHOs, lipids) • Excess removed and stored (glucose glycogen, TGs and FAs lipids) • Deficiencies corrected by: – Mobilizing stored reserves (glycogen glucose, lipids FAs and TGs – Performing synthetic activities (e.g. glucose from AAs – gluconeogenesis) 87 Liver: Metabolic Regulation • CHO metabolism – Hepatocytes stabilize blood glucose levels – When blood glucose decreases • Breaks down glycogen glucose • Synthesizes glucose from lipids or amino acids (gluconeogenesis) – When blood glucose increases • Glucose removed from blood – Stored as glycogen – Used to synthesize lipids, stored in liver or other tissues – Regulated by hormones (insulin, glucagon from pancreas) 88 Liver: Metabolic Regulation • Lipid metabolism – Hepatocytes regulate circulating TGs, FAs, cholesterol – When TGs and FAs decrease • Breaks down lipid reserves and releases them into bloodstream – When TGs and FAs increase • Removed for storage 89 Liver: Metabolic Regulation • Amino acid metabolism – Hepatocytes remove excess amino acids from bloodstream • Converted to lipids or glucose and stored • Used to synthesize proteins • Drug inactivation – Removes and metabolizes circulating drugs; limits duration of effects • Storage of fat soluble vitamins (D, E, A, and K) and B12 90 Liver: Metabolic Regulation • Removal of waste products – Toxins, various waste products removed from blood for inactivation, storage, excretion – e.g., when amino acids used to make CHOs or lipids NH2; creates ammonia (NH3, toxic waste product); liver converts to urea (harmless and excreted at kidneys) • Conversion of Iron to ferretin (a protein-iron complex) and storage 91 Liver: Hematological Regulation • Liver = largest blood reservoir in body; receives 25% of cardiac output of blood • Performs several hematological functions – Removes old/damaged RBCs, cellular debris, pathogens from bloodstream – Synthesizes plasma proteins (e.g., for clotting, transport) – Removes/metabolizes circulating hormones – Removes antibodies – Removes or stores lipid-soluble toxins (e.g., DDT) 92 Liver: Bile Production • Bile – Primarily water, minor amounts of: • • • • Ions Bilirubin = pigment derived from hemoglobin Cholesterol Bile salts – Combination of bile, FAs, and lipids – Synthesized from cholesterol in the liver – Emulsifying agents that break down lipids – Excreted into: • Gallbladder (in absence of chyme) • Lumen of duodenum (in presence of chyme) 93 Liver: Bile Production • Bile excretion – Chyme enters duodenum – Triggers production of intestinal hormone CCK – CCK • Relaxes hepatopancreatic sphincter • Stimulates contractions in walls of gallbladder • Pushes bile through common bile duct into duodenum 94 Function of Bile • Emulsification – Mechanical processing in stomach creates large drops containing lipids (because lipids not water-soluble) – Pancreatic lipase not lipid-soluble • Can only interact with lipids at surface of droplet, not inside – Bile salts • Break droplets apart = emulsification – Increases surface area available for enzymes • Facilitate interaction between lipids and pancreatic lipase • Promote lipid absorption by ileum • Enter hepatic portal circulation and recycle through liver (enterohepatic circulation = liver intestine liver) 95 Liver Damage or Disease • Serious threat to life • Liver has limited ability to regenerate after injury; depends on normal vascular pattern being established • Cirrhosis – Replacement of lobules by fibrous tissue • Hepatitis – Caused by viral infections 96 Gallbladder • 2 Major functions – Bile storage • When bile cannot enter common bile duct (when hepatopancreatic sphincter closed) it enters cystic duct and is stored in gallbladder – Bile modification • While stored, much of water absorbed, bile salts become more concentrated 97 Gallbladder • Gallstones – Form when bile is too concentrated crystals on insoluble minerals and salts – If get too large can damage gallbladder wall or block cystic or common bile duct • Gallbladder – May become infected, inflamed, perforated and need to be surgically removed (cholecystectomy) • Dilute bile 98 Coordination of Digestive Glands • Centered around duodenum – Where acids neutralized and enzymes added) • Involves combination of neural and hormonal mechanisms • Neural mechanisms – Prepare digestive tract for activity, or – Inhibit gastrointestinal activity – Coordinate movement of materials through digestive tract (via enterogastric, gastroenteric, gastroileal reflexes) 99 Coordination of Digestive Glands • Hormonal mechanisms >>>(see Figure 24-23 on slide 101, Table 24-2 on slide 102) • Hormones important to regulation of intestinal and glandular function – Gastrin – Cholecystokinin (CCK) – Gastric inhibitory peptide (GIP) – Secretin • Produced by duodenal enteroendocrine cells 100 Figure 24-23 101 102 Coordination of Absorption • Transit time through SI approx 5 hours (lunch entering when breakfast leaving) • Absorption enhanced by movement of mucosa – – – – Microvilli moved by microfilaments Villi moved by smooth muscle cells Groups of villi moved by muscularis externa Plicae moved by muscularis mucosae and muscularis externa • These movements – Stir and mix intestinal contents – Constantly change environment around each epithelial cell – Enhance absorption 103 • Today in class we will: – Conclude our discussion on the major functions of the organs, regions and anatomical structures of the digestive tract • Large intestine – Histological features – Movements » Defecation reflex – Adverse conditions/diseases – – – – Discuss nutrients, nutrient digestion and nutrient absorption Malabsorption of nutrients Trace the chemical events in digestion Effects of aging on the digestive system 104 Large Intestine • Minor function (10%) – Absorption of nutrients • Major functions – Absorption of water – Absorption of useful compounds • Organic molecules • Bile salts – reabsorbed in cecum, transported in blood to liver • Vitamins generated by bacteria – Vitamin K – blood clotting factors – Biotin – glucose metabolism – Vitamin B5 – synthesis of steroid hormone and neurotransmitters 105 Large Intestine • Major functions (continued) – Compaction of intestinal contents into feces • Reduced almost 90% (from 1400 mL to 150 mL) • Feces – 75% water, 5% bacteria, 20% indigestible materials, inorganic matter, remains of epithelial cells – Storage of fecal material prior to defecation 106 Large Intestine • Histologic features – – – – Thinner walls than SI Lacks villi Many goblet cells Distinctive intestinal glands • Deeper than in small intestine • Dominated by goblet cells – Mucosa does not produce enzymes; any digestion results from enzymes introduced in SI or from bacterial action – Mucus provides lubrication (as fecal matter becomes less moist and more compact) – Muscularis externa longitudinal layer reduced to 3 muscular bands of taeniae coli 107 Figure 24-25 108 Large Intestine • Movements – Reflexes move materials into cecum while you eat – Peristaltic waves move material through colon • Movement from cecum to transverse colon very slow; allows hours for water absorption • Segmentation movements (haustral churning) – Mix LI contents 109 Large Intestine • Mass movements – Powerful peristaltic contractions • Move contents from transverse colon through rest of large intestine – Occur 1-2 times per day – Stimulus = distention of stomach and duodenum; relayed over intestinal nerve plexuses – Force feces into empty rectum distension of rectal wall (stretch receptors) defecation reflex • Involuntary (ANS) – Defecation reflex conscious urge to defecate – Relaxation of internal anal sphincter (smooth muscle, controls movement of feces into anorectal canal) • Voluntary (CNS) – Contraction of external anal sphincter (skeletal muscle) 110 Figure 24-25 111 Large Intestine • Elimination of feces requires: – Both internal and external anal sphincters must be relaxed – Conscious activities • Opening external anal sphincter (except when internal pressure sufficiently high) • Increasing intra-abdominal pressure so fecal material forced out of rectum 112 Large Intestine • Adverse conditions/diseases – Diarrhea • Frequent, watery bowel movements • Causes – Colon mucosa can’t maintain normal levels of absorption – Rate of fluid entry into colon exceeds absorptive capacity – Bacterial, viral, protozoan infection of colon or small intestine • May be life threatening due to fluid and ion loss – Constipation • Infrequent defecation – Feces become dry,hard, compact, difficult to move, highly abrasive • Cause: fecal materials move through colon so slowly excessive reabsorption of water occurs – Related to inadequate dietary fiber and fluids, lack of exercise 113 Large Intestine • Adverse conditions/diseases (continued) – Diverticulosis • Pockets (diverticula) form in mucosa (generally sigmoid colon) • Get forced outward (during defecation), push through weak points in muscularis externa subject to recurrent infection/inflammation (diverticulitis) – Colon and rectal cancers • Best defense = early detection and prompt treatment • Screening test = blood in feces • Definitive evaluation = visual inspection of lumen (colonoscopy) 114 Nutrient Digestion • Digestion – Breakdown of large organic molecules into small fragments that can be absorbed – Occurs via hydrolysis with aid of digestive enzymes – Source of digestive enzymes • Secreted by salivary glands, tongue, stomach, pancreas, and mixed into ingested material as it passes along digestive tract • Brush border enzymes attached to intestinal microvilli 115 Carbohydrates • Sugars and starches • Building blocks – Simple sugars (monosaccharides) – Made up of 3-7 carbon atoms • Combine via dehydration synthesis to form disaccharides, trisaccharides, polysaccharides • Digestion is reverse process 116 Simple Sugars Figure 2–11 117 Formation and Breakdown of Complex Sugars Figure 2–12 118 Polysaccharides • Chains of many simple sugars, e.g., glycogen Figure 2–13 119 Carbohydrate Digestion • Polysaccharides (glycogen, starch) – In presence of salivary and pancreatic amylases • Tri- and disaccharides – In presence of brush border enzymes – e.g., maltase, sucrase, lactase • Monosaccharides – e.g., glucose • Intestinal capillaries 120 Lipids • Fats, oils, waxes • Building blocks – Glycerol + fatty acids (FAs) • Combine via dehydration synthesis to form monoglycerides, diglycerides, triglycerides • Digestion is reverse process 121 Glycerides • Glycerides – Fatty acids attached to a glycerol molecule • Triglyceride – 3 Fatty-acids – Storage molecule Figure 2–16 122 Combination Lipids Figure 2–18a, b 123 Formation and Breakdown of Triglycerides Figure 2–16 124 Lipid Digestion • Lipids (TGs) – In presence of lingual and pancreatic lipases • Monoglycerides, FAs • Bile salts emulsify micelles = lipid-bile salt complex • TGs + proteins chylomicrons • Lacteals 125 Proteins • Most abundant, most important organic component in human body • >2M different proteins, 20% of BW • Perform essential functions, e.g., support, metabolism, movement, etc. • Building blocks – Amino acids (AAs) • Form peptide bonds • Combine via dehydration synthesis to form di/tripeptides, polypeptides, proteins • Digestion is reverse process 126 Amino Acid Figure 2-19 127 Formation and Breakdown of Peptides Figure 2–20 128 Protein Digestion • Proteins – In presence of pepsin • Polypeptides – In presence of other enzymes, e.g., • Trypsin, chymotripsin, elastase, carboxypeptidase – • Short peptides – In presence of brush border enzymes (peptidases) – • Amino acids • Intestinal capillaries 129 Figure 24-27 130 Nutrient Absorption • Absorbed nutrients – Broken down to provide energy for synthesis of ATP – Used to synthesize CHOs, lipids, proteins 131 Water Absorption • By small and large intestines • Involves rapid, but passive flow of H2O along osmotic gradients • As intestinal cells absorb nutrients and ions: – Solute concentrations increase – H20 moves into cells and surrounding tissues • 9L/day enters intestinal tract, but only 150 mL lost in feces; remainder is absorbed 132 Digestive Secretion and Absorption of Water Figure 24–28 133 Ion Absorption • Each ion handled individually • Rate of intestinal absorption of each is tightly controlled • Absorption transport mechanisms include diffusion, active transport, carrier-mediated transport • Some absorption requires hormones – Ca+2 - calcitriol, PTH – Na+ - aldosterone 134 Vitamin Absorption • Vitamins = organic compounds required in very small quantities • Fat-soluble vitamins (D, E, A, K) – Easily absorbed by diffusion across digestive epithelium • Water-soluble vitamins (9) – e.g., B vitamins, C – All except B12 easily absorbed by diffusion • Required for synthesis of bone proteins and hematopoiesis • Must be bound to intrinsic factor (glycoprotein secreted by parietal cells of stomach); then can be absorbed by active transport 135 Malabsorption • Abnormal nutrient absorption • Results from: – Damage to: • Accessory glands (pancreatitis, cirrhosis) • Intestinal mucosa (radiation, toxic compoundschemotherapeutic agents, infection) – Duct blockage • Bile duct – biliary obstruction • Pancreatic – pancreatic obstruction – Genetic inability to produce gastric or intestinal enzymes (lactose intolerance) 136 Effects of Aging • Epithelial stem cell division rate decreases – Stratified epithelium (mouth, esophagus, anus) becomes thinner, more fragile – Digestive epithelium more susceptible to damage (e.g. ulcers) – Tissue repair less efficient • Smooth muscle tone decreases – Weakened muscular sphincters esophageal reflux – Motility decreases, peristaltic contractions weaker; promotes constipation – Sagging colon diverticulosis – Straining to defecate hemorrhoids (swollen rectal varicose veins) • Cancer rates increase (colon, stomach; oral, pharyngeal among smokers) 137