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23 Overview of the Digestive System PART 1 The Digestive System • Organs are divided into two groups • Alimentary canal • Mouth, pharynx, and esophagus • Stomach, small intestine, and large intestine • Accessory digestive organs • Teeth and tongue • Gallbladder, salivary glands, liver, and pancreas • Accessory organs are connected to the alimentary canal by ducts PowerPoint® Lecture Presentations prepared by Leslie Hendon • Secretions contribute to breakdown of foodstuffs University of Alabama, Birmingham © 2014 Pearson Education, Inc. © 2014 Pearson Education, Inc. Figure 23.1 The alimentary canal and the accessory digestive organs. Abdominal Regions Mouth (oral cavity) Parotid gland Sublingual gland Submandibular gland Tongue Salivary glands • Four lines divide abdominal wall into nine regions • Midclavicular lines—vertical lines of grid Pharynx Esophagus Stomach Pancreas (Spleen) Liver Transverse colon Small intestine • Connects tubercles of iliac crests Descending colon Jejunum • Connects inferior points of costal margin • Transtubercular plane—inferior horizontal line Gallbladder Duodenum • Subcostal plane—superior horizontal line Ascending colon Ileum Cecum Large intestine Sigmoid colon Rectum Appendix Anus Anal canal © 2014 Pearson Education, Inc. © 2014 Pearson Education, Inc. Figure 23.2a Divisions of the anterior abdominal wall. Right hypochondriac region Right lumbar region Right iliac (inguinal) region Figure 23.2b Divisions of the anterior abdominal wall. Epigastric region Umbilical region Hypogastric (pubic) region Left hypochondriac region Left lumbar region Left iliac (inguinal) region Nine regions delineated by four planes © 2014 Pearson Education, Inc. Liver Diaphragm Gallbladder Stomach Ascending colon of large intestine Transverse colon of large intestine Small intestine Descending colon of large intestine Cecum Appendix Initial part of sigmoid colon Urinary bladder Anterior view of the nine regions showing the superficial organs © 2014 Pearson Education, Inc. 1 Figure 23.3 Peritoneum and the Digestive System Organs (1 of 2) Abdominal Quadrants • A simpler method of sectioning the anterior abdominal wall • Right upper quadrant • Left upper quadrant • Right lower quadrant • Left lower quadrant © 2014 Pearson Education, Inc. © 2014 Pearson Education, Inc. Figure 23.3 Peritoneum and the Digestive System Organs (2 of 2) The Peritoneal Cavity and Peritoneum • Peritoneum—a serous membrane • Visceral peritoneum—surrounds digestive organs • Parietal peritoneum—lines the body wall • Peritoneal cavity—a slitlike potential space © 2014 Pearson Education, Inc. © 2014 Pearson Education, Inc. The Peritoneal Cavity and Peritoneum The Peritoneal Cavity and Peritoneum • Mesentery—a double layer of peritoneum • Ventral mesenteries • Holds organs in place • Sites of fat storage • Provides a route for circulatory vessels and nerves • Falciform ligament • Binds anterior part of liver to anterior abdominal wall • Lesser omentum • Attaches liver to the lesser curvature of stomach © 2014 Pearson Education, Inc. © 2014 Pearson Education, Inc. 2 Figure 23.4a The mesenteries. The Peritoneal Cavity and Peritoneum Falciform ligament • Dorsal mesenteries Gallbladder Liver • Greater omentum Spleen Stomach • Connects greater curvature of stomach to posterior abdominal wall Ligamentum teres • A fatty apron Greater omentum • Transverse mesocolon Small intestine • Holds transverse colon in place • Sigmoid mesocolon Cecum • Connects the sigmoid colon to posterior pelvic wall © 2014 Pearson Education, Inc. © 2014 Pearson Education, Inc. Figure 23.4b The mesenteries. Figure 23.4c The mesenteries. Greater omentum Liver Gallbladder Transverse colon Lesser omentum Transverse mesocolon Stomach Duodenum Transverse colon Descending colon Mesentery Small intestine Sigmoid mesocolon Jejunum Cecum Sigmoid colon Ileum Urinary bladder © 2014 Pearson Education, Inc. © 2014 Pearson Education, Inc. Figure 23.4d The mesenteries. The Peritoneal Cavity and Peritoneum Ligamentum teres Gallbladder Lesser omentum Spleen Liver Gastrosplenic ligament Transverse mesocolon Pancreas Duodenum, superior part Transverse colon Duodenum, horizontal part Stomach, pyloric part Duodenojejunal flexure • Retroperitoneal organs • Behind the peritoneum • Peritoneal organs • Digestive organs that keep their mesentery Greater omentum Descending colon Ascending colon Mesentery (cut) Sigmoid mesocolon Rectum Ileum Cecum © 2014 Pearson Education, Inc. © 2014 Pearson Education, Inc. 3 Table 23.1 Summary of Intraperitoneal and Secondarily Retroperitoneal Digestive Organs in the Abdomen and Pelvis Secondarily Retroperitoneal Organs • Initially formed within peritoneum • Become retroperitoneal • Fuse to posterior abdominal wall © 2014 Pearson Education, Inc. © 2014 Pearson Education, Inc. Digestive Processes Digestive Processes • Ingestion—occurs in the mouth • Chemical digestion—complex molecules broken down to chemical components • Propulsion—movement of food • Peristalsis—major means of propulsion • Mechanical breakdown—prepares food for chemical digestion • Chewing, churning food in stomach, segmentation • Segmentation is rhythmic local constrictions of intestine © 2014 Pearson Education, Inc. • Mouth • Stomach • Small intestine • Absorption—transport of digested nutrients • Defecation—elimination of indigestible substances as feces © 2014 Pearson Education, Inc. Figure 23.5 Activities of the gastrointestinal tract. Peristalsis Ingestion Food Mechanical breakdown • Chewing (mouth) • Churning (stomach) • Segmentation (small intestine) • Major means of propulsion Pharynx Esophagus Propulsion • Swallowing (oropharynx) • Peristalsis (esophagus, stomach, small intestine, large intestine) Digestion • Adjacent segments of the alimentary canal relax and contract Stomach Absorption Lymph vessel Small intestine Blood vessel Large intestine Mainly H2O Feces Defecation © 2014 Pearson Education, Inc. Anus © 2014 Pearson Education, Inc. 4 Figure 23.6a Peristalsis and segmentation. From mouth Segmentation • Rhythmic local contractions of the intestine • Mixes food with digestive juices Peristalsis: Adjacent segments of alimentary tract organs alternately contract and relax, moving food along the tract distally. © 2014 Pearson Education, Inc. © 2014 Pearson Education, Inc. Figure 23.6b Peristalsis and segmentation. Histology of the Alimentary Canal Wall • Same four layers from esophagus to anus • The mucosa—innermost layer • Consists of • Epithelium • Lamina propria • Muscularis mucosae Segmentation: Nonadjacent segments of alimentary tract organs alternately contract and relax, moving the food forward then backward. Food is mixed and slowly propelled. © 2014 Pearson Education, Inc. • The submucosa—external to the mucosa • Contains blood and lymphatic vessels, nerve fibers © 2014 Pearson Education, Inc. Figure 23.7a Histological layers of the alimentary canal. Histology of the Alimentary Canal Wall Intrinsic nerve plexuses Myenteric nerve plexus Submucosal nerve plexus • The muscularis externa—external to the submucosa Glands in submucosa • Two layers Mucosa Epithelium Lamina propria Muscularis mucosae • Circular muscularis—inner layer • Longitudinal muscularis—outer layer Submucosa Muscularis externa Circular layer Longitudinal layer • The serosa—the outermost layer • Is the visceral peritoneum Serosa Epithelium Connective tissue Mesentery Nerve Artery Vein Lymphatic vessel Lumen Gland in mucosa Duct of gland outside alimentary canal Mucosa associated lymphoid tissue Longitudinal and cross-sectional views through the small intestine © 2014 Pearson Education, Inc. © 2014 Pearson Education, Inc. 5 Figure 23.7b Histological layers of the alimentary canal. Smooth Muscle • Primarily found in walls of viscera Mucosa Submucosa • Fibers elongated • Have one centrally located nucleus • Grouped into sheets Muscularis externa Serosa Light micrograph cross section through the small intestine (85×) © 2014 Pearson Education, Inc. • Longitudinal layer—parallel to long axis of organ • Circular layer—deeper layer, fibers run around circumference of organ © 2014 Pearson Education, Inc. Figure 23.8 Arrangement of smooth muscle in the walls of hollow organs. Smooth Muscle Contraction • Mechanism of contraction Longitudinal layer of smooth muscle (shows smooth muscle fibers in cross section, 215×) Small intestine Mucosa Location and plane of section shown in (b) Cross section of the intestine showing the smooth muscle layers (one circular and the other longitudinal) running at right angles to each other Circular layer of smooth muscle (shows longitudinal views of smooth muscle fibers, 215×) © 2014 Pearson Education, Inc. • Myofilaments operate by interaction with cytoskeleton • Dense bodies—correspond to Z-discs of skeletal muscle • Sliding myofilaments shorten the muscle cell by pulling on cytoskeleton • Entry of Ca2+ into sarcoplasm stimulates contraction © 2014 Pearson Education, Inc. Figure 23.9 Cytoskeletal elements involved in the contraction of smooth muscle. Smooth Muscle Contraction • Contraction is slow and sustained • Takes 30x longer to contract and relax • Resistant to fatigue • Smooth muscle of arteries and visceral organs must sustain contraction over long periods Intermediate filament Caveolae Nucleus Gap junctions Dense bodies Relaxed smooth muscle fiber (note that gap junctions connect adjacent fibers) Nucleus • Energy requirements are low Dense bodies • Mitochondria are not abundant Contracted smooth muscle fiber © 2014 Pearson Education, Inc. © 2014 Pearson Education, Inc. 6 Figure 23.10 Innervation of smooth muscle. Innervation of Smooth Muscle Varicosities • Innervated by ANS • Few fibers per sheet innervated • Sheet of smooth muscle contracts as a unit • Called single-unit innervation Autonomic nerve fibers innervate most smooth muscle fibers. Smooth muscle cell • Multiunit innervation • Each smooth muscle cell innervated • Iris of eye and arrector pili muscles Synaptic vesicles Mitochondrion Varicosities release their neurotransmitters into a wide synaptic cleft (a diffuse junction). © 2014 Pearson Education, Inc. © 2014 Pearson Education, Inc. Nerve Plexuses The Mouth and Associated Organs • Myenteric nerve plexus • Mouth (oral cavity) • Lies between circular and longitudinal muscularis • Controls peristalsis and segmentation • Submucosal nerve plexus • Lies in submucosa • Signals glands to secrete • Innervation • Sympathetic and parasympathetic motor fibers • Mucosa-lined cavity • Boundaries are • Lips anteriorly • Cheeks laterally • Palate superiorly • Tongue inferiorly • Fauces of oropharynx posteriorly • Visceral sensory fibers © 2014 Pearson Education, Inc. © 2014 Pearson Education, Inc. Figure 23.11a Anatomy of the mouth. The Mouth and Associated Organs • The mouth—oral cavity • Mucosal layer Soft palate Palatoglossal arch Oral cavity Palatine tonsil • Stratified squamous epithelium Tongue • Lamina propria Oropharynx • The lips and cheeks • Formed from orbicularis oris and buccinator muscles, respectively Uvula Hard palate Lingual tonsil Epiglottis Hyoid bone Laryngopharynx Esophagus Trachea © 2014 Pearson Education, Inc. Sagittal section of the oral cavity and pharynx © 2014 Pearson Education, Inc. 7 Figure 23.11b Anatomy of the mouth. Anatomy of the Mouth Gingivae (gums) • The labial frenulum Palatine raphe • Connects lips to gum • The palate • Forms the roof of the mouth • Boundaries of the fauces • Palatoglossal arches • Palatopharyngeal arches Hard palate Soft palate Uvula Palatine tonsil Sublingual fold with openings of sublingual ducts Oral vestibule Lower lip Upper lip Superior labial frenulum Palatoglossal arch Palatopharyngeal arch Posterior wall of oropharynx Tongue Lingual frenulum Opening of submandicular duct Gingivae (gums) Inferior labial frenulum Anterior view © 2014 Pearson Education, Inc. © 2014 Pearson Education, Inc. The Tongue The Superior Surface of the Tongue • Interlacing fascicles of skeletal muscle • Tongue papillae • Grips food and repositions it • Filiform papillae—no taste buds • Helps form some consonants • Fungiform papillae • Intrinsic muscles—within the tongue • Vallate papillae • Extrinsic muscles—external to the tongue • Lingual frenulum • Secures tongue to floor of mouth • Sulcus terminalis • Marks border between mouth and pharynx • Posterior one-third of tongue lies in oropharynx • Lined with lingual tonsil © 2014 Pearson Education, Inc. © 2014 Pearson Education, Inc. Figure 23.12 The dorsal surface of the tongue. Epiglottis Palatopharyngeal arch Palatine tonsil Lingual tonsil Palatoglossal arch Terminal sulcus Foliate papillae Vallate papilla Medial sulcus of the tongue Dorsum of tongue The Teeth • Deciduous teeth—20 teeth • First appear at 6 months of age • Permanent teeth—32 teeth • Most erupt by the end of adolescence • Dental formula—shorthand • Formula for adult dentition indicates number and position of teeth • 2I, 1C, 2P, 3M Fungiform papilla Filiform papilla © 2014 Pearson Education, Inc. © 2014 Pearson Education, Inc. 8 Figure 23.13a Human dentition. Figure 23.13b Human dentition. Incisors Central (6–8 mo) Lateral (8–10 mo) Canine (eyetooth) (16–20 mo) Molars First molar (10–15 mo) Second molar (about 2 yr) Deciduous (milk) teeth Incisors Central (7 yr) Lateral (8 yr) Canine (eyetooth) (11 yr) Premolars (bicuspids) First premolar (11 yr) Deciduous teeth Permanent teeth Second premolar (12–13 yr) Molars First molar (6–7 yr) Second molar (12–13 yr) Third molar (wisdom tooth) (17–25 yr) Permanent teeth © 2014 Pearson Education, Inc. © 2014 Pearson Education, Inc. Vessels and Nerves to the Teeth Tooth Structure • Upper teeth • Crown—exposed surface • Innervation is superior alveolar nerves branching from maxillary division of CN V • Lower teeth • Innervation is inferior alveolar nerves branching from mandibular branch of CN V • Root—in tooth socket • Outer layer is enamel • Dentin—underlies enamel • Pulp cavity—center of tooth • Arterial supply to teeth • Superior and inferior alveolar arteries (branching from maxillary arteries) © 2014 Pearson Education, Inc. © 2014 Pearson Education, Inc. Figure 23.14 Longitudinal section of a canine tooth within its bony tooth socket. Enamel The Salivary Glands Dentin Crown Dentinal tubules Pulp cavity (contains blood vessels and nerves) Neck Gingival sulcus Gingiva (gum) Cement Root Root canal Periodontal ligament • Produce saliva • Compound tubuloalveolar glands • Parotid glands • Parotid duct—parallel to zygomatic arch • Contain only serous cells • Submandibular glands • Lie along medial surface of mandible • Sublingual glands Apical foramen Bone © 2014 Pearson Education, Inc. • Lie in floor of oral cavity • Contain primarily mucous cells © 2014 Pearson Education, Inc. 9 Figure 23.15 The major salivary glands. The Pharynx • Oropharynx and laryngopharynx • Passages for air and food Tongue Teeth • Lined with stratified squamous epithelium Parotid gland Ducts of sublingual gland Parotid duct • External muscle layer Masseter muscle Frenulum of tongue Body of mandible (cut) Sublingual gland • Consists of superior, middle, and inferior pharyngeal constrictors Posterior belly of digastric muscle Mylohyoid muscle (cut) Anterior belly of digastric muscle Submandibular duct Submandibular gland Mucous cells Serous cells forming demilunes © 2014 Pearson Education, Inc. © 2014 Pearson Education, Inc. The Esophagus The Esophagus • Gross anatomy—muscular tube • Microscopic anatomy • Begins as a continuation of the pharynx • Epithelium is stratified squamous epithelium • Joins the stomach inferior to the diaphragm • When empty, mucosa and submucosa are in longitudinal folds • Cardiac sphincter—closes lumen to prevent stomach acid from entering esophagus © 2014 Pearson Education, Inc. • Mucous glands—primarily compound tubuloalveolar glands © 2014 Pearson Education, Inc. Figure 23.16 Microscopic structure of the esophagus. The Esophagus • Muscularis externa • Skeletal muscle • First one-third of length Mucosa (stratified squamous epithelium) • Mixture of skeletal and smooth muscle Submucosa (areolar connective tissue) • Middle one-third of length Lumen Muscularis externa Circular layer Longitudinal layer • Smooth muscle • Inferior one-third of length • Adventitia Esophagusstomach junction Simple columnar epithelium of stomach Adventitia (fibrous connective tissue) Cross section through esophagus (3×) Esophagus-stomach junction, longitudinal section (85×) • Most external layer of esophagus © 2014 Pearson Education, Inc. © 2014 Pearson Education, Inc. 10 Figure 23.17a Gross anatomy of the stomach. The Stomach Cardia Fundus Esophagus • Site where food is churned into chyme • Secretion of pepsin begins protein digestion • Functions under acidic conditions Serosa Muscularis externa Longitudinal layer Circular layer Oblique layer Body Lumen Lesser curvature • Food remains in stomach approximately 4 hours Rugae of mucosa • Regions of the stomach • Cardial part Greater curvature • Fundus • Body Duodenum • Pyloric part © 2014 Pearson Education, Inc. Pyloric antrum Pyloric canal Pyloric sphincter (valve) at pylorus © 2014 Pearson Education, Inc. Figure 23.17b Gross anatomy of the stomach. Microscopic Anatomy of the Stomach Fundus Liver (cut) Body Spleen Lesser curvature • Muscularis has three layers • Circular and longitudinal layers and oblique layer • Epithelium is simple columnar epithelium • Mucosa dotted with gastric pits Greater curvature © 2014 Pearson Education, Inc. • Gastric glands—deep to gastric pits © 2014 Pearson Education, Inc. Figure 23.18 Microscopic anatomy of the stomach. Microscopic Anatomy of the Stomach Gastric pits Surface epithelium (mucous cells) • Gastric glands of fundus and body • Mucous neck cells • Secrete a special mucus • Parietal (oxyntic) cells • Secrete hydrochloric acid and gastric intrinsic factor Surface epithelium Gastric gland Lamina propria Submucosa (contains submucosal plexus) Muscularis externa (contains myenteric plexus) Serosa Chief cell Muscularis mucosae Oblique layer Enteroendocrine cell Pepsinogen Enlarged view of gastric pits and gastric glands Circular layer Longitudinal layer HCl Pepsin Mitochondria Parietal cell Stomach wall Layers of the stomach wall, longitudinal section Gastric pits Mucus-secreting cells Surface mucous cell Mucous neck cells Chief cell Enteroendocrine cell Location of the HCl-producing parietal cells and pepsin-secreting chief cells in a gastric gland HCl-secreting parietal cells Gastric gland • Pepsinogen is activated to pepsin when it encounters acid in the gastric glands © 2014 Pearson Education, Inc. Mucous neck cells Parietal cell Mucosa • Chief (zymogenic) cells • Secrete pepsinogen Gastric pit Enzyme-secreting chief cells Muscularis mucosae Micrograph of the stomach mucosa, view similar to part (b) (110×) © 2014 Pearson Education, Inc. 11 The Small Intestine—Gross Anatomy The Duodenum • Longest portion of the alimentary canal • Receives digestive enzymes and bile • Site of most enzymatic digestion and absorption • Main pancreatic duct and common bile duct enter duodenum • Three subdivisions • Sphincters control entry of bile and pancreatic juices • Duodenum • Jejunum • Ileum • Innervation • Parasympathetic fibers from vagus nerve • Sympathetic from thoracic splanchnic nerves © 2014 Pearson Education, Inc. © 2014 Pearson Education, Inc. Figure 23.19 The duodenum of the small intestine, and related organs. The Small Intestine—Microscopic Anatomy • Modifications for absorption Right and left hepatic ducts of liver Common hepatic duct Cystic duct Bile duct and sphincter Accessory pancreatic duct • Circular folds • Transverse ridges of mucosa and submucosa • Villi • Fingerlike projections of the mucosa Mucosa with folds Tail of pancreas Pancreas Gallbladder Jejunum Major duodenal papilla Hepatopancreatic ampulla and sphincter Main pancreatic duct and sphincter Duodenum • Covered with simple columnar epithelium • Microvilli • Further increase surface area for absorption Head of pancreas © 2014 Pearson Education, Inc. © 2014 Pearson Education, Inc. Figure 23.20 Structural modifications of the small intestine that increase the surface area for digestion and absorption. Vein carrying blood to hepatic portal vessel Histology of the Intestinal Wall Muscle layers • Absorptive enterocytes • Uptake digested nutrients Circular folds Lumen Villi Microvilli (brush border) • Goblet cells • Secrete mucus that lubricates chyme • Enteroendocrine cells • Secrete hormones • Intestinal crypts • Epithelial cells secrete intestinal juice Absorptive enterocytes Absorptive enterocytes Goblet cells Lacteal Goblet cell Villi Vilus Blood capillaries Mucosa associated lymphoid tissue Intestinal crypt Muscularis mucosae Duodenal gland Enteroendocrine cells Venule Lymphatic vessel Submucosa Intestinal crypt © 2014 Pearson Education, Inc. © 2014 Pearson Education, Inc. 12