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I. Main organs
A. Mouth- Foodstuffs are broken down mechanically by chewing and saliva is
added as a lubricant.
1. Functions of chewing and salivary secretions
a. Reducing size of particles
b. Formation of bolus for swallowing
c. Initiation of starch and lipid digestion
d. Antibacterial
e. Neutralization of refluxed acid in
esophagus
B. Esophagus- A muscular tube that is a simple conduit
between the back of the mouth and stomach. Food
transfer is both voluntary and involuntary (striated
muscle, CNS control), while bolus transfer is
involuntary, due to smooth muscle, and under CNS
and ENS control. The upper esophageal sphincter
provides airway protection and the lower provides
esophageal protection from the stomach.
C. Stomach - Enzymatic digestion of proteins initiated
and foodstuffs reduced to liquid form.
D. Liver- The center of metabolic activity in the body - provide bile salts to the
small intestine, critical for digestion and absorption of fats.
E. Pancreas - Provides a potent mixture of digestive enzymes to the small
intestine, which are critical for digestion of fats, carbohydrates and protein.
F. Small Intestine- This is where the final stages of chemical enzymatic digestion
occur and where almost all nutrients are absorbed.
G. Large Intestine- Water is absorbed, bacterial fermentation takes place and feces
are formed.
II. Major physiologic processes of the gut
A. Motility- Contractions of smooth muscle in the wall of the tube that crush,
mix, and propel its contents.
B. Secretion- Delivery of enzymes, mucus, ions and the like into the lumen, and
hormones into blood
C. Digestion
D. Absorption -Transport of water, ions and nutrients from the lumen, across the
epithelium and into blood.
E. Elimination
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GIN 1 Proscribe: Sarah Stafford
September 10, 2007 Reviewer: Nicole Nelles
Dr. Raj Kumar Chief Reviewer: Kimberlyn Fitchett
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September 10, 2007 Reviewer: Nicole Nelles
Dr. Raj Kumar Chief Reviewer: Kimberlyn Fitchett
SECRETION MOTILITY
-Prevention of reflux
HCl
BODY -Reservoir
IF
Pepsinogen
-Tonic Force for Emptying
Lipase
Mucus/HC03
-Mixing/Grinding
ANTRUM/PYLORUS
-Sieving
Mucus
HC03 -Regulation of Emptying
c. Duodenal
i. Involves duodenal cluster unit
d. Small Intestinal
i. Covers an Enormous surface area, with a large blood
flow (up to 25% of cardiac output after meals), and
extensive ENS controlling motility autonomously
ii. Uses both segmental (Segmentation contractions are a
common type of mixing motility seen especially in the
small intestine - segmental rings of contraction chop
and mix the ingesta. Alternating contraction and
relaxation of the longitudinal muscle in the wall of the
gut also provides effective mixing of its contents) and
peristaltic (A ring of muscle contraction appears on the
oral side moves toward the anus, propelling the
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September 10, 2007 Reviewer: Nicole Nelles
Dr. Raj Kumar Chief Reviewer: Kimberlyn Fitchett
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September 10, 2007 Reviewer: Nicole Nelles
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A. Epithelial cells cover the mucosa and differ in shape in the different regions of
the gut.
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Myenteric Plexus
Circular Muscle
Long. Muscle
Submucous Plexus
Mucosa
V. Peristaltic Reflex
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A. ENS reflex
B. Will be a detailed description in later lectures; Dr. Kumar just wanted us to
know that multiple systems were working together to produce this reflex.
VI. Communication in the Gut
A. Three methods: neural, paracrine, and endocrine
B. When ENS activated by ACh from Vagal efferents, the ENS then uses ACh to
induce parietal cells to produce acid, ECL cells to produce histamine, and G
cells to produce gastrin.
C. Multiple Sensory receptors
1. Mechanoreceptors
a. Muscle (stretch, tension, length)
b. Mucosal
2. Chemreceptors
a. Acids
b. Osmotic
c. Amino Acids
d. Lipids
e. Glucose
3. Thermoreceptors
4. Pain (?)- still not clear
D. Sympathetic prevertebral ganglia are in pathways for rapid transfer of signals
between separated regions of bowel (bypassing synaptic delays inherent in
ENS in signal transduction over long distances)
VII. Gastric emptying
A. The rate of gastric emptying is relate to the particle size (ingested particles of >
than 1-2mm are emptied only during phase III of the migrating motor
complex)
B. Rate most rapid for isotonic solutions.
C. Rate also related to caloric contents of isotonic meals (greater caloric content
takes longer to empty)
VIII. Fed and Fasting programs
A. Metabolic Programs (liver)
1. Fasting
a. Use stored fuel
b. Glycogenolysis by liver and muscle
c. Gluconeogenesis by liver
d. Net hepatic glucose release
e. Fat and protein catabolism by adipose and muscle tissue
2. Fed
a. Use ingested nutrients for fuel
b. Glycogen synthesis by liver and muscle
c. Net glucose uptake by liver
d. Fat and protein synthesis
B. Motility Programs (ENS)
1. Esophagus: Transit
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