Chapter 21

Digestive
System

Villi of the Small Intestine

Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Function of the Digestive System

Ingestion
Taking food and water into the mouth

Break down the food

Mechanical digestion: chewing, mixing, and churning
food
Chemical digestion: digestive enzymes breakdown
food

Absorb nutrients
Movement of nutrients from the GI tract to the blood or
lymph

Release of waste
Elimination of indigestible solid wastes

Histology of the Digestive Tract

Two groups of organs within the

digestive system
The digestive tract or gastrointestinal (GI)
tract is a muscular tube that winds through
the body and is responsible for the
digestion and absorption of food

Oral cavity, pharynx, esophagus, stomach, small

intestine, large intestine, and anus

The accessory digestive organs aid in the

breakdown of foodstuffs

Teeth, tongue, gallbladder, salivary glands, liver, and

pancreas

Fig. 21.1

Histology of the Digestive Tract

Tunics

Three major functions:

Mucus secretions:

Secretion of mucus
Absorption of end products of digestion
Protection against infectious disease
Protect digestive organs from digesting themselves
Ease food along the tract

Stomach and small intestine mucosa contain:

Enzyme-secreting cells
Hormone-secreting cells (making them endocrine and
digestive organs)

Histology of the Digestive Tract

The digestive tract is composed of four tunics: mucosa,
submucosa, muscularis, and serosa or adventitia.
Mucosa
Innermost layer that lines the lumen of the alimentary canal
Consists of a mucous epithelium, a lamina propria, and a muscularis
mucosae

Submucosa
Connective tissue layer containing the submucosal plexus (part of the
enteric plexus), blood vessels, and small glands

Muscularis
Consists of an inner layer of circular smooth muscle and an outer
layer of longitudinal smooth muscle
The myenteric plexus is between the two muscle layers

Serosa or adventitia
Forms the outermost layer of the digestive tract

Fig. 21.2

Histology of the Digestive Tract

Enteric Nervous System
Consists of nerve plexuses within the wall of
the digestive tract
Serves the digestive tract and regulates
digestive activity. It is composed of two major
intrinsic nerve plexuses:
Submucosal nerve plexus: regulates glands and
smooth muscle in the mucosa
Myenteric nerve plexus: major nerve supply that
controls GI tract mobility

Histology of the Digestive Tract

Enteric Nervous System
Three major types of enteric neurons
1. Sensory neurons detect changes in the chemical
composition of the digestive tract
2. Motor neurons stimulate or inhibit smooth muscle
contraction and glandular secretion
3. Interneurons connect sensory to motor neurons

Nervous regulation involves local reflexes in

the ENS and CNS reflexes

Peritoneum

The peritoneum is a
serous membrane that
lines the
abdominopelvic cavity
and organs
Mesenteries are
peritoneum that extend
from the body wall to
many of the
abdominopelvic organs
Retroperitoneal organs
are located behind the
peritoneum
Fig. 21.3

Oral Cavity

Oral cavity or mouth

Is bounded by lips, cheeks, palate, and tongue

Has the oral orifice as its anterior opening
Is continuous with the oropharynx posteriorly

Divided into two regions

Vestibule

Oral Cavity Proper

Space between the lips or cheeks and the alveolar

processes, which contain the teeth

Lies medial to the alveolar processes

To withstand abrasions:

The mouth is lined with stratified squamous

epithelium

Oral Cavity

Lips and Cheeks

Involved in facial expression, mastication, and

speech

Palate

Forms the roof of the mouth. Consists of hard and

soft areas

Hard palate: assists the tongue in chewing

Soft palate: mobile fold formed mostly of skeletal
muscle. Projecting from the soft palate is the uvula

Closes off the nasopharynx during swallowing

The mouth contains accessory glands (salivary

glands) and accessory organs (teeth and
tongue) which begin the digestive process

Fig. 21.4

Oral Cavity
Tongue
Occupies the floor of the mouth and fills
the oral cavity when mouth is closed
Functions include:
Gripping and repositioning food during chewing
Mixing food with saliva and forming the bolus
Initiation of swallowing, and speech

Frenulum secures the tongue to the floor

of the mouth

Oral Cavity

Teeth

Tear and grind food

Born with 20 deciduous teeth

Erupt between about 6 months and 24 months of age

Deciduous teeth are replaced by 32 permanent

teeth
Replacement starts at about 5 years and the process
is complete by about 11 years

The types of teeth are

Incisors
Canines
Premolars
Molars

Fig. 21.5

Oral Cavity
A tooth consists of a crown, a neck, and a root
Crown
Exposed part of the tooth above the gingiva
Dentin covered by enamel
Enamel: acellular material composed of calcium salts and
hydroxyapatite crystals; the hardest substance in the body

Root
Portion of the tooth embedded in the jawbone
Composed of dentin
Within the dentin of the root is the pulp cavity, which is filled
with pulp, blood vessels, and nerves

Periodontal ligaments hold the teeth in the alveoli

Molar Tooth in Place in the Alveolar Bone

Fig. 21.6

Oral Cavity

Salivary Glands
Produce and secrete saliva that:

Cleanses the mouth

Moistens and dissolves food chemicals
Aids in bolus formation
Contains enzymes that break down starch

Salivary glands produce serous and

mucous secretions
The three pairs of large salivary glands are
the parotid, submandibular, and sublingual

Fig. 21.7

Oral Cavity
Saliva
Produce ~1 liter of saliva/day
Secreted from serous and mucous cells of salivary
glands
Serous: enzymes, ions, and mucin
Mucous: produce mucous

97-99.5% water and slightly acidic solution containing

Electrolytes
Digestive enzyme: salivary amylase
Proteins: mucin, lysozyme, defensins, and IgA
Metabolic wastes: urea and uric acid

Oral Cavity
Control of Salivation
Primarily by the parasympathetic division of
the autonomic nervous system
Salivary glands secrete serous, enzyme-rich
saliva in response to:
Ingested food which stimulates chemoreceptors
and pressoreceptors
The thought of food

Strong sympathetic stimulation inhibits

salivation and results in dry mouth

Pharynx and Esophagus

Pharynx
Consists of the nasopharynx, oropharynx,
and laryngopharynx

Food and fluids to the esophagus

Air to the trachea

Esophagus
Connects the pharynx to the stomach

The upper and lower esophageal sphincters

regulate movement

Mucous glands produce a lubricating

mucus

Tab.
21.1

Swallowing

During the voluntary phase of swallowing, a bolus of

food is moved by the tongue from the oral cavity to the
pharynx

Fig. 21.8

Swallowing

The pharyngeal phase is a reflex caused by the

stimulation of stretch receptors in the pharynx

The soft palate closes the nasopharynx, and the epiglottis,

vestibular folds, and vocal folds close the opening into the
larynx
Pharyngeal muscles move the bolus to the esophagus

Fig. 21.8

Swallowing

The esophageal phase is a reflex initiated by the

stimulation of stretch receptors in the esophagus. A
wave of contraction (peristalsis) moves the food to the
stomach

Fig. 21.8

Peristalsis

Fig. 21.9

Fig. 21.8

Anatomy and Histology of the Stomach

Temporary storage tank where chemical

breakdown of proteins begins and food is
converted from a bolus to chyme
The openings of the stomach are the

The major regions are the

Gastroesophageal opening to the esophagus

Pyloric orifice to the duodenum
Cardiac part
Fundus
Body
Pyloric part which is continuous with the duodenum
through the pyloric sphincter

The lateral sides of the stomach consist of

greater and lesser curvatures

Anatomy and Histology of the Stomach

The wall of the stomach consists of

External serosa
Muscle layer (longitudinal, circular, and oblique)
Submucosa
Simple columnar epithelium
Surface mucous cells: produce an alkaline mucous with
bicarbonate, which coats and protects the stomach lining

An empty stomach has a volume of 50 mL but

can hold about a gallon of food
When empty one can see the folds called rugae
(submucosa and mucosa)

Anatomy and Histology of the Stomach

Fig.
21.10

Anatomy and Histology of the Stomach

There are gastric pits with glands that

produce juice
Glands include four secretory cells:
Mucous neck: secrete acid mucus
Parietal cells: secrete HCl and intrinsic factor
Chief cells: produce pepsinogen

Pepsinogen is activated to pepsin by:

HCl in the stomach

Pepsin itself via a positive feedback mechanism

Endocrine cells: produce regulatory hormones

Gastrin, histamine, endorphins, serotonin,

cholecystokinin (CCK), and somatostatin into the
lamina propria

Anatomy and Histology of the Stomach

Fig.
21.10

Secretions of the Stomach

Chyme is ingested food mixed with gastric

juice
Gastric juice

Mucus protects the stomach lining

Pepsinogen is converted to pepsin, which digests
proteins
Hydrochloric acid promotes pepsin activity and kills
microorganisms
Intrinsic factor is necessary for vitamin B12
absorption
Gastrin and histamine regulate stomach secretions

A proton pump (H+-K+ exchange pump) moves

H+ out of parietal cells

HCl production
by Parietal Cells in
the Gastric Glands
of the Stomach

Fig. 21.11

Regulation of Stomach Secretion

There are three phases of stomach secretion

Cephalic phase

Gastric phase

Initiated by the sight, smell, taste, or thought of food

Nerve impulses from the medulla stimulate hydrochloric
acid, pepsinogen, gastrin, and histamine secretion.
Initiated by distention of the stomach, which stimulates
gastrin secretion and activates CNS and local reflexes
that promote secretion

Gastrointestinal phase

Acidic chyme, which enters the duodenum and

stimulates neuronal reflexes and the secretion of
hormones (secretin, cholecystokinin) that inhibit gastric
secretions

Cephalic Phase

Gastric Phase

Gastrointestinal Phase

Fig.
21.12

Movements of the Stomach

Waves mix the stomach contents with

stomach secretions to form chyme
Peristaltic waves move the chyme into
the duodenum
Hunger contractions
Vomiting

Reverse peristalsis

Fig.
21.13

Small Intestine

The bodys major digestive organ

Digestion is completed and absorption occurs
Runs from pyloric sphincter to the ileocecal
valve
Has three subdivisions:

Duodenum - ~ 10 long. The bile and pancreatic

ducts empty here
Jejunum - ~ 8 long
Ileum - ~ 12 long

Fig.
21.14

Anatomy and Histology of the Small Intestines

Structural modifications of the small intestine wall
increase surface area about 600-fold
Circular folds
Deep folds of the mucosa and submucosa

Villi
Fingerlike extensions of the mucosa

Microvilli
Tiny projections of absorptive mucosal cells plasma
membranes. This forms a brush border

The epithelium of the mucosa is simple columnar

epithelium. Between the villi the mucosa
contains pits called intestinal glands

Anatomy and Histology of the Small Intestines

The epithelium of the mucosa is made up of:
Absorptive cells
Produce digestive enzymes

Goblet cells
Produce a protective mucus

Granular cells (Paneth cells)

Protect the intestinal epithelium form bacteria

Endocrine cells
Produce regulatory hormones

Peyers patches (aggregated lymphoid follicles)

are found in the submucosa

Fig.
21.15

Secretions of the Small Intestine

Mucus protects against digestive

enzymes and gastric acids
Digestive enzymes (disaccharidases and
peptidases) are bound to the intestinal
wall
Chemical or tactile irritation, vagal
stimulation, and secretin stimulate
intestinal secretion

Movement of the Small Intestine

Segmental contractions mix intestinal

contents
Peristaltic contractions move materials
distally
Distension of the intestinal wall, local
reflexes, and the parasympathetic
nervous system stimulate contractions
Distension of the cecum initiates a reflex
that stimulates contraction of the
ileocecal sphincter

Segmental Contractions

Fig. 21.16

Anatomy and Histology of the Liver

The liver has four external lobes: right, left,

caudate, and quadrate
Internally, the liver is divided into eight
segments
Liver segments are divided into lobules
Hexagonal-shaped liver lobules are the
structural and functional units of the liver
Composed of hepatocyte (liver cell) plates
radiating outward from a central vein
Portal triads are found at each of the six
corners of each liver lobule

Fig.
21.17

Anatomy and Histology of the Liver

Portal triads consist of

Hepatic duct: conduct bile toward the duodenum

Hepatic artery: supplies oxygen-rich blood to the
liver
Hepatic portal vein: carries venous blood with
nutrients from digestive viscera

The hepatic cords are composed of columns of

hepatocytes separated by the bile canaliculi
Sinusoids are enlarged spaces filled with blood
and lined with endothelium and hepatic
phagocytic cells

Kupffer cells: hepatic macrophages found in liver

sinusoids

Fig.
21.18

Functions of the Liver

Produces bile, which contains bile salts

that emulsify fats
Stores and processes nutrients,
produces new molecules, and detoxifies
molecules
Hepatic phagocytic cells phagocytize red
blood cells, bacteria, and other debris
Produces blood components

Blood Flow Through the Liver

Branches of the hepatic artery and the

hepatic portal vein in the portal triads
empty into hepatic sinusoids
Hepatic sinusoids empty into central
veins, which join to form the hepatic
veins, which leave the liver

Fig. 21.19
Blood and Bile Flow
Through the Liver

Bile Transport

Bile canaliculi collect bile from hepatocytes and

join the small hepatic ducts in the portal triads
Small hepatic ducts converge to form the right
and left hepatic ducts, which exit the liver
The left and right hepatic ducts join to form the
common hepatic duct
The cystic duct from the gallbladder joins the
common hepatic duct to form the common bile
duct
The common bile duct and pancreatic duct join
at the hepatopancreatic ampulla, which opens
into the duodenum at the major duodenal papilla

Gallbladder and Bile

Gallbladder

A small sac on the inferior surface of the liver

Stores and concentrates bile

Bile

A yellow-green, alkaline solution containing bile salts, bile

pigments, cholesterol, neutral fats, phospholipids, and
electrolytes
Bile salts are cholesterol derivatives that:

Emulsify fat
Facilitate fat and cholesterol absorption
Helps make cholesterol soluble

Enterohepatic circulation recycles bile salts therefore they are

never voided in the feces
The chief bile pigment is bilirubin, a waste product of heme.

Bilirubin is metabolized by bacteria in the small intestines and

urobilogen is produced, which gives feces its dark color

Liver, Gallbladder, Pancreas, and Duct System

Fig. 21.20

Regulation of Bile Secretion

Acidic, fatty chyme causes the duodenum to

release:

Cholecystokinin (CCK) and secretin into the

bloodstream

Cholecystokinin causes:

The gallbladder to contract and releases bile

Relaxation of the sphincters of the bile duct and
hepatopancreatic ampulla

Secretin increases bile secretion (water and bicarbonate

ions)
As a result, bile enters the duodenum

Bile salts and secretin transported in blood

stimulate the liver to produce bile
Vagal stimulation causes weak contractions of
the gallbladder

Control of Bile Secretion and Release

Fig.
21.21

Anatomy and Histology of the Pancreas

Location

Lies deep to the greater curvature of the stomach

The head is encircled by the duodenum and the tail sits against
the spleen

Exocrine function

Secretes pancreatic juice which breaks down all categories of

foodstuff
The pancreas is divided into lobules that contain acini

Clusters of secretory cells that contain zymogen granules with

digestive enzymes
Connect to a duct system that eventually forms the pancreatic
duct

The pancreatic duct joins the hepatopancreatic ampulla. The

accessory pancreatic duct empties into the duodenum at the
minor duodenal papilla.

The pancreas also has an endocrine function. The islets

of Langerhans release of insulin and glucagon

Fig.
21.22

Pancreatic Secretions

The aqueous component of pancreatic juice is

produced by the small pancreatic ducts and
contains bicarbonate ions

Water solution of enzymes and electrolytes (primarily

HCO3)

Neutralizes acidic chyme

Provides optimal environment for pancreatic enzymes

The enzymatic component of pancreatic juice

is produced by the acini and contains enzymes
that digest carbohydrates, lipids, and proteins

Enzymes are released in inactive form and activated in

the duodenum

Regulation of Bile Secretion and Release

Secretin stimulates the release of the aqueous

component, which neutralizes acidic chyme
Cholecystokinin stimulates the secretion of the
enzymatic component and relaxation of the
sphincters of the pancreatic duct and
hepatopancreatic ampulla
Parasympathetic stimulation increases and
sympathetic stimulation decreases secretion of
enzymes

Fig.
21.23

Anatomy and Histology of the Large Intestine

Extends from the ileocecal valve to the anus

Absorbs water and eliminate the waste via feces
Is subdivided into the cecum, appendix, colon, rectum,
and anal canal

The cecum forms a blind sac at the junction of the small and
large intestines.
The vermiform appendix is a blind tube off the cecum.
The colon has distinct regions: ascending colon, transverse
colon, descending colon, and sigmoid colon
The sigmoid colon joins the rectum
The anal canal, the last segment of the large intestine, opens to
the exterior at the anus

The anal canal contains two sphincters to allow the movement of

feces

Anatomy and Histology of the Large Intestine

Three unique features

Teniae coli: three bands of longitudinal
smooth muscle in its muscularis
Haustra: pocketlike sacs caused by the
tone of the teniae coli
Epiploic appendages : fat-filled pouches of
visceral peritoneum

The mucosal lining of the large intestine

is simple columnar epithelium with
mucus-producing crypts

Large Intestine

Fig. 21.24

Secretions of the Large Intestine

Mucus protects the intestinal lining

The bacterial flora of the large intestine consist
of:

Bacteria surviving the small intestine that enter the

cecum
Those entering via the anus

These bacteria:

Colonize the colon

Ferment indigestible carbohydrates
Release irritating acids and gases (flatus)
Synthesize B complex vitamins and vitamin K
Constitute about 30% of the dry weight of the feces

Movement in the Large Intestine

Haustra mix the contents and moves them

slowly toward the anus
Mass movements are strong peristaltic
contractions that occur three or four times a
day
Defecation is the elimination of feces

Distension of rectal walls caused by feces:

Stimulates contraction of the rectal walls

Relaxes the internal anal sphincter

Reflex activity moves feces through the internal anal

sphincter
Voluntary activity regulates movement through the
external anal sphincter

Fig. 21.25

Digestion, Absorption, and Transport

Digestion (mechanical and chemical) is

the breakdown of organic molecules into
their component parts
Chemical digestion is the breaking of
covalent chemical bonds in organic
molecules by digestive enzymes

Absorption is the uptake of digestive tract

contents
Transport is the distribution of nutrients
throughout the body

Chemical Digestion
Carbohydrate digestion
Begins in mouth with salivary amylase digesting
starches
Pancreatic amylase finishes the process in the
small intestine. Simple sugars are also broken
down here

Protein digestion
Broken down into amino acids
Begins in the stomach with pepsin
Trypsin and chymotrypsin are also important
protein digesting enzymes.

Chemical Digestion
Lipid digestion
Small intestine is the sole source of lipid
digestion by lipases
Enter lacteals and are transported to systemic
circulation via lymph

Nucleic acids
Broken down by pancreatic nucleases in the
small intestine

Tab.
21.2

Carbohydrates

Include starches, glycogen, sucrose, lactose, glucose,

and fructose
Polysaccharides are broken down into
monosaccharides by a number of different enzymes
Monosaccharides

Taken up by intestinal epithelial cells by symport that is

powered by a Na+ gradient or by facilitated diffusion
Carried to the liver, where the non-glucose sugars are
converted to glucose
Glucose is transported to the cells that require energy
Glucose enters the cells through facilitated diffusion

Insulin influences the rate of glucose transport

Transport of Monosaccharides
Across the Intestinal Epithelium

Fig. 21.26

Lipids

Include triglycerides, phospholipids, steroids,

and fat-soluble vitamins
Emulsification is the transformation of large
lipid droplets into smaller droplets and is
accomplished by bile salts
Lipase digests lipid molecules to form fatty
acids and a monoglyceride
Micelles form around lipid digestion products
and move to epithelial cells of the small
intestine, where the products pass into the
cells by simple diffusion

Lipids

Within the epithelial cells, free fatty acids are

combined with monoglycerides to form
triglycerides

Proteins coat triglycerides, phospholipids, and

cholesterol to form chylomicrons
Chylomicrons enter lacteals within intestinal villi
and are carried through the lymphatic system to
the bloodstream
Triglycerides are stored in adipose tissue,
converted into other molecules, or used as energy

Transport of Lipids Across the

Intestinal Epithelium

Fig. 21.27

Lipoproteins

Lipoproteins include
chylomicrons, VLDL, LDL,
and HDL
LDL transports cholesterol to
cells, and HDL transports it
from cells to the liver
LDL are taken into cells by
receptor-mediated
endocytosis, which is
controlled by a negativefeedback mechanism
Fig. 21.28

Proteins

Pepsin in the stomach breaks proteins into smaller

polypeptide chains
Proteolytic enzymes from the pancreas produce small peptide
chains
Peptidases, bound to the microvilli of the small intestine, break
down peptides
Tripeptides, dipeptides, and amino acids are absorbed by
symport that is powered by a Na gradient
Amino acids are transported to the liver, where the amino
acids can be modified or released into the bloodstream
Amino acids are actively transported into cells under the
stimulation of growth hormone and insulin
Amino acids are used as building blocks or for energy

Amino Acid Transport Across the

Intestinal Epithelium

Fig. 21.29

Water and Ions

About 9 liters of water

enters the digestive tract
each day

Can move in either direction

across the wall of the small
intestine, depending on the
osmotic gradients across the
epithelium
Epithelial cells actively
transport Na, K, Ca+2, and
Mg+2 from the intestine
Chloride ions move passively
through the wall of the
duodenum and jejunum but
are actively transported from
the ileum
Fig. 21.30

Effects of Aging on the Digestive System

The mucous layer, the connective tissue,

the muscles, and the secretions all tend
to decrease as a person ages
These changes make an older person
more open to infections and toxic agents

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