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Gastrointest

inal
Physiology I

Functions

4 major activities of GI tract


1.

Motility

2.

Secretion

3.

Aid in digestion and absorption

Digestion

4.

Propel ingested food from mouth toward rectum

Food broken down into absorbable molecules

Absorption

Nutrients, electrolytes, and water are absorbed

Structure of GI Tract

Arranged linearly in following


sequence

Mouth, esophagus, stomach, small


intestine, large intestine, and anus

Other structures of GI tract

Salivary glands, pancreas, liver, and


gallbladder

Structure of GI Tract

1.

Layers of GI Wall
Mucosa

2.

Submucosa

3.

4.

Innermost layer (faces lumen)


Layer of epithelial cells specialized for absorption
and secretion
Consists of collagen, elastin, glands, and blood
vessels

Muscularis

Circular and Longitudinal Smooth Muscle


Provides motility for GI tract

Serosa

Faces the blood

Innervation of GI Tract

Autonomic Nervous System has an


extrinsic and an intrinsic component

Extrinsic

Sympathetic and Parasympathetic


innervation of GI tract

Intrinsic
Called Enteric Nervous System
Contained within wall of GI tract
Communicates with Extrinsic component

Intrinsic Innervation

Can direct all functions of GI in absence


of extrinsic innervation
Controls contractile, secretory, and
endocrine functions of GI tract
Receives input from
1.
2.

Parasympathetic and sympathetic nervous


systems
Mechanoreceptors and chemoreceptors in
mucosa

Sends information directly to smooth


muscle, secretory, and endocrine cells

Esophagus

Muscular tube that conveys food


from pharynx to stomach
Inner circular muscle
Outer longitudinal muscle

Food passes through quickly


because of peristalsis

Esophagus

Pyrosis (heartburn)common esophageal


discomfort

Result of regurgitation of food and gastric fluid


into lower esophagus
Acid reflux can cause esophagitis

Stomach

Specialized for accumulation of food

Capable of considerable expansion (can


hold 2-3L)

Gastric juice converts food into


semiliquid called chyme
4 Parts
Cardia
Fundus
Body
Pylorus

Stomach

Stomach

Gastric mucosa has numerous


openings called gastric pits

Gastric glands empty into bottom of pits

4 functionally different cell types


compose glands
Mucous cells
Chief cells
Parietal cells
Enteroendocrine cells

Stomach

Small Intestine

3 Parts
1.
2.
3.

Duodenum
Jejunum
Ileum

Primary site for digestion and


absorption of nutrients
Bile duct and pancreatic duct
empty into duodenum

Small Intestine

Small Intestine

Small Intestine

Intestinal lining increases absorptive


surface area
Villi

Finger-like projections of the mucosa

Microvilli
Tiny projections on luminal membrane of
each intestinal cell
Give the apical region striated
appearance called brush border

Villi

Microvilli

Large Intestine

Cecum, ascending colon, transverse


colon, descending colon, sigmoid
colon, rectum, anal canal
Reabsorbs water and electrolytes
Eliminates waste
NO Villi
Mucosa contains numerous tubular
glands called crypts

Responsible for mucus secretion

Large Intestine

Liver

Largest internal organ


Receives major blood supply from
hepatic portal vein

Brings venous blood rich in nutrients


from digestive tract

Hepatocytes
Livers cells
Capable of regeneration

Liver

Liver

Functions
1.

2.
3.
4.
5.
6.

Protein synthesis (albumin,


prothrombin)
Bile formation and secretion
Detoxification of drugs and steroids
Lipoprotein synthesis
Carbohydrate metabolism
Urea formation from ammonium

Gallbladder

Attached to surface of the liver


Blind pouch that stores bile
Ducts
Hepatic Duct
Cystic Duct
Common Bile Duct

Gallbladder

Pancreas

1.

Exocrine and Endocrine Gland


ExocrineAcinar Cells

2.

Secretes essential digestive enzymes


through pancreatic duct into
duodenum

EndocrineIslets of Langerhans

Secretes insulin and glucagon into


blood stream

Pancreas

GI Peptides

Includes hormones, neurocrines, and


paracrines
Regulate functions of GI tract
Contraction and relaxation of smooth muscle
wall and sphincters
Secretion of enzymes for digestion
Secretion of fluid and electrolytes
Trophic (growth) effects
Some regulate secretion of other GI peptides

GI Peptides

Hormones

Peptides released from endocrine cells of GI tract


Secreted into portal circulation and enter systemic
circulation
Target cells may be in GI tract or may be located
elsewhere in body

Paracrines

Secreted by endocrine cells of GI tract


Act locally within same tissue that secretes them

Gastrin, Cholecystokinin, Secretin, and Gastric Inhibitory


Peptide

Somatostatin (inhibitory actions)

Neurocrines

Released by neurons of GI tract following an AP

ACh, norepinephrine, Vasoactive Intestinal Peptide (VIP),


Gastrin-Releasing Peptide (GRP), Neuropeptide Y, and
Substance P

GI Hormones

Gastrin

Secreted by G cells in stomach in response


to eating

Stimuli include proteins, distention of stomach,


and vagal stimulation

Gastrin-releasing peptide (GRP) is released from


vagal nerve endings onto G cells

Secretion is inhibited by low pH in stomach

Promotes H+ secretion by gastric parietal


cells
Stimulates growth of gastric mucosa

GI Hormones

Cholecystokinin

Secreted by I cells of small intestine in response to fatty


acids and small peptides

5 Actions:
1. Contraction of gallbladder

2.

Secretion of pancreatic enzymes

3.
4.
5.

Eject bile from gallbladder into small intestine necessary


for emulsification lipids
Digest lipids, carbohydrates, and proteins

Secretion of bicarbonate (HCO3-) from


pancreas
Growth of exocrine pancreas and gallbladder
Inhibition of gastric emptying

Ensures adequate time for digestive and absorptive

GI Hormones

Secretin

Secreted by S cells of duodenum in response


to H+ and fatty acids
Promotes secretion of pancreatic HCO3

Neutralizing H+ allows for pancreatic enzymes to


digest fats

Inhibits effects of gastrin on parietal cells (H+


secretion and growth)

Gastric Inhibitory Peptide (GIP)

Secreted by small intestine in response to all 3


types of nutrients
Stimulates insulin secretion by pancreas
Inhibits gastric H+ secretion

GI Paracrines

Somatostatin
Secreted by endocrine cells in response to
decreased luminal pH
Inhibits secretion of other GI hormones
Inhibits gastric H+ secretion

Histamine
Secreted in H+-secreting region of
stomach
Stimulates H+ secretion by gastric
parietal cells (along with gastrin and ACh)

GI Neurocrines

Synthesized in cell bodies of GI


neurons
AP causes release of neurocrine which
interacts with receptors on
postsynaptic cell
ACh (released from cholinergic neurons)
Norepinephrine (released from
adrenergic neurons)

Motility

Contraction and relaxation of walls and


sphincters of GI tract

Mixes ingested food to prepare it for digestion


and absorption
Propels food along GI tract

Contractile tissue of GI tract is Smooth


Muscle

Except pharynx, upper 1/3 esophagus, and


external anal sphincter are striated muscle
Smooth muscle cells coupled via gap junctions
Permits rapid spread of APs for coordinated,
smooth contraction

Motility

Segmentation Contraction
Circular muscle contracts sending chyme in
both orad and caudad directions
Intestine then relaxes allowing chyme to
merge back together

Peristaltic Contractions
Longitudinal muscle contracts orad to bolus
propeling chyme along small intestine
Simultaneously, portion of intestine caudad
to bolus relaxes

Secretion

Addition of fluids, enzymes, and


mucus to lumen of GI tract
Secretions produced by
Salivary glands (saliva)
Gastric mucosal cells (gastric secretion)
Pancreatic exocrine cells (pancreatic
secretion)
Liver (bile)

Salivary Secretion

Salivary glands produce 1 L/day of saliva


Functions of saliva

Initial digestion of starches and lipids by salivary


enzymes
Dilution and buffering of ingested foods
Lubrication of ingested food to aid its movement

Structure of Salivary Glands

Parotid glands, submandibular glands, and


sublingual glands
Each gland delivers saliva to mouth through a duct

Salivary Glands

Gastric Secretion

Gastric mucosal cells secrete gastric juice

HCl and pepsinogen initiate protein digestion


Intrinsic factor required for absorption of
vitamin B12
Mucus protects gastric mucosa from HCl

Cell Types of Gastric Mucosa

Body of stomach contains oxyntic glands

Parietal cells HCl and Intrinsic Factor


Chief cells Pepsinogen

Antrum of stomach contains pyloric glands

G cells Gastrin into the circulation


Mucous neck cells Mucus, HCO3-, and Pepsinogen

Gastric Secretion

Gastric Gland

HCl Secretion

Parietal cells secrete HCl which converts


inactive pepsinogen to pepsin

Within cell, CO2 combines with H2O to form


H+ and HCO32. At apical membrane, H+ secreted into
lumen of stomach via H+-K+ ATPase
1.

3.

Cl- follows H+ into the lumen by diffusing


through Cl- channels

At basolateral membrane, HCO3- absorbed


into blood via a Cl--HCO3- exchanger

Eventually HCO3- secreted back into GI tract by


pancreas

Regulation of HCl
Secretion

ACh

Histamine

Released from vagus nerve


Binds to receptors on parietal cells
Produces H+ secretion by parietal cells
Atropine blocks muscarinic receptors on parietal cells
Released from mastlike cells in gastric mucosa
Binds to H2 receptors on parietal cells
Produces H+ secretion by parietal cells
Cimetidine blocks H2 receptors

Gastrin

Released into circulation by G cells of stomach antrum


Binds to receptors on parietal cells
Stimulates H+ secretion

Pancreatic Secretion

Exocrine pancreas secretes ~1 L/day into


duodenum

Fluid consists of HCO3- and enzymes

HCO3- neutralizes H+ delivered to duodenum from stomach


Enzymatic portion digests carbohydrates, proteins, and
lipids into absorbable molecules

Structure of Pancreatic Exocrine Glands

Comprises ~90% of pancreas

Acinar Cells

Rest of pancreatic tissue is endocrine pancreas and blood


vessels
Line blind end of branching duct system
Secrete enzymatic portion

Ductal Cells

Line the ducts


Secrete aqueous HCO3- component

Bile Secretion

Necessary for digestion and


absorption of lipids in small intestine
Mixture of bile salts, bile pigments,
and cholesterol
Bile salts emulsify lipids to prepare
them for digestion
Solubilize products of lipid digestion in
packets called micelles