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Exit Exit Home Home BASIM ZWAIN LECTURE NOTES BASIM ZWAIN LECTURE NOTES Digest Digest ion ion Overview Overview Organs Organs 1 1 . . Alimentary canal Alimentary canal a. Function a. Function i. Digests i. Digests ii. Absorbs ii. Absorbs b. Organs b. Organs i. Mouth i. Mouth ii. Pharynx ii. Pharynx iii. Esophagus iii. Esophagus iv. Stomach iv. Stomach v. Small intestine v. Small intestine vi. Large intestine vi. Large intestine Accessory digestive Accessory digestive a. Organs a. Organs i. Teeth i. Teeth ii. Tongue ii. Tongue iii. iii. Gallbladder Gallbladder b. Glands b. Glands i. Salivary i. Salivary ii. Liver ii. Liver iii. Pancreas iii. Pancreas igestive Process igestive Process Essential activities Essential activities 1. Ingestion 1. Ingestion a. Taking food into digestive system a. Taking food into digestive system via the mouth via the mouth 2. Propulsion 2. Propulsion a. Movement of food through the a. Movement of food through the digestive tract digestive tract b. Swallowing b. Swallowing i. Voluntary i. Voluntary c. Peristalsis c. Peristalsis i. Involuntary i. Involuntary 3 3 . . Mechanical digestion Mechanical digestion a. Chewing a. Chewing b. Mixing b. Mixing i. Saliva i. Saliva c. Churning c. Churning d. Segmentation d. Segmentation i. Local constriction of the i. Local constriction of the small intestine small intestine 4. Chemical digestion 4. Chemical digestion a. Mouth through small a. Mouth through small intestine intestine 5. Absorption 5. Absorption a. Movement of digested end a. Movement of digested end products from lumen of the GI products from lumen of the GI tract into blood and lymph tract into blood and lymph 6. Defecation 6. Defecation a. Elimination of undigested a. Elimination of undigested materials materials tology of the Alimentary Canal tology of the Alimentary Canal Four basic layers Four basic layers 1. Mucosa 1. Mucosa : Innermost layer functions : Innermost layer functions in secretion, absorption and in secretion, absorption and protection. It consists of 3 sub- protection. It consists of 3 sub- layers: lining epithelium, lamina layers: lining epithelium, lamina propria & muscularis mucosae. propria & muscularis mucosae. Epithelium: Simple columnar with Epithelium: Simple columnar with goblet cells. Lamina propria: Loose goblet cells. Lamina propria: Loose areolar connective tissue with areolar connective tissue with capillary beds & lymph nodules. capillary beds & lymph nodules. Muscularis mucosae: Thin layer of Muscularis mucosae: Thin layer of smooth muscle smooth muscle 2. Submucosa 2. Submucosa : Composed of dense CT : Composed of dense CT (blood vessels & lymphatic vessels) (blood vessels & lymphatic vessels) & elastic fibers & elastic fibers 3. Muscularis externa 3. Muscularis externa : Functions in : Functions in segmentation & peristalsis. It segmentation & peristalsis. It consists of inner circular and outer consists of inner circular and outer longitudinal layer of smooth muscle. longitudinal layer of smooth muscle. Sphincters are thickened areas of Sphincters are thickened areas of smooth muscle smooth muscle 4. Serosa 4. Serosa : Areolar connective tissue : Areolar connective tissue covered with mesothelium (single covered with mesothelium (single layer of squamous epithelium) layer of squamous epithelium) unctional Anatomy unctional Anatomy Mouth (oral cavity or buccal cavity) Mouth (oral cavity or buccal cavity) 1. Boundaries: Lips, cheeks, tongue 1. Boundaries: Lips, cheeks, tongue & palate & palate 2. Palate: Hard palate (rigid & 2. Palate: Hard palate (rigid & underlain by bone) & Soft palate underlain by bone) & Soft palate (formed from muscle) (formed from muscle) Tongue Tongue 1. Bundles of skeletal 1. Bundles of skeletal muscle muscle 2. Function 2. Function a. Mix food with saliva a. Mix food with saliva i. Bolus i. Bolus b. Position bolus for b. Position bolus for swallowing swallowing Salivary glands Salivary glands 1. Function of saliva: Cleanses 1. Function of saliva: Cleanses mouth, dissolves tastants, moistens mouth, dissolves tastants, moistens & initiates chemical breakdown & initiates chemical breakdown 2. Types: Extrinsic (3 pairs: 2. Types: Extrinsic (3 pairs: parotid, subman-dibular & parotid, subman-dibular & sublingual) & intrinsic (buccal sublingual) & intrinsic (buccal glands) glands) 3. Secretory cells: Serous cells 3. Secretory cells: Serous cells (watery secretion with enzymes) & (watery secretion with enzymes) & mucous cells (viscous) mucous cells (viscous) Teeth Teeth 1. Classification: Incisors, 1. Classification: Incisors, canines, premolars & molars canines, premolars & molars 2. Dental formula: 2. Dental formula: (2I, 1C, 2PM, 3M/2I, 1C, 2PM, 3M) (2I, 1C, 2PM, 3M/2I, 1C, 2PM, 3M) X 2 = 32 X 2 = 32 Pharynx: Oropharynx to Pharynx: Oropharynx to Laryngopharynx Laryngopharynx Esophagus Esophagus 1. Laryngopharynx into esophagus 1. Laryngopharynx into esophagus 2. Pierces diaphragm & joins stomach 2. Pierces diaphragm & joins stomach via cardiac orifice gated by cardiac via cardiac orifice gated by cardiac sphincter sphincter 3. Four layers: Mucosa, submucosa, 3. Four layers: Mucosa, submucosa, muscularis (skeletal and smooth muscularis (skeletal and smooth regionally distributed) & adventia regionally distributed) & adventia (not serosa: entirely connective (not serosa: entirely connective tissue) tissue) Digestive processes in mouth, Digestive processes in mouth, pharynx & esophagus pharynx & esophagus 1. Mastication: Mechanical breakdown 1. Mastication: Mechanical breakdown by teeth and tongue by teeth and tongue 2. Deglutition: Complicated process 2. Deglutition: Complicated process of swallowing of swallowing (two phases which involves 22 (two phases which involves 22 muscles) muscles) Stomach Stomach 1. Expansion of the GI tract 1. Expansion of the GI tract 2. Sack for storage and chemical 2. Sack for storage and chemical breakdown in which food is breakdown in which food is converted to chyme converted to chyme Stomach Stomach Gross anatomy Gross anatomy 1. Four regions: Cardiac (region 1. Four regions: Cardiac (region where food enters), fundus, body & where food enters), fundus, body & pyloric. Terminates at the pylorus & pyloric. Terminates at the pylorus & connects with small intestine via connects with small intestine via pyloric sphincter. pyloric sphincter. 2. Greater curvature (lateral convex 2. Greater curvature (lateral convex surface) surface) 3. Lesser curvature (medial concave 3. Lesser curvature (medial concave surface) surface) Microscopic anatomy Microscopic anatomy 1. Four tunics 1. Four tunics 2. Lining epithelium: Simple 2. Lining epithelium: Simple columnar (entirely goblet cells) columnar (entirely goblet cells) with gastric pits (gastric glands with gastric pits (gastric glands that produce gastric juice) that produce gastric juice) 3. Secretory cells of gastric 3. Secretory cells of gastric glands: glands: Mucous neck cells Mucous neck cells (produce (produce acidic mucus), acidic mucus), parietal cells parietal cells (secrete HCl and intrinsic factor), (secrete HCl and intrinsic factor), chief (zymogenic) cells chief (zymogenic) cells (produce (produce pepsinogen which is converted pepsinogen which is converted initially by HCl into pepsin which initially by HCl into pepsin which will catalyze conversion thereafter) will catalyze conversion thereafter) & & enteroendocrine cells enteroendocrine cells (produce (produce hormones that regulate digestive hormones that regulate digestive function) function) Digestive processes occurring in Digestive processes occurring in stomach stomach 1. Enzymatic digestion: Protein 1. Enzymatic digestion: Protein digestion is initiated in stomach digestion is initiated in stomach (pepsin) (pepsin) 2. Lipid soluble substances can pass 2. Lipid soluble substances can pass through stomach mucosa (alcohol and through stomach mucosa (alcohol and aspirin) aspirin) 3. Production of intrinsic factor: 3. Production of intrinsic factor: Required for absorption of B12 Required for absorption of B12 Regulation of gastric secretion Regulation of gastric secretion 1. Three phases: 1. Three phases: Cephalic, gastric & Cephalic, gastric & intestinal intestinal 2. 2. Cephalic phase Cephalic phase : Occurs prior to : Occurs prior to food entering stomach (brain food entering stomach (brain response to food) via hypothalamic response to food) via hypothalamic stimulation of the vagus nerve stimulation of the vagus nerve (parasympathetic enteric ganglionic (parasympathetic enteric ganglionic neurons stimulate the stomach neurons stimulate the stomach glands) glands) 3. 3. Gastric phase Gastric phase : Local signaling : Local signaling within stomach due to the presence within stomach due to the presence of food (distension, peptides or low of food (distension, peptides or low acidity) lead to HCl release acidity) lead to HCl release (gastrin is released in response to (gastrin is released in response to chemical stimuli & stimulates the chemical stimuli & stimulates the release of HCl by parietal cells) release of HCl by parietal cells) 4. 4. Intestinal phase Intestinal phase : : Excitatory Excitatory phase phase : Duodenum releases a gastrin- : Duodenum releases a gastrin- like substance that promotes like substance that promotes additional activity of gastric additional activity of gastric glands. glands. Inhibitory phase Inhibitory phase : : Enterogastric reflex inhibits vagal Enterogastric reflex inhibits vagal nuclei, inhibits local reflexes, nuclei, inhibits local reflexes, activates sympathetic fibers that activates sympathetic fibers that tighten pyloric sphincter & causes tighten pyloric sphincter & causes the release of enterogastrones. the release of enterogastrones. 5. Enterogastrone are secretin, 5. Enterogastrone are secretin, cholecystokinin (CCK), vasoactive cholecystokinin (CCK), vasoactive intestinal peptide (VIP) & gastric intestinal peptide (VIP) & gastric inhibitory peptide (GIP) inhibitory peptide (GIP) mall Intestine mall Intestine Gross anatomy Gross anatomy 1. Pyloric sphincter to ileocecal 1. Pyloric sphincter to ileocecal valve valve 2. Subdivisions: Duodenum, 2. Subdivisions: Duodenum, jejunum & ileum jejunum & ileum Microscopic anatomy Microscopic anatomy 1. Expanded surface area for 1. Expanded surface area for absorption absorption 2. Structural modifications: 2. Structural modifications: Circular folds Circular folds (deep folds of the (deep folds of the mucosa and submucosa), mucosa and submucosa), Villi Villi (finger-like projections of the (finger-like projections of the mucosa) & mucosa) & Microvilli Microvilli or brush border or brush border (projections of plasma membranes) (projections of plasma membranes) Histology Histology 1. Simple columnar epithelium 1. Simple columnar epithelium 2. Submucosa includes 2. Submucosa includes lymphatic tissue: Peyer’s lymphatic tissue: Peyer’s patches patches Liver and Liver and gallbladder gallbladder D. Liver and gallbladder D. Liver and gallbladder 1. Accessory organs associated with 1. Accessory organs associated with small intestine small intestine 2. Liver has a role in digestion in 2. Liver has a role in digestion in addition to its other functions: addition to its other functions: Bile production and export Bile production and export (emulsification of fat) (emulsification of fat) 3. Gallbladder: Stores bile 3. Gallbladder: Stores bile 4. Bile: Only bile salts and 4. Bile: Only bile salts and phospolipids aid in digestion phospolipids aid in digestion (emulsify fat) other components that (emulsify fat) other components that do not contribute to digestion will do not contribute to digestion will not be discussed not be discussed 5. Regulation of bile release: CCK 5. Regulation of bile release: CCK from small intestine is released from small intestine is released into blood in response to fatty into blood in response to fatty chyme entering small intestine. CCK chyme entering small intestine. CCK stimulates secretion of pancreatic stimulates secretion of pancreatic juice & relaxes hepato-pancreatic juice & relaxes hepato-pancreatic sphincter (controls entry of sphincter (controls entry of pancreatic juice and bile entering pancreatic juice and bile entering duodenum) duodenum) Pancreas Pancreas 1. Accessory digestive organ 1. Accessory digestive organ 2. Produces digestive enzymes: 2. Produces digestive enzymes: Exocrine product (pancreatic juice) Exocrine product (pancreatic juice) 3. Acini: Secretory cells 3. Acini: Secretory cells surrounding ducts surrounding ducts 4. Composition of pancreatic juice: 4. Composition of pancreatic juice: Proteases, amylase, lipases & Proteases, amylase, lipases & nucleases nucleases Regulation of pancreatic Regulation of pancreatic secretion: Local hormones (CCK & secretion: Local hormones (CCK & secretin) & parasympathetic secretin) & parasympathetic nervous system nervous system arge Intestine arge Intestine Gross anatomy Gross anatomy 1. Ileocecal valve to the anus 1. Ileocecal valve to the anus 2. Absorbs water from indigestible 2. Absorbs water from indigestible food residues food residues 3. Unique features: 3. Unique features: Teniae Teniae coli (3 coli (3 bands of longi-tudinal smooth bands of longi-tudinal smooth muscle), muscle), haustra haustra (pocketlike sacs) & (pocketlike sacs) & epiploic appendages epiploic appendages (fat-filled (fat-filled pouches) pouches) 4. Subdivisions: 4. Subdivisions: Cecum Cecum (1 (1 st st segment: segment: saclike), saclike), appendix appendix (lymphatic dead (lymphatic dead end), end), colon colon (several regions: (several regions: ascending ascending , , transverse transverse , , descending descending & & sigmoid sigmoid ), ), rectum rectum (contains rectal (contains rectal valves: internal transverse folds) & valves: internal transverse folds) & anal canal anal canal (two sphincters: internal (two sphincters: internal involuntary and external voluntary) involuntary and external voluntary) 5. Digestive processes: No 5. Digestive processes: No breakdown, just water and vitamin breakdown, just water and vitamin absorption & major function is the absorption & major function is the peristaltic movement of fecal peristaltic movement of fecal material material 6.Defecation: rectal walls 6.Defecation: rectal walls stretch(defecation reflex) stretch(defecation reflex) which is spinal-parasympathetic which is spinal-parasympathetic reflex (causes colon reflex (causes colon & & rectum to rectum to contract contract & & anal sphincters relax) anal sphincters relax) hemical Digestion hemical Digestion Background Background 1. Hydrolysis 1. Hydrolysis a. Catabolic process a. Catabolic process b. Large molecules into b. Large molecules into monomers monomers c. Enzymes into lumen of c. Enzymes into lumen of alimentary canal alimentary canal i. Intrinsic and accessory i. Intrinsic and accessory glands glands Carbohydrates (starch) Carbohydrates (starch) 1. Carbohydrates are broken 1. Carbohydrates are broken down into glucose, fructose down into glucose, fructose and galactose and galactose 2. Process 2. Process a. Salivary amylase a. Salivary amylase b. Pancreatic amylase b. Pancreatic amylase Proteins Proteins 1. Begins in stomach 1. Begins in stomach a. Pepsinogen to pepsin a. Pepsinogen to pepsin 2. Continues in small 2. Continues in small intestine intestine a. Trypsin and chymotrypsin a. Trypsin and chymotrypsin i. Pancreatic enzymes i. Pancreatic enzymes b. Carboxypepsidase b. Carboxypepsidase i. Pancreatic enzymes i. Pancreatic enzymes Lipids Lipids 1. Digestion occurs solely in small 1. Digestion occurs solely in small intestine intestine a. Lipases from pancreas a. Lipases from pancreas 2. Bile emulsifies fats so they are 2. Bile emulsifies fats so they are soluble soluble a. Only increases area that enzymes a. Only increases area that enzymes can contact can contact Nucleic acids Nucleic acids 1. Pancreatic 1. Pancreatic nucleosides nucleosides Absorption Absorption Active transport through the Active transport through the intestinal villi intestinal villi 1. Lipids can pass through cell 1. Lipids can pass through cell membranes membranes a. Active transpost is not a. Active transpost is not requires requires 2. Carbohydrates 2. Carbohydrates a. Protein carriers a. Protein carriers i. Metabolic energy is i. Metabolic energy is required required

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Page 1: Exit Home BASIM ZWAIN LECTURE NOTES BASIM ZWAIN LECTURE NOTESDigestionOverview Organs 1. Alimentary canal a. Function i. Digests i. Digests ii. Absorbs

ExitExit HomeHomeBASIM ZWAIN LECTURE NOTESBASIM ZWAIN LECTURE NOTES

DigestionDigestion

OverviewOverview OrgansOrgans

11 . .Alimentary canalAlimentary canala. Functiona. Function

i. Digestsi. Digests ii. Absorbsii. Absorbs

b. Organsb. Organs i. Mouthi. Mouth

ii. Pharynxii. Pharynx iii. Esophagusiii. Esophagus

iv. Stomachiv. Stomach v. Small intestinev. Small intestine vi. Large intestinevi. Large intestine

Accessory digestiveAccessory digestivea. Organsa. Organs

i. Teethi. Teeth ii. Tongueii. Tongue

iii. Gallbladderiii. Gallbladder b. Glandsb. Glands

i. Salivaryi. Salivary ii. Liverii. Liver

iii. Pancreasiii. Pancreas

Digestive ProcessDigestive Process

Essential activitiesEssential activities1. Ingestion1. Ingestiona. Taking food into digestive system via the moutha. Taking food into digestive system via the mouth2. Propulsion2. Propulsiona. Movement of food through the digestive tracta. Movement of food through the digestive tractb. Swallowingb. Swallowing i. Voluntaryi. Voluntaryc. Peristalsisc. Peristalsis i. Involuntaryi. Involuntary

33 . .Mechanical digestionMechanical digestiona. Chewinga. Chewingb. Mixingb. Mixing i. Salivai. Salivac. Churningc. Churningd. Segmentationd. Segmentation i. Local constriction of the small intestinei. Local constriction of the small intestine4. Chemical digestion4. Chemical digestiona. Mouth through small intestinea. Mouth through small intestine

5. Absorption5. Absorptiona. Movement of digested end products from a. Movement of digested end products from lumen of the GI tract into blood and lymphlumen of the GI tract into blood and lymph6. Defecation6. Defecationa. Elimination of undigested materialsa. Elimination of undigested materials

Histology of the Alimentary CanalHistology of the Alimentary Canal

Four basic layersFour basic layers1. Mucosa1. Mucosa: Innermost layer functions in secretion, : Innermost layer functions in secretion, absorption and protection. It consists of 3 sub-absorption and protection. It consists of 3 sub-layers: lining epithelium, lamina propria & layers: lining epithelium, lamina propria & muscularis mucosae. Epithelium: Simple columnar muscularis mucosae. Epithelium: Simple columnar with goblet cells. Lamina propria: Loose areolar with goblet cells. Lamina propria: Loose areolar connective tissue with capillary beds & lymph connective tissue with capillary beds & lymph nodules. Muscularis mucosae: Thin layer of smooth nodules. Muscularis mucosae: Thin layer of smooth musclemuscle

2. Submucosa2. Submucosa: Composed of dense CT (blood : Composed of dense CT (blood vessels & lymphatic vessels) & elastic fibersvessels & lymphatic vessels) & elastic fibers3. Muscularis externa3. Muscularis externa: Functions in segmentation : Functions in segmentation & peristalsis. It consists of inner circular and outer & peristalsis. It consists of inner circular and outer longitudinal layer of smooth muscle. Sphincters are longitudinal layer of smooth muscle. Sphincters are thickened areas of smooth musclethickened areas of smooth muscle4. Serosa4. Serosa: Areolar connective tissue covered with : Areolar connective tissue covered with mesothelium (single layer of squamous epithelium)mesothelium (single layer of squamous epithelium)

Functional AnatomyFunctional Anatomy

Mouth (oral cavity or buccal cavity) Mouth (oral cavity or buccal cavity) 1. Boundaries: Lips, cheeks, tongue & palate1. Boundaries: Lips, cheeks, tongue & palate2. Palate: Hard palate (rigid & underlain by bone) 2. Palate: Hard palate (rigid & underlain by bone) & Soft palate (formed from muscle)& Soft palate (formed from muscle)

TongueTongue1. Bundles of skeletal muscle1. Bundles of skeletal muscle2. Function2. Functiona. Mix food with salivaa. Mix food with saliva i. Bolusi. Bolusb. Position bolus for swallowingb. Position bolus for swallowing

Salivary glands Salivary glands 1. Function of saliva: Cleanses mouth, dissolves 1. Function of saliva: Cleanses mouth, dissolves tastants, moistens & initiates chemical breakdowntastants, moistens & initiates chemical breakdown2. Types: Extrinsic (3 pairs: parotid, subman-2. Types: Extrinsic (3 pairs: parotid, subman-dibular & sublingual) & intrinsic (buccal glands)dibular & sublingual) & intrinsic (buccal glands)3. Secretory cells: Serous cells (watery secretion 3. Secretory cells: Serous cells (watery secretion with enzymes) & mucous cells (viscous) with enzymes) & mucous cells (viscous)

Teeth Teeth 1. Classification: Incisors, canines, premolars & 1. Classification: Incisors, canines, premolars & molarsmolars2. Dental formula:2. Dental formula:

(2I, 1C, 2PM, 3M/2I, 1C, 2PM, 3M) X 2 = 32(2I, 1C, 2PM, 3M/2I, 1C, 2PM, 3M) X 2 = 32

Pharynx: Oropharynx to Laryngopharynx Pharynx: Oropharynx to Laryngopharynx

EsophagusEsophagus1. Laryngopharynx into esophagus1. Laryngopharynx into esophagus2. Pierces diaphragm & joins stomach via cardiac 2. Pierces diaphragm & joins stomach via cardiac orifice gated by cardiac sphincterorifice gated by cardiac sphincter3. Four layers: Mucosa, submucosa, muscularis 3. Four layers: Mucosa, submucosa, muscularis (skeletal and smooth regionally distributed) & (skeletal and smooth regionally distributed) & adventia (not serosa: entirely connective tissue)adventia (not serosa: entirely connective tissue)

Digestive processes in mouth, pharynx & Digestive processes in mouth, pharynx & esophagusesophagus1. Mastication: Mechanical breakdown by teeth 1. Mastication: Mechanical breakdown by teeth and tongueand tongue2. Deglutition: Complicated process of swallowing2. Deglutition: Complicated process of swallowing(two phases which involves 22 muscles)(two phases which involves 22 muscles)

StomachStomach1. Expansion of the GI tract1. Expansion of the GI tract2. Sack for storage and chemical breakdown in 2. Sack for storage and chemical breakdown in which food is converted to chymewhich food is converted to chyme

StomachStomach

Gross anatomy Gross anatomy 1. Four regions: Cardiac (region where food 1. Four regions: Cardiac (region where food enters), fundus, body & pyloric. Terminates at the enters), fundus, body & pyloric. Terminates at the pylorus & connects with small intestine via pyloric pylorus & connects with small intestine via pyloric sphincter.sphincter.2. Greater curvature (lateral convex surface)2. Greater curvature (lateral convex surface)3. Lesser curvature (medial concave surface)3. Lesser curvature (medial concave surface)

Microscopic anatomy Microscopic anatomy 1. Four tunics1. Four tunics2. Lining epithelium: Simple columnar (entirely 2. Lining epithelium: Simple columnar (entirely goblet cells) with gastric pits (gastric glands that goblet cells) with gastric pits (gastric glands that produce gastric juice)produce gastric juice)

3. Secretory cells of gastric glands: 3. Secretory cells of gastric glands: Mucous neck Mucous neck cellscells (produce acidic mucus), (produce acidic mucus), parietal cellsparietal cells (secrete (secrete HCl and intrinsic factor), HCl and intrinsic factor), chief (zymogenic) cellschief (zymogenic) cells (produce pepsinogen which is converted initially by (produce pepsinogen which is converted initially by HCl into pepsin which will catalyze conversion HCl into pepsin which will catalyze conversion thereafter) & thereafter) & enteroendocrine cellsenteroendocrine cells (produce (produce hormones that regulate digestive function) hormones that regulate digestive function)

Digestive processes occurring in stomachDigestive processes occurring in stomach1. Enzymatic digestion: Protein digestion is 1. Enzymatic digestion: Protein digestion is initiated in stomach (pepsin)initiated in stomach (pepsin)2. Lipid soluble substances can pass through 2. Lipid soluble substances can pass through stomach mucosa (alcohol and aspirin)stomach mucosa (alcohol and aspirin)3. Production of intrinsic factor: Required for 3. Production of intrinsic factor: Required for absorption of B12 absorption of B12

Regulation of gastric secretionRegulation of gastric secretion1. Three phases: 1. Three phases: Cephalic, gastric & intestinalCephalic, gastric & intestinal2. 2. Cephalic phaseCephalic phase: Occurs prior to food entering : Occurs prior to food entering stomach (brain response to food) via hypothalamic stomach (brain response to food) via hypothalamic stimulation of the vagus nerve (parasympathetic stimulation of the vagus nerve (parasympathetic enteric ganglionic neurons stimulate the stomach enteric ganglionic neurons stimulate the stomach glands)glands)

3. 3. Gastric phaseGastric phase: Local signaling within stomach : Local signaling within stomach due to the presence of food (distension, peptides or due to the presence of food (distension, peptides or low acidity) lead to HCl release (gastrin is released low acidity) lead to HCl release (gastrin is released in response to chemical stimuli & stimulates the in response to chemical stimuli & stimulates the release of HCl by parietal cells)release of HCl by parietal cells)

4. 4. Intestinal phaseIntestinal phase: : Excitatory phaseExcitatory phase: Duodenum : Duodenum releases a gastrin-like substance that promotes releases a gastrin-like substance that promotes additional activity of gastric glands. additional activity of gastric glands. Inhibitory Inhibitory phasephase: Enterogastric reflex inhibits vagal nuclei, : Enterogastric reflex inhibits vagal nuclei, inhibits local reflexes, activates sympathetic fibers inhibits local reflexes, activates sympathetic fibers that tighten pyloric sphincter & causes the release that tighten pyloric sphincter & causes the release of enterogastrones.of enterogastrones.5. Enterogastrone are secretin, cholecystokinin 5. Enterogastrone are secretin, cholecystokinin (CCK), vasoactive intestinal peptide (VIP) & (CCK), vasoactive intestinal peptide (VIP) & gastric inhibitory peptide (GIP)gastric inhibitory peptide (GIP)

Small IntestineSmall Intestine

Gross anatomy Gross anatomy 1. Pyloric sphincter to ileocecal valve1. Pyloric sphincter to ileocecal valve2. Subdivisions: Duodenum, jejunum & ileum2. Subdivisions: Duodenum, jejunum & ileum

Microscopic anatomyMicroscopic anatomy1. Expanded surface area for absorption1. Expanded surface area for absorption2. Structural modifications: 2. Structural modifications: Circular folds Circular folds (deep (deep folds of the mucosa and submucosa), folds of the mucosa and submucosa), VilliVilli (finger- (finger-like projections of the mucosa) & like projections of the mucosa) & MicrovilliMicrovilli or or brush border (projections of plasma membranes) brush border (projections of plasma membranes)

HistologyHistology1. Simple columnar epithelium1. Simple columnar epithelium2. Submucosa includes lymphatic tissue: 2. Submucosa includes lymphatic tissue: Peyer’s patchesPeyer’s patches

Liver and gallbladder Liver and gallbladder

D. Liver and gallbladder D. Liver and gallbladder 1. Accessory organs associated with small intestine 1. Accessory organs associated with small intestine 2. Liver has a role in digestion in addition to its 2. Liver has a role in digestion in addition to its other functions: Bile production and export other functions: Bile production and export (emulsification of fat)(emulsification of fat)

3. Gallbladder: Stores bile3. Gallbladder: Stores bile4. Bile: Only bile salts and phospolipids aid in 4. Bile: Only bile salts and phospolipids aid in digestion (emulsify fat) other components that do digestion (emulsify fat) other components that do not contribute to digestion will not be discussednot contribute to digestion will not be discussed

5. Regulation of bile release: CCK from small 5. Regulation of bile release: CCK from small intestine is released into blood in response to fatty intestine is released into blood in response to fatty chyme entering small intestine. CCK stimulates chyme entering small intestine. CCK stimulates secretion of pancreatic juice & relaxes hepato-secretion of pancreatic juice & relaxes hepato-pancreatic sphincter (controls entry of pancreatic pancreatic sphincter (controls entry of pancreatic juice and bile entering duodenum)juice and bile entering duodenum)

Pancreas Pancreas 1. Accessory digestive organ1. Accessory digestive organ2. Produces digestive enzymes: Exocrine product 2. Produces digestive enzymes: Exocrine product (pancreatic juice)(pancreatic juice)3. Acini: Secretory cells surrounding ducts3. Acini: Secretory cells surrounding ducts4. Composition of pancreatic juice: Proteases, 4. Composition of pancreatic juice: Proteases, amylase, lipases & nucleasesamylase, lipases & nucleases

Regulation of pancreatic secretion: Local Regulation of pancreatic secretion: Local hormones (CCK & secretin) & parasympathetic hormones (CCK & secretin) & parasympathetic nervous systemnervous system

Large IntestineLarge Intestine

Gross anatomy Gross anatomy 1. Ileocecal valve to the anus1. Ileocecal valve to the anus2. Absorbs water from indigestible food residues2. Absorbs water from indigestible food residues3. Unique features: 3. Unique features: TeniaeTeniae coli (3 bands of longi- coli (3 bands of longi-tudinal smooth muscle), tudinal smooth muscle), haustrahaustra (pocketlike sacs) (pocketlike sacs) & & epiploic appendagesepiploic appendages (fat-filled pouches) (fat-filled pouches)

4. Subdivisions: 4. Subdivisions: CecumCecum (1 (1stst segment: saclike), segment: saclike), appendixappendix (lymphatic dead end), (lymphatic dead end), coloncolon (several (several regions: regions: ascendingascending, , transversetransverse, , descendingdescending & & sigmoidsigmoid), ), rectumrectum (contains rectal valves: internal (contains rectal valves: internal transverse folds) & transverse folds) & anal canalanal canal (two sphincters: (two sphincters: internal involuntary and external voluntary)internal involuntary and external voluntary)

5. Digestive processes: No breakdown, just water 5. Digestive processes: No breakdown, just water and vitamin absorption & major function is the and vitamin absorption & major function is the peristaltic movement of fecal materialperistaltic movement of fecal material6.Defecation: rectal walls stretch(defecation reflex)6.Defecation: rectal walls stretch(defecation reflex)which is spinal-parasympathetic reflex (causes which is spinal-parasympathetic reflex (causes colon colon && rectum to contract rectum to contract && anal sphincters relax) anal sphincters relax)

Chemical DigestionChemical Digestion

Background Background 1. Hydrolysis1. Hydrolysisa. Catabolic processa. Catabolic processb. Large molecules into monomersb. Large molecules into monomersc. Enzymes into lumen of alimentary canalc. Enzymes into lumen of alimentary canal i. Intrinsic and accessory glandsi. Intrinsic and accessory glands

Carbohydrates (starch) Carbohydrates (starch) 1. Carbohydrates are broken down into 1. Carbohydrates are broken down into glucose, fructose and galactoseglucose, fructose and galactose2. Process2. Processa. Salivary amylasea. Salivary amylaseb. Pancreatic amylaseb. Pancreatic amylase

ProteinsProteins1. Begins in stomach1. Begins in stomacha. Pepsinogen to pepsina. Pepsinogen to pepsin2. Continues in small intestine2. Continues in small intestinea. Trypsin and chymotrypsina. Trypsin and chymotrypsin i. Pancreatic enzymesi. Pancreatic enzymesb. Carboxypepsidaseb. Carboxypepsidase i. Pancreatic enzymesi. Pancreatic enzymes

Lipids Lipids 1. Digestion occurs solely in small intestine1. Digestion occurs solely in small intestinea. Lipases from pancreasa. Lipases from pancreas2. Bile emulsifies fats so they are soluble2. Bile emulsifies fats so they are solublea. Only increases area that enzymes can contacta. Only increases area that enzymes can contact

Nucleic acids Nucleic acids 1. Pancreatic nucleosides1. Pancreatic nucleosides

AbsorptionAbsorption

Active transport through the intestinal villiActive transport through the intestinal villi1. Lipids can pass through cell membranes1. Lipids can pass through cell membranesa. Active transpost is not requiresa. Active transpost is not requires2. Carbohydrates2. Carbohydratesa. Protein carriersa. Protein carriers i. Metabolic energy is requiredi. Metabolic energy is required