SMALL INTESTINE

INTRODUCTION

It is convoluted tube which extends from pyrolus to lealocaecal valve, where

it joins caecum i.e. first part of large intestine.
It is 6-7 m in length.
It has 3 parts – duodenum, jejunum & ileum

PARTS OF SMALL INTESTINE

DUODENUM JEJUNUM ILEUM

• First & shortest • Proximal 2/5 • Distal 3/5
part • No sharp
• 25 cm long demarcation
between them
• C shaped

2
INTRODUCTION

21-03-2022 3
MUCOUS MEMBRANE FEATURES
▪ Its length is 6m but absorptive area - 250 sq m
This large area due to :
• Plicae circularis (numerous folds of intestinal mucosa)
• Each enterocyte has 1000 micro villi (protrude from intestinal cells
surface)
• Folds , villi and microvilli increase surface area by 600 times
Folds (3 times)× villi (10 times) × microvilli(20 times)
• Presence of numerous depression ( Crypts of Lieberkuhn) that invade
lamina propria, present between villi throughout length of small
intestine.

21-03-2022 4
SUCCUS ENTERICUS
• Small intestine secrete a large amount of alkaline mucus in response
to :
1. Tactile/irritating stimuli on duodenal mucosa (local enteric
reflexes)
2. Vagal Stimulation
3. GIT hormone especially secretin.
• pH : 7.5 to 8.6 (alkaline)
COMPOSITION
• Water and electrolytes
• Enzymes : peptidases, sucrase, maltase,
lactase, lipases, enterokinase
• Mucus by Brunner’s gland.

21-03-2022 6
MOTILITY OF SMALL INTESTINE

INTERDIGESTIVE
DIGESTIVE PERIOD MOTILITY REFLEXES
PERIOD
• MMC (migrating • Mixing • Peristaltic reflex
motor complex) movements • Gastroileal reflex
(segmentation, • Intestinointestinal
pendular) reflex
• Propulsive
movements
(peristaltic
contraction &
rush)
• Movts of Villi

21-03-2022 7
MOTILITY OF SMALL INTESTINE
MMC
• Every 60-90 min
SEGMENTATION CONTRACTION
• Occurs in rhythmic fashion
• 12 times / min in duodenum
• 8 times / min in ileum
• Lasts for 5-6 sec

21-03-2022 8
MOTILITY OF SMALL INTESTINE
PENDULAR MOVEMENTS
• Constrictive waves that sweep forward backward or upward
downward in pendular fashion
PROPULSIVE MOVEMENTS – Push chyme towards aboral end of
intestine. It includes :
1. Peristaltic contraction
• 0.5 – 2 cm/ sec
• Time travelled in SI is 3 – 5 hrs
2. Peristaltic rush
• Powerful peristaltic contractions
• Stimulus : irritation of mucosa
• Within min small intestine is emptied

21-03-2022 9
MOTILITY OF SMALL INTESTINE
MOVEMENTS OF MICROVILLI
• Alternate shortening and elongation
• Helps in absorption.
• GASROILEAL REFLEX
• Stimulus : distension of stomach
• Response :
increase in peristaltic contraction in ileum
relaxation of ileocaecal sphincter
2. INTESTINOINTESTINAL REFLEX
• Stimulus : overdistension of one segment
• Response : relaxation of rest of smooth muscles

21-03-2022 10
FUNCTIONS OF SMALL INTESTINE

PROTECTIVE DIGESTIVE

FUNCTIONS
HORMONAL
HYDROLYTIC OF SI

ACTIVATOR
ABSORPTIVE
(enterokinase)

21-03-2022 11
LARGE INTESTINE
ANATOMY
▪ 6 cm in diameter
▪ 100 cm – length
▪ No plica circulares and villi
▪ Thrown into folds
producing sacculations.
▪ Large number of glands
producing mucus (crypts of
Lieberkuhn)

21-03-2022 13
SECRETIONS
▪ Rich in mucous & HCO3-
▪ pH: 8
neutralises acid formed by bacterial action on faecal matter.

INTESTINAL BACTERIAL ACTIVITY

▪ Synthesis of vit C, B- complex & folic acid
▪ Production of gases- 600 ml / day
▪ Bile pigments

21-03-2022 14
MOTILITY OF LARGE INTESTINE

▪ Proximal : absorption
▪ Distal : storage

21-03-2022 15
HAUSTRAL SHUTTLING
▪ Similar to segmentation of small intestine, contraction of circular
muscle – constriction ring
▪ Contraction of longitudinal – bulge →haustration
▪ Contraction disappears in 60 sec
▪ After few min – initiated in different area
▪ Function
▪ Mixing
▪ Propulsion

21-03-2022 16
MASS MOVEMENTS
▪ 3 – 4 times/day, after meals
▪ Initiated by
- gastrocolic or duodenocolic reflex
- intense PS stimulation
-overdistension of segment of colon
GASTROCOLIC REFLEX
▪ Stimulus : distension of stomach
▪ Response : urge to defaecate after meal
in adult training supresses this reflex.

21-03-2022 17
DEFECATION

It is process of excretion of faecal material, involves both voluntary and

reflex activity.

21-03-2022 18
EVENTS OF DEFAECATION
▪ Contraction of distal colon and rectum
▪ Relaxation of internal anal sphincter
▪ Relaxation of vol external anal sphincter
▪ Voluntary contraction of abdominal muscle

21-03-2022 19
INTRINSIC REFLEX

Gastrocolic reflex drives

faeces to rectum

Intra rectal pressure

Stimulation of stretch
receptors

Urge to defecate

21-03-2022 20
SPINAL CORD REFLEX

Distension of
rectum

Afferents through
pelvic nerve

Sacral segment of
spinal cord

PS discharge

Increase peristalsis,
sphincter relaxation

21-03-2022 21
ROLE OF VOLUNTARY CONTROL

contraction of external anal

sphincter

Internal sphincter closes

Rectum relaxes to accommodate

more fecal matter

Defecation reflex dies , recurs

after hours

21-03-2022 22