ANATOMY AND

PHYSIOLOGY
OF THE
GASTROINTESTIN
AL TRACT

part 1
Digestive System
1. Components
2. Physiology
3. Nutrition
4. Metabolism
5. Clinical Significance
Basic Processes of the Digestive System

1. Ingestion: taking food into the mouth.

2. Secretion: release of water, acid, buffers, and enzymes into the lumen of the GI
tract.
3. Mixing and propulsion: churning and propulsion of food through the GI tract.
4. Digestion: mechanical and chemical breakdown of food.
5. Absorption: passage of digested products from the GI tract into the blood and
lymph.
6. Defecation: the elimination of feces from the GI tract.
Histology of the Digestive Tract
Four major layers of the digestive tract:
(1) mucosa
(2) submucosa
(3) muscularis externa
(4) serosa

*The structure of these

layers varies by region
1. Mucosa - inner lining of the GI tract
a. Epithelium
- nonkeratinized stratified squamous epithelium: mouth,
pharynx, esophagus, and anal canal
- simple columnar epithelium: stomach and intestines:
- exocrine cells that secrete mucus and fluid into the lumen
- enteroendocrine cells: secrete hormones.
b. Lamina propria - areolar connective tissue where nutrients
are brought by blood and lymph vessels
- mucosa-associated lymphatic tissue (MALT) contain immune
system cells that protect against disease
1. Mucosa - inner lining of the GI tract

c. Muscularis mucosae
- thin layer of smooth muscle fibers
- throws the mucous membrane of the stomach and
small intestine into many small folds, which increase the
surface area for digestion and absorption
2. Submucosa
- contains loose connective tissue as well as glands, blood vessels, lymphatic
vessels, and nerves
- vessels nourish the surrounding tissues and carry away absorbed materials

3. Muscular layer (Muscularis externa)

- provides for movements of the tube
- consists of two coats of smooth muscle tissue.
a. inner coat - encircle the tube, contraction decreases the diameter of
the tube
b. outer coat - run lengthwise, contraction shortens the tube
4. Serosa or Serous layer/Adventitia
- membranous structures that cover the external surface of the
internal organs.
• Serosa covers the organs that freely move inside a cavity.
• Adventitia covers the organs that should be bound with the
surrounding structures for support.
- ex: esophagus: has no serosa but has an adventitia
- protect underlying tissues and secrete serous fluid, which
moistens and lubricates the tube’s outer surface
Lining of Peritoneal Cavity
• Two parts:
1. serosa or visceral peritoneum covers
organs that project into the peritoneal
cavity.
2. parietal peritoneum lines the inner
surfaces of the body wall.
• continuously produces peritoneal fluid,
which lubricates the surfaces.
- secretes and reabsorbs about 7 liters of
fluid each day, but the volume within the
peritoneal cavity at any one time is very
small
- liver disease, kidney disease, and heart
failure can increase the rate at which fluids
move into the peritoneal cavity = ascites
Mesenteries
• double sheets of peritoneal membrane

• areolar tissue between the mesothelial

surfaces provides a route to and from
the digestive tract for blood vessels,
nerves, and lymphatic vessels.

• stabilize the positions of the attached

organs.

• prevent the intestines from becoming

entangled during digestive movements
or sudden changes in body position.
Control of GIT Function
System Tissues innervated Divisions
I. Nervous Autonomic all smooth muscles Parasympathetic
from the middle third of ↑
esophagus to rectum Sympathetic ↓

*Enteric along the layers of the Meissner’s/

middle third of Submucosal plexus
esophagus to the
rectum Auerbach’s/
Myenteric plexus

Somatic all skeletal muscle,

mainly at the mouth to
upper third of
esophagus and anus
only
17
Gastrointestinal Reflexes
II.
III. Endocrine control - GIT Hormones

21
 Structures and
Processes
in the
Gastrointestinal
Tract
Teeth
• crown - projects beyond the gum
• root - anchored to the alveolar process of the jaw
• enamel - mainly calcium salts and is the hardest
substance in the body
- if abrasive action or injury damages enamel, it is
not replaced.
• dentin - living cellular tissue, a substance much like
bone but harder
• pulp cavity, contains a combination of blood vessels,
nerves, and connective tissue (pulp)
• cementum - thin layer of bonelike material
• periodontal ligament (periodontal membrane) -
encloses the root. composed of collagen
- firmly attaching the tooth to the jaw
The salivary glands are composed of two types of secretory cells: serous and mucous
1. Parotid and submandibular glands contain mostly serous cells.
2. Buccal glands have approximately equal numbers of serous and mucous cells
3. Sublingual glands contain mostly mucous cells.
Mastication or Chewing
 Mechanical digestion of food to
facilitate enzymatic digestion

a. Breaks food into smaller pieces

b. Mixes food with saliva (contains
enzymes)
c. Brings food into contact with
taste receptors and releases odors

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Lower Esophageal Sphincter (LES)

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Factors affecting the Lower Esophageal
Sphincter
Increases LES pressure Decreases LES pressure
(increases reflux)
Protein foods Fat
Antacids Chocolate, tomatoes
Ethanol
Peppermint
Caffeine
Smoking
Pregnancy
Stomach
 Gastric Motility

 Storage – Fundus enlarges as

food enters the stomach:
receptive relaxation
 Mixing – Food in the body and
antrum increases contraction:
peristalsis and retropulsion
 Emptying – Chyme is propelled
through the pyloric sphincter
into the intestine

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 Gastric secretions
Secretion Secretory Cells Function/s

Mucus and Bicarbonate

- protection of stomach lining from
(HCO3) - gel forming Mucus neck cell
acid
glycoproteins
- activates pepsinogen to pepsin
Hydrochloric Acid (HCl) Parietal cell
- kills microorganisms

Pepsinogen/s Chief cell - digests proteins

- binds vitamin B12 and aids

Intrinsic Factor Parietal cell
absorption in the ileum

Other enzymes gelatinase, cathepsin

Physiologic Regulation of Gastric Secretion

41
Peptic Ulcers
Pathophysiology of Peptic Ulcer

43
Vomiting or Emesis
 forceful expulsion of gastric or duodenal
contents

Preceded by:
 nausea – subjective sensation
 retching – overcomes antireflux
mechanisms

Triggered by:
Stimulation of vomiting center
chemoreceptor trigger zone
duodenal receptors
(intestine)

44
45
Metabolic Alkalosis in Vomiting

blood

46
47
 Functions of the Small Intestine
1. Segmentations mix chyme with
digestive juices
- bring food into contact with mucosa
for absorption
- peristalsis propels chyme
2. Completes the digestion of
carbohydrates, proteins, and lipids
- begins and completes the digestion
of nucleic acids
3. Absorbs about 90% of nutrients and
water that pass through the digestive
system.
Small Intestine
• Duodenum - 25 cm
- “mixing bowl”: receives chyme from the stomach and digestive secretions
from the pancreas and liver
- from the stomach, the duodenum curves in a C that encloses the pancreas

• Jejunum - 1 meter
- bulk of chemical digestion and nutrient absorption

• Ileum - 2 meters
- final segment of the small intestine and is also the longest
- ends at the ileocecal valve
Segmentation

Peristalsis
 Migrating Myoelectric Complex
 Motility in interdigestive period (between meals)
MMC –sweeping through the gut
• Celiac Disease - an inflammatory gastrointestinal (GI) syndrome characterized by an
inappropriate immunological response to the gluten found in wheat, barley, rye,
triticale and often oats (by contamination) in people who are genetically predisposed.
 Ileocecal junction

 Close link between terminal

ileum and cecum by ileocecal
ligaments – functional valve
 Prevents backflow of cecal
contents
 Keeps small intestinal bacterial
concentrations at usual low
levels
 Large Intestine

• average length of about 1.5 meters

and a width of 7.5 cm.
• three parts:
(1) cecum - pouchlike first portion
(2) colon - largest portion
(3) rectum - last 15 cm (6 in.) and
the end of the digestive tract
 Functions of the Large Intestine
1. Haustral churning, peristalsis, and mass peristalsis drive the contents
of the colon into the rectum.
2. Bacteria in the large intestine convert proteins to amino acids, break
down amino acids, and produce some B vitamins and vitamin K.
3. Absorbing water, ions, and vitamins.

4. Forming feces.

5. Defecating (emptying the rectum)

 Cecum

• Collects and stores materials

from the ileum and begins the
process of compaction.

• Vermiform appendix is
attached to the posteromedial
surface of the cecum = organ of
the lymphatic system
- normally about 9 cm long, but
its size and shape are quite
variable.
 Colon
• Larger diameter and a thinner wall than the small intestine

• Pouches, or haustra: permit the colon to expand and elongate.

• Teniae coli: longitudinal bands of muscularis externa (3) along the outer
surface, muscle tone within the teniae coli creates the haustra

• Omental appendices: teardrop shaped sacs of fat on the serosa, also called
fatty or epiploic appendages

• Four regions: ascending colon, transverse colon, descending colon, and

sigmoid colon
 Rectum

• Forms the last 15 cm of the

digestive tract

• Expandable organ for the

temporary storage of feces

• Anus, or anal orifice, is the

exit of the anal canal
 Large Intestinal Motility
 Enhances the efficiency of water and electrolyte absorption
 Promotes excretion of fecal material
 No distinction between fed and fasting state

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Mass Peristalsis

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Gastrocolic reflex

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(mass peristalsis)

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Diverticulosis and Diverticulitis
End…