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Copyright © 2006 by Elsevier, Inc.
Figure 65-6; Guyton & Hall
Copyright © 2006 by Elsevier, Inc.
Life Cycle of S.I. Enterocytes
• Villi house self-renewing population of epithelial
cells with a 5-day turnover.
• Cell types in villus include: secretory cells,
endocrine cells, goblet cells, and mature absorptive
epithelial cells.
• Cells in enterocyte lineage divide and differentiate
as they migrate up crypts, becoming mature
absorptive cells.
• Enterocytes are shed into lumen to become part of
ingesta to be digested and absorbed.
Copyright © 2006 by Elsevier, Inc.
Mechanisms of Absorption
• Four mechanisms are important in transport
of substances across intestinal cell
membrane
- Active Transport -
- primary
- secondary (co-transport, counter-transport)
- Passive Diffusion
- Facilitated Diffusion - carrier mediated
- Endocytosis
Copyright © 2006 by Elsevier, Inc.
Absorptive Pathway of Nutrients
1. Mucous layer
2. Glycocalyx
3. Apical cell membrane
4. Cytoplasm of enterocyte
5. Basolateral cell membrane
6. Intercellular space
7. Basement membrane
8. Wall of capillary or lymph vessel
• A nutrient must cross 8 barriers to be
absorbed by blood or lymph
Copyright © 2006 by Elsevier, Inc.
Stomach
(2)
Fluid Entering and Exiting the Gut
Bile (1)
0
2
4
6
8
10
Volume
(L/day)
Diet (2)
Pancreas (1)
Saliva (1)
S.I. (2)
Duodenum
and
Jejunum (4)
Colon (1.4)
Ileum
(3.5)
Volume
entering
Volume
absorbed
Volume
Excreted
100-200 ml
Copyright © 2006 by Elsevier, Inc.
Sodium Absorption in Small Intestine
Na+
Na+
Na+
Gl
Gl
Na+
Na+
Cl-
Na+
Cl-
Na+
H+
Na+
H+
P
Na+ Na+
K+ K+
Cl-
Cl-
1
2
3
4
Aldosterone
increases
Na+ reabsorption
and K+ secretion in
S.I. and colon.
Copyright © 2006 by Elsevier, Inc.
Protein Digestion and Absorption
Dipeptides and tripeptides
Cytoplasmic peptidases
Amino acids
Di- and Tri-
peptides
Large
peptides
Free
amino acids
Carriers
Peptidases
Small
amounts
Amino acids
Protein
Pepsin
Pancreatic proteases
Carriers
Copyright © 2006 by Elsevier, Inc.
Assimilation of Lipids –
Overall Scheme
Triglyceride
Fatty acids &
Monoglyceride
Triglyceride
Duodenum
Enterocyte
Copyright © 2006 by Elsevier, Inc.
Basic Steps of Lipid Assimilation
• Most dietary lipid is neutral fat or
triglyceride. Three main processes must
occur for triglyceride to be absorbed into
blood:
- Emulsification - large aggregates of dietary triglyceride
are broken down.
- Enzymatic digestion - to yield monoglyceride and fatty
acids. Both can diffuse into enterocyte.
- Reconstitution of triglyceride and chylomicron formation
Copyright © 2006 by Elsevier, Inc.
Assimilation of Lipids
Emulsified
fat
2-MG
FFA
FOOD
lecithin
bile salts
lipase-colipase
2-MG
FFA
(micelles)
bile salts
micelles
2-MG
FFA
TG
(enterocyte)
apoprotein + TG
chylomicrons
lymph vessel
Copyright © 2006 by Elsevier, Inc.
“Malabsorption”
• Malabsorption as a general phenomenon is defined
clinically in terms of fat malabsorption because fat
can be measured easily in stool, unlike
carbohydrates and proteins.
• Motility disorders - moving through too rapidly
• Digestion disorder - pancreatitis / cystic fibrosis -
(not enough lipase)
• Absorption disorder - tropical and nontropical
sprue - resection of small intestine
Copyright © 2006 by Elsevier, Inc.
Neural Control of GI Tract
• Intrinsic Control - Enteric nervous system
- Myenteric (Auerbach’s) plexus
- Submucosal (Meissner’s) plexus
• Extrinsic Control - Autonomic nervous system
- Parasympathetic - mainly stimulates (Ach)
- Sympathetic - mainly inhibits (NE)
Copyright © 2006 by Elsevier, Inc.
Figure 62-4; Guyton & Hall

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Absorption and neural control of digestion

  • 1. Copyright © 2006 by Elsevier, Inc. Figure 65-6; Guyton & Hall
  • 2. Copyright © 2006 by Elsevier, Inc. Life Cycle of S.I. Enterocytes • Villi house self-renewing population of epithelial cells with a 5-day turnover. • Cell types in villus include: secretory cells, endocrine cells, goblet cells, and mature absorptive epithelial cells. • Cells in enterocyte lineage divide and differentiate as they migrate up crypts, becoming mature absorptive cells. • Enterocytes are shed into lumen to become part of ingesta to be digested and absorbed.
  • 3. Copyright © 2006 by Elsevier, Inc. Mechanisms of Absorption • Four mechanisms are important in transport of substances across intestinal cell membrane - Active Transport - - primary - secondary (co-transport, counter-transport) - Passive Diffusion - Facilitated Diffusion - carrier mediated - Endocytosis
  • 4. Copyright © 2006 by Elsevier, Inc. Absorptive Pathway of Nutrients 1. Mucous layer 2. Glycocalyx 3. Apical cell membrane 4. Cytoplasm of enterocyte 5. Basolateral cell membrane 6. Intercellular space 7. Basement membrane 8. Wall of capillary or lymph vessel • A nutrient must cross 8 barriers to be absorbed by blood or lymph
  • 5. Copyright © 2006 by Elsevier, Inc. Stomach (2) Fluid Entering and Exiting the Gut Bile (1) 0 2 4 6 8 10 Volume (L/day) Diet (2) Pancreas (1) Saliva (1) S.I. (2) Duodenum and Jejunum (4) Colon (1.4) Ileum (3.5) Volume entering Volume absorbed Volume Excreted 100-200 ml
  • 6. Copyright © 2006 by Elsevier, Inc. Sodium Absorption in Small Intestine Na+ Na+ Na+ Gl Gl Na+ Na+ Cl- Na+ Cl- Na+ H+ Na+ H+ P Na+ Na+ K+ K+ Cl- Cl- 1 2 3 4 Aldosterone increases Na+ reabsorption and K+ secretion in S.I. and colon.
  • 7. Copyright © 2006 by Elsevier, Inc. Protein Digestion and Absorption Dipeptides and tripeptides Cytoplasmic peptidases Amino acids Di- and Tri- peptides Large peptides Free amino acids Carriers Peptidases Small amounts Amino acids Protein Pepsin Pancreatic proteases Carriers
  • 8. Copyright © 2006 by Elsevier, Inc. Assimilation of Lipids – Overall Scheme Triglyceride Fatty acids & Monoglyceride Triglyceride Duodenum Enterocyte
  • 9. Copyright © 2006 by Elsevier, Inc. Basic Steps of Lipid Assimilation • Most dietary lipid is neutral fat or triglyceride. Three main processes must occur for triglyceride to be absorbed into blood: - Emulsification - large aggregates of dietary triglyceride are broken down. - Enzymatic digestion - to yield monoglyceride and fatty acids. Both can diffuse into enterocyte. - Reconstitution of triglyceride and chylomicron formation
  • 10. Copyright © 2006 by Elsevier, Inc. Assimilation of Lipids Emulsified fat 2-MG FFA FOOD lecithin bile salts lipase-colipase 2-MG FFA (micelles) bile salts micelles 2-MG FFA TG (enterocyte) apoprotein + TG chylomicrons lymph vessel
  • 11. Copyright © 2006 by Elsevier, Inc. “Malabsorption” • Malabsorption as a general phenomenon is defined clinically in terms of fat malabsorption because fat can be measured easily in stool, unlike carbohydrates and proteins. • Motility disorders - moving through too rapidly • Digestion disorder - pancreatitis / cystic fibrosis - (not enough lipase) • Absorption disorder - tropical and nontropical sprue - resection of small intestine
  • 12. Copyright © 2006 by Elsevier, Inc. Neural Control of GI Tract • Intrinsic Control - Enteric nervous system - Myenteric (Auerbach’s) plexus - Submucosal (Meissner’s) plexus • Extrinsic Control - Autonomic nervous system - Parasympathetic - mainly stimulates (Ach) - Sympathetic - mainly inhibits (NE)
  • 13. Copyright © 2006 by Elsevier, Inc. Figure 62-4; Guyton & Hall