3. Digestive SystemDigestive System
Digestion:
The breaking down of complex food material into simple food
material with the help of chemicals.
Gastroenterology:
The branch of science that deals with structure, function,
diagnosis & treatment of diseases of stomach & intestine.
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8. Ingestion
• Taking food through the mouth
Movement
• Movement of food along the GIT
Digestion (Mechanical & Chemical)
• Breakdown of food by chemical &
mechanical processes
Absorption
• Transport of digested material into
cardiovascular and lymphatic system for
distribution to cells
Defecation
• Elimination of indigestible substances
from body in the form of feces 8
The Digestive ProcessThe Digestive Process
9. 9
Histology of alimentary tractHistology of alimentary tract
Four layers from esophagus to anus
1. Mucosa
2. Submucosa
3. Muscularis
4. Serosa
10. 10
Histology of alimentary tractHistology of alimentary tract
Inner layer (Mucosa):
It is inner lining of GI tract.
Three sub-layers
1. Epithelium
2. Lamina propria
3. Muscularis mucosae
11. 11
Histology of alimentary tractHistology of alimentary tract
Sub-mucosa:
Present above the mucosa
Consist of areolar connective tissue.
Muscularis:
It is present above the sub-mucosa layer.
Serosa:
Outer layer of GI tract.
Made up of Simple squamous epithelium
12. 12
Oral cavity or buccal
cavity
• Lining: thick stratified
squamous epithelium
It is formed by the
Cheeks
Hard palate
Soft palates
Tongue
Mouth
13. 13
Cheeks: Forms the lateral walls of oral cavity.
The anterior portions of cheeks end at the lips.
Lips or labia: Fleshy folds surrounding the opening of mouth.
Palate: It is a septum that separates the oral cavity from the
nasal cavity, forming the roof of mouth.
Hard palate: The anterior portion of roof of mouth
Soft palate: The posterior portion of roof of mouth
14. TongueTongue
Tongue together with other
muscles forms the floor of oral
cavity.
It is made up of skeletal muscles
covered with mucous
membrane.
The upper surface and sides of
tongue are covered with
papillae, contains taste buds.
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15. TongueTongue
There are 3 varieties of papillae;
Circumvallate papillae:
These 8 to 12 papillae are arranged in inverted V shape towards the base
of tongue.
All of them contains taste buds.
Largest papillae
Filiform papillae:
Whitish in color & do not contain taste buds.
Fungiform papillae:
Smallest of the three types.
Present near the tip of tongue.
Reddish dot & contains taste buds.
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16. 16
TeethTeeth
Called as dentes
Present in sockets of
mandible (lower jaw bone) &
maxilla (upper jaw bone)
Parts of teeth:
The crown
The neck
The root
17. TeethTeeth
Crown: Visible portion of tooth above the gums
Root: Embedded in the gums
Dentin: Calcified connective tissue covered by enamel
Enamel is very hard made up of calcium phosphate &
carbonate.
At the center of tooth is the pulp cavity containing blood
vessels, lymph vessels & nerves
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18. 18
TeethTeeth
Two sets of teeth
• Falling out:
“Baby” teeth
Start at 6 months
Fall out between 2-6 years
• Permanent:
• It consist of 32 teeth
19. 19
Classification of teeth according toClassification of teeth according to
shape & functionshape & function
Incisors: Cutting teeth used for
cutting off food
Canines: Cone shaped used for
cutting off food
Premolars & molar: Broad, flat
surface used for grinding or
chewing of food
Incisor
Canine
Premolar
Molar
20. Salivary glandsSalivary glands
It releases saliva into oral cavity.
3 pairs of salivary glands,
Parotid gland
Submandibular gland
Sublingual gland
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21. Salivary glandsSalivary glands
Parotid gland:
Present near to the ears.
They secrete their secretions into oral cavity by parotid duct.
Largest salivary gland
Submandibular gland:
It is present in the floor of mouth & beneath the tongue.
Sublingual gland:
Smallest salivary gland
Present beneath the tongue
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22. SalivaSaliva
It is a mixture of water, ions, mucus & enzymes
About 1 to 1.5 L is secreted every day
Acidic in nature (6.35 to 6.85)
Viscous & colorless in nature
Functions:
Keep mouth moist
Dissolves food
Moistens food
Starts enzymatic digestion (Amylase=sugars to starch)
Excretion (Urea, mercury, lead, many drugs)
Antibacterial & antiviral
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23. PharynxPharynx
It is a funnel-shaped tube, 13 cm long
Extends from nose to esophagus
Composed of skeletal muscle & lined by mucous
membrane
It is divided into 3 parts:
Nasopharynx
Oropharynx
Laryngopharynx
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24. PharynxPharynx
Nasopharynx: Superior portion of pharynx.
Important for respiration.
Oropharynx: Intermediate portion of pharynx.
Laryngopharynx: Inferior portion of pharynx
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25. EsophagusEsophagus
Muscular collapsible tube
25 cm long
2 cm in diameter
lies posterior to trachea
It continuous with pharynx &
connected to stomach.
Upper & lower ends are closed
by sphincter.
Upper esophageal sphincter (UES)
Lower esophageal sphincter (LES)
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Esophagus
26. EsophagusEsophagus
Upper esophageal sphincter (UES):
Regulates the movement of food from pharynx to
esophagus.
Lower esophageal sphincter (LES):
Regulates the movement of food from esophagus to
stomach.
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27. DeglutitionDeglutition
Swallowing (deglutition):
Movement of food from mouth into stomach is called as
swallowing
Facilitated by the secretion of saliva & mucus
It occurs in the mouth, pharynx, & esophagus
Complex but fast process completed within seconds
3 phases,
Buccal swallowing
Pharyngeal swallowing
Esophageal swallowing
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31. StomachStomach
Enlargement of GI tract
J shaped organ
Connecting organ between
esophagus & duodenum
Divided into 4 parts
Cardia
Fundus
Body
Pylorus
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32. 32
Stomach PartsStomach Parts
Cardia: Located near the opening
Fundus: Rounded portion
Body: Large central portion
Present below the fundus
Greater curvature: Concave border
Lesser curvature: Convex border
Pylorus: Present below the body
Pyloric antrum: Connects to the body of
stomach
Pyloric canal: Connects to the
duodenum
33. FunctionsFunctions
Act as a reservoir of food
With the peristaltic movement it causes mixing of food with
gastric juice
Mucosal lining is responsible for absorption of water, alcohol
& glucose to the blood stream
Causes secretion of 1-2 liter of gastric juice every day
Gastric lipase: Lipolytic activity
Pepsin: Breakdown of proteins to peptones
Mucus from mucus cell prevents mechanical injury to
stomach
HCl: Kills bacteria in food & gives protection
It forms intrinsic factor requires for absorption of vitamin B12.
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34. Gastric JuiceGastric Juice
Clear colorless juice
Acidic in nature
2 liters of gastric juice secreted daily by gastric glands in the mucosa
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35. Composition of Gastric JuiceComposition of Gastric Juice
It consists of,
Water: Liquefies the swallowed food
Mineral salts:
Mucus secreted by goblet cells: Prevents mechanical injury
to stomach
Hcl secreted by parietal cells: Kills the ingested M.O.
Intrinsic factor in gastric glands: Absorption of vitamin B12
Pepsinogen enzyme secreted by chief cells
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36. 36
Small intestineSmall intestine
It continues from stomach to large
intestine
Thin & long (4 m in length)
It lies in the abdominal cavity
surrounded by large intestine
Most enzymatic digestion occurs
Most enzymes secreted by
pancreas
Almost all absorption of nutrients
3-6 hour process
37. 37
Small intestine has 3 subdivisions
• Duodenum – Superior portion (25 cm long)
• Jejunum – Middle portion (1.5 m long)
• Ileum – Terminal portion (2 m long)
Small intestineSmall intestine
38. Histology of Small IntestineHistology of Small Intestine
Wall of SI is made up of four layers
Mucosa
Sub-mucosa
Muscularis
Serosa
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40. MucosaMucosa
Innermost mucosa forms fingerlike projections & they
increase surface area for absorption.
Simple columnar cells
Four types of cells present
Absorptive cells with brush border of microvilli: increases SA for
absorption and secrets enzymes
Goblet cells: Secrets mucus
Enteroendocrine cells: S cells, K cells and CCK cells, secrets
secretin
Paneth cells: Phagocytic in nature & contains lysozyme enzyme
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41. Intestinal JuiceIntestinal Juice
About 1-2 liters of juice secreted every day
Clear yellow fluid, alkaline in nature (pH 7.6 to 8.0)
It consists of
Water
Mucus
Mineral salts
Consist of several digestive enzymes:
Peptidases: breaks proteins to amino acids
Amylase: breaks starch to maltose
Lactase : breaks maltose to glucose
Lipase: Breaks glycerides, fatty acids and glycerol
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42. Mechanical Digestion in SIMechanical Digestion in SI
Two types of movements of small intestine
Segmentation
Peristalsis
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43. Mechanical DigestionMechanical Digestion
Segmentation:
These are rhythmical altering contraction and relaxation of SI.
These movements mixes the chyme with the food & bring
food particles into contact with mucosa for absorption
Digestion & absorption are promoted
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44. Mechanical DigestionMechanical Digestion
Peristalsis:
Entry of food into SI stimulates stretch receptors .
Stretch receptors covey message to CNS,
PNS stimulates contraction of intestine
SNS stimulate relaxation of intestine, decrease the motility of
SI.
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45. Chemical Digestion in SIChemical Digestion in SI
Digestion of carbohydrates:
Pancreatic amylase converts all polysaccharides to
Monosaccharides
Digestion of proteins:
Enzymes like trypsin, chymotrypsin, carboxypeptidase
converts all proteins to amino acids
Digestion of fats:
The enzyme lipase converts fats to fatty acid and glycerol
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46. Large IntestineLarge Intestine
Terminal portion of the GI tract
Functions:
Completion of absorption
Production of certain vitamins
Formation of feces
Expulsion of feces from the body
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47. Large IntestineLarge Intestine
1.5 m long and 2.5 cm in diameter
Extends from ileum to anus
It forms arch around the coiled small intestine
It is divided into,
Caecum
Ascending colon
Transverse colon
Descending colon
Sigmoid colon
Rectum
Anus
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48. Large IntestineLarge Intestine
Caecum:
First part of colon
Elevated portion of LI below the ileocaecal sphincter is
Caecum
Twisted coiled tube is attached called as appendix or
vermiform appendix.
Colon:
The remaining part of LI is called as colon
Divided into four parts
• Ascending colon
• Transverse colon
• Descending colon
• Sigmoid colon
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49. Large IntestineLarge Intestine
Rectum:
Dilated portion of LI
13 cm long
Starts from sigmoid colon and ends in the anus
Stores feces which consists of undigested part of food, water,
inorganic salts and bacteria, etc.
Anus:
Short passage
3.8 cm long
Starts from rectum to the exterior
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50. Function of LIFunction of LI
Absorption:
Absorption of water by osmosis, continues until the semisolid consistency
of faeces is achieved.
Mineral salts, vitamins and some drugs are also absorbed into the blood
capillaries
Microbial activity:
The large intestine is heavily colonised by bacteria which synthesize
vitamin K & folic acid i.e. E. coli, S. faecalis.
Harmless in human
Defecation Reflex:
Mass peristalsis movements push faecal material from sigmoid colon into
the rectum.
Distension of rectal wall stimulates stretch receptors which initiates
defecation reflex that empties the rectum.
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51. 51
Histology – large intestineHistology – large intestine
No villi
• Fewer nutrients absorbed
“Columnar cells” =
absorptive cells
• Take in water and
electrolytes
Goblet cells for mucus
• Lubricates stool
52. 52
LiverLiver
Largest gland in the body
1.4 kg average weight
Over 500 functions
Upper part of abdominal cavity
Right and Left lobes
Right lobe is again divided into;
Caudate lobe
Quadrate lobe
Covered by peritoneum
Falciform ligament
• A fold of peritoneum
53. 53
Liver histologyLiver histology
Made up of many functional units called as liver lobules
(about one million)
• Hexagonal structure consists of special cells called as
hepatocytes (liver cells) around a central vein
• Corners of lobules have “portal triads”
(see next pic)
54. 54
Portal triad
• Portal arteriole
• Portal venule
• Bile duct
Carries bile away
Liver sinusoids
• Large capillaries
between plates of
hepatocytes
Kupffer cells
• Liver macrophages
• Phagocytic in nature,
removes dead cells,
bacteria & foreign
matter in the blood
Liver histologyLiver histology
55. 55
Functions of liverFunctions of liver
Carbohydrate metabolism
Fat metabolism
Protein metabolism
Activation of vitamin-D
Excretion of bilirubin: Excreted in bile
Stores some vitamins (A, B12, D, E & K)
Breakdown of RBCs & phagocytosis
Detoxification of poisons & drugs
Production of heat
56. 56
GallbladderGallbladder
Small pear shaped organ
Attaches to the liver at
back side
7-10 cm long
It has 3 parts
Fundus: Expanded portion
Body: Main part
Neck: connects to cystic
duct
Functions:
Reservoir for bile
Released stored bile
57. BileBile
Secreted by liver
Stored in gall bladder
500-1000 ml of bile are secreted
Bile has pH= 8 (Alkaline)
Composition:
Water, Mineral salts, Mucus, Bile salts, Bile pigments &
cholesterol
Functions:
Bile salts emulsify fats in small intestine
Bile salts make cholesterol & fatty acid soluble.
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58. 58
PancreasPancreas
Yellowish in color
Elongated leaf shaped gland lying
below the stomach
12-15 cm long & 2.5 cm thick
Three parts
Head: Expanded portion lies near the
curve of duodenum
Body: Central portion
Tail: Tapering portion
Pancrea divided into 2 parts;
Exocrine pancrea
Endocrine pancrea
60. 60
Exocrine PancreaExocrine Pancrea
Small clusters of glandular
epithelium
99% are arranged in clusters
called as acini
Sac-like structure
Acinar cells make 22 kinds of
enzymes
• Stored in zymogen granules
• Grape-like arrangement
61. Endocrine pancreaEndocrine pancrea
Remaining 1% cells are arranged in clusters called as
pancreatic islets (Islets of Langerhans).
They secrete hormone insulin, glucagon are responsible for
maintaining blood sugar level.
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63. Pancreatic JuicePancreatic Juice
1.2 to 1.5 L of pancreatic juice
Clear, colorless liquid
Composition:
Water, Salts, Sodium bicarbonate, Several enzymes
Amylase: Carbohydrate digesting enzymes
Trypsin, Chymotrypsin, Elastage: Protein digesting enzymes
Lipase: Triglyceride digesting enzymes
Ribonuclease & deoxyribonuclease: Nucleic acid digesting
enzymes
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64. Function of pancreatic juiceFunction of pancreatic juice
Neutralizes acidic contents of chyme in duodenum due to
presence of sodium bicarbonate.
Pancreatic juice provides alkaline pH for enzyme action.
Pancreatic α-amylase digests Glycogen, starch & other
complex carbohydrate to disaccharides.
Enzyme nucleotides digest nucleoproteins.
Proteins are converted to amino acid by enzyme pancreatic
trypsin & elastase.
Pancreatic lipase converts fats to fatty acid & glycerol.
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65. Disorders of digestive tractDisorders of digestive tract
Dental caries/Tooth decay:
It involves a gradual demineralization (softening) of the enamel and
dentin.
If untreated micro-organism may invade the pulp causing inflammation
and infection with subsequent death of the pulp and abscess of the
alveolar bone surrounding the root apex requiring root canal therapy.
Periodontal disease:
It is a collective term for a variety of conditions characterized by
inflammation and degeneration of the gingivae, alveolar bone,
periodontal ligament and cement.
Periodontal diseases are often caused by poor oral hygiene, by local
irritants such as bacteria, impacted food cigarette smoke.
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66. Disorders of digestive tractDisorders of digestive tract
Peptic ulcer diseases (PUD):
It is a lesion of membrane that develop in areas of gastrointestinal tract
exposed to acidic gastric juice are called as peptic ulcer.
Complications of peptic ulcer is bleeding which can lead to anaemia if
enough blood is lost.
Causes:
The bacteria Helicobacter pylori
Non-steroidal anti-inflammatory drugs
Hypersecretions of HCl
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67. Disorders of digestive tractDisorders of digestive tract
Diverticular diseases:
In Diverticular disease, saclike outpouching of the wall of colon termed as
diverticula.
Development of diverticula called as diverticulosis.
Diverticula showing inflammation called as diverticulitis.
The condition may be characterised by pain either constipation or
increased frequency of defecation, nausea, vomiting and low grade fever.
Colorectal cancer:
Cancer of colon and rectum called as colorectal cancer.
Intake of alcohol and diet high in proteins and fats are associated with
increased risk of colorectal cancer.
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68. Disorders of digestive tractDisorders of digestive tract
Hepatitis:
It is an inflammation of the liver that can be caused by viruses, drugs and
chemicals including alcohol.
Types of hepatitis.
Hepatitis-A
Hepatitis-B
Hepatitis-C
Hepatitis-D
Hepatitis-E
Anorexia Nervosa:
Anorexia is chronic disorder characterized by self induced weight loss,
negative perception of body image and physiological changes that results
from nutritional depletion.
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