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Digestive SystemDigestive System
Dr. Mrs. Deepa K. Ingawale
(Mandlik)
Dept. of Pharmacology
Poona College of Pharmacy, Pune
1
SyllabusSyllabus
2
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.
3
Digestive systemDigestive system
 Two groups of organs:
 Gastrointestinal (GI) tract
 Accessory digestive organs
4
Organs of digestive systemOrgans of digestive system
5
Digestive systemDigestive system
 GI tract includes;
 Mouth
 Pharynx
 Esophagus
 Stomach
 Small intestine
 Large intestine
6
Digestive systemDigestive system
 Accessory digestive organs includes:
 Teeth
 Tongue
 Salivary glands
 Liver
 Gallbladder
 Pancreas
7
 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
Histology of alimentary tractHistology of alimentary tract
Four layers from esophagus to anus
1. Mucosa
2. Submucosa
3. Muscularis
4. Serosa
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
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
 Oral cavity or buccal
cavity
• Lining: thick stratified
squamous epithelium
 It is formed by the
 Cheeks
 Hard palate
 Soft palates
 Tongue
Mouth
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
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.
14
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.
15
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
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
17
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
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
Salivary glandsSalivary glands
 It releases saliva into oral cavity.
 3 pairs of salivary glands,
 Parotid gland
 Submandibular gland
 Sublingual gland
20
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
21
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
22
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
23
PharynxPharynx
 Nasopharynx: Superior portion of pharynx.
 Important for respiration.
 Oropharynx: Intermediate portion of pharynx.
 Laryngopharynx: Inferior portion of pharynx
24
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)
25
Esophagus
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.
26
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
27
DeglutitionDeglutition
 Buccal stage: The bolus is passed from oral cavity into
the oropharynx
28
DeglutitionDeglutition
29
 Pharyngeal stage: The bolus passes from pharynx into
the esophagus
DeglutitionDeglutition
 Esophageal stage: The bolus passes from the esophagus
into the stomach
30
StomachStomach
 Enlargement of GI tract
 J shaped organ
 Connecting organ between
esophagus & duodenum
 Divided into 4 parts
 Cardia
 Fundus
 Body
 Pylorus
31
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
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.
33
Gastric JuiceGastric Juice
 Clear colorless juice
 Acidic in nature
 2 liters of gastric juice secreted daily by gastric glands in the mucosa
34
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
35
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
 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
Histology of Small IntestineHistology of Small Intestine
 Wall of SI is made up of four layers
 Mucosa
 Sub-mucosa
 Muscularis
 Serosa
38
HistologyHistology
39
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
40
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
41
Mechanical Digestion in SIMechanical Digestion in SI
 Two types of movements of small intestine
 Segmentation
 Peristalsis
42
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
43
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.
44
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
45
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
46
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
47
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
48
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
49
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.
50
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
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
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
 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
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
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
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.
57
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
Histology of pancreaHistology of pancrea
59
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
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.
61
62
Endocrine pancreaEndocrine pancrea
 Islets of Langerhans are the hormone secreting cells
 Insulin (from beta cells)
• Lowers blood glucose (sugar)
 Glucagon (from alpha cells)
• Raises blood glucose (sugar)
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
63
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.
64
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.
65
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
66
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.
67
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.
68

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Digestive system

  • 1. Digestive SystemDigestive System Dr. Mrs. Deepa K. Ingawale (Mandlik) Dept. of Pharmacology Poona College of Pharmacy, Pune 1
  • 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. 3
  • 4. Digestive systemDigestive system  Two groups of organs:  Gastrointestinal (GI) tract  Accessory digestive organs 4
  • 5. Organs of digestive systemOrgans of digestive system 5
  • 6. Digestive systemDigestive system  GI tract includes;  Mouth  Pharynx  Esophagus  Stomach  Small intestine  Large intestine 6
  • 7. Digestive systemDigestive system  Accessory digestive organs includes:  Teeth  Tongue  Salivary glands  Liver  Gallbladder  Pancreas 7
  • 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. 14
  • 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. 15
  • 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 17
  • 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 20
  • 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 21
  • 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 22
  • 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 23
  • 24. PharynxPharynx  Nasopharynx: Superior portion of pharynx.  Important for respiration.  Oropharynx: Intermediate portion of pharynx.  Laryngopharynx: Inferior portion of pharynx 24
  • 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) 25 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. 26
  • 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 27
  • 28. DeglutitionDeglutition  Buccal stage: The bolus is passed from oral cavity into the oropharynx 28
  • 29. DeglutitionDeglutition 29  Pharyngeal stage: The bolus passes from pharynx into the esophagus
  • 30. DeglutitionDeglutition  Esophageal stage: The bolus passes from the esophagus into the stomach 30
  • 31. StomachStomach  Enlargement of GI tract  J shaped organ  Connecting organ between esophagus & duodenum  Divided into 4 parts  Cardia  Fundus  Body  Pylorus 31
  • 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. 33
  • 34. Gastric JuiceGastric Juice  Clear colorless juice  Acidic in nature  2 liters of gastric juice secreted daily by gastric glands in the mucosa 34
  • 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 35
  • 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 38
  • 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 40
  • 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 41
  • 42. Mechanical Digestion in SIMechanical Digestion in SI  Two types of movements of small intestine  Segmentation  Peristalsis 42
  • 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 43
  • 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. 44
  • 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 45
  • 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 46
  • 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 47
  • 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 48
  • 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 49
  • 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. 50
  • 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. 57
  • 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. 61
  • 62. 62 Endocrine pancreaEndocrine pancrea  Islets of Langerhans are the hormone secreting cells  Insulin (from beta cells) • Lowers blood glucose (sugar)  Glucagon (from alpha cells) • Raises blood glucose (sugar)
  • 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 63
  • 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. 64
  • 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. 65
  • 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 66
  • 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. 67
  • 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. 68