DIGESTIVE SYSTEM
ANATOMY TWO PARTS OF DIGESTIVE SYSTEM
DIGESTIVE SYSTEM
 The system involved in the breaking down
of food
 Gastroenterology: deals with the structure,
function, diagnosis and treatment of
diseases of the stomach and intestine
 Proctology: deals with diagnosis and
treatment of disorders of the rectum and
anus
FUNCTIONS OF DIGESTIVE SYSTEM
 Breaking down of food
 Absorption of water, vitamins and minerals
 Elimination of waste products
SIX BASIC PROCESSES
 Ingestion – taking of foods and liquids into
the mouth (eating)
 Secretion – release of water, acid, buffers
and enzymes into the lumen of the GI tract
o Total: 7 L
 Mixing and propulsion – churning and
propulsion of food through GI tract
o Motility: capability of the GI tract to
mix and move material along its
length
 Digestion – mechanical and chemical
processes break down of ingested food
o Mechanical: teeth cut and grind
food
o Chemical: digestive enzymes
produced by accessory glands
 Absorption – passage of digested products
from the GI tract into blood and lymph
 Defecation – the elimination of feces in the
GI tract
o Feces: the eliminated material
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1.) ALIMENTARY CANAL/TRACT
 Alimentary means “nourishment”
 Length: 5-7 m (16.5-23 ft)
 Cadaver: 7-9 m (23-29.5 ft)
 Mouth – for mastication and
insalivation of food
 Pharynx – organ of swallowing
 Esophagus – organ of swallowing
 Stomach – where digestive process
begins
 Small intestine – where digestive
process complete
 Large intestine – organ of egestion and
water absorption
2.) ACCESSORY GLANDS
 Teeth – aid in physical breakdown of
foods
 Tongue – assists in chewing and
swallowing
 Salivary glands – produce saliva
 Liver – produces bile
 Gall bladder – stores bile
 Pancreas – produces pancreatic juices
 General: they secrete digestive enzymes
into the alimentary canal
MOUTH
 Oral or buccal cavity
 Formed by: cheeks, hard and soft palate
and tongue
 Lips/labia: fleshy folds
 Labial frenulum: folds of mucous
membrane; b/n inner surface of lip and gums
 Oral vestibule: space bounded by
o Cheeks and lips (externally)
o Gums and teeth (internally)
 Oral cavity proper: space from gums and
teeth to fauces
 DIGESTIVE SYSTEM

 Fauces: opening b/n oral cavity and  Gingivae: gums

oropharynx (throat)  Three major external regions:
 Palate: wall/septum o Crown – visible portion above the
o Separates oral cavity from nasal gums
cavity o Root – embedded in the socket
 Hard palate: anterior portion of roof of the o Neck – constricted junction of crown
mouth and root
 Soft palate: posterior portion of roof of the  Dentin: forms majority of the tooth
mouth (internally)
 Uvula (little grape): conical muscular o Gives tooth its shape and rigidity
process o Harder than bone
o Function: helps prevent foods and  Rationale: contains 70% of
liquids from entering the nasal cavity calcium salts
during swallowing  Enamel: covered the dentin of the crown
 Two muscular folds: o Hardest substance in the body
o Palatoglossal arch  Rationale: contains 90% of
 Anteriorly calcium salts
 Side of the base of the tongue o Protects the tooth from wear and tear
o Palatopharyngeal arch o Protects tooth from acid
 Posteriorly  Cementum: covered the dentin of the root
 Side of the pharynx  Pulp cavity: space within the crown
 Tongue: forms the floor of oral cavity o Contains pulp
o Lingual frenulum:  Root canals: narrow extension of pulp
 Folds of mucous membrane cavity
 Attached to floor of the  Apical foramen: opening at the base of root
mouth canal
 Aids in limiting the  Endodontics: prevention, diagnosis, and
movement of tongue treatment of disease affecting pulp, root,
posteriorly periodontal ligament and alveolar bone
o Ankyloglossia: abnormally short or  Orthodontics: prevention and correction of
rigid lingual frenulum abnormally aligned teeth
o Papillae: nipple-shaped projections  Periodontics: treatment of abnormal
 Contains taste buds conditions of tissues surrounding the teeth
o Taste buds: the receptor for  Two dentition/sets of teeth:
gustation (taste) o Deciduous teeth
o Lingual glands: secrete mucus and  Decidu = “falling out”
water serous fluid  Primary, milk, or baby teeth
 Enzyme: lingual lipase  20 teeth
 Appear: 6 months old
TEETH/DENTES  Lost: 6-12 y/o
 Accessory digestive organs o Permanent teeth
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 DIGESTIVE SYSTEM

 Secondary teeth FOUR LAYERS OF ESOPHAGUS

 32 teeth  From deep to superficial
 Appear: 6 y/o or adulthood 1.) MUCOSA
 First premolar (bicuspids):  Contains mucous glands
 For crushing and  Layers: epithelium, lamina propia,
grinding muscularis mucosae
 Appear: 9-10 y/o  Epithelium layer:
 Second premolar o Stratified squamous epithelium:
(bicuspid): serves a protective function against
 For crushing and wear-and-tear from food particles
grinding  Lamina propria:
 Appear: 10-12 y/o  Muscularis mucosae: smooth muscle fibers
 Permanent molars: 2.) SUBMUCOSA
 1st molar – 6-7 y/o  Contains areolar connective tissue, blood
 2nd molar – 12-13 y/o vessels and mucous glands
 3rd molar – 17-21 y/o 3.) MUSCULARIS
or not at all  Superior third: skeletal muscle
 Intermediate third: skeletal and smooth
ESOPHAGUS muscles
 Long muscular tube  Two sphincters:
 Carries food and saliva (laryngopharynx to o Upper esophageal sphincter
the stomach) (UES): skeletal muscle (voluntary)
 Physiology:  Regulates movement of food
o Secretes mucus from pharynx into esophagus
o Transports food into stomach o Lower esophageal sphincter
o Does not produce digestive enzymes (LES): smooth muscle (involuntary)
o Does not carry on absorption  Regulates movement of food
 Length: 10 in. from esophagus into stomach
 Diameter: ¾ in. (1.9 cm) 4.) ADVENTITIA (not serosa)
 Level: C6-T11  Superficial layer of esophagus
 Location:  Attaches the esophagus to the surrounding
o Anterior to the vertebral bodies structures
o Posterior to the trachea and heart
 Esophagastric junction: T11 PHARYNX
 Cardiac antrum: expanded portion of the  Funnel-shaped tube
terminal esophagus  Location: internal nares to esophagus
 Three parts:
o Nasopharynx – respiratory function
only

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 DIGESTIVE SYSTEM

o Oropharynx – both respiratory and o Left hypochondriac region

digestive functions  Four main regions:
o Laryngopharynx – both respiratory o Cardia – surrounds esophageal
and digestive functions opening
o Fundus – superior portion of the
DEGLUTITION stomach
 Act of swallowing  Upright: filled with gas
 Three phases: bubbles/magenblase
o Voluntary stage – bolus passed into o Body – large central portion; inferior
oropharynx to fundus
o Pharyngeal stage – involuntary o Pyloric portion – distal portion of the
passage of bolus from pharynx to stomach
esophagus  Pyloric antrum
o Esophageal stage – involuntary  Pyloric canal
passage of bolus from esophagus to  Curvatures:
stomach o Lesser curvature
 Deglutition center:  Right border of the stomach
o Medulla oblongata  Level: esophagastric junction
o Lower pons of brain stem to pylorus
o Greater curvature
STOMACH  Left and inferior border of
 Most distensible part of GI tract the stomach
 Shapes: J-shaped or large sausage (when  Level: cardiac notch to
empty) pylorus
 Functions:  Length: 4-5 times longer
o Mixes saliva, food, and gastric juice than lesser curvature
to form chime  Cardiac orifice: opening b/n esophagus and
o Serves as a reservoir for food before stomach
release into small intestine  Cardiac sphincter: muscle that controls
o Secretes gastric juice, opening of cardiac orifice
 HCl – kills bacteria and  Pyloric orifice: opening b/n stomach and
denatures protein) small intestine
 Pepsin – begins the digestion  Pyloric sphincter: muscle that controls
of proteins opening of pyloric orifice
 Intrinsic factor – aids
absorption of vitamin B12) FOUR LAYERS OF THE STOMACH
 Gastric lipase – aids digestion  From deep to superficial
of triglycerides 1.) MUCOSA
o Secretes gastrin into blood  Inner lining of the GI tract
 Location:  Cell renewal rate: rapid (5-7 days)
o Inferior to diaphragm
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 DIGESTIVE SYSTEM
 Layers: epithelium, lamina propia,
muscularis mucosae
 Epithelium layer:
o Stratified squamous epithelium:
serves a protective function
o Simple columnar epithelium: for
secretion and absorption
o Gastic glands: columns of secretory
cells
o Mucous neck cells: secretes mucus
o Parietal cells: produce intrinsic
factor (needed for absorption of
Vitamin B12) & HCl
o Chief cells: secrete pepsinogen and
gastric lipase
o G-cell (in pyloric antrum):
secretes gastrin
o Gastric juices: 2000-3000 mL/day
(2-3 qt/day)
o Gastric pits: narrow channel at the
bottom of gastric glands
 Lamina propria:
o Connective tissue layer
o Contains many blood and lymphatic
vessels
o Contains MALT (mucosa-associated
lymphatic tissue)
 Protection against disease
 Muscularis mucosae: smooth muscle fibers
2.) SUBMUCOSA
 Contains many blood and lymphatic vessels
 Received absorbed food molecules
 Contains submucosal plexus (plexus of
Meissner)
3.) MUSCULARIS
 Three smooth muscle layers
o Longitudinal layer
o Middle layer
o Inner oblique layer
 Contains myenteric plexus (plexus of
Auerbach)
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 Skeletal muscle (voluntary):
o muscularis of mouth, pharynx,
superior and middle parts of
esophagus – produces voluntary
swallowing
o external anal sphincter – voluntary
control of defecation
 Smooth muscle (involuntary):
o Inner sheets – circular fibers
o Outer sheets – longitudinal fibers
o Functions: break down, mix and
propel foods
4.) SEROSA
 Superficial layer
 Composed of:
o Simple squamous epithelium
(mesothelium)
o Areolar connective tissue
 Other name: visceral peritoneum
 Esophagus: no serosa
o Adventitia – its superficial layer (not
serosa)
PANCREAS
 Pan = “all”; creas = “flesh”
 Retroperitoneal organ
 Length: 12-15 cm (5-6 in.)
 Thickness: 2.5 cm (1 in.)
 Location: posterior to greater curvature of
stomach
 Consists of:
o Head – expanded portion
o Body – central portion
o Tail – tapered end
 Exocrine cells: secretes pancreatic juices
 Pancreatic duct: duct of Wirsung
 Accessory pancreatic duct: duct of
Santorini
 Hepatopancreatic ampulla: ampulla of
Vater
 DIGESTIVE SYSTEM
o Opens on major duodenal papilla
 Sphincter of Oddi: sphincter of
hepatopancreatic ampula
 Acini: clusters of glandular epithelial cells
o Secretes fluid and digestive enzymes
o Pancreatic juice – 99%
 1200-1500 mL/day (1.2-1.5
qt/day)
o Pancreatic islets (islets
Langerhans) – 1%
 Secretes glucagon, insulin,
somatostatin & pancreatic
polypeptide
 Enzymes in pancreatic juice:
o Pancreatic amylase – starch-
digesting enzymes
o Trypsin, chymotrypsin,
carboxypeptidase, elastase
protein-digesting enzymes
o Pancreatic lipase – principal
tryglycerides-digesting enzymes in
adults
o Ribonuclease & deoxyribonuclease –
nucleic acid-digesting enzymes
DUCT CARRYING BILE FROM LIVER AND
GALLBLADDER AND PANCREATIC JUICE
FROM PANCREAS TO THE DUODENUM
LIVER
 Heaviest gland
 Largest internal organ
 Second largest organ
 Skin: largest organ in the body
 Weight: 1.4 kg (3 lb)
 Functions:
o Carbohydrate metabolism
of o Lipid metabolism
o Protein metabolism
o Processing of drugs and hormones
 Detoxification
 Chemically alter or excrete
thyroid hormone & steroid
hormones (estrogen &
aldosterone)
o Excretion of bilibrubin
– o Synthesized bile salts
o Storage site of vitamins
 Glycogen
 ADEK & B12
 Iron and copper (minerals)
o Phagocytosis – Kupffer cells
o Activation of Vitamin D
 Same as skin and kidneys
 Two principal lobes:
o Right lobe (large)
o Left lobe (small)
 Quadrate lobe (inferior)
 Caudate lobe (posterior)
 Falciform ligament:
o A fold of mesentery
o Divides liver into right & left lobes
 Ligamentum teres (round ligament):
o Remnant of umbilical vein of the
fetus
HISTOLOGY OF THE LIVER
 Hepatocytes: major functional cells
o Secretes bile
o 800-1000 mL/day (1 qt/day)
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 DIGESTIVE SYSTEM

 Bile: deoxygenated blood)  Liver

o Yellow, brownish or olive-green sinusoids  Central vein  Hepatic
liquid vein  Inferior vena cava  Right
o pH: 7.6-8.6 atrium
o Composition:
 Water GALLBLADDER
 Bile salts – Na & K salts  Pear-shaped sac
 For emulsification  Posterior to liver
and absorption of  Hangs from anterior-inferior margin of the
lipids liver
 Cholesterol  Length: 7-10 cm (3-4 in.)
 Lecithin (phospholipid)  Parts:
 Bile pigments o Fundus – broad portion; projects
 Several ions inferiorly
o Bilibrubin: principal bile pigment o Body – central portion; projects
 Stercobilin: gives feces their superiorly
normal brown color o Neck – tapered end; projects
 Hepatic laminae: plates of hepatocytes superiorly
 Bile canaliculi: small ducts between
hepatocytes SMALL INTESTINE
 Hepatic sinusoids: highly permeable blood  Functions:
capillaries between rows of hepatocytes o Mechanical and chemical digestion
o Has Stellate reticuloendothelial of food
cells (Kupffer cells): fixed o Completes the digestion of
phagocytes carbohydrates, proteins, and lipids
 Destroy worn-out blood o Begins and completes the digestion
WBC & RBC, bacteria & of nucleic acids.
foreign body o Absorption of nutrients
 Portal triad:  Two movements:
o Bile duct o Segmentation
o Branch of hepatic artery  Localized mixing
o Branch of hepatic vein contractions
 Hepatic lobule: functional unit of the liver  Duodenum: most rapid
 Portal lobule:  12 times/minute
o Emphasize the exocrine function of  Ileum: slow
the liver (bile secretion)  8 times/minute
 Hepatic acinus: the preferred structural and o Peristalsis
functional unit of the liver  Migrating motility complex
 Blood supply: (MMC) – type of peristalsis
o Hepatic artery (oxygenated blood) &  Pushes chyme
Hepatic portal vein (nutrient-rich forward
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 DIGESTIVE SYSTEM

 Reaches the end of  Supports

ileum in 90-120 duodenojejunal
minutes flexure
o Chyme: remains in the SI in 3-5 o Jejunum
hours  It means “empty”
 Length: 10 ft (3 m)  Rationale: found
o Cadaver: 21 ft (10 m) empty at death
 Diameter: 1 in. (2.5 cm)  Upper two fifths of small
 Level: pyloric sphincter to ileocecal valve intestine
 Three portions:  Length: 1 m (3 ft)
o Duodenum o Ileum
 It means “12”  Largest portion
 Rationale: as long as  Lower two fifths
width of 12 fingers  Length: 2 m (6 ft)
 Shortest and widest portion o Gyri: freely movable loops (jejunum
 Fixed in position and ileum)
 Shape: C-shaped o Mesentery: attached jejunum and
 Location: retroperitoneal ileum to the posterior wall of the
 Length: 10 in. (25 cm) abdomen
 Four regions:  Intestinal juice: clear yellow fluid
 Superior/duodenal o 1-2 L/day (1-2 qt/day)
bulb  Total fluid ingested and secreted:
 Descending/duodenal o 9.3 L/day
loop  Ingested – 2.3 L
o Fixed part  GI secretions – 7 L
 Horizontal/inferior  Saliva (1 L)
 Ascending  Gastric juice (2 L)
o Joins the  Bile (1 L)
jejunum  Pancreatic juice (2 L)
(duodenojejun  Intestinal juice (1 L)
al flexure)  0.1 L/day: excreted in feces
 Hepatopancreatic ampulla  1.5 L/day: excreted in urine
 Union of pancreatic  Total fluid absorbed:
and common bile o 8.3 L: absorbed by SI
ducts o 0.9 L: absorbed by LI
 Open on duodenal
papilla
 Ligament of Treitz
 Suspensory muscle of
the duodenum

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 DIGESTIVE SYSTEM
FOUR LAYERS OF SMALL INTESTINE
o From deep to superficial
1.) MUCOSAL
 Epithelial layer
o Absorptive cells – digest & absorb
nutrients
o Goblet cells – secrete mucus
o Paneth cells – secrete lysozyme
o Lysozyme: bactericidal enzyme;
capable of phagocytosis
o Intestinal glands (Crypt of
Lieberkuhn): long, straight tubular
glands
 Contains 3 types
enteroendocrine cells – S
cells, CCK cells & K cells
o S cells – secrete secretin
o CCK cells – secrete cholecystokinin
o K cells – secrete glucose-dependent
insulinotropic peptide (GIP)
 Lamina propria
o Contains MALT
o Lymphatic nodules: present in
distal ileum
o Peyer’s Patches (Aggregated
lymphatic follicles): groups of
lymphatic cells
 Present in ileum
 Muscularis mucosae
2.) SUBMUCOSA
 Contains duodenal glands (Bruner’s
glands)
o Secrete alkaline mucus
o Helps neutralize gastric acid in
chime
3.) MUSCULARIS
 Two layers of smooth muscle
o Inner – circular fibers (thicker)
o Outer – longitudinal fibers (thinner)
4.) SEROSA
 Visceral peritoneum
 Completely surrounds the small intestine
SPECIAL STRUCTURES IN SMALL
INTESTINE
1.) CIRCULAR FOLDS
 Plicae circularis
 Folds of mucosa and submucosa
 Enhance absorption by:
o Increasing the surface area
o Causing the chime to move in spiral
motion
2.) VILLI
 “tufts of hair”
of  Fingerlike projection of the mucosa
 For digestion and absorption
 Length: 0.5-1.0 mm
 Surface area: 20-40/mm2
 Lacteal (milky): a lymphatic capillary
3.) MICROVILLI
 Small fingerlike projection in the absorptive
cells
 Forms the brush border
LARGE INTESTINE
 Terminal portion of the GI tract
 Overall Functions:
o Completion of absorption
 Absorbs water, ions &
vitamins
 More absorption occurs in SI
than LI
o Production of certain vitamins
 Convert protein to amino
acids
 Breakdown amino acid to
produce B vitamin and
vitamin K
o Formation of feces
o Expulsion of feces from the body
 Defecation
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 DIGESTIVE SYSTEM

 Emptying the rectum o Junction of

 Mechanical movements: ascending and
haustral churning, peristalsis, transverse
mass peristalsis  Transverse portion
 Drive the contents of  Longest and most
the colon into the movable
rectum  Left colic/spleenic
 Level: ileocecal valve to anus flexure
 Length: 5 ft (1.5 m) o Junction of
 Diameter: 6.5 cm (2.5 in) transverse and
 Mesocolon: double layer of peritoneum descending
o Attached LI to posterior abdominal  Descending portion
wall  Retroperitoneal
 Ileocecal sphincter/valve: opening b/n  Sigmoid portion
ileum and LI  S-shaped loop
o Allows material from SI to pass LI  Ends at rectum (S3)
 Four major region: cecum, colon, rectum o Rectum
and anal canal  Anterior to sacrum and
o Cecum coccyx
 A small pouch (6 cm long)  Level: sigmoid colon to the
 Inferior to ileocecal valve anal canal
 Length: 2.5 in. (6 cm)  Length: 8 in. (20 cm)
 Diameter: 3 in. (7.6 cm)  Distal portion: 1 in
 Appendix/Vermiform (2.5 cm)
appendix:  Rectal ampulla: dilation
 Attached to cecum above the anal canal
 Vermiform = “worm- o Anal canal
shaped”  Terminal of the rectum
 Mesoappendix: mesentery of  Terminates at the anus
appendix  Length: 2-3 cm (1 in)
 Attaches appendix to  Anus: opening of the anal
inferior part of canal to the exterior
mesentery of ileum  Internal anal sphincter:
o Colon  Smooth muscle
 Colon = “food passage”  Involuntary
 Ascending portion  External anal
 Retroperitoneal sphincter:
 Right colic/hepatic  Skeletal muscle
flexure  Voluntary

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 DIGESTIVE SYSTEM

o Two AP curves of rectum and anal  Muscularis mucosae

canal: must be remembered during
enema tip insertion
 Passes inferiorly and
posteriorly to level of pelvic
floor
 Bends anteriorly and
inferiorly into anal canal
 Bacterial action: last stage of chemical
digestion in LI
 Gastrin: relaxes the sphincter
 Occult blood: refers to blood that is hidden
o Occult blood testing: to screen for
colorectal cancer
 Examined: feces and urine
 Chyme: remain in the LI in 3-10 hours
 Diarrhea: increased in frequency, volume
and fluid content of the feces
o Increased motility and decreased
absorption of intestine
 Constipation: infrequent or difficult
defecation
o Decreased motility of intestine
2.) SUBMUCOSA
 Contains areolar connective tissue
3.) MUSCULARIS
 Two layers of smooth muscle
o Inner – circular fibers
o Outer – longitudinal fibers
 Teniae coli – three
longitudinal bands of muscle
 Haustra/haustrum: series of pouches
caused by tonic contraction of teniae coli
 Haustration: the process of formation of
haustrum
4.) SEROSA
 Visceral peritoneum
 Omental (fatty) appendices: small pouches
filled with fat
o Attached to teniae coli
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FOUR LAYERS OF LARGE INTESTINE

 From deep to superficial
1.) MUCOSAL
 No circular folds
 No villi
 Has microvilli (in absorptive cells)
 Layers: epithelium, lamina propia,
muscularis mucosae
 Epithelial layer:
o Simple columnar epithelium
o Contains absorptive and goblet cells
 located in Intestinal glands
(Crypt of Lieberkuhn)
 Absorptive cells – water
absorption (primary function)
 Goblet cells – secrete mucus
 Lamina propria
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