Git Part - 1
Git Part - 1
Git Part - 1
Digestive System
• The digestive system allows your body to obtain substances
required to sustain life that your body cannot make on its
own including:
– monosaccharides, amino acids, nucleic acids, fats,
vitamins, electrolytes (ions) and water
• The alimentary canal or gastrointestinal (GI) tract is a long
muscular tube lined with epithelial tissue passing through
the body which is closed off at each end by a sphincter of
skeletal muscle
• Opens to the outside world therefore the lumen and its
contents are part of the external environment
• Its primary function is to move water, nutrients and
electrolytes from the external environment into the body’s
internal environment
Physiological anatomy of GI tract
• Functional Anatomy
– Digestive system comprises of gastrointestinal
tract (GIT) and accessory organs of digestion like
teeth, tongue, salivary glands, liver and exocrine
part of pancreas.
– GIT – Alimentary canal – Muscular tube extending
from mouth to Anus.
• The GI tract (gastrointestinal
tract)
The muscular alimentary canal
– Mouth
– Pharynx
– Esophagus
– Stomach
– Small intestine
– Large intestine
– Anus
1. Mucosa
2. Submucosa
3. Muscularis
externa
4. Serosa
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General histology of digestive tract
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• GIT from posterior pharynx to anus has the
following layers from inside outwards:
1. Mucosa: Innermost coat
1. Surface epithelium – Simple squamous to tall
columanar
2. Lamina Propria – Contains numerous glands, small
blood vessels, lymphatics, nerve fibres. Composed of
loose connective tissue.
3. Muscularis Mucosa – Composed of two thin layers of
smooth muscle fibres. Help in localised movement of
mucosa.
Mucosal Epithelium
• Simple epithelium
– absorptive cells use integral transporting proteins in the
apical and basal membranes to absorb ions, water and
nutrients out of the lumen into the body by facilitated
diffusion, primary and secondary active transport
processes
– secretory cells (endocrine and exocrine)
• exocytose digestive enzymes and mucus into lumen
for digestion and protection against the autodigestion
of the mucosa, respectively
• exocytose hormones and/or paracrine molecules into
the ECF for digestive regulation
– sensory cells act as mechano- and chemoreceptors
which detect the presence of food by the distension of
the GI wall and by the presence of specific chemicals
(proteins, salts, acids, fats…)
2. Sub Mucosa: Layer of connective tissue. Contains
blood vessels, lymphatics, nerve fibres and nerve
plexus (Miessner’s plexus)
3. Muscle Coat: Thick layer of smooth muscle fibres.
Arranged in two layers.
1. Circular muscle fibre – Inner layer
2. Longitudinal muscle fibre – Outer Layer
Auerbach’s Plexus (Myenteric Plexus)
4. Serosa: Outermost layer of connective tissue. Helps
in attachment of gut to the surrounding structures.
Histology of stomach
• Simple columnar
epithelium: secrete
bicarbonate-buffered
mucus
• Gastric pits opening into
gastric glands
– Mucus neck cells
– Parietal cells
• HCL
• Intrinsic factor (for B12
absorption)
– Chief cells
• Pepsinogen (activated to
pepsin with HCL)
• Stimulated by gastrin: a
stomach hormone
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Innervation of GIT
•Parasympathetic
Myenteric plexus Meissner’s Plexus
•Sympathetic
Motor in function Sensory in function
•Increases tone of gut •Concerned with control
of exocrine and endocrine
•Increases intensity of
secretions.
contraction
•Increases velocity of
conduction
Enteric Nervous System
• A specialized division of the nervous system associated only
with the alimentary canal
• Connected to the CNS via the Parasympathetic NS
(stimulates digestion) and Sympathetic NS (inhibits
digestion)
– Composed of two major nerve plexuses (groups) which
send both sensory and motor information throughout
the alimentary canal to control digestion
• Submucosal nerve plexus (submucosa layer)
– associated with mechano- and chemoreceptors in
the mucosa
– controls the endo- and exocrine secretion of the
mucosa
• Myenteric nerve plexus (muscularis layer)
– controls the contraction of smooth muscle
Extrinsic Innervation
• Parasympathetic innervation
– Cranial parasympathetic fibers:
Site of connecter cells- dorsal nucleus of Xth nerve (vagus)
site of ganglion cell- myentreric plexus, meisner’s plexus.
Structures supplied- gastric & intestinal glands, smooth
muscles of GIT upto the junction of proximal 2/3rd and distal
1/3rd of transverse colon.
– Sacral parasympathetic fibres :
Site of connecter cells- segment 2,3 & 4 of sacral nerves
site of ganglion cell- hypogastric ganglion
Structures supplied- rest of the large intestine.
Parasympathetic
Parasympathetic (cholinergic) nerves-
release A-ch- depolarization of smooth
muscle membrane- contraction of GIT
musculature.
I. Increase in motility and tone.
II. Relaxation of sphincters
III. Increased secretion from stomach and
intestine.
• Sympathetic innervation:
– The sympathetic fiber to gut arises from T8 to L2
spinal segment.
– These pre ganglionic fibres pass through the
lateral sympathetic chain , to continue a
splanchnic nerve.
– The pre ganglionic fibers relay in coelic and
mesenteric autonomic ganglia.
– The post ganglionic fibers terminate on enteric
nervous system.
– The sympathetic innervate all portions of GIT .
Sympathetic
• Sympathetic (adrenergic) nerves – release
epinephrine – hyperpolarisation – relaxation
of GIT musculature
– Decrease in motility and tone
– Contraction of sphincters
– Inhibition of secretion from stomach and intestine
Water balance in GIT
• Total input (9000 ml/day)
1. Ingested-2000 ml
2. Endogenous secretion-7000 ml
a. Salivary gland : 1500 ml
b. stomach: 2500 ml
c. Bile : 500 ml
d. Pancreas: 1000 ml
e. Intestine: 1500 ml
• Reabsorbed (8800 ml/day)
1. Jejunum-5500 ml
2. Ileum-2000 ml
3. Colon- 1300 ml
Physiology of Salivary secretion
• Salivary glands: Three pairs of salivary glands
– Parotid Glands: Largest salivary gland (20 to 30 gm each)
located near the angels of jaw.
Its secretion passes via Stensen’s duct.
Opens opposite to the second molar tooth in mouth.
It contains Serous cells.
It forms 25% of total salivary secretion
supplied by 9th cranial nerve
• Sub-Mandibular or Sub-Maxillary (8 to 10 gm
each)
Location – Medial to the mandibal in sub
maxillary triangle.
Its duct is Wharton’s duct, opens into floor of the
mouth along the side of the frenulum linguae.
Mixed cells – Serous + Mucous cells in 4:1 ratio.
It forms 70% of the total salivary secretion
supplied by 7th nerve
• Sub Lingual gland:
It is 2-3 gm each (smallest gland) located
subjacent to the mucosa of the floor of the
mouth.
Its secretion are discharged by 5 -15 small ducts
known as ducts of rivinus into the sub lingual part
of the mouth.
Mixed -serous + Mucous in 1:4 ratio.
Forms 5% of total salivary secretion
supplied by 7th nerve.
Innervation of salivary glands
1. Efferent nerve supply:
– Parasympathetic division
– Sympathetic division
• Parasympathetic nerve supply-
– To parotid glands
• It originates from the cells in inferior salivary nucleus i.e.dorsal
nucleus of glossopharyngeal (IX) nerve.
– To submandibular and sublingual glands
• It originates from the cell of superior salivary nucleus i.e. dorsal
nucleus of facial (VII) nerve.
• Sympathetic nerve supply
– It originates from the lateral horn cells of
T1,2segments of the spinal cord; axon via ventral
roots enter paravertebral sympathetic chain to
synapse with the cells in superior cervical
ganglion to supply the salivary glands.
2. Afferent nerve supply
• Afferent nerve fibres from salivary glands are
found in chorda tympani ( branch of VII nerve)
and IX nerves. These fibres carry pain impulses
from salivary glands.
Composition of Saliva
• Daily secretion: 1500 ml per day
• pH of saliva: 6 – 7
• Digestive enzymes: Ptyalin, Lysozymes, Kallikrein,
Lipase
• Mucin
• IgA
• Cations: Na+, K+, Ca2+
• Anions: Cl-, HCO3-, PO43-, Br-
• Organic content: Urea, uric acid, Creatinine, free
amino acids
Functions of Saliva
1. Ptyalin (salivary alpha amylase): digestion of starch to
maltose, acts at pH 6.5
– Amylase: Digestion continue in stomach for half an hour
– Amylase is ready inactivated at pH <= 4
2. Mucin: Lubricates, protects and aides speech
3. Saliva keeps mouth moist
4. Minimises risk of buccal infection
• Lysozymes (Bactericidal)
• IgA
• Lactoferrin (Bacteriostatic)
5. Buffers in proline rich proteins in saliva helps to bind toxic
tannins and maintains the oral pH at 7.
6. It contains Somatostatin, Glucagon
7. Vehicle for excretion of certain drugs.
summary of functions of saliva
• Protective function
– Dilute hot and irritant food
– Washes away food particles
– Destroys harmful bacteria
– Dilutes any hydrochloric acid and bile
• Role in mastication and deglutition
• Digestive functions
• Role in taste sensation
• Role in speech
• Excretory function
• Role in temperature function
Mechanism of Salivary secretion
• Mechanism of formation of saliva
– Primary secretion of saliva: Isotonic
– Modification of Saliva: Make saliva Hypotonic
Effect of flow rate on composition of Saliva
• Cephalic phase:
– Occurs before the food enters the the stomach.
i.e, psychic stimulation of gastric juice in response
to sight , smell thought or taste of the food.
– It is vagally mediated.
– It accounts for 30-50% of total gastric juice
secretion.
• Gastric phase:
– It occurs when food enters in the stomach.
– Its influence on gastric juice secretion are
primarily local reflex responses and response to
gastrin.
– It accounts for 50-60% of the total gastric juice
secretion.
• Intestinal influence
– It occurs when the food enters in the duodenum.
– Its influence on gastric juice secretion are the
reflex and hormonal feedback effects initiated
from the mucosa of the small intestine.
– Its contribution to gastric juice secretion is much
less as compared to the cephalic and gastric
phase.
Phases of gastric juice secretion
Regulation of gastric motility and emptying