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UNIT Ⅻ

GSATROINTESTINAL
PHYSIOLOGY
Metabolism Water
Electrolytes
Vitamins
Nutrients
carbohydrate
protein
fat

Food Alimantary tract


Chapter 62 General principles of
gastrointestinal function

Chapter 63 Propulsion and mixing


of food in the alimentary tract

Chapter 64 Secretory functions of


the alimentary tract

Chapter 65 Digestion and


absorption in the alimentary tract
Chapter 62 General principles of
gastrointestinal function

the activity of gastrointestinal


smooth muscle

Control of gastrointestinal
functions by nervous and
hormonal systems
Activity of gastrointestinal
smooth muscle

Resting potentials

Slow waves

Spike potentials

Movements of the gastrointestinal tract


Resting potentials

0
Membrane potential (mv)

-10
stretch
-20
acetylcholine
-30 parasympathetic
depolarization
hormones
-40
norepinephrine
hyperpolarization
-50 sympathetic
-60
Slow waves

stomach 3
0
duodenum 12
Membrane potential(mv)

-10 terminal ileum 8-9


-20

-30 Basic electrical


Slow wave rhythm
-40

-50

-60
Spike potentials

0 Amplitude of slow wave


Membrane potential(mv)

-10
The resting potentials
-20

-30

-40

-50

-60
Contraction of
Spike potentials
smooth muscle
Action potentials
Spike potentials
of nerve fibers

Mechanism of depolarization

1 Ca 2+
Na+ inflow Na+ inflow
Movements in the gastrointestinal tract

Propulsive movement mixing movement

Promote the food Keep the


move along the gastrointestinal
alimentary tract contents mixed
Propulsive movement
Oral cavity

Peristalsis

Distention of the gut

Physical irritation of the gut

Chemical irritation of the gut anus


mixing movement
Oral cavity

Peristalsis

sphincter

Local intermittent
constractions

anus
Summary of activity
0 Resting potentials
Membrane potential(mv)

-10

-20 Slow waves

-30
Spike potentials
-40

-50
Contraction of
-60 smooth muscle
Control of gastrointestinal functions
by nervous and hormonal systems

Nervous regulation

hormonal regulation
Hormonal regulation

cholecystokinin

secretin

Gastric inhibitory peptide


Break down
products of food Increase the
contractility of
the gallbladder
“I” cells
Increase the
secretion of
cholecystokinin pancreatic juice

Inhibit stomach
motility
acidic gastric
juice

Increase the
“S” cells
secretion of
pancreatic juice

secretin
Inhibit the activity
of most gut
Fatty acids
amino acids
carbohydrate

Mucosa of the upper


small intestine

Gastric inhibitory Inhibit the activity


peptide of stomach
Nervous regulation

Enteric nervous
system (ENS)

Extrinsic nervous
system
Enteric nervous
system (ENS)

myenteric plexus
(Auerbach’s plexus)

submucosal plexus
(Meissner’s plexus)
myenteric plexus
(Auerbach’s plexus)

Excitatory Inhibitory
effects effects

Increase the intensity of


contraction
Increase the rate of the Sphincter
rhythm of contraction
Increase the velocity of Pyloric sphincter
conduction of contraction
along the tract
Oral cavity

sphincter

anus
submucosal plexus
(Meissner’s plexus)

secretion
absorption
contraction
Extrinsic nervous system

parasympathetic nervous

sympathetic nervous
parasympathetic nervous

increase

Enteric nervous system


sympathetic nervous

norepinephrine

Smooth
muscle ENS
Decrease
Activity of gastrointestinal tract
Irritation
of the gut
mucosa Afferent ENS
sensory
nerve Sympathetic
Distension
fibers ganglia
of the gut
from the
Spinal cord or
Chemical gut
brain stem
substances
Gastrointestinal reflexes
stimulation

Sympathetic Spinal cord or


ENS
ganglia brain stem

Activity of gastrointestinal tract


Summary of nervous regulation

Irritation
of the gut
mucosa Afferent ENS
sensory
Sympathetic
Distension nerve
ganglia
of the gut fibers
from the Spinal cord or
Chemical gut brain stem
substances
Chapter 63 Propulsion and mixing
of food in the alimentary tract

Oral cavity and esophagus

Stomach

Small intestine

Large intestine
Oral cavity and esophagus

Mastication

Swallowing
Mastication

1. Mastication is important for


Cellulose
the digestions of fruits and raw
membrane
vegetables.

2. Mastication increases the Total surface area


rate of digestion by grinding exposed to the
the food into particles. digestive juices

3. Mastication prevents excoriation of GI and


increase the emptying of food.
Swallowing

The process of food coming into the


stomach from oral cavity .

1.Voluntary stage Oral cavity Pharynx

2.Pharyngeal stage Pharynx Esophagus

3.Esophageal stage Esophagus Stomach


1.Voluntary stage Oral cavity Pharynx

The pressure of the tongue


upward and backward
against the palate.
2.Pharyngeal stage Pharynx Esophagus

Receptors (pharynx)

Trigeminal Glossopharyngeal
nerves nerves
Brain stem

5th ,9th ,10th ,12th


cranial nerves
Series of automatic
pharyngeal muscle
contractions
2.Pharyngeal stage Pharynx Esophagus

1.the trachea is closed


2.the passage between the pharynx
and nasal cavities is closed
3.the esophagus is opened
4.a fast peristaltic wave originates in
the pharynx and forces the bolus of
food into the upper esophagus.
3.Esophageal stage Esophagus Stomach
peristalsis
primary secondary

The continuation Distension of the esophagus


of the peristaltic Vagal afferent
wave that begins Myenteric
in the pharynx nervous medulla
and spread into system Vagal efferent
the esophagus
Glossopharyngeal
nervous

esophagus
Lower esophageal sphincter
(gastroesophageal
sphincter) Oral cavity

Prevents reflux of stomach


contents into the esophagus

sphincter

stomach
Recpetive relaxation of the stomach
Oral cavity

sphincter

stomach
stomach
Stomach

Orad portion

First two thirds


of the body
body
Caudal portion

The remainder antrum


of the body plus
the antrum
Stomach

1.The storage of
large quantities of
food
2. Mixing this food with
gastric secretions to
from chyme

3. Slow emptying of
chyme from the stomach
into the small intestine
Chyme

The mixture of food and


gastric secretions
The storage of large
quantities of food afferent
Vagal nerve
efferent
Food enter the
stomach Vago-vagal reflex

Brain stem

stomach
Mixing and propulsion of food into the stomach

Basic electrical
rhythm

Constrictor waves

Mixed waves
Mixing and propulsion of food into the stomach
Propulsive Pyloric
Constrictor movements pump
waves
mixing
movements

pylorus
Mixing and propulsion of food into the stomach

Constrictor mixing
waves movements

The opening of
pylorus is small pylorus

Pyloric muscle
contracts
Pyloric sphincter

Water and fluids

polyrus
Hunger contractions

Constrictor waves occur when the food is


present in the stomach

Hunger contractions occur when the stomach has


been empty for several hours or more

Hunger contractions cause mild pain in the


stomach which is called hunger pang after much
longer starvation
Regulation of stomach emptying

Pyloric pump

Pyloric sohincter

polyrus
Emptying of the stomach

Nervous factor

Gastric factors
Hormonal
factor
Nervous factor

Duodenal factors
Hormonal
factor
Gastric factors
Stretching of
the stomach

Local myenteric
reflexes

Slightly inhibit Accentuate the


the pylorus activity of the
pyloric pump
Gastric factors
foods (especially digestive
products of meat)

Antral mucosa
releases gastrin

Increase the Accentuate the


movement of the activity of the
gastric body pyloric pump
Nervous factor

Duodenal factors
Hormonal
factor
Duodenal factors Nervous factor

Chyme in the duodenum


stimulate the duodenum in
different ways

Nervous reflex

Slightly increase Decrease the


the contraction of activity of the
pyloric sphincter pyloric pump
The stimulation of chyme in the duodenum

1.The distention of the duodenum


2.The irritation of the duodenal mucosa
3.The acidity of chyme
4.The osmolality of chyme
5.The breakdown products in the chyme
Nervous reflex Enterogastric reflexs

1. through enteric nervous system


2. Stimulation of
duodenum
Extrinsic nervous

Sympathetic ganglia
Sympathetic nervous fibers
stomach
3. Through the vagus nerves to the brain
stem, then inhibit the excitatory signals
transmitted to the stomach through vagi
Hormonal factor
foods

Duodenal mucosa

Release hormones

increase the Decrease the


contraction of activity of the
pyloric sphincter pyloric pump
Hormonal factor

cholecystokinin

Decrease the stomach


secretin motility

Gastric inhibitory peptide


summary

Pyloric pump The force of emptying

Pyloric sphincter Control the emptying

polyrus
summary
Nervous factor
excitatory

Gastric factors Hormonal


factor

Nervous factor
Duodenal factors
inhibitory Hormonal
factor
Small intestine

Mixing contractions

propulsive contractions
Mixing contractions segmentation contractions
Propulsive movements

segmentation contractions

peristalsis

Peristaltic rush
peristalsis

1.Occur in any part of the small intestine

2. Move analward at a slow velocity

3. Are weak and die out after


traveling only 3 to 5 centimeters

4. The net movement of chyme in


the small intestine is very slow
peristalsis

the entry of chyme Distention of the stomach


into the duodenum elicit peristalsis of small
intestine through
myenteric plexus, which
is called gastroenteric
reflex
Peristaltic rush

Powerful and rapid peristalsis

Is produced by intense irritation of the


intestinal mucosa, infectious diarrhea

Travel long distances to sweep the


contents of the intestine into the colon
and thereby relieve the small intestine
irritative chyme and excessive
distention
Ileocecal valve and ileocecal sphincter

Sphincter remains constricted cecum


and slows the emptying of
ideal contents into the cecum ileum

The lips of the ileocecal valve protrude into


the lumen of the cecum to prevent the
backflow of fecal contents from the colon into
the small intestine
Large intestine

1. Absorption of water and electrolytes


from the chyme to form solid feces
Proximal half of the colon

2. Storage of fecal matter until it can


be expelled
distal half of the colon
Mixing movements haustrations

Circular constrictions is longer

Circular constrictions is larger so


the constriction of the lumen
could produce occlusion
propulsive movements Mass movements
Defecation Is initiated by defecation reflexes
Descending
Enteric nervous colon
system reflex Sigmoid contract

Parasympathetic rectum
reflex
Internal anal
relax
sphincter
Cerebral Pudendal external anal
cortex nerve sphincter
Enteric nervous system reflex

When feces enter


the rectum external anal
sphincter

Distend the Internal anal


rectal wall sphincter

Descending
Myenteric colon
plexus Sigmoid
rectum
Parasympathetic reflex

When feces enter


the rectum external anal
sphincter

Nerve endings in the


Internal anal
rectum are stimulated
sphincter

Descending
Pelvic nerves, colon
spinal cord Sigmoid
rectum
Chapter 64 Secretory functions of
the alimentary tract

Subserve two primary functions

1.digestive enzymes are secreted in most areas


from the mouth to the distal end of the ileum

2. Mucous glands, from the mouth to the anus


provide mucus for lubrication and protection
of all parts of the alimentary tract
1. General principles of alimentary
tract secretion
2. Secretion of saliva
3. Gastric secretion
4. Pancreatic secretion
5. Secretion of bile
6. Secretion of the small intestine
and the large intestine
General principles of alimentary tract secretion

Act as a lubricant that protects


mucus the surfaces from excoriation
and digestion

Organic
Digestive enzyme
substances

Water and
Chloride, sodium
electrolyte
General principles of alimentary tract secretion

Basic mechanisms of stimulation of


the alimentary tract glands

Basic mechanism of secretion by


glandular cells
Basic mechanisms of stimulation of
the alimentary tract glands
The presence of food in the
gastrointestinal tract

Tactile stimulation
chemical irritation
distension
Enteric nervous
directly indirectly system
Secretion
of glands
Basic mechanisms of stimulation of
the alimentary tract glands
Parasympathetic nerves
Secretion
of glands
Sympathetic nerves

Increase the Constriction of


secretion the blood vessels

decrease the
secretion
Basic mechanisms of stimulation of
the alimentary tract glands

Sympathetic stimulation can have s dual effect :

1. Sympathetic stimulation alone usually


increase secretion

2. If other factors have caused copious


secretion, superimposed sympathetic
stimulation reduces the secretion because of
vasoconstrictive reduction of the blood supply
Basic mechanisms of stimulation of
the alimentary tract glands

In the stomach and intestine, several different


gastrointestinal hormones help regulate the
secretion of glands.
These hormones are liberated from the
gastrointestinal mucosa in response to the
presence of food in the lumen of food
These hormones are absorbed into the
blood and carried to the glands and
stimulate the secretion
Basic mechanism of secretion by
glandular cells
Water and electrolyte Glandular duct

Ductal cell

Extracellular
fluid
Secretion of saliva
parotid Serous secretion

submandibula Serous secretion


Salivary
glands r
sublingual mucous secretion

buccal mucous secretion

Saliva contains two types of protein secretion:

1.Serous secretion: contains ptyalin, which is


an enzyme for digesting starches
2.mucous secretion: contains mucin, which is
for lubricating and surface protective purpose
Secretion of ions in the saliva
Resting
conditions
Large quantities 7 times as great as
of K+ that in plasam

Large quantities
2 or 3 times
saliva of HCO3-
One seventh or
A few of Na+ one tenth their
A few of Cl- concentrations
inplasam
Secretion of ions in the saliva
Submandibular salivary glands:
acini and salivary ducts

Acini secrete Ptyalin,


ducts primary mucin,
Salivary
secretion is secretion ions
a two-stage
operation: As the primary secretion
flows through the ducts, two
acini major active transport
pocesses take place to
modify the ionic
Secretion of ions in the saliva
1. Na+ are actively reabsorbed
ducts
and K+ are actively secreted in
Cl- exchange for the Na+
2. There is excess of Na+
Na+ reabsorption over K+ secretion,
K+ so creates electrical negativity in
HCO3- the ducts, and in turn cause Cl-
to be reabsorbed passively.

acini 3. HCO3- are secreted into


the lumen actively or by
exchange of Cl-
Secretion of ions in the saliva
1. During maximal salivary, the salivary
ionic concentrations change considerably
ducts 2. The rate of formation of primary
secretion by the acini increase greatly
3. The acinar secretion then flows
through the ducts so rapidly that
the ductal reconditioning of the
acini secretion is considerably reduced.
4. Compared with the saliva
under resting conditions, the [Cl-]
increase and the [K+] decrease.
Nervous regulation of salivary secretion

Parasympethetic
nervous
Taste and tactile stimuli
salivary from the oral cavity, sour
secretion taste, presence of smooth
objects, rough objects

Sympethetic
nervous
Gastric secretion

Oxyntic glands
(gastric glands)
Hydrochloric acid, pepsinogen,
Tubular intrinsic factor, mucus
glands

Pyloric glands
pepsinogen, gastrin, mucus
Gastric secretion
Mucous neck cells:
mucus and
pepsinogen

Oxyntic glands Peptic(chief) cells:


(gastric glands) pepsinogen

Parietal(oxyntic)
cells: Hydrochloric
acid, intrinsic factor
Basic mechanism of hydrochloric acid secretion
Parietal cells secrete an acid solution, pH is
about 0.8, which is about 3 million times
that of the arterial blood

canaliculi
apical canaliculi

Na+

K+
Cl-

Extracellular fluid
basal
K+
HCl Cl-
H2O

OH- H+ H+-K+ATPase
H+
K+ Cl-
Osmotic pressure
H2O

OH- + CO2 HCO3- Cl-


K+
HCl
H2O

H+
OH- + CO2 HCO3- Cl-
Secretion and activation of pepsinogen
Peptic(chief) cells and Mucous neck cells
secrete deferent types of pepsinogen which
have the same functions

pepsinogen Has no digestive


activity
HCl

Has digestive
pepsin activity
Secretion and activation of pepsinogen
Pepsin is an active proteolytic enzyme in a
highly acid medium(optimum pH 1.8to 3.5).

but above a pH of 5 pepsin become


inactiveted in a short time.

HCl functions: 11111111111


1. Activate the pepsinogen 2222
2. Provide the acid circumstances
for the activity of pepsin
Secretion and activation of pepsinogen
Pepsin is an active proteolytic enzyme in a
highly acid medium(optimum pH 1.8to 3.5).

but above a pH of 5, pepsin


become inactiveted in a short time.

HCl functions: 11111111111


1. Activate the pepsinogen 2222
2. Provide the acid circumstances
for the activity of pepsin
Pyloric glands - secretion of mucus and
gastrin

Pyloric glands

pepsinogen

mucus Lubricate food movement

gastrin
Surface mucous cells
Surface mucous cells lie on the surface of
gastric mucosa between the glands.
Surface mucous cells secrete large
quantities of ciscid mucus
Mucus is insoluble and coats the stomach
mucosa with a gel layer, providing a mayor
shell of protection for the stomach wall and
contributing to lubrication of food transport
Mucus is alkaline, therefore the normal
underlying stomach wall is not directly
exposed to the highly acidic
Regulation of gastric secretion

The basic neurotransmitters and hormones that


directly stimulate secretion by the gastric
glands:
Peptic cells
acetylcholine mucus cells
parietal cells
gastrin
parietal cells
histamine
Regulation of gastric secretion
Located in the
pyloric glands
Stimulate
the release gastrin Gastrin cells
of (G cells)
histamine G-34,
G-17

Meats reach the


antral stomach
Regulation of gastric secretion

Located in the body


of stomach and is
adjacent to the
gastric glands
Stimulate
the histamine enterochromaffin
secretion cells
of HCl

gastrin acetylcholine
Regulation of gastric secretion

acetylcholine

Pepsinogen
secretion
HCl

The rate of secretion of pepsinogen is


strongly influenced by the amount of
acid in the stomach
Feedback inhibition of gastric secretion of both
acid and pepsinogen by excess acidity
When the acidity of the gastric juices increases
to de pH below 3.0, the gastric mechanism for
stimulating gastric secretion becomes blocked.

Block the secretion


of gastrin
excess
acidity
Cause an inhibitory nervous reflex
that inhibits gastric secretion
Feedback inhibition plays an important roles in
protecting the stomach against excessive acidity
and excessive pepsin concentration and also in
maintaining optimal pH for function of the
peptic enzymes
Regulation of gastric secretion

gastrin
acetylcholine
histamine

secretion Pepsinogen
of HCl secretion
inhibit
inhibit

excess
acidity
Pancreatic secretion

Pancreatic
acini enzymes
acinus
duct +
H2O, Na+,
ducts HCO3-,
other ions

Pancreatic
secrfetion
Pancreatic digestive enzymes
Pancreatic secretion contains enzymes for digesting
all three major types of food:
protein, carbohydrates, fats
Pancreatic Pancreatic
trypsin
amylase lipase
chymotrypsin
Cholesterol
Carboxypolypeptidase esterase
Elastases, nucleases
phospholipase
inactive enterokinase

trypsinogen trypsin

chymotrypsinogen chymotrypsin

procarboxypolypeptidase

Carboxypolypeptidase
protein
trypsin
chymotrypsin
peptides

Carboxypolypeptidase

Amino acids
starches glycogen

Pancreatic
amylase

Disaccharides
and
trisaccharides
Pancreatic
lipase Fatty acids and
Neutral fat
monoglycerides

Cholesterol Cholesterol
esterase esters

phospholipase phospholipid
Acini also secrete trypsin inhibitor
trypsin inhibitor prevents the activation of
trypsin, therefore inhibit the other proteolytic
enzymes
trypsin inhibitor prevents the digestion of
pancreas by trypsin and other enzymes
When the pancreas is severely damaged, large
quantities of pancreatic secretion become pooled in
the damaged areas of the pancreas.
Under these conditions, the effect of trypsin
inhibitor is sometimes overwhelmed, so pancreatic
secretions become activated and literally digest the
pancreas, which produce a kind of disease called
acute pancreatitis
Secretion of bicarbonate ions

ducts HCO3-

There are large numbers of HCO3- in the


pancreatic juice, which could neutralize the HCl
emptied into the duodenum from the stomach
Luminal border
Osmotic pressure increase

H2O
Na+ HCO3-
H+
H2CO3
Carbonic
anhydrase
H2O+CO2

CO2
Na+ Blood border
blood
Regulation of pancreatic secretion
three basic stimuli are important in causing pancreatic secretion

Nervous endings Stimulate the acinar cells of


the pancreas much more
acetylcholine
than the ductal cells
Intestinal mucosa Cause production of large
quantities of pancreatic
cholystokinin enzymes but relatively small
quantities of fluid and ions
Intestinal mucosa Cause production of large
quantities of fluid and ions but
secretin relatively small quantities of
pancreatic enzymes
Phases of pancreatic secretion

Account for 20% of the total


Cephalic phase secretion of pancreatic enzymes
after a meal

gastric phase 5 to 10%

Secretin
intestinal phase
cholecystokinin
Secretin

Acid chyme

“S” cells
Secrete large quantities
of water and NaHCO3
secretin

Secretin is absorbed
pancreas
into the blood
NaHCO3

Neutralize HCl coming Provides an


from the stomach appropriate pH for
action of the
HCl+ NaHCO3 =NaCl+H2CO3
pancreatic enzymes,
which function
optimally in a slightly
CO2 H2O alkaline or neutral
Protect the stomach
mucosa
cholecystokinin

Break down
products of food

“I” cells
Secrete large quantities
of pancreatic enzymes
cholecystokinin

cholecystokinin is
pancreas
absorbed into the blood
Secretion of bile
Large quantities
of bile salts
Emulsifying function
Detergent action on the fat particles
in the food, so decrease the surface
tension of the particles
Break the fat globules into small size
to increase the area of the fats
exposed to lipase
Promote the
Promote the digestion of fats absorption of
fats
Promote the absorption of fats

Some breakdown products of fats are insoluble


and can not be absorbed by intestine,

Bile salts form minute complexes with these


lipids, which are called micelles

Micelles are soluble, so could ferry these lipids to


the mucosa
Secretion of the small intestine and large intestine

mucus
Small bicarbonate
intestinal
secretions Water and
other ions
Secretion of the small intestine and large intestine

Large mucus
intestinal
secretions bicarbonate
link
Action potentials
Spike potentials
of nerve fibers
Ca 2+
Na+ Na+
inflow inflow
ENS

myenteric plexus submucosal plexus

Inrease the intensity of


contraction
Increase the rate of the secretion
rhythm of contraction absorption
Increase the velocity of contraction
conduction of contraction
Inhibit the Sphincter
Sympathetic
ganglia
Spinal cord or
brain stem

sympathetic
ENS
nervous

parasympathetic ENS
nervous
Smooth
muscle
Movement of
alimentary tract
Secretion of digestive juices
and digestion of the food
Absorption of nutrients
Circulation of blood through the
gastrointestinal organs

Control of these functions by


nervous and hormonal systems
myenteric plexus submucosal plexus
(Auerbach’s plexus) (Meissner’s plexus)

neurotransmitters

acetylcholine Excitatory effects

norepinephine Inhibitory effects