DIGESTIVE SYSTEM

Dr. ANIS A.MAKKY, drg., M.Kes

Physiology
Dental Medicine Faculty Universitas Airlangga
 DEFINITION

a complex series of organs and glands that processes

food
in order to use the food we eat our body has to
break the food down into smaller molecules that it
can process
it also has to excrete waste.

most of the digestive organs tube-like

the digestive system is essentially a long
twisting tube that runs from the mouth to the anus
plus a few other organs (like the liver and pancreas)
that produce or store digestive chemicals.
 Digestive organ

1. Oral cavity 9. Pancreas

2. Pharynx 8. Liver

3. Esophagus 7. Rectum

4. Stomach 6. Colon

5. Duodenum jejunum -
ileum
 The principal of digestive

Layers of intestinal wall (from outer) :

1. serosa
2. longitudinal muscle layer
3. circular muscle layer
4. submucosa
5. mucosa
Muscle :
type : smooth muscle
electrical activity : 1. slow wave (resting)
2. spike (depolarization)
intensity : 5 -15 mvolt
frequency : 3 12 x/minute (stomach duodenum)
RMP : -50 sd -60 mvolt

Negativeness << depolarization fiber

excitable
Negativeness >> hyperpolarization fiber
excitable

Hyperpolarization :
effect of epinephrine or norepinephrine
stimulation sympathetic nerve
Spike potential :
true action potential
MP : -40 mvolt
1 10 spikes/second
stimulation : muscle stretch, Ach, parasympathetic

Slow wave :
Calcium-sodium channel
Ca2+ > Na+
Slower open close

Tonic contraction :
= rythmic contraction
caused by : repetitive spike potential
hormone
Neuronal control : Enteric nervous system

Lies : in the wall of gut : esophagus anus

100 milion cells

Composed of 2 plexus :
1. myenteric or Auerbachs plexus :
GI movement
2. submucosal or Meissners plexus
GI secretion and local blood flow
 Plexus myentericus of Aurbach

Lies between longitudinal circular layer

Stimulation :
1. tonic contraction
2. intensity of rythmical contr.
3. rate of rythm cotrac. slightly
4. velocity of conduction peristaltik movement

Not entirely excitatory : some of neuron inhibitory (VIP)

inhibit some sphincter impede movement food
*pyloric sphinter (control emptying of stomach into
duodenum)
*ileocaecal valve (control emptying of small intestine into
cecum)
 Plexus submucosal or Meissner

Lies inner wall

Stimulation :
1. control intestine secretion
2. local absorption
3. local contr. submucosal muscle
 Blood Flow

Splanchnic circulation

During GIT activity blood flow , caused :

1.Vasodilator released : CCK, VIP, gastrin, secretin
2.GIT gland release 2 kinin : kallidin & bradykinin
3.Concentr. O2 : blood flow 50 -100%
 Digestive system activity

1. Movement : mixing
propulsion

2. Secretion

3. Absorption
 Swallowing, stage

1. Voluntary :
food rooled post into pharynx by pressure of tongue upward &
backward against the palate
2. Pharyngeal : food esophagus
3. Esophageal : food stomach
 Oral Cavity

area where food enters the digestive tract

Mechanical digest : .......
Chemis digest : .....
Gustation : .....
 Saliva

Function :
cleanses the mouth
digestion : ptyalin/-amylase : amylum maltosa
helps moisten and compact food into a round mass called
a bolus
dissolves food chemicals so they can be tasted

Secrete by glands :
1. Major gland : parotid
2. Minor gland : submandibular, sublingual
The salivary glands are composed :
two types of secretory cells
1. Serous cells :
produce a watery secretion containing ions, enzymes,
a small amount of mucin.
Primarily : parotid, submandibular gland.
2. Mucous cells :
produce mucus.
Mainly : sublingual gland.
Saliva composition :
secretion : 800 1500 ml /day
its 97-99.5% water (makes it hypoosmotic)
its osmolarity depends on the glands that are active
pH : 6.75-7.00

enzymes amylase and lingual lipase

proteins mucin, IgA, and lysozyme
metabolic wastes (uric acid, urea)
its solutes include electrolytes
(mainly sodium, potassium, chloride, and
bicarbonate)
 Saliva secretion

Saliva secretion :
acid : secretion 8-10x
parasympathetic secretion
sympathetic secretion slight

salivatorius nuclei sup inf in brain stem

stimulate salivatory gland
 Saliva protection

Saliva protects against microorganisms :

IgA antibodies
lysozyme : a bactericidal enzyme
it inhibits bacterial growth in the mouth and its unclear
whether or not it may help prevent tooth decay
Defensins : function as cytokines and call defensive cells
(lymphocytes) into the mouth
Control of Salivation
when food is ingested chemorecep and mechanorecep
signals to the salivatory nuclei (in the brain stem) to the
pons and medulla parasympathetic activity impulses
sent by motor fibers in N.VII (facialis) and N.IX
(glossopharyngeal)
watery saliva
chemoreceptors activated most by acidic foods and liquids
(vinegar, pickles)
mechanoreceptors are activated by almost any type of
mechanical stimulus in the mouth (chewing).
 Pharynx

part of the throat

behind the mouth and nasal cavity
above the oesophagus and the larynx,
the tubes going down to the stomach and the lungs.
 Esophagus

a channel that is composed of smooth muscle 30 cm

hook up the food from the mouth to the stomach
At the end of the throat (pharynx), there is a thin
membrane epiglottis serves to direct the
course of bolus into the digestive tract by covering the
respiratory tract that is located in front of the digestive
tract
Epiglotis will open back when swallowed bolus
when we talk while swallowing, then it opens epiglotis
(there are vocal cords in the respiratory tract), thereby
potentially entry of food to the food into the
respiratory tract choke
 Stomach

A bag J form
Consist of 3 parts :
1. cardia
2. fundus
3. pylorus
4 layer wall
Mucous layer :
cells secrete enzyme, gastric
acid,
hormone
There are 2 tubular gland :
1. Oxyntic (gastric) gland
2. Pyloric gland

Oxyntic (gastric) gland :

Located : inside surface body n fundus
80% stomach

Pyloric gland :
Located : anthral
20% stomach
 Oxyntic (gastric) gland

1. Mucous neck cell : mainly mucus

pepsinogen

2. Peptic (chief) cell : mainly pepsinogen

3. Parietal (oxyntic) cell : mainly HCl

intrinsic factor
Pepsinogen :
First secrete : has no digest activity
If contact with HCl : form active pepsin
Pepsin : active proteolytic enzyme
highly acid medium (pH : 1.8 3.5)
pH 5 no proteolytic acivity

HCl is necessary for form pepsin protein digest in

stomach
 Intrinsic factor :
For absorption of vit. B12 in the ileum
Secreted by parietal cell along HCl
Chronic gastritis :
HCl production or damage achlorhidria
intrinsic
fact. vit. B12 maturasi eritrosit anemi
perniciosa

2. Peptic (chief) cell : mainly pepsinogen

Others enzymes that secreted stomach :
1. Gastric lipase :
tributyrase (mainly activity to tributyrin = butter fat)
2. Gastric amylase :
minor role on starch digest
3. Gelatinase :
help to liquefy proteoglican on meats
 Pyloric gland

a few peptic cell : few pepsinogen

almost no parietal cell
mostly : mucous cell
large amount : thin mucus
also secrete : hormone gastrin control gastric
secretion

Thin mucus :
Lubricate food movement
Protect stomach from digest by gastric enzyme
Stomach wall is not directly contact highly acid
mucus :
o mainly insoluble
o gel layer
o thick = 1 mm
o alkaline

Hormone that direct stimulate gastric secretion:

1. acetylcholin (Ach)
2. gastrin + receptor secretory
process :
3. histamine pepsinogen (peptic cell)
HCl (parietal cell)
mucus (mucous cell)
Hunger contraction

o Stomach has been empty for several hours or more

o Rythmical peristaltic contr. in the body of stomach
o Succesive contr. extremily strong :
often fuse cause continuing tetanic contr. (2-3 minutes)
o Intense in young
o Healthy people high degrees GIT tonus
o Blood sugar contr.
o Mild pain in the pit of stomach hunger pangs
12-24 hours after last ingestion
o Starvation : greatest intesity 3-4 days
gradually weaken in succeeding days.
Small intestine
Movement :
1. mixing (segmentation contr.)
2. Propulsive (peristaltic)

Segmentation contr. :
chyme distension small intestine contr. concentric
form segement segmentation contr.
Weak : atropin (anti spasm)

Propulsive :
Substance enhance : gastrin, CCK, insulin, serotonin
Substance decrease : secretin, glukagon
Intense iritation at mucous layer powerfull and rapid
peristaltic peristaltic rush
 Colon

Function :
1. Absorption water and electrolite from chyme to form solid
feces
2. Storage fecal matter untill it can be expelled

Movement :
1. Mixing (haustration)
2. propulsive
 Secretion function

4 types glands :
1. Surface epi : mucous cell = goblet cell (response mucous
irritation)
2. Pit (invaginasion epi into submucous)
small intestine : cryp Lieberkuhn
3. Stomach + upper duodenum tubular gland
4. Salivary gland, pancreas, liver

Regulation secretion :
1.Parasympathetic : secretion
2.Sympathetic : secretion slightly
3. Hormone :